By BETSY TAYLOR

Mercy Care and Mercy Housing, two organizations rooted in the ministry of the Sisters of Mercy, have developed affordable housing and a full-service health care clinic on the same campus in the Atlanta suburb of Chamblee, Ga.

"In this particular development, we saw the colocation of housing and health care as a way to remove barriers our residents have to quality health care," said James Alexander, president of Mercy Housing Southeast.

The nonprofit Mercy Housing, based in Denver, manages more than 22,000 units at 325 properties. In 2018, the median annual income of its residents was less than $16,000 at its properties in the Southeast. Mercy Care is an Atlanta-based federally qualified health center, which has 11 locations in the region. Saint Joseph's Health System, parent of Mercy Care, is a member of Trinity Health.

Blanca Ledesma, a retired school custodian, shows off her apartment at the Senior Residences at Mercy Park. Photo courtesy of Mercy Care

It's early to say if colocating housing and health care will improve quality of life or health outcomes in Chamblee, but the organizations that developed the new Mercy Park campus believe that providing safe, affordable housing, as well as ready access to preventive care, will yield favorable results.

The Mercy Care clinic on the 4-acre Mercy Park property opened in April of 2017. The Senior Residences at Mercy Park began accepting tenants this spring. The 79 apartments are for seniors age 62 or older earning at or below 30 percent to 60 percent of the area's median income. Residents include some veterans and seniors with disabilities. Their rents range from about $550 to $780 a month, based on their income and whether they have a one- or two-bedroom apartment.

One resident, 73-year-old Blanca Ledesma, a retired high school custodian, said the complex is peaceful and she appreciates that she can walk next door for doctors' appointments and a class on healthy habits. A Spanish speaker, she said through an interpreter that having the clinic as well as stores within walking distance allows her to maintain her independence and not have to ask for favors, like rides to the doctor's office. The housing is also near public transportation.

From the ground up
About five or six years ago, Mercy Care reached capacity at its 5,000-square-foot clinic in Chamblee, a community of about 9,800 residents about 14 miles from downtown Atlanta. Mercy Care, with federal Health Care for the Homeless funding, provided health care to many homeless people in the region, as well as to low-income populations, including many Hispanic residents around Chamblee. When Mercy Care leadership began planning for a new clinic, they wanted it to offer much more than basic health care, to take a comprehensive approach to providing care and promoting health.

A stairwell at Mercy Care Chamblee.
Photo courtesy of Mercy Care

A community health needs assessment identified the need for improved health care access for low-income seniors and children in Chamblee. Mercy Care set out to fill those care gaps as it planned for the replacement clinic. Tom Andrews is president and chief executive of Saint Joseph's Health System, the parent company for Mercy Care and its foundation. He said Mercy Care leadership invited Mercy Housing to partner on the property.

"We'd been looking at ways to go down the path of a housing and health development," he said. Both organizations have consistently worked to make sure their clients have stable, secure housing, allowing the clients to then give attention to other needs. For instance, Mercy Care helps many homeless clients into transitional or permanent housing, working with other community partners. And Mercy Housing staff provide support with health navigation services, and some of its residences provide health-related offerings, including chronic disease prevention education, fall prevention and nutritional cooking classes on-site.

Mercy Care launched a capital campaign that raised $16 million from private donors and foundations to build the new clinic. Uninsured patients who can afford it are charged nominal sliding scale fees for care at the clinic. The clinic relies on contributions from private donors to offset an operating deficit related to charity care.

Health care by design
The 45,000 square foot clinic has four health care hubs, two for adults and two for pediatrics. Each hub has six exam rooms, one procedural room and two counseling rooms, with providers and support staff using work space at the center of each hub, Andrews explained.

The new clinic's volume is 40 percent greater than at the old location. (Patients moved with the clinic.) Staffing levels stayed about the same, owing to increased efficiencies.

Clinic staff and community organizations offer nutrition, health and wellness classes in the clinic's health education rooms. Topics include ways to reduce diabetes and hypertension risks and combat childhood obesity. Families learn how to make healthy meals. The center also has a fitness room for the roughly 45 staffers on-site and a quiet room for them to relax and decompress. The building houses foundation offices and has about 10,000 square feet set aside for future growth.

Dr. Richard Hansen examines Cleofa Castro, 63, of Atlanta, at Mercy Care Chamblee in Chamblee, Ga. He says having so many resources on site means he can easily link patients to other care providers to meet additional needs.
Photo courtesy of Mercy Care

The clinic offers integrated primary care and behavioral health. It provides dental, vision and diagnostic services. "It really is a one-stop shop for our clients," said Andrews. "Many times our clients are battling all sorts of other challenges in their daily lives. We want to try and do as much for them in one visit as we possibly can."

Dr. Richard Hansen is a long-time volunteer with Mercy Care who now works at Mercy Care Chamblee eight hours a week having retired from full-time practice. He said convenience and proximity matter to clinicians and patients. "I think when a resource is right there, you become much more keyed into the potential."

At Mercy Care Chamblee, if a patient screening shows a need for behavioral health support or nutrition counseling, Hansen refers the patient, often immediately, to a psychiatrist, clinical social worker or nutritionist on-site.

Blanca Ledesma, 73, relaxes in her apartment at the Senior Residences at Mercy Park. She says having the Mercy Care Chamblee clinic and stores within walking distance helps her maintain her independence.

Hansen said the hope is that by improving access to primary care in Chamblee, more patients will be prompted to get preventive care and manage chronic diseases.

Integrating health care
As tenants move in to the Senior Residences at Mercy Park, a resident services coordinator assesses their health needs. The health care clinic and Mercy Housing also are working on an agreement to share information about health care needs for Mercy Park residents who give permission.

Mercy Care is routinely recognized by the federal Health Resources and Services Administration for its excellent health outcomes and management of chronic diseases, though it's too early for extensive data about how colocating housing and health care may improve health of those living and receiving health care there. The two sites don't yet know how many tenants will use the clinic for their health care; a few residents have started. They're considering other collaborations, such as visits by a nurse and a community health worker to the housing complex to conduct health assessments and to check on patients to make sure they're managing chronic illnesses.

Mercy Housing has some experience bringing together its housing with nearby health care. Two of its properties in San Francisco, Mission Creek Senior Community and Presentation Senior Community, are adjacent to adult day health centers. River Station Senior Residences in Kankakee, Ill., is next to AMITA Health's Presence St. Mary's Hospital Kankakee, and the 7th & H Street housing community in Sacramento, Calif., is adjacent to a federally qualified health center.

While Alexander said Mercy Housing tailors its offerings to needs at each of its residences, colocating housing and health care creates a "deeper and more present partnership between housing and health care than you would otherwise find."

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