A Project in Pennsylvania

Health Progress, Mar/Apr 2005 by Williams, Robert

Catholic Health Care and Social Service Organizations Teamed Up to Construct Housing for Seniors

GROWING OLD used to be less complicated than it is today. In the past, senior citizens usually resided with or near their children and other members of their extended family. Social Security helped offset the bills. Major health problems might have required a hospital stay, but minor ones were taken care of by the family physician, who made house calls. Counseling, when sought, was done by one's pastor. People tended not to live as long as today and usually died at home.

In the mid-1960s, with the advent of social programs such as Medicare and Medicaid, health care was expanded to include visiting nurses, medical equipment in the home, and nursing home care. More funding became available for social service agencies. Legislation such as the Older Americans Act of 1965 gave birth to Area Agencies on Aging, Meals on Wheels, and similar programs. As a result of improved nutrition and health care, among other causes, people began to live longer. Two-income families became the norm. The nuclear family splintered, producing fewer children and more divorce. The once-crowded family home is today often inhabited by a single senior burdened with medical problems, housekeeping duties, loneliness, and creeping impoverishment.

Programs have been created to help less-affluent seniors. The Program of All-inclusive Care for the Elderly, adult day and senior centers, prescription drug assistance, and family medical leave for caretaker children-to some extent, these provide the care once furnished by the extended family. Unfortunately, coordination of such elder-care programs and agencies is often absent or inconsistent.

However, consistent, coordinated care is a hallmark of St. Catherine's Manor, Dunmore, PA.

ST. CATHERINE'S MANOR

St. Catherine's is a 60-unit housing project for people aged 62 and older. Developed by Catholic Social Services (CSS) of the Diocese of Scranton, PA, and Mercy Health Partners (MHP) Northeast Region, Scranton, it sits on 5.5 acres of land in a suburb of that city. St. Catherine's is a two-story, colonial-style facility overlooking a lake. It has 50 one-bedroom units and 10 two-bedroom units. Six units are wheelchair-accessible and three are equipped for the hearing and vision impaired. Five percent of St. Catherine's nearly 47,000 square feet is community and common areas. All units have fully furnished kitchenettes and showers equipped for the handicapped.

A county-sponsored bus provides transportation to and from St. Catherine's front door. St. Catherine's was the first housing project in Pennsylvania to offer a service-enriched model of care that meets senior's social and medical needs under a single roof.

Not an assisted-living facility, St. Catherine's attempts to provide the supportive services needed by elderly people who, though frail, are in general good health. The site includes a fully equipped medical examination room for a nurse practitioner who visits several times a month. During these visits, which are funded through MHP's Community Health, a community-out-reach program, the nurse practitioner takes residents' vital signs, monitors their blood glucose, and makes physician referrals for residents who need medical care.

A podiatrist visits St. Catherine's frequently to provide residents with foot care. Health educators come to present in-service sessions. A social worker from CSS conducts ongoing individual needs assessments. If they choose, residents can arrange privately to get help with light housekeeping, laundry, meal delivery, nurse-aide services, and bathing and other personal care needs. St. Catherine's has a building manager on site daily.

FINANCING THE PROJECT

Although Catholic social services agencies and health care providers have always shared a common vision, close collaboration between them is a fairly recent phenomenon. Before creating St. Catherine's, MHP and CSS had collaborated on a few small projects-for example, meal services to the homebound, employee assistance programs, and health prevention and promotion programs-in northeastern Pennsylvania. But they had attempted nothing of the magnitude of a multimillion-dollar affordable-housing project.

However, it became clear that many of the region's low-income seniors needed such housing. In 1998 the leaders of MHP and CSS began meeting to discuss what their organizations might do to meet this need. They decided to construct a housing development that would, for an affordable price, allow seniors to maintain their independence in a homelike setting that also met their social and medical needs.

The partners' common culture allowed them to work together smoothly. The Sisters of Mercy have been present in northeastern Pennsylvania for more than 100 years. As part of Catholic Healthcare Partners, Cincinnati, the congregation currently cosponsors three area hospitals and a number of community health entities. CSS, which is part of Catholic Charities USA, has been active in the area for nearly 75 years. A key project planner was CSS's director, Steve Nocilla, who had experience with the Low Income Housing Tax Credits (LIHTC).* Nocilla had earlier led the rehabilitation of two housing facilities for low-income people. LIHTCs, administered by the U.S. Internal Revenue Service (IRS) in conjunction with state agencies, are allocated to each state at the rate of approximately $1.25 per resident. The agency in this case, the Pennsylvania Housing Finance Agency, administers about $20 million in LIHTCs annually.