HOLGATE HOUSE

1
HOLGATE HOUSE
Holgate House 4601 SE 39th Street Portland,
Oregon 97202
- One of four high-rise buildings where
Congregate Housing Program operates - 120 Total
CHSP Slots

• Partners
• U.S. Department of Housing and Urban Development
• Housing Authority of Portland (HAP)
• Portland Area Agency on Aging
• Oregon Department of Human Services

2
BACKGROUND

• 1981 HAP initiated the Congregate Housing
  Services Program (CHSP)
• Thirty slots in one building
• Provided support services to the frailest
  elderly and disabled individuals
• HUD funded the program except residents paid a
  sliding scale portion of the fee
• CHSP funds managed by HUD Office of Housing
• 1993 HAP requested from HUD received ninety
  additional slots
• A total of one-hundred twenty slots in four
  buildings 3PH, one mixed population
• 1993 HUD initiated a 60 matching requirement

HOLGATE HOUSE
PORTLAND, OR
3
DESIGN / STAFFING

• HAP manages the buildings and the CHSP
• Management, service coordinators and kitchen
  staff are HAP employees
• Personal care, housekeeping, transportation,
  nursing, podiatry and senior companion services
  are contracted out

HOLGATE HOUSE
PORTLAND, OR
4
PROCESS

• 1993 HAP obtained 50 of required 60 matching
  funds via the Oregon State Home and Community
  Based Care (HCBC) Medicaid Waiver program.
• 10 of matching funds from participant fees
• HCFA provided the funds and the Oregon State
  Department of Aging administered the fund
• CHSP participants continued to pay their rent
• HCBC provides HAP with a monthly capitated rate
  per CHSP program participant regardless of the
  level of service required by each individual
• CHSP participants must meet Medicaid income
  level requirements (income of 500.00 dollars per
  month, assets under 2,000)

HOLGATE HOUSE
PORTLAND, OR
5
PROCESS (Continued)
FUNDING SOURCES (averages) FUNDING SOURCES (averages) FUNDING SOURCES (averages) FUNDING SOURCES (averages)
MONTH ANNUAL
Medicaid Community Based Care Waiver Program 302 3,624 Contributes toward cost of 1 meal per day, housekeeping, personal care, transportation, basic nursing, case management, senior companion services
HUD Congregate Housing Services Program funds, administered by the Housing Department 242 2,904 Contributes toward cost of 1 meal per day, housekeeping, personal care, transportation, basic nursing, case management, senior companion services
Participant 60 720 Contributes toward cost of 1 meal per day, housekeeping, personal care, transportation, basic nursing, case management, senior companion services
Total 604 7,248

ALF 2,938 35,256
Nursing Home 3,500 42,000
HOLGATE HOUSE
PORTLAND, OR
6
MANAGEMENT / MARKETING

• CHSP not regulated in Oregon
• HAP Administrator and Service Coordinators
  provide onsite program monitoring
• No formal marketing necessary
• Referrals from Area Agency on Aging and word of
  mouth within the housing authority and outside
  communities

HOLGATE HOUSE
PORTLAND, OR
7
CHALLENGES/FAILURES/LESSONS LEARNED

• February 2003 state budget cuts have drastically
  affected the level of Medicaid funding
• Now more difficulty meeting level of care
  standard.
• Further state budget cuts anticipated 4/03.
  Likely result will be less funding per
  individual recipient
• There are no alternative sources of matching
  funding once Medicaid funds are decreased
• Recognizing time to pursue a higher level of
  care placement.
• Ability to secure alternative placement in an
  expeditious manner
• HAP would consider developing an Assisted Living
  program and thereby access ALF Medicaid funds
• Obstacle--there are no HUD or other funds to
  retrofit the buildings

HOLGATE HOUSE
PORTLAND, OR
8
ACCOMPLISHMENTS/SUCCESSES/HIGHLIGHTS

• Enables low income individuals to reside
  independently much longer than would otherwise be
  the case
• Enables some program participants to completely
  avoid institutionalization
• The program has improved the quality of the
  lives of participants
• The program has assisted to preserve
  participants health, actually increasing life
  spans
• To date the program has met the budgetary
  challenges and managed to provide an adequate
  level of care to the program participants
• Provides the services at an incredibly
  reasonable price
• The program has been able to meet the needs of
  an increasingly frail population

HOLGATE HOUSE
PORTLAND, OR
9
SUMMATION

• Currently, only HAs that received CHSP funding
  as of 1995 are eligible to apply for this program
  
• HUD should consider allowing additional HAs to
  apply
• HUD should consider a more reasonable CHSP
  funding match (currently 60), so that current
  HAs can remain in the program
• HUD should consider increasing CHSP funding
  because alternatives are more costly
• CHSP, combined with community resources, can
  adequately maintain many frail elderly residents
  until nursing home placement is necessary or
  until natural death occurs

HOLGATE HOUSE
PORTLAND, OR
10
SUMMATION (Continued)

• A continuum of care, i.e. CHSP and if needed,
  ALF, is an economical alternative to nursing home
  care
• Many elderly individuals experience physical
  and/or mental deterioration due to inability to
  take meds as prescribed causing otherwise
  unnecessary NH placement
• CHSP regulations should contain a mandatory
  provision for medication management
• HUD should consider ways that HAs could access
  funds to modify buildings/apartments to comply
  with state ALF requirements
• Retrofitting costs cannot be absorbed within
  most HAs current budgets

HOLGATE HOUSE
PORTLAND, OR