HELEN SAWYER PLAZA

1. HELEN SAWYER PLAZA Helen Sawyer Plaza 1150 N.W. 11th Street Miami, FL 33136 * The Nation’s First Licensed Assisted Living Facility Within Public Housing (1999) - 104 Units - Partners: U.S. Department of Housing and Urban Development Miami-Dade Housing Agency (Florida) State of Florida Department of Elderly Affairs

2. BACKGROUND Public sector funding along with private sector expertise provide the structure for Helen Sawyer Plaza Service Providers: Miami Dade Housing Agency (MDHA) retains ownership and operational control of Helen Sawyer Plaza Provides day-to-day management of the facility and hands-on care for the residents – annual contract cost of $100,000 per year HELEN SAWYER PLAZA MIAMI, FL

3. BACKGROUND (Continued) • PHAs - turning to Assisted Living Facility (ALF) models as a vehicle to enable seniors to age in place • Avoid premature transfers to more intrusive and costly housing and service options such as nursing home facilities • 1976 - Provided elderly public housing - Group meals only •  1995 - No longer provided congregate meal service = Hardship • 1995 - No meal service combined with poor transportation, no services, and a declining neighborhood = 30% occupancy rate HELEN SAWYER PLAZA MIAMI, FL

4. BACKGROUND (Continued) Envisioned by MDHA - Meet physical and emotional needs of elderly public housing residents Evolved from a lack of affordable housing alternatives to meet the demand for senior housing Need for new funding sources to satisfy the problem of long-term care  MDHA - converted an underutilized independent living facility into a multi-service center for elderly residents 1999 - MDHA opened the “Helen Sawyer Plaza Assisted Living Facility” HELEN SAWYER PLAZA MIAMI, FL

5. BACKGROUND (Continued) Conversion to a Public Housing Assisted Living Facility: Step 1:Contracted with a consultant who is an expert in the Assisted Living Facility field Step 2: HUD funding to rehabilitate the building according to Housing Quality Standards Step 3: Obtained an Assisted Living Facility license from the state of Florida Step 4: Coordinated work efforts with Miami and Dade Counties to revitalize abandoned buildings in HSP neighborhood - expanded transportation Step 5: Petitioned the State of Florida Department of Elderly Affairs - grant a Medicaid waiver -Helen Sawyer Plaza elderly services eligible for Medicaid funding reimbursement HELEN SAWYER PLAZA MIAMI, FL

6. DESIGN / STAFFING Amenities: Lobby, public restrooms, full kitchen with resident dining room, community room, administrative offices and maintenance staff areas Additional Building Features: Electronic security system with 24-Hour security guards Staffing Needs: Staffing includes an Administrator, Receptionist, Accountant, Maintenance Staff, Cook and Cook Assistants, Housekeepers, Certified Nursing Assistants, Activity Coordinator and a Social Worker HELEN SAWYER PLAZA MIAMI, FL

7. DESIGN / STAFFING (Continued) ACCOUNTING ADMINISTRATOR MAINTENANCE ACTIVITIES DIRECTOR NURSE RESIDENT CARE FOOD SERVICE CONSULTANT AR/AP HELEN SAWYER PLAZA MIAMI, FL

8. PROCESS Resident Eligibility Requirements: Must be low-income individuals Able to perform activities of daily living with supervision or assistance Be at risk of placement in a nursing home Medicaid eligible Must be at least 62 years old Do not require 24-hour nursing supervision Do not require licensed, professional mental health treatment  Program Demographics: (104 residents) Average age is 85 Average length of stay is 35 months 40% of residents are former residents of nursing homes HELEN SAWYER PLAZA MIAMI, FL

9. PROCESS (Continued) Benefits and Features: • Married couples can continue to live together • Helen Sawyer Plaza provides: • Services including bathing, grooming and feeding • 30 hours of activities per week - dancing, exercise, shopping and cultural events • 24-hour supervision by trained staff • Assistance with Medications • Physical Therapy • Transportation services • Cafeteria Meals (three hot meals - two snacks per day) HELEN SAWYER PLAZA MIAMI, FL

10. PROCESS (Continued) $4,808 per unit - Miami Dade Housing Agency subsidizes rent for all units - 65 residents receive Medicaid waivers that reimburse up to $28 per day for services $22,000 per unit subsidy vs. Nursing Home subsidy rate that is 5-6 times higher! HELEN SAWYER PLAZA MIAMI, FL

11. PROCESS (Continued) Assessment of Service Fees: Residents are assessed $685 per month for services. The cost is subsidized through the Optional State Supplement (OSS), which is a State supplement to Social Security Income Cost Comparison: Nursing home facility vs. Assisted Living Facility - nursing home facility will cost 68% more Nursing Home = $38,000 per year Assisted Living Facility = $12,000 per year HELEN SAWYER PLAZA MIAMI, FL

12. PROCESS (Continued) Helen Sawyer Plaza has an Extended Congregate Care License - required to access the Medicaid Waiver Result of petitioning - State legislature enacted a demonstration project Medicaid Waiver for $1.3 million First time a Medicaid Waiver and case management was allocated to public housing 100% of the units are affordable to 50% of area median income Residents pay rent set at 30% of adjusted gross income HELEN SAWYER PLAZA MIAMI, FL

13. MANAGEMENT / MARKETING Management: Participatory management Constant training and communication among staff Residents are treated with respect, care and devotion Monthly training for social service staff Marketing: Outreach through resident services Sells concept that MDHA is a Medicaid provider and case management agency Clients come through word of mouth from publicity, newspaper articles, radio, T.V. and Community Groups 30% of residents come from Community Group referrals The residential waiting list averages 20-30 persons On average, MDHA loses 20 elder residents per month to death/nursing home/private assisted living facilities HELEN SAWYER PLAZA MIAMI, FL

14. CHALLENGES/FAILURES/LESSONS LEARNED • State and Federal Government requires excessive documentation • Government Catch 22: • Obtaining an ALF license –- Cannot be obtained until development is complete • Lender Loans are difficult to obtain without a guarantee of Medicaid Funding • Impossible to underwrite the Medicaid Waiver as a source of revenue because waivers cannot be committed before the facility is operational • Petition the State of Florida Department of Elder Affairs to grant a Medicaid waiver is a hit and miss process What Helen Sawyer Plaza may have done differently: • Opened the facility 6 months earlier • Admitted more residents into the Medicaid Waiver Program • Spent more time talking to key staff and residents for support HELEN SAWYER PLAZA MIAMI, FL

15. ACCOMPLISHMENTS/SUCCESSES/HIGHLIGHTS Resident Successes: • Based on Florida International University Center of Aging study: • Health and mental condition of residents have significantly improved • Residents have a high level of satisfaction with services • Residents have a renewed desire to engage in life Helen Sawyer Plaza Successes: • Achieved 100% lease-up within one year • Achieved the lowest attrition rate among residents and staff • Has saved the Florida Medicaid budget over $8 million • Received recognition from legislatures and policy makers Awards: • HUD Best Practices Award • NAHRO Human Services Award • National Association of Counties Achievement Award • Florida Housing Coalition Success Stories Award HELEN SAWYER PLAZA MIAMI, FL