How did APC acquire the property on McKay?
APC submitted a successful application for the property after it was declared surplus and suitable for homeless use. The complete set of application documents is located on http://caringalameda.org/resources/ under documents.
“Under the Stewart B. McKinney Homeless Assistance Act (42 U.S.C. 11411, as amended), public bodies and eligible nonprofit organizations and institutions that are concerned with providing assistance to the homeless may apply to acquire Government property (through permit, lease, or deed) that has been determined suitable by HUD for homeless use. Public bodies are identified as states and their political subdivisions and instrumentalities and tax-supported institutions. Eligible nonprofit organizations and institutions are identified as those held exempt from taxation under Section 501(c)(3) of the 1954 Internal Revenue Code.” – From the GSA Notice of Determination of Homeless Suitability and Availability, issued on April 28, 2017
What is the ownership status of the property now?
The Federal Health and Human Services Department still the owner, and has entered into a no-fee, 3 year lease (extendable to 20 years) with APC. The lease, published on the City Website restricts uses to those approved in APC’s application, and limits all uses of the property to serving the homeless population. The intent of the lease and agreement with HHS is to convert the lease to a quit claim deed (APC would become owners). The deed would still have the same restrictions as the lease, and would revert to the federal government if APC closed down operations at the site. We can select other operators, but they still need to perform the same services. We cannot sell the property.
Who will the project serve?
Almost 50% of all the clients will be Alameda residents. The project will serve approximately 575 clients a year. Of that, 200 clients accessing services at the resource center will be Alameda residents in risk of or newly homeless. Another 40-50 Alameda residents will be among those selected through a countywide screening process that will prioritize medical acuity.
What services will be provided on the site?
A description of the project services is at http://caringalameda.org/about/
How will development of the site be funded?
Construction and rehab costs for the senior housing will come through A-1 Bond funds (APC has already been recommended for approval for $11.5 million) Low Income Tax Credits, No Place Like Home funding(state bond funding from the Mental Health Services Act) and other appropriate sources being developed. Funding for the clinic will come from Medical Provider Organizations, including Kaiser, Sutter, Alameda Health Services, New Market Tax Credits, and County funding. APC has already secured $690,000 in funding from the County Health Care Services Agency, and has been invited by Kaiser to submit a request for $5 million. For every application, APC and development partner Mercy Housing must adequately demonstrate that the project is financially viable.
How are project decisions being made?
APC has established a steering committee that is made up of medical and other service providers, representatives from various funding agencies, and consumers. The steering committee had its first meeting at the end of last year, and will be convening on a regular basis to provide expertise, input and guidance to APC for the development of the Center. Final decision making rests with APC and our development partner Mercy Housing
How will operations be funded?
A variety of subsidies, including Section 8, HUDVASH, Shelter Plus Care, Medicare and Medicaid funding will be utilized for the senior housing. Subsidy commitments are typically not made until after construction is underway, so specific amounts of subsidies is still to be determined. Respite and clinic costs will be covered by reimbursements, and contributions from the Medical Provider Organizations. Some respite programs designate beds for each funding organization to ensure there is room for their clients, but there is now a trend to develop a performance based pool of operating funds that provides more flexibility and serves the best suited clients first. The Steering committee (see below) will be developing policy on this going forward.
What kind of staffing will the project have?
The senior housing component will have a property manager, case managers, support services to assist with activities of daily living, transport and support staff (housekeeping, maintenance, dining etc.). Residents will also have access as needed to medical staff of the clinic. The medical respite and health clinic will have a Medical Director, Admissions Coordinator, Multiple LVN’s or CAN’s, Case Managers, Community Health Workers, Housing Specialists and support staff (kitchen, housekeeping, driver, volunteer coordinator etc.) In addition to the Resident Manager, there will be medical and security staff available 24/7
What security will be provided?
Upon assuming control of the site in September, APC installed security cameras and hired a firm to provide security onsite. This will continue in some form throughout the development phase. Once operational the project will have 24/7 security provided either by a firm or task specific staff whose primary role will be ensuring residents and clients are safe, and access is monitored. Other respite programs have done one or the other, with pros and cons for each arrangement.
Will APC also provide security on the street?
APC clearly is not a law enforcement entity and would not have authority to “patrol” a public right of way or enforce parking or loitering laws. Residents and Clients will have house rules they are expected to abide by or face eviction or expulsion, and APC will ensure they behave appropriately when outside the facility. We will make our video available to police if needed, and inform APD and/or EBRPPD of any issues that may need their attention.
How will homeless access services?
Supportive housing residents will be selected through the county-wide Coordinated Entry System that prioritizes homeless based on need. Within that list, seniors over 55 with acute medical conditions will be prioritized. Two organizations, Building Futures and Operation Dignity have been doing street outreach in Alameda over the last year working with homeless and getting them enrolled in the Coordinated Entry System so they will be eligible. Clients for Medical Respite will be referred from discharge coordinators at the major safety net hospitals in the region, including Alameda Hospital, Highland Hospital, Kaiser, and Alta Bates Summit. Referrals will also come from qualified medical providers, specifically the Alameda Paramedic’s program. The resource center will be the only program offering drop-in services and will be open to Alamedans who are at-risk of or newly homeless eligibility will be determined by methods similar to those used at the Alameda Food Bank – a recent rent receipt, bill with an alameda address, library card, note from local service provider or congregation, etc.
Are there any State licenses required to operate this facility?
The Alameda Senior Housing and Medical Respite Center proposes senior permanent supportive housing, medical respite, a resource center, and a primary care clinic. There are a number of state laws that apply to the licensing, operation and management of such facilities. Although the City does not have adequate information at this time to know what licenses will be required, APC has informed the City that the primary care clinic will require state licensing, the licensing requirement for assisted living will depend on the level of medical support provided, and the respite care will not require state licensing.
How can the community be involved?
APC is establishing a community oversight committee that will help establish and monitor community agreements around traffic, security, operational parameters and other issues. The committee will will be made up of 10-15 members, primarily consisting of residents, businesses and other stakeholders in the immediate vicinity of the project. APC will also be holding a series of open houses at the project site in the next few months, and you can sign up to be notified of future project actions at http://caringalameda.org/
What additional information can you provide about the operations
The 90 units of senior housing is permanent supportive housing and will be studios with their own bathroom and a small kitchenette with a sink, microwave and small refrigerator, with the idea that residents can prepare snacks and light meals at home, but will also be encouraged to eat in a congregate dinning facility. As part of the design, APC will be exploring setting up one wing as a hospice and/or memory wing. Residents of the senior housing will have freedom to come and go as they please, and are capable. In some instances, for those who have difficulty walking, they may be accompanied by a volunteer or aide. Residents will have access to all the medical services on site, but in case they need to travel elsewhere for treatment, van transportation will be provided.
The medical respite will not be a Skilled Nursing Facility. There is currently no licensing required for medical respite, although that may change in a few years. The program will comply with the standards for medical respite operation established by the National Health Care for the Homeless Coalition: https://www.nhchc.org/standards-for-medical-respite-programs/ The respite center will be closely connected with the health clinic, and clients can access staff whenever needed. There will be qualified medical and behavioral health staff onsite 24/7. In addition to a Medical Director and a Doctor, there will also be adequate nursing(at least 12 FTE) and behavioral health staff(at least 6 FTE) at the center to provide robust care.
Some medical respite programs operate as a closed campus – similar to a hospital stay, and some operate as an open campus. Each model has their pros and cons and will be evaluated by the steering committee before a final decision is made.
The resource center will be staffed by several case managers and a housing specialist and will provide drop in and by appointment services.