CalOptima Health, Orange County’s publicly funded health insurance provider, is investing approximately $49 million to establish the Community Living Center of Tustin to address challenges facing one of the county’s most vulnerable populations, people who suffering from homelessness and aging.
From 2017 to 2021, the number of people ages 55 and older who used homeless services in Orange County increased by about 89%, according to the state’s Homeless Data Integration System. They are part of a growing “silver tsunami” of older adults becoming homeless for the first time in their 50s.
“A lot of this has to do with the financial crisis of 2008. The early baby boomers had good jobs and pensions and things like that, but the baby boomers towards the end of this generation often had lower-paying jobs with no pensions…They were a lot more financially vulnerable,” said Kelly Bruno-Nelson, executive director of Medi-Cal/CalAIM at CalOptima, and added that with the onset of the housing crisis, many of these people were pushed into the booming rental market. “So it meant a spouse died or lost a job and became homeless.”
Some struggling with homelessness use walkers or are in wheelchairs, or have cognitive problems. They may need help with bathing or other daily needs. Because of this, it’s difficult to figure out where to go, Bruno-Nelson said.
“You can’t go to a shelter because the shelters often have bunk beds and the services are very far away. These people are in wheelchairs, but the corridors are not wide enough. You are incontinent and can’t wait to go to the bathroom. There is no grooming. You can’t move around in a traditional shelter,” said Bruno-Nelson. “Recreational care is limited in time and does not require a permit. Because of this, they cannot help with bathing or dressing. You cannot administer medication. So it’s really not that much better.”
These deficiencies leave this population group with two options: to enter a nursing home early if possible, or to live on the streets. CalOptima wants to build a facility where the unaccommodated, aging group can find all the services they need under one roof.
Tustin’s Community Living Center will convert an existing building on Yorba Avenue to combine recreational care and the services of the existing All Inclusive Care for the Elderly program, also known as PACE.
All guests are allowed to stay until they find stable, permanent housing, the agency said. CalOptima Health anticipates that the median length of stay will be one year. Most guests leave recreation facilities or hospitals. The center does not provide accommodation for people who do not require medical assistance or rehabilitation services.
The only people entitled to the facility are adults 55 and older who are not accommodated and meet medical criteria. The only way for an unhoused elderly resident to get a bed at the center is through a direct referral from a hospital, Tustin law enforcement, or an emergency shelter in the city of Tustin.
In all, the convalescent care center will care for 119 uninhabited elderly adults who are working towards permanent placement. The PACE center is expected to serve up to 500 people from both the surrounding community and the recovery care center.
Each semi-private room has an en-suite bathroom and shower. The building will be divided into five ‘pods’, each with around 25 beds, which will be staffed 24 hours a day by a dedicated social worker and nurse, as well as a guest security agent. Each capsule also has its own living room and social space.
The facility will include a gym, shop, beauty salon and cyber café. PACE services include routine checkups, outpatient surgical and psychiatric services, rehabilitation therapy, and transportation services. The convalescent care program provides additional services such as medication management, three meals a day, assistance accessing welfare services, and temporary housing until permanent housing is secured.
“The protection system is not designed for this demographic, but for economies of scale. It is designed to serve as many people as possible. “It’s meant to serve a younger, more physically agile group of people,” Bruno-Nelson said, adding that this facility should be designed to serve the older residents in a way that traditional housing doesn’t offer.
Bruno-Nelson said CalOptima is now working with the City of Tustin to get through the Planning Commission and have the project approved.