# Presentation: 673523

## HELEN SAWYER PLAZA

**HELEN SAWYER PLAZA**

**Helen Sawyer Plaza**
**1150 N.W. 11****th**** Street**
**Miami, FL  33136**

** ****U.S. Department of Housing and Urban Development**
** ****Miami-Dade Housing Agency (Florida)**
** ****State of Florida Department of Elderly Affairs**

**- 104 Units -**

_**Partners**_**:**

*** The Nation’s First Licensed Assisted Living Facility Within Public Housing (1999)**

## Public sector funding along with private sector expertise provide the structure for

_**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**

**BACKGROUND**

**MIAMI, FL**

***Public sector funding along with private sector expertise provide the structure for***
***Helen Sawyer Plaza***

## BACKGROUND  (Continued)

**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**

##  Envisioned by MDHA - Meet physical and emotional needs of elderly public housing residents

** ****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”**

**BACKGROUND  ****(Continued)**

**HELEN SAWYER PLAZA**

**MIAMI, FL**

## Conversion to a Public Housing Assisted Living Facility: 

_**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

**BACKGROUND  ****(Continued)**

**HELEN SAWYER PLAZA**

**MIAMI, FL**

## DESIGN / STAFFING

**DESIGN / STAFFING**

| 104 Units |  |
| --- | --- |
| 0  BR | 83 |
| 1  BR | 21 |

_**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**

## DESIGN / STAFFING (Continued)

**DESIGN / STAFFING ****(Continued)**

**CONSULTANT **

**AR/AP**

**HELEN SAWYER PLAZA**

**MIAMI, FL**

## PROCESS

**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**

## PROCESS (Continued)

**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**

## PROCESS (Continued)

| HELEN SAWYER PLAZA IS 100% SUPPORTED BY |  |  |
| --- | --- | --- |
| Optional State Supplement (OSS) to SSI | $945,000 | 41% |
| State Sponsored Medicaid Waivers for Services | $655,200 | 29% |
| HUD Operating Subsidy | $424,200 | 18% |
| HUD Utility Subsidy | $138,168 | 6% |
| Private Pay Residents | $134,400 | 6% |
| Total: | $2,296,968 |  |

| REHABILITATION FUNDING SOURCES |  |
| --- | --- |
| HUD Modernization  | $350,000 |
| Borrowed Start-up | $150,000 |
| Total: | $500,000 |

**- Miami Dade Housing Agency subsidizes rent for all units**
**- 65 residents receive Medicaid waivers that reimburse up to $28 per day for services**

**$4,808**
** ****per unit**

**HELEN SAWYER PLAZA**

**MIAMI, FL**

**$22,000 per unit subsidy**
**vs. Nursing Home subsidy rate that is 5-6 times higher!**

## PROCESS (Continued)

**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**

## PROCESS (Continued)

**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**

## MANAGEMENT / MARKETING

**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**

## CHALLENGES/FAILURES/LESSONS LEARNED

**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**

## ACCOMPLISHMENTS/SUCCESSES/HIGHLIGHTS

**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**