Sheyan Irving, a mother of a 1-year-old daughter, pays $990 a month for a two-bedroom apartment on the site of a former dairy processing plant in New Orleans' Central City neighborhood. Facilities such as a 24-hour gym and on-site community clinic are within reach.
“I'm a first-time mother, so if my daughter coughs for too long, I try to take her to the doctor,” said Irving, 30, a disaster case manager at Catholic Charities. “Here, you can literally walk to the clinic. If there's a wait, you can just wait in your apartment.”
The affordable housing complex, which opened in January and features 192 apartments, is part of Alembic Community Development and the affordable housing development company formed after Hurricane Katrina to rebuild the Gulf Coast region. It is a joint project of the Gulf Coast Housing Partnership. The complex aims to become a model for communities across the country by linking stable housing to improved health.
Aetna, a managed care organization active in the region, invested $26.7 million in an $80 million project called H3C. The “H” in H3C stands for health, and the “3Cs” stand for commerce, culture, and community. Tenants and community members will have access to a medical clinic operated by the DePaul Community Health Center on the ground floor. Researchers at the Louisiana Public Health Institute will study patient health outcomes, and consultants at Health Management Associates will use de-identified data to determine more effective ways for health systems to collaborate with developers. It's planned.
H3C shows that health systems increasingly benefit from building affordable and safe housing, from improving the health of local communities to how much managed care groups can financially benefit from healthier populations. Just one of many examples of how you're starting to feel . These factors, as well as other factors such as the country's lack of housing for its workforce, are encouraging healthcare organizations to become partners and investors in affordable housing.
Peggy Bailey, vice president of housing policy at the Center on Budget and Policy Priorities think tank, said such partnerships are “necessary.” “It takes so many investors and so many types of capital to make affordable housing development happen.”
“It's important for hospitals to reinvest in the places they serve,” especially if they are in underserved areas, she says.
Oakland, Calif.-based managed care giant Kaiser Permanente has committed $400 million to funding affordable housing through its Thriving Communities fund, which aims to build or preserve 30,000 units by 2030. And the Healthcare Anchor Network, a national coalition formed in 2017 that includes more than 70 health systems focused on investing in local economies, is investing more capital in homes, neighborhoods and grocery stores. and other commercial projects. From 2017 to the end of September 2022, the network invested $450 million in affordable housing projects, according to the group's latest data.
This type of long-term capital typically comes in the form of low-cost loans, but it has become even more valuable in times of rising interest rates, financial uncertainty, and rising costs for builders. The cost of developing these is a huge undertaking. His H3C, funded through government and private funds, was estimated at $60 million before his budget increased by a third due to supply and inflation.
But health systems don't function as banks, said David Zuckerman, president and founder of Healthcare Anchor Network. He said it is “bridging the gap created by the financial sector not investing properly in affordable housing and the public sector not providing the subsidies needed to make it all work.” said.
Affordable housing helps hospitals and health systems meet nonprofit community benefit requirements and allows nonprofit health care providers to invest capital from cash on hand to cover operating expenses and unforeseen expenses. It has become a means of (Strong reserves are an indicator of financial stability and can help improve a nonprofit health care facility's credit rating.)
There are some early examples of health systems investing in housing, particularly Catholic hospitals working with groups like Mercy Housing, an organization that provides affordable housing.
But over the past decade, hospitals, health systems, and insurance groups have expanded these efforts by collaborating with affordable housing developers. They built transitional housing for the most vulnerable and created programs to temporarily house the homeless, especially those with severe mental health issues.
A recently expanded pilot program through Medicaid, called the 1115 Waiver, allows certain health care providers to use Medicaid funds to provide transitional housing. Washington state used this model to leverage federal funding for rental assistance and $141 million in state funds to build new housing as a way to target populations with the highest need.
A lack of housing available for hospital staff is also driving further development. Kathy Parsons, a consultant and former vice president at CentraCare, a health system in St. Cloud, Minn., said moving health care workers to the area is difficult and the network is looking for ways to work with developers. said that he had done so. . Housing shortages can be acute in rural areas. These can lead to longer commutes, significantly higher overtime costs, staff burnout, and closure of hospital services in areas that need them most.
A growing number of projects are also considering building housing for people with special care needs. In New Jersey, demand for the Hospital Partnership Grant Program is beginning to expand from large cities to the suburbs, with proposed specialized housing projects to support people with multiple sclerosis and Down syndrome. The program, launched in 2018, provides millions of dollars in government grants to help hospitals break ground on investments in housing projects.
Berkeley Place, the first project completed under the state program, opened in Paterson in July. His first floor of the 56-unit apartment complex includes a wellness center, with several units set aside for residents with chronic health conditions. The project was developed through a partnership between the New Jersey Community Development Corporation and St. Joseph's Health and will provide support services to residents.
In Minnesota, the Greater Minnesota Housing Fund, which has supported 20,000 units of affordable housing since 1996, says about 20 percent of its projects provide some additional health care focus. said Eric Maschler, director of health equity. The organization's new initiative is to educate health professionals about the importance of housing solutions in health equity and provide financing to developers to fill gaps in overall project financing plans.
“Building more housing always requires more capital,” Muschler said. “The housing system is broken and we need to think beyond just subsidies.”
Hospitals can also use another important resource: their own land and property. Boston Medical Center and Trinity Health both have plans to build affordable housing complexes on their sites.
John Vu, Kaiser's vice president of community health strategy, said this is the first step in solving the housing problem. The next phase will use the data collected in the development to determine how future partnerships can better address the health and housing needs of the community, he said.
Numerous studies by pediatric researchers and organizations such as Children's Health Watch show how housing assistance can help people who are homeless, people with chronic illnesses or disabilities, or families who need more health care than usual. It shows what you can do.
Kaiser is also working with Enterprise on the Housing for Health initiative, which brings together housing developers and public health organizations to assess how housing determines health across 30 factors. Masu.
The program had been collecting data for four years, said Stephanie De Ciciolo, vice president of Enterprise Community Partners, a state-run nonprofit development company that has worked with Kaiser on some of its housing investments.
