An unusual program that has placed a social worker and a nurse at Manning Apartments, the housing development for low-income elders and disabled people, has changed residents’ lives in ways that would not be expected in a typical public housing project. Now the Cambridge Housing Authority is looking for money to maintain the services and bring them to other CHA developments.
It’s been a win for Manning residents, who extolled the 4-year-old program in comments submitted with a funding request. (Despite the glowing reviews, the request was unsuccessful.) “It has been a blessing to have you here,” wrote one resident.”Without you we would be really in a mess … You care about us as no one has before.” Another wrote: “You are open-minded, sincere, realistic and honest about how you help us. Invaluable.”And another: “You have had a great effect on people and they are feeling less isolated.” Asked for her opinion of the program, Ethel Delgado, head of the Manning residents’ council, didn’t hesitate before saying: “It’s awesome.” She added: “There are people here who would not be here if not for this program.”
Among the specific cases identified in a memo to the housing authority board: a woman who had concluded she couldn’t meet her needs on her own and had no choice but to move to a nursing home. The nurse and social worker helped the resident get to her doctors’ appointments and obtain medical care that improved her vision, hearing and mobility; they also helped her enroll in a health care program that provided help at home. Their work aided the resident’s “quality of life and ability to manage tremendously” and “she realized she did not have to move to a nursing home and is living happily in her apartment at Manning.”
Manning, whose 19 stories rise above Central Square, is home to 205 households. Many face health, social and economic challenges, not to mention loneliness, experts say. Living in proximity to others like them may actually discourage people from making connections. “Sometimes senior buildings can be more isolating for folks,” said Eileen O’Brien, director and founder of Boston Medical Center’s Living Well at Home program.
That Boston Medical Center program provided the full-time “community health advocate,” a social worker, at Manning. Cambridge Health Alliance contributed the half-time nurse. The intervention may never have happened if staff members at the Cambridge Housing Authority had not heard about Megan Sandel, a Boston Medical Center pediatrician and researcher who advocates for housing-based services.
“Most of my time is research about how housing is connected to health,” Sandel said in a recent interview with Cambridge Day. “For people to be healthy they need to live in a stable, decent affordable home.”
Authority executive director Michael Johnston said authority staffers heard Sandel speak at conferences in 2016 and 2017, and one 2018 interview particularly drew their attention. “Dr. Sandel advocates for placed-based investing – focusing on specific, disinvested neighborhoods and ZIP codes to address health inequities.” Johnston said. In the 2018 interview, she also said that Boston Medical Center had “provided wellness programs to Boston area affordable housing developments such as Codman Square CDC. Cambridge Housing Authority staff was inspired by Dr. Sandel’s presentations and work to reach out to her to meet about the possibility of creating a comparable program in Cambridge,” Johnston said.
Or, as O’Brien said, Cambridge Housing Authority staff heard about the “wellness program” at the Madison Park public housing development in Boston and “they were like, ‘We want that too.’”
That wasn’t the only serendipity in the creation of the Manning program. In 2017, Boston Medical Center wanted to spend significant funds to redesign its campus and needed a “determination of need” approval from the state health department. The hospital, which – like the Cambridge Health Alliance – serves a high percentage of poor and uninsured patients, had to show it was providing community benefits to get the approval, Sandel said.
BMC fulfilled the requirement by promising to invest $6.5 million over five years in affordable housing programs in Boston and surrounding communities, an unusual single focus for a hospital. The wellness program at Madison Park public housing development, which caught the eye of Cambridge Housing Authority staff, was one of those investments.
The discussions between the authority and Boston Medical Center “quickly expanded to include the Cambridge Health Alliance” and the Manning wellness program was started, Johnston said.
It began in March 2020, which meant the nurse and community health advocate couldn’t be at the building initially because of the pandemic, but did give advice to housing authority staff there, O’Brien said. Despite the initial drawback, the two workers, now onsite, have “been able to develop trust” since they are at the building every weekday. “When it comes time to help with problem-solving [the community health worker] is available, whether to help with paperwork or something like hoarding,” O’Brien said.
The housing authority memo said the program team estimates that “in one way or another they have touched all members of the 205 households at Manning.” About 150 households now receive services, with 40 to 50 residents interacting with the team regularly. They get help with tasks such as monitoring their own health, communicating with their doctors and “accessing benefits and services.”
The two workers “spend significant time” helping residents with psychological problems, the memo said. Fifteen to 20 residents “see the team each week for check-ins, assistance navigating the [behavioral health] system and monitoring their treatments and medications,” the staff memo said.
The team also helped with challenges during the pandemic, such as getting tested and vaccinated. “As a result, it is estimated that at least 90 percent of residents at Manning are vaccinated against Covid-19, and participation in the flu vaccination program has more than doubled in the last two seasons,” the memo said.
All significant accomplishments, but funding is a problem. For the first two years, Boston Medical Center paid for the community health advocate, Cambridge Health Alliance for the nurse, and the housing authority provided office space, utilities and information technology services, Johnston at the housing authority said.
When the BMC funding ended, the authority continued the program with federal pandemic funds and extended it with its own money in March – but only until this coming Feb. 28.
The city rejected a request for American Rescue Plan Act funds, and the state’s Community Health and Healthy Aging program turned down a bid that would have provided enough money to continue the program at Manning and extend it to Millers River, another development for seniors and disabled tenants, Johnston said.
“Despite these setbacks, staff continue to work to identify and pursue other funding avenues,” he said.
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