Models for Affordable Assisted Living

1. Models for Affordable Assisted Living AAHSA Spring Conference April 10, 2002 www.ncbdc.org

2. NCB Development Corporation • Mission: To address the problems that poverty creates in America. • Loaned or invested more than $1 billion for economic and community development. • Resulting in, among many other things, over 1,000 units of affordable assisted living.

3. Coming Home Program • A Robert Wood Johnson Foundation funded initiative, providing on-going technical assistance for Affordable Assisted Living in 9 states. • With these 9 states well on their way, NCB Development Corporation would like to work with other states to promote affordable assisted living.

4. NCBDC/ AAHSA Affordable Assisted Living Award • To recognize & disseminate operating examples of affordable assisted living projects that provide excellence in services, environment and support.

5. NCBDC/ AAHSA Affordable Assisted Living Award • Must be an operating project. • Call for proposals will appear @ www.ncbdc.org in May, • Submissions due late summer, • Awards announced at AAHSA fall conference in Baltimore.

6. Three Successful Projects • Rock Cove, Skamania Co., Washington. Rural project with a public housing authority. • McDonald Residence, Portland, Oregon. Inner city project with deep subsidy. • John Whitaker Place, Penacook, NH. Rural project in partnership with aging agency using layered smaller subsidies.

7. Site PhotoRock Cove

8. Rock Cove Assisted Living • 30 units, 8 one bedroom (506 sq. ft) & 22 studio (308 sq. ft.) Total sq ft: 18,390 • Single story frame building on Columbia River cove that separates Oregon & Washington • In rural, economically depressed part of Washington State.

10. Rock Cove Income • 15 units serve incomes at or below 80% of the Area Median Income. 10 of the 15 are M.A. eligible, so they are < 50% of AMI • The other 15 are market rate. • Current average income is: $22,600 • Area median income, Stevenson, WA is $29,800.

11. Approach toRock Cove

12. Rock Cove Demographics: • 22 women & 8 men (73% / 27%) • Age range: 55 - 100, average of 82

13. Rock Cove Acuity • Average resident needs assistance with 5 ADLs • 75% receive medication management assistance • 50% have significant cognitive impairment

14. Rock Cove Services: Home like setting supporting maximum independence and respecting privacy. • 3 homemade meals per day in dining room w/ fireplace and beautiful view • Nursing, Housekeeping, recreation, transportation, behavior management, ADL Assistance, home health & hospice

15. Rock Cove Dining Room

16. Rock Cove Rates (studio) • Private Pay Medicaid • Level I: $1,770 $54 • Level II: 2,005 $60 • Level III: 2,240 $66

17. Rock Cove Real Estate Development, Costs: • Land (lease): $102K • Buildings: 1,620K • Soft Costs: 267K • Developer (deferred): 200K • Financing & other 116K Total: $2,305K Total per unit: $77K

18. Rock Cove Real Estate Development, Sources: • Wash. Comunty Reinvstmt (30 yr): $ 1,495 • Local gov’t trust fund (1% 50 yrs): 500 • Deferred Developer’s fee: 225 • Land leased by county, nominal fee: 85 Total: $2,305

19. Rock Cove Operating Expenses (monthly) • Payroll / Employee: $30,517 • Administrative 3,950 • Dietary 5,335 • Utilities 3,412 • Property, Contracts, Misc. 14,090 Total $57,304 Per unit per month: $1,910

20. Rock Cove Operating Income (Monthly) • Private pay income: $30,700 • Medicaid (services) Income: • Residents 9,357 • State 20,877 Total: $60,934

21. Rock Cove What makes this special? • Revitalized site in a rural, economically depressed area. • Beautiful views of the water, great design • Capacity to serve very low income (< 50% of AMI)

22. Rock Cove

23. Street ViewMacdonald Residence

24. Macdonald Residence • 54 Units- all studio, 271 – 425 sq. ft. • 4-story design accommodates common dining, living and recreational space on ground floor and an enclosed courtyard • Residential units are on floors 2 – 4 with kitchenettes and private baths. • Serves downtown urban core of Portland, OR

26. Macdonald Residence Income • All 50 units serve incomes at or below 50% of the Area Median Income- Medicaid waiver eligible. • Area Median Income, Multnomah Co. OR: $40,000

27. Macdonald Residence Demographics • 22 women & 31 men (40% / 60%) • Age range: 27 - 83, average of 55 • Expect a younger population • Minimum age is 18

28. Macdonald Residence

29. Macdonald Residence Acuity • 75% need assistance with ADLS • All need nutrition management • Almost all need medication management • 40% or more have a mental health diagnosis

30. Macdonald Residence Services • Meals, housekeeping, laundry, ADLs, nursing, medication • Van • Macdonald Center Groups Spiritual & emotional support from volunteer students from four nearby nursing schools

31. Macdonald Residence Rates • Rent: $447 • Services: 1,413 • Total: $1,860 • Increases at rate of 3% annually • State has 5 levels, negotiated a single rate, all at Level 4, regardless of acuity.

32. Macdonald Residence

33. Macdonald Residence Real Estate Development, Costs: • Land 0 • Construction $3,882K • Developmt & Finance 908K • Start-up 165K • Reserves: 192K • Total: $5,147K • Cost per unit: $95K

34. Jim Gray: Big gifts including Murdoch, Collilns & Meyer Jim Gray: PDC=Portland Development Community Terms: contingent on CF, 3%, 30 yrs capped @ $10K Macdonald Residence Real Estate Development, Sources: • Loan: $1,138 • FHLBank AHP Grant: 200 • PDC Loan 200 • Private Fund Raising 873 • LIHTC Equity 2,736 Total $5,147

35. Site PhotoMacdonald Residence

36. Macdonald Residence Operating Expenses(monthly) • Payroll / Employee $54,179 • Administrative 6,803 • Dietary 7,755 • Utilities 5,254 • Property, Contracts & Misc. 14,562 • Total: $88,553 • Total per unit per month: $1,640

37. Macdonald Residence Operating Income (monthly) • Rental Income (Tenants): $21,873 • Services Income: • Tenants 6,812 • State 63,176 • Miscellaneous: 2,405 • Total $94,266

38. Macdonald Residence What makes this special? • Serves a very low income population in the inner city with no additional operating subsidies beyond SSI and Medicaid. • High quality building in a high cost area

39. Macdonald Residence

40. John Whitaker Place • 50 Units • Central core includes living room, dining room, community room, library and elevator • Residential units are in wings

42. Jim Gray: 7 mi. N of Concord

47. John Whitaker Place Income • 50 units, 11 Medicaid Waiver & 39 limited to 175% of Area Median Income • Current income range is $6,360 to $64,531. • Area Median Income, Concord, NH: $59,090.

48. John Whitaker Place Demographics • 40 women & 11 men (78% / 22%) • Age range: 58 – 96, average of 81

49. John Whitaker Place Acuity • 90% receive assistance with ADLs, most of these need medication management. For remainder, spouse needs assistance. • 2 are totally visually impaired, 2 on dialysis, majority ambulate with walkers and canes.