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Tim Bolding, executive director, United Housing
Challenge: Many Medicaid patients are prematurely placed in institutions because they can’t afford to receive care in their own homes or make them safe and accessible. In Tennessee, over 8,000 Medicaid recipients do get residential or community based services, but another 20,000 live in skilled nursing facilities. Many of those who are either elderly or have cognitive or physical disabilities would prefer to live at home if they could. But while the costs of residential services can be considerably less than those charged by institutions, many patients have no access to them. With tens of thousands to serve across the state, expanding residential care through innovative solutions has become ever more urgent.
All too often, seniors and people with disabilities find themselves forced into nursing homes because they don’t have access to long-term care and other support in their homes. In many cases, they may not require the costly skilled care from an institution, just nursing care or therapy and help with medication, transportation and grocery shopping. But long-term insurance, including Medicaid, may not cover such residential services, and while some states do offer financial assistance for home- and community-based care, financial hurdles still exist across the country.
In Tennessee, more than 20,000 Medicaid recipients live in skilled nursing facilities, according to the latest figures from TennCare, Tennessee’s Medicaid program. Over 8,000 recipients are cared for through residential and community based services, an option provided for the elderly and people with disabilities who prefer to remain in their homes. Extending such residential services to more patients rather than institutionalizing them would significantly cut costs, but traditional approaches fail to incorporate more cost-effective systems.
United Housing Inc.’s (UHI) mission is to provide quality housing opportunities to Mid-South residents through financial education, mortgage lending, home building and renovation, and creative partnerships with public, private and nonprofit entities. UHI serves residents that are underserved by the traditional homeownership and banking industry, as well as individuals with disabilities who need accessible homes to live comfortable, stable lives. Since 1994, UHI has helped over 4,000 families buy or keep their homes.
The success of our endeavors is in large part due to the establishment of regional networks and to investments from many national and federal programs and sources. These relationships positioned UHI to play a leading role in helping stabilize Western Tennessee’s most threatened residents and neighborhoods.
Recently, UHI partnered with TennCare and others to help more vulnerable Tennessee residents stay in their homes. The initiative is aimed at providing the elderly and people with intellectual, developmental and physical disabilities with quality home care and accessibility modifications to their residences. This includes not only supporting those who want to stay in their homes, but those able to move back home from institutions.
TennCare has long provided medical care for the state’s sick and elderly residents by covering their nursing home costs. But the work of UHI and our partners, Shelby Residential and Vocational Services (SRVS) and Meritan, demonstrates that it is possible to cut TennCare’s costs significantly by providing care in the home.
Key to this initiative is expanding housing options and services. After longtime UHI supporter Henry Varnell put Executive Director Tim Bolding in touch with CEO of SRVS, Tyler Hampton, the two realized that they shared an area of service: single-family housing. UHI and SRVS immediately partnered to renovate seven houses that would be owned by SRVS. After
success with this program, an additional opportunity to collaborate with Meritan became available through new funding for additional accessible homes.
UHI and other NeighborWorks America organizations in the state are preparing a pilot with TennCare to connect nonprofit builders in the NeighborWorks network with organizations providing medical residential service (MRS). These homes can be used to house recipients of one or many of TennCare’s healthcare programs.
SRVS, a nonprofit offering assistance and services to people with disabilities in Shelby County, has a unique model in which three individuals live together in a single-family home that has been retrofitted to be accessible in accordance with the Americans with Disabilities Act.
Meritan, a nonprofit home health care service provider, has a similar program. Meritan’s clients have a wide range of disabilities. In addition to the primary diagnosis of a developmental disability, many of their clients also have mobility issues and limited vision, hearing and speech. Medical residential services are provided in a home where all residents require direct skilled nursing as well as habilitative support that enables an individual to acquire, retain or improve skills necessary to reside in a community-based setting. MRS patients require direct skilled nursing care on a daily basis and at a level that cannot for practical purposes be provided through two or fewer daily skilled nursing visits. All of these services can be provided in the home by licensed nurses.
United Housing has worked with Meritan for several years on the common goal to increase livability among the most vulnerable populations in Memphis. The UHI-Meritan partnership has yielded four completed homes so far with more underway.
“Meritan is proud of our partnership with United Housing,” Meritan’s Executive Director Melanie Keller said in a 2013 event marking the completion of the first home. “Our combined efforts are resulting in community housing and support for individuals with developmental and intellectual disabilities. We feel our relationship exemplifies how two nonprofits with seemingly different missions can join together to serve our community.”
Shortly after the event, UHI was awarded a $3 million grant from the Tennessee Department of Economic Development to build 16 homes for Meritan and SRVS clients.
Each one of the TennCare’s affordable units will follow Tennessee Housing Development Agency’s accessibility guidelines. Those include step-free entry with features such as wheelchair ramps, lowered cabinets and accessible restrooms. This gives people with cognitive or physical disabilities the opportunity to maintain some independence while receiving top-quality medical care. It also means large-scale savings for TennCare, which can now employ less costly care in homes and communities instead of footing nursing home bills. TennCare also saves on construction by deploying the expertise of nonprofit housing developers across the state.
But UHI’s partnership with Meritan and SRVS benefits not just these health care organizations, the residents and TennCare. Generating income through our developed area of expertise means that UHI earns revenue for doing what it already knows how to do and expands our capacity to do more while maintaining a healthy organization.
As UHI begins strategic planning for the next five years, our vision is to provide the necessary housing for a diverse population. While traditionally UHI has focused on homeownership, the organization understands how health intersects with housing and neighborhood environments. UHI stands ready to provide healthy homes through creative partnerships with care organizations, hospitals, insurance providers and other potential partners while maintaining our traditional homeownership work.
We have learned that while complex partnerships such as these are beneficial to all, they are not always easy to achieve. We needed the support of the NeighborWorks network to help us expand through capacity building. This in turn encouraged each organization to develop strategies that pull the best from the public and private sectors
Challenge: Many Medicaid patients are prematurely placed in institutions because they can’t afford to receive care in their own homes or make them safe and accessible. In Tennessee, over 8,000 Medicaid recipients do get residential or community based services, but another 20,000 live in skilled nursing facilities. Many of those who are either elderly or have cognitive or physical disabilities would prefer to live at home if they could. But while the costs of residential services can be considerably less than those charged by institutions, many patients have no access to them. With tens of thousands to serve across the state, expanding residential care through innovative solutions has become ever more urgent.
All too often, seniors and people with disabilities find themselves forced into nursing homes because they don’t have access to long-term care and other support in their homes. In many cases, they may not require the costly skilled care from an institution, just nursing care or therapy and help with medication, transportation and grocery shopping. But long-term insurance, including Medicaid, may not cover such residential services, and while some states do offer financial assistance for home- and community-based care, financial hurdles still exist across the country.
In Tennessee, more than 20,000 Medicaid recipients live in skilled nursing facilities, according to the latest figures from TennCare, Tennessee’s Medicaid program. Over 8,000 recipients are cared for through residential and community based services, an option provided for the elderly and people with disabilities who prefer to remain in their homes. Extending such residential services to more patients rather than institutionalizing them would significantly cut costs, but traditional approaches fail to incorporate more cost-effective systems.
United Housing Inc.’s (UHI) mission is to provide quality housing opportunities to Mid-South residents through financial education, mortgage lending, home building and renovation, and creative partnerships with public, private and nonprofit entities. UHI serves residents that are underserved by the traditional homeownership and banking industry, as well as individuals with disabilities who need accessible homes to live comfortable, stable lives. Since 1994, UHI has helped over 4,000 families buy or keep their homes.
The success of our endeavors is in large part due to the establishment of regional networks and to investments from many national and federal programs and sources. These relationships positioned UHI to play a leading role in helping stabilize Western Tennessee’s most threatened residents and neighborhoods.
Recently, UHI partnered with TennCare and others to help more vulnerable Tennessee residents stay in their homes. The initiative is aimed at providing the elderly and people with intellectual, developmental and physical disabilities with quality home care and accessibility modifications to their residences. This includes not only supporting those who want to stay in their homes, but those able to move back home from institutions.
TennCare has long provided medical care for the state’s sick and elderly residents by covering their nursing home costs. But the work of UHI and our partners, Shelby Residential and Vocational Services (SRVS) and Meritan, demonstrates that it is possible to cut TennCare’s costs significantly by providing care in the home.
Key to this initiative is expanding housing options and services. After longtime UHI supporter Henry Varnell put Executive Director Tim Bolding in touch with CEO of SRVS, Tyler Hampton, the two realized that they shared an area of service: single-family housing. UHI and SRVS immediately partnered to renovate seven houses that would be owned by SRVS. Aftersuccess with this program, an additional opportunity to collaborate with Meritan became available through new funding for additional accessible homes.
UHI and other NeighborWorks America organizations in the state are preparing a pilot with TennCare to connect nonprofit builders in the NeighborWorks network with organizations providing medical residential service (MRS). These homes can be used to house recipients of one or many of TennCare’s healthcare programs.
SRVS, a nonprofit offering assistance and services to people with disabilities in Shelby County, has a unique model in which three individuals live together in a single-family home that has been retrofitted to be accessible in accordance with the Americans with Disabilities Act.
Meritan, a nonprofit home health care service provider, has a similar program. Meritan’s clients have a wide range of disabilities. In addition to the primary diagnosis of a developmental disability, many of their clients also have mobility issues and limited vision, hearing and speech. Medical residential services are provided in a home where all residents require direct skilled nursing as well as habilitative support that enables an individual to acquire, retain or improve skills necessary to reside in a community-based setting. MRS patients require direct skilled nursing care on a daily basis and at a level that cannot for practical purposes be provided through two or fewer daily skilled nursing visits. All of these services can be provided in the home by licensed nurses.
United Housing has worked with Meritan for several years on the common goal to increase livability among the most vulnerable populations in Memphis. The UHI-Meritan partnership has yielded four completed homes so far with more underway.
“Meritan is proud of our partnership with United Housing,” Meritan’s Executive Director Melanie Keller said in a 2013 event marking the completion of the first home. “Our combined efforts are resulting in community housing and support for individuals with developmental and intellectual disabilities. We feel our relationship exemplifies how two nonprofits with seemingly different missions can join together to serve our community.”
Shortly after the event, UHI was awarded a $3 million grant from the Tennessee Department of Economic Development to build 16 homes for Meritan and SRVS clients.
Each one of the TennCare’s affordable units will follow Tennessee Housing Development Agency’s accessibility guidelines. Those include step-free entry with features such as wheelchair ramps, lowered cabinets and accessible restrooms. This gives people with cognitive or physical disabilities the opportunity to maintain some independence while receiving top-quality medical care. It also means large-scale savings for TennCare, which can now employ less costly care in homes and communities instead of footing nursing home bills. TennCare also saves on construction by deploying the expertise of nonprofit housing developers across the state.
But UHI’s partnership with Meritan and SRVS benefits not just these health care organizations, the residents and TennCare. Generating income through our developed area of expertise means that UHI earns revenue for doing what it already knows how to do and expands our capacity to do more while maintaining a healthy organization.
As UHI begins strategic planning for the next five years, our vision is to provide the necessary housing for a diverse population. While traditionally UHI has focused on homeownership, the organization understands how health intersects with housing and neighborhood environments. UHI stands ready to provide healthy homes through creative partnerships with care organizations, hospitals, insurance providers and other potential partners while maintaining our traditional homeownership work.
We have learned that while complex partnerships such as these are beneficial to all, they are not always easy to achieve. We needed the support of the NeighborWorks network to help us expand through capacity building. This in turn encouraged each organization to develop strategies that pull the best from the public and private sectors
