Baltimore, MD
Photo credit: Yianni Mathioudakis

A Healthcare System Leader Reflects on Housing Partnerships and Investments

Hospitals and healthcare systems across the country are increasingly investing in housing initiatives in order to support the health and well-being of the patients and communities they serve. Bon Secours Mercy Health (BSMH) is one of the nation’s leaders, taking a multi-pronged approach to housing interventions in communities across seven states. The system has been lauded for its Housing for Health program, an affordable housing program for renters with low incomes in West Baltimore, MD that has demonstrated significant social value for the community. A recent evaluation of BSMH’s eviction and foreclosure prevention program in Cincinnati, OH has also recently shown positive impacts, protecting housing stability among participants.

The Housing Solutions Lab spoke with Kendra N. Smith, AICP, Vice President of Community Health, to learn more about how Bon Secours Mercy Health is tackling housing affordability and stability as key determinants of health.

BSMH has been a leader among healthcare systems working to address the social determinants of health such as housing. What motivated your system to focus on this issue?

Kendra Smith: BSMH has more than 30 years of experience developing, managing, and providing housing to those most in need. We began this work because we heard from members of our communities that there was a need for more safe, affordable housing and neighborhoods. We obtained this feedback from community driven meetings and dialogue, Community Health Needs Assessments, and patient screenings. 

While our work began in West Baltimore, we have since launched housing interventions in many of our markets, including Richmond, VA; Cincinnati, Lima, and Toledo, OH; Greenville, SC; and Northeastern, KY. We continue to explore opportunities to grow and diversify our approach to housing investment and programming. The importance of addressing social determinants of health and the need to improve the infrastructure, health and well-being of our communities continues to motivate this work.

Kendra Smith
Kendra N. Smith, AICP, Vice President of Community Health

What are some of the key housing and neighborhood interventions that you have made to support your patient population and the broader community? 

We have created more than 800 units of BSMH-owned affordable units; supported the operations of local land trusts that expand homeownership opportunities;  provided more than $200K in direct assistance to assist renters, owners, and landlords to avoid eviction and foreclosure; and have supported capacity building efforts for local and community-based organizations that support housing services, programming, and development. We’ve also provided no-cost Wi-Fi and tablets to expand community access to telehealth services.

The positive impacts we’ve seen to date have encouraged us to deepen our community investment portfolio through a dedicated low interest, long-term loan program that supports local CDFIs, housing development organizations, and other direct service entities. 

How has BSMH developed its housing interventions and strategies?

Our community investment and programming work is designed to benefit not only our patient populations but the larger community as well. We work with local stakeholders including residents, elected officials, municipal departments, developers and financial institutions to understand the current landscape and identify future opportunities for local project pipelines and initiatives for investment. Our programmatic approach is largely led by the results of our Community Health Needs Assessments. 

As we continuously fine tune our approach, we remain committed to being active in community-based efforts to strengthen neighborhood conditions, and improve health and well-being. We work to ensure our investment efforts are economically sound and based on community-derived, community-led priorities and that our programs are structured to address the most pressing health and social needs of our communities. 

Healthcare and housing are two very different and complex sectors. As a healthcare institution, how did BSMH develop the necessary knowledge and partnerships to get involved in this work? Did you find any particular resources or intermediaries helpful for doing this work and building your partnerships? 

Very early on in our work in West Baltimore, we partnered with the Enterprise Foundation (now Enterprise Community Partners) to develop our affordable housing presence in Baltimore. The key to success in this partnership was developing a shared agenda to build local capacity and grow the number of quality housing projects in the community. After building a successful partnership with Enterprise, we were well positioned to seek similar partnerships in the other markets we serve, identifying additional mission-driven housing developers, community-based organizations, and financial institutions that have helped fill gaps in expertise that we did not originally have as a healthcare institution. 

We also built our own internal capacity to navigate these partnerships, by adding staff and leadership to our team with housing and community development expertise. While we still have knowledge and experience gaps that we lean on our partners to help us fill, we have deepened our internal capacity to be a strong participant in cross-sector conversations, planning sessions, and development deals that allow us to better direct our investments.  

“Welcome a diversity of partners to the table, including grassroots partners as well as company executives. Acknowledge the value and expertise that each contributor brings while also challenging each other to think differently and outside of your own expertise.”

-Kendra Smith

We are continuously evaluating our efforts and transforming our work to meet current housing needs, align with local and national housing policy, set new standards for housing quality and access, and ensure long term financial viability of our investments.

Do you have any recommendations for how healthcare and housing stakeholders can most effectively communicate and work together towards developing a shared agenda? 

My first recommendation is to come to the table ready to listen. While organizational missions, visions, and values may be aligned, each will have different needs that impact the partnership and the ability to build a shared agenda. Understanding the capacity of your cross-sector partners, their limitations, and their unique contributions will go a long way. 

Additionally, welcome a diversity of partners to the table, including grassroots partners as well as company executives. Acknowledge the value and expertise that each contributor brings while also challenging each other to think differently and outside of your own expertise.The housing crisis in our communities has been created by many contributing factors so it is important to acknowledge that one sector or one set of stakeholders does not have the power to solve this issue alone.

Finally, be willing to ask and answer questions. I have experience in both housing development and healthcare, however I still have a long list of questions for partners in both sectors. There are no bad questions. Housing and healthcare are two complicated and ever-changing fields and trying to align them is no easy task. Sharing your sector expertise and learning from your cross-sector partners is essential for developing a shared agenda.

Some hospitals and healthcare systems are just beginning to think about how to get involved in housing and/or community development. What steps would you suggest for those who are just looking for a place to start? 

Take the time to truly understand the needs and vision of your communities. Residents and community-based organizations have often been engaging, planning, and implementing efforts for decades. In order to build trust and develop the most responsive strategies,  you must first learn from the community, identify the local leaders that drive the work, learn what partners are already at the table, and determine how you can be an asset. 

Be sure your system can clearly articulate why getting involved in housing or community development is an important priority.

Find like-minded mission partners in the community who are working toward the same goal of supporting housing, community development, economic development—whatever area is the right fit for your system and work with them to engage the community, build capacity and explore best places to start. No one should try to jumpstart this work in a silo, find your partners and move forward together. 

Lastly, understand that any kind of community development work may take a long time, requires many partners, and that there is rarely a straight line from the initial visioning of a project to its completion, so, have patience and perseverance.  

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