Overall, these residents reported positive housing situations; this finding is important, given that stable housing is a crucial platform for delivering other services. Still, the focus group participants were struggling with economic and health-related challenges that likely necessitate changes in service delivery strategies.
Housing as a platform. No participants discussed concerns about having stable and sufficient housing. Some mentioned wanting a bigger apartment or additional amenities, but overall, they felt their housing was better since they had relocated through HOPE VI. The biggest and most often-raised concern relating to housing was the struggle to pay utility bills. Even for those receiving utility assistance, their monthly bills often exceeded the subsidy amount. This is consistent with findings from other studies of HOPE VI relocatees and represents a fundamental challenge for users of the HCV program—particularly for former public housing residents who have not previously paid utilities separately. Voucher holders receive a utility allowance as part of their housing assistance, but clearly these allowances do not keep pace with costs.
Current benefit receipt. Most participants were receiving HCVs, and a few currently live in public housing. Most were not currently receiving cash assistance, other than SNAP. A few mentioned cash benefits and SSI or SSDI (for their children). The older participants relied almost entirely on Social Security.
When asked how they make ends meet, participants reported borrowing money from family and a few did periodic and informal jobs, such as doing hair or some hourly work cleaning. The few currently working did so as temporary warehouse or retail workers, and the pay was not sufficient to fully support their households. Some were concerned that working would reduce the amount of the benefits they receive, particularly for those receiving disability.
Seniors and children seemed to have health insurance and access to healthcare, but most of the other adults without significant health problems or disabilities did not have health insurance. Several people said they relied on public clinics that had bad service, where they often waited hours for appointments. Others described using emergency room care for non-urgent illnesses. When asked how they dealt with the sizeable medical bills from emergency room care, most reported that they merely threw them away.
Current case management. Focus group participants were recruited out of a pool of relocatees currently receiving Memphis HOPE case management services. The vision for creating a separate community-funded entity of Memphis HOPE was that a more comprehensive system could be created and sustained over time, but this model is difficult to sustain. The initial funding for both Lamar Terrace and Dixie Homes (a total of $7.2 million over five years) officially expired in 2011. Memphis HOPE continues to operate as the service provider for the Cleaborn Homes HOPE VI caseload, as well as for some of the remaining public housing residents (funded by HUD's ROSS program). While some of the Lamar Terrace and Dixie Homes residents continue receiving services beyond the grants' official end dates, the focus groups suggest that these services are not intensive.
Participants' experience with case management suggests that their contact with case managers is currently infrequent and limited. A minority of focus group participants were able to identify specific assistance they had received from case managers, however, these accounts were limited and assistance varied, suggesting an absence of coordinated case management services.
Similarly, participants noted difficulties communicating with case managers. Many cited long waiting times between follow-up with case managers, regarding resources such as utility assistance and employment and child-related program opportunities. Several participants noted that these long waits and challenges communicating with the case managers were not problems until the last year or two; previously, they said that the case managers were more responsive and helpful. Many of the challenges participants shared suggest organizational constraints coupled with limited time and resources hinder case managers in providing comprehensive supportive services to meet residents' needs (including support navigating pathways to health care access). Further, these residents' experience suggests that they are not able to access the kinds of supportive services they need in their new communities.
Ongoing service and resource needs. Overwhelmingly, participants reported that their greatest need was employment. Utility assistance and health care coverage were also mentioned repeatedly as significant expenses. A few participants spoke specifically about the sizeable medical bills they incurred from using the emergency room as their only providers. The participants seemed realistic about their job expectations given their education and skills. (Most reported wanting warehouse and housecleaning positions, often because they could work alone.) Only a few people discussed a desire or need for more schooling or training.
Mental health. Each group discussed living with depression and anxiety. For some, mental health problems made it difficult to obtain or maintain employment. Others discussed the burden they feel of caring for family and struggling with depression.
My health is failing and I'm really struggling. I try to keep that smile up there, but behind that smile there's pain, there's pressure, there's depression. A whole lot is going on inside of me. Stressed out knowing you got a family to take care of and it's hard when you try to get from point A to point Z. I see my children doing well in school, and they are being there and doing what they're supposed to be doing, but me, they look at mom and think mom can't do anything for us. That's a hurtful thing. I split myself in half to take care of my mom (who just had a stroke) and take care of my children.
Transportation accessibility and costs. Few participants had their own cars, but only a few said they relied exclusively on public transportation. Many relied on family or friends, generally for a fee of $15–20 per trip. Several people added that, in addition to charging a fee, family and friends providing transportation asked them to purchase a few items while at the store. In those cases, the total cost for getting a ride to the store was easily $30. Though public housing developments were and are located in the central part of the city, the low density of Memphis means that shopping is not convenient via a limited bus system. The exception to this problem is participants who currently live in the Frayser neighborhood of North Memphis. While Frayser is poor overall, a number of large grocery stores and occupied strip malls provide many retail options.
Changes since relocation from public housing. One concern that prompted HHS to undertake this project was that public housing relocation moved residents to areas without community service providers. However, participants in our groups reported that the proximity to services was not a problem for them (Many services had not been nearby even when they were in the centrally located public housing because of transportation accessibility). They saw lack of follow up contact from case managers was the true frustration; as noted above, most had received services through Memphis HOPE for some period after they relocated, but those services have now been cut back. Memphis HOPE staff are not currently able to do as much outreach to clients now dispersed across Memphis communities, especially given that high-touch case management is not currently funded by MHA or any other funding source.
Views on returning to redeveloped public housing. Almost all participants who had HCVs said they were not interested in returning to the redeveloped public housing. While many are struggling with paying utilities, they are happy with their new housing and neighborhoods. Several mentioned concerns that the new developments would quickly return to the level of crime that existed at the old development. However, many focus group participants still living in public housing are interested in moving to one of the newer developments. There seemed to be some confusion about the criteria and cost to live at the new developments. For example, though most in the group were unemployed and only a few were receiving disability, no one mentioned the work requirement as a possible barrier to moving back—which would likely affect most of them. Also, the consensus in two of the three groups was that public housing at the new developments cost about $2,000 per month—which is not the case.
Relocatees learning from their peers. Over the discussion, participants learned about available resources from one another (e.g., caregiving programs, youth services, and toy drives for Christmas). When asked how they normally discover available services and resources, participants answered that they often learn about these resources through friends and acquaintances. At the end of each focus group, participants either exchanged more information about services or shared phone numbers. Several participants informed the focus group leaders that the conversations were useful and enjoyable. Given this high degree of peer learning, MHA, Memphis HOPE, and other service agencies may consider convening and facilitating similar discussion in the future, with the goal of allowing residents to share common challenges and solutions.
"Memphis Final Brief.pdf" (pdf, 717.21Kb)
"Appendix A-Focus Group Materials.pdf" (pdf, 174.61Kb)
"Appendix B-Maps.pdf" (pdf, 3.81Mb)