Homelessness in Knoxville and Knox County, 2011-2012

 

Contact Information

Knoxville-Knox County Homeless Coalition
Rev. Dr. Bruce Spangler, President
[email protected]

Roger
 Nooe,
 Ph.D.
 
 
Professor
 Emeritus,
 UT-­‐College
 of
 Social
 Work
 
Director
 of
 Social
 Services,
 Community
 Law
 Office
 
[email protected]
 

Knoxville Homeless Management Information System
David A. Patterson, Ph.D., Director
[email protected]

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 ii

Table of Contents
Acknowledgements..............................................................................................................v

Note to the Reader ............................................................................................................. vi
Introduction....................................................................................................................... vii

Interviewers..........................................................................................................................x
Section I

Defining Homelessness........................................................................................................1
Numbers ...................................................................................................................1

Review of Contributing Factors...........................................................................................4
Housing ................................................................................................................................5

Current Economic Crisis......................................................................................................7
Mental Illness & Deinstitutionalization ...............................................................................7

Employment .........................................................................................................................9
Substance Abuse ..................................................................................................................9

Education ...........................................................................................................................11
Personal Crises...................................................................................................................11

Other Risk Factors .............................................................................................................13
Homelessness as a Lifestyle...............................................................................................15

Section II

Executive Summary ...........................................................................................................16
2011 KnoxHMIS Annual Report .......................................................................................18

New Clients Entered into KnoxHMIS ...................................................................18
Active Clients Utilizing Services...........................................................................19

Basic Demographic Information on Active Clients...............................................21
Disability Status of Active Clients.........................................................................22

Self-Reported Primary Reason for Homelessness .................................................23
Subpopulations of Active Clients ..........................................................................24

Chronic Homelessness ...............................................................................24
Veterans .....................................................................................................27

Female Single Parents................................................................................27
Street Homeless .........................................................................................28

Children......................................................................................................28
Services Capture in KnoxHMIS ............................................................................29

Emergency Shelter & Transitional Housing ..........................................................30
Housing Outcomes.................................................................................................30

Permanent Supportive Housing .............................................................................31
Homelessness Prevention & Rapid Rehousing Program .......................................31

Casenotes ...............................................................................................................32
Maps of Zip Codes.................................................................................................33

KnoxHMIS Data Quality .......................................................................................36
AHAR Participation...............................................................................................37

Director’s Commentary .........................................................................................37

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 iii

Knoxville-Knox County Homeless Coalition Biennial Study ...........................................39
Design ................................................................................................................................39
Demographics ....................................................................................................................40
Roots ..................................................................................................................................42
Family ................................................................................................................................43
Military Service .................................................................................................................44
Causes of Homlessness ......................................................................................................45
Housing ..............................................................................................................................46
Employment .......................................................................................................................46
Health .................................................................................................................................48
Mental Health.....................................................................................................................49
Alcohol & Other Drugs......................................................................................................50
Crime..................................................................................................................................51
Life on the Streets ..............................................................................................................52
Women ...............................................................................................................................55
Commentary.......................................................................................................................59

Section III
Resources in Knoxville ......................................................................................................61
References..........................................................................................................................69

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 iv

ACKNOWLEDGEMENTS
 
Homelessness
 in
 Knoxville/Knox
 County:
 2012
 represents
 twenty-­‐six
 years
 of
 studies
 

sponsored
 by
 the
 Knoxville/Knox
 County
 Homeless
 Coalition.
 
 Homelessness
 continues
 to
 be
 
a
 major
 problem
 in
 East
 Tennessee.
 
 Many
 dedicated
 people
 are
 working
 toward
 finding
 
solutions.
 
 
 We
 are
 indebted
 to
 their
 help
 in
 conducting
 this
 study
 as
 well
 as
 previous
 ones.
 

The
 interviewers
 who
 helped
 contribute
 their
 time
 and
 skills
 deserve
 a
 special
 
thanks.
 
 The
 agency
 executives,
 Major
 Don
 Vick,
 Burt
 Rosen,
 Ginny
 Weatherstone,
 Fr.
 Ragan
 
Schriver,
 Patrick
 White,
 Dan
 Hoxworth,
 Marigail
 Mullin,
 Sheila
 Pellasma,
 Maxine
 Raines,
 
Barbara
 Kelly,
 Preacher
 Bob
 Burger,
 and
 Joyce
 Shoudy
 were
 supportive
 of
 the
 study.
 
 Jamie
 
Brennan,
 Dr.
 David
 Patterson,
 Mary
 Lou
 Hammer,
 Rev.
 Dr.
 Bruce
 Spangler
 and
 Gabrielle
 
Cline
 were
 tremendous
 resources
 in
 planning
 and
 conducting
 the
 study.
 
 Shelter
 and
 
agency
 staff-­‐-­‐Larry
 Lindsey,
 Treva
 Jerigan,
 Donna
 Wright,
 Rev.
 Mychal
 Spence,
 Cynthia
 
Russell,
 Barbara
 Davis,
 Becky
 Nolan,
 Keith
 Farrar,
 Beverly
 Lakin,
 Rick
 Walker,
 Stephanie
 
Goodman,
 Susan
 Cashion,
 Greg
 Lay,
 Mimi
 Vivio,
 and
 Alle
 Lily
 were
 most
 cooperative
 and
 
helpful
 in
 our
 data
 collection.
 
 The
 Homeward
 Bound
 staff,
 Barbara
 Disney,
 Erin
 Lang,
 Sissy
 
Flack,
 and
 Beatrice
 Irwin
 did
 extra
 work
 in
 interviewing
 and
 assisting
 with
 the
 study.
 
 Carl
 
Williams
 and
 Roosevelt
 Bethel
 were
 essential
 in
 surveying
 outside
 locations.
 
 
 

My
 colleagues
 at
 the
 Community
 Law
 Office,
 Matt
 Silvey
 Chris
 Smith
 and
 Phillip
 
Carrigan
 were
 very
 helpful.
 
 My
 graduate
 students,
 Jennifer
 Smith,
 Lindsay
 Preskenis,
 Jaime
 
Frimpong,
 and
 Brad
 Jennings
 conducted
 interviews
 and
 helped
 as
 needed.
 
 A
 special
 thank
 
you
 goes
 to
 my
 secretary,
 Marybeth
 Snyder.
 
 Mark
 Stephens,
 Knox
 County
 Public
 Defender,
 
has
 provided
 countless
 resources
 and
 allowed
 us
 to
 use
 meeting
 rooms
 for
 interviewer
 
training.
 

Mike
 Dunthorn,
 project
 director
 of
 the
 Ten
 Year
 Plan
 to
 End
 Chronic
 Homelessness,
 
was
 instrumental
 in
 sponsoring
 this
 study.
 
 The
 City
 of
 Knoxville
 provided
 support
 for
 the
 
study.

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 v

Note
 to
 the
 Reader
 

 

“Imagination
 is
 more
 important
 than
 information.”
 
Albert
 Einstein
 


 
“As
 long
 as
 leaders…base
 their
 confidence
 on
 how
 much
 data
 they
 have
 acquired,
 they
 are
 

doomed
 to
 feel
 inadequate,
 forever.”
 
Edwin
 Friedman
 


 

  Before
 I
 venture
 into
 the
 relevance
 of
 Albert
 Einstein’s
 preference
 for
 imagination
 
and
 Friedman’s
 suggestion
 of
 the
 “paralysis
 of
 analysis”
 for
 the
 2012
 Knoxville/Knox
 
County
 Homeless
 Study,
 I
 must
 begin
 by
 expressing
 my
 immense
 gratitude
 to
 everyone
 
who
 has
 made
 this
 study
 possible.
 
 
 Many
 individuals
 offered
 so
 much
 energy
 to
 make
 
this
 document.
 
 I
 would
 be
 remiss
 in
 attempting
 to
 name
 everyone
 because
 I
 am
 sure
 
that
 I
 may
 inadvertently
 overlook
 the
 contribution
 of
 someone.
 
 So
 I
 offer,
 instead,
 a
 
wide
 “blanket”
 of
 thanks
 and
 gratitude
 to
 all
 of
 those
 whose
 hands
 and
 hearts
 are
 
responsible
 for
 the
 compilation
 of
 this
 2012
 study.
 

However,
 I
 would
 be
 further
 remiss
 not
 to
 mention
 Dr.
 Roger
 Nooe
 and
 Stacia
 
West.
 
 
 

Dr.
 Roger
 Nooe,
 University
 of
 Tennessee
 Professor
 Emeritus,
 College
 of
 Social
 
Work
 and
 Director
 of
 Social
 Services
 of
 the
 Knox
 County
 Public
 Defenders
 Office,
 has
 
once
 again
 assumed
 the
 role
 as
 the
 principal
 investigator
 for
 the
 study.
 
 This
 is
 a
 role
 
that
 he
 has
 fulfilled
 with
 unquestionable
 integrity
 and
 scholarly
 passion
 for
 the
 past
 two
 
and
 a
 half
 decades.
 
 
 Though
 the
 Knoxville/Knox
 County
 Homeless
 Coalition
 
commissions
 the
 study,
 Dr.
 Nooe
 has
 fully
 earned
 the
 distinction
 and
 rightful
 claim
 by
 
most
 that
 this
 study
 is
 really
 “Roger’s
 study.”
 
 
 
 

In
 an
 attempt
 to
 compliment
 yet
 contrast
 the
 findings
 and
 discoveries
 of
 this
 
study
 and
 the
 University
 of
 Tennessee’s
 College
 of
 Social
 Work’s
 Annual
 Report
 of
 
Homelessness
 from
 the
 data
 of
 the
 Homeless
 Management
 Information
 System
 (HMIS),
 
Stacia
 West,
 Data
 Analyst
 with
 KnoxHMIS,
 accepted
 the
 Coalition’s
 invitation
 to
 join
 
efforts
 with
 Dr.
 Nooe
 for
 the
 compilation
 of
 this
 study.
 
 
 Her
 technological
 and
 analytical
 
skills
 and
 competencies
 have
 few
 equals.
 
 
 
 
 

Therefore,
 I
 pause
 to
 extend
 an
 additional
 thanks
 to
 Roger
 and
 Stacia,
 “Thanks!”
 
This
 study
 is
 a
 window
 into
 homelessness
 in
 the
 Knoxville/Knox
 County
 area.
 The
 
results
 and
 conclusions
 are
 found
 within,
 so
 I
 do
 not
 wish
 to
 repeat
 or
 rehearse
 any
 of
 
them.
 
 
 The
 results
 and
 conclusions
 speak
 for
 themselves
 and
 in
 the
 end
 will
 find
 
multiple
 and
 varied
 voices
 in
 their
 interpreters
 and
 challengers.
 
 
 You
 shall
 find
 within
 
these
 covers
 a
 lot
 of
 data,
 information
 and
 some
 extrapolations.
 
Yet,
 my
 note
 to
 you
 is
 far
 from
 passive
 in
 character
 and
 intent.
 
 
 If
 Einstein’s
 
insight
 has
 any
 validity
 or
 worthiness
 of
 imitation,
 then
 I
 propose
 that
 you
 use
 the
 
“imaginative
 and
 creative”
 force
 that
 you
 possess
 to
 translate
 this
 data
 into
 actionable
 
insights
 and
 proposals.
 
 
 The
 collection
 of
 data
 in
 this
 document
 is
 well
 worth
 paying
 
attention
 to
 because
 YOU
 can
 use
 it
 as
 a
 catalyst
 for
 change
 in
 the
 way
 our
 community
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 vi

responds
 to
 and
 with
 the
 individuals
 whose
 identity
 is
 temporarily
 “hijacked”
 by
 the
 
experience
 of
 homelessness!
 
 If,
 however
 and
 on
 the
 other
 hand,
 the
 “facts
 and
 figures”
 
herein
 are
 just
 another
 proliferation
 of
 information,
 then
 the
 addictive
 stupor
 of
 data
 
collection
 has
 once
 again
 mesmerized
 us
 into
 nonaction.
 

In
 his
 book,
 A
 Failure
 of
 Nerve,
 Edwin
 Friedman
 notes
 how
 the
 proliferation
 of
 
information
 will
 often
 paralyze
 leaders.
 No
 doubt,
 the
 flow
 and
 volume
 of
 information
 is
 
relentless
 and
 ceaseless.
 
 To
 assume
 that
 one
 can
 “corral”
 all
 the
 data
 needed
 on
 
homelessness
 before
 drawing
 decisive
 and
 definitive
 proposals
 is
 delusional,
 and
 
effectively
 impedes
 any
 sense
 of
 change
 or
 progress.
 The
 purpose
 for
 the
 collection
 of
 
data
 in
 this
 volume
 has
 its
 main
 objective
 and
 only
 purpose:
 to
 bring
 an
 end
 to
 chronic
 
homelessness
 and
 shorten
 any
 experience
 of
 homelessness
 for
 children,
 women
 and
 
men
 in
 our
 communities.
 
 
 
 

I
 believe
 that
 with
 an
 informed
 and
 measured
 balance
 of
 personal
 responsibility
 
and
 systematic
 change,
 future
 studies
 will
 reflect
 that
 the
 Knoxville/Knox
 County
 area
 is
 
an
 imaginative
 landscape
 of
 purposeful
 leaders,
 advocates
 and
 system
 changers
 with
 
many
 individuals
 reclaiming
 both
 their
 names
 and
 identity
 from
 the
 clutches
 of
 
homelessness.
 

Please
 receive
 this
 2012
 study
 as
 a
 gift
 from
 the
 Knoxville/Knox
 County
 Homeless
 
Coalition
 to
 you
 and
 our
 community
 partners.
 

 
I
 write
 respectfully
 and
 sincerely,
 

 

 
Rev.
 Dr.
 Bruce
 W.
 Spangler,
 President
 
 
Knoxville/Knox
 County
 Homeless
 Coalition
 

 

 
“The
 mission
 of
 the
 Knoxville/Knox
 County
 Homeless
 Coalition
 is
 to
 foster
 collaborative
 
community
 partnerships
 in
 a
 focused
 effort
 that
 seeks
 permanent
 solutions
 to
 prevent,
 

reduce
 and
 end
 homelessness.”
 
adopted
 January
 27,
 2009
 


 

 

 

 

 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 vii

 
 
 
 
  INTRODUCTION
 
Homelessness
  in
  Knoxville-­‐Knox
  County
  2011-­‐2012
  is
  the
  fifteenth
  study
  of
 

homelessness
  in
  Knoxville-­‐Knox
  County
  sponsored
  by
  the
  Knoxville-­‐Knox
  County
 
Homelessness
  Coalition
  and
  highlights
  twenty-­‐six
  years
  of
  collecting
  data.
 
  The
  first
 
study
 was
 conducted
 in
 1986
 with
 regular
 studies
 conducted
 biennially
 thereafter,
 plus
 
two
  smaller
  intermediate
  studies.
 
  When
  initially
  appointed
  in
  November
  1985
  as
  the
 
Knoxville
  Coalition
  for
  the
  Homeless,
  the
  coalition
  was
  charged
  with
  three
  major
 
responsibilities:
  (1)
  to
  ascertain
  the
  extent
  of
  homelessness
  in
  Knoxville,
  (2)
  to
 
determine
  services
  available
  to
  the
  homeless
  and
  make
  recommendations
  concerning
 
deficient
 or
 nonexistent
 services,
 and
 (3)
 to
 increase
 communication
 and
 coordination
 of
 
services
  among
  existing
  agencies
  and
  organizations
  working
  with
  the
  homeless.
 
  The
 
coalition
  continues
  to
  meet
  on
  a
  monthly
  basis
  and
  in
  addition
  to
  sponsoring
  studies,
 
serves
  as
  a
  forum
  for
  exchange
  of
  ideas
  and
  information.
  It
  has
  taken
  an
  increasingly
 
active
 community
 role
 through
 public
 education
 activities,
 supporting
 implementation
 of
 
the
 Ten
 Year
 Plan
 to
 End
 Chronic
 Homelessness,
 and
 developing
 housing
 for
 the
 homeless.
 

In
 July
 2011,
 the
 Coalition
 adoped
 the
 following
 permanent
 solutions
 to
 prevent,
 
reduce,
 and
 end
 homelessness:
 
 

 
HOUSING
 ACCESSIBILITY
 

1)
 
 
 
 Develop
 a
 range
 of
 permanent
 housing
 options
 to
 include
 permanent
 
supportive
 housing
 and
 appropriate
 levels
 of
 support
 based
 on
 individual
 need.
 
2)
 
 
 
 Transitional
 housing
 options
 for
 special
 populations
 (for
 example,
 families
 
with
 children,
 youth
 aging
 out
 of
 foster
 care,
 etc.).
 
3)
 
 
 
 Community
 integration
 –
 availability
 of
 housing
 throughout
 the
 community,
 
neighborhoods
 become
 more
 accommodating.
 
 

 
 
SUPPORTIVE
 SERVICES
 
1)
 
 
 
 Increased,
 timely
 access
 to
 alcohol
 and
 drug
 treatment
 services
 and
 
community
 based
 mental
 health
 services.
 
2)
 
 
 
 Expanding
 case
 management
 services
 to
 those
 at
 risk
 of
 homelessness,
 such
 
as
 residents
 in
 family-­‐style
 public
 housing.
 
3)
 
 
 
 More
 funding
 for
 utility
 and
 rent
 assistance
 to
 prevent
 evictions.
 

 
 
PROACTIVE
 COMMUNITY
 RESPONSE
 
1)
 
 
 
 Advocating
 for
 changes
 in
 interpretation
 and
 implementation
 of
 commitment
 
for
 treatment
 criteria
 (i.e.
 Title
 33)
 to
 ensure
 that
 both
 inpatient
 and
 outpatient
 
treatment
 is
 available
 to
 persons
 in
 psychiatric
 crisis
 and/or
 situations
 that
 pose
 
a
 risk
 of
 harm.
 
2)
 
 
 
 Expanding
 the
 capacity
 for
 services
 that
 are
 already
 proven
 to
 work
 –
 case
 
management,
 subsidized
 housing,
 etc.
 
3)
 
 
 
 Better
 coordination
 of
 systems
 and
 resources
 to
 prevent
 discharging
 to
 the
 
streets
 from
 jail,
 hospitals
 and
 foster
 care.
 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 viii

A
  number
  of
  significant
  activities
  continue
  in
  Knoxville-­‐Knox
  County.
 
  The
  Ten
 
Year
 Plan
 to
 End
 Chronic
 Homelessness
 developed
 at
 the
 request
 of
 Knoxville
 Mayor
 Bill
 
Haslam
  and
  Knox
  County
  Mayor
  Mike
  Ragsdale
  represents
  the
  first
  community
  plan
  to
 
address
  homelessness
  in
  a
  comprehensive,
  coordinated
  manner.
  The
  plan’s
  central
 
theme,
  Housing
  First,
  is
  a
  different
  approach
  to
  homelessness
  and
  builds
  on
  agencies’
 
efforts
  that
  have
  evolved
  to
  get
  persons
  out
  of
  homelessness
  rather
  than
  focusing
  on
 
easing
  their
  discomfort
  on
  the
  streets.
  Previous
  studies
  have
  noted
  the
  changing
 
orientation
  of
  shelters
  and
  agencies,
  from
  providing
  emergency
  or
  crisis
  services
  to
 
assisting
  homeless
  persons
  to
  become
  stabilized
  in
  permanent
  housing.
  In
  addition,
 
Mayors
  Daniel
  Brown
  and
  Tim
  Burchett
  appointed
  the
  Compassion
  Knoxville
  Task
 
Force,
  which
  helped
  gather
  and
  organize
  public
  opinion
  on
  homelessness
  in
  our
 
community.
 
 

Over
  the
  past
  two
  years,
  homeless
  service
  providers
  in
  Knoxville
  have
  worked
 
toegther
  to
  build
  collaborative
  programs
  that
  move
  people
  out
  of
  homelessness.
  For
 
example,
  the
  Knoxville-­‐Knox
  County
  Community
  Action
  Committee
  has
  led
  the
  charge
  of
 
homelessness
  prevention
  through
  offering
  case
  management
  in
  the
  high
  rises
  of
  KCDC
 
and
  by
  adminstering
  the
  homeless
  prevention
  and
  rapid
  rehousing
  programs.
  Knoxville
 
Leadership
  Foundation
  opened
  Flenniken
  Landing
  in
  South
  Knoxville,
  a
  new
  permanent
 
supportive
  housing
  facility
  that
  will
  house
  48
  individuals.
  Voluneer
  Ministry
  Center
 
provides
 case
 management
 for
 those
 residents.
 
 
 

The
  development
  of
  the
  Knoxville
  Homeless
  Management
  Information
  System
 
(KnoxHMIS)
  offers
  a
  means
  of
  greater
  service
  coordination
  and
  accountability.
 
  Fifteen
 
agencies
  are
  participating
  and
  KnoxHMIS
  continues
  to
  be
  in
  discussion
  with
  potential
 
partners
  planning
  to
  join
  the
  system,
  approximately
  27,000
  individuals
  have
  been
 
entered
  into
  the
  database.
  KnoxHMIS
  is
  an
  important
  management
  tool
  for
  coordinated
 
case
 management
 as
 well
 as
 monitoring
 the
 extent
 of
 homelessness.
 

This
  report
  incorporates
  much
  of
  the
  narrative
  from
  the
  earlier
  reports.
  The
 
research
  findings
  from
  2012
  are
  reported
  and
  compared
  with
  the
  2010
  data.
  The
 
description
 of
 resources
 has
 been
 updated.
 Previous
 introductory
 material
 on
 definition,
 
causes,
 and
 patterns
 is
 still
 quite
 relevant,
 with
 a
 few
 additional
 research
 citations.
 
 One
 
feature
  initiated
  in
  the
  2002
  study
  was
  brief
  case
  examples
  that
  “put
  a
  face”
  on
 
homelessness
 and
 this
 is
 continued
 in
 the
 2012
 study.
 These
 composites
 were
 submitted
 
by
  agency
  staff
  and
  do
  not
  violate
  the
  confidentiality
  of
  the
  respondents
  or
  agency
 
clients.
 
 
 

  Despite
 the
 experience
 of
 studying
 homelessness
 for
 more
 than
 twenty-­‐six
 years,
 
a
  number
  of
  variables
  continue
  to
  impact
  findings:
 
  how
  one
  defines
  homelessness,
  the
 
transitional
  nature
  of
  homelessness,
  and
  the
  complexity
  of
  causes
  of
  homelessness.
 
 
Since
  the
  initial
  research,
  it
  has
  been
  apparent
  that
  any
  study
  of
  homelessness
  poses
  a
 
formidable
 challenge
 including
 how
 one
 determines
 methods
 of
 enumeration.
 
 Likewise
 
identifying
  contributing
  factors
  is
  a
  complex
  task.
 
  A
  brief
  examination
  of
  these
  factors
 
illustrates
 the
 issues.
 
 

 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 ix

 

 


 
 
 INTERVIEWERS

Chris
 Smith
 
  Laurel
 Laewski
 
Mark
 Stevens
  Jennifer
 Smith
 
Sonya
 Roberts
  Jaime
 Frimpong
 
Amye
 Lewis
  Shannon
 Hitchcock
 
Autumn
 Lowry
  Joyce
 Shoudy
 
Vanessa
 Hensley
 
Mary
 Lou
 Hammer
  Erin
 Lang
 
Wright
 Karlin
  Judy
 Blackstock
 
Starlandria
 Starks
  Bruce
 Spangler
 
Amanda
 Messer
 
Tess
 Leffman
  Eva
 Krug
 
Brad
 Jennings
  Misty
 Goodwin
 
Marybeth
 
 Snyder
  Carl
 Williams
 
Kristina
 Kirkland
  Roosevelt
 Bethel
 
Jenna
 Dougherty
  Steven
 Stothard
 
Barbara
 Disney
  Lindsay
 Preskenis
 

Linda
 Rust
  Matt
 Silvey
 
Mike
 Dunthorn
  Phillip
 Carrigan
 
Beatrice
 Irwin
 
Issac
 Merkle
 
Gabe
 Cline
  Kristy
 Carter
 
Brittany
 Adams
  Debbie
 Taylor
 
Jan
 Cagle
 
Sissy
 Flack
 

  Stacia
 West
 

  Roger
 M.
 Nooe
 

 
 

 
 
 

 

 

 

 

 

 

 

 

 

 

 

 


 

Homlessness in Knoxville and Knox County, Tennessee 2011-20102 x

 

Section I
 

A. Defining Homelessness
B. A Review of Contributing Risk Factors

 

Defining
 Homelessness
 


  How
 one
 defines
 homelessness
 will
 have
 a
 significant
 impact
 on
 estimated
 numbers
 
and
 characteristics.
 
 Most
 studies
 are
 limited
 to
 counting
 people
 who
 are
 in
 shelters
 or
 on
 
the
  streets.
  In
  almost
  every
  city,
  the
  estimated
  number
  of
  homeless
  people
  exceeds
  the
 
availability
  of
  emergency
  shelters
  and
  transitional
  housing
  (U.S.
  Conference
  of
  Mayors,
 
2007,
 National
 Law
 Center
 on
 Homelessness
 and
 Poverty,
 1997
 and
 2004).
 These
 findings
 
along
  with
  other
  available
  studies
  suggest
  that
  many
  people
  experiencing
  homelessness
 
may
  be
  “couch
  homeless”,
  living
  with
  friends
  or
  relatives
  in
  temporary
  arrangements
 
(Hoback
  &
  Anderson,
  2006,
  Wright,
  Caspi,
  Moffit,
  &
  Silva,
  1998).
  This
  “Doubled-­‐up
 
housing”
  (temporary
  residence
  with
  relatives
  and
  friends)
  may
  not
  be
  included
  in
  a
 
definition
 and
 subsequent
 count.
 Likewise,
 persons
 living
 in
 single
 room
 occupancy
 hotels
 
(SROs)
  and
  in
  substandard
  housing,
  extremely
  vulnerable
  to
  homelessness,
  are
  generally
 
not
  included.
 
  The
  Annual
  Homeless
  Assessment
  Report
  (AHAR)
  study
  (Khadduri
  &
 
Culhane,
  2010)
  underscores
  the
  high
  risk
  of
  homelessness
  and
  resulting
  utilization
  of
 
homeless
  residential
  services
  for
  persons
  “doubled
  up”
  or
  precariously
  housed.
  In
 
addition,
  persons
  temporarily
  staying
  with
  friends
  or
  family
  together
  make
  up
  30.2%
  of
 
those
 accessing
 homeless
 residential
 assistance
 nationally.
 
 
 

The
 term
 “homeless”
 itself
 is
 misleading
 in
 that
 it
 implies
 that
 the
 lack
 of
 residence
 
is
  both
  the
  problem
  and
  cause,
  obscuring
  the
  broader
  factors,
  such
  as
  poverty,
  lack
  of
 
affordable
  housing,
  and
  employment,
  as
  well
  as
  personal
  disabilities.
  The
  most
  widely
 
utilized
  definition
  that
  has
  emerged
  is
  found
  in
  the
  Homeless
  Emergency
  Assistance
  and
 
Rapid
  Transition
  to
  Housing
  Act
  of
  2009
  (Public
  Law
  111-­‐22).
 
  The
  act
  defines
 
homelessness
 as
 including
 persons,
 

 

...who
 resided
 in
 a
 shelter
 or
 place
 not
 meant
 for
 human
 habitation
 and
 who
 
are
  exiting
  an
  institution
  where
  he
  or
  she
  temporarily
  resided,
  (2)
  people
 
who
  are
  losing
  their
  housing
  in
  14
  days
  and
  lack
  support
  networks
  or
 
resources
 to
 obtain
 housing,
 (3)
 people
 who
 have
 moved
 from
 place
 to
 place
 
and
 are
 likely
 to
 continue
 to
 do
 so
 because
 of
 disability
 or
 other
 barriers,
 and
 
(4)
 people
 who
 are
 victims
 of
 domestic
 violence
 and
 sexual
 assault.
 
 

 
While
 the
 above
 provides
 a
 working
 definition,
 the
 reader
 should
 be
 aware
 that
 no
 single
 
definition
 or
 characteristic
 describes
 all
 persons
 experiencing
 homelessness.
 

 

 
Numbers
 

  Attempts
  to
  estimate
  the
  extent
  of
  homelessness
  have
  shown
  wide
  variation
  over
 
time.
  Studies
  of
  homelessness
  are
  further
  complicated
  by
  problems
  of
  methodology.
  The
 
1996
  and
  1998
  Knoxville
  studies
  recognized
 
  the
  range
  of
  findings
  and
  noted
  the
 
difficulties
 in
 enumeration:
 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 1

 


 The
  U.
  S.
  Department
  of
  Housing
  and
  Urban
  Development
  estimated
  that
 
192,000
 were
 homeless
 (HUD,
 1984),
 in
 contrast
 housing
 activists
 argued
 that
 
3.2
  million
  persons
  were
  homeless
  (Holmes
  &
  Snyder,
  1982).
 
  Later,
  1990
 
government
 materials
 relied
 on
 a
 study
 conducted
 by
 the
 Urban
 Institute
 that
 
found
  that
  on
  any
  given
  night
  up
  to
  600,000
  persons
  were
  homeless
  (Burt
  &
 
Cohen,
  1989).
 
  However,
  activists
  continued
  to
  argue
  that
  there
  were
  more
 
than
  three
  million
  homeless
  people
  in
  the
  United
  States
  (Kozol,
  1988).
  In
 
1994,
  The
  Interagency
  Council
  on
  the
  Homeless
  (ICH)
  published
  “Priority:
 
Home!
  The
  Federal
  Plan
  to
  Break
  the
  Cycle
  of
  Homelessness.”
 
  A
  major
 
conclusion
  of
  the
  ICH
  was
  that
  the
  homeless
  population
  was
  not
  a
  static
  one,
 
but
 that
 large
 numbers
 of
 different
 people
 flow
 through
 shelters
 over
 time
 (a
 
conclusion
  that
  had
  been
  emphasized
  by
  the
  Knoxville
  studies
  in
  1987
  and
 
1988).
  This
  new
  federal
  position
  emphasized
  that
  homelessness
  had
  been
 
previously
 underestimated.
 

 
 

  A
 continuing
 major
 difficulty
 in
 examining
 the
 extent
 of
 homeless
 lies
 in
 the
 use
 of
 
different
  sources.
  In
  2009
  for
  example,
  the
  State
  of
  Homelessness
  in
  America
  Report
 
indicated
  that
  as
  many
  as
  656,000
  people
  are
  homeless
  on
  any
  given
  night
  and
 
approximately
  3.5
  million
  people,
  1.3
  million
  of
  them
  children,
  experience
  homelessness
 
each
  year
  (National
  Alliance
  to
  End
  Homelessness,
  2011,
  National
  Law
  Center
  on
 
Homelessness
  and
  Poverty,
  2007).
  More
  recent
  studies
  suggest
  that
  the
  total
  number
  of
 
homeless
  persons
  increased
  by
  less
  than
  1%
  between
  2009
  and
  2010.
  A
  snapshot
  of
 
homeless
 persons
 in
 2010
 found
 
 that
 over
 649,000
 were
 
 homeless
 on
 a
 given
 night,
 with
 
approximately
  1.59
  million
  people
  spending
  at
  least
  one
  night
  in
  a
  shelter
  between
 
October
  2009
  and
  September
  2010
  (Annual
  Homeless
  Assessment
  Report,
  2010).
 
Projections
  suggest
  that
  approximately
  1%
  of
  the
  U.S.
  population
  will
  experience
 
homelessness
  each
  year
  (Urban
  Institute,
  2000).
  According
  to
  the
  U.S.
  Conference
  of
 
Mayors
 (2011)
 survey,
 hunger
 and
 homelessness
 continue
 to
 rise
 in
 major
 American
 cities.
 
In
  the
  twenty-­‐nine
  cities
  that
  responded
  to
  the
  survey,
  the
  number
  of
  families
 
experiencing
  homelessness
  increased
  by
  an
  average
  of
  sixteen
  percent
  in
  2010
  (U.S.
 
Conference
 of
 Mayors,
 2011).
 

The
  methodology
  to
  use
  in
  counting
  individuals
  experiencing
  homelessness
  is
  a
 
major
 issue.
 
 For
 example
 an
 early
 study
 by
 Link
 (1994)
 suggested
 that
 homelessness
 was
 
two
  to
  three
  times
  more
  extensive
  than
  early
  estimates.
  Using
  a
  household
  sampling
 
method,
 the
 researchers
 found
 that
 approximately
 7.4
 percent
 of
 all
 adult
 Americans
 had
 
at
  some
  point
  experienced
  literal
  homelessness.
  An
  interesting
  aspect
  of
  the
  report
  was
 
recognition
  of
  the
  difficulties
  in
  counting
  the
  homeless,
  including:
  (1)
  finding
  the
  hidden
 
homeless,
  i.e.,
  those
  who
  sleep
  in
  boxcars,
  on
  roofs,
  or
  other
  obscure
  locations,
  (2)
 
encountering
 respondents
 who
 deny
 homelessness
 or
 refuse
 interviews
 (Rossi,
 1989),
 and
 
(3)
  not
  including
  people
  who
  experience
  short
  or
  intermittent
  episodes
  (Link,
  1994).
  As
 
noted,
 determining
 the
 extent
 of
 homelessness
 is
 difficult,
 and
 reliable
 studies
 are
 scarce.
 
The
  National
  Census
  in
  1990
  and
  2000
  included
  a
  concentrated
  effort
  to
  identify
  those
 
persons
  who
  were
  homeless,
  however,
  counting
  difficulties
  continued
  to
  hamper
  this
 
effort.
 The
 1990
 effort
 included
 S-­‐night
 (referring
 to
 counting
 street
 and
 shelter
 residents)
 
along
 with
 experiments
 using
 “homeless
 decoys”
 in
 five
 major
 cities.
 A
 significant
 number,
 
over
  one-­‐half
  were
  missed,
  demonstrating
  the
  difficulty
  in
  counting
  the
  people
 
experiencing
  homelessness
  (Wright
  &
  Devine,
  Straw,
  1995).
  The
  2010
  census
  used
  a
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 2

 

service-­‐based
  enumeration
  (SBE)
  that
  focused
  on
  persons
  who
  were
  homeless.
 
  The
 
recommendation
  following
  the
  2000
  “dress
  rehearsal”
  detailed
  that
  SBE
  appears
  to
  be
  a
 
successful
 method
 of
 including
 people
 who
 otherwise
 would
 not
 be
 counted.
 

Another
  consideration
  in
  counting
  the
  homeless
  is
  whether
  the
  count
  is
  a
  point-­‐
prevalence
 or
 period-­‐prevalence
 estimate.
 Point-­‐prevalence
 estimates
 are
 made
 at
 a
 given
 
time,
  but
  do
  not
  account
  for
  turnover
  or
  variability
  over
  time.
  On
  the
  other
  hand,
  the
 
period-­‐prevalence
  counts
  reflect
  the
  size
  of
  the
  population
  for
  a
  specified
  period
  of
  time.
 
 
Consequently,
 period-­‐prevalence
 counts
 typically
 exceed
 point-­‐prevalence
 counts
 (Quigley
 
&
  Raphael,
  2001).
  The
  Homeless
  Management
  Information
  System
  (KnoxHMIS)
  that
  was
 
initiated
  in
  2004
  increases
  accuracy
  in
  counting
  the
  homeless
  as
  well
  as
  charting
 
variations.
 

In
 sum,
 reports
 have
 been
 consistent
 in
 recognizing
 that
 the
 homeless
 population
 is
 
not
 static.
 The
 Knoxville
 studies
 have
 consistently
 asserted
 that
 the
 homeless
 population
 is
 
dynamic
  and
  that
  numbers
  must
  be
  explained
  within
  a
  designated
  time
  frame.
  Different
 
patterns
  of
  homelessness–situational,
  episodic,
  and
  chronic–will
  determine
  who
  is
 
homeless
 at
 a
 given
 time.
 


 
Situational
  homelessness
  is
  usually
  acute,
  a
  home
  burns,
  the
  wage
  earner
  is
 
laid
  off,
  a
  family
  is
  evicted
  or
  family
  abuse
  causes
  unexpected
  homelessness.
 
 
Episodic
  homelessness
  is
  recurring,
  a
  person
  works
  seasonally
  and
  has
 
lodging,
  disability
  benefits
  are
  sufficient
  for
  a
  room
  (SRO)
  several
  weeks
  a
 
month,
  or
  the
  person
  has
  a
  home
  with
  family
  when
  not
  drinking.
  This
  group
 
includes
  the
  "couch
  population"
  who
  usually
  stays
  with
  relatives
  or
  friends
 
but
  have
  meals
  at
  shelters.
  Chronic
  homelessness
  is
  ongoing,
  the
  person
 
remains
 on
 the
 street
 indefinitely,
 some
 may
 be
 alcoholic
 or
 severely
 mentally
 
ill
 (Nooe
 &
 Cunningham,
 1990).
 


 
These
  different
  patterns
  offer
  explanation
  for
  differences
  in
  enumeration
  and
  also
 
public
  perceptions
  of
  homelessness.
  While
  the
  chronic
  homeless
  are
  usually
  the
  most
 
visible,
  they
  likely
  represent
  the
  smallest
  segment
  of
  the
  homeless
  population.
  The
 
category
 of
 situational
 homelessness
 is
 the
 largest
 when
 measured
 over
 time.
 The
 fact
 that
 
the
  chronic
  segment
  is
  most
  costly
  in
  terms
  of
  use
  of
  public
  services
  is
  a
  key
  rationale
  in
 
cities
 developing
 a
 Ten
 Year
 Plan
 to
 End
 Chronic
 Homelessness.
 

 

 

 

 

 


 


 

 


 

 

 


 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 3

 

Review
 of
 Contributing
 Risk
 Factors
 

The
  homeless
  population
  continues
  to
  be
  one
  of
  the
  fastest
  growing
  sub-­‐
populations,
 despite
 the
 United
 States
 having
 periods
 of
 significant
 economic
 growth.
 The
 
impact
  of
  the
  economic
  crisis
  being
  experienced
  by
  the
  United
  States
  since
  2008
  is
 
continuing
 to
 be
 examined.
 According
 to
 the
 U.S.
 Conference
 of
 Mayors
 (2011),
 twelve
 
 of
 
twenty-­‐nine
  cities
  surveyed
  reported
  an
  increase
  in
  homelessness,
  and
  seventeen
 
 
reported
  adopting
  new
  policies
  as
  a
  result
  of
  the
  recent
  increase
  in
  need
  following
  the
 
housing
 crisis.
 
 


 
 The
  National
  Coalition
  for
  the
  Homeless
  asserts
  that
  two
  trends
  are
  primarily
 
responsible
 for
 the
 increase
 in
 homelessness
 during
 the
 past
 twenty-­‐five
 years:
 a
 growing
 
shortage
  of
  affordable
  housing
  and
  a
  simultaneous
  increase
  in
  poverty
  (NCH,
  2007).
  In
  a
 
sense,
  homelessness
  represents
  the
  “poorest
  of
  poor”.
  In
  2010,
  people
  below
  the
  official
 
poverty
  thresholds
  numbered
  46.2
  million,
  a
  figure
  2.6
  million
  higher
  than
  the
  2009
 
estimate
 (U.S.
 Conference
 of
 Mayors,
 2011).
 
 

Related
 to
 the
 problems
 of
 poverty
 is
 the
 decline
 in
 public
 assistance.
 The
 Knoxville
 
studies
 have
 included
 questions
 about
 sources
 of
 assistance
 and
 also
 loss
 of
 benefits.
 The
 
National
 Coalition
 for
 the
 Homeless
 offered
 this
 finding:
 


 
The
  declining
  value
  and
  availability
  of
  public
  assistance
  is
  another
  source
  of
 
increasing
  poverty
  and
  homelessness.
  Until
  its
  repeal
  in
  August
  1996,
  the
  largest
 
cash
  assistance
  program
  for
  poor
  families
  with
  children
  was
  the
  Aid
  to
  Families
 
with
  Dependent
  Children
  (AFDC)
  program.
  The
  Personal
  Responsibility
  and
  Work
 
Opportunity
  Reconciliation
  Act
  of
  1996
  (the
  federal
  welfare
  reform
  law)
  repealed
 
the
  AFDC
  program
  and
  replaced
  it
  with
  a
  block
  grant
  program
  called
  Temporary
 
Assistance
  to
  Needy
  Families
  (TANF).
  In
  2005,
  TANF
  helped
  a
  third
  of
  the
  children
 
that
  AFDC
  helped
  reach
  above
  the
  50%
  poverty
  line.
  Unfortunately,
  TANF
  has
  not
 
been
  able
  to
  keep
  up
  with
  inflation.
  The
  Center
  on
  Law
  and
  Social
  Policy
  states
  a
 
27%
  decrease
  in
  the
  TANF
  block
  grant
  due
  to
  recent
  inflation.
  Given
  this
  drastic
 
decrease
 in
 available
 funding,
 low-­‐income
 families
 are
 not
 able
 to
 receive
 sufficient
 
assistance
  from
  the
  very
  program
  that
  was
  conceived
  to
  help
  them
  (Carey,
  2010).
 
Between
 2006
 and
 2008,
 TANF
 case
 load
 has
 continued
 to
 decline
 while
 food
 stamp
 
caseloads
 have
 increased.
 (NCH,
 2009).
 
 

 

These
 changes
 in
 public
 attitudes
 and
 policy
 have
 major
 implications,
 although
 the
 
effects
  have
  not
  been
  fully
  assessed.
  The
  United
  States
  has
  witnessed
  the
  most
  dramatic
 
shift
  in
  welfare
  policy
  since
  its
  inception
  in
  1935
  (Berger
  &
  Tremblay,
  1999).
  Changing
 
public
 attitudes
 are
 producing
 revisions
 that
 result
 in
 stricter
 guidelines
 for
 subsidies
 and
 
services
  (Dunlap
  &
  Fogel,
  1998).
  Resources
  such
  as
  AFDC
  have
  been
  important
  in
 
preventing
  homelessness,
  and
  more
  exclusionary
  guidelines
  will
  likely
  increase
 
vulnerability
  to
  homelessness
  (Institute
  for
  Children
  and
  Poverty,
  2001,
  Butler,
  1997).

 
 

While
  the
  foregoing
  and
  other
  studies
  present
  a
  case
  for
  structural
  or
  external
 
factors,
 such
 as
 lack
 of
 housing,
 income
 and
 employment
 opportunities
 (McChesney,
 1991,
 
Trimmer,
 Eitzen,
 &
 Talley
 1994,
 Quigley
 &
 Raphael,
 2001),
 there
 is
 considerable
 evidence
 
that
  homelessness
  is
  also
  due
  to
  personal
  problems
  or
  internal
  factors
  such
  as
  mental
 
illness,
 substance
 abuse,
 and
 personality
 deficits
 (U.S.
 Conference
 of
 Mayors,
 2005,
 Bassuk,
 
Rubin
  &
  Lauriat,
  1984,
  Lamb
  &
  Lamb,
  1990,
  Baum
  &
  Barnes,
  1993,
  Jenks,
  1994,
  Federal
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 4

 

Task
  Force
  on
  Homelessness
  and
  Severe
  Mental
  Illness,
  1992).
  Most
  likely,
  homelessness
 
is
 due
 to
 multiple
 interacting
 factors.
 These
 contributing
 factors
 may
 vary
 for
 segments
 of
 
the
  homeless
  population,
  for
  example,
  differences
  exist
  in
  rural
  and
  urban
  homelessness,
 
not
  only
  in
  the
  environment
  but
  also
  in
  coping
  strategies
  (Goodfellow,
  1999,
  Cummins,
 
First,
  &
  Toomey,
  1998,
  Nooe
  &
  Cunningham,
  1992).
  Perhaps
  Burt
  (1992)
  sums
  up
  the
 
complexity
 of
 factors
 most
 accurately:
 


 

 
 
 “...poverty
  represents
  a
  vulnerability,
  a
  lower
  likelihood
  of
  being
  able
  to
 
cope
  when
  the
  pressure
  gets
  too
  great.
  It
  thus
  resembles
  serious
  mental
 
illness,
  physical
  handicap,
  chemical
  dependency,
  or
  any
  other
  vulnerability
 
that
 reduces
 one’s
 resilience...”
 

 
While
 recognizing
 that
 the
 reasons
 behind
 homelessness
 are
 complex,
 and
 multiple
 factors
 
are
 usually
 interacting,
 it
 is
 helpful
 to
 examine
 risk
 factors
 such
 as:
 
 
 (1)
 lack
 of
 affordable
 
housing,
  (2)
  mental
  illness
  and
  deinstitutionalization,
  (3)
  labor
  market
  changes,
  (4)
 
substance
 abuse,
 (5)
 lack
 of
 education,
 (6)
 personal
 crises
 [abuse,
 divorce,
 death]
 and
 (7)
 
personal
 risk
 factors.
 

 
Housing
 
The
  increasing
  shortage
  of
  affordable
  housing
  and
  the
  decrease
  of
  available
  public
 
assistance
 due
 to
 federal
 budget
 cuts
 are
 major
 contributors
 to
 homelessness.
 Many
 families
 
are
  now
  paying
  more
  than
  fifty
  percent
  of
  their
  annual
  income
  in
  order
  to
  maintain
 
permanent
  housing.
  With
  housing
  costs
  at
  an
  unprecedented
  high,
  many
  homeowners
  and
 
renters
  are
  finding
  it
  difficult
  to
  provide
  for
  other
  basic
  needs
  such
  as
  healthcare
  and
 
nutrition
  (HUD
  2011).
  Roughly
  seventy
  percent
  of
  families
  with
  who
  experience
  difficulty
 
affording
 housing
 have
 an
 income
 below
 thirty
 percent
 of
 the
 states
 median
 income,
 which
 
is
 approximately
 equivalent
 to
 the
 poverty
 threshold
 
 
,
  2007).
  Approximately
  150,000
  Section
  8
  vouchers
  were
  lost
  between
  2005
  and
 
2007,
 due
 to
 
 federal
 budget
 cuts
 and
 the
 increasing
 pressure
 to
 reduce
 domestic
 spending
 
(Rice
  &
  Sard,
  2007).
 
  In
  addition,
  Rice
  &
  Sard
  (2007)
  explain
  that
  over
  170,000
  low
  rent
 
units
  were
  lost
  over
  the
  past
  decade
  due
  to
  demolition,
  decay
  or
  abandonment,
  thus
 
resulting
  in
  fewer
  housing
  options
  for
  low-­‐income
  families.
  The
  Joint
  Center
  for
  Housing
 
Studies
  (2011)
  estimated
  a
  gap
  between
  affordable
  units
  and
  low-­‐income
  renters
  of
  more
 
than
  6.4
  million
  units
  in
  2009.
  The
  significant
  reduction
  in
  private
  sector
  low-­‐income
 
housing
 is
 often
 overlooked
 in
 the
 clamor
 for
 more
 public
 housing.
 
The
 loss
 of
 single
 room
 occupancy
 housing
 (SRO)
 has
 been
 particularly
 devastating.
 
 
Dolbeare
  (1996)
  estimates
  that
  more
  than
  one
  million
  units
  were
  lost
  in
  the
  1970's
  and
 
80's.
 
 Many
 Knoxville
 citizens
 can
 remember
 private
 sector
 hotels
 and
 rooming
 houses
 that
 
provided
 cheap
 lodging,
 but
 many
 of
 these
 have
 
 been
 razed
 or
 converted
 to
 condominiums
 
in
  the
  apparent
  gentrification
  of
  the
  inner
  city.
  It
  may
  be
  that
  the
  new
  SROs
  are
  the
 
increasing
  number
  of
  suburban
  motels,
  offering
  low
  rates
  and
  catering
  to
  a
  transient
 
population.
  The
  availability
  of
  various
  types
  of
  housing
  that
  includes
  SROs,
  as
  well
  as
 
subsidized
  supervised
  housing
  and
  private
  housing
  is
  a
  critical
  factor
  in
  preventing
 
recurrent
 homelessness
 (Wong,
 Culhane,
 &
 Kuhn,
 1997).
 
 
As
 noted,
 an
 interesting
 phenomenon
 in
 recent
 years
 has
 been
 the
 transformation
 of
 
motels
 into
 SROs,
 and
 the
 expansion
 of
 these
 into
 locations
 outside
 the
 central
 city.
 This
 is
 
evidenced
  in
  a
  variety
  of
  motels
  in
  the
  Knoxville
  and
  Knox
  County
  Metropolitan
  area
  that
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 5

 

have
 become
 SROs
 over
 the
 past
 six
 years.
 The
 conversion
 of
 the
 motels
 from
 tourist-­‐based
 
facilities
  to
  serving
  low
  income
  and
  working
  poor
  families
  is
  resulting
  in
  a
  new
 
distributional
 pattern
 of
 homelessness
 throughout
 Knox
 County.
 Another
 aspect
 of
 housing
 
mentioned
  earlier
  is
  the
  practice
  of
  “doubling-­‐up”.
 
  Staying
  with
  friends
  or
  relatives
 
commonly
 precedes
 homelessness
 (Hoback
 &
 Anderson,
 2006,
 Wright,
 Caspi,
 Moffit,
 &
 Silva,
 
1998).
  This
  practice
  results
  in
  what
  has
  been
  called
  the
  “couch
  population”,
  and
  while
 
“doubling
  up”
  represents
  a
  type
  of
  housing,
  the
  risk
  for
  homelessness
  is
  very
  high.
  The
 
challenge
  is
  to
  reduce
  this
  risk
  through
  stable,
  permanent
  housing.
  The
  following
  vignette
 
describes
 some
 of
 these
 challenges:
 


 
Amy
 and
 her
 son
 lived
 at
 the
 Broadway
 building
 that
 was
 condemned.
 They
 
had
 only
 been
 in
 the
 building
 a
 few
 months
 prior
 to
 the
 demolition.
 Amy
 was
 
recently
  divorced
  and
  previously
  lived
  somewhere
  that
  was
  not
  energy
 
efficient
  and
  incurred
  unaffordable
  utility
  bills.
  Amy
  was
  unable
  to
  pay
  the
 
utilities
  and
  thus
  had
  to
  move.
  The
  rental
  on
  Broadway
  included
  utilities
 
with
  the
  rent.
  In
  order
  to
  afford
  her
  rent,
 
  Amy
  worked
  as
  a
  low
  paid
 
manager
  of
  a
  bakery
  in
  town.
  She
  could
  pay
  her
  rent
  but
  was
  never
  able
  to
 
catch
 up
 on
 the
 utilities
 and
 afford
 the
 $200
 deposit
 and
 $20
 connection
 fee
 
KUB
 would
 require
 before
 she
 could
 move
 into
 a
 decent
 place.
 With
 the
 help
 
of
  a
  case
  manager,
  Amy
  was
  able
  to
  temporarily
  move
  with
  her
  son
  to
  a
 
friend’s
 house.
 The
 friend
 lived
 far
 north
 so
 this
 case
 manager
 provided
 bus
 
tickets
  for
  both
  Amy
  and
  her
  son
  to
  go
  to
  school
  and
  work.
  The
  case
 
manager
  helped
  the
  family
  search
  for
  affordable
  housing.
  The
  original
 
eviction
  was
  a
  barrier
  but
  advocacy
  on
  the
  part
  of
  the
  case
  manager
 
convinced
 the
 apartment
 complex
 to
 take
 a
 chance
 on
 Amy.
 With
 funds
 from
 
the
  city,
  Amy
  was
  able
  to
  pay
  off
  the
  utility
  bill,
  obtain
  a
  section
  8
  voucher,
 
and
  pay
  the
  housing
  application
  and
  deposit
  so
  that
  the
  she
  could
  go
  into
 
decent
 affordable
 housing.
 The
 client
 and
 her
 son
 remain
 in
 that
 housing
 at
 
this
 time
 and
 are
 stable.
 

 
Finding
  permanent
  housing
  may
  be
  complicated
  by
  poor
  payment
  history,
  prior
 
criminal
  offenses
  and
  substance
  abuse.
  There
  is
  also
  the
  need
  for
  supportive
  housing
  for
 
those
  with
  disabilities
  including
  mental
  illness
  and
  addictive
  disorders.
  As
  the
  National
 
Coalition
  for
  the
  Homeless
  (2005)
  points
  out,
  during
  the
  last
  two
  decades,
  competition
  for
 
increasingly
  scarce
  low-­‐income
  housing
  has
  been
  particularly
  traumatic
  for
  those
  with
 
addictive
 and
 mental
 disorders,
 often
 increasing
 the
 risk
 for
 them
 becoming
 homeless.
 
In
  some
  respects,
  Knoxville
  has
  more
  housing
  resources
  than
  other
  metropolitan
 
areas.
 The
 combination
 of
 public
 housing,
 private
 facilities
 and
 emergency
 shelters
 results
 
in
  less
  than
  twenty-­‐five
  percent
  of
  the
  homeless
  living
  in
  outside
  locations
  and
  this
  is
 
often
  by
  choice.
  Some
  cities
  report
  that
  the
  greatest
  numbers
  of
  homeless
  are
  living
  in
 
outside
  locations,
  and
  in
  the
  National
  Survey
  of
  Homeless
  Assistance
  Providers
  and
 
Clients
  (NSHAPC)
  study,
  thirty-­‐one
  percent
  reported
  sleeping
  on
  the
  streets
  or
  in
  other
 
places
 not
 meant
 for
 human
 habitation
 (U.S.
 Conference
 of
 Mayors,
 2007,
 ICH,
 1999).
 The
 
Ten
  Year
  Plan
  called
  for
  a
  “housing
  first”
  approach
  that
  combines
  affordable,
  permanent
 
housing
 with
 the
 supportive
 services
 necessary
 for
 the
 individual
 to
 remain
 in
 permanent
 
housing.
 The
 need
 for
 comprehensive
 supportive
 services
 to
 maintain
 persons
 in
 housing
 
is
  underscored
  by
  the
  Knoxville
  studies’
  consistent
  findings
  that
  many
  persons
  placed
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 6

 

into
  housing
  without
  support
  services
  simply
  recycle
  back
  into
  homelessness
  (Ten
  Year
 
Plan,
 2005,
 Homelessness
 in
 Knoxville-­‐Knox
 County,
 2004).
 

 
Current
 Economic
 Crisis
 

 
  Currently,
  the
  United
  States
  is
  enduring
  a
  substantial
  economic
  crisis
  that
  began
 
with
  the
  failing
  and
  subsequent
  bailouts
  of
  numerous
  national
  financial
  institutions.
  The
 
recession
  of
  2008
  is
  still
  affecting
  citizens
  in
  terms
  of
  employment,
  access
  to
  social
 
services,
  and
  the
  ability
  to
  obtain
  housing.
  People
  experiencing
  homelessness
  or
  extreme
 
poverty
 are
 especially
 at
 risk
 during
 times
 of
 national
 economic
 strain
 (Olivet
 et
 al.,
 2010).
 
Specifically,
  the
  number
  of
  people
  experiencing
  homelessness
  increased
  between
  2008
 
and
  2009
  by
  20,000
  following
  the
  first
  year
  of
  economic
  crisis
  (National
  Alliance
  to
  End
 
Homelessness,
 2011).
 
 
 

  Prior
  to
  the
  recession
  of
  2008,
  the
  unemployment
  rate
  in
  the
  United
  States
  was
 
5%,
 as
 of
 February
 2012
 it
 was
 8.3%,
 with
 a
 peak
 unemployment
 rate
 of
 10%
 in
 October
 
of
 2010
 (Bureau
 of
 Labor
 and
 Statistics,
 2012).
 With
 the
 unemployment
 rate
 hovering
 at
 
an
 unprecedented
 high,
 more
 people
 have
 been
 left
 without
 the
 ability
 to
 afford
 housing,
 
health
  insurance,
  and
  other
  basic
  needs
  necessary
  for
  survival.
  People
  experiencing
 
homelessness
 are
 especially
 affected
 by
 the
 declining
 number
 of
 available
 jobs.
 
 

  In
 addition,
 the
 United
 States
 government
 has
 implemented
 federal
 budget
 cuts
 to
 
social
  service
  funding.
  In
  2012,
  the
  Department
  of
  Health
  and
  Human
  Services
  incurred
 
the
  second
  largest
  proposed
  budget
  cut
  of
  the
  year,
  a
  loss
  of
  $876
  million.
  Among
  the
 
Department
  of
  Health
  and
  Human
  Services
  programs
  that
  have
  been
  cut
  is
  the
 
Homelessness
 Prevention
 and
 Rapid
 Re-­‐Housing
 Program
 (HPRP).
 HPRP,
 a
 three
 year,
 1.5
 
billion
 dollar
 program,
 was
 able
 to
 serve
 over
 700,000
 individuals
 and
 families
 during
 its
 
first
 year,
 however,
 the
 time
 allotted
 has
 run
 out
 and
 the
 program
 no
 longer
 exists
 to
 aid
 
individuals
 and
 families
 in
 need
 of
 emergency
 housing
 (Khadduri
 &
 Culhane,
 2010).
 As
 a
 
result,
 programs
 that
 assist
 those
 who
 are
 homeless
 or
 at
 risk
 of
 becoming
 homeless
 are
 
either
 losing
 federal
 funding
 or
 ceasing
 to
 exist
 altogether.
 
 
 

  The
 national
 housing
 market
 has
 also
 been
 detrimentally
 affected
 by
 the
 economic
 
crisis
  evidenced
  by
  a
  significant
  reduction
  affordable
  housing
  units
  (Wardrip,
  et.
  al,
 
2009).
  Individuals
  and
  families
  already
  experiencing
  difficulty
  obtaining
  permanent
 
housing,
 such
 as
 those
 in
 extreme
 poverty
 or
 low-­‐income
 families,
 are
 now
 finding
 it
 even
 
more
  difficult.
  The
  economic
  crisis
  has
  caused
  more
  than
  2
  million
  home
  foreclosures
  in
 
2007
  alone
  (NCH,
  2008).
  According
  to
  the
  National
  Coalition
  for
  Homelessness
  (2008),
 
there
  is
  a
  direct
  correlation
  between
  the
  economic
  crisis
  and
  the
  increase
  in
  national
 
homelessness
 as
 more
 families
 are
 losing
 their
 homes.
 

 
Mental
 Illness
 &
 Deinstitutionalization
 

The
  role
  of
  mental
  illness
  and
  deinstitutionalization
  in
  homelessness
  has
  been
 
debated.
 Lee
 et
 al.,
 (2003)
 argue
 that
 deinstitutionalization
 is
 a
 major
 contributing
 factor,
 
whereas
  the
  National
  Coalition
  for
  the
  Homeless
  (1997)
  initially
  asserted
  that
 
deinstitutionalization
 had
 little
 impact
 on
 the
 number
 of
 homelessness
 but
 more
 recently
 
identified
  it
  as
  a
  contributing
  factor
  (NCH,
  2008).
  The
  Knoxville
  studies,
  as
  well
  as
  a
 
number
  of
  national
  studies,
  present
  strong
  evidence
  that
  mental
  illness
  and
 
deinstitutionalization
 are
 significant
 contributing
 factors.
 
 

The
  estimated
  rates
  of
  mental
  illness
  among
  the
  homeless
  are
  wide-­‐ranging
 
depending
  on
  methodology,
  definitions,
  sample
  selection
  and
  diagnostic
  criteria.
  For
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 7

 

example,
 shelter
 users
 tend
 to
 have
 higher
 rates
 of
 mental
 illness
 than
 do
 non-­‐sheltered
 
homeless
 persons.
 The
 2010
 AHAR
 indicated
 that
 roughly
 thirty-­‐seven
 percent
 of
 shelter
 
residents
  had
  a
  disability,
  although
  it
  did
  not
  specify
  the
  conditions.
  The
  Knoxville
 
studies
  have
  consistently
  found
  that
  approximately
  50%
  of
  the
  homeless
  individuals
 
surveyed
  had
  been
  treated
  for
  emotional
  problems.
  However,
  these
  estimates
  are
  likely
 
conservative,
  given
  the
  incidence
  of
  untreated
  individuals
  and
  those
  who
  are
  in
  jails,
 
prisons,
  or
  otherwise
  unidentified
  (AHAR,
  2007,
  Toro,
  Bellavia,
  Daeschler,
  Owens,
  Wall,
 
&
  Passero,
  1995,
  Lamb
  &
  Weinberger,
  1998,
  Susser,
  Lin,
  Conover,
  &
  Struening,
  1997).
 
The
 incidence
 of
 mental
 illness
 is
 complicated
 by
 the
 number
 of
 mentally
 ill
 persons
 who
 
abuse
  substances,
  i.e.,
  the
  dually
  diagnosed.
  Persons
  who
  have
  a
  severe
  mental
  illness
 
(e.g.,
  schizophrenia
  or
  bipolar
  disorder)
  and
  drug
  dependencies
  are
  five
  times
  more
 
likely
 to
 become
 homeless
 (Shelton
 et
 al.,
 2009).
 Studies
 have
 found
 that
 approximately
 
thirty
 percent
 of
 persons
 discharged
 from
 state
 psychiatric
 institutions
 will
 be
 homeless
 
within
  six
  months
  (Belcher
  &
  Toomey,
  1988).
  For
  persons
  with
  mental
  illness,
 
homelessness
 has
 a
 detrimental
 effect
 and
 like
 any
 other
 crisis
 or
 trauma,
 may
 “catalyze
 
and/or
  exacerbate
  mental
  illness
  producing
  disorder
  where
  previously
  it
  did
  not
  exist”
 
(NCEH,
 2000,
 Koegel
 &
 Burnam,
 1992,
 p.
 96).
 

 

Scott
  is
  a
  Knoxville
  native
  in
  his
  mid-­‐twenties.
 Raised
  in
  a
  middle
  class
  home,
  he
 
had
  a
  good
  education
  and
  private
  medical
  insurance.
 When
  he
  became
  ill
  with
 
schizophrenia
  in
  his
  late
  teens,
  Scott’s
  parents
  were
  able
  to
  get
  him
  into
 
treatment.
 
 However,
 once
 he
 became
 an
 adult,
 he
 was
 free
 to
 make
 his
 own
 choices
 
about
  continuing
  on
  medication.
  Sadly,
  one
  symptom
  of
  his
  illness
  was
  to
  believe
 
that
  the
  voices
  he
  heard
  were
  direct
  messages
  from
  God.
  Soon,
  the
  arguments
 
between
 Scott
 and
 his
 parents,
 as
 well
 as
 the
 physical
 destruction
 he
 caused
 when
 
fighting
  “demons,”
  made
  it
  impossible
  for
  him
  to
  continue
  to
  live
  at
  home.
 After
 
several
  years
  on
  the
  street,
  Scott
  connected
  with
  a
  case
  manager.
 Scott
  engaged
 
with
 a
 mental
 health
 provider
 and
 was
 able
 to
 obtain
 housing.
 Unfortunately,
 even
 
with
  supportive
  services,
  Scott
  continued
  to
  refuse
  medication
  as
  part
  of
  his
 
treatment
 plan.
 After
 over
 a
 year
 of
 outbursts
 in
 his
 apartment,
 he
 had
 to
 leave
 due
 
to
  disturbing
  his
  neighbors
  and
  damaging
  the
  property.
 
  Because
  there
  were
  no
 
services
 that
 could
 meet
 his
 needs,
 Scott
 returned
 to
 the
 streets.
 

 
Homelessness
  and
  mental
  illness
  have
  become
  intertwined
  with
  the
  criminal
 
justice
 system.
 There
 is
 mounting
 evidence
 of
 an
 increasing
 number
 of
 severely
 mentally
 
ill
  persons
  in
  jails
  and
  prisons
  (Greenberg
  &
  Rosenheck,
  2006,
  Lamb
  &
  Weinberger,
 
1998).
 People
 experiencing
 homelessness
 have
 become
 criminalized,
 and
 in
 a
 sense,
 jails
 
are
  becoming
  today's
  asylums
  (The
  Bazelon
  Center
  for
  Mental
  Health
  Law,
  2008).
 
  The
 
interaction
 of
 these
 factors
 is
 seen
 in
 the
 finding
 that
 non-­‐homeless
 mentally
 ill
 persons
 
going
 into
 jail
 have
 a
 significantly
 increased
 risk
 of
 housing
 loss
 (NCH,
 2008,
 Solomon
 &
 
Draine,
 1995).
 The
 cost
 of
 this
 recycling
 from
 homelessness
 to
 incarceration
 and
 back
 is
 
costly,
  and
  supportive
  housing
  treatment
  programs
  provide
  a
  feasible
  alternative
 
(Rosenheck,
 et
 al.,
 2003).
 

 

Dominic is a 38-year-old man who was recently released from prison. Prior to

incarceration, he lived in Knoxville. While serving a 14-year sentence for a violent

offense Dominic was diagnosed with paranoid schizophrenia and started taking

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 8

 

medication. Dominic came to the day shelter 3 days after his release, noting that he

didn’t have any of his antipsychotic medications, did not have a doctor, and did not

know where to go for help. Luckily, several agencies were able to coordinate and he

was soon seen by a medical professional who was able to get him back on his

medication. Dominic worked on a case plan of following up with mental health care,

completing an anger management class and starting an application for disability

benefits. Dominic applied for housing, but unfortunately was denied. When he went to

his appeal, he was told to return in 6 months with no new charges. Dominic has

managed to stay on track and is now ready to reapply with the landlord. He is hopeful

that he will soon be off the streets and in his own apartment.

 

Employment
 
Lack
  of
  employment
  is
  often
  identified
  as
  a
  major
  cause
  of
  homelessness,
 

however,
  many
  people
  experiencing
  homelessness
  report
  being
  employed
  or
  having
 
occasional
 work.
 The
 difficulty
 is
 that
 many
 of
 these
 jobs
 do
 not
 provide
 adequate
 wages
 
and
 benefits
 for
 self-­‐sufficiency.
 The
 current
 value
 of
 the
 minimum
 wage
 has
 not
 kept
 up
 
with
  economic
  growth
  and
  this
  is
  particularly
  detrimental
  in
  the
  midst
  of
  the
  economic
 
crisis.
 The
 growing
 disparity
 between
 the
 rich
 and
 poor
 is
 particularly
 straining
 to
 low-­‐
wage
 earners
 due
 to
 the
 insufficient
 real
 value
 of
 the
 federal
 minimum
 wage
 that
 has
 not
 
kept
  pace
  with
  inflation.
  In
  2010,
  the
  federal
  minimum
  wage
  was
  $7.25
  per
  hour,
  as
 
opposed
  to
  the
  1968
  minimum
  at
  $8.50
  per
  hour,
  in
  2010
  dollars
  (Economic
  Policy
 
Institute,
 2011).
 
 The
 ICH
 found
 that
 the
 median
 monthly
 income
 for
 persons
 who
 were
 
homeless
  was
  about
  44%
  of
  the
  federal
  poverty
  level
  (1999).
  While
  the
  value
  of
  the
 
minimum
  wage
  has
  not
  kept
  up
  with
  inflation,
  there
  has
  also
  been
  a
  decline
  in
 
manufacturing
  jobs
  and
  a
  corresponding
  increase
  in
  low
  paying
  service
  employment,
 
globalization,
  decline
  in
  union
  bargaining
  power,
  and
  increase
  in
  temporary
  work,
  that
 
are
 factors
 in
 wage
 decline
 (USICH,
 1999).
 
 
 


 Many
  of
  the
  jobs
  held
  by
  homeless
  persons
  are
  temporary
  or
  do
  not
  provide
 
sufficient
 wages
 to
 provide
 self-­‐sufficiency.
 The
 ICH
 (1999)
 recognized
 that
 employment
 
prospects
 are
 dim
 for
 those
 who
 lack
 appropriate
 skills
 or
 adequate
 schooling.
 The
 labor
 
market
  has
  changed,
  as
  evidenced
  by
  "plant
  relocations
  and
  closures,
  persistent
  racial
 
discrimination,
 changes
 in
 industry
 that
 have
 increased
 the
 demand
 for
 highly
 educated
 
people,
  the
  decline
  in
  the
  real
  value
  of
  the
  minimum
  wage,
  and
  the
  globalization
  of
  the
 
economy"
 (ICH
 p.
 27).
 Employment
 instability
 and
 the
 lack
 of
 employment
 benefits
 have
 
both
  been
  identified
  in
  several
  studies
  as
  a
  risk
  factor
  for
  homelessness
  (NCH,
  2009,
 
Wagner,
  1994).
  Women
  and
  minorities
  seem
  to
  experience
  fewer
  employment
 
opportunities
 (Anti-­‐Discrimination
 Center
 of
 Metro
 New
 York,
 2005,
 ACLU,
 2004,
 Butler,
 
1995).
 
 
 

The
  Ten
  Year
  Plan
  to
  End
  Chronic
  Homelessness
  calls
  for
  increased
  economic
 
opportunities
  for
  homeless
  persons.
  Achieving
  maximum
  economic
  self-­‐sufficiency
  will
 
involve
  developing
  appropriate
  training
  programs,
  supportive
  employment,
  and
 
establishing
 income
 management
 and
 financial
 guardianship
 programs
 where
 applicable.
 

 
Substance
 Abuse
 

Habitual
  heavy
  substance
  abuse
  is
  a
  major
  contributor
  to
  homelessness
 
  (Tam,
 
Zlotnick
  &
  Robertson,
  2003,
  Marqura,
  2000).
  Instances
  of
  drug
  and
  alcohol
  abuse
  are
 
disproportionately
  high
  among
  the
  population
  of
  persons
  experiencing
  homelessness
 
(NCH,
 2009).
 However,
 the
 relationship
 between
 homelessness
 and
 substance
 abuse
 may
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 9

 

be
 more
 complex
 than
 it
 first
 appears.
 
 For
 example,
 those
 who
 are
 addicted
 may
 be
 more
 
impacted
 by
 the
 decrease
 in
 availability
 of
 SROs
 (NCH,
 2007).
 Likewise,
 the
 lack
 of
 access
 
to
 affordable
 health
 insurance
 may
 be
 a
 barrier
 in
 dealing
 with
 addiction.
 Policy
 changes
 
in
  1996
  reducing
  eligibility
  for
  Social
  Security
  Income
  (SSI)
  based
  on
  chronic
  substance
 
abuse
 likely
 increased
 the
 risk
 for
 loss
 of
 housing
 and
 homelessness
 (National
 Health
 Care
 
for
 the
 Homeless
 Council,
 2005).
 Similarly,
 policy
 changes
 that
 result
 in
 persons
 convicted
 
of
  drug
  abuse
  or
  sales
  being
  barred
  from
  public
  housing
  have
  created
  additional
 
dilemmas.
  Use
  of
  drugs
  other
  than
  alcohol
  has
  increased
  dramatically
  among
  the
 
homeless.
 
 Single
 homeless
 men
 are
 especially
 likely
 to
 have
 histories
 of
 substance
 abuse
 
(Toro,
 Bellavia,
 Daeschler,
 Owens,
 Wall
 &
 Passero,
 1995).
 In
 any
 case,
 substance
 abuse
 is
 
a
  major
  factor
  as
  illustrated
  by
  a
 
  study
  estimating
  that
  roughly
  60%
  of
  homeless
  men
 
experience
  long-­‐term
  alcoholism
  (Hwang,
  2001).
  Substance
  abuse
  disorders
  are
  also
 
prevalent
 among
 homeless
 women
 (Bassuk,
 Buckner,
 Perloff
 &
 Bassuk,
 1998).
 

Many
 individuals
 are
 dually
 diagnosed,
 suffering
 from
 both
 a
 major
 mental
 illness
 
and
  substance
  abuse
  (Hartwell,
  2003,
  Task
  Force,
  1992,
  Barber,
  1994).
  These
  dually
 
diagnosed
  individuals
  frequently
  fall
  between
  the
  cracks
  because
  neither
  mental
  health
 
nor
  substance
  abuse
  treatment
  facilities
  provide
  comprehensive
  services.
  Substance
 
abuse
  contributes
  to
  the
  lack
  of
  funds
  for
  housing
  and
  also
  may
  increase
  family
  conflict,
 
leading
 to
 family
 unwillingness
 to
 allow
 individuals
 to
 remain
 in
 the
 home.
 
 
 


 
After
  Rachel’s
  house
  caught
  fire,
  she
  and
  her
  7-­‐year-­‐old
  daughter
  had
 
nowhere
  to
  go.
  They
  continued
  to
  live
  in
  the
  burnt,
  condemned
  house
  as
 
long
  as
  they
  could
  because
  it
  was
  their
  only
  option.
  Finally
  Rachel
  and
  her
 
daughter
  left
  the
  house
  and
  began
  living
  in
  their
  car.
  Living
  in
  these
 
conditions
 had
 a
 severe
 effect
 on
 her
 daughter’s
 health
 and
 performance
 in
 
school.
  Her
  school
  social
  worker
  became
  involved
  and
  referred
  Rachel
  to
  a
 
permanent
 supportive
 housing
 program
 for
 women
 and
 their
 children.
 After
 
receiving
  short-­‐term
  assistance
  from
  an
  emergency
  shelter,
  Rachel
  was
 
accepted
 into
 the
 permanent
 supportive
 housing
 program.
 Sadly,
 just
 before
 
Rachel
  was
  able
  to
  move
  in,
  DCS
  removed
  her
  daughter
  from
  her
  custody
 
due
  her
  previous
  inability
  to
  provide
  a
  safe,
  stable
  home
  for
  her
  daughter.
 
Rachel
  moved
  into
  a
  fully-­‐furnished
  apartment
  and
  was
  assigned
  an
 
advocate
  to
  help
  her
  adjust
  to
  her
  new
  housing
  and
  independence.
  Rachel
 
has
  a
  mental
  health
  diagnosis
  of
  PTSD
  and
  depression,
  and
  her
  advocate
 
worked
  with
  her
  and
  connected
  her
  with
  resources
  to
  ensure
  that
  her
 
mental
 health
 was
 stabilized
 and
 her
 medications
 managed
 correctly
 so
 that
 
she
 could
 move
 forward
 with
 her
 mental
 health
 recovery.
 Rachel
 also
 had
 a
 
past
  history
  of
  substance
  abuse,
  but
  was
  not
  receiving
  any
  treatment
  or
 
support
 for
 her
 addiction
 when
 she
 entered
 the
 program.
 Her
 advocate
 was
 
able
  to
  connect
  her
  with
  community
  resources
  for
  substance
  abuse,
  and
 
Rachel
 now
 attends
 a
 recovery
 program
 on
 a
 regular
 basis
 and
 is
 addressing
 
her
 addiction.
 Rachel
 is
 working
 with
 her
 advocate
 to
 apply
 for
 SSI
 benefits
 
so
  that
  she
  can
  have
  a
  stable
  income.
  Most
  importantly,
  Rachel
  has
  been
 
working
 with
 her
 advocate
 on
 her
 goal
 of
 regaining
 custody
 of
 her
 daughter.
 
She
  has
  been
  working
  diligently
  with
  DCS,
  and
  she
  now
  has
  regular
  visits
 
with
 her
 daughter.
 Rachel
 looks
 forward
 to
 getting
 overnight
 visits
 with
 her
 
daughter
  soon,
  and
  ultimately
  regaining
  custody
  of
  her
  daughter
  so
  that
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 10

 

their
 family
 will
 be
 whole
 again.
 

 
Education
 
Inadequate
  education
  has
  not
  been
  clearly
  identified
  as
  a
  causative
  factor
  in
 
studies
  focused
  on
  homelessness.
  However,
  the
  National
  Law
  Center
  on
  Homelessness
 
and
  Poverty
  states
  that
  less
  than
  38%
  of
  the
  homeless
  population
  has
  obtained
  a
  high
 
school
  degree
  by
  the
  age
  of
  eighteen
  (2010).
  In
  the
  Knoxville
  studies,
  more
  than
  fifty
 
percent
  of
  the
  respondents
  reported
  having
  graduated
  from
  high
  school,
  with
  a
 
significant
  percent
  having
  post-­‐high
  school
  education.
  However,
  given
  the
  increased
 
requirement
 for
 technical
 and
 educational
 competence
 to
 be
 self-­‐sufficient,
 it
 is
 logical
 to
 
assume
 that
 poor
 education
 is
 a
 contributing
 factor
 to
 homelessness.
 

 
David
  grew
  up
  in
  the
  foster
  care
  system.
  As
  a
  child,
  David
  was
  angry
  and
  proved
 
problematic
 for
 both
 his
 foster
 parents
 and
 DCS
 workers.
 
 He
 dropped
 out
 of
 school
 
and
  also
  got
  his
  girlfriend
  pregnant
  as
  a
  teenager.
  Not
  long
  after
  dropping
  out
  of
 
school,
  David
  noticed
  his
  younger
  brother
  doing
  the
  same
  things
  and
  realized
  he
 
could
 not
 help
 his
 brother
 unless
 he
 first
 helped
 himself.
 David
 decided
 to
 enter
 an
 
independent
  living
  program
  sponsored
  by
  Department
  of
  Children
  Services.
 
Though
  the
  program
  was
  able
  to
  aid
  David
  in
  getting
  his
  GED,
  unfortunately
  they
 
were
  unable
  to
  secure
  independent
  housing.
  When
  David
  turned
  eighteen,
  he
 
became
 homeless.
 He
 began
 to
 move
 around,
 staying
 with
 friends
 and
 his
 biological
 
family
  who
  were
  not
  stable
  and
  ended
  up
  homeless
  themselves.
  At
  the
  age
  of
 
nineteen,
  David
  found
  himself
  living
  at
  a
  local
  social
  services
  agency.
  Eventually,
 
David
  was
  able
  to
  find
  himself
  a
  full-­‐time
  job
  and
  bought
  an
  old
  car
  for
 
transportation.
 
 He
 tested
 for
 the
 LPN
 program
 through
 a
 technical
 school
 
 and
 was
 
accepted
 into
 the
 program,
 but
 will
 have
 to
 wait
 almost
 a
 year
 to
 start
 classes
 due
 
to
 a
 waiting
 list.
 While
 waiting,
 David
 remained
 homeless
 until
 being
 referred
 to
 a
 
local
 program
 that
 helps
 people
 experiencing
 homelessness
 obtain
 housing.
 A
 case
 
manager
 with
 the
 program
 was
 able
 to
 assist
 him
 in
 finding
 an
 apartment
 he
 could
 
afford
 and
 helped
 him
 with
 his
 rental
 deposit.
 
 David
 now
 knows
 where
 he
 is
 going
 
to
 sleep
 every
 night,
 continues
 to
 work,
 is
 excited
 about
 starting
 LPN
 classes
 in
 the
 
fall
 and
 feels
 confident
 about
 his
 future.
 
 
 
 

 
One
  reason
  that
  studies
  may
  fail
  to
  identify
  educational
  level
  as
  a
  contributing
 
factor
 is
 illustrated
 in
 an
 evaluation
 of
 an
 employment
 program.
 In
 comparing
 those
 who
 
were
  successful
  in
  gaining
  employment
  and
  housing
  versus
  those
  who
  were
 
unsuccessful,
 the
 educational
 levels
 of
 the
 groups
 were
 similar.
 However
 an
 examination
 
of
  proficiency
  levels
  in
  reading
  and
  math
  found
  substantial
  differences
  between
  the
 
successful
 and
 unsuccessful
 groups
 (Nooe,
 1994).
 

 
Personal
 Crises
 
Personal
 crises
 involve
 various
 stressful
 situations
 such
 as
 abuse,
 family
 conflict,
 
loss
  of
  a
  job
  or
  housing,
  and
  loss
  of
  significant
  others.
  Crook
  (1999)
  notes,
  “Women
  are
 
particularly
 vulnerable
 to
 the
 precipice
 of
 homelessness
 because
 of
 four
 major
 factors:
 1)
 
family
  dissolution,
  2)
  family
  violence,
  3)
  lack
  of
  affordable
  housing,
  and
  4)
  low
  wage
 
status”
  (p.
  52).
  Many
  homeless
  women
  are
  survivors
  of
  abuse,
  and
  while
  leaving
  the
 
home
  may
  represent
  a
  solution
  to
  one
  problem,
  lack
  of
  employment
  and
  affordable
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 11

 

housing
 frequently
 results
 in
 homelessness
 (Civil
 Liberties
 Union,
 2004).
 A
 recent
 study
 
shows
 that
 one
 in
 four
 women
 will
 experience
 domestic
 abuse
 within
 their
 lifetime
 and
 
39%
 of
 cities
 name
 domestic
 abuse
 as
 the
 leading
 cause
 for
 female
 homelessness
 (NCH,
 
2009).
  In
  addition,
  women
  who
  have
  experienced
  violence
  may
  encounter
 
discrimination
  from
  landlords
  who
  are
  relunctant
  to
  rent
  to
  them
  (ACLU,
  2004).
 
Likewise,
  approximately
  half
  of
  the
  cities
  surveyed
  by
  the
  U.S.
  Conference
  of
  Mayors
 
identified
 abuse
 as
 a
 major
 cause
 of
 homelessness
 (2005).
 


 
 
Cindy
  is
  a
  Veteran
  of
  the
  U.S.
  Army
  and
  a
  full-­‐time
  student
  at
  a
  Knoxville
 
area
  college.
  This
  summer,
  her
  abusive
  boyfriend
  almost
  killed
  her
  and
 
her
  eight-­‐year-­‐old
  son
  by
  recklessly
  driving
  into
  on-­‐coming
  traffic.
  She
 
called
 a
 local
 domestic
 violence
 shelter
 several
 
 days
 later
 when
 
 he
 was
 at
 
work
  and
  brought
  herself
  and
  her
  son
  to
  shelter.
  Through
  the
  safety
 
provided,
  she
  is
  able
  to
  live
  in
  a
  secured,
  undisclosed
  location
  safe
  from
 
him.
  She
  has
  been
  granted
  a
  preliminary
  order
  of
  protection
  and
 
continues
 going
 to
 school,
 where
 she
 has
 a
 4.0
 GPA.
 Her
 son
 continues
 to
 
attend
  his
  regular
  school
  as
  made
  possible
  by
  the
 
  county’s
  school
 
homeless
  programs,
  and
  he
  is
  shuttled
  everyday
  to
  the
  same
  school
  he
 
attended
  last
  year,
  increasing
  his
  stability
  and
  continuity.
  She
  attends
 
weekly
  support
  groups
  and
  often
  meets
  with
  a
 
  therapist
  to
  discuss
  the
 
abuse
 she
 has
 suffered.
 Through
 these
 meetings
 she
 says
 she
 has
 learned
 
 
about
 warning
 signs
 of
 abusive
 personalities
 and
 can
 avoid
 partners
 such
 
as
  this
  in
  the
  future.
  Her
  son
  attends
  a
 
  children’s
  group
  that
 
  focuses
  on
 
non-­‐violent
  conflict
  resolution
  in
  an
 
  effort
  to
  break
  the
  cycle
  of
  violence
 
from
  generation
  to
  generation.
  They
  attend
  parenting
  classes
  to
  learn
 
non-­‐violent
  forms
  of
  discipline
  and
  to
  foster
  a
  positive,
  nurturing
 
relationship
  together.
  Through
  referrals
  to
  community
  agencies,
  she
  will
 
be
  receiving
  a
  VASH
  Voucher
  for
  assistance
  with
  public
  housing
  and
  will
 
move
  into
  a
  new
  apartment
  in
  November.
 
  The
  assistance
  Cindy
  has
 
received
  has
  allowed
  her
  to
  continue
  with
  her
  education
  and
  will
  allow
 
her
 to
 move
 on
 with
 her
 life
 as
 a
 productive
 member
 of
 society
 while
 she
 
and
 her
 son
 live
 free
 from
 violence
 and
 abuse.
 

 
In
  2011,
  the
  U.S.
  Conference
  of
  Mayors
  reported
  that
  food
  and
  housing
  insecurity
 
rates
  for
  families
  headed
  by
  single
  women
  were
  disproportionately
  higher
  than
  the
 
national
  average.
  A
  number
  of
  studies
  have
  found
  that
  female-­‐headed
  households
  have
 
greater
  risks
  for
  poverty
  (National
  Center
  for
  Law
  and
  Economic
  Justice,
  2011,
  U.S.
 
Department
  of
  Commerce,
  1998)
  and
  subsequently
  have
  greater
  risks
  of
  homelessness
 
(Caton,
 Shrout,
 Boanerges,
 Eagle,
 Opler
 &
 Cournos,
 1995,
 DiBlasio
 &
 Belcher,
 1995).
 The
 
National
  Center
  for
  Law
  and
  Economic
  Justice
  notes
  that
  34.2%
  of
  single
  female
 
households
 are
 poor
 while
 17%
 of
 single
 female
 households
 are
 impoverished
 (2011).
 As
 
Jencks
  observed
  "married
  couples
  hardly
  ever
  become
  homeless
  as
  long
  as
  they
  stick
 
together"
 (1994).
 

 

 

 
Other
 Risk
 Factors
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 12

 

Increased
  research
  on
  homelessness
  has
  resulted
  in
  identification
  of
  risk
  factors
 
for
  homelessness.
  For
  example,
  the
  National
  Coalition
  for
  Homelessness
  suggested
  the
 
following
 risk
 factors:
 foreclosure,
 poverty,
 eroding
 work
 opportunities,
 decline
 in
 public
 
assistance,
 unaffordable
 housing,
 lack
 of
 health
 care,
 mental
 illness,
 addiction
 disorders,
 
and
  domestic
  violence
  (2009).
  Wagner
  and
  Perrine
  identified
  similar
  factors
  in
 
comparing
  housed
  vs.
  homeless
  women,
  recognizing
  that
  homeless
  women
  had
  more
 
mental
  illness,
  unstable
  employment
  and
  housing,
  abuse
  history,
  substance
  abuse
  and
 
fewer
 social
 skills
 (1994).
 

Homeless
 families
 are
 most
 frequently
 headed
 by
 single
 mothers
 (Rog
 &
 Buckner,
 
2007).
 The
 National
 Alliance
 to
 End
 Homelessness
 found
 that
 previously
 abused
 women
 
are
 more
 likely
 to
 become
 homeless
 and
 develop
 depression,
 anxiety,
 or
 substance
 abuse
 
disorders
  (2010).
  However,
  it
  may
  well
  be
  that
  depression
  and
  substance
  abuse
  are
  a
 
consequence
 rather
 than
 cause
 of
 homelessness.
 Just
 as
 gender
 may
 increase
 the
 risk
 of
 
homelessness,
 minority
 status
 may
 also
 increase
 vulnerability
 to
 homelessness.
 In
 2010,
 
minority
 status
 as
 a
 risk
 factor
 is
 illustrated
 by
 the
 finding
 that
 in
 26.6%
 of
 Hispanics
 and
 
27.4%
  of
  African
  Americans
  live
  below
  poverty
  (Walt,
  Proctor
  &
  Smith,
  2011).
  There
 
may
 be
 racial
 differences
 among
 the
 causes
 of
 homelessness,
 in
 that
 whites
 report
 more
 
internal
  causes,
  such
  as
  substance
  abuse
  and
  mental
  illness,
  compared
  to
  non-­‐whites
 
reporting
 more
 external
 factors
 such
 as
 low
 income
 and
 unemployment
 (North
 &
 Smith,
 
1994).
 
 

Several
  studies
  have
  examined
  childhood
  risk
  factors
  for
  adult
  homelessness.
 
 
Economic
  and
  residential
  instabilities,
  along
  with
  poverty,
  are
  examples
  of
  childhood
 
antecedents
 (Burt,
 2001,
 Koegel,
 Melamid
 &
 Burnan,
 1995,
 Miller,
 Donavan,
 Este
 &
 Hofer,
 
2004).
 Increasingly,
 research
 is
 showing
 that
 disruption
 in
 childhood,
 such
 as
 foster
 care
 
placement,
  inadequate
  parenting
  and
  neglect,
  results
  in
  a
  greater
  chance
  of
  adult
 
homelessness
  (Pecora
  et.al.,
  2005,
  Roman
  &
  Wolfe,
  1997,
  Tyler
  &
  Melander,
  2010),
  as
 
well
 as
 substance
 use
 and
 unemployment
 (Tam,
 Zlotnick
 &
 Robertson,
 2003).
 There
 is
 an
 
especially
  strong
  link
  between
  homelessness
  and
  childhood
  sexual
  and
  physical
  abuse
 
(Brooks
 &
 Campbell,
 2011,
 Johnson
 et
 al.,
 2006,
 Nyamathi,
 Longshore,
 Keenan,
 Lesser
 &
 
Leake,
 2001).
 


 
Janice
  is
  a
  twenty-­‐year-­‐old
  female
  from
  North
  Carolina
  whose
  mother
 
struggled
  with
  drug
  addiction.
  Most
  of
  her
  life,
  Janice
  has
  battled
  with
 
issues
  associated
  with
  having
  a
  mother
  addicted
  to
  crack
  cocaine.
  Due
  to
 
her
  mother’s
  drug
  use,
  most
  of
  Janice’s
  childhood
  was
  spent
  in
  the
  state’s
 
custody.
 Throughout
 her
 youth,
 Janice
 was
 moved
 from
 one
 foster
 home
 to
 
another.
 She
 was
 separated
 from
 her
 siblings
 and
 did
 not
 know
 where
 they
 
were
  for
  most
  of
  her
  life.
  Janice
  became
  pregnant
  with
  a
  baby
  girl
  upon
 
release
  from
  foster
  care.
  During
  her
  pregnancy,
  Janice
  located
  a
  sister
 
living
 in
 Johnson
 City.
 Janice
 traveled
 to
 her
 sister’s
 residence
 hoping
 to
 be
 
housed
  but
  instead
  she
  and
  her
  baby
  were
  turned
  away.
  With
  the
 
assistance
 of
 her
 sister,
 Janice
 was
 able
 to
 travel
 back
 to
 Knoxville
 and
 was
 
dropped
  off
  at
  a
  local
  social
  services
  agency.
  Recently,
  Janice
  has
  shared
 
that
  she
  is
  again
  pregnant
  and
  that
  her
  boyfriend
  will
  soon
  be
  joining
  her
 
here
 in
 Knoxville.
 She
 spent
 several
 months
 in
 Knoxville
 staying
 in
 a
 local
 
shelter
  and
  with
  friends
  she
  met
  through
  foster
  care.
  With
  the
  help
  of
 
another
  local
  social
  services
  agency,
  Janice
  was
  recently
  able
  to
  obtain
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 13

 

housing
  and
  aid
  with
  the
  rental’s
  security
  deposit.
  Most
  recently,
  Janice
 
received
 assistance
 for
 furniture
 and
 other
 necessary
 apartment
 items.
 
 
 
 

 
The
  state
  of
  one’s
  health
  and
  the
  availability
  of
  health
  care
  are
  also
  factors
 
contributing
  to
  homelessness.
  While
  mental
  illness
  has
  been
  previously
  discussed,
 
chronic
  and
  acute
  health
  problems
  are
  frequent
  among
  the
  homeless
  (National
  Health
 
Care
  for
  the
  Homeless
  Council,
  2005).
  Frequently,
 
  among
  minimum
  wage
  paying
  jobs,
 
employers
  will
  not
  provide
  health
  insurance
  to
  their
  employees.
  This
  lack
  of
  health
 
insurance
  or
  unavailability
  of
  basic
  health
  care
  may
  result
  in
  loss
  of
  employment
  and
 
eventual
 eviction
 resulting
 in
 homelessness.
 

 
Carrie
 is
 an
 elderly
 woman
 who
 moved
 to
 Knoxville
 almost
 nine
 years
 ago.
 
She
  has
  no
  family,
  as
  she
  is
  an
  only
  child
  and
  her
  parents
  are
  deceased.
 
Though
  Carrie
  has
  mental
  health
  issues,
  she
  went
  many
  years
  without
 
accessing
  mental
  health
  services.
  She
  has
  stayed
  at
  a
  local
  agency
  for
 
several
 years
 and
 made
 friends
 by
 participating
 in
 on-­‐site
 drug
 and
 alcohol
 
abuse
  programs.
  Over
  time
  she
  developed
  some
  health
  issues
  with
  her
 
ankles,
  which
  led
  her
  to
  seek
  medical
  care
  at
  a
  Knoxville
  clinic.
  This,
  in
 
turn,
 led
 to
 Carrie
 seeking
 help
 for
 her
 mental
 health
 issues.
 Gaining
 some
 
insight
  into
  managing
  her
  mental
  illness
  and
  tiring
  of
  life
  on
  the
  street,
 
Carrie
  contacted
  a
  local
  agency
  with
  the
  goal
  of
  obtaining
  subsidized
 
housing.
 Today,
 Carrie
 has
 been
 drug
 and
 alcohol
 free
 for
 more
 than
 three
 
years.
 She
 signed
 a
 lease
 on
 an
 apartment
 that
 accommodates
 her
 mobility
 
issues
 and
 will
 soon
 celebrate
 three
 years
 residing
 at
 this
 address.
 

 
Various
  groups
  may
  experience
  risk
  factors
  for
  homelessness.
  For
  example,
  some
 
Vietnam-­‐era
 veterans
 appear
 to
 be
 more
 vulnerable
 than
 other
 veterans.
 Factors
 such
 as
 
post-­‐military
  social
  isolation,
  psychiatric
  disorders,
  substance
  abuse,
  and
  childhood
 
trauma
  (including
  foster
  care)
  have
  been
  implicated
  as
  predisposing
  factors
  (Gamache,
 
Rosenheck
 &
 Tessler,
 2003,
 Rosenheck
 &
 Fontana,
 1994).
 
 
 
There
 appears
 to
 be
 an
 increasing
 number
 of
 young
 adults
 who
 become
 homeless
 
after
  transitioning
  out
  of
  state
  custody.
  Among
  children
  aging
  out
  of
  foster
  care,
 
estimates
  suggest
  that
  as
  many
  as
  twenty-­‐two
  percent
  become
  homeless
  within
  a
  year
 
(Pecora
 et
 al.,
 2005,
 Roman
 &
 Wolfe,
 1997).
 

 
Phillip
 was
 18
 years
 old
 when
 he
 came
 to
 a
 transitional
 living
 program
 in
 April
 of
 
last
 year.
 He
 had
 moved
 away
 from
 his
 immediate
 family,
 and
 was
 living
 with
 his
 
extended
  family
  in
  Knoxville.
  He
  was
  in
  GED
  classes,
  but
  was
  feeling
  frustrated
 
with
 his
 slow
 progress
 due
 to
 a
 mild
 intellectual
 disability.
 When
 he
 began
 seeking
 
help,
 his
 family
 felt
 that
 he
 was
 taking
 his
 “family’s
 business”
 outside
 of
 the
 home,
 
and
  he
  was
  forced
  to
  move
  out.
  He
  was
  left
  homeless
  in
  the
  Alcoa
  area
  when
  he
 
became
  involved
  with
  a
  youth
  empowerment
  network
  that
  referred
  him
  to
  a
 
transitional
  housing
  program.
  When
  he
  moved
  into
  the
  housing
  program,
  he
  had
 
limited
 daily
 living
 skills,
 and
 did
 not
 know
 how
 to
 clean,
 cook,
 pay
 bills,
 or
 find
 a
 
job.
 During
 his
 time
 living
 in
 the
 program,
 he
 learned
 how
 to
 do
 laundry
 and
 keep
 
his
 room
 clean.
 Staff
 helped
 him
 learn
 how
 to
 make
 a
 resume
 and
 taught
 him
 skills
 
for
 job
 interviews.
 Phillip
 interviewed
 for
 jobs
 and
 was
 able
 to
 obtain
 employment
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 14

 

at
  a
  retail
  store,
  a
  job
  that
  he
  still
  holds
  today.
  Staff
  assisted
  Phillip
  with
  learning
 
bus
  routes,
  and
  assisted
  him
  with
  enrolling
  in
  a
  new
  GED
  program,
  which
  made
 
accommodations
  for
  his
  special
  needs,
  and
  where
  he
  was
  more
  satisfied.
  During
 
his
  time
  in
  the
  program,
  he
  disclosed
  some
  significant
  past
  trauma,
  and
  was
 
displaying
  signs
  of
  severe
  depression
  but
  was
  reluctant,
  at
  first,
  to
  seek
  therapy.
 
After
 time,
 he
 did
 seek
 treatment
 with
 staff’s
 encouragement,
 and
 has
 continued
 to
 
go
  to
  weekly
  trauma
  therapy,
  and
  he
  been
  successful
  in
  resolving
  many
  of
  his
 
traumatic
  issues
  and
  moving
  forward
  with
  his
  life.
  Phillip
  turned
  19
  last
  fall
  and
 
aged
  out
  of
  the
  housing
  portion
  of
  the
  transitional
  living
  program’s
  services.
  At
 
this
 point,
 staff
 assisted
 him
 in
 finding
 an
 apartment,
 where
 he
 lives
 independently
 
today.
  Since
  moving
  out
  of
  the
  program,
  Phillip
  continues
  to
  be
  involved
  as
  a
 
community
  client
  of
  the
  program
  and
  still
  visits
  frequently.
  Phillip
  is
  a
  very
 
talented
 artist
 and
 has
 been
 able
 to
 get
 several
 small
 art
 gigs
 in
 the
 community
 and
 
even
 had
 his
 artwork
 displayed
 at
 a
 local
 museum.
 Phillip
 came
 into
 the
 
 program
 
homeless,
  frustrated,
  and
  with
  minimal
  daily
  living
  skills.
  Now
  he
  has
  his
  own
 
apartment,
  is
  employed,
  is
  making
  steady
  progress
  on
  his
  GED,
  is
  resolving
  his
 
trauma
 issues,
 and
 is
 pursuing
 his
 passion
 of
 art.
 
 

 
Regardless
 of
 the
 factors
 involved,
 the
 availability
 of
 social
 support,
 whether
 from
 
friends,
  relatives,
  or
  agencies,
  appears
  to
  influence
  both
  risks
  for
  and
  recovery
  from
 
homelessness.
  Kingree,
  Stephens,
  Braithwaite
  &
  Griffin,
  for
  example,
  found
  that
  low
 
levels
 of
 support
 from
 friends
 were
 associated
 with
 homelessness
 following
 completion
 
of
  a
  substance
  abuse
  treatment
  program
  (1999).
  Similarly,
  adolescents
  running
  away
 
from
  or
  being
  kicked
  out
  by
  families
  are
  at
  risk
  for
  homelessness
  (Maclean,
  Embry
  &
 
Cauce,
  1999).
 
  The
  availability
  of
  ongoing
  support
  for
  those
  exiting
  foster
  care,
  mental
 
health
  and
  correctional
  facilities
  is
  especially
  critical
  for
  avoiding
  or
  escaping
 
homelessness.
 
 
 
In
  sum,
  this
  discussion
  has
  emphasized
  the
  linkage
  between
  homelessness
  and
 
poverty
  as
  well
  as
  other
  factors.
  It
  is
  logical
  to
  assume
  that
  those
  living
  in
  poverty
  are
 
most
  vulnerable
  to
  becoming
  homeless.
  In
  recent
  years,
  greater
  recognition
  has
  been
 
given
 to
 the
 risk
 factors,
 reflected
 in
 the
 findings
 that
 homeless
 persons
 are
 less
 likely
 to
 
be
  receiving
  public
  benefits,
  more
  likely
  to
  be
  addicted
  to
  drugs
  or
  alcohol,
  have
  higher
 
levels
 of
 psychological
 distress
 and
 mental
 illness,
 more
 likely
 to
 be
 victims
 of
 domestic
 
violence
  and
  to
  have
  been
  abused
  as
  children
  (Toro,
  Bellavia,
  Daeschler,
  Owens,
  Wall
  &
 
Passero,
 1995).
 The
 cost
 of
 homelessness
 is
 high,
 both
 economically
 and
 personally.
 

  The
  above
  factors
  are
  not
  exhaustive,
  nor
  are
  they
  exclusive.
  Most
  likely
  these
 
factors
  are
  interactive
  and
  reflect
  the
  complexity
  of
  homelessness.
  It
  is
  important
  to
 
remember
  that
  they
  represent
  not
  only
  individual
  problems,
  but
  also
  issues
  of
  public
 
policy.
 

 
Homelessness
 as
 a
 Lifestyle
 
There
  is
  often
  an
  impression
  that
  people
  are
  homeless
  because
  they
  want
  to
  be
 
homeless
 or
 simply
 prefer
 the
 lifestyle.
 While
 there
 are
 obviously
 some
 who
 choose
 to
 be
 
homeless,
  the
  number
  is
  quite
  small,
  likely
  less
  than
  five
  percent.
  These
  individuals
  are
 
often
  more
  visible
  than
  the
  majority
  of
  homeless
  persons
  who
  are
  in
  shelters
  or
  on
  the
 
street
 because
 of
 loss
 of
 housing,
 unemployment,
 mental
 illness,
 or
 abuse.
 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 15

 

Section II

A. Executive Summary
B. 2011 KnoxHMIS Annual Report
C. Knoxville-Knox County Homeless Coalition Biennial Study


 

Executive
 Summary
 of
 Homelessness
 in
 Knoxville
 and
 Knox
 County,
 TN:
 2011-­‐2012
 

 

Since
 1986,
 the
 Knoxville-­‐Knox
 County
 Homeless
 Coalition
 (KKCHC)
 has
 conducted
 
a
 biennial
 survey
 and
 enumeration
 of
 individuals
 experiencing
 homelessness
 in
 Knoxville.
 
In
 2004,
 the
 director
 of
 the
 study,
 Dr.
 Roger
 Nooe,
 partnered
 with
 Dr.
 David
 Patterson
 of
 
the
 UT
 College
 of
 Social
 Work
 to
 implement
 the
 Knoxville
 Homeless
 Management
 
Information
 System
 (KnoxHMIS),
 a
 secure
 online
 database
 to
 connect
 service
 providers
 
and
 generate
 community-­‐wide
 statistics
 about
 homelessness
 in
 real-­‐time.
 
 Each
 year
 since
 
its
 inception,
 KnoxHMIS
 has
 generated
 an
 annual
 report
 detailing
 the
 characteristics
 of
 
individuals
 experiencing
 homelessness,
 services
 provided,
 and
 housing
 outcomes.
 This
 
year,
 the
 Coalition
 study
 does
 not
 feature
 an
 enumeration.
 Instead,
 longitudinal
 data
 from
 
KnoxHMIS
 are
 presented
 to
 demonstrate
 the
 scope
 of
 homelessness
 in
 our
 community.
 
 In
 
an
 effort
 to
 provide
 a
 single,
 authoritative
 source
 of
 information
 on
 homelessness
 for
 our
 
community,
 data
 from
 KnoxHMIS
 and
 the
 2012
 Biennial
 Knoxville-­‐Knox
 County
 Homeless
 
Coalition
 Study
 are
 presented
 jointly.
 
 
 

Some
 questions
 asked
 in
 the
 online
 KnoxHMIS
 assessment
 and
 the
 KKCHC
 
 survey
 
are
 very
 similar.
 Both
 request
 information
 from
 clients
 regarding
 demographic
 
information,
 e.g.
 gender,
 age,
 primary
 race,
 ethnicity,
 etc.
 However,
 some
 questions
 are
 
asked
 differently.
 For
 example,
 the
 KnoxHMIS
 assessment
 asks
 about
 the
 primary
 reason
 
for
 homelessness
 and
 allows
 for
 only
 one
 answer.
 In
 contrast,
 the
 KKCHC
 survey
 asks
 for
 
the
 causes
 of
 homelessness,
 and
 allows
 for
 multiple
 responses.
 
 

In
 addition
 to
 the
 framing
 of
 questions,
 KnoxHMIS
 data
 are
 collected
 over
 the
 
course
 of
 the
 year
 on
 individuals
 who
 access
 services
 from
 partner
 homeless
 service
 
agencies.
 Data
 for
 the
 KKCHC
 study
 are
 collected
 over
 the
 course
 of
 three
 days
 in
 February
 
from
 shelters,
 outside
 locations,
 substance
 abuse
 treatment
 centers,
 and
 at
 outdoor
 meal
 
programs.
 As
 such,
 data
 gathered
 by
 KnoxHMIS
 includes
 individuals
 who
 are
 seeking
 
services
 for
 homelessness
 prevention,
 are
 currently
 experiencing
 homelessness,
 and
 those
 
who
 have
 been
 housed,
 but
 still
 engage
 in
 case
 management
 or
 other
 services.
 The
 KKCHC
 
sample
 includes
 only
 individuals
 who
 are
 acutely
 experiencing
 homelessness.
 
 
 

The
 authors
 of
 this
 study
 urge
 the
 reader
 to
 view
 these
 two
 sources
 of
 data
 as
 
complimentary.
 
 Each
 takes
 a
 different
 perspective,
 and
 thus
 has
 respective
 strengths.
 The
 
KKCHC
 data
 provides
 a
 detailed
 and
 in-­‐depth
 look
 of
 at
 236
 individuals
 currently
 
experiencing
 homelessness.
 KnoxHMIS
 data
 provides
 a
 comprehensive
 overview
 of
 7,320
 
individuals
 accessing
 services
 from
 area
 homeless
 service
 providers.
 
 


 KnoxHMIS
 reports
 that
 the
 average
 age
 of
 women
 seeking
 services
 is
 34,
 in
 
contrast,
 the
 KKCHC
 data
 report
 the
 average
 age
 of
 women
 acutely
 experiencing
 
homelessness
 to
 be
 40.
 This
 difference
 may
 be
 explained
 by
 the
 aforementioned
 different
 
population
 samples.
 Statistically
 speaking,
 larger
 samples
 are
 more
 representative
 of
 
poulations.
 Conversely,
 the
 depth
 of
 psychosocial
 information
 provided
 by
 the
 KKCHC
 
expands
 our
 understanding
 of
 this
 complex
 population.
 As
 a
 result,
 this
 report
 contains
 a
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 16

 

vast
 array
 of
 information
 to
 allow
 readers
 to
 better
 understand
 the
 scope
 and
 complexity
 
of
 homelessness
 in
 Knoxville
 and
 Knox
 County.
 
 


  The
 data
 compiled
 for
 this
 study
 and
 national
 data
 from
 the
 Annual
 Homelessness
 
Assessment
 Report
 to
 Congress
 show
 a
 modest
 increase
 in
 the
 overall
 numbers
 of
 
individual
 accessing
 services
 for
 homelessness.
 However,
 the
 economic
 recession
 of
 2008
 
appears
 to
 have
 negatively
 impacted
 some
 groups
 more
 than
 others.
 
 Family
 
homelessness,
 especially
 among
 single
 mothers,
 continues
 to
 increase
 both
 in
 the
 
Knoxville-­‐Knox
 County
 area
 and
 across
 the
 nation.
 While
 chronic
 homelessness
 has
 been
 
slowly
 trending
 downward
 nationally,
 the
 oppposite
 is
 true
 for
 our
 community.
 However,
 
some
 of
 this
 increase
 may
 be
 explained
 by
 improved
 data
 collection
 techniques.
 Here
 are
 a
 
few
 key
 findings
 from
 the
 study:
 

 

• Each
 month
 in
 2011,
 an
 average
 of
 1,595
 people
 access
 services
 for
 homelessness.
 
For
 the
 year,
 the
 total
 number
 of
 individuals
 utilizing
 services
 was
 7,320—a
 3
 
percent
 increase
 over
 2010.
 
 

• Ten
 percent
 of
 homeless
 individuals
 accessing
 services
 self-­‐report
 a
 mental
 illness,
 
33
 percent
 have
 received
 treatment
 for
 mental
 illness
 while
 homeless.
 
 

• Between
 21-­‐25
 percent
 of
 individuals
 report
 that
 loss
 of
 a
 job
 caused
 them
 to
 lose
 
their
 home.
 
 

• Fourteen
 percent
 of
 individuals
 that
 were
 homeless
 during
 2011
 are
 employed.
 
 

• Twenty-­‐four
 percent
 of
 individuals
 experiencing
 homelessness
 report
 a
 disability
 
of
 long
 duration.
 
 

• Single
 female
 parents
 comprise
 9
 percent
 of
 the
 total
 population
 experiencing
 
homelessness.
 
 

• Eighty
 percent
 of
 individuals
 experiencing
 homelessness
 in
 Knoxville
 and
 Knox
 
County
 report
 a
 last
 permanent
 address
 in
 Knox
 or
 a
 surrounding
 county.
 
 

• Fifty-­‐seven
 percent
 of
 homeless
 individuals
 are
 originally
 from
 Tennessee.
 
 

• In
 2011,
 791
 children
 under
 the
 age
 of
 ten
 accessed
 homeless
 services
 with
 a
 family
 
member.
 
 
 


 

  As
 a
 response
 to
 the
 persistent
 issue
 of
 homelessness,
 both
 the
 federal
 government
 
and
 local
 communities
 have
 implemented
 innovative
 programs
 to
 help
 alleviate
 the
 
growing
 problem.
 Since
 implementation
 in
 late
 2009,
 the
 Homelessness
 Prevention
 and
 
Rapid
 Rehousing
 Program
 (HPRP)
 helped
 700,000
 people
 across
 the
 country
 stay
 in
 their
 
homes
 or
 move
 out
 of
 homelessness.
 Our
 local
 implemenation
 of
 HPRP
 provided
 
rehousing
 or
 prevention
 assistance
 to
 1,523
 individuals.
 Since
 2008,
 local
 service
 
providers
 have
 reported
 3,412
 housing
 placements
 for
 individuals
 acutely
 homelesss
 or
 at
 
risk
 of
 homelessness.
 


 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 17

 


 


 


  KnoxHMIS
 2011
 Annual
 Report
 

New
 Clients
 Entered
 into
 KnoxHMIS
  Table
 1:
 Percent
 Change
 in
 Number
 of
 
In
 2011,
 3,264
 new
 clients
 were
 entered
 into
 
KnoxHMIS
 representing
 a
 25
 percent
 decrease
 from
 
 
 
 
 
 
 
 
 
 
 
 Clients
 Entered
 (2007-­‐2011)
 
2010
 (Table
 1).
 
 The
 adjacent
 table
 shows
 the
 percent
 
2007
  +12%
 (3,613)
 

change
 in
 new
 clients
 entered
 in
 KnoxHMIS
 each
 year
  2008
  +31%
 (4,731)
 

since
 2006.
  2009
  -­‐21%
 
 (3,727)
 

 
 


  2010
  +17%
 (4,394)
 

 

 
2011
  -­‐25%
 (3,264)
 


 

 

Chart
 1:
 New
 Clients
 Added
 from
 2006
 to
 2011
 

 
Table
 2
 compares
 the
 number
 of
 individuals
 in
 identified
 sub-­‐groups
 of
 the
 homeless
 
population
 that
 were
 newly
 entered
 into
 KnoxHMIS
 in
 2010
 and
 2011.1
 
 Of
 new
 clients
 
entered
 in
 2011,
 there
 was
 an
 increase
 in
 the
 following
 subgroups:
 females,
 individuals
 in
 
a
 female
 single
 parent
 household,
 people
 with
 a
 disability
 and
 children.
 Most
 notably,
 
there
 was
 a
 5
 percent
 increase
 in
 the
 number
 of
 people
 with
 a
 disability
 of
 long
 duration
 
and
 a
 2
 percent
 increase
 in
 the
 number
 of
 individuals
 in
 female
 single
 parent
 households.
 
This
 increase
 in
 female
 single
 parents
 reflects
 a
 continuing
 national
 trend
 of
 an
 increase
 of
 
families
 experiencing
 homelessness
 (AHAR,
 2010).
 
 In
 2011,
 there
 was
 a
 slight
 decrease
 in
 
the
 number
 of
 Black
 or
 African
 American
 individuals
 experiencing
 homelessness.
 
 

1The
 subgroups
 in
 Table
 2
 are
 potentially
 overlapping,
 and
 therefore
 the
 columns
 do
 not
 sum
 to
 100
 percent.
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 18

 


 

Table
 2:
 Subgroups
 of
 New
 Clients
 Added
 (2010-­‐2011)
 
 

 

Active
 Clients
 Utilizing
 Services
 

For
 the
 purposes
 of
 this
 report,
 “active
 clients”
 are
 individuals
 receiving
 services
 from
 
KnoxHMIS
 partner
 agencies.
 
 While
 the
 majority
 of
 active
 clients
 are
 homeless
 (N=5,717),
 

some
 active
 clients
 are
 in
 housing
 (N=1,603)
 and
 are
 formerly
 homeless
 or
 at
 risk
 of
 

becoming
 homeless.
 The
 flowchart
 below
 illustrates
 the
 different
 groups
 of
 individuals
 
who
 are
 included
 in
 the
 active
 client
 population.23
 

Chart
 2:
 2011
 Subgroups
 of
 Active
 Clients
 
 
 

 
 

2Individuals
 categorized
 as
 homeless
 meet
 HUD’s
 definition
 for
 homelessness.
 

3The
 sum
 of
 all
 subgroups
 in
 the
 flowchart
 will
 not
 equal
 the
 total
 number
 of
 active
 clients
 (7,320)
 due
 to
 

null
 data
 of
 the
 chronically
 homeless
 variable.
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 19

 


 
In
 all
 of
 2011,
 there
 were
 7,320
 active
 clients
 in
 Knox
 County,
 a
 3
 percent
 increase
 

compared
 to
 the
 number
 of
 active
 clients
 in
 2010.
 Although
 the
 number
 of
 active
 clients
 

increased
 in
 2011,
 the
 percentage
 of
 active
 clients
 who
 were
 chronically
 homeless
 slightly
 
increased
 from
 20
 percent
 in
 2010
 (1,410/7,089)
 to
 21
 percent
 in
 2011
 (1,565/7,320),
 a
 1
 

percent
 increase.
 Table
 3
 displays
 the
 percent
 change
 from
 2010
 to
 2011
 in
 the
 non-­‐

chronically
 homeless
 population,
 chronically
 homeless
 population,
 and
 the
 total
 homeless
 
population.
 


  Table
 3:
 Active
 Clients
 by
 Homeless
 Status
 (2010-­‐2011)
 
 


 


 

 


 


 
 


 
Charts
 3
 and
 4
 show
 the
 homeless
 status
 of
 active
 clients
 on
 a
 quarterly
 and
 monthly
 basis
 

for
 2011.
 On
 average,
 2,880
 clients
 sought
 services
 per
 quarter
 (1,595
 per
 month).
 Of
 

those
 clients,
 an
 average
 of
 762
 were
 chronically
 homeless
 per
 quarter
 (480
 per
 month).
 
The
 higher
 counts
 of
 active
 clients
 on
 a
 quarterly
 basis
 (Chart
 3)
 compared
 to
 a
 monthly
 

basis
 (Chart
 4)
 indicate
 that
 clients
 are
 engaging
 inconsistently
 with
 homeless
 services
 
providers.
 Please
 note
 that
 the
 sum
 of
 active
 clients
 by
 quarter
 and
 month
 will
 not
 equal
 

the
 total
 number
 of
 active
 clients
 (7,320)
 because
 the
 same
 clients
 may
 be
 active
 from
 

month
 to
 month
 and
 quarter
 to
 quarter.
 
 


 
 
 
 
 Chart
 3:
 Active
 Clients
 Quarterly
 by
 Homeless
 Status
 in
 2011
  20
Homelessness in Knoxville and Knox County, Tennessee 2011-2012

 

Chart
 4:
 Active
 Clients
 Monthly
 by
 Homeless
 Status
 in
 2011
 
 

 
Basic
 Demographic
 Information
 on
 Active
 Clients
 
The
 charts
 below
 provide
 demographic
 information
 on
 active
 clients
 in
 2011.
 The
 
percentage
 breakdown
 for
 gender
 and
 race
 is
 consistent
 with
 2010
 data,
 however,
 the
 
percentage
 of
 Black
 or
 African
 American
 individuals
 has
 increased
 slightly
 from
 27
 
percent
 in
 2010
 to
 29
 percent
 in
 2011.
 Notably,
 9
 percent
 of
 the
 Knox
 County
 population
 
and
 16.7
 percent
 of
 the
 Tennessee
 population
 is
 Black
 or
 African
 American4.
 Therefore,
 a
 
disproportionate
 percentage
 of
 African
 Americans
 are
 seeking
 homeless
 services
 
compared
 to
 the
 percentage
 of
 African
 Americans
 represented
 in
 Knox
 County
 and
 the
 
state
 of
 Tennessee.
 The
 category
 of
 Other/Multiracial
 constitutes
 3
 percent
 of
 active
 
clients
 includes
 individuals
 who
 are
 American
 Indian,
 Alaskan
 Native,
 Asian,
 Native
 
Hawaiian,
 and
 Multiracial.
 
 


 
Chart
 5:
 2011
 Gender
 of
 Clients
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Chart
 6:
 2011
 Primary
 Race
 of
 Active
 Clients
 

 

 

4
 2010
 US
 Census
 Bureau
 (quickfact.census.gov)
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 21

 

Chart
 7
 illustrates
 the
 age
 distribution
 of
 active
 clients
 by
 gender.
 In
 2011,
 the
 most
 
common
 age
 (mode)
 for
 homeless
 men
 was
 40,
 while
 the
 most
 common
 age
 for
 homeless
 
women
 was
 34.
 Of
 particular
 interest
 is
 that
 the
 peak
 age
 concentration
 for
 homeless
 
women
 is
 26
 years
 younger
 than
 the
 peak
 age
 concentration
 of
 homeless
 men.
 
 

Chart
 7:
 2011
 Age
 Distribution
 of
 Active
 Clients
 by
 Gender
 

 
Disability
 Status
 of
 Active
 Clients
 
In
 2011,
 24
 percent
 of
 active
 clients
 had
 a
 disability.
 Chart
 8
 shows
 the
 percentage
 of
 
active
 clients
 with
 disability
 types
 by
 homeless
 status.
 Strikingly,
 23
 percent
 of
 the
 
chronically
 homeless
 population
 reports
 having
 a
 mental
 health
 disability
 while
 only
 10
 
percent
 of
 the
 non-­‐chronically
 homeless
 reports
 having
 a
 mental
 health
 disability.5
 

Chart
 8:
 Disability
 Type
 by
 Homeless
 Status
 

5
 These
 percentages
 on
 disability
 types
 represent
 only
 those
 individuals
 who
 have
 a
 recorded
 disability
 type
 

in
 KnoxHMIS
 (n=2,070).
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 22

 


 
Self-­‐Reported
 Primary
 Reason
 for
 Homelessness
 of
 Active
 Clients
 
As
 is
 illustrated
 in
 the
 chart
 below,
 differences
 in
 primary
 reason
 for
 homelessness
 
differed
 by
 gender
 in
 2011.
 Males
 most
 frequently
 report
 Loss
 of
 Job
 (21%)
 as
 primary
 
reason
 for
 homelessness,
 while
 females
 most
 frequently
 report
 No
 Affordable
 Housing
 and
 
Loss
 of
 Job
 (12%,
 respectively).6
 This
 variable
 is
 based
 on
 the
 client’s
 perception
 of
 his
 or
 
her
 primary
 reason
 for
 homelessness.
 Therefore
 this
 variable
 may
 be
 subject
 to
 the
 social
 
desirability
 bias
 in
 which
 individuals
 tend
 to
 respond
 in
 ways
 that
 will
 be
 viewed
 
favorably
 by
 others.
 
 

Chart
 9:
 Self-­‐Reported
 Primary
 Reason
 for
 Homelessness
 by
 Gender
 


 
Table
 4
 shows
 the
 percentage
 of
 adult
 women
 
Table
 4:
 Percent
 of
 Women
 Clients
 
active
 clients
 between
 2007
 and
 2011
 who
  Citing
 Domestic
 Violence
 as
 

reported
 domestic
 violence
 as
 the
 primary
 reason
  Primary
 Reason
 for
 Homelessness
 
for
 homelessness.
 In
 2011,
 11.5
 percent
 (150)
 
women
 clients
 reported
 domestic
 violence
 as
  2007
  15.0%
 
primary
 reason
 for
 homelessness,
 which
 represents
 a
  2008
  14.5%
 
3.5
 perent
 decrease
 in
 prevalence
 from
 2007.
 
  2009
  13.8%
 

  2010
  12.8%
 

2011
  11.5%
 

6These
 percentages
 on
 primary
 reason
 for
 homelessness
 represent
 only
 those
 individuals
 who
 have
 a
 

recorded
 primary
 reason
 for
 homelessness
 in
 KnoxHMIS
 (n=4,888).
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 23

 


 
Subpopulations
 of
 Active
 Clients
 
In
 this
 section,
 the
 following
 five
 sub-­‐populations
  Table
 5:
 Percent
 of
 All
 Active
 
are
 examined:
 chronically
 homeless,
 veterans,
  Clients
 in
 Subpopulations
 

female
 single
 parents,
 street
 homeless,
 and
 
  All
 Active
 Clients
 
children.
 For
 the
 purposes
 of
 this
 report,
  n=7,320
 
individuals
 identified
 as
 “street
 homeless”
 were
  Chronically
  21%
 
living
 in
 a
 place
 not
 meant
 for
 human
 habitation
  Homeless
 
(i.e.
 on
 the
 street,
 in
 a
 vehicle,
 or
 camping).
 Table
 5
  Children
  16%
 
shows
 the
 percentage
 of
 all
 active
 clients
 falling
 in
  Veterans
  10%
 
each
 of
 the
 five
 designated
 subpopulations.
 
  Street
 Homeless
 

  Female
 Single
  9%
 
The
 tables
 under
 each
 subpopulation
 reveal
 the
  Parents
  9%
 

degree
 of
 overlap
 among
 these
 subgroups.
 
 Of
 

particular
 interest
 is
 that
 while
 21
 percent
 of
 all
  Table
 6:
 Characteristics
 of
 the
 
active
 clients
 are
 chronically
 homeless
 (Table
 5),
 
Chronically
 Homeless
 Population
 
40
 percent
 of
 veterans
 (Table
 6)
 and
 57
 percent
 of
 
street
 homeless
 (Table
 7)
 are
 chronically
  Chronically
 Homeless
 Population
 
 
 
 
 
 
 
 
 
 
 
homeless.
 
 

  (n=1,565)
 
Chronic
 Homelessness
 
African
 American
  29%
 

Street
 Homeless
  19%
 


 As
 defined
 by
 Housing
 and
 Urban
 Development
  Veterans
  19%
 

Female
 Single
 Parents
  3%
 

(HUD),
 chronically
 homeless
 describes
 an
 

individuals
 or
 family
 who
 has
 been
 homeless
 for
 at
 least
 a
 year
 or
 has
 had
 at
 least
 four
 

episodes
 of
 homelessness
 in
 the
 past
 three
 years
 AND
 the
 head
 of
 household
 in
 a
 family
 or
 
the
 individual
 has
 a
 disabling
 condition.
 
 

With
 the
 exception
 of
 gender,
 the
 

demographic
 characteristics
 of
 
chronically
 homeless
 individuals
 

are
 similar
 to
 the
 demographic
 
characteristics
 of
 the
 non-­‐

chronically
 homeless
 individuals.
 

Seventy-­‐five
 percent
 of
 the
 
chronically
 homeless
 population
 

was
 male
 compared
 to
 only
 61
 
percent
 of
 the
 non-­‐chronically
 

homeless
 population
 (Chart
 10).7
 

Additionally,
 street
 homeless
 
individuals
 and
 veterans
 are
 a
 

larger
 percentage
 (19%
 and
 19%
 

respectively)
 of
 the
 chronically
 
homeless
 population
 than
 they
 

are
 of
 the
 general
 homeless
 
population.
 
 


 

Chart
 10:
 2011
 Homeless
 Status
 of
 Active
 Clients
 by
 Gender
 

7Chart
 10
 only
 displays
 data
 on
 individuals
 with
 chronically
 homeless
 status
 and
 gender
 reported
 (n=6183).
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 24

 
 

 

 
 
Charts
 11
 and
 12
 below
 illustrate
 the
 differences
 in
 the
 age
 distribution
 of
 chronically
 
 
homeless
 males
 and
 females.
 As
 is
 evidenced
 in
 Chart
 11,
 a
 notably
 large
 percentage
 of
 
 
chronically
 homeless
 males
 are
 between
 the
 ages
 of
 45
 and
 55,
 whereas
 the
 distribution
 of
 
 
chronically
 homeless
 females
 does
 not
 have
 a
 pronounced
 peak.
 
 
 

 

 
 

 
 

 
Chart
 11:
 2011
 Age
 Distribution
 of
 Males
 by
 Homeless
 Status
 
 

 

 

 

 

Chart
 12:
 2011
 Age
 Distribution
 of
 Females
 by
 Homeless
 Status
  25

 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012

 

The
 following
 chart
 compares
 the
 self-­‐reported
 primary
 reason
 for
 homelessness
 of
 the
 
chronically
 homeless
 and
 non-­‐chronically
 homeless
 populations.8
 Chronically
 homeless
 
individuals
 were
 more
 likely
 to
 report
 substance
 abuse,
 mental
 health,
 criminal
 activity
 
and
 a
 medical
 condition
 as
 their
 primary
 reason
 for
 homelessness
 compared
 to
 non-­‐
chronically
 homeless
 individuals.
 Again,
 these
 figures
 could
 be
 impacted
 by
 the
 social
 
desirability
 bias
 in
 which
 individuals
 tend
 to
 respond
 in
 ways
 that
 reflect
 positively
 on
 
themselves.
 

 


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Chart
 13:
 Self-­‐Reported
 Primary
 Reason
 for
 Homelessness
 by
 Homeless
 Status
 

 

 

 

8These
 percentages
 on
 primary
 reason
 for
 homelessness
 represent
 only
 those
 individuals
 who
 have
 a
 

recorded
 primary
 reason
 for
 homelessness
 and
 a
 homeless
 status
 in
 KnoxHMIS
 (n=4,699).
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 26

 

Veterans
  Table
 7:
 Characteristics
 of
 the
 
Ten
 percent
 of
 active
 clients
 in
 KnoxHMIS
 were
 
Veteran
 Population
 
veterans.
 According
 to
 the
 2009
 Annual
 Homeless
 

Assessment
 Report
 to
 Congress
 (AHAR),
 nationally
 
  Veterans
 (n=746)
  40%
 
11.5
 percent
 of
 sheltered
 homeless
 individuals
  Chronically
 Homeless
 
were
 veterans.
 This
 lower
 representation
 of
 
veterans
 in
 KnoxHMIS
 could
 be
 due
 to
 the
 fact
 that
  African
 American
  27%
 

veterans
 are
 seeking
 services
 from
 agencies
 funded
  Street
 Homeless
  15%
 
through
 the
 U.S.
 Department
 of
 Veterans
 Affairs,
  1%
 
which
 are
 not
 yet
 captured
 in
 HMIS.
 KnoxHMIS
 data
  Female
 Single
 Parents
 

suggest
 that
 veterans
 are
 frequently
 engaging
 with
 emergency
 services
 and
 are
 not
 

engaging
 with
 case
 management
 from
 our
 partner
 agencies
 as
 frequently.
 Furthermore,
 40
 
percent
 of
 active
 clients
 who
 are
 veterans
 were
 described
 as
 chronically
 homeless
 in
 2011.
 
 


 

Female
 Single
 Parents
 
  Table
 8:
 Characteristics
 of
 Female
 
 
 
 
 

In
 2011,
 9
 percent
 of
 active
 clients
 were
 female
 single
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Single
 Parents
 

parents
 with
 their
 children.
 The
 average
 female
 single
  Female
 Single
 Parents
 (n=648)
 
parent
 was
 33
 and
 had
 1.4
 children.
 Furthermore,
 of
 
these
 single
 female
 parents,
 20
 percent
 reported
  Chronically
 Homeless
  7%
 
domestic
 violence
 as
 the
 primary
 reason
 for
 
homelessness
 followed
 by
 underemployment/low
  Veterans
  1%
 

Street
 Homeless
  3%
 

income
 (14%)
 and
 eviction
 (12%).
 
 Female
 single
 parent
 households
 constituted
 30
 

percent
 of
 all
 households
 seeking
 services
 in
 2011
 (Chart
 14).
 
 

 

Chart
 14:
 2011
 Percentage
 of
 Household
 Type
 
 

  27

 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012

 


 
Street
 Homeless
 
As
 defined
 by
 HUD,
 an
 individual
 who
 is
 street
  Table
 9:
 Characteristics
 of
 the
 
homeless
 currently
 lives
 in
 a
 place
 not
 meant
 for
  Street
 Homeless Population

human
 habitation.
 Of
 the
 195
 individuals
 who
 were
  Street
 Homeless
 (n=195)
  57%
 
street
 homeless
 in
 2011,
 70
 percent
 were
 male
 and
 
  31%
 
1
 percent
 were
 children.
 These
 individuals
 spent
 an
  Chronically
 Homeless
  17%
 
average
 of
 338
 days
 living
 in
 a
 place
 not
 meant
 for
  23%
 
human
 habitation.
 The
 street
 homeless
 population
  African
 American
 
accessed
 a
 total
 of
 11,291
 services
 in
 2011,
 meaning
  1%
 
that
 each
 individual
 accessed
 an
 average
 of
 58
  Veterans
 

services.
 Of
 those
 services,
 the
 street
 homeless
 most
  Female
 Head
 of
 
Household
 
Children
 

frequently
 accessed
 meals
 and
 the
 drop-­‐in
 center.
 Seventy
 percent
 of
 the
 street
 homeless
 

population
 reported
 a
 disability.
 Chart
 15
 displays
 the
 disability
 types
 of
 individuals
 with
 a
 

reported
 disability.
 
 
 
 

 


 
 
 
 
 
 
 
 Chart
 15:
 2011
 Disability
 Type
 of
 Street
 Homeless
 Population
 
 


 


 

Children
 
In
 2011,
 12
 percent
 of
 active
 clients
 were
 under
 the
 age
 of
 18
 (861
 clients),
 and
 8
 percent
 

were
 10
 years
 old
 or
 younger
 (579
 clients).
 The
 average
 age
 of
 active
 client
 children
 was
 
8.3
 years.
 Additionally,
 74
 percent
 of
 these
 children
 were
 in
 female
 single
 parent
 

households,
 and
 19
 percent
 were
 in
 two-­‐parent
 household.
 


 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 28

 

Services
 Captured
 in
 KnoxHMIS
 
The
 average
 number
 of
 services
 provided
 per
 month
 has
 decreased
 from
 32,985
 in
 2010
 
to
 32,119
 in
 2011,
 a
 1
 percent
 decrease.
 Chart
 16
 illustrates
 the
 number
 of
 services
 
recorded
 per
 month
 over
 the
 last
 three
 years.
 The
 large
 spike
 in
 number
 of
 services
 
captured
 in
 September
 and
 October
 of
 2010
 indicates
 when
 Knoxville
 Area
 Rescue
 Mission
 
(KARM)
 implemented
 a
 device
 that
 scanned
 clients’
 KnoxHMIS
 Card
 to
 capture
 all
 meals
 
served.
 The
 notable
 spike
 in
 services
 captured
 in
 April
 of
 2009
 corresponds
 with
 KARM’s
 
capturing
 of
 emergency
 shelter
 beds.
 
 
 

2009-­‐2011
 
Services
 Captured
 

60,000
 
50,000
 
40,000
 
30,000
 
20,000
 
10,000
 

0
 
Number
 of
 Services
 
 
January
 

March
 
May
 
July
 

September
 
November
 

January
 
March
 
May
 
July
 

September
 
November
 

January
 
March
 
May
 
July
 

September
 
November
 

2009
  2010
  2011
 
 

Chart
 16:
 Services
 Captured
 in
 KnoxHMIS
 (2009-­‐2011)
 


 

The
 charts
 below
 display
 that
 21
 percent
 of
 clients
 receiving
 services
 were
 chronically
 
homeless
 (Chart
 17)
 while
 the
 chronically
 homeless
 population
 accounted
 for
 42
 percent
 

of
 all
 services
 delivered
 in
 2011
 (Chart
 18).
 Therefore,
 the
 chronically
 homeless
 

population
 consumed
 a
 larger
 proportion
 of
 services
 than
 the
 non-­‐chronically
 homeless
 
population.
 
 Furthermore,
 the
 chronically
 homeless
 population
 consumed
 107
 services
 per
 

capita
 compared
 to
 the
 non-­‐chronically
 homeless
 populations’
 45
 services
 per
 capita.
 
These
 findings
 are
 consistent
 with
 the
 previous
 data
 in
 2009
 and
 2010
 in
 which
 the
 

chronically
 homeless
 population
 consisted
 of
 23
 percent
 of
 clients
 receiving
 services
 but
 

accounted
 for
 41
 percent
 of
 all
 services
 provided.
 

Chart
 17:
 Percent
 of
 Clients
 Receiving
  Chart
 18:
 Percent
 of
 Total
 Services
 Received
 
Services
 by
 Homeless
 Status
 
 
 
 
 
 
 
 
 
 
 
  by
 Homeless
 Status
 
 
 
 
 
 
 
 
 
 
 
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 29

 

Emergency
 Shelters
 and
 Transitional
 Housing
 
New
 to
 the
 report
 this
 year,
 we
 have
 begun
 analyzing
 the
 utilization
 of
 transitional
 

housing
 and
 emergency
 shelters.
 Table
 10
 displays
 the
 average,
 mode
 and
 maximum
 

nights
 stayed
 in
 Emergency
 Shetlers
 and
 Transitional
 Housig
 during
 2011.
 

 

  Table
 10:
 2011
 Average
 Nights
 Stayed
 
 

  in
 Emergency
 Shelter
 and
 Transitional
 Housing


  ! "#$%&'$! ()&*+&%+! /.+$! /&0-121!

  ,$#-&)-.*!

 
31$%'$*45! "#$%&! '($)*! +! (*#!

  (6$7)$%!

  8*9:;:<=!

  >%&*?-)-.*&7! +*)$,#! +)+$')! )%! ,)%!

  @.2?-*'!

  8*9:;<=!

 


 
Housing
 Outcomes
 

Since
 July
 2008,
 when
 KnoxHMIS
 began
 capturing
 data
 on
 housing
 outcomes,
 KnoxHMIS
 

partner
 agencies
 have
 housed
 
 3,412
 individuals.
 Of
 these
 housing
 placements,
 1482
 
individuals
 have
 been
 placed
 in
 permanent
 supportive
 housing,
 935
 formerly
 homeless
 

individuals
 rent
 a
 house
 or
 apartment
 without
 a
 subsidy,
 and
 58
 individuals
 own
 their
 
own
 homes.
 Chart
 19
 illustrates
 the
 number
 of
 individuals
 placed
 into
 each
 housing
 type
 

since
 July
 2008.
 


 


 Chart
 19:
 Housing
 Placement
 Data
 by
 Type
  30
Homelessness in Knoxville and Knox County, Tennessee 2011-2012

 


 
Permanent
 Supportive
 Housing
 
The
 gender
 breakdown
 of
 formerly
 homeless
 individuals
 placed
 in
 permanent
 supportive
 
housing
 was
 fairly
 even
 with
 49
 percent
 being
 female.
 Additionally,
 49
 percent
 of
 
individuals
 in
 permanent
 supportive
 housing
 have
 a
 disability
 of
 long
 duration.
 Of
 those
 
individuals
 with
 a
 reported
 disability
 type,
 41
 percent
 had
 a
 mental
 health
 problem
 
followed
 by
 15
 percent
 with
 a
 physical/medical
 problem.
 


 

Chart
 20:
 Disability
 Type
 of
 Formerly
 Homeless
 Individuals
 in
 Permanent
 Supportive
 
Housing
 

Homelessness
 Prevention
 and
 Rapid
 Rehousing
 Program
 

In
 September
 2009,
 two
 KnoxHMIS
 partner
 agencies
 received
 funding
 through
 the
 
Homeless
 Prevention
 and
 Rapid
 Rehousing
 Program
 (HPRP),
 part
 of
 the
 American
 

Recovery
 and
 Reinvestment
 Act.
 The
 program
 serves
 individuals
 and
 families
 who
 are
 

currently
 homeless
 through
 the
 Homeless
 Assistance
 program,
 and
 individuals
 and
 
families
 who
 are
 at
 risk
 of
 homelessness
 through
 the
 Homelessness
 Prevention
 program.
 

Table
 11
 below
 illustrates
 the
 number
 of
 individuals
 and
 families
 assisted
 through
 these
 
funds.
 
 


 
 
 

Table
 11:
 2010
 HPRP
 Assistance
 

Homeless
 Prevention
  Homeless
 Assistance
 
Total
 Program
 Enrollment
 
  n=1439
  n=282
 
 

Exited
 to
 Permanent
 Destination
  1294
  229
 
 

Exited
 to
 Temporary
 Destination
  30
  9
 
 

Exited
 to
 Institutional
 Destination
  7
  0
 
 

Exited
 to
 Other/Don't
  54
  44
 
 
Know/Deceased
 


 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 31

 

Of
 the
 1,439
 individuals
 who
 have
 left
 the
 Homelessness
 Prevention
 program,
 90
 percent
 
(1294)
 of
 them
 stayed
 in
 permanent
 homes,
 such
 as
 an
 apartment
 or
 rental
 house.
 Of
 the
 

186
 literally
 homeless
 individuals
 that
 completed
 the
 Homeless
 Assistance
 program,
 81.2
 

percent
 (229)
 exited
 to
 permanent
 destinations.
 
 

 

Casenotes
  Table
 12:
 2009-­‐2011
 Percentage
 of
 
The
 casenote
 feature
 in
 KnoxHMIS
 allows
 case
  Active
 Clients
 with
 Casenotes
 
managers
 to
 record
 detailed
 information
 on
 clients
 

that
 they
 are
 assisting.
 
 In
 2011,
 KnoxHMIS
 partner
 
  Percentage
 of
 Active
 

agencies
 recorded
 12,701
 casenotes
 on
 994
 clients,
  Clients
 with
 Casenotes
 

averaging
 12.8
 casenotes
 per
 client.
 These
 figures
 are
  2011
  13.6%
 

an
 increase
 in
 casenote
 per
 client
 (Table
 13)
 and
 a
  2010
  20%
 

slight
 decrease
 in
 clients
 with
 casenotes
 from
 2010
  2009
  28%
 

(Table
 12).
 However,
 only
 a
 few
 KnoxHMIS
 partner
 

agencies
 have
 integrated
 the
 casenote
 feature
 into
 practice.
 
 Although
 the
 number
 of
 total
 
casenotes
 is
 fairly
 consistent
 with
 a
 slight
 increase
 from
 2010
 to
 2011
 (10,505
 and
 12,701
 

total
 casenotes
 respectively),
 the
 percentage
 of
 active
 clients
 with
 casenotes
 has
 
decreased.
 Chart
 21
 illustrates
 the
 fluctuation
 of
 casenotes
 entered
 on
 a
 monthly
 basis.
 

Table
 13:
 2008-­‐2011
 Average
 Number
 of
 Casenotes
 per
 Client
 
 

 


  Total
  Clients
 with
  Average
 Casenotes
 
 

 Casenotes
  Casenotes
 
  per
 Client
 
 
2011
  994
  12.8
 
 
2010
  12,701
  1,411
  7.9
 
 
2009
  10,505
  1,560
  6.58
 
 
2008
  10,265
  720
  7.9
 
 

5,719
 

Chart
 21:
 2010-­‐2011
 Casenote
 Usage
 
 
 
Homelessness in Knoxville and Knox County, Tennessee 2011-2012
 

32

 

Maps
 of
 Zip
 Code
 of
 Last
 Permanent
 Address
 

 
The
 following
 maps
 show
 the
 distribution
 of
 clients
 who
 received
 services
 in
 2011
 by
 the
 
client’s
 zip
 code
 of
 last
 permanent
 address.
 Zip
 code
 was
 recorded
 for
 82
 percent
 of
 active
 
clients,
 this
 was
 a
 22
 percent
 increase
 from
 2010.
 These
 maps
 illustrate
 that
 the
 
majority
 of
 active
 clients
 had
 a
 last
 permanent
 address
 in
 the
 Knoxville-­‐Knox
 
County
 area
 (60%).
 In
 addition,
 80
 percent
 of
 individuals
 experiencing
 
homelessness
 in
 Knoxville
 in
 2011
 report
 their
 last
 permanent
 address
 in
 Knox
 or
 a
 
surrounding
 county.
 

 
Map
 1
 illustrates
 the
 distribution
 of
 last
 permanent
 address
 within
 the
 Knoxville
 City
 
Limits.
 The
 highest
 concentration
 of
 clients
 had
 a
 last
 permanent
 address
 located
 in
 37917
 
and
 37915.
 Please
 note
 that
 some
 zip
 codes
 may
 only
 partially
 fall
 within
 the
 city
 of
 
Knoxville
 and
 are
 therefore
 included
 in
 Knoxville.
 
 

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Map
 1:
 Distribution
 of
 Clients
 in
 Knoxville
 by
 Zip
 Code
 of
 Last
 Permanent
 Address
 

 

 

 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 33

 

Map
 2
 illustrates
 the
 distribution
 of
 clients
 by
 zip
 code
 of
 last
 permanent
 address
 within
 
Knox
 County.
 
 Sixty
 percent
 of
 clients
 had
 a
 zip
 code
 within
 the
 Knox
 County
 limits.
 
 
 

Map
 2:
 Distribution
 of
 Clients
 in
 Knoxville-­‐Knox
 County
 by
 Last
 Permanent
 Address
 

 

 

 

 

 

 

 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 34

 

Map
 3
 illustrates
 the
 distribution
 of
 clients
 by
 last
 permanent
 address
 in
 Knox
 County
 and
 
the
 surrounding
 8
 counties9.
 Eighty
 percent
 of
 clients
 had
 a
 last
 permanent
 address
 within
 
Knoxville
 or
 the
 surrounding
 counties.
 Map
 4
 shows
 the
 distribution
 of
 clients
 across
 the
 
entire
 state
 of
 Tennessee.
 Please
 note
 the
 accompanying
 legend
 that
 indicates
 areas
 
shaded
 white
 represent
 only
 one
 client
 within
 that
 zip
 code.
 
 

Map
 3:
 Distribution
 of
 Clients
 in
 Knoxville
 and
 Surrounding
 8
 Counties
 by
 Last
 Permanent
 
Address
 

Map
 4:
 Distribution
 of
 Clients
 Across
 Tennessee
 by
 Last
 Permanent
 Address
 
 

 

9The
 surrounding
 8
 counties
 include:
 Anderson,
 Union,
 Grainger,
 Jefferson,
 Sevier,
 Blount,
 Roane,
 and
 

Loudon
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 35

 


 

 

 KnoxHMIS
 Data
 Quality
 
The
 data
 quality
 of
 information
 stored
 in
 KnoxHMIS
 is
 central
 to
 the
 functioning
 of
 the
 
system.
 With
 better
 data
 quality,
 agencies
 and
 case
 managers
 can
 more
 accurately
 
coordinate
 services
 for
 the
 homeless
 population.
 Data
 quality
 also
 affects
 the
 ability
 of
 
KnoxHMIS
 to
 report
 on
 a
 federal
 level
 by
 participating
 in
 the
 Annual
 Homeless
 Assessment
 
Report
 to
 Congress.
 Furthermore,
 data
 quality
 is
 also
 important
 to
 the
 Knoxville
 
community
 so
 that
 accurate
 and
 meaningful
 data
 is
 reported
 on
 the
 efficacy
 of
 programs
 
assisting
 the
 homeless
 population.
 

 
Chart
 22
 displays
 the
 percentage
 of
 HUD
 required
 data
 elements
 that
 are
 incomplete
 on
 a
 
monthly
 basis.
 Entry/exit
 data
 quality
 refers
 to
 the
 data
 quality
 of
 clients
 who
 are
 entered
 
into
 a
 specific
 program,
 whereas
 new
 client
 data
 quality
 refers
 to
 the
 data
 quality
 of
 clients
 
newly
 entered
 into
 the
 system.
 The
 clients
 captured
 under
 entry/exit
 data
 quality
 
represent
 those
 who
 are
 having
 more
 consistent
 contact
 with
 an
 agency.
 
 

 


 

Chart
 22:
 2011
 Average
 Data
 Quality:
 Percent
 of
 Fields
 Incomplete
 
 

 

 
 

 
 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 36

 

AHAR
 Participation
 
KnoxHMIS
 participated
 in
 the
 2010
 Annual
 Homeless
 Assessment
 Report
 to
 Congress
 
(AHAR).
 The
 AHAR
 reports
 on
 the
 number
 of
 homeless
 individuals
 and
 families
 across
 the
 
U.S.
 staying
 in
 emergency
 shelter,
 transitional
 housing,
 and
 permanent
 supportive
 
housing.
 
 This
 year,
 KnoxHMIS
 was
 able
 to
 provide
 information
 for
 emergency
 shelter,
 
transitional
 housing,
 and
 permanent
 supportive
 housing
 for
 both
 individuals
 and
 families.
 
As
 is
 evident
 in
 Table
 14,
 KnoxHMIS
 data
 is
 remarkably
 similar
 to
 the
 demographic
 
characteristics
 of
 the
 national
 data
 reported
 in
 the
 2010
 AHAR.
 

 

Table
 14:
 
 Comparison
 of
 2010
 AHAR
 and
 KnoxHMIS
 Data
 


  2010
 AHAR
 
  KnoxHMIS
 

Single
 Person
  63%
  60%
 

Male
  62%
  61%
 

African
 American
  37%
  29%
 

Individuals
 with
 a
 Disability
  37%
  24%
 

Under
 18
 years
 of
 age
  22%
  16%
 

Chronically
 Homeless
  20%
  21%
 

Veteran
  13%
  10%
 


 

 

Director’s
 Commentary
 
 


 

  Since
 November
 2004,
 more
 than
 27,000
 unique
 individuals
 have
 sought
 services
 

for
 current
 or
 imminent
 homelessness
 from
 homeless
 service
 providers
 in
 Knoxville
 and
 
Knox
 County.
 This
 year’s
 KnoxHMIS
 Annual
 Report
 provides
 a
 highly
 detailed
 examination
 
of
 those
 7,320
 individuals
 and
 family
 members
 who
 have
 sought
 services
 during
 2011.
 
The
 purpose
 of
 this
 Director’s
 Commentary
 is
 to
 offer
 context
 and
 perspective
 on
 the
 
wealth
 of
 data
 on
 the
 people
 in
 poverty
 presented
 here.
 The
 magnitude,
 scope,
 and
 
complexity
 of
 homelessness
 are
 the
 dominant
 themes
 of
 this
 report.
 
 

  It
 is
 commonly
 believed
 that
 the
 primary
 reasons
 for
 homelessness
 are
 drug
 and
 
alcohol
 abuse
 and
 mental
 illness.
 In
 an
 article
 entitled
 The
 Ecology
 of
 Homelessness,
 Dr.
 
Roger
 Nooe
 and
 I
 described
 how
 homelessness
 is
 best
 understood
 as
 a
 phenomenon
 
resulting
 from
 a
 complex
 interaction
 of
 individual
 factors,
 structural
 and
 economic
 forces,
 
and
 environmental
 circumstances.
 
 Evidence
 of
 this
 interactive
 effect
 is
 found
 in
 this
 
present
 report.
 
 For
 women,
 the
 dominant
 self-­‐reported
 reasons
 for
 homelessness
 are
 
poverty
 (no
 affordable
 housing,
 loss
 of
 job,
 underemployment/low
 income)
 and
 violence
 
(specifically
 domestic
 violence).
 Combined,
 these
 factors
 account
 for
 45
 percent
 of
 self-­‐
reported
 reasons
 for
 homelessness
 among
 female
 active
 clients
 in
 the
 past
 year.
 
 For
 men,
 
those
 four
 factors
 account
 for
 47
 percent
 of
 the
 self-­‐reported
 reasons
 for
 homelessness.
 
 
As
 described
 in
 the
 report,
 it
 may
 be
 easier
 for
 individuals
 to
 both
 self-­‐recognize
 and
 
report
 economic
 reasons
 than
 personal
 or
 familial
 problems
 associated
 with
 
homelessness.
 
 Case
 managers’
 assessments
 indicate
 that
 24
 percent
 of
 active
 clients
 have
 
a
 HUD
 recognized
 disability.
 
 Taken
 together,
 these
 two
 sets
 of
 facts
 support
 the
 national
 
research
 perspective
 that
 homelessness
 is
 most
 frequently
 an
 interplay
 of
 individual
 and
 
structural/economic
 factors.
 
 
 

  Contrary
 to
 the
 often-­‐stated
 belief
 that
 homeless
 individuals
 come
 to
 Knoxville
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 37

 

from
 elsewhere,
 our
 data
 maps
 demonstrate
 that
 a
 majority
 (60
 percent)
 are
 from
 Knox
 
County
 and
 the
 vast
 majority
 (80
 percent)
 are
 from
 Knox
 County
 and
 the
 surrounding
 
eight
 counties.
 Further,
 it
 is
 important
 to
 point
 out
 that
 the
 demographic
 profile
 of
 the
 
population
 of
 people
 experiencing
 homelessness
 in
 Knoxville
 and
 Knox
 County
 is
 
strikingly
 reflective
 of
 national
 data
 published
 in
 the
 HUD
 Annual
 Homeless
 Assessment
 
Report
 to
 Congress.
 

  This
 year,
 a
 new
 metric
 was
 addded
 to
 the
 report
 to
 show
 the
 average
 lengths
 of
 
stay
 for
 individuals
 and
 families
 in
 transitional
 and
 emergency
 housing.
 This
 metric
 will
 be
 
included
 in
 forthcoming
 reports
 to
 show
 the
 change
 over
 time
 in
 utilization
 of
 these
 
programs.
 In
 addition,
 KnoxHMIS
 data
 show
 that
 3,412
 individuals
 have
 been
 placed
 in
 
housing
 since
 July
 of
 2008.
 We
 applaud
 the
 efforts
 of
 the
 case
 managers
 who
 have
 devoted
 
their
 time
 and
 energy
 to
 alleviating
 homelessness
 in
 our
 community.
 
 

  The
 KnoxHMIS
 Annual
 report
 would
 not
 be
 possible
 without
 the
 ongoing
 data
 
collection
 efforts
 of
 131
 licensed
 users
 in
 our
 14
 partner
 agencies
 and
 their
 dedicated
 
directors.
 
 We
 greatly
 appreciate
 their
 work
 to
 serve
 the
 individuals
 and
 families
 who
 are
 
homeless
 in
 our
 area
 and
 to
 document
 their
 endeavors
 in
 this
 data
 system.
 
 We
 also
 offer
 
our
 thanks
 to
 the
 all
 too
 numerous
 individuals
 and
 families
 experiencing
 homelessness
 
who
 gave
 their
 permission
 to
 have
 their
 information
 entered
 into
 KnoxHMIS.
 
 The
 
resulting
 data
 enables
 us
 to
 serve
 the
 community
 by
 providing
 critical
 information
 to
 our
 
community,
 the
 partner
 agencies,
 the
 City
 of
 Knoxville,
 Knox
 County,
 and
 to
 HUD.
 
 The
 
resulting
 information
 is
 critical
 to
 reducing
 duplication
 of
 services
 and
 focusing
 the
 efforts
 
to
 address
 the
 multiple
 needs
 of
 persons
 experiencing
 homelessness
 in
 the
 community.

  This
 collaborative
 report
 between
 the
 Knoxville-­‐Knox
 County
 Homeless
 Coalition
 
and
 KnoxHMIS
 is
 the
 product
 of
 the
 combined
 efforts
 of
 the
 KnoxHMIS
 team
 including
 
Deidre
 Ford,
 Don
 Kenworthy,
 Mark
 Steel,
 Stacia
 West,
 and
 our
 MSSW
 interns
 Steven
 
Stothard
 and
 Jayme
 Hogan.
 
 Stacia,
 Jayme,
 and
 Steven
 put
 in
 countless
 hours
 running
 
numerous
 data
 analysis
 procedures
 necessary
 to
 produce
 this
 report.
 
 
 Well
 done.
 

 
David
 A.
 Patterson,
 Ph.D.
 
 
Director,
 KnoxHMIS
 

 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 38

 

KKCHC
 2012
 Biennial
 Study
 

Since
  its
  formation
  in
  November
  of
  1985,
  the
  Knoxville-­‐Knox
  County
  Homeless
 
Coalition
  has
  sponsored
  studies
  designed
  to
  determine
  the
  extent
  of
  homelessness
  in
 
Knoxville-­‐Knox
 County.
 The
 initial
 study
 was
 conducted
 in
 February
 1986,
 and
 follow-­‐up
 
surveys
  and/or
  enumerations
  have
  been
  completed
  every
  two
  years
  thereafter
  (1988,
 
1990,
  1992,
  1994,
  1996,
  1998,
  2000,
  2002,
  2004,
  2006,
  2008
  and
  2010).
  The
  Coalition
 
sponsored
  a
  small
  study
  in
  July
  1987
  examining
  the
  duration
  of
  homelessness.
  The
 
Community
  Action
  Committee
  (CAC)
  sponsored
  a
  survey
  in
  May
  1988
  as
  part
  of
  a
  state-­‐
wide
 study,
 the
 state
 effort
 was
 not
 published.
 


 
Design
 

The
  current
  study
  was
  conducted
  in
  January
  2012.
  It
  included
  interviews
  with
  a
 
sample
  of
  persons
  in
  shelters
  and
  outside
  locations
  during
  an
  evening/early
  morning
 
period.
 Past
 studies
 included
 an
 enumeration
 based
 on
 shelter
 census
 during
 the
 month
 
of
  February.
  However,
  in
  2012
  the
  shelter
  census
  was
  dropped
  and
  HMIS
  data
  were
 
used.
 The
 shelter
 sites
 included
 The
 Salvation
 Army,
 Knoxville
 Area
 Rescue
 Ministries,
 the
 
Family
  Crisis
  Center,
  Serenity
  Shelter,
  the
  YWCA,
  AGAPE,
  E.M.
  Jellinek
  Center,
  Transitional
 
Living,
  Steps
  House,
  Family
  Promise,
  and
  Catholic
  Charities.
  Outside
  locations
  included
 
various
 camps
 as
 well
 as
 Lost
 Sheep
 Ministries.
 

The
  questionnaires
  used
  in
  studies
  over
  the
  past
  twenty-­‐six
 
  years
  contained
 
many
 of
 the
 same
 questions.
 However,
 modifications
 were
 made
 in
 the
 questionnaire
 as
 
researchers
 and
 interviewers
 identified
 aspects
 that
 needed
 inclusion
 or
 elaboration.
 For
 
example,
  specific
  questions
  about
  family
  background,
  mental
  health,
  health,
  problem
 
solving
 abilities,
 and
 more
 recently
 questions
 about
 substance
 abuse,
 domestic
 violence,
 
foster
 care,
 and
 experiences
 with
 social
 service
 agencies
 were
 added.
 In
 2010,
 the
 study
 
added
 questions
 about
 the
 use
 of
 emergency
 rooms,
 hospitalization,
 and
 incarceration
 to
 
examine
 the
 cost
 of
 homelessness.
 Questionnaires
 used
 in
 all
 studies
 contained
 the
 same
 
questions
  about
  causes
  of
  homelessness,
  reasons
  for
  coming
  to
  Knox
  County,
 
employment
 history,
 mental
 health
 history,
 and
 demographics.
 
 

Forty-­‐three
  persons
  served
  as
  interviewers.
  Many
  had
  participated
  in
  previous
 
studies,
 however,
 a
 training
 session
 was
 conducted
 for
 all
 interviewers
 during
 the
 week
 
prior
 to
 the
 study.
 The
 session
 included
 a
 review
 of
 the
 questionnaire,
 instructions
 about
 
the
  study,
  guidelines
  for
  research
  interviewing,
  and
  answering
  questions
  asked
  by
  the
 
interviewers.
 All
 interviewers
 signed
 a
 pledge
 to
 maintain
 confidentiality.
 
 
 

Outside
  feeding
  programs
  were
  visited
  on
  Wednesday
  evening,
  all
  shelters
  on
 
Thursday
 evening
 and
 early
 morning
 interviews
 were
 conducted
 on
 Friday,
 
 the
 evening
 
 
interviews
  were
  started
  at
  approximately
  6:30
  p.m.
  This
  time
  was
  selected
  to
  allow
 
shelters
  to
  have
  completed
  check-­‐in
  and
  to
  have
  finished
  the
  evening
  meal
  before
 
interviewers
  arrived.
  The
  project
  director
  had
  contacted
  the
  shelters
  in
  advance
  to
 
determine
  average
  numbers
  of
  individuals
  staying
  at
  the
  respective
  shelters
  so
  that
  the
 
number
  of
  interviews
  and
  team
  size
  could
  be
  planned.
  Each
  shelter
  designated
  a
  staff
 
member
 as
 contact
 person
 to
 assist
 with
 sampling
 and
 to
 help
 minimize
 disruption
 of
 the
 
evening
  routine.
  On
  the
  evening
  prior
  to
  the
  shelter
  visit,
  six
  interviewers
  visited
  the
 
Blackstock
  area
  during
  the
  weekly
  Lost
  Sheep
  Ministry
  feeding
  program.
  In
  the
  morning
 
following
 the
 shelter
 interviews,
 eight
 interviewers
 visited
 areas
 where
 persons
 staying
 
in
  outdoor
  locations
  were
  known
  to
  congregate.
  These
  locations
  included
  Western
 
Avenue,
 Second
 Creek,
 Cumberland
 Avenue,
 interstate
 bridges,
 and
 individual
 “camps”.
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 39

 

A
  total
  of
  two
  hundred
  and
  thirty-­‐six
  (236)
  interviews
  were
  completed.
  Women
 
were
  slightly
  oversampled.
 
  All
  respondents
  were
  paid
  $3.00
  and
  were
  advised
  of
  their
 
right
 not
 to
 participate
 and
 of
 their
 right
 to
 refuse
 to
 answer
 any
 question.
 Women
 were
 
slightly
 oversampled.
 
 

The
  research
  design
  has
  been
  used
  in
  previous
  studies,
  however,
  there
  are
 
constraints.
 The
 mobility
 of
 the
 homeless
 population
 and
 difficulties
 in
 locating
 subjects
 
make
 sampling
 difficult.
 Even
 more
 basic
 is
 the
 question
 of
 definition,
 i.e.,
 who
 is
 defined
 
as
 homeless?
 Persons
 living
 in
 shacks,
 SROs
 or
 residing
 sporadically
 with
 friends,
 who
 in
 
reality
  could
  be
  defined
  as
  homeless,
  are
  excluded
  by
  a
  definition
  which
  focuses
  on
 
individuals
 who
 are
 staying
 in
 shelters
 or
 outside
 locations.
 In
 spite
 of
 these
 constraints,
 
the
  sample
  of
  shelters
  and
  outside
  locations
  was
  viewed
  as
  representative
  of
  the
  area
 
homeless
 population.
 

In
  addition
  to
  the
  data
  available
  through
  this
  sample,
  the
  accompanying
  2011
 
study
  from
  Knoxville
  Homeless
  Management
  Information
  System
  (KnoxHMIS)
  should
  be
 
used
  for
  comparison.
  In
  examining
  the
  information
  provided
  by
  the
  this
  combined
 
KnoxHMIS
 and
 Coalition,
 the
 reader
 should
 be
 aware
 that
 the
 KnoxHMIS
 data
 is
 based
 on
 
service
  users,
  for
  example
  "in
  2011,
  7,320
  individuals
  sought
  services."
 
  In
  contrast
  the
 
coalition
 study
 was
 a
 "point
 in
 time"
 sample,
 the
 sample
 was
 drawn
 at
 agencies
 and
 also
 
persons
  in
  outside
  locations
  who
  may
  or
  may
  not
  have
  been
  service
  users.
  The
  reader
 
should
  also
  note
  that
  the
  data
  sources
  are
  not
  asking
  the
  same
  questions,
  resulting
  in
 
variation.
 Thus,
 the
 findings
 while
 not
 identical
 can
 be
 viewed
 as
 complimentary.
 


 
Demographics
 

It
  should
  be
  noted
  that
  the
  2012
  data
  is
  based
  on
  the
  sample
  whereas
  the
  2010
 
data
  for
  gender
  and
  race
  is
  based
  on
  the
  shelter
  census.
  The
  demographics
  for
  the
 
 
studies
  were
  based
  on
  the
  interview
  sample.
  Table
  1
  offers
  comparisons
  of
  2012
  and
 
2010
  demographics.
  The
  mean
  age,
  gender,
  race,
  marital
  status,
  education
  and
  military
 
service
 represent
 adult
 population
 characteristics.
 

Comparison
  of
  the
  data
  for
  2012
  and
  2010
  indicated
  similarities,
  including
  the
 
number
 of
 women
 and
 minorities.
 The
 findings
 on
 race
 were
 eighty-­‐one
 percent
 white
 in
 
this
 study.
 The
 percentage
 of
 children
 has
 decreased
 from
 seven
 percent
 in
 the
 previous
 
study
 to
 zero
 in
 2012.
 

Homelessness in Knoxville and Knox County, Tennessee 2011-2012 40