Is spending health care dollars on housing a viable solution for at-risk seniors in Monterey County?

Cindy Klanieki sees it in her work with the elderly as a counselor in the Monterey Bay Area all the time. It’s a situation she and her colleagues call “one hip fracture away from being homeless.” Over the last few years she noticed the problem intensifying, but there’s been no concentrated effort among local governments and nonprofit agencies to find a solution.

“I’m amazed more people aren’t talking about this,” Klanieki says. “We are headed into a crisis point, and there aren’t enough resources.”

Klanieki is one of the founders of HOME Collaborative (Housing Options Meaningful to Seniors), a group made up of government representatives, nonprofit housing, homeless and disabled services agencies, health care providers and for-profit senior housing and service companies. While a major focus of the group is senior citizens, their mission also encompasses people aged 55 and over with age-related illnesses, as well as the disabled.

The collaborative members are on the frontlines, watching as some of the county’s most fragile residents teeter on the edge of homelessness or are squeezed out of their homes and onto the streets. It was not a surprise to them when the results of Monterey County’s 2017 homeless point-in-time census were announced in June, showing that homelessness has increased by 23 percent since 2015. And unlike the public perception that the rise is from outsiders coming into the area, the data shows most of the homeless are long-time residents.

No wonder, in a county where more than 50 percent of those employed — mostly in agriculture and hospitality, and mostly Hispanic workers — make $25,000 or less, but the average income needed to afford just a one-bedroom apartment is $45,320. For the elderly and disabled, government benefits do not begin to cover the costs of living in the county. The average monthly social security income benefit is only $891 a month, but average fair market rent for a one-bedroom apartment is $1,133.

Sensing the crisis will only continue to intensify for the most fragile members of the community, the HOME Collaborative is now putting it’s organizing efforts behind a new effort, housing as health care. The goal is to convince health care organizations, government agencies and community leaders to direct health care dollars into creating new affordable housing opportunities in Monterey County. The group is relying on successful models already at work in cities like San Francisco, where data shows that providing supportive housing results in dramatic decreases in health care costs per person.

This solution is not without tremendous challenges, however. As one city council member said at an economic forum in Monterey recently, it’s hard to take steps toward providing more housing “when a thousand people are screaming at you.” The force of NIMBYism is very strong in Monterey County. Efforts to create homeless services are often met with intense opposition, which leads to leaders doing nothing to create lasting change. Affordable housing projects are often protested by residents based on fears they would bring a negative element to existing communities, while environmental groups challenge new building on the basis of possible degradation and impact to the county’s endangered sources of freshwater.

My project is to explain the concept of housing as health care to the community and push the conversation away from the usual knee-jerk reactions of detractors and toward a more productive public discussion of this potential solution for at-risk people. I intend to explore both the data and the human stories behind why housing as health care works and could be a good idea for Monterey County. I plan on laying out a case for how ultimately it could result in a significant health care cost savings for the county, and keep at-risk residents off the streets.

In addition, I will explore challenges to housing in the Monterey Bay community, such as  short-term vacation rentals, and how they are changing the face of available housing in seaside areas. Other issues include a state order to cut back on overpumping the Monterey Peninsula water supply by 70 percent, with limits on new water hookups, and serious land-use concerns about converting agricultural and recreational land to housing.

I’ll be interviewing members of HOME, governmental leaders, health care agencies and leaders of model programs in other cities like San Francisco, among others to research a series of stories on the topic. To further push the public dialogue, we will host town halls with community leaders, to provide a platform for people to learn more and share their housing challenges and concerns.

[Photo by Presidio of Monterey via Flickr.]