The healthcare organization CareOregon has purchased a former Red Lion Hotel in Seaside, Oregon, with the goal of turning it into both workforce housing and permanent supportive housing for people with behavioral health needs. CareOregon’s Columbia Pacific CCO will run the building and provide mental health and addiction treatment support. Two-thirds of the building will house healthcare workers. Mimi Haley, executive director of Columbia Pacific CCO, and Amy Baker, executive director of Clatsop Behavioral Health, join us with the details of the project.
Note: This transcript was computer generated and edited by a volunteer.
Dave Miller: From the Gert Boyle studio at OPB, this is Think Out Loud. I’m Dave Miller. Oregon’s largest Medicaid provider made a big announcement yesterday. CareOregon has purchased an old Red Lion Inn in Seaside for $8 million. In the coming years, the hotel will be turned into housing for two different populations. There will be units for people with behavioral health needs and workforce housing for healthcare professionals. CareOregon’s Columbia Pacific CCO will run the building in partnership with Clatsop Behavioral Health. Mimi Haley is the executive director of that CCO. Amy Baker is executive director of Clatsop Behavioral Health. They both join me now. It’s great to have both of you on Think Out Loud.
Mimi Haley: Thanks, Dave.
Amy Baker: Thanks, Dave.
Miller: So Mimi Haley first, the whole point of CCOs in Oregon - at least this is my short version, you can tell me if this is how you describe it too - is to consolidate all different kinds of health care providers so that Medicaid dollars can be used efficiently and effectively to keep Oregonians healthy, Oregonians who are on the Oregon Health Plan. How does housing fit into that?
Haley: Well, thank you. That’s a very good description and we are also required to work at the behest of our communities and our communities’ priorities really dictate where we spend our time in terms of health improvement. Housing is health. There’s no question about that and the shortage of housing on the north coast is acute. So being able to solve the housing shortage issue by adding these 50 or 60 new apartments is a big deal, both for our partners like Amy, and for our members who will be able to receive supportive housing services.
Miller: You said that housing is health, there’s no doubt about that. What exactly do you mean?
Haley: People who are unhoused have much higher rates of hospitalizations, for situations that could have been handled in primary care. They have much lower rates of engagement with the primary care system. They will often pass away at a much younger age, and they often have mental illnesses or substance use disorders that can be really addressed with stable housing.
Miller: Can you explain the basics of this arrangement and who’s going to do what?
Haley: Yes. CareOregon owns the building. CareOregon is my CCO’s parent company and I would not have been able to do this without them, let’s be clear…
Miller: When you say this, you didn’t have $8 million to spend to buy an old hotel?
Haley: No, I did not have $8 million to buy an old hotel. That’s exactly right, Dave. But my organization will be the one that works with Amy’s organization and that works with Clatsop Community Action, which will actually do the facility management, making sure that the units are occupied and the rent is paid and those kinds of things. So we’ll be taking the responsibility to manage this asset that belongs to CareOregon.
Miller: Amy Baker, can you give us a sense for the target population for the permanent supportive housing units? I think it makes sense to break these up into the two different sections of housing. Who are you expecting to stay in the permanent supportive housing side?
Baker: Thanks, Dave. That’s a great question. Clatsop County has a really high homelessness rate. We’re actually almost six times the state’s average and we have somewhere around 200 chronically homeless folks. And a lot of the folks that we work with who either have serious mental health issues or severe addictions end up living on the street in Clatsop County. And so this housing is really designed for folks who are going to need extra support in order to be stable in their housing. And just a really obvious and basic point, like we can’t help people heal if they don’t have a safe place to sleep at night. But being housing insecure, either you’re on the verge of homelessness or you are homeless, forces you to live in that lizard part of your brain, the amygdala, and you can’t access treatment, you can’t do any kind of healing unless you’re able to tap into your prefrontal cortex.
So basically, and we had this conversation with CP CCO all along, that we can’t do our job unless we are able to find housing for folks who really need it. So not everybody will need this housing, just people who need extra support.
Miller: What are the supports that are embedded in that phrase, supportive housing?
Baker: That’s always a mystery, isn’t it? The services that we’re gonna provide. Well, first of all, let me just say, like meeting other people around you to talk to when you’re having a rough day does not make you weak, it makes you human. And so we’re intending to hire folks who have lived experience, people who have been there, who will staff the project at least 16 hours a day, seven days a week. And what we would foresee happening is if there’s little issues that come up, potential disagreements, if we’re worried that somebody may be spending too much time alone in their room, that we have staff on site who can check in with the residents and just to make sure everything’s going okay.
We’re also intending on having a living resident manager who’s there 24/7 for the same reason. We want to be good neighbors and we want to make sure that the folks who are living there are well supported. If they have mental health needs outside of that, like, whether they need substance use treatment, they will have access to Classic Behavior Healthcare’s full range of services including prescriptions for Suboxone, supported employment, psychiatry, recovery support groups, any kind of service that’s going to meet their specific and individual need.
Miller: Is your thinking that the people who stay in these units will be there for years, will be there indefinitely, or is it your hope that this will be a springboard to some other version, maybe a version of less supported, less locally supported housing?
Baker: I think it really depends on the person. Some folks, absolutely, this will be a transitional stepping stone and they’ll move on to independent living. Other folks who have more debilitating mental health issues may need ongoing support in order to live in the community and those folks will be absolutely welcome to stay as long as they want. We want to serve both those populations. But what we don’t want to do is set arbitrary timelines that we’re pushing people out the door.
Miller: Mimi Haley, with a global look at the patients you serve, the Oregon Health Plan recipients in these coastal counties, how will you know that this hotel is working?
Haley: Well, I think there are two populations, Dave: the population that Amy was just describing, those with support housing needs, and we will see them engage in services. When they are housed and they’re able to access the kinds of supports that Amy mentioned, as well as primary care services, that we will be watching and paying attention and we should see increased engagement with primary care services and behavioral health services, with Amy’s organization. And we should see decreases in unnecessary hospitalizations, unmanaged chronic disease and those kinds of things.
Now, with the second half, the other population, the other two thirds of the units that are gonna be apartments for healthcare providers, it’s kind of a new idea, it’s not unique, but it’s new enough that what we want to be looking at are occupancy rates, we want to look at the ability for our clinical partners to recruit providers. We want to be able to see their ability to retain providers. So turnover should be less. And we are also going to work to evaluate in some ways, a little bit more formally, any other kinds of outcomes that we will see by providing housing for the workforce.
Miller: So let’s turn to the other two thirds or so of this project. Sticking with you, Mimi Haley, can you give us a sense for what you’ve heard from your various providers about the challenges they faced specifically because of housing for their staff?
Haley: Oh, yes. And when I’ve finished speaking, Amy can give you direct experience from her own organization’s perspective. But, for example, we invested in an opioid treatment program in Seaside several years ago, it opened its doors just before the public health emergency was declared. So the census wasn’t as robust as we anticipated it would be, as people declined to get services anywhere, for obvious reasons. They almost had to shut their doors because they could not recruit a clinic manager, because there was no place for somebody to live. And that’s a serious issue. That’s a very serious problem.
Miller: Are we talking about housing affordability for that prospective hire or the availability of any units?
Haley: It’s both, Dave, and that’s an astute question. It is both the availability and the affordability. Now, our workforce housing will be market rate. But, we know from our partners that they cannot recruit the providers that they need. They can’t. They have to find Airbnbs for people who are on call, who have to be able to respond within 30 minutes of being called into work. We had a dental partner that built a brand new dental clinic in Seaside and was not able to keep it open for more than four hours a week because they could not find housing for dentists, for dental hygienists or for other staff who would staff that clinic. So we hear it all the time from all of our partners, across all provider levels and types.
Miller: Amy Baker, you are one of those providers at Classic Behavioral Health. What has the shortage of workforce housing meant for you and your staff?
Baker: So we have definitely experienced that with our organization. Generally speaking, when we go to hire new staff from out of area, there’s about a 50% chance they’ll take the job. If they do take the job, there’s like a 50% chance that they’ll show up. And if they do make it that far, then there’s a 50% chance that they’ll continue to stay here because the cost of housing is so expensive out here.
We’ve lost many good staff because of the house prices. We actually rented a cottage so that we could relocate folks into that cottage while they tried to find more permanent housing. Unfortunately, that one cottage isn’t even nearly enough. We just lost a really gifted residential counselor, really good with the clients. She split up with her partner and was not able to find housing for just her in this community. And so she had to leave. The Red Lion project would have absolutely been an assistance with that situation.
Miller: How does the lack of housing you’re talking about directly impact the care you can provide?
Baker: Well, it affects the care across all levels. It’s the care of our staff. Good care starts with employees who are well taken care of. And then what we see in terms of homelessness is really the tip of the iceberg because if you’re not homeless, for a lot of the folks who are on Medicaid, they’re like one step away from that, their one car accident, their one anything and it’s hard to have a sense of well being or that you have any kind of security when you’re living with that, with that kind of fear that sort of permeates the life of folks who are living on the edge.
Miller: Amy Baker, will this be the case that social workers or case workers or people who are helping to take care of and to provide the supports you were talking about earlier, in terms of the behavioral health needs, might they be living right next door to or in the same old hotel development as the people that they are helping?
Baker: Yeah, absolutely. That will be an interesting phenomena. The hotel itself is set up very nicely for this project. There’s an old part of the hotel and a new part of the hotel. And so the two parts are pretty separate. But yeah, definitely, helping the employees set boundaries so that they’re literally not taking their work home with them, will be an interesting dilemma that we’ll have to deal with once we open. But I think that the piece that gives me hope and faith is that you go into this work because you care about people and ultimately like having a place for somebody to live, it’s just a good thing. And this project is super creative. It’s exactly the kind of solution that we need to address this problem. I think that CareOregon is doing what was originally envisioned for the whole CCO model and that is investing in the health of local communities. And I really think other CCOs should take note.
Miller: Is there an example of this kind of set up in Oregon or somewhere else that you can look to for guidance here? I mean, specifically a place where behavioral health clients or patients and their caregivers are essentially living under the same roof? As you note, it seems like it’s a challenge and I’m wondering if there is existing experience you can rely on or if you’re just gonna have to figure this out yourselves as you go?
Haley: Dave, we did talk to Albertina Kerr in the Portland area and theirs is a much larger endeavor. It’s probably twice the size of what we’re doing in Seaside. But they have broken ground on putting workforce and clients in the same facility. And so we have conferred with them and we’re going to continue to confer with them and share ideas and brainstorm solutions to things that arise. And hopefully to Amy’s point, we’ll have others who are doing the same kind of work, so that we can create a learning collaborative, if you will, for these kinds of projects.
Miller: Mimi Haley, last year, about a year ago, we talked about a proposal in Astoria that would have put in 33 units of permanent supportive housing in addition to 64 workforce housing units, not specifically health care, but workforce more broadly. It was killed because of both economic reasons and as we heard from the Mayor, NIMBY reasons, people saying “I don’t want these people next to me downtown.” This project, that in some respects really does seem similar and it’s just 15 miles or so south on Highway 101, why is this one going forward?
Haley: I think a couple of reasons and Amy will have some good insights into this as well. One, that project was in the middle of the commercial district of Astoria, that relies heavily on tourism traffic. And there was some concern about how that facility in that location might affect the economy. In our situation, we are off the beaten track. We are not in the heart of Seaside, we’re south and we’re not on the beach. And there are already supportive housing units in the neighborhood. And also I think the Seaside City Council and the Planning Commission understand the dire need for these kinds of projects. So we just have not had any concerns addressed. At the conditional use permit hearing, we did have a couple of neighbors who expressed some concerns and we also had a couple of neighbors who told us they were thrilled that this kind of a project with apartments would be much quieter and more stable than a motel with people coming and going all of the time. And we will be a good neighbor. So that is who we are. It’s what we do and, and we will take into account any issues that might arise from this kind of facility.
Miller: Amy Baker, what is the planned time frame right now? How long before these units are occupied?
Baker: I actually think that might be a better question for Mimi since they have to go through the design process to get the building ready for occupancy.
Miller: Mimi, what’s the likely time frame?
Haley: Yeah, thank you for asking that question. Now that CareOregon has acquired this building, we are entering into the next phase which is to hire a contractor to go through a design/build process. And we would anticipate having a finished building ready for occupancy by spring of 2024. Now that, of course, is subject to supply chain issues and the ability to retain a contractor who can work on schedule and on budget and those kinds of things. But we are hoping to have the building occupied in a little bit more than a year from now.
Miller: All the retrofits to go from a hotel to apartments in just a year?
Haley: It’s not that hard to imagine if you think about it. First of all, several of the rooms in this particular facility are quite large, larger than a studio apartment and we will also be converting some of the units into one bedroom apartments. And that’s why the conditional use permit process went pretty quickly, really you’re rehabbing these to include kitchenettes, but they already have a bathroom, they already have a living space, they already have internet. And so really what you’re doing is you’re converting the use from transient moteling into apartment dwelling and it’s not that big a stretch.
Miller: Mimi Haley and Amy Baker, thanks very much.
Baker: Thank you.
Haley: Thank you, Dave.
Miller: Mimi Haley is the executive director of the Columbia Pacific CCO Coordinated Care Organization. Amy Baker is executive director of Clatsop Behavioral Health. They joined us to talk about the announcement yesterday from CareOregon, the partner organization for Columbia Pacific CCO that it bought an old Red Lion Inn in Seaside to turn it into workforce housing and supportive housing for patients with behavioral health needs.
Contact “Think Out Loud®”
If you’d like to comment on any of the topics in this show, or suggest a topic of your own, please get in touch with us on Facebook or Twitter, send an email to email@example.com, or you can leave a voicemail for us at 503-293-1983. The call-in phone number during the noon hour is 888-665-5865.