HELEN SAWYER PLAZAHELEN SAWYER PLAZA
Helen Sawyer Plaza1150 N.W. 11th Street
Miami, FL 33136
U.S. Department of Housing and Urban Development Miami-Dade Housing Agency (Florida) State of Florida Department of Elderly Affairs
- 104 Units -
Partners:
* The Nation’s First Licensed Assisted
Living Facility Within Public Housing (1999)
Assisted Living FacilitiesModels in Public Housing
2
Service Providers:
Miami Dade Housing Agency (MDHA) retains ownership and operational control of Helen Sawyer Plaza
Provides day-to-day management of the facility and hands-on care for the residents – annual contract cost of $100,000 per year
HELEN SAWYER PLAZA
BACKGROUND
MIAMI, FL
Public sector funding along with private sector expertise provide the structure for
Helen Sawyer Plaza
Assisted Living FacilitiesModels in Public Housing
3BACKGROUND (Continued)
PHAs - turning to Assisted Living Facility (ALF) models as a vehicle to enable seniors to age in place
Avoid premature transfers to more intrusive and costly housing and service options such as nursing home facilities
1976 - Provided elderly public housing - Group meals only
1995 - No longer provided congregate meal service = Hardship
1995 - No meal service combined with poor transportation, no services, and a declining neighborhood = 30% occupancy rate
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
4
Envisioned by MDHA - Meet physical and emotional needs of elderly public housing residents
Evolved from a lack of affordable housing alternatives to meet the demand for senior housing
Need for new funding sources to satisfy the problem of long-term care
MDHA - converted an underutilized independent living facility into a multi-service center for elderly residents
1999 - MDHA opened the “Helen Sawyer Plaza Assisted Living Facility”
BACKGROUND (Continued)
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
5
Conversion to a Public Housing Assisted Living Facility:
Step 1: Contracted with a consultant who is an expert in the Assisted Living Facility field
Step 2: HUD funding to rehabilitate the building according to Housing Quality Standards
Step 3: Obtained an Assisted Living Facility license from the state of Florida
Step 4: Coordinated work efforts with Miami and Dade Counties to revitalize abandoned buildings in HSP neighborhood - expanded transportation
Step 5: Petitioned the State of Florida Department of Elderly Affairs - grant a Medicaid waiver -Helen Sawyer Plaza elderly services eligible for Medicaid funding reimbursement
BACKGROUND (Continued)
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
6DESIGN / STAFFING
104 Units0 BR 83
1 BR 21
Amenities:
Lobby, public restrooms, full kitchen with resident dining room, community room, administrative offices and maintenance staff areas
Additional Building Features:
Electronic security system with 24-Hour security guards
Staffing Needs:
Staffing includes an Administrator, Receptionist, Accountant, Maintenance Staff, Cook and Cook Assistants, Housekeepers, Certified Nursing Assistants, Activity Coordinator and a Social Worker
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
7DESIGN / STAFFING (Continued)
CONSULTANT
ADMINISTRATORACCOUNTING
AR/AP MAINTENANCE ACTIVITIES DIRECTOR
NURSE RESIDENT CAREFOOD SERVICE
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
8PROCESS
Resident Eligibility Requirements: Must be low-income individuals Able to perform activities of daily living with supervision or
assistance Be at risk of placement in a nursing home Medicaid eligible Must be at least 62 years old Do not require 24-hour nursing supervision Do not require licensed, professional mental health treatment
Program Demographics: (104 residents)
Average age is 85 Average length of stay is 35 months 40% of residents are former residents of nursing homes
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
9PROCESS (Continued)
Benefits and Features:
Married couples can continue to live together
Helen Sawyer Plaza provides: Services including bathing, grooming and feeding 30 hours of activities per week - dancing, exercise,
shopping and cultural events 24-hour supervision by trained staff Assistance with Medications Physical Therapy Transportation services Cafeteria Meals (three hot meals - two snacks per day)
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
10PROCESS (Continued)
HELEN SAWYER PLAZA IS 100% SUPPORTED BYOptional State Supplement (OSS) to SSI $945,000 41%
State Sponsored Medicaid Waivers for Services $655,200 29%
HUD Operating Subsidy $424,200 18%
HUD Utility Subsidy $138,168 6%
Private Pay Residents $134,400 6%
Total: $2,296,968
REHABILITATION FUNDING SOURCESHUD Modernization $350,000
Borrowed Start-up $150,000
Total: $500,000
- Miami Dade Housing Agency subsidizes rent for all units- 65 residents receive Medicaid waivers that reimburse up to $28 per day for services
$4,808 per unit
HELEN SAWYER PLAZA MIAMI, FL
$22,000 per unit subsidyvs. Nursing Home subsidy
rate that is 5-6 times higher!
Assisted Living FacilitiesModels in Public Housing
11PROCESS (Continued)
Assessment of Service Fees:
Residents are assessed $685 per month for services. The cost is subsidized through the Optional State Supplement (OSS), which is a State supplement to Social Security Income
Cost Comparison:
Nursing home facility vs. Assisted Living Facility - nursing home facility will cost 68% more
Nursing Home = $38,000 per year
Assisted Living Facility = $12,000 per year
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
12PROCESS (Continued)
Helen Sawyer Plaza has an Extended Congregate Care License - required to access the Medicaid Waiver
Result of petitioning - State legislature enacted a demonstration project Medicaid Waiver for $1.3 million
First time a Medicaid Waiver and case management was allocated to public housing
100% of the units are affordable to 50% of area median income
Residents pay rent set at 30% of adjusted gross income
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
13MANAGEMENT / MARKETING
Management: Participatory management Constant training and communication among staff Residents are treated with respect, care and devotion Monthly training for social service staff
Marketing: Outreach through resident services Sells concept that MDHA is a Medicaid provider and case
management agency Clients come through word of mouth from publicity,
newspaper articles, radio, T.V. and Community Groups 30% of residents come from Community Group referrals The residential waiting list averages 20-30 persons On average, MDHA loses 20 elder residents per month to
death/nursing home/private assisted living facilities
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
14CHALLENGES/FAILURES/LESSONS LEARNED
State and Federal Government requires excessive documentation
Government Catch 22: Obtaining an ALF license –- Cannot be obtained until development is
complete Lender Loans are difficult to obtain without a guarantee of Medicaid
Funding Impossible to underwrite the Medicaid Waiver as a source of revenue
because waivers cannot be committed before the facility is operational
Petition the State of Florida Department of Elder Affairs to grant a Medicaid waiver is a hit and miss process
What Helen Sawyer Plaza may have done differently: Opened the facility 6 months earlier Admitted more residents into the Medicaid Waiver Program Spent more time talking to key staff and residents for support
HELEN SAWYER PLAZA MIAMI, FL
Assisted Living FacilitiesModels in Public Housing
15ACCOMPLISHMENTS/SUCCESSES/HIGHLIGHTS
Resident Successes: Based on Florida International University Center of Aging study:
Health and mental condition of residents have significantly improved Residents have a high level of satisfaction with services Residents have a renewed desire to engage in life
Helen Sawyer Plaza Successes: Achieved 100% lease-up within one year Achieved the lowest attrition rate among residents and staff Has saved the Florida Medicaid budget over $8 million Received recognition from legislatures and policy makers
Awards: HUD Best Practices Award NAHRO Human Services Award National Association of Counties Achievement Award Florida Housing Coalition Success Stories Award
HELEN SAWYER PLAZA MIAMI, FL