National attention is focused on the Housing with Services model that Cedar Sinai Park conceived in 2012 to support seniors in its four downtown affordable housing buildings.
The Housing with Services LLC that grew out of that impulse now assists seniors and people with disabilities living in 11 Portland affordable housing buildings. Nine housing, health and social service providers, of which CSP is the largest equity shareholder, work together to help the residents maintain their health and quality of life to successfully age in place. CareOregon, the state’s largest Medicaid insurer, is the largest resource contributor to HWS both through their equity contribution (second largest after CSP) and dedication of staff resources (2 Health Navigators and Give2 Get staff) to the project.
In June, Housing with Services Project Director Howard Klink participated in a Congressional briefing on affordable housing plus services in Washington, D.C. Klink was part of a delegation of three members and two staffers from LeadingAge, which is an advocacy and policy association of 6,000 not-for-profit organizations dedicated to making America a better place to grow old.
“We are viewed as one of the more unique and innovative models in the country,” says Klink.
The goal of the briefing was to explain to Congressional representatives and staff how affordable senior housing plus services strategies can help address the social, health and long-term services and support policy concerns associated with the rapidly growing low-income older adult population.
When Portland State University completes its evaluation of the project in October, Klink says he expects it will show several benefits.
“We anticipate the evaluation will show we have significantly reduced health care costs (through fewer emergency room visits), improved health outcomes, reduced evictions, and we hope to show reduced frequency of inappropriate nursing home and institutional care,” he explains.
He attributes a reduced eviction rate to a crisis response system and social workers on site who can help residents deal with mental health issues that often result in evictions.
Services include a health and wellness center, primary and urgent care, mental health and addiction services, nutrition assistance, Give2Get resident service exchange, and culturally specific outreach and support.
Those services are having a positive effect according to Dan Valliere, COO of REACH, one of three housing organizations participating in the LLC.
“Our goal and the goal of our residents is stable housing,” says Valliere. “Individual health and well-being is a fundamental determinant of their ability to keep housing stable. We support people to stay healthy and access preventative care, and support exercise, nutrition and behavioral health. … We are breaking down barriers by working with the health care system so it is more connected to and available in a friendly and customer-focused way where people live.”
Funding for the project included contributions from the nine equity partners and a variety of grants including a $440,000 Centers for Medicare and Medicaid Services State Innovative Model Grant. Construction of the health center, located at CSP’s “1200 Building,” was provided by the Harry and Jeanette Weinberg Foundation.
“The hope is the briefing will set a foundation for a formal hearing on housing plus services later this year,” he says. The key question is “How do we get policy changes to allow for more flexible use of Medicaid money?”
One of the primary recommendations Klink made at the briefing was to create “explicit policy support for use of Medicaid funding to support services coordination, rent assistance and health-related interventions such as mold remediation and air conditions.”
Klink has been involved in Portland’s Housing with Services program since its inception. In 2012 CSP acquired three buildings downtown – Lexington Apartments, Park Tower Apartments and the 1200 Building, which now houses the health center servicing residents in all 11 buildings in the LLC. Combined with the 2007 purchase of Rose Schnitzer Tower, CSP became the operator of four affordable housing buildings within blocks of each other.
That was the genesis of Housing with Services, says Klink: “David Fuks (who was then CEO of CSP) asked, ‘How do we help people in our buildings age in place and have a high quality of life. How do we bring services and support to people in our buildings?’ ”
Klink, who has belonged to Havurah Shalom for 30 years, says Fuks hired him to facilitate the planning process to create a service delivery model for people in CSP-owned buildings.
As soon as the model was created, it drew attention. Home Forward (formerly the Portland Housing Authority) wanted to participate with four buildings it operated nearby. REACH wanted in with its three buildings in the same neighborhood. The group started submitting grant requests and created an LLC, for which Klink serves as project director. Social service agencies, including Jewish Family and Child Service, joined the project.
This month Outside In, known for its programs for homeless youth and adults, will begin operating the health and wellness clinic, for which it is a federally qualified provider. The clinic includes geriatric specialists, primary care physicians, acupuncture and massage.
Food from Urban Gleaners and the Oregon Food Bank is delivered to the 1200 Building twice a week and then distributed to food pantries in each of the buildings.
An active Resident Advisory Council helps with design, prioritization and evaluation of projects.
“Projects like this need to be brought to scale in publically subsidized housing to generate health care savings of interest to coordinated care organizations and insurance companies,” says Klink.
He hopes his presentation in D.C. helps that happen.