When Amy Baker moved to Oregon’s north coast to take the helm of Clatsop Behavioral Healthcare, she spent about six months bouncing from vacation rental to vacation rental, unable to find permanent housing, she told The Lund Report. That was in 2016, and now, she said, the housing crunch is “infinitely worse.”
Anna Bovee, an advanced registered nurse practitioner from Washington state, can vouch for how bad it is now. Finding a place to live was “almost impossible” in June when Providence Health & Services hired her to work at its walk-in clinic in Seaside, she said.
Baker and Bovee found places to live, but many new hires are not so lucky, and it’s posing a big challenge to health care providers in areas of the state where housing isn’t just unaffordable — it’s unavailable.
On the north coast, it means many employees commute long distances each day. Baker has colleagues who drive in from as far as Forest Grove and Longview, Washington. She said her organization has begun helping people who already have housing in the community to become behavioral health care workers — that’s because it can be easier than finding a place to live for someone who’s already licensed.
Farther south, Lincoln County Commissioner Claire Hall said local behavioral health care providers there are operating with about 40% of their staff positions vacant.
“Again, and again, I hear that price and availability of housing is the number one barrier for recruitment,” she said.
It’s not a new problem in her community. Hall remembers about five years ago when Lincoln County couldn’t retain a mental health supervisor due to the housing shortage in Newport.
The problem hurts coastal residents’ access to health care, said Mimi Haley, executive director of Columbia Pacific CCO, which operates in Clatsop, Columbia and Tillamook counties.
“If you’re a new patient, to get primary care, you could wait six to eight months to get seen,” she said.
Now, the situation has prompted one coastal provider to take the initiative to create housing for its employees and other health care workers in the region.
On March 8, CareOregon, the Portland-based nonprofit, announced it bought a Red Lion Inn & Suites for $8 million in Seaside, where it operates a regional insurer, Columbia Pacific, that is contracted by the state to serve Oregon Health Plan members as a coordinated care organization. It plans to convert the hotel’s two wings into housing that supports care. One wing will contain 20 units of supported housing for people with behavioral health needs, and the other wing will contain 35 apartments reserved for people working in the health care sector in Clatsop County — whether they are doctors, nurses, cooks or custodians.
The apartments will rent on the “modest side” of market rate for health care workers, said Leslie Ford, Columbia Pacific’s housing strategy and development advisor.
This will fill a critical need for the two area hospitals, as well as other providers. Haley said her organization works with two dental groups that “cannot keep their offices fully open, because they can’t recruit providers to staff them appropriately.”
“When we interview new candidates, the first thing they are concerned about is finding a place to live,” Pam Cooper, director of finance at Providence Seaside Hospital told The Lund Report. “With the number of AirBNB, Vacasa, and other vacation rentals, the available number of long term rentals is extremely limited and often rented via word of mouth and not found online.”
The problem runs statewide, and the Red Lion purchase is not the first time employers in Oregon’s health care sector have supplied workforce housing.
In November, Albertina Kerr filled the last unoccupied unit of its new 150-unit complex in Gresham, which was built to house both its caregivers and some of the adults with developmental disabilities that they serve.
And following the 2020 wildfires in southern Oregon, Providence’s foundation purchased 15 RVs to house displaced caregivers in Medford and Central Point, Providence spokesperson Mike Antrim told The Lund Report. He said it was in response to an emergency and not a long-term workforce housing strategy.
Leveraging Medicaid for housing
The federal Medicaid health care program is increasingly allowing states — including Oregon with its program renewal last September — to use federal funds for housing support for low-income health consumers. Research shows there’s a health benefit when patients have a roof over their head, explained Nora Leibowitz, CareOregon’s chief strategy officer.
That research includes a 2021 study by Providence’s Center for Outcomes Research and Education that studied Medicaid recipients who were discharged from Hooper, a Portland drug withdrawal management facility, and then received recovery housing from Blackburn Center or another provider within four days. The study found housing resulted in lower health care costs, fewer emergency room visits, and those who were housed increased their use of primary care by about three visits annually.
However, there’s less evidence around the health benefits to a community when those who care for the community, the health care workforce, can easily access housing. That’s something CareOregon hopes to change as it works with Providence to study the impacts of its housing project in Seaside, Leibowitz said. The research could build the case for even more flexibility in spending Medicaid funds.
“If you can’t attract providers to your community, you’re going to have an access problem, and we certainly see that on the ground,” Leibowitz said, but “there isn’t research.”
Health systems elsewhere in the U.S. are getting creative in funding workforce housing, too. Martha’s Vineyard Hospital purchased 26 acres in 2021 to house elderly patients with skilled nursing care as well as employees. And in North Carolina, Atrium Health financed $5 million of a 341-unit housing project in exchange for 50 units being reserved for Atrium workers in need of assistance.
Housing can come with outpatient services
The new housing project in Seaside will help to plug another gap: the lack of residential behavioral health care and treatment options.
Clatsop County had the highest rate of homelessness in Oregon in 2019.
Baker said her organization, Clatsop Behavioral Health, has the goal of adding 80 units of housing that are coupled with behavioral health services. It will partner with Columbia Pacific to operate the former- Red Lion building and has an application in with the state for another 30 units in Astoria.
Because of the housing crisis and the increased potency of meth and fentanyl, Baker said, “helping people get their lives back … has become harder.”