Pioneering Affordable Housing With Integrated Healthcare Services in Paterson, New Jersey

As the first project under New Jersey Housing and Mortgage Finance Agency's Hospital Partnership Subsidy Program, Barclay Place serves as a blueprint for healthcare institutions and affordable housing developers to partner in providing quality housing and medical services to low-income households. Photo credit: Elizabeth Lara-Collado

With a population of 160,000, Paterson, the third-largest city in New Jersey, relies on St. Joseph's University Medical Center as the leading provider for comprehensive hospital services. A surge in redevelopment has left Paterson struggling with a shortage of accessible healthcare services, leaving low-income residents underserved compared with residents of the city's more affluent areas. Recognizing the connection between housing and health, the New Jersey Housing and Mortgage Finance Agency (NJHMFA) launched the Hospital Partnership Subsidy Program in 2019 to encourage hospitals in the state to invest in affordable and supportive housing. In a groundbreaking effort to bridge the gap between healthcare institutions and community development, St. Joseph's University Medical Center and the New Jersey Community Development Corporation (NJCDC) partnered under the new initiative to prioritize medical care and resident well-being. The product of this partnership is Barclay Place, a 56-unit development serving as a pilot project for addressing the social determinants of health through quality affordable housing, services, and amenities.

Housing Services as Preventive Health Care

In 2019, discussions concerning the development of Barclay Place began between Kevin Slavin, then-president and chief operations officer of St. Joseph's Health, and Robert Guarasci, chief executive officer of NJCDC. Their focus was on fortifying the connections between anchor healthcare institutions and community development. These conversations delved into the social determinants of health and explored ways in which hospitals and community organizations could collaborate to enhance the overall health and well-being of Paterson residents. An opportunity to act on this shared goal emerged when the NJHMFA introduced a partnership program incentivizing hospitals to invest in affordable housing. St. Joseph's Health and NJCDC cemented their partnership in 2020 and closed on initial funding in 2021. Despite facing pandemic-induced delays, the development opened to residents in March 2023.

Barclay Place is a 56-unit development with one-, two-, and three-bedroom units for low-income residents of Paterson, NJ, including those experiencing chronic mental health issues. Photo credit: Elizabeth Lara-Collado

The development transformed a vacant lot owned by St. Joseph's Health into a 5-story building consisting of 15 one-bedroom units, 29 two-bedroom units, and 12 three-bedroom units distributed throughout the upper levels. A defining feature of the project is the ground floor, which was strategically designed to house resident amenities and 3,000 square feet of tenant space operated by St. Joseph's Health. Unlike previous NJCDC developments, whose services primarily focus on case management and mental health care, Barclay Place brings medical care and holistic health services onsite. The collaboration with St. Joseph's University Medical Center regularly brings a physician, nurse practitioners, nutritionists, and diabetes educators onsite, ensuring that residents receive comprehensive health support.

In addition to providing healthcare services, Barclay Place's ground-floor space also supports social and wellness services offered through NJCDC. These services range from financial literacy assistance (including helping residents secure financial aid for their children) to mindfulness workshops. Resident amenities include a fully equipped gym, laundry facilities, and a rooftop patio, which foster community and a sense of belonging.

Hospital Partnership Subsidy Program

The basis of NJHMFA's Hospital Partnership Subsidy Program is that housing is a form of health care — a claim that is in line with research conducted by the New Jersey Department of Community Affairs showing that supportive housing is linked to health care and cost savings for the government. Barclay Place is a direct result of this program, emphasizing the agency's commitment to fostering partnerships between affordable housing developers and healthcare providers. Under this program, the agency matches the partnering hospital's investment into the property dollar for dollar, up to $4 million. St Joseph's Health contributed $4.5 million toward developing Barclay Place. In addition to matching the hospital's investment, NJHMFA administered more than $11 million in 4 percent low-income housing tax credits. The $26.6 million project also received a $1 million contribution from NJHMFA's Special Needs Housing Trust Fund, which required NJCDC to reserve 10 Barclay Place units for individuals experiencing chronic mental health issues. The innovative financing structure, which includes a hospital subsidy loan and a deferred developer fee, highlights the collective buy-in for creating affordable housing with integrated healthcare services.

Barclay Place Blueprint for Housing and Wellness

NJCDC has outlined metrics for success for Barclay Place's first year to offer tangible evidence of the benefits of safe and affordable housing with integrated health and social services for community well-being. These metrics include measures of baseline healthcare statistics such as blood pressure or weight changes as well as mental health statistics such as rates of depression and anxiety. Quantitative metrics aside, Guarasci explains that residents appreciate the quality of Barclay Place's housing and amenities, especially because many residents previously lived in substandard housing. Although NJCDC currently has no plans for a similar development, they anticipate that other hospitals in the state will follow suit. According to Guarasci, two other hospitals — Barnabas Healthcare System in New Brunswick and University Hospital in Newark — are currently undertaking projects through the Hospital Partnership Subsidy Program.