April 2004

Planning

Copyright by American Planning Association

2004 National Social Advocacy Award

Lapham Park Venture, Milwaukee

By Michael Davidson

Most residents of Lapham Park, a nine-story public housing facility in Milwaukee, are elderly, some of them very old.

Two are over 100, nine are past 90. Thirteen percent are octogenarian, 18 percent septuagenarian. Seventy-four percent of the 200 residents have a median annual income below $8,000. The facility serves 202 residents, of whom 96 percent are African American and 56 percent women.

Lapham Park is unusual public housing. Because of a program known as the Lapham Park Venture, some of the city's most vulnerable residents can now age in place with access to a full range of health care and other services in an environment that is both socially and aesthetically stimulating.

APA recognizes the Lapham Park Venture with the 2004 National Social Advocacy Award. This award, made in the name of advocacy planning pioneer Paul Davidoff, recognizes a project, group, or individual demonstrating sustained social commitment to planning for the needs of less fortunate members of society.

Created in 1993, the Venture is a synergy of public, private, and nonprofit investment, drawing on the contributions of experts and practitioners in housing, medicine, social service, gerontology, and architecture and design.

The Venture's program of consumer-focused health care has produced results. Nursing home placements have fallen from five to less than two percent a year. Some 75 percent of residents have their needs met at the facility. On-site services for independent living permit 96 percent to age in place.

In addition, the number of evictions because of behavioral problems and inability to pay rent has dropped. Taxpayers also win as public dollars are saved through increased efficiency and a smarter use of resources. The Venture has reduced Medicaid nursing home costs by an estimated $1 million a year.

The Venture's founding partners are a mix of public and private organizations: the Housing Authority of the City of Milwaukee, the Milwaukee County Department on Aging, Service Empowerment Transformation Ministry Inc. (known as S.E.T.), the Lapham Park Residents Organization, and Community Care Organization, a local care provider for the elderly and disabled. These groups, together with the YWCA, a local Alzheimer's chapter, and others make up the Lapham Park Venture today.

Leaders of the founding groups saw that because of diminishing fiscal resources and limited affordable housing, Lapham Park's most vulnerable residents were being moved to nursing homes prematurely. Costs of nursing home care were rising and service delivery for long-term care was inefficient.

Shared responsibilities

The housing authority built Lapham Park in 1964. The authority operates the project, and as the Venture got under way, facilitated the remodeling. As part of its responsibilities, the authority provides liaison with the residents' organization, which addresses resident concerns and organizes social and community-building activities.

The County Department on Aging operates a common dining room and provides transportation to doctors, shopping, and other activities. It contracts with S.E.T. on case management and long-term care. The Community Care Organization provides on-site medical treatment. St. Mary's Family Practice Clinic offers physician services on site to residents who are referred by other partners. Marquette University has graduate-level nurses available for hands-on student training.

During the planning process, S.E.T. conducted focus groups in which residents identified service needs, including on-site clinical care and more frequent access to medical facilities. The resulting clinic meets routine medical needs during weekday hours and special, more critical needs on a 24-hour basis. On-site services include prescription drug refills, hospice care, dentistry, home health care, physical therapy, and podiatry services. S.E.T. staff, social workers, and registered nurses visit interested residents regularly for evaluation. Lapham Park administrators coordinate the services of more than 20 providers and 200 specialists in health care and social service.

Lapham Park is located on Walnut Street. The facility's 14,000-square-foot basement has been made into a community space — known as Lower Walnut Street — with a beauty and barber shop (complete with striped barber's pole), movie theater, billiard room, craft room, and "town square," non-glare lighting, and park benches. Photographs of 1930s storefronts cover the walls. There is new space for medical consultation and treatment — examination rooms, pharmacy, gymnasium, whirlpool baths, and physician offices.

The city housing authority raised $1.3 million from corporations and foundations to renovate the basement, and $600,000 for services. Lapham Park operates through funds from the county aging department, which pays for most of the staff; the housing authority covers the rest.

For information, see www.hacm.org, or contact Susan July at the Housing Authority of the City of Milwaukee at SJULY@hacm.org or 414-286-2177.

Michael Davidson is a research associate at APA, staff manager of the Planning Advisory Service, and co-editor of Zoning Practice.