In many parts of the United States, developers cannot win the funding they need to build new affordable seniors housing unless they commit to providing some social services.
“Just about every state in the country has an effective requirement that you provide some kind of services,” says Milton Pratt, executive vice president of Michaels Development, headquartered in Camden, New Jersey. Projects that provide services often earn extra points in the state-run competitions for federal low-income housing tax credits (LIHTCs). “You generally can’t live without those points.”
With little available funding to pay for these services, many new properties include a social services coordinator on the payroll. “Service coordination is the most common service that we provide and that we believe others provide,” says Michelle Norris, executive vice president of external affairs and growth strategies, National Church Residences.
“[The coronavirus] crisis has highlighted the need to fund service coordination,” says Lori Little, CEO and president of the National Affordable Housing Trust. Many service coordinators are making daily calls to check up on seniors, arranging the delivery of needed food and cleaning items, and even setting up [video calls] between seniors and their family members, says Little.
Service coordinators have been critical to the housing community’s ability to identify and augment needed services and understand replacement services and options for residents as their needs rapidly change.
— Linda Couch, vice president of housing policy for LeadingAge
“Neither the service coordinator or other staff actually provide any service,” says Couch. “Rather they connect residents to existing services and programs that help older adults age in community.”
For example, many seniors housing properties owned by Michaels Development has at least one service coordinator who spends time at the property. Belmont Heights Estates in Tampa, Florida, which includes 825 affordable rental apartments for families and seniors, has several service coordinators. A collection of smaller affordable properties located near each other, with just a few dozen residents each, might share a service coordinator who spends a day or two a week at each community. Michaels partners with Better Tomorrows, an independently owned nonprofit organization based in Camden to provide these coordinators.
Each community has different needs. “None of this is standard,” says Pratt. “Our team does a comprehensive needs assessment—it all starts with that.”
A community where the average resident is 62 to 70 years old might need services tailored to a younger population, like exercise or nutrition education. A community where the average resident is 79 or 80 might be better served by services that help residents stay connected to family and lighter exercise, like chair yoga.
Some services may cost the property little or nothing to provide. Residents may be eager to donate their time. Local organizations may have their own sources of volunteers or funding that they are mandated to spend in the local area. “The best food always starts out with the best ingredients, and the best ingredients for social services are always local,” says Pratt.
Many seniors need health services, which can help them continue to live in their current communities as opposed to moving to a nursing home. Service coordinators often form partnerships with home health agencies to provide basic health screenings or education programs in their common areas. Health professionals from local hospitals and even physical and occupational therapists may also visit, says Alisha Sanders, director of housing and services policy research for LeadingAge at its long-term services and supports center at the University of Massachusetts Boston.
In some states, the seniors living in a few seniors housing properties have received health services at their communities through Medicare or Medicaid. For example, several NeighborWorks network organizations such as St. Mary Development Corporation in Dayton, Ohio, are exploring models that will provide Medicare or Medicaid reimbursement for some health services.
However, these arrangements are still relatively rare. “While there is a lot of discussion about partnerships between affordable seniors housing and health care providers, my perception is that it's relatively low right now,” says Sanders.
Instead, service coordinators often also help their residents apply for and maintain benefits like Medicaid, in addition to food stamps, energy assistance, and travel assistance.
“We feel it is a worthwhile investment,” says Pratt. “We can’t do seniors housing without doing services.”