Service Enriched Housing
Service-enriched housing integrates a social support system for residents into the operation and management of housing. Affordable housing providers such as the SAHF members can either provide services directly to residents or link residents with services that enable them to improve their lives. On-site services provide support and opportunities, reduce resident isolation, build neighbor relations, and promote resident pride in their communities. The essential component is the service coordinator who, in addition to resource and referral services, helps to plan and implement services, programs, and activities.
SAHF members offer a wide range of services to enable their residents--whether families, seniors, the disabled, or the formerly homeless—to improve their social and economic wellbeing.
The Challenge
Affordable housing providers who provide services to residents face a significant challenge to cobble together adequate resources to do so. The challenge of funding services is great in affordable properties financed with subsidized mortgages or Low Income Housing Tax Credits (LIHTC) or funded with Section 202/811 grants and properties assisted with project-based Section 8. The multiple obligations that owners bear—to own and operate their real estate, enduring periods of increased operating costs and other challenges, can take time and attention from service delivery and eat into any property—based resources that may be available to support service provision.
Most funding available to support service delivery is in the form of grants. To launch and sustain a program of services, housing providers must compete successfully for grant funding, often year after year. Competing for funds is time-consuming and costly, and any lapse in funding undermines the desired outcomes from service delivery, ranging from assisting families to improve their financial wellbeing and prospects for their children to enabling low-income seniors and disabled individuals to live independently.
The Opportunity
HUD and HHS have taken to heart the benefits of investing in service enriched housing by introducing key measures that would bring to scale a variety of service models. The tabs below outline both the policy initiatives in place to provide financial resources and the human capital needed to bring to scale the service enrich housing model and also provide of what SAHF members have done to finance and implement projects with an array of services.
Housing and Families
Years of developing and perfecting practice coupled with tracking outcomes inform our discussion. Drawing on this treasure of practice and evidence, SAHF members are in a position to bring resident services for families to scale through having developed data tools to standardize tracking the success of residents in using services such as employment, financial management, children’s school success and property management. Indeed after years of research, the evidence demonstrates what affordable housing practitioners have long known: that the provision of resident services at affordable housing developments results in dramatic benefits for both residents and affordable housing developers.
Residents who have access to services see growth in household income, improvement in family financial management, and a general increase in quality of life. Affordable housing developers who provide certain services are able to significantly lower operating costs through savings associated with lower vacancy rates, reduction in vandalism to the property and a decrease in legal fees.
Choice Neighborhoods
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The Administration's Choice Neighborhoods (more information) would provide new tools for the revitalization of affordable rental housing as part of an overall neighborhood revitalization strategy. This new effort is an important and logical extension of successful elements of the HOPE VI Public Housing revitalization program. Like distressed public housing, privately- owned assisted housing is sometimes located in opportunity-starved neighborhoods with weak schools, poor transportation access, and substandard services.
A comprehensive neighborhood approach that aims to rehabilitate and deconcentrate assisted housing— whether public, private, or both—combined with making housing a platform for transformative services for both residents and nonresidents alike, provides the focus, attention, and support that poor neighborhoods have long needed.
A few examples illustrate SAHF member projects being developed within the framework of the larger community. While these examples of developments are not formal Choice Neighborhood grant recipients, they model the initiative’s overall aim of working in partnership with the local community to create housing that links to transportation hubs, job centers, and education opportunities.
Preservation of Affordable Housing (POAH) Grove Parc Project
Mercy Housing, Inc. Sunnydale Project
Charlotte-Mecklenburg Housing Partnership, Inc. (CMHP) Double Oaks Project
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Senior Housing
SAHF, in partnership with LeadingAge (formerly AAHSA), is working to design a practical policy solution to providing affordable housing for low-income elderly with a supportive services network that allows residents to age in place and in many cases to provide a consumer preferred and much less expensive alternative to institutional care. SAHF and AAHSA published a white paper that outlines our policy goals and objectives. AAHSA has subsequently published a report on the May 2010 National Summit on Affordable Senior Housing and Services.
The U.S. is experiencing unprecedented changes in its elderly population. The senior population is expected to double by 2030, when one in five citizens will be over the age of 65. By 2050, one in four seniors will be 85 or older. Research shows a strong correlation between old age and chronic conditions, disability, and the use of long-term care services. This convergence of trends places an enormous strain on the United States’ long-term care system while exponentially increasing costs to Medicaid and Medicare.
Affordable senior housing properties, such as Section 202, Low-Income Housing Tax Credit (LIHTC) or public housing communities, provide a cost-effective answer by providing affordable housing with supportive services. For seniors, housing and health care are no longer tangentially related, but intricately enmeshed: over two million lower-income seniors across the country live in affordable housing with supportive services. This number is certain to increase in the upcoming years because many residents have aged in place. Residents in Section 202 properties have an average age of 76, and more than 1/3 are over 80 and experiencing declining health and increasing frailty and disability levels.
Many residents are eligible for nursing home level of care, and thus, the typical resident services associated with senior housing do not suffice. Proactive housing providers such as the SAHF members have cobbled together various public and private resources to provide needed supports for elderly residents—reducing costs to Medicare and Medicaid budget by reducing emergency room visits and 911 calls and by preventing premature hospitalization and/or institutionalization. These successes could be expanded to benefit more residents and reduce the nation's health care costs. Developing a sustainable, cost- effective solution that addresses these issues requires transcending many of the barriers that have long separated executive departments to create models that harness multiple departmental programs.
Guiding Principles:
SAHF supports a new framework to advance the scalable development of affordable housing plus services models across the country, with two essential components: (1) an affordable housing platform linked with (2) reliable, coordinated revenue streams to provide health and supportive services for those who choose to receive them in a housing setting.
- Support residents so that they safely age in place as their health and functional needs change, thus preventing unnecessary or premature transfers to higher levels of care at higher costs to Medicare and Medicaid.
- Enable the tools and approaches for housing finance, including both operating and capital support, to work effectively with the tools provided for supportive services.
- Dedicate services funding to the housing property and/or housing residents,
- Allow for the provision of health related and other supportive services on site, increasing resident access.
- Permit delivery by the housing property and/or through partnerships with service providers.
- Capitalize on the economies of scale created by congregate settings to provide for the efficient and cost-effective delivery of services.
Housing Platform with Supportive Services Policy Recommendations:
- Reform and expand the Section 202 senior housing program to optimize the scale of the properties, to enable sponsors more easily to serve frail seniors, and to facilitate its use with additional capital sources, including the LIHTC program.
- Establish a dedicated and predictable funding stream for the delivery of services in affordable congregate senior housing settings by reforming federal and state medical and other service delivery programs for seniors.
Permanent supportive Housing
Permanent supportive housing is a combination of affordable housing with on-site, case-management type services for those faced with some of the most complex challenges to remaining housed. Individuals who struggle with substance abuse, addiction or alcoholism, mental illness, HIV/AIDS or other serious challenges, who have very low incomes and are confronted with homelessness, will find on-site social services aimed at job training, alcohol and drug abuse programs, education and health services. Permanent supportive housing is a very successful way of preventing homelessness. Furthermore, it helps people recover while reducing the overall cost of care to local service providers.
The Interagency Council on Homelessness (USICH), is exploring ways to bring to scale successful models of homelessness prevention. The USICH developed a national strategic plan to prevent and end homelessness in accordance with the Homeless Emergency and Rapid Transition to Housing Act of 2009 (HEARTH Act). SAHF submitted comments in April 2010 prior to the completion of the plan. SAHF has advocated for an increase in project-based vouchers that enable affordable housing developers to leverage the vouchers in order to develop supportive housing properties.
Moreover, while SAHF members develop and serve a wide range of homeless families and individuals in their supportive housing developments, new attention has been placed on creating and providing supportive housing for homeless veterans. While many homeless veterans face the same problems of alcohol addiction and substance abuse, their cases are often compounded by the emotional trauma experienced from combat. SAHF members National Church Residences, Mercy Housing, and Volunteers of America have worked with SAHF to design a policy initiative that would link the VA and HUD through its VASH voucher program. Key here is to project-base a portion of the VASH vouchers at a scale that will allow SAHF members and others like them to leverage that subsidy to develop supportive housing for homeless veterans.
SAHF members have developed wonderful properties to serve homeless veterans by cobbling together multiply layers of financing, but key to each property is the ability to obtain project-based vouchers to aid in the financing. Read about NCR’s Commons at Livingston and the VOA’s Hope Manor Apartments.