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T E N N E S S E E D E P A R T M E N T O F M E N T A L H E A L T H A N D D E V E L O P M E N T A L D I S A B I L I T I E S. Tennessee Creating and Expanding Housing Options that Promote Recovery Opportunities. Marie Williams, LCSW

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slide1

T E N N E S S E E D E P A R T M E N T O F M E N T A L H E A L T H

A N D D E V E L O P M E N T A L D I S A B I L I T I E S

Tennessee Creating and Expanding Housing Options that Promote Recovery Opportunities

Marie Williams, LCSW

Assistant Commissioner, Division of Recovery Services & Planning

615-253-3049 Marie.Williams@state.tn.us

what is recovery when is a person recovered
What is Recovery?When is a Person Recovered?
  • WHEN REVIEWING LITERATURE WRITTEN BY THE LEADERS IN THE FIELD OF RECOVERY:
    • DR. PAT DEEGAN
    • MARY ELLEN COPELAND
    • DR. BILL ANTHONY
    • AND OTHERS
    • IT IS CLEAR THAT RECOVERY IS A JOURNEY
    • WHOSE DESTINATION INCLUDES…..
slide3

~ The process in which people are able to live, work, learn, and participate fully in their communities. Recovery is the ability to live a fulfilling and productive life despite a disability. ~

[President’s New Freedom Commission on Mental Health:Report to the President, 2003]

r ecovery h appens
RECOVERY HAPPENS

ecovery means that the mental illness is no longer the central focus of

R

a person’s life…

…even when symptoms persist.

d efining t erms
DEFINING TERMS
  • RECOVERY refers to the ways in which a person with a psychiatric disorder manages his or her disability in the process of reclaiming his or her life in the community.
  • RECOVERY-ORIENTED CARE refers to what psychiatric treatment and rehabilitation practitioners offer in support of a person’s recovery.

—The Matrix Model @ Horizon House

t hree g oals of r ecovery
THREE GOALS OF RECOVERY

C

onsumers engaged in the process of reintegration (recovery) strive to achieve three goals:

  • restoring relationships;
  • moving toward independent living; and
  • obtaining meaningful work.

—Reintegration Today: Summer 2004

slide7
The Tennessee Department of Mental Health and Developmental Disabilities’ Response to Expand Community Recovery Options

THE RESPONSE

slide8

THESETH CAMPAIGN

The SETH Campaign is a strategic plan to partner with Tennessee community providers to increase the following community options for persons with mental illness and co-occurring disorders on the path to recovery:

Housing - Phase 1

Employment/Education - Phase 2

Support Services - Phase 3

Transportation - Phase 4

slide10

CHI:

CREATING HOMES INITIATIVE

A

strategic plan of the Department of Mental

Health and Developmental Disabilities to partner with communities to create housing options for people with mental illness and co-occurring disorders effectively and strategically in Tennessee.

recovery housing our current reality
Recovery & Housing:Our Current Reality
  • Housing ranks as a priority concern of individuals with serious mental illness. Locating affordable, decent, safe and appropriate housing is often difficult, and out of financial reach. Stigma and discrimination also restrict consumer access to housing.

MentalHealth: A Report of the Surgeon General, 1999

recovery housing our current reality12
Recovery & Housing:Our Current Reality
  • Housing is, perhaps, the first line of treatment for people with serious mental illness.
  • The lack of decent, safe, affordable, and integrated housing is one of the most significant barriers to full participation in community life for people with mental illnesses.

President’s New Freedom Commission on Mental Health:

Report to the President, 2003

americans with mental illness
Americans with MentalIllness
  • Persons with mental illness and co-occurring disorders receiving SSI benefits average monthly income ($623) are among the lowest income households in the country.
  • There is not a single housing market in the U.S. where a person on SSI can afford to rent a modest efficiency apartment.
tennesseans with mental illness
Tennesseans with Mental Illness
  • There are a total of 173,377 persons assessed with severe and persistent mental illness in Tennessee who have used some service covered by TennCare (Tennessee’s Medicaid waiver program).
  • Of those, approximately 2,000 individuals live in 212 licensed supportive facilities.
  • Approximately 20% of the criminal justice system and 25% of the homeless populations are diagnosed with mental illness and co-occurring disorders totaling 12,000.
  • Therefore, it is safe to conclude that approximately 187,377 persons in need of housing assistance.
tennesseans with mental illness15
Tennesseans with Mental Illness
  • For every 100 households at or below 30% of median income, there were only 36 units both affordableand available for rent.
  • The cost of a one-bedroom apartment is 80% of SSI monthly income
  • Current estimates show that over 180 persons in our regional mental health institutes could be discharged if appropriate housing, with the proper support services existed.
creating homes initiative the milestones
Creating Homes InitiativeThe Milestones
  • February 2000- Origins
    • Commissioner Elisabeth Rukeyser establishes Office of Housing Planning and Development (OHPD) with Marie Williams as Director
  • August 2000 - Kicks Off
    • Announces Creating Homes Initiative (CHI) at TN/KY Housing Institute
  • September 2000- $2.5 million for Phase One
  • Nashville
  • Jackson
  • Chattanooga
  • Memphis
creating homes initiative the milestones17
Creating Homes InitiativeThe Milestones
  • $2 million from Tennessee Housing Development Authority
  • HUD Section 8
  • Statewide group proposal review and rank
  • Funding announcements
  • Produces media events
  • Fights NIMBY/Legal issues
  • January - April 2001 - Moves forward

A Place to Call Home

  • www.housingwithinreach.org
  • click on NIMBY (Not In My Backyard)
  • click on NIMBY literature
creating homes initiative the milestones18
Creating Homes InitiativeThe Milestones
  • April 2001 - Hires Staff, Submits Grants
    • Hires Regional Housing Facilitators
    • Applies for new funding with CMS, THDA, HUD Continuum of Care, Section 8 and 811
  • October. 2001 - Accepts Additional Project
    • Receives $1.8 million CMS Real Choice Systems Change Grant
  • October 2001 - Phase II Begins
  • Clarksville
  • Nashville
  • Johnson City
  • Knoxville
  • Jackson
  • Murfreesboro
  • Memphis
  • Chattanooga
creating homes initiative the milestones19
Creating Homes InitiativeThe Milestones
  • December 2002 - Receives funding awards
    • $8 million from Federal Home Loan Bank Affordable Housing Program
    • $5 million from HUD Continuum of Care
    • Continues to work on HUD Collaborative Initiative to End Homelessness
  • October 2002 - Successes
    • Surpasses goal of 2005
    • Announces new goal of 4010 by 2005
creating homes initiative the milestones20
Creating Homes InitiativeThe Milestones
  • July 2004 – DMHDD Reorganization
    • Commissioner Virginia Trotter Betts forms the Division of Recovery Services to coordinate provision of services in areas of Support, Employment/Education, Transportation, and Housing/Homelessness (SETH).
    • Regional Housing Facilitators become Regional SETH Facilitators
    • Regional SETH Facilitators continue CHI activities
  • January 2007 – Regional Housing Facilitators reinstated and return to Housing as single focus
    • Initiative doesn’t miss a beat!
slide21

CHI: THE VISION

T

o create and expand affordable, safe, permanent and quality housing options for people with mental illness and co-occurring disorders in Tennessee

CHI Packet on the Internet

http://www.tennessee.gov/mental/publications/CHIpacket.pdf

slide22

CHI: THE MISSION

T

o partner with local communities, assertively and strategically, to educate, inform and expand affordable, safe, permanent and quality housing

options for people with mental illness and co-occurring disorders.

slide23

CHI: THE GOAL

Set in 2000:

2005 by 2005

Met in 2002, so reset to:

8009 by 2009

creating homes initiative current outcomes
Creating Homes Initiative Current Outcomes
  • More than $200 million has been leveraged
  • More than 7,100 new or improved units have been developed
  • More than 1,155 individuals from local, regional and statewide organizations have participated in making CHI success
  • 95% statewide decrease in re-hospitalization
creating homes initiative recognition and replication
Creating Homes InitiativeRecognition and Replication
  • Eli Lilly National Housing Award
  • CMS Best Practices Award
  • HUD Best Practices in Fair Housing Award
  • NAMI - Phillip and Sarah Francoeur Award for Housing
  • The Commonwealth Fund State Behavioral Health Innovations: Best Practice
  • Many regional and local awards
  • CHI Model in Georgia
  • CHI Model in Kentucky
slide26

Jeanne Price

Tameka Favors

Rozann Downing

Sandie Shaver

Cheré Bradshaw

Vonda Gray

Susan Greene

REGIONAL HOUSING

FACILITATORS

Seven Regional Housing Facilitators in Seven Mental Health Planning and Policy Council Regions

slide27

Louetta Hix

Vacant

Lawrence Wilson

Gina Turley

CONSUMER HOUSING

SPECIALISTS

slide28

TOTAL CHIUNITS CREATED

Supervised

Group

Housing

24-Hour On-Site Staff

Ex: Multi-person Supportive Living Facility

Partially Supervised Group Housing

Staff On-Site as Needed

Ex: Multi-person Group Homes & Residential Homes

Independent Congregate Living

No Staff

On-Site

Ex: Non-supervised Group Homes, Boarding Homes

Rental Housing/ Voucher (Home or Apartment)

Ex: Private Market,

Public and Non-Profit Housing

Home Ownership

Ex: Permanent Homes or Condos

365 417 185 5,684 485

Total Units Created = 7, 136

Total Amount Leveraged = $200,722,055

f unding n eeds
FUNDING NEEDS
  • Capital
    • Acquisition
    • Rehab
    • New Construction
  • Operating
    • Recurring Housing Costs (utilities, maintenance, reserves, etc.)
  • Services
a ffordable h ousing c hallenge
AFFORDABLE HOUSING CHALLENGE

Assume homeless individual has or can get on SSI

(SSI/SSDI Outreach, Access & Recovery)

$623 per month income

30% to spend on housing (including utilities)

= $187 per month for housing

vs. Fair Market Rent for 1 Bedroom

= $586 per month or

$399 over affordability

f unding s trategy
FUNDING STRATEGY

In order to keep housing affordable for very low income consumers,

  • Reduce or eliminate mortgage
  • Reduce or eliminate property taxes
  • Build or rehab for energy savings
  • Rental subsidies
c ondo o wnership n ashville
CONDO OWNERSHIP, NASHVILLE

TDMHDD $9,000

FHLB Am. Dream $13,300

FHLB Welcome Home $7,500

Owner deposit $500

Owner mortgage $32,100

Cost + Closing $62,400

Total monthly payments inc. PITI + Condo fee = $377

Two brothers with severe mental illness, both on SSI

Cost savings to State in saved rental subsidy

in 30 yr. = $180,000+

h ome o wnership j ackson t ennessee
HOME OWNERSHIP,JACKSON, TENNESSEE
  • Habitat for Humanity new construction
  • 4-bedroom, 2-bath home valued at $80,000
  • Total cost of Habitat Home $65,000
    • THDA HOME grant -$14,999
    • FHLB American Dream -$15,000
    • FHLB Welcome Home -$ 7,500
    • Owner mortgage with Habitat $27,501
    • 30 yr. mortgage @ 0%
    • Monthly payments = $78 per month
a lpha o mega v eterans s ervices m emphis
ALPHA OMEGA VETERANS SERVICES, MEMPHIS

THDA $238,362

Plough Foundation $245,000

HUD SHP $300,000

City of Memphis $500,000

FHLB AHP grant $575,140

Owner’s Contribution $337,627

TOTAL $2,296,129

Operations and Support

  • HUD SHP $190,000
  • United Way
  • Permanent supportive housing for homeless veterans who are disabled by mental illness and/or substance abuse
  • New construction of two-story, 32 one-bedroom units plus common meeting and dining area
  • Support services on and off site
f reedom r ecovery c ommunity n ashville
FREEDOM RECOVERY COMMUNITY, NASHVILLE
  • Permanent supportive housing for formerly homeless women with mental illness and/or substance abuse and returning to the community from prison
  • Twenty 2-bedroom apartments plus laundry, meeting room, office space
  • Support on and off site

FHLB AHP grant $251,000

HUD SHP $135,000

Memorial Foundation $75,000

TDMHDD $100,000

THDA Trust Fund$500,000

TOTAL acq. & rehab $1,061,000

Operations and Services

HUD SHP $241,551

b ulls g ap t ennessee
BULLS GAP, TENNESSEE
  • Eight 2-bedroom apartments for homeless people who have mental illness
  • Bulls Gap Historical donated land and building
  • Clinch Powell Rural Dev. and First TN Dev. Dist. Applied for HOME

THDA HOME $460,732

Bulls Gap Historical Railroad

(land and building) $60,000

Operations:

Kingsport Housing Authority

16 Section 8 vouchers annually $92,928

Frontier MHC /TN Care

  • Kingsport PHA supplies Section 8 vouchers
  • Frontier Health, using MCD, provides case management
potential opportunities
Potential Opportunities

Relative to Increasing Housing Opportunities For People Diagnosed with Mental Illness and Co-occurring Disorders

slide46
Establishes new, independent agency, Federal Housing Finance Agency, to regulate Federal Home Loan Banks (FHLB) (as well as Fannie Mae and Freddie Mac) with broader management and enforcement powers, including revision of goals of FHLB and expanding use of FHLB advances for use in community development projects and mortgage foreclosure avoidance.
  • Impact: Unknown at this time, but will likely modify FHLB focus and funding of Affordable Housing Program and American Dream Home Ownership Challenge Program which have been major sources of housing for CHI. Broader use of AHP funds will reduce funding available for new housing projects, at least for short-term future.
slide47
Creates National Housing Trust Fund. 65% of revenue from 4.2 basis points of Fannie and Freddie profits will create this fund to be distributed on formula basis to states, likely to supplement or create parallel THDA Housing Trust Fund in Tennessee. Very rough guess, depending on formula created, may provide $6 million - $10 million annually to be distributed through THDA. Minimum 90% to be spent on rental housing; minimum 75% on families at 30% or less AMI; remaining 25% for families at 50% or less AMI.
  • Impact: As early as 2010, this could be a major source of added funding for developing housing opportunities for those people with very low income that we serve, especially rental housing projects, but also including some home ownership options.
slide48
Creates Capital Magnet Fund. Designed to attract private investment into affordable housing. 35% of the revenue from 4.2 basis points of Fannie and Freddie profits (rough guess $200 million annually) goes to a competitive grant program operated by Secretary of Treasury and open to “community development financial institutions” and non-profit housing developers (e.g. CHDOs) for “affordable housing, economic, and community revitalization projects.” Aggregate cost of all projects funded must be at least 10 times grant amount.
  • Impact: Beginning 2010, potential new funding layer for affordable housing projects.
slide49
Creates fund to redevelop abandoned and foreclosed homes. Although it is currently not clear what locations in Tennessee might qualify, this provides nearly $4 billion nationally for states and local governments to purchase, rehab, resell, or tear down abandoned and foreclosed homes. Funds distributed like CDBG money, i.e. 70% to localities, 30% to state. At least 25% of these funds will be used to house individuals or families at 50% or less of AMI. Funds are to be used within 18 months.
  • Impact: May provide opportunities for low income rental housing development by agencies or even free acquisition of properties with rehab financed by local housing authority with restriction that low income families, such as our consumers, be housed there. We should talk soon with local housing authorities and THDA about the option of using these funds for our consumers’ housing and then carefully monitor what funds come to what places in Tennessee so we can act where funding is allocated.
h elpful w ebsites
HELPFUL WEBSITES
  • www.hud.gov
    • Extensive info on all HUD funding and Ohio HUD activities
  • www.csh.org
    • Corporation for Supportive Housing
    • Click on Resources; click on Financing guide
  • www.nlihc.org
    • National Low Income Housing Coalition
    • Current info on National Housing Trust Fund
h elpful w ebsites51
HELPFUL WEBSITES
  • www.housingwithinreach.org
    • Tennessee’s Creating Homes Initiative
    • Click on Housing Developer Information
  • www.tacinc.org
    • TAC is a non-profit organization that works to achieve positive outcomes on the behalf of people with disabilities and other special needs.
w e w ill m ake a d ifference
WE WILL MAKE A DIFFERENCE

ever doubt that a small group of

thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.

—Margaret Mead

N