What do case managers do? As discussed at length here, case managers often facilitate “…coordination of services at a community level. Case managers connect their clients with the resources they need to take control of their lives, and are focused on the goals of the individual client. Case management is about empowering them to meet their goals. Case management is a way for you to go from one place to another place that you could not have gone on your own.”

Mike Dunthorn recently spoke with four of Volunteer Ministry Center’s case managers who work with residents of supportive housing. They talk about what they do, the folks they work with, and what they see happening in the lives of people who are given the opportunity to get off the streets and into housing in our community. Listen to what they have to say.

Click here to view the embedded video.

“The condition of where the building was to where it is today is symbolic of where the plan ends,” said 10 Year Plan Director Jon Lawler. “We started in the beginning and everyone thought, ‘How could this ever come together?’ And it is coming together.”

The News Sentinel anticipates publishing a feature-length piece in tomorrow’s paper.

Minvilla’s official ribbon cutting happens tomorrow, October 30, at 11am.

Click here to learn more about Minvilla Manor.

Permanent supportive housing remains the most effective strategy in combating homelessness, and communities around the country have found ways to locate housing developments in scattered neighborhoods. These developments have a record of success for both the residents and the neighborhoods.

The TYP can point to success in our own community, and Lyons and Martin underscore some of it:

Jon and his team have done a very good job of working with agencies to align their services to avoid redundancy and more effectively move folks toward getting the help they need. They are working effectively with faith-based organizations to make sure that assistance for the homeless leads folks to a path toward personal responsibility rather than enabling a culture of dependency.

Stephanie Matheny, of Citizens for the Ten-Year Plan, adds in the comments below the op-ed, that

In addition to the successes mentioned in the editorial, there are approximately 300 people who were chronically homeless who now have an apartment and a case manager because of the TYP. There are an additional nearly 300 people who were at-risk of becoming homeless, but who were able to remain in housing through the TYP’s homelessness prevention efforts. These quiet successes are easy to overlook.

Credit for these “quiet successes” rightly belongs to the people who do the work on the ground. Partners like Volunteer Ministry Center, Knoxville-Knox County Community Action Committee, The Salvation Army, Knox Area Rescue Ministries, Catholic Charities, to name a few, provide the housing and case management support that helps people move off the streets and into housing, keep their housing, and begin to rebuild their lives in the community.

We’re grateful for the support, and and for the support given by so many of Knoxville’s people to the organizations that make it possible for people who’ve been trapped in homelessness to make such significant changes.

Small teams of mentors are invited from congregations throughout Knox County to participate. The program’s coordinator provides training so that the teams will understand the basic purpose, expectations, and goals of a mentoring team and provides an understanding of the issues faced by the chronically homeless. Here’s a glimpse:

Each mentor team is matched with a formerly homeless neighbor and is partnered with a professional case manager and other social workers. Mentor teams are focused on helping their neighbor understand and relate to the community at large. This could be anything from simple housekeeping, decorating an apartment, understanding basic money management, or engaging in social and recreational activities. Each mentor team is matched with a formerly homeless neighbor and is partnered with a professional case manager and other social workers. Mentor teams are focused on helping their neighbor understand and relate to the community at large. This could be anything from simple housekeeping, decorating an apartment, understanding basic money management, or engaging in social and recreational activities.

The TYP held a public conversation last night, Wednesday, May 19, 2010 at the Cansler YMCA about the cost of permanent supportive housing (PSH). Bill Lyons, the City of Knoxville’s Senior Director of Policy & Communication, acted as moderator. Jon Lawler, Director of the TYP, delivered a presentation about the cost of PSH in the context of the Flenniken Housing development. The meeting was well attended, and the conversation, once again, was respectful and helpful on several different levels.

I’ve transcribed my notes from the conversation below, edited for clarity, with absolutely no concern for brevity. I’ve incorporated information from the PowerPoint slideshow Jon Lawler used to support his presentation.

Notes

[These are my notes. I tried to capture as much of what was said as I could. If I've misrepresented anything here, or left out something you believe to be significant, please mention that in the comments below this post.]

Attendees included several City Councilpersons (Marilyn Roddy, Nick Pavlis, Nick Della Volpe) and at least one County Commissioner (Finbarr Saunders). Apologies if I’ve missed anyone. Also in attendance were several members of the staff of the City’s Community Development department. The format of this meeting was one hour. The first half hour was mostly used for presentation, the second half hour was for conversation with attendees.

Bill Lyons, Senior Director of the City’s Policy & Communications Department, acted as moderator. He focused this meeting’s topic on the cost of permanent supportive housing (PSH), and mentioned that this meeting is the second in a series to fully explain and dialog about the components and strategies connected with our community’s efforts to end chronic homelessness.

Dr. Lyons also mentioned that it would be inappropriate to begin this discussion without mentioning that we have a baseline of cost already. We’re not starting from zero. The costs we presently incur are counted in places like the Knox County Jail, hospital emergency rooms, etc., and the tax dollars presently being spent in our community to cover those costs. Part of the impetus behind the TYP, and behind the development of more supportive housing in the community, is the great cost we already bear.

Jon Lawler presented the agenda:

1. Introductory Comments by Dr. Bill Lyons
2. Presentation of the Cost Components of Permanent Supportive Housing (PSH)
   1. Development Cost
   2. Operational Cost
   3. Case Management Cost
3. Questions from the Audience

The majority of those who’ve been placed in housing in connection with the TYP have been placed in already-existing housing in the community. Our TYP has the ambitious goal of ending chronic homelessness in ten years, mainly by providing housing with support. We have enough affordable housing stock to meet some of the need, but not all. New housing will need to be developed. Since housing with support is the means to end chronic homelessness, we want to address the cost of providing housing with support, and we’ll do this by examining what it will cost to develop and operate a new PSH project.

PSH is essential to end chronic homelessness, but the TYP does not have access to unlimited resources to develop affordable housing. Our office must ensure that PSH units could be developed by an entity that could utilize all of the sources of funding that are available for this type of development. Southeastern Housing Foundation (SHF), a 501(c)(3) non-profit affordable housing developer, offers its services as development partner of the TYP. A key part of SHF’s role is to increase the stock of PSH by aggressively assembling multiple layers of funding for each development.

This task is very challenging, and is undertaken by developers with a mission to develop this type of special needs housing. SHF has a deep commitment to that mission. What is the methodology SHF or any other PSH developer uses to fund the development cost of PSH? Flenniken Housing is a good example of how these developments are put together.

Development Cost: The Flenniken Example (Cost: approximately $7,050,000)

Low-Income Housing Tax Credits (LIHTC): $3,100,000
The federal government created the LIHTC program in 1986 to stimulate the development of affordable housing. Developers compete for award of tax credits which they then sell to a for-profit tax credit investor. These are typically banks and other financial institutions like them. This investment becomes equity in the development, so the investor is a financial stakeholder in the development.

Federal Home Loan Bank (FHLB) Grant: $1,000,000
The FHLB system is composed of 12 regional FHLBs with many member banks. “[Its] Affordable Housing Program (AHP) is one of the largest private sources of grant funds for affordable housing in the United States. It is funded with 10% of the Federal Home Loan Banks’ net income each year. The AHP allows for funds to be used in combination with other programs and funding sources, like the Low-Income Housing Tax Credit. These projects serve a wide range of neighborhood needs: many are designed for seniors, the disabled, homeless families, first-time homeowners and others with limited resources. More than 623,000 housing units have been built using AHP funds, including 391,000 units for very low-income residents.” (Here’s the source link for the quoted material.)

Federal Pass-thru Dollars
These funds are appropriated by Congress and come to local governments as federal grants to be spent at local discretion within established parameters in support of federal spending priorities. Flenniken has the following federal monies in its funding mix:

• CDGB (Community Development Block Grant) Funds: $100,000
• HOME (HUD’s HOME Investment Partnerships Program) Funds: $250,000
• NSP (Neighborhood Stabilization Program) Funds (Stimulus Funds): $800,000

TCAP/Monetization Funds: $1,500,000
TCAP (Tax Credit Assistance Program) provides funds directly to state housing finance agencies, like the Tennessee Housing Development Agency, to disperse to existing tax credit developments in need of additional gap funding. This program came into existence in response to bad conditions in the tax credit market that began to create serious difficulties back in 2009 for developers with tax credits in their developments. TCAP funds make up the difference between the value of tax credits and what those tax credits could actually be sold for in the market subsequent to the economic troubles of late 2008 and thereafter.

First Mortgage (CITC Loan): $300,000
This will be the only permanent debt carried by Flenniken.

Jon stopped at this point for questions, acknowledging that this had been a very complex part of the presentation. This is fairly typical of an affordable housing development’s funding package. All of these funds must be on the table to make deals like this work, and it is very difficult to put all of this together.

Barbara Disney asked which of these funding sources has to be paid back. Jon said that every source here is a grant, except for the first mortgage. That is the one source that, like any loan, must be repaid.

Joe Minichiello asked how else the money represented here could have been used. Jon replied that all of the funding represented here except the federal pass-thru dollars have to be used to develop affordable housing. David Arning added that affordable housing development was a focus of the NSP program.

Will these developments always be this expensive?

Jon next addressed the issue of costly developments. Will PSH projects always carry the high price tags associated with Minvilla and Flenniken? No, they won’t. But let’s look at why these two are particularly expensive compared to new construction.

Minvilla: The old 5th Avenue Motel was designated as a historic rehab before it ever was considered as a site for PSH. Historic preservation creates design inefficiencies that increase cost. PSH in general, and Minvilla specifically, has more common area than typical affordable housing, and this adds cost. There’s also more office space necessary due to the onsite presence of case managers and a management company.

Flenniken: Classified as an adaptive reuse project: an old school is being converted into apartments. Adaptive reuse commonly generates a higher per-foot rehab cost than new construction. KCDC’s Eastport School development (elderly housing) has a similar if not higher price per square foot. Certain design elements also add cost: 12 foot corridors, generous community space (gymnasium), and extra office space. Certain construction factors add cost: the dilapidated condition of the building and the extensive amount of environmental abatement work that needs to be done there.

New construction of PSH will not be as expensive as these two exceptional examples. New PSH can be developed at very close to the done at market rate for typical affordable housing plus a little more for necessary additional common area.

Who are the residents and what do they pay?

It is estimated that:

• 40% to 50% of the chronically homeless population qualify for Supplemental Security Income (SSI), which currently pays $674 per month
• 10% of the chronically homeless do not qualify for SSI but earn an income equal to or greater than SSI
• 40% of the chronically homeless do not qualify for SSI and earn less than what SSI pays.

None of our residents have sufficient income to pay fair market rent on their own, which means they need rental assistance. This rental assistance is provided in the form of a Section 8, Tenant-based voucher. In our community, the Section 8 program is administered by Knoxville’s Community Development Corporation (KCDC).

Operating Costs

Operating costs are a little bit higher in PSH than they are in typical affordable housing. On average, it costs about $3,200 per year to operate a typical affordable housing unit. It costs closer to $4,500 to operate a typical PSH unit for a year. Why is this? It costs more to staff PSH because the needs are a bit more intensive. For example, at Flenniken, an overnight staff presence every day adds cost. Utilities, repair and maintenance, and taxes and insurance would be very similar to typical affordable housing. The management cost will be higher than typical because of the level of expertise required to manage a PSH development. The role of the manager is to maximize revenue, control expenses, and preserve the value of the physical asset.

About developer risks and rewards

Jon mentioned that it’s been said that developing PSH is about easy money and no risk. Quite the opposite is true. This is very hard work, and it’s also quite risky. Tenant revenue is highly unpredictable, and the majority of expenses are fixed as opposed to variable. Folks who have been chronically homeless means are tenants who never have enough personal income to pay fair market rent, and even fair market rent does not ensure cushiony surpluses of funds. PSH providers in Knoxville/Knox County are dependent upon a working relationship with KCDC to have access to tenant-based assistance when it is needed. If assistance isn’t available, then providers are going to be housing someone without the ability to collect sufficient rent, which decreases operating reserves. Additionally, PSH providers are staffing and operating a property with higher than normal fixed operating costs and must maintain higher than normal reserves so they can do things like fund those tenants who are still working on gaining access to sufficient funds to pay rent. This is an extremely challenging operational model, and it takes a special kind of mission-driven company to meet it.

Case management cost

Case management cost is an expense beyond the operating budget of a PSH development, Funds for case management come largely via philanthropic support from the community. HPRP (HUD’s Homeless Prevention and Rapid Re-Housing program) funds; other grants from government sources like SAMHSA (the Department of Health and Human Service’s Substance Abuse and Mental Health Services Administration); and, potentially, pay for performance from the Knox County Sheriff’s Office based on savings realized by the jail (the largest provider of mental health services in Knox County) through housing people who have been chronically homeless.

Discussion

Bill Lyons moved the conversation into its second half. There aren’t many ground rules here, but let’s keep this more to questions and less to extended comments.

Bill Murrah spoke. A lot of concern has been expressed by people saying “not in my back yard.” Wouldn’t it be wonderful if we could have access to people who live in neighborhoods close to the kinds of people and facilities we’re talking about? I’m one of those people who lives in a neighborhood like that. I raised my kids in 4^th and Gill and nobody has ever bothered them. Our area is not a high crime area, and I challenge anyone to find an area whose property values have increased more than ours have. Our neighborhood is safe, even though it’s right next to the mission district. I have a brother who is schizophrenic, and who lived in a supportive housing situation. He lived as full a live as possible because of the support he got there. I want to allay the fears that people attach to this issue.

Joe Minichiello said that the $800,000 development fee for Flenniken was a lot, and that it seems that Southeastern Housing Foundation will become the owner of Flenniken without incurring any risk. Who determines what kind of development fee a developer is entitled to? Bill Lyons replied that the fee is suggested by THDA (Tennessee Housing Development Agency, the agency that administers the Low-Income Housing Tax Credit program, the Housing Trust Fund, and many other programs designed to stimulate development of affordable housing). The developer fee is essential to maintain and operate PSH facilities. SHF is a nonprofit, and their developer fee has to be channeled back into their mission, which is development of affordable housing. David Arning stated that the developer fee cannot exceed 15% of “eligible expenses” as stipulated by the IRS, and that these expenses are less than the total project cost. This fee looks fat on paper, but there’s a risk that you’ll never see it. The risk is in the recapture of funds. The developer makes certain guarantees to investors and if the developer fails to deliver on those, the investors will come after the developer. LIHTC is the single most important incentive to the development of affordable housing, and the developer fee is the lone incentive to the developer, besides the fulfillment of a charitable mission. These fees are critical to building reserves and are the sole source of income for a non-profit developer like SHF.

Nick Della Volpe asked whether or not it was easier to get money for Flenniken and Minvilla because the buildings were old. Jon Lawler responded that their age really didn’t’ have anything to do with making it easier to get money into the projects. He mentioned that Minvilla has Historic Tax Credits, but that Flenniken does not. Bill Lyons said that the City tried without success to find private developers for Minvilla. The development of PSH there will preserve a significant structure that will be a very attractive gateway between downtown and the surrounding neighborhoods.

Dan Smith asked a question about the ratio of clients to case managers in PSH. He said that we seem to have moved from a 10:1 to a 25:1 ratio and seemed to be asking if, even with this higher ratio, we could afford to pay all of the required case managers. Bill Lyons said that these developments don’t happen at that kind of pace. They come online one at a time at the rate of about 50 units per year or so, which means two new case managers at a time, and that organizations providing case management services in them have to step up and meet the challenge of raising funds to support case management delivery. If at some point over time an organization reaches what it believes to be the limit of its capacity to support this activity, we will not try to push beyond that. Sustainability is addressed on an ongoing, project-by-project basis. How do we know we can always raise the money to provide these services? We don’t have a guarantee that we can do any of these things going forward. Nothing comes with that kind of assurance attached to it, but we still move forward and do the very best that we can.

A gentleman named Tim spoke about the need to address the spiritual needs of people who experience homelessness. You can’t just give them a place to stay. People become homeless because of very bad things that occur in their lives, and we must show them compassion.

Ron Peabody asked how many chronically homeless people have been identified in HMIS (Homeless Management Information System, the main database used by service providers to gather data about homeless people in our community). Jon Lawler replied that approximately 1000 people designated in the database as chronically homeless received services in the last year. Mr. Peabody asked what the goal for PSH development is. Jon said that SHF can do one project per year, and that existing stock is being used on a regular basis, and that we’re developing a better understanding of what we need to develop in our community. Mr. Peabody said that 500 people are on KCDC’s waiting list for Section 8 vouchers. Jon responded that the wait list has been revised to a smaller number since Mr. Peabody got his information from KCDC two weeks ago, and that there is not a limitless supply of vouchers. [We met with KCDC the morning of May 19 and the wait list has been revised to approximately 270.] There is an art to making vouchers work. KCDC is not simply handing them out. This is one reason the developer of PSH must have sufficient reserves—to cushion against the unpredictable revenue from PSH tenants.

Stephanie Matheny asked David Arning what SHF has risked, so far, at Flenniken? David replied that SHF has $95,000 in Flenniken so far, of non-recoverable dollars that would be lost if the project fails to go forward.

Someone asked if any surplus funds would be reinvested in local projects, or would SHF develop outside the Knoxville/Knox County community? David Arning responded that SHF’s focus is on this community.

Nick Della Volpe asked if we could mimic the nursing home care continuum, in the sense that residents of a relatively costly kind of supportive housing could be helped to the extent that they’d be capable of moving into less-expensive housing. Jon Lawler answered that PSH isn’t the only kind of supportive housing and that it’s not appropriate for everyone. Tenants are not just put into housing, and residents of a particular development are not all at the same place with regard to the level of their disability and need. Barbara Disney added that residents who have Section 8 vouchers can take those vouchers with them to less expensive environments if they want to.

Duane Grieve asked if it is realistic to think that we can do away with existing cost as we fulfill the mission of the TYP. Jon Lawler responded that the TYP calls upon us to end chronic homelessness, but that it also calls upon us to do a lot of work to prevent homelessness in the first place. Mr. Grieve asked if we wouldn’t be adding new chronically homeless people each year. Bill Lyons responded that it’s not like there are slots that people move out of when they’re housed that are immediately occupied by some new chronically homeless person. Every person who is not stuck in the cycle of chronic homelessness is one person who is not adding to the cost borne by the community. We want to minimize the number of disabled people stuck in homelessness because it’s the right thing to do and because when they’re living on the street they are utilizing so many costly services.

Dave Gartner expressed disappointment that we didn’t provide a spreadsheet with costs of actual operations broken down into dollar figures.

Ron Peabody mentioned that TennCare is making major cuts and dropping people from its rolls. He asked how this will effect service delivery for mental health and basic healthcare. Ginny Weatherstone acknowledged that this places a burden on the service provider community. She indicated that she had been in contact with Cherokee Health Systems and Helen Ross McNabb Center to discuss this issue and that both of them are committed to continuing to serve their patients and clients who lose insurance provided by TennCare. She said that all agencies like these will continue the aggressive pursuit of other sources of funding, as in the example of the City’s recent submission of a Mental Health Transformation Grant to SAMHSA in partnership with Volunteer Ministry Center and Helen Ross McNabb. The bottom line is that there are people in the community who need this kind of help, and those who are committed to serving them will have to work harder to make sure they can deliver that help.

Suggestions

I had a very good conversation with an attendee after the meeting. She recommended, among other things, that a good topic for a meeting like this one might be the rationale behind the scattered site approach to PSH development. That approach is advocated in the TYP. There are good reasons for it, and she would like to hear them explained and opened up for dialog.

Another attendee offered some recommendations about presentation and materials that might be made available at these public conversations. We employed far too many acronyms in our speech and presentation materials, and this creates confusion and misunderstanding. Acronyms hurt. Spell things out. Point taken.

Some folks (I don’t think Dave Gartner was alone in this) wanted to see much more financial detail. This kind of material should be put on our website, along with images and reports on progress. Minvilla’s budget info has been up for a while. I need to update it, I’m sure. I’ll check on that and adjust as appropriate. I’ve not created a similar resource for Flenniken, but I will have it up within the week.

We need to create a handout for each of these meetings, and it seems reasonable to think we should make the same content available online.  The suggestion is for a two page piece printed double-sided on one sheet that contains links to additional information online.

All good suggestions. I’ll follow through on them.

Next meeting

The next public conversation will be held at the Deane Hill Recreation Center from 6-7pm on Wednesday, June 23. The topic will be how the Ten-Year Plan came about. Dr. Roger Nooe, our community’s recognized expert on the subject of homelessness, Mike Dunthorn of the Ten-Year Plan office, who helped write the plan, and Linda Rust, of Knox County’s Community Development Department, who facilitated Community Concerns working groups’ input in the TYP’s formation for a period of about a year, will present as a panel. We’ll follow the same basic format. First half hour presentation, second half conversation about the subject.

The TYP held a public conversation on Wednesday, April 28, 2010 at the Cansler YMCA about case management in permanent supportive housing. Bill Lyons, the City of Knoxville’s Senior Director of Policy & Communication, acted as moderator. Ginny Weatherstone, CEO of Volunteer Ministry Center, and several members of VMC’s staff along with a resident of the Jackson Apartments, a PSH apartment building owned by VMC, presented led the discussion about case management in PSH as practiced by VMC. The meeting was well attended, and the conversation was very good.

I’ve transcribed my notes from the conversation below with very few minor edits for clarity.

Meeting Notes

[These are my notes. I tried to capture as much of what was said as I could. If I've misrepresented anything here, or left out something you believe to be significant, please mention that in the comments below this post.]

Attendees included all City Councilpersons except one who was recovering from a medical procedure. Two Knox County Commissioners were present.

Bill Lyons, Senior Director of the City’s Policy & Communications Department, acted as moderator. He defined this meeting’s topic as being focused on case management in permanent supportive housing (PSH), and said that this meeting will be the first of a series to fully explain and dialog about the components and strategies connected with our community’s efforts to end chronic homelessness. The format of this meeting was one hour. The first half hour was mostly used for presentation, the second half hour was for conversation with attendees.

Ginny Weatherstone, CEO of Volunteer Ministry Center (VMC) presented. VMC views case management as the road from homelessness into housing. case management is a very big topic. Other agencies do case management, and there are many ways to do it. Tonight we will skim the surface, and our discussion will be focused on how we do case management at VMC.

We believe in the effectiveness of the case management we do. It works. Case management for us is facilitated coordination of services at a community level. Case managers connect their clients with the resources they need to take control of their lives, and are focused on the goals of the individual client. Case management is about empowering them to meet their goals. Case management is a way for you to go from one place to another place that you could not have gone on your own.

Homelessness is characterized by chaos, noise, uncertainty, lack of safety, lack of privacy, proximity to illicit substances, lack of trust, no autonomy, little responsibility and very little accountability. This is the environment within which a homeless person must work to regain control of his or her life, and to gain the stability necessary to live a good life in the community. For some people, it is impossible to cope with the challenges of life on the street, and with the challenge of trying to get off the streets.

Housing changes this environment completely. Life in one’s own apartment is characterized by safety, security of person and possessions, calm, privacy, autonomy, high levels of responsibility and accountability because residents pay rent and must abide by the terms of a lease agreement. All of can be very positive, but can also be extremely difficult for a person who has been homeless for a long time. Not all of them can get there without help.

Case management is about building and maintaining relationship, and this happens in steps.

• It begins with an individual’s expression of the desire to leave homelessness.
• An individual assessment is performed and the person is matched with a case management. At VMC, the end goal is always housing and becoming a part of the community.
• Secure the documents that are necessary for gaining access to housing. This can involve many different kinds of agencies and can be very daunting. case managers help  their clients navigate the bureaucracies involved.
• Apply for housing. In our community, there’s not a huge supply of appropriate housing. There’s usually a wait, and that lag time is productively used. It lets the case management client relationship build.
• Once housing is obtained, case managers help clients get the stuff they need and help them move in and get established.
• Case managers help clients to find and get to all of the services they need to help them meet their individual recovery goals and stay successfully housed.
• Case managers facilitate basic skills development. These can be related to many different things, such as skills related to successful employment, managing money, healthy diet, etc.
• Case managers engage in advocacy on behalf of their clients.
• Case managers visit clients often in the client’s apartment. This is a critical component of the ongoing assessment. It lets the case management know immediately if the client is experiencing any kind of issues that might affect his or her ability to remain successfully housed on the path to recovery.
• Case managers help clients find people who will help them feel good, have fun, and do things that are interesting and fulfilling. We’re really talking about helping them find and make friends with people who are different from their old associates.

Case management delivery is cost efficient when clients live close together. Sometimes the first case manager engaged by a client will make a “handoff” of that client to another case manager who is attached to the residence.

Case managers also plan and conduct activities that foster a sense of community. This helps residents decide that their housing is something that they really want to keep, to decide that “I want this to be my life and it’s worth working to maintain it.”

Two case managers, Megan Lappas and Matt Nance, and one of their clients, James Johnson, comprised a panel.

Challenges: Megan Lappas: One of the biggest challenges faced by case managers is that there is not enough housing. it is hard to instill hope when move-in is far away. Navigating bureaucracies is hard enough for case managers—imagine how challenging that is for a person who lives in the chaos of the streets. Matt Nance: The case manager’s fight is the fight against the tide of the chaos of the streets.

Megan Lappas: Our presence helps to keep people calm at Jackson Apartments, but so does the sense of community among the residents. Matt Nance: Community is a strong reinforcer of cohesion. “Don’t do bad things here because that will mess up what we’ve all built and are doing here.”

James Johnson: We depend on case managers for good advice. They’re not too authoritative. They’re kind of like family members. You can trust them. My apartment at Jackson Apartments is a blessing. I don’t know what I would do or where I’d be without it.

Dr. Lyons established ground rules for the second half. No reason for anyone to exceed 3 minutes with their comments/questions. Stay on the topic for this evening. Other than that, there are very few rules.

Della Volpe: Will the family atmosphere translate to 57 units? Matt Nance: It’s like a dorm experience in college. Lots of small interactions create the sense of community. That doesn’t happen necessarily because of big events.

Joe Minichiello: Does federal money restrict zero tolerance policies?  Ginny Weatherstone: Good case managers know what is in a lease. Most leases address disruptive behavior, not alcohol consumption per se. If a case manager suspects that a person is going to be a disruptive presence because of issues related to any addiction, then that person will not be placed in that housing. Not all homeless people are addicts, though, and not all are alcoholics. It is very important to note this. Only about half the residents at Jackson Apartments, for example, are mentally ill. Members of this population are all disabled, but they are also very diverse.

Dan Smith: Where does the sustaining funding for case management come from? Bill Lyons: It doesn’t all get secured at once or from one source. Ginny Weatherstone: We get grants from the City and the County for case management funding. Plus, VMC has embraced this as what we do. We fundraise. We’re increasing our pursuit of grants. We do much else to raise money for this work. Also, we will not provide ALL of the case management for everyone in PSH. Helen Ross McNabb, for example, does a great deal of excellent case management in the community, and they seek funding in many of the same ways we do. It’s just what you have to do.

Ginny Weatherstone: We know that what we do will save the community money, but that the effect of that savings will be cumulative and will not be immediately apparent. We will see it down the road when the jail doesn’t have to build another pod, for instance. You’re not going to immediately notice a savings to the community when just one person is housed, though.

Whitney Stanley: Are there separate approaches to case management and separate restrictions for people who are chronically homeless as opposed to those who are just down on their luck? Ginny Weatherstone: The latter would not be housed in a PSH development. Are there tighter restrictions on people in PSH? A better way to think of it is that there is a lot more supervision.

Is disability income used to pay for treatment? Ginny Weatherstone: Yes, part of the treatment.

Is this housing really permanent, or is it more transitional? Ginny Weatherstone: It is whatever the resident needs it to be. One of our folks at Jackson has been there for 15 years and will probably be with us for the rest of his life. Others have moved out much faster. It all depends on their needs.

How diverse is the chronically homeless population? Ginny Weatherstone: Very. They are disabled, but their disability is not always caused by addiction and it’s not always caused by mental illness. I mentioned before that only about half of the residents at Jackson have mental illness. We have some residents whose disability is simply the result of a physical impairment. Some are very young and some are elderly.

Nancy Mott: I have a concern about our progress moving forward. The old way was very expensive and it was less effective. I have brought some resources to help people understand this and would like to hand them out. They address myths about Ten-Year Plans, statistics on savings. You cannot treat addiction in people who are living on the streets.

Ron Peabody: Can disability recipients work? Ginny Weatherstone and Matt Nance: They can work, which scales back the disability payments for which they’re eligible.

Joe Minichiello: I’d like to ask James if I may where he is from and why he is here. James Johnson: I’m originally from Florida. I came here looking for work, and after I got here, I couldn’t find work and found myself homeless.

How are case managers trained? What kind of turnover do they experience? How stressful is the work environment? Megan Lappas: We have very low turnover at VMC. Our training occurs on a constant basis. The stress is pretty high, but the work is very rewarding.

Is two hours per week per client a sufficient amount of time for case management delivery? Megan Lappas: Different clients have different needs. I might have a client that I need to see on a daily basis, and I might have others who become self-sufficient enough that I might check in with them once a month. They’re very diverse in their needs and that affects the intensity of engagement. Matt Nance: We also maximize our efficiencies. For instance, I might wait until I’ve got a group of 4 or 5 clients who need to go to the Social Security office, and then get a van and take them all there at one time. We look for ways to do that kind of thing whenever we can.

Commissioner Brown: How do you make sure that meds are being taken? Megan Lappas: Some clients are responsible enough to take them on their own. Some get PACT (Programs of Assertive Community Treatment) supervision, which is for people who need more intensive mental healthcare. Sometimes the solution is as simple, and effective, as getting them an alarm watch to remind them of when they should take their medication. Matt Nance: The home visits we do let us check very closely on how this is going. We can see if a bottle of medication is being consumed at an appropriate rate. We can check on the condition of their apartment. All of those things will tell us if we have an issue that we need to deal with. Ginny Weatherstone: Also, not all  PSH residents are mentally ill. There is also a very high incidence of diabetes, hypertension, and we have to watch those things too.

The last question related to cost, and I didn’t really get much on paper about it. I think someone asked how we “arrived at a figure of $7M.” Someone else asked why Minvilla was not bid, I believe. The answer to the latter is that Minvilla’s construction contract was bid twice. (The contractor is making excellent progress on Minvilla, btw.)

Bill Lyons wrapped up our time by pointing out that the pro forma for Flenniken was presented at a recent City Council meeting, and it shows that no local tax dollars are in its funding mix, which is made up of private dollars invested via purchase of tax credits, grants, and federal dollars already appropriated for like purposes, allocated by the City and the County. He thanked everyone for taking the time to come out, and for the good dialog.

The next public conversation will be held at the Cansler YMCA from 6-7pm on Wednesday, May 19. The topic will be cost of PSH. We’ll follow the same basic format. First half hour presentation, second half conversation about the subject.

The neighborhood organizations representing the Kingston Hills and Kingston Woods neighborhoods held a meeting on Thursday, March 18, 2010 at the Arnstein Jewish Community Center. Bill Lyons, the City of Knoxville’s Senior Director of Policy & Communication, Jon Lawler, Director of the Ten-Year Plan to End Chronic Homelessness, David Arning of Southeastern Housing Foundation, Bruce Spangler of Volunteer Ministry Center, and several representatives of area neighborhood groups were in attendance. There was also lively public input from community members who asked questions and made comments.

I’ve transcribed my notes from the meeting below with very few minor edits for clarity. I don’t want to use this post to editorialize about the meeting, but I will say that we took away several important points and some recommendations upon which we intend to act as soon as possible.

1. Quite a few attendees expressed the belief that the Ten-Year Plan (TYP) needs to do a much better job of communicating with the public about the TYP, specifically
   1. good and comprehensive estimates of costs to implement the TYP,
   2. clear and specific descriptions of case management and delivery of other services to people in permanent supportive housing,
   3. the history of the TYP and who participated in its creation.
2. Many attendees said that they’d like to see the TYP get out more often. They suggested that we conduct much more frequent and regular meetings with the public to explain the TYP and its approach to addressing chronic homelessness, and to get input from community members, answer questions and address concerns.
   1. We are committed to re-starting a public dialog about the TYP. We’re not entirely sure what shape that should take, so our next community meeting will be for the purpose of getting input on that. This next meeting is planned for Wednesday, April 21. We’ll get more details out about that meeting very soon.
3. It became clear at this meeting, as it has been clear at every single other one that I’ve attended, that the jargon surrounding the issue of chronic homelessness is very confusing to many members of the public who don’t live with this language every day. The TYP needs to find ways to disambiguate the discussion.

Meeting Notes

[These are my notes. I tried to capture as much of what was said as I could. If I've misrepresented anything here, or left out something you believe to be significant, please mention that in the comments below this post.]

The meeting’s moderator was Gene Patterson, and was structured to give the Administration and TYP time to present, Ron Peabody and homeowners’ association time to present, followed by a question and answer session.

Bill Lyons commented right after Mr. Patterson’s opening remarks, and expressed Administration’s commitment to an open and transparent public dialog about the TYP. The more we talk the better. We want to speak with you not talk at you. We want to work towards understanding, addressing, and contextualizing the controversy.

• National context–deinstitutionalization. Ten-Year Plans were established in 2003 and most of them stressed Housing First. People who are chronically homeless have no chance of getting off the streets and staying off unless they are first helped to find their way into Supportive Housing. Research show that housing first is the best approach in “most places.”
• The nationwide movement towards ending homelessness is bipartisan. Fundamentally, there are not competing views: there is a broad and deep consensus as to supportive housing being at the heart of the solution. The prior emphasis had been on delivery of emergency services, the kind you see a concentration of in Knox County in the Mission District. The services available in the mission district are specifically for homeless people who are experiencing a housing crisis.
• But residents of permanent supportive housing (PSH) are not homeless. There is absolutely no evidence that property values are lowered by PSH. On the contrary, residents of PSH are good neighbors because they are motivated to change their lives and because of the support they get in PSH.
• We’re working on a siting process. What is that? That’s what we want to find out. Whatever that process looks like, we’re committed to these inseparable moral imperatives:
  • We have a moral imperative to address the problem of chronic homelessness in the most effective way.
  • We have an equal moral imperative that no neighborhood is harmed by the development of PSH. If we believed PSH would harm neighborhoods, we would not do it. It’s as simple as that. This approach is not based on faith–it’s based on evidence, and its success is demonstrable.

Jon Lawler followed Dr. Lyons.

• TYP was established to end chronic homelessness, but it has several other objectives:
  • Reduce duplication of services, which is happening in Knoxville as we better-coordinate service delivery.
  • Fully implement HMIS (Homeless Management Information System) so we know our homeless population, the services they need and the services they use. HMIS is now widely deployed, and we now know more than ever about who the homeless are, their issues, and the environments in which those issues are being addressed.
  • Increase the accountability of people moving into PSH in order to prevent more people falling into homelessness. This is being accomplished right now through the placement of case managers in KCDC properties that are presently being used to provide PSH. Case managers at those properties have reduced evictions to the street from over 60 in one year to zero in the first year of implementation.
• Mr. Lawler gave the official HUD definition of Chronic Homelessness and then defined people who are chronically homeless as people with mental health, substance addiction, or other disabling issues whose lack of access to the resources to address those issues leads to homelessness. PSH provides support network that was missing before.
• PSH is a safe, secure apartment. The case manager relationship is integral to the PSH model. The case manager is the resident’s broker of supportive services to ensure success in housing. Every individual has a service plan to ensure that they reach their potential.
• Success in PSH means that residents have the opportunity and are empowered to become vital members of the community.
• Mr. Lawler said that the TYP is working.
  • In the past 18 months, we have housed over 300 people who used to be chronically homeless in PSH, and our retention rate is approximately 90%. That’s better than the national average of 84%.
  • In that same 18 months, there have been no evictions to the street at the KCDC towers in which we’ve placed case managers.
  • HMIS is being used by every major service provider
  • We have more PSH in the pipeline.

Gene Patterson spoke next to acknowledge members of City Council, County Commission, and other officials present at the meeting.

Ron Peabody presented a PowerPoint display titled Components and Costs Ten-Year Plan 2010. Tonight we want to talk about what it would cost to implement the TYP. Mr. Peabody said that he could not find specific information related to cost at the TYP website, and that he’d had to extrapolate costs based on his own independent research. After presenting, Mr. Peabody called for community forums to discuss costs.

John King, a local attorney, spoke next. He said that there are other approaches to addressing the challenges of chronic homelessness that are just as effective as Housing First. He didn’t offer any specific discussion of these alternate approaches. He addressed site selection and said that there needs to be “better due diligence.” Pedestrian access is nonexistent at the Teaberry site. This group of people is special-needs and they need special transportation networks. The Teaberry site wasn’t optimum. Review of any potential PSH site should include input from fire, emergency, law enforcement. Should be engineering review “very early on.” Access to public transit. Given the problems that these people have, we should require that any site proposed for housing for the chronically homeless should have sidewalk access to public transit. Access must be close so that these people aren’t endangered. Suggested appraisal very early in the due diligence process.

Don Daugherty followed Mr. King with some remarks advocating a centralized housing-with-services facility at the old Baptist Hospital site in South Knoxville. He said that we don’t want to leave this problem for future generations to have to deal with it. The TYP hasn’t been able to meet expectations. Scattering homeless across the county may not be the best idea. Proposes a central location services and housing. We’ve got other locations we could use: Rule, Oakwood, Brownlow, abandoned retail facilities. The TYP isn’t the only option.

At this point, Mr. Patterson opened up the mic for questions and comments.

Joe Creighton (sp?) is a  pastor and a psychiatric chaplain. Haven’t heard anyone say that they’ve asked the homeless what they want. Self-regard is a fragile thing. Putting people who are chronically homeless into a community where they’re not wanted is a  bad idea because it can lead to harm, especially with people who are mentally ill or who are addicts.

• Bruce Spangler, who supervises case managers at Volunteer Ministry Center (VMC), spoke about the wrap around supportive services that PSH residents need in order to succeed in housing and in the community. Case managers make the vital connections for their clients with these services. Mr. Spangler mentioned that he is the person who will be responsible for case management services at Minvilla.
• Jon Lawler made the point that the TYP works with VMC to provide case management in PSH developed in conjunction with the TYP.
• Bill Lyons reinforced the point that delivery of supportive services is an integral part of PSH.

Rodney Beverly said that these facilities would house patients with chronic conditions. He asked how we would ensure that people in these dwellings will not carry on in those conditions. What method ensures their good behavior?

• Bruce Spangler responded that people who live in PSH are residents, not patients, and that residents have to honor the terms of their leases. If they present a danger in housing, state law allows eviction within three days.

Ron Ashford referred to one of the numbers in Ron Peabody’s presentation on costs. He said that we needed to be cost-effective.

• Jon Lawler responded that if we have 800 CH people living in Knoxville, we are spending $32,000,000 to maintain them in homelessness ( at a cost of $40,000 per person per year). The cost to the community drops substantially when a person is housed.
• Bill Lyons mentioned that the costs to taxpayers are located in incarceration and consumption of other emergency services, and those things drop dramatically once a person is in PSH.

Robert Burgess asked how many people we serve who are from outside of Knox County.

• Jon Lawler responded that if a person falls into homelessness in a neighboring county, comes to Knox, and decides that for whatever reason this is where he or she wants to stay, then they’re going to stay here. This happens all the time in cities like ours that are surrounded by mostly rural counties, which are relatively undeveloped, less-populated, and can’t offer the array of resources for which all kinds of people, not just those who are homeless, move to cities. HMIS shows that for 80% of the homeless people who receive services in Knoxville, their last permanent address was within a zip code beginning with the 37 prefix; 59% had a last permanent address in 379. In any event, we don’t ask where people are born before offering them services, and we will serve anyone who is here.

Kelly Rafferty asked about case management and treatment. Not clear on medical needs. there are no clinics located in West Knox–all that stuff is located close to downtown. Will you build a medical clinic centrally? How do residents see providers?

• Bruce Spangler responded that case managers make sure their clients get to the services they need, wherever they live and however it has to happen. He listed several transportation alternatives. He also said that VMC considers 1:25 to be a reasonable, manageable case manager to client ratio. He underscored that case managers coordinate care, but that they are not themselves care providers. Care providers are the mental health care providers, physicians, dentists, employment specialists, etc.

Sheryl McCormick said that she lives in Rocky Hill. She’s got a psychiatric disorder and has been homeless. She would not have been successful if she’d been warehoused or segregated. Community integration, with housing built out in the community, is hugely important. The TYP needs to mount a strong community education campaign.

Dr. Reuben Pelot said that if you’ve never worked with people who are truly homeless, you’ve missed an opportunity. The homeless people he’s worked with are some of the most delightful people he’s ever come into contact with. The thing that keeps people from interacting with the homeless is fear, and that’s unfounded. Dr. Pelot welcomes what we’re doing and thinks it’s very positive. He applauds the TYP.

Don Byerly is a Professor (Emeritus) at UT. He wholeheartedly endorses the TYP. As a geologist who lives nearby, he already knew about the earth problems at the Teaberry site. He pointed out that no due diligence was done at the Meadows, which is now having a lot of soil-related problems. He also mentioned that sinkhole damage is very costly. He recommended having a geologist examine any properties considered for PSH development.

• Bill Lyons addressed the issue of real estate purchase contracts and likened them to putting down earnest money on a house. He mentioned that the day the option on Teaberry was executed, we made it public. We want to be early, transparent, and immediately initiate meetings with neighborhoods surrounding any potential PSH site. We’re committed to discussion, early in the process, to address suitability of any proposed site. As soon as we found out about the sinkhole, we investigated. Dr. Lyons repeated the commitment to early discussion.
• Gene Patterson asked if what had happened at the proposed site at Debusk had influenced the decision to become more proactive about communication related to site suitability.
• Dr. Lyons responded that earlier experience showed us that we didn’t have a rational place for input/access to elected officials. City Council can then vote, very early in the process, explicitly on site appropriateness, as opposed to voting on funding or some other issue, much later in the process.

Harlan Hannah spoke of his own experience of homelessness and suggested that most of us, if we had to forgo one or two paychecks, would experience homeless too. Knoxville people want to be in on every piece of what the TYP is doing. Want to track it, costs, etc. Mr. Hannah suggested that the almighty would bless us if we seek to address the problem of homelessness. The challenge is a big one, but so was the World’s Fair, and we did that. We just need to roll up our sleeves and get this done.

David Howard expressed personal appreciation for the TYP. He said that he is not qualified to say that it’s a bad idea to do this plan, but that he can say how it looks. If the Teaberry site had not been taken off the table, the TYP and the Administration would have been walking into a lions’ den tonight. The concept of exporting an urban problem to the suburbs just doesn’t make sense. The choice of the Teaberry site without public conversation was shocking. We do have a moral imperative to fix the problem. The way this happened was flawed, insensitive, uncaring, callous, and demonstrates Government arrogance towards its citizens.

• Dr. Lyons responded. This is a community problem, not an urban problem. The only people who even get considered as PSH residents are people who have demonstrated commitment. And we’re talking about where people will live. Those stereotypical problems won’t be here. Without the right motivation, people will not become residents of PSH. As to people who do come to live in PSH, they’re not in shelters. PSH facilities are safe. They feature controlled access, which means you’re not going to have a resident inviting a gang of friends over to drink Jack Daniels in his apartment. A well-managed PSH development is simply not detrimental to the community.

Joe Thompson mentioned that he’s got a brother in Nashville who works at a church, and lives in an old Sears building that has been converted into small apartments. Residents there have pulled themselves up. The apartment building has given them a place to have a permanent address, get off the streets. Not sure if there’s something like this in the TYP. If so, they need transportation as a first criterion. These are not people you need to be afraid of. I would like to know how you’re doing funding here.

• David Arning explained that SHF is the nonprofit affordable housing development partner of the TYP. We always look for convenient access to public transit. Essentially, residents of PSH are looking for the same things you’d be looking for if you were looking for an apartment. We do ask homeless people what they want in an apartment.

Clarence wondered why we don’t reopen Eastern State? What is the difference between the TYP and Habitat for Humanity? What about jobs? Due diligence?

• Mr. Arning explained the 90 day free look before any money at all was even put down. We do go through the process of due diligence as a conscientious developer for every property on which we propose to build PSH.
• Mr. Lawler explained that Lakeshore is not going to be restored to its formal size/function because of civil liberties, etc. As to Habitat for Humanity, a single family, owner-occupied home is simply not appropriate for people who need PSH; they need a small apartment.
• Dr. Lyons further addressed due diligence. Site control is first, then due diligence. When we begin this process, we’re entering a covenant with the community, the neighborhood, to stay engaged at the beginning of the process, in the middle of it, and after a development is completed and occupied. We need a better way to listen to concerns and to better explain what we’re doing along the way. We must, and we will, ensure that there are no negative consequences for the neighborhood.

Kyle Stooksbury asked if this approach (PSH/TYP) is Federally-mandated.

• Dr. Lyons explained that it is not mandated, but that it is a Federal priority. A lot of it is accomplished with private dollars, and because it is not a Federal mandate, there’s no danger that Federal funding for it will be withdrawn.

Stephanie Matheny expressed disappointment that PSH will not be developed at the Teaberry site. She lived in Seattle WA for 11 years developing PSH projects like the one proposed at Teaberry. In 1992-’93, she worked on the Wintonia Apartments there. The Wintonia contains 92 units: half of residents were chronic public inebriates and the other half were the chronic, long-term homeless. The developer held many community meetings, and much anger and controversy swirled around the project. But now, Wintonia is a success and is embraced by the community. In America, we have long, national experience with concentrating very low income people in relatively small areas, and we’re now spending billions of dollars tearing that housing down. But housing must be proper to its context. You do multifamily development in multifamily areas. In Knox County, we’re working towards a siting process. Every time a new PSH site is proposed, there’s a lot of concern expressed. The TYP is at fault because they’ve been too short on specific information. The TYP must cover all the bases in this conversation, and must address all the concerns.

Brad Fultz  asked how many homeless people are in Knoxville right now.

• Mr. Lawler responded that in a given three month period, there are 1100 people in our community who would benefit from PSH [a large subset of that number are people who are chronically homeless] and 870+ people who are episodically homeless will receive services in Knoxville.

Robin Zollin-Brown is a social worker. She suggests that the 1:10 client:case manager ratio is not good, and that we should have smaller facilities and more staff.

• Bruce Spangler responded that VMC’s present client:case manager ratio is 1:25, and that there are awake staff on site [who are not themselves case managers] in the Minvilla and Flenniken facilities 24/7. Rev. Spangler suggested that without this kind of case manager involvement, it’s not supportive housing.
• Mr. Lawler said that, yes, the 1:10 ratio does appear in the TYP document, but practitioners here believe 1:25 is a very good ratio, and very workable.

Diana Ritter asked if it were true that four sites have been rejected. She said that she was under the impression that if the TYP didn’t have a site under control by December 31, 2010, that the TYP is dead. She asked if that is true. [Actually, neither of those things is accurate.] Ms. Ritter said that PSH would really improve the area but that she has run into a great deal of irrational fear. We must embrace this solution. It’s a “we’re all in this together” moment.

Elaine Davis asked if it is true that a chronically homeless person, whose cost she pegged at $45,000 per year, will really only cost the community about $17,000 per year once that person is a PSH resident. She asked if that includes “all the variables.”

• Mr. Lawler answered that that estimate is all-inclusive, including the cost of the facility. He said that our goal is to build PSH debt-free so that the facilities can be operated with the highest level of efficiency.
• Ms. Davis asked if the developer would come back and ask for more public dollars to do rehab on PSH facilities.
  • Mr. Arning responded that the owner would protect his investment in the property by managing it very well, which will necessitate hiring a property manager who has experience managing these kinds of housing developments. Likewise, the owner will hire an organization to deliver case management services.
• Mr. Lawler restated the commitment to hold meetings with the public, and to stay engaged with the public.

Tim Hutchison said that he is a believer in helping people close to the mission district, because that’s where the services are already located. He suggests that the TYP get out into the community for meetings in advance.

• Mr. Lawler pointed out that the services available in the mission district are focused on helping people who are in crisis, and who are homeless. The TYP is focused on meeting them there and helping them move beyond crisis and into stability in PSH.

Dan Smith said that we’re all responsible for not being up to speed on this. He suggested that the TYP could be public-inputted to death, and that we should land on a number of people who are chronically homeless in our community and stick with it. Be up front with the community about the true cost of homelessness and the true cost of implementing any plan to address it.

Written comments submitted at the meeting

First commenter: Why hung up on splatter effect? Why not go to Baptist Hospital? Much more cost-effective. Centrally located to services. Less expenditure per year. If not Baptist, why not Lakeshore? Lots of land available, already owned [by City]. Originally chartered for similar usage. Safe environment. People need to know about this plan. Don’t ask us to endorse and pay for something that is so secretive.

Second commenter: 1. How is funding planned for such projects? 2. How can addicts and alcoholics be integrated int o a community which has mentally ill, depressed, handicapped? 3. If people are “homeless” (inferring unemployed), how can they be expected to pay any rent, etc. 4. I think the cost $40,000 for for 450 sq. ft. is ABSURD!  5 Why can’t unused school buildings, old Baptist Hospital, McClung Warehouses be renovated? 6. $38 million a year to support approximately 1200-1400 people is ridiculously expensive!! 7. [A certain private citizen] should consider contributing one of his buildings for the homeless.

Third commenter: How about 5th Ave. Motel being remodeled for the homeless? I passed by there this morning and crowds in each side of the sidewalk with cell phones, cigarettes in their ears and mouth, whose paying for all this? Why can’t they go there?

The Ten-Year Plan to End Chronic Homelessness (TYP) in Knoxville and Knox County is part of a national movement to end long-term or chronic homelessness. A person who is chronically homeless is, by HUD’s definition, a disabled individual who has been homeless for at least one year or who has had four episodes of homelessness in the last three years. Another perspective: People who are chronically homeless struggle with some disabling condition, whether it be mental, physical, or related to addiction, and lack the resources with which to address their issues. We always find homelessness where mental illness and addiction meet poverty. The TYP offers a long-range, comprehensive approach to ending homelessness, a key part of which is helping homeless people gain stability in permanent supportive housing (PSH).

Permanent Supportive Housing (PSH) Characteristics

PSH offers residents permanent rental housing set up for independent living (an apartment), and then surrounds them with the social services they require in order to stay in their housing.

• A PSH development is not a mental institution, an emergency shelter, a halfway house, or transitional housing.
• PSH residents sign a lease, pay rent, and can stay as long as they need/want to and as long as they abide by the terms of their lease agreements, just like residents of any other longterm rental housing.
• PSH saves money. It costs the community much less to house someone in PSH than it costs to leave them in a state of chronic homelessness because PSH residents consume far fewer emergency services. Dr. Roger Nooe’s 2006 study Local Cost Estimates (Knoxville, Tennessee) found that a chronically homeless person costs our community an average of over $40,000 per year. We are still gathering data on costs, but we believe that an average PSH resident would cost our community less than half that amount.

The Teaberry Housing Development

Teaberry Housing is a proposed 48-unit permanent supportive housing development for men and women who are chronically homeless. The development is in its very earliest stages. An architect has not yet been engaged and no design work has been completed, so the following description is general in nature.

• Teaberry will be owned and operated by Southeastern Housing Foundation, a nonprofit affordable housing developer in Knoxville. Development will be funded by a mix of tax credit equity and various grants. The developer will contract with a professional property management firm with experience in affordable housing, and case management programming will be carried out by Volunteer Ministry Center.
• Teaberry’s facility will include a number of the physical attributes necessary to any permanent supportive housing development. These attributes contribute to a safe, secure, and healthy living environment.
• Safety and security are vital to residents, case managers, and the community. Teaberry residents will be very low-income, and will likely need HUD Section 8 Housing Choice vouchers. KCDC must do certain kinds of background investigations on applicants for these vouchers, and cannot grant them to people who have been convicted of violent felonies, certain kinds of drug offenses, or sex offenders. If a prospective resident does not plan to use a voucher, the owner/developer of Teaberry (Southeastern Housing Foundation) will conduct background investigations to the same standard as KCDC’s.
• Teaberry will feature a common entry with controlled access. The property will include offices for a property manager, office space for case managers, laundry facilities, common-area bathrooms, and ample community space.
• The development will be quality new construction and will consist of 48 one-bedroom units, each including its own private kitchen and bath. The structure will probably be two stories in height, with a brick and/or Hardie siding exterior.

The first story ran on Friday, and you can watch it here.

Click here to watch the second story.

The idea behind this series is to give viewers a window into PSH, which is such a critical part of our community’s strategy to end chronic homelessness.

What keeps a person living on the streets for years? How big a factor is mental illness? Addiction? What difference does it make to have a safe, secure place of one’s own? What about the role of case managers? How does housing with support change the life of a person who’s been on the street for long time?

Stay tuned. This series should touch on all of those questions, and more. We appreciate WBIR’s interest, and Ms. Morrow’s excellent work.