When members of a local homeless coalition in Fort Atkinson, Wisconsin, learned that there were about 30 families in the city who were considered homeless, they knew they had to find a way to help.
It was 2019, and the newly formed Homeless Coalition of Fort Atkinson was already providing emergency shelter in a local church, offering people a bed for the night and coupons for breakfast at a nearby McDonald’s. But transitional housing was harder to establish. Houses are in short supply in Fort Atkinson, and a search for affordable rental housing was unsuccessful.
Over the last several years, however, the coalition has partnered with a growing hospital and health care system to secure a couple of units of permanent transitional housing for unhoused families, as well as services to help them get back on their feet.
How did the partnership begin, how does the program work, and what lessons can other community organizations and health systems learn from it?
Fort HealthCare (FHC) is a health care system that operates Fort Memorial Hospital and several clinics in the city of Fort Atkinson and surrounding Jefferson County. The hospital has grown since it was built in 1949, and FHC has met the hospital’s evolving needs in part by buying neighboring property to make room for expansion.
For years, FHC had been purchasing single-family properties directly across the street from the hospital, with the intent to demolish or relocate the houses to expand the hospital’s parking lot. But FHC couldn’t move forward with the project without first getting the city to approve its plans and make some zoning changes in the area, a process that could often take years. While FHC awaited the city’s OK, conversations between Fort HealthCare officials and Jude Hartwick, the founder of the Homeless Coalition of Fort Atkinson, made FHC consider a new a possibility.
‘We have a housing shortage in the area, so we’ve been trying to do as much as we can not to destroy those homes. But it clearly would have been more financially advantageous for us to landfill them than it was to move them.’
The homeless coalition saw an opportunity to provide short-term housing for homeless families while the city’s approval process ran its course. So, several years ago, Hartwick says he approached Mike Wallace, then FHC’s CEO, and Jim Nelson, FHC’s senior vice president for finance and strategic development, about renting one of the houses. At the time, Hartwick also served as a councilman on the Fort Atkinson City Council, and the three men knew one another through local volunteer activities. Hartwick says he and Nelson had also recently talked about ways to make their community a “better, longer-living place.”
“I think they had an understanding of the need,” he says, in part because the homeless coalition had been vocal about it.
The hospital’s own assessment of the community in 2019 also highlighted the area’s urgent housing needs. As a nonprofit hospital, FHC conducts Community Health Needs Assessments (CHNAs) once every three years and uses them as the basis for developing Community Health Implementation Plans (CHIPs). In 2019, the assessment identified eight significant health needs in the community, one of which was the need for more affordable housing. While the 2019-2021 CHIP indicated that FHC would not directly address those needs, it did say FHC would contribute to their resolution.
The hospital is also aware of the value of secure housing as one of the social determinants of health—the nonmedical factors that influence our health—says Nelson. For example, if a person’s blood pressure is not improving, “we understand that . . . if they’re homeless, getting blood pressure medication—that’s not a priority when you’re maybe really trying to figure out the food, or you’re trying to take care of your kids.” Addressing issues like housing helps keep people out of the emergency room, Nelson says, and ultimately helps control health care costs.
FHC’s understanding of the connection between housing and health—and its relation to health care costs—was a factor in the hospital’s decision to work with the homeless coalition, says Nelson.
“We have a housing shortage in the area, so we’ve been trying to do as much as we can not to destroy those homes. But it clearly would have been more financially advantageous for us to landfill them than it was to move them,” Nelson says. “We understand that if we can deal with some of these other issues and offer some stability for [patients], we can help—you know, one family at a time, but it’s still one family more than there was yesterday.”
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FHC agreed to allow two of the houses to be used as transitional housing while it waited for city approvals. Coalition members visited the houses to be sure they were suitable for families, says Hartwick, and the hospital worked with the coalition to make needed updates. Hartwick describes the hospital as “a wonderful partner, very receptive and helpful,” and says each organization paid attention to the other’s needs.
Tenants moved in in December 2021 and January 2022, and the coalition paid for utility costs, but that was all. Each house was occupied by one family for about a year and a half. Ideally, a family will use transitional housing for six months to a year while preparing to live independently, says Becky Tuttle, the vice president of the coalition’s board of directors. But because no one was sure exactly how long the city’s land-use process would take, the initial occupants were allowed to stay as long as the houses were available. Around May 2023, FHC decided to relocate the houses to vacant land it owns nearby, and the tenants moved out so the houses could be prepared for the shift.
It was then that the coalition asked about acquiring the two houses, says Nelson. The hospital was amenable, and, with help of hospital grant writers, the Homeless Coalition of Fort Atkinson sought federal funding to purchase the buildings and lots on which they could be placed. Those funds were not awarded, says Tuttle, but “the hospital offered to sell us each of the houses for $1 apiece.” FHC also agreed to donate the land on which the houses were placed.
The two groups agreed that the coalition would pay to have the houses moved, placed on new foundations, and connected to utilities, and to have driveways and landscaping installed. The hospital worked out a budget, says Nelson, and supported the coalition in raising the funds that would be needed—estimated at about $200,000. FHC also reached out to the Fort Atkinson Community Foundation, which agreed to provide $100,000 in matching funds once the coalition had raised $50,000. The coalition had already raised over $70,000 during a kickoff capital campaign at the beginning of the project, says Tuttle, and in late 2023, a local foundation donated $25,000 to support the project. Another local group, Heart of the City, has raised funds and will provide volunteers to landscape the houses, with guidance from the county Cooperative Extension office.
The coalition has agreed to pay the hospital $150,000 to cover the agreed-upon costs. Some of the remaining funds will be used for repairs and replacements that are needed before the houses can be occupied—a new roof, a stove, toilets, a new HVAC system. The rest of the money will be used for ongoing maintenance and repairs.
As of January, the houses have been moved and placed on foundations. Construction of a new road that will provide access to the homes—and accommodate utility and storm sewer lines—is underway. Weather permitting, that work may be complete by the end of January, Nelson says. The project’s general contractor—a former Habitat for Humanity board member who is donating his time—expects that service connections will be complete and the houses ready for occupancy by the end of February, says Tuttle.
More Than Houses
Both Tuttle and Nelson emphasized that the transitional housing project offers residents much more than a place to live. The coalition maintained close contact with the initial occupants of the two houses, says Tuttle. The coalition’s executive director, Sheri Bronstad, visited frequently, by appointment, helping to connect the families with resources and to problem solve.
For instance, the coalition ensures that families are connected with the county’s human services department and the Community Action Coalition for South Central Wisconsin, a social service nonprofit that works to provide food, shelter, and essential resources such as transportation, financial literacy training, and winter coats. Families served by the homeless coalition also have access to the community’s food pantry, a weekly shared meal provided by a local church, and diapers and clothing for children, supplied by another local organization. And the coalition works with the families to address transportation challenges—a big issue in their small community, says Tuttle.
Residents of the transitional houses were expected to maintain the homes, including caring for lawns and removing snow from sidewalks. That was an important stipulation for FHC, says Nelson, as the hospital knew it would have to field complaints from neighbors if the houses were not well looked after. Both FHC and the Homeless Coalition of Fort Atkinson worked with residents to address barriers; for instance, hospital staffers shoveled snow for a pregnant woman until she was able to do it herself postpartum, and the homeless coalition secured a donated lawnmower for a family that didn’t have one.
The program is about much more than putting roofs over people’s heads—it’s about equipping them for a fresh start and a successful future. Helping families prepare financially for that is part of the homeless coalition’s program, says Tuttle. Rents were and will be tied to household income, and rent payments are put in trust, to be returned to the residents so they can pay move-in expenses when they’re ready to move to more permanent homes. The coalition also requires people who live in the houses to receive financial coaching, provided by either Jefferson County or the Fort Community Credit Union.
Nelson says it’s important for all parties to be clear about expectations. “We’re always trying to be a really good neighbor,” he says. That’s a challenge for a hospital that operates 24 hours a day with “helicopters landing, ambulances coming and going, 500, 600 employees coming and going.” FHC does the best it can in the context of those limitations, Nelson says, and that includes making sure that the houses the hospital owns are good neighbors. The transitional housing program can give tenants an opportunity to learn some of the life skills that are involved in being a good neighbor, Nelson says, and he thinks the homeless coalition has been learning to use the program to teach those skills. Residents may need to be coached to do things like keep dogs quiet, change furnace filters, and call the landlord when appliances or plumbing need work, for example.
Tuttle says she’s become very aware of how much is involved in helping people become independent. Families in transition often have complex needs, and those needs may be met through a variety of social programs with different rules. Complying with one agency’s requirements may make an individual or family ineligible for another agency’s services. “There are a lot of Catch-22s with government agencies,” Tuttle says. For coalition members who are providing support and serving as liaisons, “There’s a lot to know and understand.”
Also, she says, “you have to respect where people are coming from.” As a volunteer with a middle-class background, says Tuttle, it’s easy to “think that there’s an easy solution for everything, and there’s not—these are really difficult situations. You can’t use a cookie cutter approach to fixing it.” Some people are reluctant to accept help, she said, especially when mental health challenges are involved.
“It’s so easy to see [unhoused] people being judged,” says Tuttle. “When you start to know them personally . . . I don’t know if I could have lived through a lot of what they have lived through.”
“Sometimes it just helps to talk to people, and for them to know somebody’s listening to them,” she said.
Both Nelson and Tuttle emphasized that “it takes a village” to address challenges like homelessness. Tuttle says the community’s generosity has made the coalition’s programs possible. Spontaneous gifts, generous donations during the capital campaign, special collections by churches, and charity events hosted by local restaurants and pubs have all helped fund the transitional housing project. The Homeless Coalition of Fort Atkinson also worked closely with the director of Bethel House of Whitewater, which has operated a transitional housing program about 10 miles from Fort Atkinson for nearly 30 years. The coalition modeled its bylaws, lease agreement, and tenant support services on those used by Bethel House. Bethel House staff provided a “wealth of knowledge that we needed,” says Hartwick, and he expects that the homeless coalition will continue to benefit from the other organization’s experience and guidance.
Shared interests in local residents’ health and well-being—as reflected in the hospital’s CHNA and CHIP— make it likely that Fort HealthCare and the Homeless Coalition of Fort Atkinson will collaborate again, but for now they have no definite plans. Overseeing the complex and multifaceted transitional housing project has required significant investments of time and energy from the homeless coalition early in its life. At this stage, “we just want to get through this project and see what happens,” says Tuttle.