helen sawyer plaza helen sawyer plaza 1150 n.w. 11 th street miami, fl 33136 u.s. department of...

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


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


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)



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)



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



7DESIGN / STAFFING (Continued)

CONSULTANT

ADMINISTRATORACCOUNTING

AR/AP MAINTENANCE ACTIVITIES DIRECTOR

NURSE RESIDENT CAREFOOD SERVICE



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



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 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


$22,000 per unit subsidyvs. Nursing Home subsidy

rate that is 5-6 times higher!



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 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



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



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



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 helen sawyer plaza 1150 n.w. 11 th street miami, fl 33136 u.s. department of...

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