Investments in Housing for
Vulnerable SeniorsCourtney Christenson
October 18, 2019
Improving Lives
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What We DoCSH is a touchstone for new ideas and best practices, a collaborative and pragmatic community partner, and an influential advocate for supportive housing.
Lines ofBusiness
Training &
Education
Policy Reform
Consulting &
Assistance
Lending
Research-backed tools, trainings and knowledge sharing
Powerful capital funds, specialty loan products and development expertise
Custom community planning and cutting-edge innovations
Systems reform, policy collaboration and advocacy
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Homelessness, Health & Aging
*Information presented by Dr. Rebecca Brown from University of California, SF, Division of Geriatrics, Dept. of Medicine© All rights reserved. No utilization or reproduction of this material is allowed without the written permission of CSH
Poor physical and behavioral health causes homelessness
Homeless adults 50+ have higher rates of chronic illnesses similar to housed individuals 65+
Homeless adults 50+ are 4X more likely to have 1+ chronic illnesses compared to younger homeless adults
Homeless adults 50+ have geriatric conditions of those 70+ in general population
Those w/ geriatric conditions more likely to frequent ER (4+ times/year) and more likely to be institutionalized
Housing Impacts Health
Communicable Diseases Malnutrition Harmful Weather
No Medication Storage Violence
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Highest Need
Adult Homes/ Assisted Living
Licensed residential programs
Supportive Housing
NORCs
Affordable Senior Housing
Highest Rent Subsidy &
Support Service Need
Lowest Rent Subsidy &
Support Service Need
Housing & Support Service Needs for a Growing Aging Population
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CSH’s Focus On Aging Adults • Our focus: Older Adults with Housing & Service
Needs Wishing to Age-in-Community
• Includes Adults 50+ • experiencing homelessness, • inappropriately institutionalized, or • currently aging in place in SH who desire to age
healthily and safely in their own homes for as long as they can
• SH seen as an ideal solution to address needs of aging tenants with adaptable housing models and flexible service packages
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Making the Case for Healthcare Investment in Housing
1. Patient Health• Homelessness Poor Health Outcomes + High Costs
2. Community Leadership• Anchor institutions with community responsibility• Positioned to catalyze collaboration
3. Realignment of the Traditional Hospital and Managed Care Business Models• Affordable Care Act New requirements and incentives
• Hospital Community Benefit• Value-Based Purchasing Models (VBP)
4. Cost Savings and Cost Avoidance• Study after study shows: Supportive Housing lowers or
prevents costs for frequent utilizers
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Not A One-Size-Fits-All Approach
Health Systems are exploring the myriad of ways they can address social determinants like housing:1. Hospital Community Benefit2. Donating Underutilized Hospital Land3. Financial Investment/ Donation4. Leveraging LIHTC/ Federal, State & Local
Resources5. Respite
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Quality Supportive ServicesA variety of housing models exist with common factors including:
Located in within safe neighborhoods with close proximity to:• Transportation• Employment opportunities • Services• shopping, recreation and socialization.
Tenants have a lease identical to those of tenants who are not in supportive housing.
Services are voluntary and consumer-driven. They focus on ensuring that tenants can obtain and thrive in stable housing, regardless of barriers they may face.
The housing and its tenants are good neighbors, contributing to meeting community needs and goals whenever possible.
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Core Supportive Housing Services
Housing: AffordablePermanentIndependent
Support:Flexible
VoluntaryTenant-centered
Coordinated Services
Supportive housing combines affordable housing with services that help people who face the most complex challenges to live with stability, autonomy and dignity.
Peer Support helps tenants access other services and foster a sense of community!© All rights reserved. No utilization or reproduction of this material is allowed without the written permission of CSH.
© All rights reserved. No utilization or reproduction of this material is allowed without the written permission of CSH.
Boston Medical Center
• Invested $6.5M in Affordable Housing to Improve Community Health and Patient Outcomes, Reduce Medical Costs
• 25% of BMC patients admitted to the hospital are homeless
• $1M for a no-interest loan and operating subsidy to support a new, Good Food Markets in a new housing development in Roxbury
• $1M for a stabilization fund that will provide grants to CBOs to help Boston families avoid eviction
• $1M million to the Pine Street Inn, the Boston Health Care for the Homeless Program
• BMC’s $6.5M investment also represents the 1st time that a MA hospital has put ALL its required community health investment into one social determinant of health -housing
“The ROI for projects like these is two-fold. There is a direct health benefit, but that in turn creates significant savings in health care spending. Most importantly, we are building healthy communities.”-Megan Sandel, MD, BMC pediatrician
NYS Senior Supportive Housing Pilot
• State “Medicaid Redesign Team” launched in 2011 to transform how health care is delivered and paid for under Medicaid
• Included half-billion dollar investment in supportive housing to address the social drivers of preventable utilization and disparate health outcomes
• $500,000 to 8 SH agencies for capital improvements and supportive services
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Chicago’s FLEXIBLE HOUSING POOL SOLUTION
• Modeled on LA County Program • 67.5% ER visits• 76.5% inpatient days• 59.5% use of mental health
crisis stabilization services
• Rapid connections to supportive housing, increase access to needed services
• New model to deliver flexible resources, applying best practices in coordination between housing and health care
• 3,000 individualssuccessfully housed in supportive housing
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Informed by pilot initiatives from UI Health, Swedish Covenant Hospital, and Cook County Health
Phase 1: House 50-80 people while gathering data and testing processes
Fundraising: $12 M to serve 750 patients in two to five years
FHP Coordination Agency:Center for Housing and Health
Participating Health
Care Entities
(CCH, AAH)
HOW IT WORKS
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NJ Housing and Mortgage Finance Agency Investment in SH
• NJ HMFA committed in summer 2018 to provide $12 million in capital financing and guidance on SH development to hospitals through the Hospital Partnership Subsidy Pilot Program
• CSH serves as technical assistance provider on SH development, operations, and partnerships
• NJHMFA will match hospitals’ funding contributions for mixed-use developments that must include units set aside for special needs residents and/or frequent users of hospital emergency room services
“A stable living environment is critical to maintaining good health...Hospitals serve as anchors in a community, and this innovative partnership not only addresses the need for housing that is affordable but also helps some of our residents who are most in need maintain better health through permanent housing.”
- NJHMFA Executive Director Charles A. Richman
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SAVE THE DATE
CSH SUMMIT 2020
PHILADELPHIA, PA
MAY 27-29, 2020
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