holgate house holgate house 4601 se 39 th street portland, oregon 97202 partners: u.s. department of...

HOLGATE HOUSEHOLGATE HOUSEHolgate House

4601 SE 39th StreetPortland, Oregon 97202

Partners: U.S. Department of Housing and Urban Development Housing Authority of Portland (HAP) Portland Area Agency on Aging Oregon Department of Human Services

- One of four high-rise buildings where Congregate Housing Program operates- 120 Total CHSP Slots

Assisted Living FacilitiesModels in Public Housing

2BACKGROUND

HOLGATE HOUSE PORTLAND, OR

1981 HAP initiated the Congregate Housing Services Program (CHSP)

Thirty slots in one building

Provided support services to the frailest elderly and disabled individuals

HUD funded the program except resident’s paid a sliding scale portion of the fee

CHSP funds managed by HUD Office of Housing

1993 HAP requested from HUD received ninety additional slots

A total of one-hundred twenty slots in four buildings; 3PH, one mixed population

1993 HUD initiated a 60% matching requirement


3DESIGN / STAFFING


HAP manages the buildings and the CHSP

Management, service coordinators and kitchen staff are HAP employees

Personal care, housekeeping, transportation, nursing, podiatry and senior companion services are contracted out


4PROCESS


1993 HAP obtained 50% of required 60% matching funds via the Oregon State Home and Community Based Care (HCBC) Medicaid Waiver program.

10% of matching funds from participant fees

HCFA provided the funds and the Oregon State Department of Aging administered the fund

CHSP participants continued to pay their rent

HCBC provides HAP with a monthly capitated rate per CHSP program participant regardless of the level of service required by each individual

CHSP participants must meet Medicaid income level requirements (income of $500.00 dollars per month, assets under $2,000)


5PROCESS (Continued)


FUNDING SOURCES (averages)MONTH ANNUAL

Medicaid Community Based Care Waiver Program

$302 $3,624 Contributes toward cost of 1 meal per day, housekeeping, personal care, transportation, basic nursing, case management, senior companion services

HUD Congregate Housing Services Program funds, administered by the Housing Department

$242 $2,904

Participant $60 $720

Total: $604 $7,248

ALF $2,938 $35,256

Nursing Home $3,500 $42,000


6MANAGEMENT / MARKETING


CHSP not regulated in Oregon

HAP Administrator and Service Coordinators provide onsite program monitoring

No formal marketing necessary

Referrals from Area Agency on Aging and “word of mouth” within the housing authority and outside communities


7CHALLENGES/FAILURES/LESSONS LEARNED


February 2003 state budget cuts have drastically affected the level of Medicaid funding

Now more difficulty meeting level of care standard.

Further state budget cuts anticipated 4/03. Likely result will be less funding per individual recipient

There are no alternative sources of matching funding once Medicaid funds are decreased

Recognizing time to pursue a higher level of care placement.

Ability to secure alternative placement in an expeditious manner

HAP would consider developing an Assisted Living program and thereby access ALF Medicaid funds

Obstacle--there are no HUD or other funds to retrofit the buildings


8ACCOMPLISHMENTS/SUCCESSES/HIGHLIGHTS


Enables low income individuals to reside independently much longer than would otherwise be the case

Enables some program participants to completely avoid institutionalization

The program has improved the quality of the lives of participants

The program has assisted to preserve participants’ health, actually increasing life spans

To date the program has met the budgetary challenges and managed to provide an adequate level of care to the program participants

Provides the services at an incredibly reasonable price

The program has been able to meet the needs of an increasingly frail population


9SUMMATION


Currently, only HA’s that received CHSP funding as of 1995 are eligible to apply for this program

HUD should consider allowing additional HA’s to apply

HUD should consider a more reasonable CHSP funding match (currently 60%), so that current HA’s can remain in the program

HUD should consider increasing CHSP funding because alternatives are more costly

CHSP, combined with community resources, can adequately maintain many frail elderly residents until nursing home placement is necessary or until natural death occurs


10SUMMATION (Continued)


A continuum of care, i.e. CHSP and if needed, ALF, is an economical alternative to nursing home care

Many elderly individuals experience physical and/or mental deterioration due to inability to take meds as prescribed causing otherwise unnecessary NH placement

CHSP regulations should contain a mandatory provision for medication management

HUD should consider ways that HA’s could access funds to modify buildings/apartments to comply with state ALF requirements

Retrofitting costs cannot be absorbed within most HA’s current budgets

holgate house holgate house 4601 se 39 th street portland, oregon 97202 partners: u.s. department of...

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