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Feeling defeated is an emotional experience universally held at different times in our lives. Recently, I was asked a vulnerable and honest question by a board member: "What is holding up the progress of us establishing a Medical Respite campus?" My initial response was, "Well, it's nuanced." Then, I went through the complexities of land acquisition, public support, stifled funding, etc. And, all that is true. They're each an issue and each deserves to be addressed holistically. I generally consider myself to be an optimist, confident that the reliance on data and research will move the needle forward. But today, I find myself fallible and struggling to maintain that optimism. Maybe my research methodology with an applied community approach is weighing too heavilyly on me. Perhaps it's the family I'm working to find support for— a couple who have lived in a trailer for quite some time. The wife, we'll call her Miranda, is on dialysis for 10 hours multiple days a week, and live on a fixed income of $900-odd dollars a month. Their current circumstances are insufficient for survival; but now that a new landlord has acquired the trailer park, he wants to evict them and jack up the price. If you've been paying attention to my work, you know our shelters are at max capacity and folks with medical illnesses quite literally have nowhere to go. Even if the shelters could accommodate this couple, it's highly likely she'd be turned away due to her susceptibility to contract an infection in a congregate living facility. The current administration announced on May 2 the "skinny budget" for HUD. It was a 43% reduction in all HUD services and an end to permanent supportive housing. Thankfully, it didn't get passed, but it gives you an indication of the federal landscape’s terrain. It is absolutely exhausting paying taxes into a system that doesn't serve its people. It's amazing to me that it's a "hot take" or "controversial" to want my tax dollars used for infrastructure and the betterment of our communities. Regardless of your political opinions or moral credence, what the launch of a Medical Respite campus to help the people of East Tennessee requires is money. It doesn't matter if it's federal, state, or private funds; it still requires that green. We've worked our hind ends off for the money we have in the bank. But ultimately, to stay around a 2.5 million dollar build (including the land purchase), we still need 20% down. As a person who had to clamor her way into the middle class, that $750,000 price tag (more, if you don't want to take out loans) feels damn near impossible. I hear regularly about how valuable our work is, yet we remain in a holding pattern. I'm no genius, but I'm no dummy either. We're making all the low-risk investments we can to propel ourselves forward. I'm taking all the partnership opportunities. I'm going after the limited grant opportunities that are left. I'm taking all coffee/tea/lunches with anyone willing to give up a dime for this work. The reality is, I'll continue to do so. I'm tired and fed up and exasperated; I'm sure that was easily gathered. But I'm not facing the reality of living on the street with open port access to receive dialysis. I launched Unity Housing in 2023, and together with our Board, we have been able to raise awareness and work toward a downpayment to purchase land to build a medical respite community. And while it was urgent before, it’s even more urgent now. Our family, friends, and neighbors are at risk. I need you to donate to help us reach our $750,000 goal so we can make that downpayment. Can you commit to making it a monthly donation? $25 a month equals $300 a year. I know this goal we’ve set for ourselves, and our community, might seem lofty and out of reach. I know that times are financially hard for all of us. But I also understand how powerful our community is when we come together. Anything is possible. So, what's the takeaway from this moment of raw honesty? It's that the frustration is real, the obstacles are significant, but the need is even greater. This isn't just about a building; it's about Miranda, it's about every individual whose health and dignity are compromised by a system that too often falls short. The fight for this Medical Respite campus, for a more just and compassionate community, continues – fueled by the unwavering belief that even when the path is daunting, the people we serve deserve nothing less than our relentless effort. And while optimism might flicker, the resolve to find that "green," to build that hope, and to change those realities, burns on. There’s a lot going on that can leave us feeling frustrated and helpless. And the obstacles ahead of us are significant. But I’m not giving up and neither should you. Making this vision of a medical respite facility a reality is something we can build together. Miranda needs us to do this work. So many in our community need us to do this work. Will you join me?

As part of our commitment to transparency and keeping you informed, we're launching this monthly blog to share updates on Unity Housing's progress, challenges, and vision for the future. This is our first entry, and I hope it provides valuable insight into our work and the road ahead. We are running an organization dedicated to filling a gap in our community that shouldn’t need to exist. It's a paradox, isn't it? Our healthcare system, regardless of payer, is something we all contribute to. Unpaid debts become charitable write-offs for non-profit hospitals. 49.2% of hospitals in the United States are registered as non-profits [1] Our regional system, Ballad Health, is no exception and operates as a non-profit through the Ballad Health Foundation [2]. It's infuriating that our nation's system intended to serve our most vulnerable still has such broad gaps in care. Our biggest project on the horizon is to build a Medical Respite campus to serve an elderly population. "Elderly" is considered those who are 55+, given the tragic reality that homelessness expedites mortality by 17.5 years on average [3]. Sadly, many of those experiencing homelessness are Veterans. These two populations are those who’ve already paid into the system, through a lifetime of contributions or dedicated service, and are disproportionately represented among those we aim to serve. Veterans comprise a staggering 13% of the homeless adult population [4], and older Americans are experiencing homelessness at an alarming rate [5]. It is devastating every time I see someone who appears to be my grandparent’s age accessing our emergency shelters; and it’s happening more and more. The frustration deepens knowing that once operational, research demonstrates a positive return on investment for Medical Respite programs [6]. It's a perpetual "rock and hard place" scenario. We know reimbursement is possible, potentially covering overhead, yet access requires being launched. This makes sense until grant funding is reliant on property ownership, and property ownership requires our current funding as a down payment. To work with a bank, we must retain that funding for a 20% down payment. Even with that, we have to make sure there's enough funds to provide direct care, reimbursement services, yet that also hinges on having patients. So, we remain an organization propelled by professional expertise and a deep-rooted cultural understanding of Appalachia, classically underfunded – a familiar story to many, I suspect. My dream is for us to become a Cinderella story. As an underdog since launch, our founding board – comprised of some of the most seasoned professionals in the region – set a course that we will steadfastly stay the course on. Medical Respite is what our community deserves; a crucial service gap in East Tennessee filled. While frustrating, this challenging reality is simply the realistic path to creating something meaningful. I have been studying Medical Respite for about three years now, from reimbursement rates and effectiveness to best practices, ROI, and required social services. If it's peer-reviewed, I've likely devoured it, much to the chagrin of my friends who can attest to my increasing obsession. I wake each day weighing the frustration of stagnation with the excitement of possibility. I've studied the gaps in our service system for individuals experiencing homelessness and I am excited, and ready, to do the hard work to gain public trust and forge bridges with key partners to achieve financial viability. Because, at the end of the day, I know what we need to make our community better. Once Medical Respite is established, I can't wait to start this process again, envisioning our next project: building something for our families experiencing homelessness, a day shelter, or a pet-friendly shelter – all critical programmatic deficits identified by the data. Can you imagine what we can accomplish as a community, through grassroots efforts, in one of the most volatile political landscapes in American history? How incredible would it be to act in our residents' best interests, despite governmental efforts to minimize services for our elderly and veterans? It may be Polly Anna-esque, but that's what I lean into. Every day I see folks wanting this problem solved, wanting our residents to have better. Instead of waiting for things to change, help us in providing direct and lasting care that has a direct impact on the community. Here's how you can get involved: Donate: Every dollar counts in getting us closer to purchasing our campus/location for medical respite. Your contributions will provide those essential startup costs for medical supplies, and our team. Here is our initial fundraising page for MR [INSERT LINK] Become a Board Member: CPAs, accountants, lawyers, physicians, nurses – check out our opportunities page [INSERT LINK] Join our Community Advisory Committee: Contribute on social media, volunteer at an event, take charge of events, fundraise - check out our opportunities page [INSERT LINK] Spread the Word: Share our story with your friends, family, and colleagues. Help us raise awareness about the need for Medical Respite in Johnson City and beyond! By sharing and getting the word out, that will enable us to create those new bonds with investors and possible financial partners. Let's build a healthier, more compassionate Johnson City, one step at a time. Resources: 1. ASPE - Hospital Ownership Data Brief: https://aspe.hhs.gov/sites/default/files/documents/582de65f285646af741e14f82b6df1f6/hospital-ownership-data-brief.pdf 2. Ballad Health Foundation: https://www.balladhealth.org/foundation 3. National Healthcare for the Homeless Council - Mortality and Homelessness: https://nhchc.org/wp-content/uploads/2024/11/mortality-and-homelessness.pdf 4. National Coalition for Homeless Veterans - Veteran Homelessness: https://nchv.org/veteran-homelessness/#:~:text=Homeless%20veteran%20demographics-,13%25%20of%20the%20homeless%20adult%20population%20are%20veterans,compared%20to%2019%25%20non%2Dveterans 5. National Alliance to End Homelessness - Older Americans and Homelessness: https://endhomelessness.org/blog/paint-by-numbers-older-americans-and-homelessness/ 6. National Institute for Medical Respite Care - Business Case for Medical Respite: https://nimrc.org/wp-content/uploads/2021/01/Business-Case-for-Medical-Respite-Shepard-Shetler-v721.pdf

Discover how Unity Housing is dedicated to creating a Medical Respite Facility in Johnson City, inspired by the success of the Village at Glencliff in Nashville, to provide shelter and medical care for individuals experiencing homelessness. Join us in bringing hope and healing to our community.