Housing Assistance and Supportive Services in Memphis

By: Lesley Freiman, Laura Harris, Amanda Mireles, Susan Popkin

This brief provides an overview of the Housing Assistance and Supportive Services in Memphis project and presents all of the project findings. Three related technical appendices contain additional information on the focus group materials, project maps, and the assessment phase.

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INTRODUCTION

The U.S. Department of Health and Human Services (HHS) entered into a contract with the Urban Institute and its subcontractor the University of Memphis to foster effective delivery of services to current and former recipients of housing assistance in Memphis. This work was intended to inform Memphis' Strong Cities, Strong Communities planning effort and includes: 1) an assessment of current conditions, challenges, and opportunities; and 2) dialogue with and technical assistance to local stakeholders who coordinate, fund, and provide services to high-needs Memphis residents who receive housing assistance funded by the U.S. Department of Housing and Development (HUD). The project spanned 16 months (September 2011 through January 2013). This brief presents our final assessment of the needs of housing assistance recipients relocated through Memphis' HOPE VI initiatives as well as a discussion of future directions for service coordination and policy.

In 2011, the City of Memphis was selected for the White House Strong Cities, Strong Communities (SC2) initiative. SC2 provides federal technical assistance to help cities access or leverage existing federal and local resources for community revitalization and to form new organizational connections on a federal and local level. One key goal of the SC2 initiative is to help to break down existing silos between local governments and federal departments. This project is intended to support that effort by providing information about programs for residents of assisted housing, particularly those who have been affected by Memphis' HOPE VI revitalization efforts.

As part of this work, the project assessed five research questions:

1. What federally funded services are available and provided to current and former recipients of HUD-assisted housing in Memphis?
2. What other types of services (e.g., local government, privately funded) are available to assist these former residents? Are these coordinated with the federally supported service system?
3. What barriers do stakeholders in Memphis identify for the effective delivery of supportive services to HOPE VI relocatees? How do these barriers differ among residents who have relocated with vouchers, those who moved to new mixed income housing, and those who remain in traditional public housing or project-based Section 8 housing?
4. How has any relocation of individuals and families from public housing facilities to other housing types affected access and use of federally funded supportive services?
5. How can providers in Memphis improve the effectiveness of service provision to HOPE VI relocatees, regardless of their current housing assistance status?

 

BACKGROUND AND MEMPHIS SERVICE CONTEXT

Over the past two decades, policymakers have sought to transform public and assisted housing from a symbol of the failures of social welfare policy into a catalyst for revitalizing neighborhoods and helping residents improve their life chances. Public housing residents face numerous barriers to self-sufficiency: low educational attainment, poor mental and physical health, limited access to social networks that facilitate job access, and physical isolation from opportunity. Different federal initiatives have attempted to help residents overcome these barriers—by relocating residents to higher-opportunity areas, offering alternative rent structures, and replacing distressed developments with new mixed income housing (Turner, Popkin, and Rawlings 2009).

Evidence from evaluations of the largest federal initiatives suggests that increasing public housing residents' geographic access to opportunity improved their quality of life—but was not enough to help them overcome their multiple personal and structural barriers to self-sufficiency (Popkin, Levy and Buron 2009; Briggs, Popkin, and Goering 2010; Comey, Popkin, and Franks 2012). The $6 billion HOPE VI program, which funded the demolition and revitalization of hundreds of distressed public housing communities across the nation, had as a core goal of improving residents' quality of life and helping them move toward self-sufficiency. However, the program included only modest funding for community supportive services. Generally, these services have focused on workforce efforts and been limited in size and scope (Popkin et al. 2004) (For additional information on the evidence base for effective service provision to HOPE VI relocatees and housing assistance recipients in general, see companion document, Best Practices for Serving High-Needs Populations.)

Population, Geography, and Housing Assistance Migration in Memphis

The geographic distribution of HUD-assisted households in Memphis has changed dramatically over the last 15 years. Since the 1990s, Memphis has redeveloped five properties with HOPE VI grants; the city now has only one remaining traditional family public housing development (Foote Homes). Like other large city housing authorities, the Memphis Housing Authority (MHA) now relies heavily on vouchers and assisted households are dispersed throughout the city. However, most MHA housing choice voucher (HCV) recipients still live in very poor and predominantly African American neighborhoods.

By population, Memphis is a large city, with 646,889 residents as of the 2010 census. It also has an unusually large geographical footprint (315 square miles) and low population density for a city of its size (2,053.3 persons per square mile).^[1] Memphis residents have become more geographically dispersed in recent decades as the city has incorporated surrounding areas, though the total population has changed little since the 1960s. Memphis' increased size presents a challenge for service delivery because of high poverty and need and the extremely limited public transportation system.

Unemployment in Memphis is high; the 2011 American Community Survey showed unemployment among those over 16 years old and in the labor force was at 14.5 percent, compared to 10.6 percent in Tennessee and 10.3 nationally. Memphis also has a high poverty rate; approximately 22.6 percent of families living or having recently lived below the poverty level in 2010, compared to 13.7 statewide and 11.7 percent nationwide. Child poverty is extremely high in Memphis, with 42.1 percent of all Memphis children living in households in poverty, compared to 26.3 percent statewide and 22.5 percent nationwide.[2]

The majority of Memphis residents are African American. In 2011, an estimated 62.4 percent of residents were African American/black and 29.6 percent were Caucasian/white. Just over 7 percent were Hispanic/Latino (only 4.0 percent of Latinos/Hispanics are African American/black while 34.2 percent are Caucasian/white).[3]

Maps 1 and 2 in appendix B respectively illustrate the geographic dispersion of poverty level and the percentage of residents who are African American/black (non-Hispanic) by census tract.

HOPE VI and Housing Assistance in Memphis

Over the past 20 years, numerous public housing authorities have used HOPE VI grants to demolish some of the most dilapidated and dangerous public housing developments in the country and rehouse residents in new units in mixed income developments and in the private market with Housing Choice Vouchers (HCVs or vouchers). The Memphis Housing Authority (MHA) has received five HOPE VI grants since 1995, the most recent in 2010 (for the Cleaborn Homes housing development). In 2011, the MHA received a Choice Neighborhoods Planning grant (the successor program to HOPE VI) for the Foote Homes, its last remaining family public housing development. In 2012, the MHA applied for an implementation grant to conduct work designed during the planning grant, but was not selected.

Our project has focused on households receiving MHA housing assistance, and in particular, those relocated from public housing developments in the most recent three HOPE VI relocations, including Cleaborn Homes (relocations in 2010), Dixie Homes (2008), and Lamar Terrace (2003). Residents relocated from these distressed public housing developments are particularly high need; those who were most able moved elsewhere as conditions deteriorated. In addition, relocation may have removed access to services, resources, and transportation networks that these residents relied on previously. MHA provided case management, relocation, and post-relocation services through Memphis HOPE, an independent non-profit that is part of Urban Strategies' national service network for housing redevelopment initiatives.[4] Memphis HOPE was created in 2006, funded by the Women's Foundation for a Greater Memphis. Figure 1 (below) shows the original locations of the last three developments for which MHA received HOPE VI grants (and from which it relocated residents) as well as the location of Foote Homes.

Figure 1

Service Landscape

Historically, low-income Memphis residents have received services through individual government programs or funding sources, including funds flowing from federal sources (e.g., Medicare, TANF, and Supplemental Nutrition Assistance Program (SNAP) formerly food stamps) and local community organizations, many of which are small faith-based entities. Memphis also has had an unusually large number of community development corporations (CDCs) (over 30 incorporated and over 100 including those not formally incorporated), most with few resources or staff. In recent years, the city and the community organizations within it have attracted and dedicated substantial new resources and sources of funds, many with sweeping and ambitious mandates. Several of the larger and most ambitious efforts set in motion since 2010 are place-based, with the aim of organizing and growing existing resources and services, creating new neighborhood- or housing-based services and resources, spurring neighborhood economic development, and fostering community.

One of these new place-based efforts is Agape's[5] Powerlines Community New initiative, which is based out of apartment buildings in poor and distressed neighborhoods. Powerlines' goal is to coordinate, provide, and leverage community resources for neighborhood residents. Another is Memphis Community LIFT, which grew out of a longer-term community planning process. LIFT is focused on specific clusters of neighborhoods identified in the planning process, where it will work to foster neighborhood-level economic development and revitalization. On a city-wide level, the Mayor's office has obtained several new sources of funding. This includes substantial federal and private funding awards for strategies and implementation regarding local business revitalization, reduction of gun violence (particularly among youth), and prevention of teen pregnancy.

(For a detailed summary of new and continuing local efforts, see the assessment memo included as appendix C.)

ASSESSMENT AND TECHNICAL ASSISTANCE

For this project, the research team has conducted three main tasks: 1) an assessment of service need and provision in Memphis, 2) reporting to and communication with the U.S. Department of Health and Human Services, and 3) technical assistance to the Memphis service provision community in the form of gathering information on relocatees' needs from focus groups and compiling information on best practices for serving this population.

Assessment Phase

The research team produced an assessment of the service needs, geographic distribution, and service landscape for high-needs populations in Memphis. This work focused on households receiving MHA housing assistance, particularly those relocated from public housing developments in the most recent three HOPE VI relocations, including Cleaborn Homes (relocations in 2010), Dixie Homes (2008), and Lamar Terrace (2003). From the assessment, the research team produced a memo, which is available as appendix C.

This work included discussions and interviews with a variety of stakeholders, including city and county government officials, the contracting agency providing Community Supportive Services to HOPE VI relocatees in Memphis (Memphis HOPE), non-profit leaders, local service funders, and local researchers, as well the head of the HUD field office and members of the Memphis Strong Cities, Strong Communities (SC2) team.

The interviews covered a range of topics, including details of the policy, planning, and service provision landscape in Memphis, new and long-standing challenges in serving high-needs populations, coordination between service providers and other stakeholders, and current and upcoming programs and initiatives. In each interview, the research team also discussed possibilities for the technical assistance that the team might provide for local stakeholders.

The research team also obtained household- and client-level administrative data on public housing residents relocated as a result of MHA HOPE VI initiatives. We received data from two sources: Urban Strategies, which administers the Memphis HOPE program that provides case management and supportive services to HOPE VI relocatees, and the HUD field office in Memphis. The data from Urban Strategies pertain to households that receive services from Memphis HOPE and were relocated from Cleaborn Homes, Dixie Homes, and Lamar Terrace; data include current (or last known relocation) and former locations, housing assistance use, service referral history, and demographics.[6] The HUD field office provided an extract from the Public Housing Information Center database, which includes information on all households currently receiving housing assistance through MHA housing voucher programs.[7] We used these two data sources to analyze the current and former locations and concentrations (or dispersion) of housing assistance users in Memphis, as well as to compile information about likely service needs based on referral records and demographics.

These data showed that HOPE VI relocatee households have particularly low incomes (in line with their need and eligibility for public housing at the time of relocation), with a median monthly income of just $304 per household. About one-quarter of heads of household receive TANF (25.5 percent) and Supplemental Security Income (SSI) (27.7 percent). Virtually all relocatee heads of household were African American, and most were female.

The research team found that relocatee households continue to live in high-poverty areas after relocation. A large majority of HOPE VI relocatee households (68.9 percent) use HCVs. A small portion—just 9.3 percent—live in Foote Homes (the last remaining family public housing development in Memphis), and a slightly larger portion live in public housing developments for the elderly and disabled (11.3 percent). Under 4 percent (3.8 percent) live in new HOPE VI mixed income developments.[8] Many have relocated a substantial distance to other neighborhoods within Memphis. Relocatee households that transitioned onto HCVs moved in a similar dispersal to all voucher-holding households.[9] (See appendix B for density maps of relocatee households, voucher-holding households, and voucher-holding relocatee households). MHA's traditional public housing developments were located centrally, near downtown; in stakeholder interviews, respondents reported that most former residents have relocated primarily to the large communities of Hickory Hill (southeast), Frayser (north), and Raleigh (northeast), all miles from the city center.

Our spatial analysis confirms this assessment. Memphis households receiving MHA assistance are located throughout the city, although the households receiving assistance tend to be clustered in areas with high poverty rates and high percentages of African American residents. Households relocated from Lamar Terrace, Dixie Homes, and Cleaborn Homes are more highly concentrated in their former neighborhoods than MHA voucher holders overall. However, while many have stayed near their original public housing location, others have moved to neighborhoods across the city, following similar patterns of dispersion to the overall population of voucher-assisted households.

The Memphis HOPE administrative data also revealed patterns of referrals for services. Overall, 40 percent of all relocatees have been referred to services more than once, nearly 28 percent only once, and 32 percent have never been referred. The highest share of all relocatees (for whom data are available) were referred at one point to employment services, though this number is still relatively low. This low rate of referral likely reflects factors such as service availability, appropriateness, and high caseloads rather than need, which the income data, discussions with stakeholders, and resident focus groups all suggest is great. Approximately 16 percent of relocatees for whom referral data are available were referred to employment services, 11 percent to child care, 9 percent to education, 8 percent to material resources (e.g., food and clothing supply), 5 percent to youth services, 3 percent to health, and 1 percent to financial literacy.

Technical Assistance

The assessment clarified that there are many initiatives underway in Memphis with the goal of ameliorating poverty by addressing housing, health, or human service needs. During the January site visit, the project team and a number of different stakeholders discussed the fact that there are so many initiatives in Memphis, which creates challenges in coordination and avoiding duplication of services. These efforts receive funding from a variety of sources (public, private, philanthropic); provide services from unconnected sources (e.g., branches of city government, county/state government, and local non-profit or partnered service providers); and employ different strategies.

Through an assessment of needs, resources, and efforts currently underway in Memphis, the research team, with the support of HHS, determined it could best assist Memphis stakeholders and HHS through gathering and sharing additional qualitative information about service use, concerns, and unmet needs among HOPE VI relocatees in Memphis and by recommending evidence-based best practices for meeting the needs which the Memphis service community is working to address. The project team has produced a summary memo which aims to provide Memphis service stakeholders, including service providers, local funders, development organizations, and city and county government, with research-supported practices for serving high-needs populations. Our hope is that this information will help local stakeholders focus ongoing and new efforts toward proven and promising practices. This summary of proven and promising practices is available in the companion document to this brief, Best Practices for Serving High-Needs Populations. The research team will also share with stakeholders the maps and tables and the findings produced during the assessment phase of the project.

The following section of this document is comprised of a summary report and findings from three focus groups held with HOPE VI relocatees in Memphis in October and November 2012.

FOCUS GROUPS WITH HOPE VI RELOCATEES IN MEMPHIS

To further understand the experiences of service receipt for adults in households receiving housing assistance, we conducted three focus groups in October and November 2012. The focus group topics were developed to help answer two of the project's five research questions:

 

3.       What barriers do stakeholders in Memphis identify for the effective delivery of supportive services to HOPE VI relocatees? How do these barriers differ among residents who have relocated with vouchers, those who moved to new mixed income housing, and those who remain in traditional public housing or project-based Section 8 housing?

4.       How has any relocation of individuals and families from public housing facilities to other housing types affected access and use of federally funded supportive services?

 

The focus group protocol (see appendix A) was developed to address these issues, focusing on understanding a wide range of experiences that relate to participants' housing situation and service needs.

Focus Group Participants

The intent of this project was to address service needs for people receiving housing assistance. As described above, this project has focused on HOPE VI relocatees because they are a known high-needs population and because households relocated via HOPE VI may have been removed from their previous resource and service networks. Based on case management and location data provided by Memphis HOPE, we identified three populations for our focus groups:

 

·         Focus group one: This group consisted of former Cleaborn Homes residents who currently live in zip code 38126. We choose to limit this group to Cleaborn Homes residents to concentrate on a group that has more recently been relocated and actively involved in initial case management activities. (Residents from the other two HOPE VI sites in the Memphis HOPE case management data we examined were initially relocated five or more years ago.)

·         Focus groups two and three: These groups consisted of a combination of residents from Lamar Terrace, Dixie Homes, and Cleaborn Homes, and were geographically based. We conducted one focus group with adults living in the 38127 zip code (Frayser area of North Memphis) and one with adults living in 38106/38109 (South Memphis area).

 

Memphis HOPE conducted the recruitment for focus group participants and provided assistance in arranging transportation. (A more detailed description of research methods, including selection and recruitment criteria, is available in appendix A, along with protocols, consent forms, and recruitment script).

 

Descriptive Information about Focus Group Participants. The three focus groups included a total of 26 people.

 

• 24 women, 2 men
• 25 black, 1 white
• Approximately 40 percent were 62 or older
• Most participants said that they had less than a high school education, and only a few reported having earned their GED.
• Some participants lived alone (several seniors, but also a few younger single people on disability), while others had households that included family beyond their immediate family.
• A few residents lived in public housing, but most used HCVs in single-family housing or apartments. Most were receiving SNAP, though some seniors received as little as $25.
• Four people reported that they had their own cars. Only a few relied on public transportation (i.e., the bus system), while most relied on friends, family, or others they pay to transport them.
• Only one was currently employed, only part-time.

Summary Findings

Overall, these residents reported positive housing situations; this finding is important, given that stable housing is a crucial platform for delivering other services. Still, the focus group participants were struggling with economic and health-related challenges that likely necessitate changes in service delivery strategies.

 

Housing as a platform. No participants discussed concerns about having stable and sufficient housing. Some mentioned wanting a bigger apartment or additional amenities, but overall, they felt their housing was better since they had relocated through HOPE VI. The biggest and most often-raised concern relating to housing was the struggle to pay utility bills. Even for those receiving utility assistance, their monthly bills often exceeded the subsidy amount. This is consistent with findings from other studies of HOPE VI relocatees[10] and represents a fundamental challenge for users of the HCV program—particularly for former public housing residents who have not previously paid utilities separately. Voucher holders receive a utility allowance as part of their housing assistance, but clearly these allowances do not keep pace with costs.

 

Current benefit receipt. Most participants were receiving HCVs, and a few currently live in public housing. Most were not currently receiving cash assistance, other than SNAP. A few mentioned cash benefits and SSI or SSDI (for their children). The older participants relied almost entirely on Social Security.

 

When asked how they make ends meet, participants reported borrowing money from family and a few did periodic and informal jobs, such as doing hair or some hourly work cleaning. The few currently working did so as temporary warehouse or retail workers, and the pay was not sufficient to fully support their households. Some were concerned that working would reduce the amount of the benefits they receive, particularly for those receiving disability.

 

Seniors and children seemed to have health insurance and access to healthcare, but most of the other adults without significant health problems or disabilities did not have health insurance. Several people said they relied on public clinics that had bad service, where they often waited hours for appointments. Others described using emergency room care for non-urgent illnesses. When asked how they dealt with the sizeable medical bills from emergency room care, most reported that they merely threw them away.

 

Current case management. Focus group participants were recruited out of a pool of relocatees currently receiving Memphis HOPE case management services. The vision for creating a separate community-funded entity of Memphis HOPE was that a more comprehensive system could be created and sustained over time, but this model is difficult to sustain. The initial funding for both Lamar Terrace and Dixie Homes (a total of $7.2 million over five years) officially expired in 2011. Memphis HOPE continues to operate as the service provider for the Cleaborn Homes HOPE VI caseload, as well as for some of the remaining public housing residents (funded by HUD's ROSS program). While some of the Lamar Terrace and Dixie Homes residents continue receiving services beyond the grants' official end dates, the focus groups suggest that these services are not intensive.

 

Participants' experience with case management suggests that their contact with case managers is currently infrequent and limited. A minority of focus group participants were able to identify specific assistance they had received from case managers, however, these accounts were limited and assistance varied, suggesting an absence of coordinated case management services.

 

Similarly, participants noted difficulties communicating with case managers. Many cited long waiting times between follow-up with case managers, regarding resources such as utility assistance and employment and child-related program opportunities. Several participants noted that these long waits and challenges communicating with the case managers were not problems until the last year or two; previously, they said that the case managers were more responsive and helpful. Many of the challenges participants shared suggest organizational constraints coupled with limited time and resources hinder case managers in providing comprehensive supportive services to meet residents' needs (including support navigating pathways to health care access). Further, these residents' experience suggests that they are not able to access the kinds of supportive services they need in their new communities.

 

Ongoing service and resource needs. Overwhelmingly, participants reported that their greatest need was employment. Utility assistance and health care coverage were also mentioned repeatedly as significant expenses. A few participants spoke specifically about the sizeable medical bills they incurred from using the emergency room as their only providers. The participants seemed realistic about their job expectations given their education and skills. (Most reported wanting warehouse and housecleaning positions, often because they could work alone.) Only a few people discussed a desire or need for more schooling or training.

 

Mental health. Each group discussed living with depression and anxiety. For some, mental health problems made it difficult to obtain or maintain employment. Others discussed the burden they feel of caring for family and struggling with depression.

 

My health is failing and I'm really struggling. I try to keep that smile up there, but behind that smile there's pain, there's pressure, there's depression. A whole lot is going on inside of me. Stressed out knowing you got a family to take care of and it's hard when you try to get from point A to point Z. I see my children doing well in school, and they are being there and doing what they're supposed to be doing, but me, they look at mom and think mom can't do anything for us. That's a hurtful thing. I split myself in half to take care of my mom (who just had a stroke) and take care of my children.

 

Transportation accessibility and costs. Few participants had their own cars, but only a few said they relied exclusively on public transportation. Many relied on family or friends, generally for a fee of $15–20 per trip. Several people added that, in addition to charging a fee, family and friends providing transportation asked them to purchase a few items while at the store. In those cases, the total cost for getting a ride to the store was easily $30. Though public housing developments were and are located in the central part of the city, the low density of Memphis means that shopping is not convenient via a limited bus system. The exception to this problem is participants who currently live in the Frayser neighborhood of North Memphis. While Frayser is poor overall, a number of large grocery stores and occupied strip malls provide many retail options.

 

Changes since relocation from public housing. One concern that prompted HHS to undertake this project was that public housing relocation moved residents to areas without community service providers. However, participants in our groups reported that the proximity to services was not a problem for them (Many services had not been nearby even when they were in the centrally located public housing because of transportation accessibility). They saw lack of follow up contact from case managers was the true frustration; as noted above, most had received services through Memphis HOPE for some period after they relocated, but those services have now been cut back. Memphis HOPE staff are not currently able to do as much outreach to clients now dispersed across Memphis communities, especially given that high-touch case management is not currently funded by MHA or any other funding source.

 

Views on returning to redeveloped public housing. Almost all participants who had HCVs said they were not interested in returning to the redeveloped public housing. While many are struggling with paying utilities, they are happy with their new housing and neighborhoods. Several mentioned concerns that the new developments would quickly return to the level of crime that existed at the old development. However, many focus group participants still living in public housing are interested in moving to one of the newer developments. There seemed to be some confusion about the criteria and cost to live at the new developments. For example, though most in the group were unemployed and only a few were receiving disability, no one mentioned the work requirement[11] as a possible barrier to moving back—which would likely affect most of them. Also, the consensus in two of the three groups was that public housing at the new developments cost about $2,000 per month—which is not the case.

 

Relocatees learning from their peers. Over the discussion, participants learned about available resources from one another (e.g., caregiving programs, youth services, and toy drives for Christmas). When asked how they normally discover available services and resources, participants answered that they often learn about these resources through friends and acquaintances. At the end of each focus group, participants either exchanged more information about services or shared phone numbers. Several participants informed the focus group leaders that the conversations were useful and enjoyable. Given this high degree of peer learning, MHA, Memphis HOPE, and other service agencies may consider convening and facilitating similar discussion in the future, with the goal of allowing residents to share common challenges and solutions.

FUNDING AND COORDINATION

As discussed in the introduction, this project was designed to answer five broad research questions about service provision in Memphis. We addressed two of these (questions 3 and 4) primarily through the focus groups. We addressed questions 1, 2, and 5 during the assessment phase and have summarized the results below.

1.       What federally funded services are available and provided to current and former recipients of HUD-assisted housing in Memphis?

To summarize the HHS funding streams that support services in Memphis, the research team reviewed available data from the Tracking Accountability in Government Grants System and USAspending.gov. The research team discovered that, while housing assistance recipients, particularly relocatees from MHA public housing, use a number of services and resources that come through federal programs (such as Medicaid), these resources almost never flow directly from the federal government. The bulk of funds flowing directly from HHS to municipal and county agencies or individual organizations (including universities and hospitals) go to medical research, particularly to research in the large Memphis-based children's hospital. Much HHS funding toward services is awarded to the state, which distributes this money down to the county or locality, and from there to individual service recipients. (A full list of direct HHS funding to entities in the City of Memphis or in Shelby County is available in the assessment memo.)

A large share of HOPE VI relocatees who receive housing assistance in Memphis also receive TANF. (Economic and demographic information for HOPE VI relocatees and HCV recipients are available in the assessment memorandum produced in the earlier stages of this project, included as appendix C of this brief). The report resulting from the focus groups further discusses HOPE VI relocatee service use. Because of the income requirements for housing assistance eligibility, we know that all MHA HOPE VI relocatees (who originally lived in public housing) and most of the current housing assistance recipients are income eligible for Medicaid. However, TANF and Medicaid funding is administered by the state and through local jurisdictions.

2.       What other types of services (local government, privately funded) are available to assist these former residents? Are these coordinated with the federally supported service system?

The research team was also able to address this question during the assessment phase. An extensive summary of local service efforts and strategies, compiled in the assessment memo, is included in appendix C. An earlier section of this document (“Service Landscape”) summarizes recent notable local, private and government service provision and anti-poverty efforts, many of which are new, ambitious, and neighborhood-based.

While coordination with federally funded services is a concern for Memphis (demonstrated by the enthusiasm with which the mayor's office has met the federal SC2 initiative) much new funding the city and its service providers have acquired runs independently of federally funded resources and has no clear, direct link to federal sources. In fact, as we found in the assessment phase, many new and long-standing local efforts, both private and public, run parallel. This includes the common silos seen in government and private service communities nationwide. For example, many MHA staff members have a specific contact at the Shelby County department of Health and Human Services, and vice versa, but there are no common procedures or processes or communication plans to make sure each agency is aware of relevant issues arising in its major counterparts. The assessment memo (Appendix C) addresses the key challenges of coordination in more detail.

LESSONS LEARNED

The assessment pointed to a large need for services, connection to community providers, and extensive follow up for housing-assisted populations in Memphis. HOPE VI relocatees confirmed in the focus groups that they face many challenges and are having both existing and new difficulties accessing services now that they are living in the larger community.

Memphis HOPE has a role of connecting the relocatees with community providers, but because the agency is primarily funded through the MHA's HOPE VI funds, its caseloads are large and it has few resources for tracking of and outreach to relocatees who have moved to the private market with HCVs. The agency has provided more intensive services in the past when it had additional philanthropic resources through agencies such as the Women's Foundation for a Greater Memphis, but at this time, it is primarily able to serve drop-in clients. In the absence of additional resources that would permit smaller caseloads and more aggressive outreach, this situation seems unlikely to change.

Another finding from our focus groups was that these residents are not being picked up by community providers in their new neighborhoods. Therefore, a key opportunity to improve service delivery would be to increase coordination between Memphis HOPE/MHA and other community providers to ensure smooth transitions for high-need MHA relocatees. Since Strong Cities, Strong Communities (SC2) has coordination as its core mission, working to plan effective hand-offs seems like an area where the team should focus attention and resources.

In our assessment, we also pointed to the large number of new neighborhood-based poverty alleviation, service, and development efforts in Memphis. It would be useful to facilitate communication and coordination among community-based agencies that serve MHA relocatees and other low-income, vulnerable Memphis residents to create a community of practice. This coordination would help nascent neighborhood-based agencies and efforts learn from one another as they develop. Coordination may help groups anticipate common challenges and share effective practices for serving similar communities. SC2 could be instrumental in organizing a forum for regular meetings and communication so that agencies serving a vulnerable population can share lessons learned. One possible scenario would be to provide some funds to Memphis HOPE to convene the group, since they have the most knowledge about the challenges facing the MHA relocatee population.

LESSONS FOR SERVING VULNERABLE PUBLIC HOUSING RESIDENTS

As described above, Memphis is in some respects an unusual city. The city covers a large area and the population is relatively sparse. In addition, the city has recently attracted several substantial new sources of funding for development, planning, anti-poverty, and anti-violence initiatives. At the same time, Memphis shares many challenges and opportunities with other cities throughout the country, and many of the lessons outlined in this document will apply more broadly to urban areas around the country.

Over the past 20 years, public housing transformation has meant a shift away from hard units of deeply-subsidized housing to HCVs. Hundreds of thousands of distressed public housing units have been demolished under the HOPE VI program and other initiatives, meaning that there are now about twice as many voucher households as public housing households (Turner and Kingsley 2010). The Urban Institute's research on HOPE VI relocatees in a number of cities has documented that residents who receive HCVs move to better quality housing in safer neighborhoods, but that these neighborhoods are still largely high-poverty and predominantly minority (c.f. Popkin, Levy and Buron 2009; Turner, Popkin, and Rawlings 2009). Further, these former public housing residents often face many challenges, including physical and mental health problems, disability, and unemployment. Low-touch case-management programs tend not to be sufficient to meet the needs of these vulnerable residents; more intensive models have shown promising results for adults (Popkin et al. 2010; Popkin et al. 2012), so high-touch case management and neighborhood-based initiatives are promising options for addressing these populations in other cities as well. Delivering services to a widely-scattered population is extremely challenging—while the geography and transportation system in Memphis may make the scale and urgency of the challenge greater than in some other cities, there is no question that the problem is widespread. The Chicago Family Case Management Demonstration showed that it was possible to provide intensive, wrap around services to vulnerable families at a relatively low cost (Popkin et al. 2010b), but even this relatively low cost may be out of reach for most housing authorities, especially for agencies coping with reductions in federal funding.

Finally, there is increased emphasis on place-based efforts as a promising strategy to address entrenched poverty and chronic disadvantage. The federal Choice and Promise Neighborhood initiatives are the most prominent, but there are also numerous other efforts, including SC2, the Byrne Criminal Justice Initiative, and numerous smaller, localized efforts such as the many programs serving Memphis communities. For all of these efforts, large and small, coordination is critical to increase effectiveness and avoid service duplication. Groups involved in these efforts would benefit from establishing regular meetings and other strategies to create communities of practice both locally and nationally. Supporting a community of practice seems like a natural role for private foundations, many of which have community change as a key focus. To help support local, community-based efforts, federal agencies could potentially reach out to philanthropic partners. The benefits of such a strategy could be great for both local communities and vulnerable families.

 

REFERENCES

 

Briggs, Xavier de Souza, Susan J. Popkin, and John Goering. 2010. Moving to Opportunity: The Story of an American Experiment to Fight Ghetto Poverty. Oxford: Oxford University Press.

Comey, Jennifer, Susan J. Popkin, and Kaitlin Franks. 2012. MTO: A Successful Housing Intervention. Cityscape 14(2): 87-107

Freiman, Lesley, Laura Harris, Amanda Mireles, and Susan Popkin. 2013. Housing Assistance and Supportive Services in Memphis: Best Practices for Serving High Needs Populations. Washington, D.C.: Urban Institute.

Popkin, Susan J., Diane K. Levy, Larry Buron. 2009. “Has HOPE VI Transformed Residents' Lives? New Evidence From the HOPE VI Panel Study.” Housing Studies 24(4): 477-502.

Popkin, Susan J., Bruce Katz, Mary K. Cunningham, Karen D. Brown, Jeremy Gustafson, and Margery Austin Turner. 2004. A Decade of HOPE VI : Research Findings and Policy Challenges. Washington, D.C.: The Urban Institute.

Popkin, Susan J., Brett Theodos, Liza Getsinger, and Joe Parilla. 2010. A New Model for Integrating Housing and Services. Supporting Vulnerable Public Housing Families Brief No. 2. Washington, DC: The Urban Institute.

Turner, Margery A., Susan J. Popkin and Lynette Rawlings. 2009. Public Housing Transformation: The Legacy of Segregation. Washington DC: Urban Institute Press.

Turner, Margery Austin, and G. Thomas Kingsley. 2008. Federal Programs for Low-Income Housing Needs: A Policy Primer. Washington, DC: Urban Institute.

Appendix A. Focus Group Materials: Selection and Recruitment Procedures, Guide, Recruitment Script, and Consent Form

Focus Group Selection and Recruitment

The intent of this project was to address service needs for Memphis residents receiving HUD-supported housing assistance. As described in the body of the brief, this project has focused on HOPE VI relocatees because they are a known high-needs population and because households relocated via HOPE VI may have been removed from their previous resource and service networks. Memphis HOPE has provided the research team with access to its Tracking-at-a-Glance (TAAG) case management data, which provides information on location, demographics, and Memphis HOPE case management status for individuals and households relocated during the most recent three HOPE VI relocations.

 

Selection criteria for participants. We analyzed the information in the TAAG database for households listed as current^[12] (though only relocatees from Cleaborn Homes are currently in Memphis HOPE's formal caseloads), and compiled tables of these households by zip code. Because the project's research questions pertaining to service delivery were tied to questions of accessibility, we planned the focus groups according to where potential participants lived. The following zip codes contain more than 50 households from the pooled caseloads of former residents of Lamar Terrace, Dixie Homes, and Cleaborn Homes.

 

Zip code (and description)	Number of households (including Lamar, Dixie, and Cleaborn)
38106 (South Memphis)	57
38109 (South Memphis)	54
38126 (Foote area)	98
38127 (Frayser)	65

 

Based on these analyses, we identified three main groups for which we conducted focus groups. The first group resides in the central part of the city, in the same zip code (38126) as the only remaining family public housing development and the most recent HOPE VI demolition (Cleaborn Homes). For the second and third focus groups, we chose residents from one neighborhood in North Memphis (Frayser) and pooled two zip codes (38106 and 38109) for a combined group in South Memphis.

 

·         Focus Group One: This group consisted of former Cleaborn Homes residents who currently live in 38126. We choose to limit this group to Cleaborn Homes residents to concentrate on a group that has more recently been relocated and actively involved in initial case management activities. (Residents from the other two HOPE VI sites in the TAAG data we examined were initially relocated five or more years ago.) This focus group took place at the Vance/Crenshaw Library on October 31, 2012.

 

·         Focus Groups Two and Three: These groups consisted of a combination of residents from Lamar Terrace, Dixie Homes, and Cleaborn Homes, and were geographically based. We conducted one focus group with adults living in the 38127 zip code (Frayser area) and one with adults living in 38106/38109 (South Memphis area). These focus groups took place at the offices of the Works Community Development Corporation in South Memphis, on November 2 and 14, 2012.

 

Contacting Participants. Because the data source we were using did not include contact information, we worked with Memphis HOPE to recruit participants for the groups. We created a random sample of adults for each of the three focus groups and then transferred the resident ID numbers to Memphis HOPE via a secure file transfer site. Memphis HOPE contacted possible focus group participants and asked if they would be willing to participate (The participant recruitment script is available in this appendix).

 

For each focus group, we sought to include a maximum of nine participants, but knew that we should overbook the groups because no-shows would likely occur. In the end, Memphis HOPE needed a pool of approximately 50 people for each of the three groups in order to confirm the appropriate numbers. Approximately half of those in the sample had phone numbers that were no longer working, and another significant share did not answer or return messages. Only a few refused, and those refusals were due to timing. Ultimately, from the 150 former public housing residents selected for these three groups, we were able to confirm participation with 24 individuals. (Two additional Cleaborn relocates participated in the first group, having been invited by other participants.)

 

Focus Group Guide

 

UNDERSTAND RELOCATION TIMING AND FREQUENCY

 

Where do you live now?

 

Let's talk about when you moved away from Lamar Terrace, Dixie Homes, or Cleaborn

• When did you move from those developments?
• How long had/have you lived in public housing?
• How much time did you have between when you found out and when you actually had to move?

 

Were you told you could move to the new development (University Place, Legends Park)?

• How did you find out?

 

Where do you want to live? (PROBE: neighborhood, type of housing)

 

 

CASE MANAGEMENT AND OTHER SOCIAL SERVICE RECEIPT

 

We want to understand more about the types of help you have gotten from different case managers in recent years. In particular, we are interested in learning more about case management services you have received from the housing authority or Memphis HOPE.

• Have you worked with a case manager from MHA or Memphis HOPE?
• Are you currently working with a case manager?
• (PROBE: contact in the last month? Six months?)

 

Let's talk about the types of help you are currently receiving or have received from the case manager? (PROBE: for information about who delivered the services and details about programs)

• What kinds of help are you receiving now?
• What kinds of help have you received in the past?

 

• Which type of help has been most important or useful to you?
• Which types of help have been least helpful?

Now I'd like to ask a few questions about health care in particular.

• Do you have health insurance?
• IF YES: What kind of insurance do you have? (PROBE: TennCare, private, through employer, etc.)
• IF NOT: Why don't you have any health insurance?

GEOGRAPHIC LOCATION OF SERVICES

 

We also want to know about where you have to travel to participate in services.

• Where do you receive case management assistance and other services (such as child care, health care, employment/education assistance)?
• PROBE: the physical location, distance travelled, number of places resident goes overall

 

Are there other types of assistance you need that you have not received?

o   PROBE: education, employment, child care, transportation, health care

 

• Why have you not been able to get this type of assistance?
• PROBE: not offered, inaccessible time/place, no childcare

 

• What is the most important thing in your life that you need assistance with?

 

Was it easier to get any services you needed in public housing? (IF CURRENTLY IN PUBLIC HOUSING, CLARIFY BY COMPARING NOW TO WHEN IN PRIOR HOPE-VI DEVELOPMENT.)

 

 

CONCLUSIONS

 

Overall, how would you describe your experiences relocating to a new place because of the HOPE VI program?

Do you think it is easier or harder for you to get services now where you are, or when you lived at Cleaborn Homes before it was torn down?

In your opinion, what could programs and case managers do to make it easier to help you?

 

Script for Recruiting Focus Group Participants

 

 

The following is the script used by Memphis HOPE staff as a basis for recruiting focus group participants.

Researchers from The Urban Institute and the University of Memphis would like to speak with a few small groups of families receiving housing assistance (vouchers or in public housing). They will ask questions about different kinds of experiences in your life, including looking for work, getting health care, and providing for your children. All of the information is only for research, and your name will never be shared. The information will not be shared with the housing authority or any other agencies.

 

These focus groups will take place in the next few weeks, somewhere in your neighborhood. They will offer you $25 to compensate you for your time and participation. The focus group discussions will last about an hour and a half. If you are interested, I can send them your name and phone number so that they can contact you with the details about the time and location. Would you be willing to participate?

 

Consent Form

 

Thank you for agreeing to participate in this focus group for the Housing Assistance and Supportive Services research project. As part of this project, it is really important for to us to understand your family's experiences—what works for you and what doesn't-- so that programs such as Memphis HOPE can continue to improve programs that are available to families like yours. The information you share might even be used to help design programs for families in other communities across the country.

 

The focus group will last about 1 ½ hours. We'll be taking notes today to make sure we capture everything you say accurately. We'd also like to record the session today to back up the notes. This recording will be stored in a confidential place and will be destroyed at the end of the project. If no one objects, we'll go ahead and record; but if there are concerns, we can proceed without the recording.

 

When all focus groups have been held, the University of Memphis will summarize the information without revealing any identities of focus group participants. The University of Memphis staff will keep everything that you say during the focus group confidential – no one will identify what you said – and choosing to participate or not will not change any services you or your family may be receiving.

 

You can contact Lesley Freiman, directly if you have any questions: 202-261-5663.

 

I understand:

• Everyone who works on this study has signed a Pledge of Confidentiality requiring them not to tell anyone outside the research staff anything I tell them during the focus group. The only exception is if I tell the facilitator about my intention to harm myself or someone else. The facilitator may be required by law to report this kind of information.

• The focus group will be audio recorded if all participants agree to this, but the audio will only be used to back up the notes that are taken during the discussion and will subsequently be destroyed at the end of the project.

• While Urban Institute and the University of Memphis promise to respect my confidentiality; my fellow participants may not. Therefore, I need to use discretion about what I reveal, particularly things that might jeopardize my housing status or relationships with staff.

• My participation is voluntary. I only have to answer questions I want to, and I can choose to stop participating at any time.

 

I consent to participate in this focus group. I understand that my participation is voluntary and I understand that I can stop participating at any time or refuse to answer questions at any time.

 

Participant name (PLEASE PRINT) _________________________________________

 

Participant Signature______________________________________ Date ______________

 

Appendix B. Maps: Memphis Demographics and Housing Assistance

Map 1. Family Poverty Level by Census Tract (2006-2010 ACS Estimates), with former sites of Cleaborn Homes, Dixie Homes and Lamar Terrace

Map 2. Percent of the Population African American non-Hispanic, by Census Tract 2010, with former sites of Cleaborn, Dixie, and Lamar Terrace

Map 3. Major Memphis Zip Codes, with Census Tract family poverty rate 2010

Map 4.- Location of All HCV Holder Households in Memphis, March 2011-Feb 2012

Map 5. Location of HOPE VI Relocatee Households in Memphis (Lamar Terrace, Dixie Homes, Cleaborn Homes)

Map 6. Locations of HOPE VI Relocatees with Housing Choice Vouchers (Relocated from Lamar Terrace, Dixie Homes, Cleaborn Homes)

Map 7. Relocatee Households (Lamar, Dixie, Cleaborn) and All Voucher-Holder Households

Map 8. HOPE VI Relocatee Households (Lamar, Dixie, Cleaborn) with Poverty Rate by Census Tract

Map 9. MHA Voucher Holders with Poverty Rate by Census Tract

Appendix C. Assessment Memo

CONTENTS

INTRODUCTION

The U.S. Department of Health and Human Services has contracted with The Urban Institute and its subcontractor The University of Memphis to foster effective delivery of services to current and former recipients of housing assistance in Memphis. This memo, Task 2.2 of the project contract, summarizes the project's assessment of current efforts in Memphis to coordinate with health and human services for families receiving housing assistance and indication of need based on spatial distribution of households receiving housing assistance.

This memo summarizes the project team's activities during the assessment phase, and includes findings from stakeholder interviews and administrative data. The memo concludes with a plan for the technical assistance phase of the project that will take place through January 2013.

ASSESSMENT METHODOLOGY

In order to assess the state of need and service provision in Memphis, the research team used a combination of qualitative and quantitative data collection techniques. On February 26 and 27, 2012, the research team (Dr. Susan Popkin, Lesley Freiman and Amanda Mireles from the Urban Institute and Dr. Laura Harris from the University of Memphis) conducted a series of semi-structured interviews in Memphis with a variety of stakeholders. These stakeholders included local government officials at the city and county level, the contracting agency implementing HOPE VI in Memphis, non-profit leaders, local service funders, and local researchers, as well the head of the U.S. Department of Housing and Urban Development (HUD) field office and members of the Memphis Strong Cities, Strong Communities (SC2) team. Prior to this visit, Dr. Harris had conducted a series of informal interviews and conversations with local stakeholders. (See Attachment C for a complete list of interview respondents).

The interviews covered a range of topics, including details of the policy, planning, and service provision landscape in Memphis, new and longstanding challenges in serving high-needs populations, coordination between service providers and other stakeholders, and current and upcoming programs and initiatives. In each interview, the research team also discussed possibilities for the technical assistance that the team will provide for local stakeholders.

The research team also obtained household- and client-level administrative data on public housing residents relocated as a result of the Memphis Housing Authority's (MHA) HOPE VI initiatives. We received data from two sources: Urban Strategies, which administers the Memphis HOPE program that provides case management and supportive services to HOPE VI relocatees, and the HUD field office in Memphis. The data from Urban Strategies pertain to households receiving services from Memphis HOPE who were relocated from Cleaborn Homes in 2010, Dixie Homes (2008), and Lamar Terrace (2003), including current (or last known relocation) and former locations, housing assistance use, service referral history, and demographics. The data provided on former Lamar Terrace and Cleaborn Homes residents were extracted from the case management data system in April 2012, and the data provided on former residents of Dixie Homes were extracted in October 2011. However active case management for Lamar Terrace and Dixie Homes relocatees ended in 2008 and 2011, respectively, so many of these records have not been updated in a number of years. For these cases, we used the last available information Memphis HOPE could provide on location, demographics, services, and income for each household or resident. The HUD field office provided an extract from the Public Housing Information Center (PIC) database, which includes information on all households currently receiving housing assistance through MHA housing voucher programs. The data extract includes all Memphis households either receiving a voucher for the first time or undergoing annual recertification between March 2011 and February 2012 and provides information on location, household size, and demographics of head of household. We used these two data sources to both analyze the current and former locations and concentrations (or dispersion) of housing assistance users in Memphis, as well to compile information about likely service needs based on referral records and demographics.

MEMPHIS CONTEXT AND LOCATION OF HOUSEHOLDS RECEIVING HOUSING ASSISTANCE

The geographic distribution of HUD-assisted households in Memphis has changed dramatically over the last 15 years. Since the 1990s, Memphis has redeveloped five properties with HOPE VI grants; the city now has only one remaining traditional family public housing development (Foote Homes). Like other large city housing authorities, MHA now relies heavily on vouchers, and assisted households are now dispersed throughout the city. However, most MHA HCV recipients, while they are more dispersed, still live in very poor and predominantly African-American neighborhoods.

By population, Memphis is considered a large city, with 646,889 residents as of the 2010 census. However, it has an unusually large geographical footprint (315 square miles) and a relatively low population density for a city of its size (2,053.3 persons per square mile). [13] One mayor's office official noted that the city has become more geographically dispersed in recent decades by incorporating surrounding areas, though the total population has changed little since the 1960s. Memphis' increased size presents a challenge because of the overall high poverty level and extremely limited public transportation system—without prompting, all key stakeholders raised public transportation as a key challenge.

Unemployment in Memphis is very high; the 2010 American Community Survey (ACS) showed unemployment among those over 16 years old and in the labor force was at 14.9 percent in Memphis, compared to 11.3 percent in Tennessee, and 9.7 nationally. Memphis also has a very high poverty rate; approximately 21.9 percent of families living or having recently lived below the poverty level in 2010, compared to 13.4 state-wide and 11.3 percent nation-wide. Child poverty is particularly high in Memphis with a stunning 39.9 percent of all Memphis children living in households in poverty, compared to 25.7 percent statewide and 21.6 percent nationwide. Maps 1 and 2 (below) respectively illustrate the geographic dispersion of poverty level and the percent of resident who are African American/Black (non-Hispanic) by Census tract.

 

Map 1. Family Poverty Level by Census Tract (2006-2010 ACS Estimates)

Map 2. Percent of the Population who are African American/Black (non-Hispanic), by Census Tract

Location of HUD-Assisted Households

MHA's traditional public housing developments were located centrally, near downtown; interview respondents reported that most former residents have relocated primarily to the large communities of Hickory Hill (Southeast), Frayser (North), and Raleigh (Northeast), all of which are miles from the city center.

 

Our spatial analysis confirms this assessment. As illustrated by Map 4 (next page), Memphis households receiving MHA assistance are located throughout the city, although the households receiving assistance tend to be clustered in areas with very high poverty rates and high percentages of African American residents. As illustrated by Map 5 (next page), Households relocated from Lamar Terrace, Dixie Homes, and Cleaborn Homes (original locations shown in Map 3, below) are much more highly concentrated in their former neighborhoods than MHA voucher holders overall. However, while many have stayed near their original public housing location, others have moved to neighborhoods across the city, following similar patterns of dispersion to the overall population of voucher-assisted households (For more detailed mapping, see Attachment A, which provides a map with an overlay of locations of relocatee households and all current voucher holder households, and Attachment B, which provides a map with an overlay of locations of HOPE VI relocatees and poverty rate by Census tract). As shown in Map 6, HOPE VI relocatees who hold a housing choice voucher live in much more dispersed locations than relocatees overall.

 

Map 3. Original Homes of HOPE VI Relocatees

Map 4.- Location of All HCV Holder Households in Memphis

 

Map 5. Location of HOPE VI Relocatee Households in Memphis

Relocatee Housing Assistance Type and Neighborhoods

Map 6 (below) shows that HOPE VI relocatee households with HCV are more dispersed than relocatee households overall. These relocatee households with HCVs follow a similar pattern to the overall population of MHA HCV-holding households (Map 4), with a bit more central concentration.

Relocatees who receive MHA housing assistance but do not hold housing choice vouchers live in new HOPE VI mixed-income developments, Foote Homes (the only remaining traditional family public housing development in Memphis), or elderly and disabled public housing buildings near the former public housing developments, whereas HCV-holders can move to any area where they can find appropriate, affordable housing with a landlord who will accept a voucher. Map 5 (above) shows, the full population of HOPE VI relocatee households are concentrated in the communities around their original public housing development.

A large majority (68.9 percent) of HOPE VI relocatee households use HCVs. A small portion—just 9.3 percent—live in Foote homes, and a slightly larger portion live in elderly and disabled public housing developments (11.3 percent). Under four percent (3.8 percent) live in new HOPE VI mixed income developments, though this number may be higher in reality than the available data show, as these developments are new and the Lamar Terrace and Dixie Homes relocatee data were only updated as long as the relocatees remained in case management.

 

Map 6. Locations of HOPE VI Relocatees with Housing Choice Vouchers

Location and Dispersion by Zip Code

 

We also examined the distribution of households by zip code to provide a sense of the larger distribution of HOPE VI relocatee households and MHA voucher-holders, in geographic areas more in line with Memphis neighborhoods, many of which cover a large number of census tracts. Memphis planners and researchers who use data refer to areas of the city by zip code, as data are available at this geography and Memphis zip codes approximate clusters of neighborhoods. Table 1 (below) illustrates the locations of HOPE VI relocatee households, all MHA HCV households, and HOPE VI relocatee households with an HCV by common relocatee zip codes.

 

Almost half (46.4 percent) of all relocated households from Lamar Terrace, Dixie Homes, and Cleaborn Homes (including all housing assistance types) now live within one of five zip codes, some of which cover relatively small geographic areas. Of these households, the largest share live in 38126, where Cleaborn Homes was located, and where Foote Homes remains as the only standing traditional public housing development in Memphis (as described above, approximately 80 relocatee households – more than 9 percent of all relocatee households – live in Foot Homes itself). More than 16 percent of relocatee households live in this area, which is small by Memphis standards (approximately 3 square miles in size).

 

The second largest group of relocatees live in 38105, which is where Dixie Homes stood, and where a number of MHA developments for elderly and disabled residents are located. More than 11 percent of relocatee households live in this small area of Memphis. However, relatively few non-relocatee HCV-holders live in this area (Only 1.5 percent and 1.7 percent of all voucher holders live in 38126 and 38105, respectively). The most common zip codes for all MHA HCV-holders (only a small share of whom are relocatees) to live are 38127 (11.4 percent of voucher-holding households), 38109 (11.1 percent), 38118 (9.5 percent), 38115 (9.1 percent), and 38128 (8.9 percent).

 

 

Table 1. Locations of HOPE VI Relocatee Households, All MHA HCV Households, and HOPE Relocatee Households with an HCV by Common Relocatee Zip Codes

Households by Common Relocatee zip codes, HOPE VI relocatees and all MHA voucher holders
	All HOPE VI Relocatees (Households)		MHA HCV Holders (Households)		HOPE VI Relocatees with HCV (households)
Zip code	Number of households	Percent (of Total Relocatee Households)	Number of households	Percent (of total MHA HCV- households)	Number of Households	Percent (of total HCV Relocatee Households)
38126	189	16.4	76	1.5	35	6.2
38105	131	11.4	85	1.7	42	7.4
38127	75	6.5	583	11.4	64	11.3
38106	76	6.6	261	5.1	53	9.3
38109	64	5.6	570	11.1	60	10.6
Remaining Zip Codes	618	53.6	3546	69.2	313	55.2
Total (All Zip Codes)	1153	100.0	5121	100.0	567	100.0

Note: All totals and percentages exclude households for which no zip code is available.

Map 7 (below) shows the locations of major Memphis zip codes and the poverty rates in those areas.

 

Map 7. Major Memphis Zip Codes (with family poverty rate)

 

Demographics of HOPE VI Relocatees by Zip Code

 

In most ways, the demographics of HOPE VI relocatee households are similar to those for all Memphis voucher-holders. Both have low incomes, and tend to have female-headed households. However, as described above, these two populations tend to live in different neighborhoods (which affect access to public transportation and services) and they have different personal histories (i.e. some are former public housing residents).

 

The MHA HOPE VI relocatees are almost all African American and are all very low income. As Table 2 (below) shows, the majority of relocatee households are female-headed (86 percent), but an even higher share of all MHA voucher holder households are female-headed. If we just examine relocatees who hold vouchers (e.g., excluding those in public housing and elderly/disabled housing), they look similar to MHA vouchers holders who were not relocated.

 

Table 2. Household Demographics of Relocatees with HCV, and Relocatees, and All Voucher Holders

Household Demographics of Relocatees with HCV, All Relocatees, and All Voucher Holders
	Female-Headed households		Age of Householder		Total Number of Households
	Number	Percent	Mean	Median
All HOPE VI Relocatees	997	86.5	46.1	44	1153
HOPE VI Relocatees with an HCV	520	91.7	42.9	41	567
All MHA HCV Holders	5184	92.2	41.7	39	5620

Note: This table only includes households for which composition data are available.

As displayed in Table 3 (below), HOPE VI relocatee households tend to be small, with an average household size of just two people. Average household size for all Memphis voucher holders (regardless of whether or not they are HOPE VI relocatees) is more than 50 percent larger, with 3.1 members per households.

 

Table 3. Household Composition for HOPE VI Relocatees and All MHA Voucher Holders

	Zip Codes	Average Members per Household	Average number of children under 18 years old per Household	Total Number of households
HOPE VI Relocatees (regardless of assistance type)	38126	1.9	0.7	189
	38105	1.3	0.2	131
	38127	2.6	1.4	75
	38106	2.5	1.0	76
	38109	2.4	1.2	64
	Remaining Zip Codes	2.0	0.8	618
	All Zip Codes (All Relocatees)	2.0	0.8	1153
	All MHA HCV Households	3.1	.	5620
	HOPE VI Relocatee Households with HCV	2.3	1.1	567

Note: This table only includes households for which composition data are available.

 

Nearly ten percent (10.4 percent) of HOPE VI relocatees (including all household residents) are disabled. Twenty-four percent of heads of relocatee household are disabled (this rate inherently excludes children, who are less likely to be disabled). The household disability rate is similar for all MHA HCV households (24.1 percent).

 

Table 4. Disability among HOPE VI Relocatee Households and All MHA Voucher Holder Households

	Zip Codes	Head of Household is Disabled		Total Number of Households
		Total Number	Percent
HOPE VI Relocatees (regardless of assistance type)	38126	50	26.5	189
	38105	52	39.7	131
	38127	13	17.3	75
	38106	12	15.8	76
	38109	17	26.6	64
	Remaining Zip Codes	136	22.0	618
	All Zip Codes (All relocatees)	280	24.3	1153
	All Voucher Holder Households	1354	24.1	5620

 

 

The average household monthly income for relocatees varies by geographic location, but is extremely low overall, and within each zip code (Table 5 shows this distribution). HOPE VI relocatee households have an average monthly income of $467.49, and a median monthly income of $304.

 

On the whole, a very high share of HOPE VI relocatee households receive TANF and SSI. A quarter (25.5 percent) of heads of HOPE VI relocatee households receive TANF and 27.7 percent receive SSI. TANF use among relocatee households is remarkably high (48 percent) in the zip code 38127, where household size and number of children per household are highest (see Table 3).

 

 

Table 5. Income and Benefits Use for HOPE VI Relocatee Households

 

Income and Benefits Use for HOPE VI Relocatee Households
	Household Monthly Income		Heads of Household Receiving TANF		Heads of households receiving SSI
	Mean	Median	Number	Percent	Number	Percent
38126	$371.09	$205.00	57	30.2	57	30.2
38105	$388.16	$400.00	5	3.8	46	35.1
38127	$404.14	$264.00	36	48.0	14	18.7
38106	$396.79	$226.00	27	35.5	20	26.3
38109	$465.52	$254.00	24	37.5	22	34.4
Remaining Zip Codes	$530.37	$414.50	145	23.5	160	25.9
All Relocatees	$467.49	$304.00	294	25.5	319	27.7

 

Assessment of Referrals to Memphis HOPE Relocatees by Zip Code and Type of Services

Assessment of Referrals to Memphis HOPE Relocatees by Zip Code and Type of Services

Memphis HOPE case management records provide a valuable opportunity to review service use and types of services to which relocatees have been referred. These records provide an idea of needed services that are available to relocatees.

 

As Table 6 (below) shows, the incidence and frequency of service referrals (for relocatees for whom Memphis HOPE referral data are available) varies by zip code. The majority of residents who have been referred for services have received more than one referral; there is some variation by zip code, with residents from 38105 and 38126, being the largest percent having been referred more than once and the smallest percentage never referred across zip codes. Overall, 40 percent of all relocatees have been referred to services more than once, nearly 28 percent only once, and 32 percent have never been referred.

 

Table 6. Frequency of Memphis HOPE Referrals Caseworker for All Service Types

Zip Code	Frequency of Memphis HOPE Referral for Any Services (All members of HOPE VI relocatee households)						Total Number of Residents(for which referral data are available)
	Never Referred		Referred Once		Referred More Than Once
	Number of Residents	Percent of Residents	Number of Residents	Percent of Residents	Number of Residents	Percent of Residents
38126	119	27.4	121	27.8	195	44.8	435
38105	49	27.5	48	27.0	81	45.5	178
38127	75	31.0	77	31.8	90	37.2	242
38106	76	34.4	64	29.0	81	36.7	221
38109	62	35.6	46	26.4	66	37.9	174
Remaining Zip Codes	531	33.6	423	26.8	627	39.7	1581
Total (All Zip Codes)	912	32.2	779	27.5	1140	40.3	2831

Note: This table only includes members of HOPE VI relocatee households for which referral data are available.

Our analysis of Memphis HOPE service referrals by zip code illustrates the diverse needs of relocatees. Table 7 (below) provides a tabulation of number of residents referred to each type of service at least once. Overall, the highest share of all relocatees (for whom data are available) were referred at once point or another to employment services, though this number is still relatively low (possibly reflecting more on service availability, appropriateness of services, and caseworker caseloads than on need, which the income data in table 5 suggests, is great). Approximately 16 percent of the relocatees for whom referral data are available were referred to employment services, 11 percent to child care, 9 percent to education, 8 percent to material resources (e.g. food and clothing supply), 5 percent to youth services, 3 percent to health, 1 percent to financial literacy, nearly 1 percent to transportation, nearly 1 percent to counseling, less than 1 percent to senior services, and 12 percent to other services (e.g. in-take, focus groups, and other ambiguous application services).

The largest number of HOPE VI residents were referred for employment, education, or child care services. However, it should be noted that referrals may be driven by which services are available at least as much as by which services relocatees most need, so relative numbers and percentages of relocatees referred across zip codes made provide more reliable information than raw numbers of referrals in each category. In general, relocatees in areas further from the former public housing developments are more frequently referred for education or child care services, and less frequently referred for employment services. This may be because a higher share of the residents are themselves children (and do not need employment services), because child rearing makes parents less likely to seek employment, or some combination of these factors. Zip code 38105, where relocatee children tend not to live (see table 3), has the highest percent of residents referred to Employment Services and one of the lowest percentages across all zip codes referred to Education Services (though even fewer were referred for Educational Services in 38106, where children are not particularly common in households).

These referral differences highlight common differences between the populations living in these areas. In the less centrally located areas (e.g. 38127, Raleigh/Frayser), relocatees are most often Housing Choice Voucher holders, more likely to have children (see Table 3), and far fewer are elderly or disabled than in the neighborhoods of former public housing and current MHA developments.

Table 7. Number and Share of Relocatees Who have Ever Been Referred to Services in Each Category

Number and Share of Residents Ever Referred to Services in Each Category
SERVICE CATEGORY		38126	38105	38127	38106	38109	Remaining Zip Codes	Total (All Zip Codes)
Employment	Number	64	31	32	38	25	175	365
	Percent	17.6	22.1	15.5	20.8	18.5	14.2	16.1
Education	Number	21	8	25	5	12	139	210
	Percent	5.8	5.7	12.1	2.7	8.9	11.3	9.3
Youth Services	Number	19	4	5	3	7	73	111
	Percent	5.2	2.9	2.4	1.6	5.2	5.9	4.9
Child Care	Number	33	14	28	17	12	147	251
	Percent	9.1	10	13.5	9.3	8.9	11.9	11.1
Transportation	Number	3	1	3	1	1	8	17
	Percent	0.8	0.7	1.5	0.6	0.7	0.7	0.8
Counseling	Number	14	2	.	6	1	8	31
	Percent	3.9	1.4	.	3.3	0.7	0.7	1.4
Financial Literacy	Number	1	2	.	.	.	26	29
	Percent	0.3	1.4	.	.	.	2.1	1.3
Health	Number	8	23	4	6	4	32	77
	Percent	2.2	16.4	1.9	3.3	3	2.6	3.4
Material Resources	Number	34	6	8	6	12	125	191
	Percent	9.3	4.3	3.9	3.3	8.9	10.1	8.4
Senior Services	Number	2	.	1	1	.	2	6
	Percent	0.6	.	0.5	0.6	.	0.2	0.3
Other	Number	56	19	25	31	20	123	274
	Percent	15.4	13.6	12.1	16.9	14.8	10	12.1
Total number of residents for whom referral data is available)		364	140	207	183	135	1236	2265

 

CURRENT EFFORTS AT SERVICE DELIVERY AND COORDINATION

Through our interviews, we learned that there are a number of new, city-wide initiatives underway in Memphis, all intended to serve high needs populations and spur neighborhood-level development. Memphis has had severe poverty and employment problems for decades, but only recently have there been concerted efforts to address these challenges. Stakeholders we interviewed repeatedly talked about the recent change in mayoral leadership, for both the city and the county, as a key factor spurring this increased activity. The City and County mayors work closely together, and in many ways share a vision of what needs to happen in the community, particularly regarding poverty, education, and crime.

 

It is important to note that both new and continuing initiatives are operating at differing levels (e.g. city government, county government, nonprofit providers, public-private partnerships) and that some major services are provided by the city or county government only (rather than both). For example, our conversations with stakeholders indicated that all funding and authority for public health services (including clinics and mental health outreach) is provided by the state and administered via the county. Having different levels of government and private agencies involved in service delivery creates a number of challenges, including: (1) making it less likely that service providers will inform users of complementary services; (2) making it more difficult for service providers to provide services in a way that complements other available services; and (3) making it more difficult for service providers to share broadly relevant lessons learned and resources between agencies.

 

Current Broad Initiatives Relevant to Health and Human Services for Low-Income Households

There are many organizations and initiatives in Memphis currently (or recently) serving high-needs populations and distressed neighborhoods. Several of these initiatives have ambitious, sweeping goals, and most are new, starting within the past year. The large number of initiatives brings both opportunity and challenges: if the different actors coordinate, they could make a powerful collective impact, but if they do not, there is a high risk that there will be substantial duplication of efforts and even conflict.

 

A.     Strong Cities, Strong Communities. In 2011, Memphis was selected as one of six cities to participate in the Obama Administration's Strong Cities, Strong Communities (SC2) initiative. The goal of the SC2 initiative is to foster economic growth and stability by streamlining federal government processes, leveraging federal resources, and building local capacity by fostering collaboration, improving communication, strengthening networks among local stakeholders and improving local infrastructure. The issues of housing for the poor and improving health and economic status for poor families are a key component of this initiative.

 

B.      Bloomberg/Social Innovation Fund is a three-year initiative designed to help mayors effectively resolve city challenges. Memphis is one of five cities to be selected for this initiative, which began in July 2011. The initiative defines three priority areas: innovative solutions, implementation plans, and progress towards defined targets. Within these priority areas, Memphis will focus on implementing new job-growth strategies. This priority area is aligned with Memphis Mayor Wharton's goals to increase small business growth in target neighborhoods and reduce handgun violence. The Bloomberg/Social Innovation Fund in Memphis is in the beginning processes of creating and leveraging programs to revitalize vacant property throughout the core of Memphis and reduce handgun violence. The $4.8 million over the three-years will directly fund the innovation delivery team assigned to creating plans, setting goals, and monitoring progress.

 

C.      National Youth Violence Forum is a part of the Obama Administration's National Forum on Youth Violence Prevention. In April 2010, Memphis became one of six cities participating in the creation and implementation of a comprehensive community-based plan to address youth and gang violence. Representatives from public and private local agencies have formed the Memphis Youth Violence Prevention Policy Council to assess effective practices in juvenile violence prevention, intervention, re-entry, and enforcement. The Forum is co-led by the U.S. Departments of Justice and Education and leverages resources from other federal agencies such as Housing and Urban Development, Health and Human Services, and Centers for Disease Control. The federal agencies are charged with attempting to better coordinate funding streams at a local level.

 

D.     Teen Pregnancy Prevention

The Memphis Adolescent Parent Program is a Memphis City Schools (MCS) collaborative initiative for pregnant and parenting students aimed at providing comprehensive services for students working toward educational and self-sufficiency goals. The program receives resources from a combination of local and federal agencies, including MCS Mental Health Center, Memphis-Shelby Health Department, and the U.S. Department of Health and Human Services.

 

Le Bonheur Community Health and Well Being “Be Proud! Be Responsible! Memphis!” Program is a teen pregnancy prevention program collaborative effort between school centers, schools, and churches in Memphis funded by a $4 million grant from the Office of Adolescent Health in the U.S. Department of Health and Human Services over four years. The goals of the program are to increase knowledge and reduce risky sexual behaviors.

 

The Tennessee Department of Health is the recipient of a U.S. Department of Health and Human Services Abstinence Grant for $1,141,533. It is unclear at this time which local organizations and initiatives are receiving funding from the Abstinence Grant.

 

E.      Choice Neighborhoods is the successor to HUD's HOPE VI program, and provides grants intended to revitalize both distressed public housing and the surrounding neighborhood. MHA received a Choice Neighborhoods Planning Grant in FY2010 for its last family public housing development (Foote Homes) and the Vance Avenue neighborhood (which is also the neighborhood where the most recent HOPE VI grant was based). This $250,000 grant is being used to determine the best way to help rebuild and revitalize the neighborhood. This process includes forming partnerships within local nonprofits and other local government entities, such as the police department.

 

Models Specifically Addressing Health and Human Services for Households Receiving Housing Assistance

The following section describes several key initiatives currently underway that are directly relevant to clients receiving housing assistance who receive or qualify for health and human services assistance.

 

A.      One model of coordinated case management for households receiving housing assistance is that provided by Memphis HOPE, a non-profit organization created in 2006 to provide supportive services to MHA HOPE VI relocatees. By the time MHA received its third and fourth HOPE VI grants (Lamar Terrace and Dixie Homes), there were local stakeholders, including the housing authority, who saw the need for a more structured, intensive and comprehensive case management system to help move households toward economic self-sufficiency. The most important stakeholder to become involved in the HOPE VI redevelopment efforts was the Women's Foundation for a Greater Memphis, who made a financial commitment to support the case management component, called Community and Supportive Services (CSS). They made a commitment to raise $7,200,000, to fund the entire cost of CSS for both HOPE VI developments. In addition to the financial resources, the Women's Foundation also brought a tremendous amount of leverage locally, bringing other stakeholders to the table to figure out how to offer more coordinated case management services. Through the strength of their Board of Directors and their relationships throughout the city, they have built a more comprehensive and coordinated social services program for HOPE VI residents.

 

During this time, MHA identified Urban Strategies as a key partner in providing technical assistance to the CSS program for the Lamar Terrace and Dixie Homes HOPE VI residents. Urban Strategies is the service arm of McCormack Baron Salazar, a HOPE VI developer based in St. Louis. In early summer 2006, Urban Strategies, MHA, and the Women's Foundation agreed to create a new non-profit organization, called Memphis HOPE, which would be responsible for case management for HOPE VI residents. The agency now serves not only all the relocatees from these two HOPE VI grants and the fifth HOPE VI grant awarded to Memphis (Cleaborn Homes), but also the residents in the one remaining public housing development (Foote Homes) who receive case management as part of a HUD grant (Resident Opportunities and Self-Sufficiency).

 

Using private funding and operating as a separate non-profit organization, Memphis HOPE has been more flexible in the programming they develop and more responsive to clients' needs over time. As the staff members of Memphis HOPE (the organization providing case management) have learned more about the individuals in their caseload, they have developed more strategic approaches to cultivate partnerships with programs that are more focused on the key barriers the clients were facing. They have continued to develop relationships with area public and nonprofit agencies to address specific issues among their clients.

 

B.      A place-based model that has recently been implemented is managed by the Powerlines Community Network. This initiative operates under the auspices of Agape Child & Family Services, a Christian non-profit organization which provides and coordinates services to families in distressed neighborhoods and apartment complexes in Memphis. This initiative began in 2009, and now serves three neighborhoods, including:

 

• Whitehaven, focusing in and around Summit Park Apartments and Bent Tree Apartments.

• Hickory Hill/Southeast Memphis, focusing in and around the Autumn Ridge Apartments.

• Frayser/Raleigh (beginning December 2011), focusing in and around the Ashton Hills Apartments.

 

The Powerlines Community Network engages a wide range of partners, including area non-profits, churches, schools, branches of local government, and businesses. The services that the network provides to residents run the gamut, includes education, tutoring, resume and job search help, mental health services, public safety watch, and religious services. The Powerlines neighborhood coordinators have offices in the target apartment buildings, from which they provide services such as computer labs and workshops to help residents apply for benefits (e.g. SNAP). Agape itself provides direct services to families with housing need, including housing and services, provided on the condition that the head of household is able to contribute sixty dollars per month and is absent from home (in some sort of productive activity) for certain core hours of the day. During these core hours, an Agape employee is permitted to enter the home and ensure that the head of household is not present. This place-based effort is focusing on particular apartment communities (to date those funded by Low-Income Housing Tax Credits), and anticipates broadening their work into surrounding neighborhoods over time.

C.      Community LIFT is a new organization that grew out of multiple conversations occurring in city agencies and local non-profits. These conversations led to a sweeping strategic planning report, Greater Memphis Neighborhoods: A Blueprint for Revitalization[14], which was produced by a partnership of local foundations, city agencies and local development associations to lead re-development on the neighborhood level.

Community LIFT launched in autumn 2011, with an Executive Director Eric Robertson who had been part of the strategic planning process. He hired a second staff member at the beginning of 2012, and is in the process of hiring staff to work in specific communities. The agency's goal is to work in the city's most distressed neighborhoods to foster community development around a single neighborhood plan. The organization has a strong emphasis on coordinating and engaging neighborhood-level stakeholders and it has plans to create a Community Development Financial Institution (CDFI) that will lend money for development projects. Community LIFT has raised some funds from local foundations and businesses and is seeking additional support. Community LIFT is currently working in three neighborhoods: Greater Binghampton, Frayser, and Upper South Memphis and plans to set up a steering committee in each target community, consisting of neighborhood leaders and business leaders.

This Community LIFT place-based model arose from the realization that city-wide solutions to community economic development needed to be taken back down to the neighborhood level. However, part of the strategic planning process had been to identify community organizations with substantial capacity, as well as recognizing the need for an organization like Community LIFT to connect those neighborhood needs and assets to resources and planning efforts at the city level.

Challenges of Coordination

In almost every meeting during the January 2012 site visit, respondents acknowledged that there are many different initiatives in process at the moment and that coordinating them to enhance one another, rather than confuse potential service users or duplicate efforts, is a challenge. The individuals running the initiatives and local government officials working in the related areas of service interest are broadly aware of one another, but tend to communicate primarily on a case-by-case or project-by-project basis. While, in practice, individuals know who to call on related initiatives where questions arise, it does not mean these same individuals have been able to think strategically about these partnerships. For example, the county government, Memphis HOPE, and SEEDCO, a national nonprofit organization that advances economic opportunity for people, businesses and communities in need, may all have the same clients but do not have any clear mechanism available to learn about each other's services, goals, and strategies for serving these clients, or any specific way of knowing when one of these related providers' goals, funding, priorities or policies change.

 

Despite sharing goals and clients to serve, respondents concluded that federal and local agencies and organizations experience difficulties crossing silos to coordinate efforts, and share relevant organization information about current work. Two themes discussed repeatedly during the site visit were the possibilities for coordinating data systems and convening ongoing meetings to communicate during the planning and early implementation stages. Much of the coordination that currently occurs is based on individual relationships and for specific one-time needs, and most of the stakeholders volunteered that a better model for coordination services would be beneficial.

HHS FUNDING STREAMS TO MEMPHIS

Respondents throughout our January 2012 site visit had very little knowledge of the funding streams of other organizations and initiatives charged with similar goals. Beyond funding, it was also unclear to respondents what many other organizations and initiatives actually did at the local level. Respondents concluded that a basic understanding of where and how funding streams were purposed at the local level would be a beneficial start to addressing silo problems.

 

In an effort to summarize these federal funding streams that support services in Memphis, the research team reviewed available data from Tracking Accountability in Government Grants System (TAGGS) and USAspending.gov. The majority of funding in TAGGS appears to be concentrated in the Administration for Children and Families (ACF) ($32,996,412) and the Health Resources and Services Administration (HRSA) ($15,733,710) (Table 8).

 

Table 8. HHS Funding Streams by Agency and Amount (TAGGS)

Funding streams by agency and amount.
Source	Organization Type	Amount
TAGGS	Health Resources and Services Administration (HRSA)	$15,733,710
	Administration for Children and Families (ACF)	$32,996,412
	National Institutes for Health (NIH)	$2,709,054
	Center for Disease Control and Prevention (CDC)	$1,465,080
	The Substance Abuse and Mental Health Services Administration (SAMHSA)	$100,000
	Office of Public Health and Science (DHHS/OS)	$568,283
		Total: $53,572.539

 

Using USAspending.gov and parsing funding streams by agency, it appears the majority of funding is concentrated in the National Institutes of Health (NIH) ($2,385,375) out of a total $3,225,092. NIH funding accounts for approximately 73% of USAspending.gov recorded funding sources (Table 9).

 

Table 9. Funding Streams by Agency and Amount (USAspending.gov)

Funding streams by agency and amount.
Source	Agency	Amount
USAspending.gov	National Institutes for Health (NIH)	$2,385,375
	Food and Drug Administration (FDA)	$27,448
	Indian Health Service (IHS)	$9,236
	Administration for Children and Families (ACF)	$797,809
	Office of Assistant Secretary for Health (ASH)	$5,224
		Total: $3,225,092

 

Attachment D includes more detailed funding information.

POSSIBLE DIRECTIONS FOR TECHNICAL ASSISTANCE

It is clear that there are many different initiatives in Memphis that have some focus on ameliorating the deleterious effects of poverty, in various ways that address housing, health, and human services. During the January site visit, the project team and a number of different stakeholders discussed the fact that there are so many initiatives in Memphis, from a variety of funding sources (public, private, philanthropic) and which provide services from different, unconnected sources (e.g. services provided by various branches of city government, county/state government, and local non-profit or partnered service providers).

 

Based on conversations with stakeholders, particularly during the February site visit, we recommend a technical assistance strategy that includes two components.

 

1)      Best Practices. It was noted that there are not only a great number of different initiatives and strategies at work in Memphis currently, but also a fairly large variety. If stakeholders agree, the Urban Institute team may be able to provide technical assistance by producing a concise review of evidence pointing to the most effective strategies for supporting high-needs communities and facilitating robust economic development. This work could help local government agencies and funders decide where to focus their efforts and how best to coordinate. This work would primarily consist of a review of public administration, social science, and economic literature. Again, this work would generate a report that we could circulate to the various stakeholders involved in service provision.

 

2)      Relocatee Focus Groups. Focus groups with HOPE VI relocatees in neighborhoods around the city in order to better understand their service needs, awareness of existing services, and views about existing service providers. These focus groups will also provide perspective on the interests and concerns of high-needs assisted housing populations living outside of the city center.  The research team will present this information to service provider stakeholders and assist them in using these data together with geographic data sources in order to better target their efforts to help HOPE VI relocatees in Memphis.

 

While the data used in producing this memo provide a partial picture of service use and needs, these focus groups would be essential in gaining a richer understanding of the most important needs of newly dispersed former public housing residents, how geography affects their service access, and how their needs relate to the available services and current initiatives in Memphis. We currently intend to conduct three focus groups, each in a different area of the city.

ATTACHMENT A: Map of Relocatee Households and All MHA HCV Households

ATTACHMENT B: Maps of Relocatee Households and All MHA HCV Households with Poverty Rate

ATTACHMENT C: List of Stakeholders Consulted

 

Name

Maura Sullivan, City CAO

Doug Scarboro, City SC2

Robert Lipscomb, MHA Director

Mairi Albertson, Memphis Housing Planning and Development

Dottie Jones, Memphis Community Services

Vickie Jerideau, Memphis HOPE

Sarah Ray, SC2

John Gemmill, HUD Field Office

Stan Hyland, UofM

Cynthia Sadler, UofM

Phyllis Betts, UofM

Eric Robertson, Community LIFT

Eva Mosby, Shelby Co. Human Services

Ruby Bright, Women's Foundation

 

ATTACHMENT D: Funding Streams in Memphis

 

Source: Tracking Accountability in Government Grants System (TAGGS)
Fiscal Year	Recipient Name	Organization Type	Award Title	HHS Agency	Award Amount
2011	Baptist Memorial College of Health Sciences	Non-Profit Private Non-Government Organizations	Scholarships for Disadvantaged Students	Health Resources and Services Administration (HRSA)	$21,371
2011	Children's Bureau Inc. Porter-Leath Children Center	Non-Profit Private Non-Government Organizations	Basic Center Program	Administration for Children and Families (ACF)	$133,517
2011	Children's Bureau Inc. Porter-Leath Children Center	Non-Profit Private Non-Government Organizations	Early Head Start	ACF	$1,104,243
2011	Christ Community Health Services Inc.	Non-Profit Private Non-Government Organizations	Health Center Cluster	HRSA	$2,876,866
2011	Christian Brothers University	Non-Profit Private Non-Government Organizations	Mid-South Coalition for Minority Health International Research Training	National Institutes of Health (NIH)	$242,208
2011	Grace Medical Inc.	Private Profit (Small Business) Organization	Molded Hydrogel Tympanic Membrane Repair Constructs	NIH	$157,910
2011	Le Bonheur Community Outreach	Non-Profit Private Non-Government Organizations	Supporting Evidence Based Home Visitation Program To Prevent Child Maltreatment	ACF	$1,995,412
2011	Memphis and Shelby County Department of Health	County Government	Project Motivated Offenders Succeeding Tomorrow	ACF	$797,809
2011	Memphis and Shelby County Department of Health	County Government	Healthy Start Initiative: Eliminating Disparities in Perinatal Health	HRSA	$692,691
2011	Memphis City Board of Education	City Government	Memphis City Schools: YRBS, HIV Prevention and Asthma Case Management	Center for Disease Control and Prevention (CDC)	$266,387
2011	Memphis City Board of Education	City Government	Affordable Care Act (ACA) Grants for School Based Health Centers Capital Program	HRSA	$499,167
2011	Memphis Health Center	Non-Profit Public Non-Government Organizations	Health Center Cluster	HRSA	$3,192,451
2011	Memphis State University	State Government	ADVANCED EDUCATION NURSING GRANTS	HRSA	$262,500
2011	Memphis State University	State Government	ADVANCED EDUCATION NURSING TRAINEESHIP	HRSA	$34,776
2011	Memphis State University	State Government	FAMILY-ENHANCED COGNITIVE BEHAVIORAL THERAPY FOR COMORBID PTSD AND ALCOHOL ABUSE.	NIH	$154,376
2011	Memphis State University	State Government	VOCAL EXPLORATION AND INTERACTION IN THE EMERGENCE OF SPEECH	NIH	$584,315
2011	Memphis State University	State Government	EFFECTIVENESS OF BASIC AND PREMIUM HEARING AID FEATURES FOR OLDER ADULTS	NIH	$292,294
2011	Memphis State University	State Government	ASSESSMENT OF PSYCHOSTIMULANT ADDICTION RISK FOLLOWING DEVELOPMENTAL PCB EXPOSURE	NIH	$249,000
2011	Memphis State University	State Government	CELLULAR DETERMINANTS OF AH RECEPTOR SIGNALING	NIH	310,866
2011	Memphis State University	State Government	CEREBELLAR MODULATION OF FRONTAL CORTICAL FUNCTION	NIH	$309,686
2011	Memphis State University	State Government	MEMPHIS STEPS (SUICIDE, TRAINING, EDUCATION, AND PREVENTION SERVICES)	The Substance Abuse and Mental Health Services Administration (SAMHSA)	$100,000
2011	Molecular Design International Inc.	Private Profit (Small Business) Organization	NOVEL TOPICAL THERAPY FOR DIABETIC RETINOPATHY USING BETA-ADRENERGIC RECEPTOR AGO	NIH	$108,399
2011	Nursing Institute of the Mid-South, Inc	Non-Profit Public Non-Government Organizations	Nurse Education Practice and Retention	HRSA	$322,165
2011	Qsource	Non-Profit Private Non-Government Organizations	TENNESSEE HEALTH INFORMATION TECHNOLOGY REGIONAL EXTENSION CENTER	Office of Public Health and Science (DHHS/OS)	$568,283
2011	Regional Medical Center at Memphis	Non-Profit Public Non-Government Organizations	Early Intervention Services	HRSA	$951,605
2011	Shelby County Government	County Government		ACF	$23,856,294
2011	St. Jude Children's Research Hospital	Non-Profit Private Non-Governmental Organization		CDC/HRSA	$1,198,693
2011	Shelby County Division of Community Services	County Government	Ryan White Heart HIV Emergency Relief Program	HRSA	$6,880,118
2011	Translational Sciences	Private Profit (Small Business) Organization	Reducing Stroke by a Novel Clot Reducing Antibody	NIH	$300,000
2011	University of Tennessee Center for the Health Sciences	State Government		ACF/FDA/NIH/CDC./ AHRQ (Agency For Health Care Research and Quality)/HRSA	$5,009,137
2011	Youth Villages Inc	Non-Profit Private Non-Government Organizations	Basic Center Program	ACF	$100,000

 

 

Source: USAspending.gov
Fiscal Year	Recipient Name	Type of Spending	HHS Agency	Award Amount
2011	FedEx Corporation	Contract	Indian Health Service (HIS)	$9,096
2011	NEXAIR LLC	Contract	Food and Drug Administration (FDA)	$21,498
2011	Service Master Holding Corporations	Contract	HIS	$140
2011	University of Memphis	Grant	National Institutes of Health (NIH)	876,609
2011	University of Memphis	Contract	NIH	$30,000
2011	Chesney MD Russel W	Contract	NIH	$25,000
2011	Genome Explorations	Contract	NIH	$425,949
2011	Grace Medical	Grant	NIH	$157,910
2011	MedNet Locator	Contract	NIH	$7,125
2011	MGT Computer Controls	Contract	CDC	$6,000
2011	Molecular Design	Grant	NIH	$108,399
2011	Process and Power Inc	Contract	FDA	$5,950
2011	Shelby County	Grant	Administration for Children and Families (ACF)	$797,809
2011	Smith and Nephew PLC	Contract	Office of the Assistant Secretary for Health (ASH)	$5,224

 

Source: Find Youth Info
Recipient	Program Title	Funding Agency
CHRIST COMMUNITY HEALTH SERVICES, INC.	Community-Based Abstinence Education (CBAE)	ACF
Le Bonheur Community Outreach	Child Abuse and Neglect Discretionary Activities	ACF
Shelby County Division of Corrections	Healthy Marriage Promotion and Responsible Fatherhood Grants	ACF
CHILDRENS BUREAU INC PORTER-LEATH CHILDREN C	Basic Center Grant	ACF
Shelby County Division of Corrections	Healthy Marriage Promotion and Responsible Fatherhood Grants	ACF
Le Bonheur Community Outreach	Coordinated Services and Access to Research for Women, Infants, Children, and Youth	HRSA
Le Bonheur Community Outreach	Maternal and Child Health Federal Consolidated Programs	HRSA
ST JUDE CHILDREN`S RESEARCH HOSPITAL	Sickle Cell Treatment Demonstration Program	HRSA
MEMPHIS & SHELBY COUNTY DEPARTMENT OF HEALTH	Healthy Start Initiative	HRSA
MEMPHIS HEALTH CENTER	Consolidated Health Centers	HRSA
MIDTOWN MENTAL HEALTH CENTER	Substance Abuse and Mental Health Services – Projects of Regional and National Significance	SAMHSA
MEMPHIS CITY BOARD OF EDUCATION	Cooperative Agreements to Support Comprehensive School Health Programs to Prevent the Spread of HIV and Other Important Health Problems	CDC