Many people who come to live in Alaska value their independence and have adventuresome spirits, but for a variety of reasons, some find themselves without a home.
"Anchorage is a transient city. People come and go for work opportunities or adventure. Alaska has also been known to be a boom or bust state," said Cynthia Libby, the president and chief philanthropy officer of Providence Alaska Foundation, based in Anchorage. "If something significant in life happens to someone who doesn't have an established local support network, our community depth of resources to help them through is limited. Especially for seniors."
To assist that population, Providence Alaska and community partners in July opened Q'et'en Qenq'a–Providence House, a supportive housing and recuperative care facility in Anchorage for people ages 55 and older experiencing homelessness.
As of the end of August, 10 residents had moved in, and 90 people had applied to live there.
The facility includes 45 supportive housing units, six recuperative care units, and wraparound services on-site provided by the Southcentral Foundation, a tribal organization that specializes in offering health and other services to the native community, and other agencies.
Q'et'en Qenq'a (pronounced cut-un kunk-ah), means "Elder's House" in the Dena'ina language. The Dena'ina people are one of many native populations of Alaska.
Tim Zaricznyj, the executive director of supportive housing at Providence St. Joseph Health, said Q'et'en Qenq'a, built with $17.5 million in private and public funding, is the system's 19th such project and its first in Alaska.
"It's always been out there as an opportunity," he said. "But Alaska, for any number of different reasons — distance, or geography — it was always going to be a heavy lift. So that's an extra reason for us to celebrate."
Good partners and timing
Leaders in Anchorage asked Providence about partnering, Zaricznyj said. "The community came knocking on our door," he recalled. "They said, we have philanthropic interest. We have a development consultant. We have land. We have health care expertise. But what we really need is an affordable housing owner-operator. That's what I do."
Libby added: "This story is an example of many partnerships coming together to make this much-needed community project happen." She singled out the Cook Inlet Housing Authority as a key partner.
The conversation about the project started before the pandemic, and during that time, the Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act, released millions of federal dollars for affordable housing, in part because people experiencing homelessness or who were at risk of getting COVID-19 needed space for isolation or quarantine, Zaricznyj said.
At the same time, Providence Alaska's community health needs assessment for the Anchorage area, an Affordable Care Act requirement for health systems, identified housing as a need.
"Housing as a social determinant of health began gaining traction, exposure and interest across health care," Zaricznyj said.
Hospitals don't want to discharge people experiencing homelessness onto the streets, especially during the winter months when temperatures are below zero or in the teens in Alaska. Often, people with nowhere else to go occupy acute care beds when they don't need acute care, Zaricznyj said.
Complicated circumstances
The people in need of post-acute housing are often "medically complex," with chronic physical conditions that can include mental health and social challenges.
Demographics studies show the 55+ population in Alaska is growing, said Libby. "In previous generations, when someone who came to Alaska at some point in their life reaches an age or experiences a health issue that requires more help, they may have returned to their home communities in another state," she said. "Alaska has now been a state for enough decades that generations of people who were born and raised in Alaska want to stay here in their elder years."
She added: "I think that's contributing to the growth of this senior and elder population. And yet, we don't have all of the pieces in place structurally, with supportive care or housing. ... we're several steps behind what's needed."
Zaricznyj said a director of a women's shelter in Anchorage told him she is seeing a growing number of widows who "did everything right. They did everything they were told to do. At this stage, without their husband's income, and with the expense of a home, and relying solely on a Social Security benefit, they simply can't make it anymore and they wake up one morning finding themselves in a women's shelter in downtown Anchorage."
The first group of applications for Q'et'en Qenq'a–Providence House came from this shelter, he said.
'Warm and welcoming'
All the apartments are open floor plan studios with kitchens and private bathrooms. Each is furnished with a bed, chair and small table. Residents are encouraged, but not required, to access free services provided by the Southcentral Foundation, which has offices on-site.
Southcentral Foundation provides individual case management, connections to mental and behavioral health services, care coordination, help in accessing benefits, community support and primary care. Residents also have access to social activities and help with skills like laundry, keeping up an apartment, money management, and getting along with neighbors.
At the same time, case and care managers who work on-site as well as other care providers can keep an eye on the residents, recognize changes in symptoms and get those changes addressed. Security is present at the site overnight.
"Our goal is to move folks in and give them everything they need to become stable in that place and to age in place, and to do so as independently as possible," Zaricznyj said. "Basic support needs to be provided to live successfully indoors."
The apartments are state subsidized, and residents contribute 30% of their income toward their rent. Zaricznyj emphasized that these are not licensed beds but apartments, and tenants who achieve stability might choose to move elsewhere.
"Once people find space from the trauma of living on the street, they begin to aspire to a better life," he said. "Having said that, some of our residents are so complex, they're going to need those wraparound supports for the rest of their lives."
During the opening celebration in July, native dancers and musicians performed. Libby recalled admiring a local design firm's work in the lobby — an image of a rope winding along the walls, signifying strength and ties to the community.
As Zaricznyj guided tours of the building, he consistently heard the comment, "It's so homey."
"Maybe with the Providence brand, people came in thinking it would be a little clinical, and what people got instead was ... it was warm and welcoming and homey," he said. "And that makes me feel good. I feel like we did our jobs. If the building itself is welcoming and homey, we did well."