BUILDING RELATIONSHIPS: PACE PROGRAMS AND AFFORDABLE HOUSING FOR the ELDERLY

1. BUILDING RELATIONSHIPS: PACE PROGRAMS AND AFFORDABLE HOUSINGFOR the ELDERLY Aimee Reimann, COO United Church Homes and Services Lane Sarver, Owner Sarver Housing Group Gregg Warren, President/Executive Director: dhic, Inc

2. Aimee Reimann, COOUnited Church Homes and Services Aimee Reimann spearheaded UCHS’ first PACE program (Carolina SeniorCare) in 2012. Recently her efforts have been focused on new PACE services in Forsyth Stokes and a portion of Yadkin counties as well as expansion of Carolina SeniorCare in Beaufort, Carteret, Craven and Pamlico Counties in Eastern North Carolina.

3. Lane Sarver, Founder and PresidentSarver Housing Group • Lanebrings over 45 years of experience in affordable housing, • Lane is based in Chapel Hill, North Carolina. • Lane holds a BArch and a BA in Sociology from Louisiana State University, a Master of Regional Planning from the University of North Carolina at Chapel Hill, and a Master of International Housing and Social Change from the London School of Economics. Lane serves on the North Carolina Interagency Council for Coordinating Homeless Programs and recognized as a leading figure in affordable housing throughout North Carolina.

4. Gregg Warren, President and EDDHIC • Gregg has led DHIC since 1985. Over the years, DHIC has established a reputation as an innovative, productive developer of affordable housing in the Triangle area. Award winning properties provide stable, quality housing for the residents we serve, and our homeownership education programs provide clients with long term success. • Prior to DHIC, Gregg spent six years in state government distributing housing and community development funds and providing technical assistance to smaller towns and counties across North Carolina. He also worked as the founding Executive Director of the Chatham Housing Authority and as a housing planner for Triangle J Council of Governments.

5. United Church Homes and Services • Incorporated in 1961, UCHS has a rich tradition of commitment to older adults, offering lifestyle opportunities with something for everyone • A supporting foundation • Three retirement communities • Abernethy Laurels, Newton, NC • Piedmont Crossing, Thomasville, NC • Lake Prince Woods, Suffolk, VA

6. United Church Homes and Services • Seven supportive housing programs • Carolina Senior Living, Lexington, NC • Covenant Place, Chapel Hill, NC • Emmanuel’s Place, Statesville, NC • St. Matthew’s Place, Albemarle, NC • New Bern Older Adult Housing (NOAH), New Bern, NC • St. Joseph’s Place, Durham, NC • The Willows, Burlington, NC

7. United Church Homes and Services • Home Care Services • Laurels at Home, Newton, NC • Piedmont Crossing Home Care, Thomasville, NC

8. WHAT IS PACE? Comprehensive, fully integrated health care delivery system for the frail, older adults • Community-based • Comprehensive (medical and social services) • Capitated (managed care) • Coordinated • Honors the desires of the frail elderly

9. WHY PACE? • Participants stay in familiar surroundings • Participants maintain a certain self-sufficiency • Participants maintain a maximum level of physical, social and cognitive function

10. PACE and Housing Role with housing – Nearly all PACE programs (95%) serve participants who reside in senior housing. Participants residing in senior housing –Nearly half (45%) of serveparticipants that reside in 5-10 senior housing buildings, and most (63%) are located between 5 and 10 miles from their PACE center.

11. PACE and Housing Ownership of senior housing – Less than one-third (29%) of PACE programs own eitheraffordable senior housing or assisted living units; of these, most include funds from the HUD Section 202 program. Co-location with senior housing – Nearly one-third (32%) of PACE programs co-locate at least one of their centers with senior housing.

12. Carolina SeniorCare Desire for participants remain independent as long as possible in the least restrictive setting

13. Sarver Housing Group Sarver Housing Group works with non-profit organizations and for-profit developers to create affordable housing opportunities for the elderly and people with disabilities

14. Affordable Housing for Low Income Elderly Affordability: residents usually pay 30% of income for shelter and utilities

15. Affordable Housing for Low Income ElderlyContinued • Sources of Affordable Housing: Federal • Public Housing - Elderly Housing Projects • Number of PHA’s in NC • Number of elderly specific projects • Public Housing – Section 8 Vouchers • Number of Section 8 agencies in NC • Number of vouchers limited, long waiting lists

16. Affordable Housing for Low Income ElderlyContinued • For persons whose only income is Supplemental Security Income of $710, rent + utilities should not exceed $213. • Supplements or subsidies are needed to make the difference to rents of modest but decent housing - HUD has established “Fair Market Rents” for each county, which is supposed to represent the rent at the 40% range of rents.

17. Affordable Housing for Low Income ElderlyContinued • Private Non-profit Housing • Rent Supplement Projects (Section 236) • Older projects, many being phased out • Project Based Section 8 Projects • Older projects were Federal allocations • Newer project must obtain vouchers from PHA’s limited supply, through attrition as vouchers are returned • Section 202 - Capital Advances and Project Rental Assistance Contract (PRAC units) • Number of projects/units in NC • Program has ended capital advances, is slated to provide rental assistance units to Housing Finance Agencies.

18. Affordable Housing for Low Income ElderlyContinued • Private Non-Profit and For-Profit Housing • Low Income Housing Tax Credit – Allows lower rents by inviting private investment in return for credits against income tax liabilities for 10 years. • Approx 2500 units in North Carolina each year • Highly competitive, does not reach low income except with additional rental subsidies.

19. HUD • Promote seniors to age in place • Provide seniors a safe, affordable home

20. Affordable Housing for Low Income ElderlyContinued Housing with PACE – Section 202 housing provided by non-profit PACE operators • United Church Homes and Services - Co-locating housing adjacent to PACE site, Carolina SeniorCare and Carolina Senior Living • St. Joseph of the Pines – 202 projects that serve Fayetteville PACE Center, LIFE St. Joseph of the Pines

21. About DHIC • DHIC is a leadingnon-profit affordable housing developer based in Raleigh, North Carolina • Established in 1974 with a mission to build communities in the Research Triangle region of North Carolina that are diverse, economically vibrant, and affordable • DHIC is the developer/owner of 21rental communities for families,13senior rental communities,2supportive housing complexes, all of which total2,100apartments in 8counties

22. About DHIC • All of our senior apartments are designed for independent livingwith full kitchens and baths • Two types of senior housing • Tax credit:7communities w/ 460apartments • HUD 202:5communities w/ 179apartments • Partner with Resources for Seniors to provide service Coordination • HIGH DEMAND!

23. What is Service Coordination? • A service coordinator’s objective is toassisteach resident in maximizing independence while remaining in his/her home. This goal is accomplished by linkingresidents with appropriatecommunity resources. • The service coordinator: • Conducts client assessments and identifies potential needs • Arranges health, wellness, and educational presentations at the senior community • Service coordinators do not provide direct services Service coordination operates on a fee-based contract

24. Site Map Highland Village Cary, NC Highland Village Apartments Highland Townhomes Highland Manor Apartments Highland Terrace Apartments The Commons @ Highland Village

25. Site Overview Highland Village Cary, NC

26. Demographics Highland Terrace Cary, NC 80 apartments 86 residents Female HH: 68 Male HH: 12 Joint/Married: 6 Average Age: 74 Average Income $18,660 Contract Rent: $365-$615 Average Rent: $558 Resources for Seniors and the Town of Cary are the service partners for our senior sites at Highland Village

27. HUD 202 Turnberry Wake Forest, NC

28. Demographics Turnberry Wake Forest, NC 41 apartments 41 residents Female HH: 37 Male HH: 4 Average Age: 76 Average Income $12,939 Contract Rent: $416 Average Rent: $195 Walking distance to Northern Wake Senior Center Resources for Seniors is the service partner for Turnberry Apartments

29. Carolina SeniorCareCarolina Senior LivingSite Map

30. Carolina SeniorCare and Carolina Senior Living

31. Carolina Senior Living

32. Carolina Senior Living • 30 Units • 1 Bedroom/1 Bathroom • Handicap Accessible • Rent Based on Income • Age Requirement: 62 and older Other amenities include a multipurpose community room with a kitchen, a screened-in porch, common laundry rooms, fitness room, library and media room.

33. Carolina Senior Living

34. Example of Unit Floor Plan

35. Building Relationships What PACE can offer Housing: • Highly Coordinated Care • Transportation • Socialization • Entertainment • Volunteer Opportunities, sense of purpose • Ability to age in place • Meals • Tenant Retention • Other ideas, telehealth, health screens

36. Building Relationships • Participant access to affordable, safe and secure housing • Participant can age in place • Build friendships • Referral Source How PACE Benefits from Housing:

37. Community Benefits • Revitalization of neighborhoods (many PACE sites are renovated properties) • New businesses (a new pharmacy has opened adjacent to Carolina Senior Living)

38. New pharmacy opens near Carolina SeniorCare and Carolina Senior Living

39. Winning Combinations UCHS Future Plans Include: • Carolina SeniorCare Expansion near our HUD property (NOAH) in New Bern, NC

40. Measuring the Costs, Savings of Aging in Place • Evidence suggests programs that support aging in place may yield cost savings for families, government, and health systems • Aging in place has also been shown to have health and emotional benefits over institutional care

41. It's catching on. A recent article in HousingFinance.com illustrates how developers for-profit and non-profit are recognizing the benefits of combining housing and healthcare. We are delighted to be on the forefront of this trend in North Carolina Housing and healthcare is a winning combination

42. How to find affordable senior rental housing www.nchfa.com www.hud.gov

43. Questions Contact Information: United Church Homes and Services 100 Leonard Avenue Newton, NC 28658 Aimee Reimann 828-465-8011 Sarver Housing Group 900-C Franklin Square1829 E. Franklin StreetChapel Hill, North Carolina 27514Lane Sarver 919-967-5520 DHIC, Inc.113 South Wilmington StreetRaleigh, NC 27601 Gregg Warren919-832-4345