T E N N E S S E E D E PA R T M E N T O F M E N TA L H E A LT H
AN D D E V E LO PM E N TAL D I SAB I LI 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?
• 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…..
~ 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]
RECOVERY HAPPENS
ecovery means
that the mental
illness is no
longer the central
focus of
a person’s life…
…even when symptoms persist.
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
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
THE RESPONSE
The Tennessee Department of Mental
Health and Developmental Disabilities’
Response to Expand Community
Recovery Options
THE SETH 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
Phase 1
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 cooccurring disorders effectively
and strategically in Tennessee.
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.
Mental Health: A Report of the Surgeon General, 1999
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
• 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
• 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 Illness
• For every 100 households at or below 30% of median
income, there were only 36 units both affordable and
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
• 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
Jackson
Memphis
Nashville
Chattanooga
Creating Homes Initiative
The Milestones
• January - April 2001 - Moves forward
–
–
–
–
–
–
$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
A Place to Call Home
• www.housingwithinreach.org
• click on NIMBY (Not In My Backyard)
• click on NIMBY literature
Creating Homes Initiative
The 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
Jackson
Memphis
Nashville
Johnson City
Knoxville
Murfreesboro
Chattanooga
Creating Homes Initiative
The Milestones
• October 2002 - Successes
– Surpasses goal of 2005
– Announces new goal of 4010 by 2005
• 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
Creating Homes Initiative
The 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!
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
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 cooccurring disorders.
CHI: THE GOAL
Set in 2000:
2005 by 2005
Met in 2002, so
reset to:
8009 by 2009
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 rehospitalization
Creating Homes Initiative
Recognition 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
REGIONAL HOUSING
FACILITATORS
Rozann Downing
Cheré Bradshaw
Jeanne Price
Tameka Favors
Vonda Gray
Susan Greene
Seven Regional Housing Facilitators in Seven Mental Healt
Planning and Policy Council Regions
CONSUMER HOUSING
SPECIALISTS
Vacant
Lawrence Wilson
Louetta Hix
Gina Turley
TOTAL CHI UNITS CREATED
Supervised
Group
Housing
Partially
Supervised
Group
Housing
Independent
Congregate
Living
Rental
Housing/
Voucher
(Home or
Apartment)
Home
Ownership
24-Hour OnSite Staff
Staff On-Site
as Needed
No Staff
On-Site
Ex: Multiperson
Supportive
Living
Facility
Ex: Multiperson Group
Homes &
Residential
Homes
Ex: Nonsupervised
Group Homes,
Boarding
Homes
Ex: Private
Market,
Public and
Non-Profit
Housing
Ex:
Permanent
Homes or
Condos
365
417
185
5,684
485
Total Units Created = 7, 136
Total Amount Leveraged = $200,722,055
CHI: THE FUNDING PARTNERS
CHI
CHI Carry Forward Grant
CHI Downpayment Assistance
$1,125,875
$149,578
CHI Leverage
$4,493,457
CHI Leverage and THDA HOME
$2,082,818
CHI Permanent Supportive Housing
$8,603,394
CHI TOTAL
$16,455,122
FEDERAL HOME LOAN BANK
FHLBank Affordable Housing Program
FHLBank American Dream
$22,163,429
$1,813,217
FHLBank New Neighbors
$20,000
FHLBank Welcome Home
$278,005
FHLBank Pilot Program
FHLB TOTAL
$15,000
$24,289,651
CHI: THE FUNDING PARTNERS
HUD
HUD 202 / 811
HUD ADDI
$22,561,275
$8,310
HUD CDBG
$1,070,000
HUD COC SSO
$4,484,106
HUD HOME
$15,000
HUD Home Counseling
$45,000
HUD HOPE VI
HUD Housing for Homeless Persons Addicted to Alcohol
HUD Housing Options for Persons with AIDS
HUD RHED GRANT
$11,900,000
$999,936
$1,367,145
$780,988
CHI: THE FUNDING PARTNERS
HUD (continued)
HUD/RHED – THDA/HOME
$140,000
HUD Ross
$494,040
HUD Section 8
$10,283,717
HUD Section 8 (Designated)
$2,140,353
HUD Section 8 (Fair Share)
$446,172
HUD Section 8 (Mainstream)
$2,160,467
HUD Section 8 (Project based)
$1,576,500
HUD Shelter Plus Care
HUD SHOP
$20,719,115
$30,000
HUD Supportive Housing Program
HUD/VA/HHS
$13,686,551
$2,600,000
HUD/VASH
284,000
HUD TOTAL
$97,792,675
CHI: THE FUNDING PARTNERS
THDA
THDA
$288,723
THDA ADDI
$7,500
THDA HOME / CHDO
$16,011,704
THDA Housing Trust Fund
$3,879,601
THDA Low Income Tax Credit
$9,670,000
THDA Section 8
$10,000
THDA TOTAL
$29,867,528
OTHER SOURCES
City of Johnson City CDBG
$10,000
City of Bristol CDBG
$30,000
City of Brownsville
$75,000
City of Memphis HDC Continuum of Care Match
City of Memphis CDBC
$1,637,500
$306,660
CHI: THE FUNDING PARTNERS
OTHER SOURCES (continued)
City of Memphis HCBG
City of Memphis HCD - HOME
$60,000
$697,500
City of Memphis HCD - TBRA
$1,366,149
City of Memphis HCD - CHDO
$500,000
City of Murfreesboro
$10,000
CMS Real Choice Systems Change Grant
$1,768,604
Contributions
$2,411,498
Delta Regional Authority
$115,000
Dept. of Human Services ESG grant
$348,905
Dept. of Labor
$700,000
Dept. of Justice
$255,000
CHI: THE FUNDING PARTNERS
OTHER SOURCES (continued)
DHHS – SAMHSA
Eastern Eight
Fairview Housing Management Corp.
$8,740,000
$1,000
$1,900,000
FAHE
$93,750
FIHE
$27,900
First TN Bank Grant
Gala (Fund Raiser)
Hawkins County Habitat for Humanity
Hawkins County Inner Club Council
$550
$21,000
$296,790
$10,000
HOME – CHDO
$202,260
Landlord Equity
$2,570,000
MDHA
$50,000
CHI: THE FUNDING PARTNERS
OTHER SOURCES (continued)
MDHA HOME
$295,000
Neighborhood Reinvestment
$51,692
Owner equity and mortgage
$6,619,024
RCDI 3 and 4 – Rural Development
Rural Development – USDA
$23,400
$175,951
Rural Development – Telemedicine
$50,000
Rutherford County Habitat for Humanity
$22,000
TDMHDD Suspender
$766,000
Tennessee Habitat for Humanity
$20,000
United Way
$26,000
VA
$62,946
TOTAL OTHER SOURCES
$32,317,079
GRANT TOTAL ALL SOURCES
$200,722,055
FUNDING NEEDS
• Capital
– Acquisition
– Rehab
– New Construction
• Operating
– Recurring Housing Costs (utilities,
maintenance, reserves, etc.)
• Services
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
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
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+
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
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
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
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
• Kingsport PHA
supplies Section 8
vouchers
• Frontier Health,
using MCD,
provides case
management
THDA HOME
$460,732
Bulls Gap Historical Railroad
(land and building)
$60,000
Operations:
Kingsport Housing Authority
16 Section 8 vouchers annually
Frontier MHC /TN Care
$92,928
Housing and Economic
Recovery Act of 2008
PL 110-289
Potential Opportunities
Relative to Increasing Housing
Opportunities For People
Diagnosed with Mental Illness
and Co-occurring Disorders
•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.
• 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.
• 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.
• 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.
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
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.
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
WHAT I REALLY WANT
TO KNOW IS . . .
Questions
and
Answers