Housing the Elderly Homeless

The Mercy Housing experience at

Mission Creek Senior Community

NAEH ConferenceJuly 13, 2010

Jane Graf President, Mercy Housing Ca

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To create stable, vibrant and healthy communities by developing, financing and operating affordable, program-enriched housing for families, seniors and people with special needs who lack the economic resources to access quality, safe housing opportunities.

Founded in 1981 by the Sisters of Mercy, Omaha

Mission

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Housing Developmentparticipated in the development, preservation and/or financing of more than 37,200 affordable homes serving more than 128,000 people

Property ManagementManages 16,132 apartment homes 236 Mercy Housing properties37 properties managed for other non-profitsStaff in 17 statesOperate in 5 major markets nationwide

Major Activities

Mission Creek

139 one bedroom apartments for frail & formerly homeless elderlyOpened March, 2006

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Funding & Partners11,340,429 San Francisco Redevelopment Deferred loan13,092,518 National Equity Fund – equity on 4% LIHTC 1,000,000 San Francisco Redevelopment – HOPWA 360,000 San Francisco Redevelopment – CDBG 451,069 SFRA-Hazardous Materials Loan 7,500,000 State MHP-Residential and nonresidential 8,017,513 Citibank-bonds 625,500 AHP with BofA 396,472 GP Equity & Early Occupancy income 100,000 Northern California Community Loan Fund Grant$42,883,501 total sources

Cost: $42,883,501 Per square foot: $246 Per unit: $306,610Total Bldg size: 166,295 square feetTotal Commercial: ADHC: 6,198 Square feet; retail: 3,936

square feetLibrary: 7,449 square feet in a condo – not in dev cost

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88 units serve <50% AMI = $39,600/annual income max• $1,353/month/unit = contract rent• Project based Sec 8 rent subsidized; residents pay

30% of income – referred by the SF Housing Authority

51 units serving formerly homeless• < 20% AMI= $15,840/annual income max• $969/month/unit

• DPH subsidy = $592/month; resident = $377/mo

• Residents are formerly homeless referred through DPH

Rents

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Courtyard

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Resident activities

Ti Chi

Group meetings

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Resident activities

Halloween

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Resident activities

4th of July Celebration

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Unit Plan

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Typical Unit

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Philz Coffee Shop

Mission Creek retail

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• The San Francisco Library has a branch on-site which serves the community and is widely used by the residents

• Mercy Housing developed the space for the library which owns it as a condo

Mission Creek Public Library Branch

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• 3FTE service staff as part of property management staff• 2FTE Service staff; 1FTE Activities staff

• Full service Adult Day Health Center on site provided by Stepping Stones – medicaid eligible – 35 – 40 residents attend ADHC from Mission Creek Community

• In Home Support Services as needed – medicaid eligible – 50% of units receive IHSS support

• Case management provided by numerous agencies

• Meals on Wheels meals as needed• 51 DPH units set aside for formerly homeless

Service Staffing

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Services & FundingBasic Services provided Funding Source

Dedicated services staff Rents and HUD subsidies

Adult Day Health Services Medicaid, Dept Public Health, & private pay (sliding scale)

In Home Support Services Medicaid

Case management Medicaid, Dept. Public Health

Meals Medicaid, County, private

Health services/visiting nurseor Dr. hours SF Dept. of Public Health

Wellness promotion Self funded or City contract Substance Abuse support through other nonprofit Money Management organizations

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• Of the 51 DPH homeless residents after 3 years:– 78% still housed – 3 evictions; 3 to

higher level care; 5 deaths– Average reduction of $29,000 per

person/per year in Medical/Medicare reimbursed services

Findings from DPH Study

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• Advocacy efforts pushed the City of SF to start funding housing and services for homeless elders in 2005

• SF policy is that all housing supported by City funds will have a 20% set aside for the homeless

• Support is through City/County General Funds– $400 to $700 per unit/per month rent subsidy– $400/per resident service funding

• City manages wait list for homeless residents and assures services

• City loan committee that manages all City funding of affordable housing includes representation from:– Redevelopment Agency– Mayors Office of Housing– Department of Public Health– Department of Human Services

Reflections: public agency point of view

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• Age criteria lowered to 55 to account for the advanced aging of homeless individuals

• Direct Observation Therapy – aka medication management – is an essential component to success

• Nursing hours are essential – for every 75 to 100 units of housing – not less than ½ day of nurse availability 2 to 3 times per week

• All homeless residents in the program have access to a city owned health clinic (FQHC) that provides psychiatric and primary care

• Rigorous conferencing on the needs of residents with medical personnel & the housing provider is essential to success

Reflections: public agency (cont.)

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• When the formerly homeless residents entered Mission Creek, highly skilled service staff needed to be available 7 days per week 12 hours per day– Constant attention needed to make the transition from the street– Needed help learning to cook/use appliances/basic things– Sounds indoors were foreign and caused alarm and fear

• After 4 years, many formerly homeless residents remain isolated by choice – pro-active outreach is essential

• Formerly homeless residents require a high level of patience from staff – continued meeting to deal with their concerns and willingness to go the extra mile to maintain them in housing

• Site staff must have more than property management skills – they must have a commitment to services & the flexibility required to assure residents maintain their housing

Reflections from a houser

Some lessons learned• Don’t assume people will take the services offered

• Money management to assure payment of rent is vital to maintaining the seniors in their housing

• Property management team experience and education is pivotal to success

• People seem to work harder to maintain their housing based on the beauty of their environment

• Partners with like minded vision is essential

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