Creating Homes Initiative (CHI)

"Rainbow" by Van

Never doubt that a small 
group of thoughtful, committed 
citizens can change the world.   can change the world.
Indeed, it’s the only  
thing that ever has.  
MARGARET MEAD     

Background / Problem Identification
The lack of safe, decent, quality, permanent and affordable housing options for persons with mental illness is a major problem in Tennessee. An independent evaluation conducted in Tennessee as part of the Housing within Reach grant found that 30 percent of the people surveyed wanted or needed alternative housing. Applying this to the 129,892 people served in the public mental health system in Fiscal Year 2008, we can estimate there are at least 38,968 people living with mental illness or co-occurring mental illness and substance use disorders in Tennessee in need of some sort of housing assistance.

Response To Need
Virginia Trotter Betts, MSN, JD, RN, FAAN, former Commissioner of the Department of Mental Health and Developmental Disabilities (now the Departmrnt of Mental Health and Substance Abuse Services was appointed in January 2003), fully supported a response to this need. Her commitment is seen in both her goal of moving toward a true belief that recovery from mental illness is not only possible but expected and also in her dedication to the work and goals of the Creating Homes Initiative (CHI).

History of CHI Beginnings
The CHI was launched in August of 2000 and was the brainchild of Marie Williams, LCSW. Ms. Williams launched this new initiative following her appointment as the Director of the newly formed Office of Housing, Planning and Development (now the Division of Recovery Services and Planning) in February of 2000. This appointment was made by the former Commissioner of what was known as the Tennessee Department of Mental Health and Developmental Disabilities (now the Department of Mental Health and Substance Abuse Services), Elisabeth Rukeyser (March 1999 - January 2003).

Ms. Williams and a volunteer team of housing experts conducted an arduous review of current housing, support services and resources for persons diagnosed with mental illness, met one-on-one with consumers, and talked with mental health stakeholders as well as community citizens to get the real picture first-hand. Based on information gathered from this process, Ms. Williams authored a targeted, grassroots, local community, multi-agency strategic plan founded in a state/community collaborative partnership known as the Creating Homes Initiative (CHI).

Implementation

The first step of the CHI was to establish and facilitate task forces in four communities with the greatest need. The task forces included representation from the following entities: Tennessee Mental Health Consumers' Association (TMHCA), Tennessee Departmrnt of Mental Health and Substance Abuse Services (TDMHSAS), Fannie Mae, Homebuilders Association, United Way, Mental Health Centers and Mental Health Social Service Agencies, National Alliance for the Mentally Ill (NAMI), Housing Authority, Statewide/Regional Mental Health Planning Councils, Habitat for Humanity, Department of Housing and Urban Development (HUD), Association of Realtors, Office of Economic and Community Development, Development Districts, Local Government, Foundations, Business Community, Tennessee Housing Development Agency (THDA), Tennessee Association of Mental Health Organizations (TAMHO), Behavioral Health Organizations, Faith-based community, local banks, landlords, housing counselors, supportive living/group home operators, Federal Home Loan Bank, Federal Reserve Bank, architects and builders, and other interested community persons. Members of these task forces identified the housing needs in their local community, solicited proposals, and recommended the best proposals to receive funding assistance from TDMHSAS. The Tennessee Housing Development Agency (THDA) provided additional funding to increase the number of projects that could be completed in this first CHI funding cycle. At this point, the following organizing principles were established for CHI:

Vision
To create and expand affordable, safe, permanent and quality housing options in local communities for people with mental illness and co-occurring disorders in Tennessee.

Mission
To assertively and strategically partner with local communities to educate, inform, and expand quality, safe, affordable and permanent housing options for people with mental illness and co-occurring disorders.

Goal
To continue to create safe, affordable housing for adults with mental illness and co-occurring disorders along a continuum from 24/7 supervised living facilities to home ownership. The original goal of 2005 by 2005 was met and surpassed in 2002. The next goal of 4010 by 2005 was achieved in the fall of 2005. The next goal was 8009 by 2009.

During 2001, state-supported housing facilitators were hired by local agencies in each of the original four target cities to be regional housing development and housing funding experts. These facilitators facilitate the local task forces and are dedicated full time to housing development. By May of 2003, three more facilitators were added, one for each of the TDMHSAS planning regions, making CHI a truly statewide initiative.

To continue and expand CHI, the local task forces rapidly moved toward implementation of the CHI goal by implementing the following steps. Each Task Force:

  1. Established a seven- to nine-person steering committee made up of local CHI participants who were not requesting funding for a housing project. This steering committee would review, rank and recommend housing proposals to the TDMHSAS Housing Council for funding.
  2. Created and executed a local strategy to expand the menu of needed permanent housing and supportive services options (single room occupanycy units, one bedroom apartments, congregate housing, homewonership, subsidized housing, permanent supportive housing, etc.) for people with mental illness based on the needs determined through the community housing assessment;
  3. Created a local strategy to maintain, enhance and upgrade current housing options for persons with mental illness based on information gathered; and
  4. Develop and maintain a local housing resource mechanism based on local housing assessment information.
  5.  

To provide leadership for this initiative, TDMHSAS Director of Housing and Homeless Services, Bob Currie, and the seven Regional Housing Facilitators, currently:

  1. Facilitate the local task force meetings;
  2. Aggressively seek out and collaborate with potential funding entities to leverage and funnel housing funds to local communities;
  3. Identify and recommend financing strategies and grants that will provide support for the development of permanent housing options and associated support services;
  4. Collaborate with all available local resources through the local CHI task forces to increase the availability of and access to housing;
  5. Coordinate with other public agencies and the private sector to stimulate the preservation, development, and enhancement of housing options;
  6. Direct new resources and develop plans, as funds become available, to increase housing options;
  7. Uphold the quality of the current housing utilized for those persons diagnosed with mental illness and co-occurring disorders.

The above mentioned strategies have been successful in bringing together non-traditional partners to generate ultimately more than $250 million in funding resources, which in turn have affected 7,228 lives through new, increased housing options. The Creating Homes Initiative (CHI) Regional Housing Facilitators are working hands-on in collaboration with grassroots community task forces in each of the seven statewide mental health planning and policy council regions to create and develop safe, affordable, quality, permanent housing options for persons diagnosed with a mental illness or co-occurring disorder. If you are interested in becoming involved with the CHI, please contact the appropriate Regional Housing Facilitator.

The CHI faced some unanticipated obstacles, such as lawsuits brought on by community neighborhood organizations that were opposed to this new housing. Stigma issues and the “Not In My Back Yard" syndrome (NIMBY) were met head-on through countless hours of court proceedings; neighborhood meetings; and city, county, and state legislative hearings advocating on behalf of consumers for their right to live in any Tennessee community of their choice. These efforts ultimately resulted in a landmark partnership with Tennessee Fair Housing Council that has been nationally recognized as a best practice.

Outcomes / Evaluation
Since the inception of the CHI, persons with mental illness have benefited from the range of quality, safe, affordable, permanent housing from home ownership to 24/7 supervised group settings. These options are being developed in partnership with local CHI communities that determine the local needs and implement the plans to address these needs. The annual allocation for the Creating Homes Initiative is $2,500,000. These dollars assist in the development and leveraging of new federal, other state, local, and private funds producing permanent housing in the following categories: homeownership, private/public market rental housing, partially supervised group housing, and supervised group housing with 24-hour on-site care. In addition, these dollars have provided seed funding and support services for the CHI and for the seven Regional Housing Facilitators. These Regional Housing Facilitators are located in each of the statewide mental health planning regions for the purpose of enhancing and expanding housing options for persons with mental illness, providing a local extension of the TDMHSAS Office of Housing and Homeless Services. Quality reviews of the housing created through the CHI are conducted to ensure that quality standards are being upheld while the number of units created increases.

TDMHSAS' Office of Housing and Homeless Services was awarded a Centers for Medicare and Medicaid Services (CMS) Real Choice Systems Change grant in the amount of $1.8 million beginning in 2003. Besides supporting the development of the original Housing within Reach website, this grant included the recruitment and employment of four mental health consumers across the state to provide quality review, enhance consumer access to housing developed by CHI, and expand the involvement and voice of consumers in housing maintenance and development. When the grant period ended in 2007, TDMHSAS secured funding to hire these four Consumer Housing Specialists permanently.

The TDMHSAS strongly supports the full participation of persons with mental illness in all aspects of community life. This belief necessarily entails creating opportunities for individuals to have access to community housing in the most appropriate setting that is consistent with their needs and choice. It has been evidenced through the work of the CHI that once individuals live in community settings with proper supports in place, a rapid transformation begins to occur. How can one truly be in recovery without a home? How can one participate in community life without a home? The CHI provides a real strategy with which to address this much needed source of strength--home. With this new-found confidence and security in their lives, individuals assisted through the CHI find themselves more willing to take an active, contributing role in the communities in which they live, either through volunteer work or through employment.

The CHI illustrates that a concerted strategy can stop the cycle of hospitalization, discharge, and homelessness that continues in our communities. It is our belief that the value of CHI is reflected in the lives that have been impacted by the CHI and the lives in other locations around the country that are being impacted by replications or adaptations of CHI that promote meaningful housing and community participation opportunities for persons with mental illness in other communities.


Please take a moment to view a quick video presentation on the CHI.

Awards

First Place, 2002 Lilly Reintegration Award

HUD 2003 Best Practices in Fair Housing Award

NAMI’s 2004 Philip and Sarah Francouer Award for Housing

2006 CMS / Commonwealth Fund Promising Practice Award


Contact Us

Tennessee Department of Mental Health and Substance Abuse Services
Office of Housing and Homeless Services
5th Floor Andrew Jackson Building-
500 Deaderick Street
Nashville, TN 37243
615-253-3051 (voice)
615-253-6822 (fax)