1) Mercy Housing developed Mission Creek Senior Community, a 139-unit affordable housing property in San Francisco that provides housing and supportive services for formerly homeless elderly residents. 2) The $42 million project received funding from various public and private sources and offers on-site services like meals, healthcare, and activities to help residents transition from homelessness. 3) A study found that after 3 years, 78% of the originally homeless residents remained housed, with reductions in public costs for medical services, demonstrating the effectiveness of providing supportive housing for the elderly homeless population.

1. Housing the Elderly HomelessThe Mercy Housing experience at Mission Creek Senior CommunityNAEH ConferenceJuly 13, 2010Jane Graf President, Mercy Housing Ca LIVE IN HOPE

2. Mission To create stable, vibrant and healthy communities by developing, financing and operating affordable, program-enriched housing for families, seniors and people with special needs who lack the economic resources to access quality, safe housing opportunities. Founded in 1981 by the Sisters of Mercy, Omaha LIVE IN HOPE

3. MajorActivities Housing Development participated in the development, preservation and/or financing of more than 37,200 affordable homes serving more than 128,000 people Property Management Manages 16,132 apartment homes 236 Mercy Housing properties 37 properties managed for other non-profits Staff in 17 states Operate in 5 major markets nationwide LIVE IN HOPE

4. Mission Creek 139 one bedroom apartments for frail & formerly homeless elderly Opened March, 2006 LIVE IN HOPE

5. Funding & Partners 11,340,429 San Francisco Redevelopment Deferred loan 13,092,518 National Equity Fund – equity on 4% LIHTC 1,000,000 San Francisco Redevelopment – HOPWA 360,000 San Francisco Redevelopment – CDBG 451,069 SFRA-Hazardous Materials Loan 7,500,000 State MHP-Residential and nonresidential 8,017,513 Citibank-bonds 625,500 AHP with BofA 396,472 GP Equity & Early Occupancy income 100,000 Northern California Community Loan Fund Grant $42,883,501 total sources Cost: $42,883,501 Per square foot: $246 Per unit: $306,610 Total Bldg size: 166,295 square feet Total Commercial: ADHC: 6,198 Square feet; retail: 3,936 square feet Library: 7,449 square feet in a condo – not in dev cost LIVE IN HOPE

9. Courtyard LIVE IN HOPE

10. Resident activities Ti Chi Group meetings LIVE IN HOPE

11. Resident activities Halloween LIVE IN HOPE

12. Resident activities 4th of July Celebration LIVE IN HOPE

13. Unit Plan LIVE IN HOPE

14. Typical Unit LIVE IN HOPE

15. Mission Creek retail Philz Coffee Shop LIVE IN HOPE

17. Mercy Housing developed the space for the library which owns it as a condo LIVE IN HOPE

19. Services & Funding Basic Services provided Funding Source Dedicated services staff Rents and HUD subsidies Adult Day Health Services Medicaid, Dept Public Health, & private pay (sliding scale) In Home Support Services Medicaid Case management Medicaid, Dept. Public Health Meals Medicaid, County, private Health services/visiting nurse or Dr. hours SF Dept. of Public Health Wellness promotion Self funded or City contract Substance Abuse support through other nonprofit Money Management organizations LIVE IN HOPE

20. Findings from DPH Study Of the 51 DPH homeless residents after 3 years: 78% still housed – 3 evictions; 3 to higher level care; 5 deaths Average reduction of $29,000 per person/per year in Medical/Medicare reimbursed services LIVE IN HOPE

22. SF policy is that all housing supported by City funds will have a 20% set aside for the homeless

23. Support is through City/County General Funds

24. $400 to $700 per unit/per month rent subsidy

25. $400/per resident service funding

26. City manages wait list for homeless residents and assures services

27. City loan committee that manages all City funding of affordable housing includes representation from:

28. Redevelopment Agency

29. Mayors Office of Housing

30. Department of Public Health

31. Department of Human ServicesLIVE IN HOPE

33. Direct Observation Therapy – aka medication management – is an essential component to success

34. Nursing hours are essential – for every 75 to 100 units of housing – not less than ½ day of nurse availability 2 to 3 times per week

35. All homeless residents in the program have access to a city owned health clinic (FQHC) that provides psychiatric and primary care

36. Rigorous conferencing on the needs of residents with medical personnel & the housing provider is essential to successLIVE IN HOPE

37. Reflections from a houser When the formerly homeless residents entered Mission Creek, highly skilled service staff needed to be available 7 days per week 12 hours per day Constant attention needed to make the transition from the street Needed help learning to cook/use appliances/basic things Sounds indoors were foreign and caused alarm and fear After 4 years, many formerly homeless residents remain isolated by choice – pro-active outreach is essential Formerly homeless residents require a high level of patience from staff – continued meeting to deal with their concerns and willingness to go the extra mile to maintain them in housing Site staff must have more than property management skills – they must have a commitment to services & the flexibility required to assure residents maintain their housing LIVE IN HOPE

39. Money management to assure payment of rent is vital to maintaining the seniors in their housing

40. Property management team experience and education is pivotal to success

41. People seem to work harder to maintain their housing based on the beauty of their environment

42. Partners with like minded vision is essentialLIVE IN HOPE