| Name | Anna |
|---|---|
| Last Name | Protano-Biggs |
| Home Address | 472 West MLK Blvd. 472 West MLK Blvd. Chattanooga, TN 37402 United States |
| Organization Name | AIM Center, Inc. |
| Describe Your Role In The Organization | President and CEO |
| Organization Address | 472 West MLK Blvd. 472 West MLK Blvd. Chattanooga, TN 37402 United States |
| Website | https://www.aimcenterinc.org |
| Best Phone Number To Reach You | (423) 702-8002 |
| Alternate Phone Number | (423) 290-2536 |
| Email Address | annaprotanobiggs@aimcenterinc.org |
| Alternate Email Address | a.protanobiggs@gmail.com |
| Please Describe Your Project In Detail | The AIM Center is licensed by the State of Tennessee as a Psychosocial Rehabilitation facility to serve adults who have a verifiable mental health diagnosis, ages 18 and older. Persons who attend the AIM Center are identified as members, not patients or clients. Additionally, AIM is the only Tennessee entity accredited by Clubhouse International. AIM offers employment, education, housing, socialization, and wellness opportunities for adults living with serious mental illness focusing on recovery for a member based upon his/her individual goals. Staff and members work together to help members build skills with an ultimate goal of community integration or re-integration. AIM’s Clubhouse model provides a restorative environment for persons 18 years of age and older who are diagnosed with a mental illness. It is a place of acceptance, belonging and inclusivity and an antidote to isolation. It is a safe, open and welcoming environment where people can be themselves without fear of being judged for who they are, who they are not, or who they are yet to become. AIM Members have the opportunity to regain their life after diagnosis while they learn how to successfully manage living with a mental illness. The Clubhouse offers membership, a chance to belong. For some it may be the first time they have ever been invited to join a group which supports their lives and believes in their future. The Clubhouse model of psychosocial rehabilitation offers adults of all ages, wherever they are in their journey, an opportunity to find their place. A place where they will not only be honored and accepted for who they are, but also a place where their strengths can be recognized, and their interests are supported and safe to pursue. Opportunities to increase social and vocational skills, build relationships, increase better overall mental and physical health and obtain education, employment and housing are found at AIM. Seventy-eight percent (78%) of our membership have diagnoses of chronic mental health conditions: schizophrenia, schizoaffective disorder, bipolar disorder and/or chronic depression. Many of our members also have significant physical health diagnoses: obesity, type 2 diabetes, hypertension, heart disease, and lung disorders. In a 2019 Chattanooga-Hamilton County Health Department report regarding health disparities between persons of color and non-color, it was stated “When compared to white people in Hamilton County, black people are: 2.5X more likely to die from diabetes, 2X more likely to die from kidney disease, 35% more likely to die from stroke, and 30% more likely to die from heart disease”. Fast forward to the present in which we learn from the ONE Chattanooga Strategic Plan that “Black residents are 4 times as likely to die from hypertension and hypertensive renal disease than whites in Hamilton County“. We no longer have time to just study the health problems of our Chattanooga residents. We must act on the knowledge of studies now to effect the results of disparities. Pre-COVID persons of color constituted 52% of AIM’s active membership. By zip code, we know the majority of these members lived in neighborhoods hit the hardest by the pandemic. Additionally substance use also occurs within a large portion of those we serve. Only a few of our members have ventured past a high school experience. Most use public transportation if they live outside a group home. Over 90% of our members live below the federal poverty threshold. From this perspective, AIM submits this proposal to the City of Chattanooga in which we offer direct assistance to members and prospective members so they will “emerge stronger from the COVID-19 pandemic”. AIM Center will create and fill three new staff positions to assist individuals in our community with mental illness. These positions will mitigate and directly respond to effects of the COVID-19 public health emergency. The staff selected to fill two of the three positions will train to become SOAR Specialists. SOAR is a SAMHSA (Substance Abuse and Mental Health Services Administration) evidence-based program that “increases access to Social Security disability benefits for eligible children and adults who are experiencing or at risk of homelessness and have a serious mental illness, medical impairment, and/or co-occurring substance use disorder”. Currently AIM Center is only able to open its doors to members who have TennCare insurance. Existing members enrolled in Medicare or Behavioral Health Safety Net (BHSN), or have no form of insurance participate under the Clubhouse philosophy of “once a member, always a member”. Presently these persons represent 25% of the active membership of AIM Center. However, this same population comprises 217 individuals or 70% of all the total 308 new referrals made to AIM in the last eight months. Adding SOAR-trained staff to AIM would enable us to start working with individuals with a mental illness referred to us that do not have TennCare insurance. In the State of Tennessee, SOAR Specialists succeed in helping 90% of the individuals they work with qualify for Social Security (SS) benefits. Nationally 60% of SOAR assisted-applications receive approval in comparison to only 30.8% of applications without SOAR assistance. The significant difference within Tennessee is attributable to the technical assistance offered by Tennessee Department of Mental Health and Substance Abuse Services to SOAR Specialist across the state, and the high level of need of Tennesseans with whom SOAR Specialists work. Today, 691 individuals have reported to 58 Hamilton County service providers that they have a mental health disorder and no income. These providers input their data into the Coordinated Entry Assessment System from which this information obtained. Individuals with mental illness and no income, and often with no place to call home are among the top utilizers of community services. Many of these individuals cycle between the mental health crisis walk-in center, Moccasin Bend Mental Health Institute, hospital emergency departments, contacts with law enforcement and the county jail, and various providers who serve the homeless population. Imagine instead a homeless person with a mental illness who works with a SOAR Specialist and obtains SS benefits and TennCare insurance. From there an individual has a strong base to access housing and increase their housing stability. The health of Chattanoogans will improve as they are able to access insurance and benefits and increase their use of mental health and addiction services. Both mental and physical health providers will be able to back bill for up to three (3) months of their services once benefits are awarded, thereby helping the local economy. This will reduce participants use of public resources, reduce the cost to taxpayers, and increase public safety, all the while helping individuals stabilize and begin a positive integration into our community. The need to start people on a path to self-sufficiency is critical. SOAR initiatives across the country work to reduce the influence of implicit bias and to encourage diversity, equity and inclusion (DEI) when deciding which potential individuals to work with. In its continual learning cycle, AIM works to strengthen our engagement practices. AIM recently took on specialized work on Safe Spaces/Places in which members and staff offered input on their struggles and their needs to be safe, seen, heard and respected while at the Clubhouse. As an extended part of their role, SOAR Specialists stay connected to individuals they assist in applying for SS benefits. They help individuals obtain other needed services and treatments such as housing, physical and mental health care, and other support services such as food and clothing. We propose that each SOAR Specialist will process 27-30 clients a year with an initial 80% success rate for initial approval of applications approved within three to six months. We believe our specialists can assist 140 Chattanoogans to apply for SS benefits over a 30 month period. The third position for which this proposal is submitted is a Wellness Coach. This staff member will help AIM Center members address chronic physical illnesses linked to behavioral health issues identified as diabetes, heart disease, obesity and the use of tobacco products that can lead to major health consequences. In his article Metabolic Syndrone and Mental Illness published in the American Journal of Managed Care, Vol. 13, No. 7, John W. Newcomer, M.D. states: "Patients with mental illnesses such as schizophrenia and bipolar disorder have an increased prevalence of metabolic syndrome and its components, risk factors for cardiovascular disease and type 2 diabetes. Although the prevalence of obesity and other risk factors such as hyperglycemia are increasing in the general population, patients with major mental illnesses have an increased prevalence of overweight and obesity, hyperglycemia, dyslipidemia, hypertension, and smoking, and substantially greater mortality, compared with the general population. Persons with major mental disorders lose 25 to 30 years of potential life in comparison with the general population, primarily due to premature cardiovascular mortality." It is commonly accepted that COVID-19 has had a negative impact on most person’s mental health. The toll on physical health continues to be studied; however, for persons living at or below the poverty line, circumstances and effects have been elevated. Chattanooga neighborhoods which already struggled with health and safety issues saw those issues exacerbate due to COVID-19. Medical offices changed their practices of seeing their patients. Many offered virtual-only services which unfortunately caused accessibility problems for members. Access to fresh food became more restrictive for some while the availability of packaged foods became more prevalent with often an unhealthy impact. Weight gain occurred due to diets and lack of exercise as people stayed inside so as not to contract the virus. AIM currently offers wellness opportunities to its members consisting of healthy eating topics, wellness walks, stretching and relaxation techniques. The health needs of our members make us realize we need to take a radically different approach. We need a health and/or wellness trained staff member to work with our members in individual and group setting tackling topics on obesity, heart disease, diabetes, hypertension and smoking. Utilizing formal curriculums, a wellness coach would lead Chronic Disease Self- Management, Diabetes Self-Management, and Smoking Cessation programs. Formal health assessments would occur from which members would establish their individualized health goals. Positions funded by the Chattanooga Relief and Recovery fund will “facilitate access to resources that improve health outcomes, including services that connect residents with health care resources and public assistance programs and build healthier environments”. We estimate being able to engage 150 members in focused wellness activities/groups which will result in their achieving better health outcomes. |
| Please explain how your project meets the requirements of the American Rescue Plan | The American Rescue Plan seeks to offer stability and improvement to the lives of those who suffered/are suffering economic and health impacts during the pandemic. The AIM Center offers support for individuals with disabilities and older adults. AIM Center members of color and their support systems faced higher infection rates, hospitalizations and death as well as higher rates of unemployment and lack of the basic necessities such as food and housing. Having helped them obtain food, medications, patch-up rental needs, and their most immediate medical issues, it is time now to assist, moving away from crisis help to sustained recovery. Helping an individual with serious mental health issues and homeless or at-risk for homelessness obtain SS benefits is a "once in a lifetime game changer". Individuals and our community will feel immediate effects of someone gaining income, and health insurance. Once a person obtains TennCare, they can be welcomed into AIM where they will be supported to address their education and employment goals. Those whose mental and physical health issues were worsened in the pandemic will be supported to address those issues by participating in AIM’s recovery programming. AIM staff will work with their medical providers to help our members understand their disease and promote a culture of trust with the health industry. Offering a formal wellness program that addresses health concerns tied to the root causes of health issues associated with mental illness, we know our members will accept the challenge to learn healthier habits thereby helping themselves overcome issues enhanced by the pandemic. Once we help our membership move out of the public health crisis and into health stability, we can then begin to have serious discussions on what it would take for them to seek employment or educational opportunities. |
| Where would your project take place? | At the AIM Center and in the Community |
| How much will your project cost in total? | 228328 |
| Do you have any matching funding sources from other local governments, private entities, non-profits, or philanthropic entities for your project? | No |
| Please describe the source and list amounts of any other funding. | |
| What portion of the project are you asking the city to fund? | |
| If funded, when would your project start? | July 1, 2022 |
| How long would your project take to complete? | 30 months. The project would be complete at the end of 2024 when the ONE Chattanooga Relief and Recovery funding is fully expended. |
| What milestones would you use to measure your project’s progress? | SOAR # of SOAR applications completed # of people awarded SSI/SSDI benefits, as a result of SOAR application # of people who obtained TennCare benefits Wellness # of people who had a physical health assessment # of people who set health goals # of people who completed health course # of people who report an improvement in their health These milestones are specific to this request. Progress made toward individual goals are monitored on a constant basis. |
| How would you ensure accountability and transparency throughout the project lifecycle? | To achieve our desired outcomes SOAR Specialists will utilize the SOAR Framework for SSI/SSDI applications using an Outcome Plan. We will utilize the SOAR national On Line Application Tracking System (OAT) in which we can 1) track the number of applications submitted, 2) assess the use of SOAR critical components, 3) review SSI/SSDI application approval rates and reasons for denial, 4) measure the timeframe to complete applications, 5) calculate retroactive payment and monthly benefits amounts. Continual status updates with individuals will keep them fully informed of where they are in the benefits process. Each individual we work with will be asked to sign a Release of Information that will allow us to also give status updates to other community entities who may also be working with individuals. The AIM Center AWARDS electronic health record system will be our repository of information on all members. Working with a recovery coach or the wellness coach, members will create an Individualized Recovery Plan (IRP) in which goals will be established and action steps created to help assist in their accomplishment. Member progress toward their goals is documented in Weekly Progress Summaries written with members present. Benchmarks within group work will established for the purpose of further keeping members on track. |
| If successful, how would your project benefit the community? | Two areas outlined in this proposal will help people: increase a person’s economic stability once awarded Social Security benefits; become more secure within their neighborhoods; improve racial and socioeconomic disparities; improve public health outcomes by improving the mental and physical health of Chattanoogans; move into or toward housing with AIM support as affordable housing slots open-up or are created; gain greater ability to understand and manage a chronic disease and learn healthier lifestyles. The environment offered by the AIM Center Clubhouse and its staff can help people gain stability in their lives which leads to them to be able to move out of loneliness into relationship, out of isolation into socialization, out of poor health into significant health improvement; all which opens a path to wellness, education, and employment. We feel there is no coincidence that today's six main social determinants of health so closely align with the 70+ year old Clubhouse model: socioeconomic status, education, neighborhood and physical environment, employment and social support networks as well as access to health care. Every day at AIM Clubhouse we work with members to help them become more self-sufficient. Now more than ever we feel a sense of urgency that NOW is the time to help persons with mental illness move past the effects the COVID pandemic. We choose not to leave vulnerable populations behind or unattended but rather have them know their self-worth and abilities to contribute to community. |
| How will you attract community buy-in for your project? | The need for and the benefit of dedicated fulltime SOAR-trained workers is well known within local social services and health agencies. We expect we would receive more referrals than there will be bandwidth to process given that we would first use referrals from the Coordinated Entry System. We will market our formalized wellness services to community mental health center agencies, Federally Qualified Health Centers, and primary care physician offices. We believe these health providers will refer their patients with mental illness to AIM when they understand that our recovery programing has a strong wellness component. Backed by AIM’s 32 years of service to Chattanooga, our commitment to help adults with mental illness continues as our long-term investment to the City and to the lives we serve. We believe that we will be able to sustain the Wellness Coach after recovery funds are exhausted. Our current budget prohibits hiring additional staff as we are still down significant pre-pandemic levels of revenue. We believe the outcomes achieved by the SOAR positions will position AIM to secure community funding to keep SOAR in place. We pledge to look at every alternate funding source in the future, none of which are available at this time. |
| Name | Wendy Winters |
| Contact Information | wwinters@homlesscoalition.org |
| Name | Neru Gobin |
| Contact Information | neru.gobin@tn.gov |
| Name | Cassie O'Neal |
| Contact Information | cnoneill@chattanooga.gov |
| Name | Jimmy Catlett, Johnson MHC/Volunteer Behavioral Health |
| Contact Information | jcatlett@vbhcs.org |
| Name | Gayle Ladato, Helen Ross McNabb |
| Contact Information | gayle.lodato@mcnabb.org |
| Name | Nicole Bates, Mental Health Cooperative |
| Contact Information | |
| Name | FQHC's: CEMPA, Erlanger, Memorial, Homeless Health Care |
| Contact Information | can be supplied |
| Is there anything else you would like us to know about your project? | We strongly believe that the AIM Center’s Clubhouse model is the right environment in which people can succeed in changing and bettering their lives. We believe persons with serious and persistent mental health issues can have lives they value and can make contributions to our community. |