The Lowry Project: Health and Housing in North Minneapolis

Neighborhood HealthSource, a community clinic in North Minneapolis, would like to pursue developing a health and housing multi-use facility on Lowry Avenue North and is requesting support for the project.

Having spent over fifty years working with our neighbors as they try to thrive while confronted with the negative impact of disparate access to essential tools for health( (social determinants health), NHS would like to use this moment in time- when housing need is high, the Fremont Clinic needs a new building, and residents want positive development on a key corridor, to create a Health and Housing project in North Minneapolis.

Project Overview

The Lowry Living Project will be a multi-use building with a full primary care clinic (Neighborhood HealthSource) and five levels (possibly four or six) of apartments with permanent supportive housing. Our target population for the housing is people living with HIV/AIDS or another disability. The site we would like is on Lowry Ave N and Colfax Ave N and is currently owned by Hennepin County. We have not decided on the number of units as it depends on if we serve families or single adults. The PSH partner would determine this. We know the community needs multi-bedroom apartments, but we also know that there are also hundreds of singles on waitlists. If there is space and funding is available, we could have retail or childcare space on the lower level.

Based on conversations with different PSH service providers and looking at the space on the site. We’d like to do at least 50% PSH with a preference for 100% PSH. The size of the units is unknown but a similar project by one of the possible partners had 24 single units (studio) and six three-bedroom apartments. We do not have a specific PSH% determined because we have not selected the PSH provider

Project Team

Neighborhood HealthSource (NHS) proposes a new mixed-use building on Lowry Avenue N. The facility will house a federally qualified health center (NHS) and supportive housing units with both single and family units. NHS provides primary care and behavioral health services to uninsured and low-income patients. The housing partner will provide supportive housing to low-income families and individuals. The vision is for a partnership between health and housing, recognizing the growing understanding that stable housing is necessary for good health. While NHS will be available to provide clinical, behavioral, and educational health to residents, housing residents will not be obligated to use NHS services.

North Minneapolis is a designated medical shortage area. In the Twin Cities, in 2019, the rate of uninsured people of color was more than 2-1/2 times greater than the rate among whites (6.9% vs. 3.0%). (MN Health Access Survey). Hispanics have the highest uninsured rate because of documentation status. In NHS’ patient population, 26.5% were uninsured in 2020. The Fremont Clinic, the focus of this proposal, serves a higher number of African and African American patients than our other three clinics.

Need

Families and individuals living in North Minneapolis need housing and affordable, accessible health care. Although the neighborhoods have some of the lower rents in the city,[1] the rent costs are still prohibitively high. Between 2000 and 2019, “the median renter income in Minnesota increased by just one percent, while the median gross rent for the state increased by 14 percent.[2]” The disparities faced by African Americans in Minnesota are demonstrated in both health and housing. 58 percent of African American renters are cost-burdened; 44 percent of white renters are cost-burdened.[3]

While new construction is evident up and down Broadway Avenue, the most recognizable corridor in North Minneapolis, Lowry Avenue is not receiving a similar amount of development and investment. There remain shells of burned down buildings and abandoned lots.

Increasing access to quality preventive and primary care, and behavioral health services, is necessary to address the severe health disparities faced by North Minneapolis residents. According to the Minnesota Primary Care Association, the current (November 2017) low-income population to provider ratio is 8,051:1 for the North Minneapolis service area. Although the uninsured rate fell from 8.2% of the population to about 4.9% with the implementation of the Affordable Care Act (State Health Access Data Assistance Center), it has been rising since then. According to the Minnesota Department of Health, as of July 2020, the uninsured rate is 4.6% in Minnesota. In 2019, the American community survey reported that 6.6% of 19 years and up and 3.4% of individuals 19 and below are uninsured in Minneapolis. Despite this significant drop in the uninsured rate, the picture varies when parsed among different races/ethnicities.

“While the overall un-insurance rate for Minnesota has declined across virtually all demographic categories, significant disparities in health insurance coverage persist in the state, especially by race, ethnicity, age, and income.” (Minnesota Health Access Survey, MN Dept. Health, 2015).  In the Twin Cities, in 2019, the rate of uninsured people of color was more than 2-1/2 times greater than the rate among whites (6.9% vs. 3.0%). (MN Health Access Survey). Hispanics have the highest uninsured rate because of documentation status. In NHS’ patient population, 26.5% were uninsured in 2020.

Model

Mercy Housing and The Low-Income Investment Fund for The California Endowment put out a report on the Health and Housing model in 2017, stating that case studies <of health and housing collaborative models> show there is “significant opportunity to produce tangible results that improve the lives of homeless people, people living with poverty, and people living in institutions.” Nationally, the Health Resources and Services Administration (HRSA) has been supporting the development of mixed use projects that include Federally Qualified Health Centers (like Neighborhood HealthSource -Fremont Clinic) and affordable or permanent supportive housing providers.

The Fremont Clinic serves a high-need, disparately unwell and disparately uninsured population of families and individuals in North Minneapolis. We offer walk-in services, same day appointments, a full lab, MNsure navigation, and a sliding scale. We partner with the State to provide free cancer screening and family planning services. We are a necessary partner in North Minneapolis and are dedicated to staying in the neighborhood. We believe that a new facility in a higher-traffic area, like on Lowry Ave, will increase our visibility in the community, drive patients to the clinic, and increase our sustainability.

We are looking for a Permanent Supportive Housing provider who has a strong operating budget that can take in additional units without concern about sustaining the budget. NHS has reached out to several local nonprofit housing providers to gauge interest in this project including People for Pride in Living, Aeon, Haven Housing, Beacon, Catholic Charities, and Clare Housing. The most likely partner, we are moving forward but have not yet signed a formal agreement, is Clare Housing. Clare is a self-developer and provides permanent supportive housing for people living with HIV. NHS has specific strengths in serving people living with HIV and with chronic illnesses, but we are open to serving any type of disability.

We have over fifty years of experience working with people experiencing homelessness and people with extremely low incomes. Our clinics in North and Northeast Minneapolis serve a population that is about 80% low-income and overall, 24% are both low-income and not on public assistance for health insurance due to system barriers. Our medical providers and clinical staff regularly treat people with disabilities and people living in deep poverty. We have a large Community Health Team that serves low-income households through education, clinic services in community locations, outreach, and navigation. We have a team of four people who work specifically to connect people experiencing homelessness with resources, especially primary care and treatment for chemical dependency. Patients with chronic conditions are often assisted by a community health worker or a care coordinator to navigate the systems that provide them with financial or other supports. In 2022, with our Coon Rapids clinic, we provided medical care to approximately 6,150 low- or no-income people. Our partnerships for this project will include a property manager, housing owner, and PSH provider who are all dedicated and experienced with serving people with disabilities experiencing homelessness. We expect they will drive the different amenities in the housing side of the development. On the clinical side, we offer nursing, same day appointments, and integrated primary and behavioral health care. We have a full time Suboxone nurse who supports patients engaged in treatment for opioid use disorder.

Contacts

Steven J. Knutson, Executive Director, Sknutson@neighborhoodhealthsource.org, 612-287-2428

Tessa Wetjen, Director of Community Health and Fund Development, twetjen@neighborhoodhealthsource.org, 612-875-7749

Sources

[1] Minneapolis Public Housing market research, 2022.

[2] Statistics from Minnesota Housing Partnership, accessed 10/22.

[3] Statistics from Minnesota Housing Partnership, accessed 10/22