2010 Client Survey Synopsis Southeast Tennessee Region

RYAN WHITE NEEDS ASSESSMENT

2010 Client Survey SynopsisSoutheast Tennessee Region

Response Rates

268 Surveys were distributed 99 to Chattanooga CARES clients 108 to Ryan White Dental /Nancy’s House clients 50 to Channels of Love clients 10 to Chattanooga CARES Healthy Relationships

13 were “Returned to Sender” Net of 255 sent and received

79 responded…and they are still coming in! 30.98 % response rate…so far

What did the survey measure?

Who we are serving (aka demographics) Their situation in re: housing, finances,

health What services they need and are receiving What services they need and do not receive What services are not needed Access to services Barriers to service Satisfaction with services

Demographics

2 were filled out by mothers of clients (and yes, it was for their grown sons)

Males = 48 (60.8%) 13-24: 1 ( 2.1%) 25-44: 14 (29.2%) 45-64: 32 (66.6%) ≥ 65: 1 (2.1%)

Females = 29 (36.7%) 13-24: 1 (3.4%) 25-44: 15 (51.7%) 45-64: 10 (34.5%) ≥ 65: 2 (6.9%) No response: 1 (I guess she holds fast to that “Never ask a woman her age!”)

Transgendered = 0 No response = 2 ( 2.5%)

No response on age either

Demographics

Age: 0-12: 0 (0.00%) YES!!! 13-24: 2 ( 2.5%) 25-44: 29 (36.7%) 45-64: 42 (53.2%) 65-?: 3 ( 3.8%)

No response: 3 (3.8%)

Demographics

Race African American: 36 (45.6%) Caucasian: 39 (49.4%) Multiracial: 3 ( 3.8%) No response: 1 ( 1.2%)

• Ethnicity Non-Hispanic: 47 (59.5%) Hispanic: 2 ( 2.5%) No Response: 30 (38.0%)

Demographics

Sexual Orientation Heterosexual/ Straight: 37 (46.8%) Gay or Lesbian: 30 (38.0%) Bisexual: 6 (7.6%) Not Applicable: 3 (3.8%) 1 A-Sexual No Response: 3 (3.8%)

Primary Language:• English: 78 (98.7%)• Spanish: 0 (0.00%)• Other: 1 (1.3%) (American Sign

Language)

Demographics

Counties: Hamilton: 61 (77.2%) Bradley: 7 ( 8.9%) Marion: 2 ( 2.5%) Polk: 2 ( 2.5%) Bledsoe : 2 ( 2.5%) McMinn: 1 ( 1.3%) Georgia (Whitfield, Catoosa: 1 each): 2

(2.5%) Collin, TX: 1 (1.3%) No Response: 1 (1.3%)

Where do you live?

30721: 1 30736: 1 37303: 2 37311: 3 37312: 2 37323: 2 37341: 1 37343: 3 37367: 1 37373: 1 37379: 5 37380: 2 37381: 1 37391: 1

37402: 4 37403: 2 37404: 4 37405: 4 37406: 12 37407: 3 37408: 3 37410: 3 37411: 7 37412: 1 37415: 4 37416: 1 37419: 2 37421: 1

GA: 2 ( 2.5%)TX: 1 ( 1.3%)TN (Rural): 24 (30.4%)Athens: 2 ( 2.5%)Cleveland: 7 ( 8.9%)Harrison: 1 ( 1.3%)Hixson: 3 ( 3.8%)Sale Creek: 1 ( 1.3%)Soddy Daisy: 5 ( 6.3%)South Pittsburg: 2 ( 2.5%)Spring City: 1 ( 1.3%)Turtletown: 1 ( 1.3%)Chattanooga: 51 (64.5%)37406 is 15.2% alone

No Response: 1 ( 1.3%)

Now that we have broken them down, let us put them back together…

Men: 4 Bisexual African American Men, aged 25-44, living in Hamilton

County 8 African American MSM, 1 aged 13-24, 5 aged 45-64, 7 living in

Hamilton County, 1 in Bradley County 2 Multiracial MSM living in Hamilton County 9 Caucasian MSM living in Hamilton County, 1 aged 65 and over 6 Caucasian MSM living in Bradley County 5 Caucasian MSM living in the Rural TN (Bledsoe,Marion, McMinn,

Polk) area and GA 4 African American Heterosexual living in Hamilton County 4 Caucasian Heterosexual living in Hamilton County 1 Caucasian Heterosexual living in Catoosa County, GA 1 Bisexual Caucasian Man, aged 45-64, living in Hamilton County 1 Caucasian A-sexual, aged 45-64, living in Hamilton County 1 African American Heterosexual living in TX

Now that we have broken them down, let us put

them back together…

Women 18 African American, Heterosexual, living in

Hamilton County, 1 aged 65 and over 5 Caucasian, Heterosexual, living in Hamilton

County, 1 aged 65 and over 3 Caucasian, Heterosexual, living in Rural TN

(Bledsoe, Marion, Polk) 1 African American, No orientation given, age 25-

44 1 Multiracial, Heterosexual, living in Hamilton

County, age 25-44 1 Caucasian, Bisexual, living in Hamilton County ,

age 25-44

Household Size

1 Person: 27 (34.2%)2 People: 28 (35.4%)3 People: 10 (12.6%)4 People: 7 (8.9%)5 People: 2 (2.5%)6 People: 4 (5.1%)No response: 1 (1.3%)

Monthly Income

$903 or less: 42 (53.2%) $904-$1805: 26 (32.9%) $1806-$2708: 3 (3.8%) $2709 & over: 1 (1.3%) Don’t know: 5 (6.3%) No response: 2 (2.5%)

Source of Income (More than 1 response)

SSI/SSDI: 50 (63.3%) Employment: 15 (19.0%) AFDC: 6 (7.6%) Food Stamps: 6 (7.6%) No response: 4 (5.1%) Parent supports me: 2 (2.5%) VA Widow’s Pension: 1 (1.3%) Child support/ Alimony: 1 (1.3%) Unemployment: 1 (stated “retired”) (1.3%) No Income: 1 (1.3%)

HIV Care Paid By…

Ryan White: 54 (68.3%) Medicare: 32 (40.5%) TennCare: 24 (30.4%) Private Insurance: 6 (7.6%) Veterans’ Administration: 2 (2.5%) Other (Mom or boyfriend; myself; health

department; BBBC; QMB; Healthnet; Humana: 7 (8.9%)

Need but cannot access these services:

Vision: 43 Legal Services: 22 Low Income Housing: 21 Dental: 20 Alternative/Complementary treatment: 20 Food basket/food vouchers/food pantry: 14 Voluntary Support Person/Buddy system: 13 Medical Insurance Assistance: 13 Support Group: 13 Nutritional Supplements: 11 Budgeting Assistance: 11 Transportation to medical appointments: 11


Case management: 10 Rent/Mortgage Assistance: 10 Utility Assistance: 10 Health Care Service Referrals: 10 Transportation to social service appointments: 9 Employment Counseling/vocational rehabilitation: 9 Non-medical supplies: 8 Transportation to Pharmacy: 6 Individual Counseling: 6 Psychiatric/ Mental Health Care (Outpatient): 5 Nutritional guidance/ counseling: 4 Prescription Drug Assistance: 4


Emergency/ Transitional Housing: 4 Independent Living Skills Training: 4 Medical Equipment: 3 Clinical Trial Referrals: 3 Visiting Nurse/Home healthcare: 3 Specialist: 3 Home delivered meals: 3 Representative Payee/ financial management/ guardianship: 3 Adult Daycare: 2 Adherence Counseling: 2 Psychiatric/Mental Health Care (Inpatient): 2 Help understanding medications/treatment education: 2 Hospice Care: 2 Alcohol/ drug treatment (Outpatient): 1 Respite Care: 1 Child Daycare: 1 Temporary Child Placement: 1 Primary/ HIV Doctor: 0

Need and Receive These Services:

Primary/HIV Doctor: 47 Dental Care: 38 Prescription Drug Assistance: 37 Food basket/food vouchers/food pantry: 27 Case Management: 27 Utility Assistance: 19 Psychiatric/ Mental Health (Outpatient): 16 Nutritional guidance/ counseling: 16 Medical Insurance Assistance: 16 Health care service referrals: 15 Nutritional Supplements: 14 Support Group: 14 Rent/Mortgage Assistance: 14 Eye Care: 12


Individual Counseling: 10 Specialist: 10 Help understanding medications/treatment education: 9 Transportation to medical appointments: 7 Low Income Housing: 6 Budgeting assistance: 6 Legal Services: 5 Voluntary Support/Buddy system: 5 Employment Counseling/ vocational rehabilitation: 5 Psychiatric/ Mental Health (Inpatient): 5 Medical Equipment: 5 Clinical Trial Referrals: 4 Transportation to Social Service appointments: 4 Emergency/ Transitional Housing: 4


Home delivered meals: 4 Transportation to Pharmacy: 4 Non-Medical Supplies: 3 Hospice Care: 3 Visiting Nurse/Home healthcare: 3 Representative Payee/Financial

Management/Guardianship: 2 Adherence Counseling: 2 Independent Living Skills Training: 1 Adult Daycare: 1

Most Important Services:

Dental: 25 Medical Care: 21 Food: 21 (1 stated food stamps) + 1 Ensure Rental Assistance/Low income housing: 21 Prescriptions: 16 Utilities:15 Transportation: 11 Financial Assistance for gas, moving*, copays, other necessities: 7 Counseling: 5 Household goods/ cleaning supplies: 3 Support Group: 3 Job/Employment: 2 Health Insurance: 2 Legal: 2 Vision: 2 Case management: 1

Barriers to Service

Don’t

know

whe

re to

get

nee

ded

serv

ices (

28)

Didn’

t think

the

serv

ice w

as a

vaila

ble

(20)

I hav

e no

trou

ble

getti

ng se

rvice

s (16

)

Told th

at se

rvice

was

una

vaila

ble

(16)

Lack

of t

rans

porta

tion

(10)

0

5

10

15

20

25

30

17 “Other” Barriers to Service

RW doesn't cover eye exams It just that I have foot surgery April 24, 2009 and it hard to walk that long time to

get to appt PS: But I still work and I Told I didn't qualify Need someone to sit w/family member while I go out. Haven't been contacted from RW to know if I have come off the waiting list for

dental care. Hate Chattanooga CARES Case management @Health Dept. was not consistent w/ asst. and her "stories"

changed until I contacted her No insurance Due to NH closing I live in GA ; I live in TX Lack of $$ Income qualifications Money! Don Ellis is my case manager He has been very helpful at Chattanooga CARES Have gotten rental asst. several times Because of past criminal record

When Diagnosed

1985

1987

1989

1991

1993

1995

1997

1999

2001

2003

2005

2007

2009

Can't

rem

ember

0

1

2

3

4

5

6

7

8

9

10

Where Diagnosed

TN GA CA FL AL TX IN NJ

DR'S O

FFIC

E0

5

10

15

20

25

30

35

40

45

5049

4 42 1 1 1 1 1

CD4 Count

≤ 50

51-2

00

201-

350

351-

500

> 500

UNKNOWN

NO RES

PONSE

0

5

10

15

20

25

04

13

18

22

17

5

Viral Load

< 400

400-

9,99

9

10,0

00-4

9,99

9

50,0

00-9

9,99

9

100,

000

OR ABOVE

DON'T K

NOW

NO RES

PONSE

05

101520253035404550

43

9

1 1 0

20

5

Last Labs Drawn

< ONE

MONTH

AGO

1-3

MONTH

S AGO

3-6

MONTH

S AGO

> 6 M

ONTHS

AGO

NO RES

PONSE

0

5

10

15

20

25

30

35

40

17

36

17

2

7

I CONTRACTED HIV/AIDS THROUGH

32; 40%

19; 24%

8

4

4

4

2

1 1 1 1

1 1 1

Man to Man Sexual Contact Heterosexual ContactUndetermined/Unknown Recipient of Blood/Blood

productsOther No ResponseOccupational Exposure IV Drug UseHeterosexual/IDU Undetermined/MSMHeterosexual/Blood products Heterosexual /IDUHeterosexual/IDU/Blood Products

Heterosexual/MSM

Current Physical Health vs. 1 Year Ago

IMPR

OVED

STAYE

D THE

SAME

DETER

IORATE

D

DIAGNOSE

D W/ M

AJOR IL

LNES

S

NOT SU

RE

NO RES

PONSE

0

10

20

3027

31

105 4 2

Current Mental Health vs. 1 Year Ago

Other =Diabetes

Impr

oved

Stay

ed th

e Sa

me

Deter

iora

ted

Not S

ure

Other

No Res

pons

e0

5

10

15

20

25

30

35

19

33

18

51

3

In the past 12 months, I stayed…

58; 73%

14; 18%

2

1 1

1 1 1

Own house/apartmentWith Friend/Family memberOwn home/With Family/FriendIn a shelterW/Family or Friend/On StreetsW/Family or Friend/In PrisonOwn home/With Family/Friend/On streets/In PrisonNone

Currently, I live…

61; 77%

14;

18%

1 111Own house/apt With friend/family

memberOn the Streets Own house/apt/ with

Friend/Family Mem-ber

Own home/will have to move

No response

I have trouble taking my HIV medications…

67; 85%

10; 13%

2; 3%

NOYESNO RESPONSE

Why it is difficult for me to take my HIV medications

Forg

et

I can

't aff

ord

my

copa

y

Too

Many

Pills

Other

(I d

on't

know

)

Side

Effec

ts

Too

busy

Don't

like

to b

e re

min

ded

that

I ha

ve H

IV

Too

man

y pi

lls/I

forg

et

Medica

re D

onut

Hol

e

Afraid

peo

ple

will fi

nd o

ut I

have

HIV

0

1

2

3

4

5

65

3

2 2 2

1 1 1 1 1

I was receiving RW services, but stopped getting them because…

I don't know if I 'm receiving RW services: 14 I didn't qualify for the service: 4 Didn't need the service anymore: 3 Other: 7

Have not been in b/c of foot surgery They cancel my last appt. b/c the dentist quit Don't know anything about RW services- I'd like to Funding for dental was not available I let go of b/c of the SSI medication part, unless necessary I got Medicaid and didn't qualify Because of jail time Still receive housing, but too many restrictions apply now.

Who provides your HIV medical care?

Dr. Si

zem

ore/

CARES

Dr. So

ufler

is

Dr. And

erso

n

Dr. Hill

Size

mor

e/So

ufler

is

Dr. Cor

nea

Ander

son/

CARES

CCC/Raff

anti

Dr. Hill

/CARES

Dr. So

ufler

is/Oth

er

Dr. Haw

kins

Raffan

ti/Coo

kevi

lle

Hawki

ns/C

ARES

Other

:

No re

spon

se0

5

10

15

20

25

30

35

Who provides your HIV medical care?

Other: Dr. David Barnes (Birmingham, AL) Veterans Administration (Murfreesboro,

TN) Dr. Younger Parkland Medical Center, Texas

Does the Medical Staff Treat You with Dignity and Respect?

60; 76%

11; 14%

7; 9%1

AlwaysMost of the TimeSometimesRarelyNeverNo Response

“Sometimes” was attributable to :Chattanooga CARES: 3 times Dr. Anderson 2 times CARES + another provider 2 times

Comorbidities

Hepatitis A or B; 3

Hepatitis C; 6

Genital Herpes; 2

Chlamydia; 1

Hepatitis C and Genital

Herpes; 2

Hepatitis A,B, and

C; 1

Hepatitis A&B,

Genital Herpes; 1

Hepatitis C, Genital Herpes, Gonor-rhea; 1

Other; 2

Hepatitis A or BHepatitis CGenital HerpesChlamydiaGonorrheaHepatitis C and Genital HerpesHepatitis A,B, and CHepatitis A&B, Genital HerpesHepatitis C, Genital Herpes, Gonor-rheaOther

Other: COPD, Back Problems

I currently receive case management

56; 71%

17; 22%

6; 8%

YesNoNo Response

CHANNELS OF LOVE (1 SOLELY) AND WITH CHATTANOOGA CARES (4) OR “NASHVILLE”

(1)

5; 83%

1; 17%

YesNo

I AM AWARE OF THE SERVICES AVAILABLE FROM MY CASE MANAGER

4; 67%

1; 17%

1; 17%

Most of the timeNot very oftenNever

I FEEL COMFORTABLE ASKING FOR ASSISTANCE


(1)

2; 33%

2; 33%

2; 33%

Most of the timeSometimesN/A

MY CASEMANAGER IS KNOWLEDGEABLE ABOUT COMMUNITY RESOURCES AND IS ABLE TO CONNECT

ME TO THESE RESOURCES

583%

117%

AlwaysMost of the time

MY CASEMANAGER TREATS ME WITH DIGNITY AND RESPECT


(1)

3; 50%

2; 33%

1; 17%

AlwaysMost of the timeSometimes

MY CASEMANAGER UNDERSTANDS MY NEEDS

1; 17%

2; 33%

3; 50%

AlwaysMost of the timeSometimes

MY CASEMANAGER IS ACCESSIBLE


(1)

2; 33%

1; 17%1; 17%

1; 17%

1; 17%

> 1x per month1x per monthEvery 3 monthsI have not heard from my cmI CALLED HIM

Last year, my case manager contacted me…

CHATTANOOGA CARES CASE MANAGEMENT

YesNo

I I AM AWARE OF THE SERVICES AVAILABLE FROM MY CASE MANAGER

9

11

2

21

AlwaysMost of the timeSometimesNot very oftenNever

I FEEL COMFORTABLE ASKING FOR ASSIS-TANCE


6

10

3

3

21

AlwaysMost of the timeSometimesNot very oftenN/AYET TO BE DE-TERMINED

MY CASEMANAGER IS KNOWLEDGE-ABLE ABOUT COMMUNITY RESOURCES

AND IS ABLE TO CONNECT ME TO THESE RESOURCES

22

11 1

AlwaysMost of the timeSometimesN/A



8

12

3

2

AlwaysMost of the timeSometimesN/A


8

12

2

12

AlwaysMost of the timeSometimesNot very oftenN/A



6

3

5

5

2

3

More than 1xmonthOnce a monthEvery 3 monthsEvery 6 monthsOnce a yearI have not heard from my CM this year


CHATTANOOGA-HAMILTON COUNTY HEALTH DEPARTMENT

5; 56%

4; 44%YesNo

I AM AWARE OF THE SERVICES AVAILABLE FROM MY CASE MANAGER

7; 78%

2; 22%

AlwaysSometimes

I FEEL COMFORTABLE ASKING FOR ASSISTANCE


6; 67%

1; 11%

1; 11%

1; 11%

AlwaysMost of the TimeNot Very OftenN/A

MY CASEMANAGER IS KNOWLEDGEABLE ABOUT COMMUNITY RESOURCES AND IS ABLE TO CONNECT

ME TO THESE RESOURCES

8; 89%

1; 11%

AlwaysSometimes



778%

111%

111%

AlwaysMost of the TimeNot Very Often


5; 56%3; 33%

1; 11%

AlwaysMost of the TimeNot Very Often



2; 25%

1; 13%

1; 13%

4; 50%

> 1x per month1x per monthEvery 3 monthsEvery 6 months


SERVICE BARRIERS

OTHER= Nancy's House closing (3) Funds not available (2) I didn’t know about these

services (2) EYE CARE, NO SERVICE

PROVIDED I just did things on my own like

finding out things My appt. was canceled Negative experiences with

multiple agencies/case managers Need to update w/manager but

don't have time Legal Services? Seems like the guidelines change

quite frequently

TRANSP

ORTATI

ON

I DID

NOT

QUALIFY

FOR T

HE SE

RVICE

I DON'T

KNOW

WHER

E TO

GO

WORRIE

D MY

STATU

S W

OULD B

E FO

UND OUT

OTHER

0

5

10

15

20

25

30

TRANSPORTATION SERVICES

ALWAYS

MOST

OF TH

E TI

ME

SOMET

IMES

NOT VER

Y OFT

EN

NEVER

NOT APP

LICABLE

0

5

10

15

20

25

ABLE TO ACCESS SERVICES?

VERY

MUCHSO

ME

A LIT

TLE

NOT AT

ALL

NOT APP

LICABLE

0

5

10

15

20

25

30

HOW HELPFUL WERE SERVICES ?

HOUSING & UTILITY ASSISTANCE

ALWAYS

MOST

OF TH

E TI

ME

SOMET

IMES

NOT VER

Y OFT

EN

NEVER

NOT APP

LICABLE

0

2

4

6

8

10

12

14

16

I have received assistance when I needed it

ALWAYS

MOST

OF TH

E TI

ME

SOMET

IMES

NOT VER

Y OFT

EN

NEVER

NOT APP

LICABLE

0

2

4

6

8

10

12

14

16

18

20

Assistance received has helped me maintain stable housing/utility service

Food and Nutritional Services

Food

Pan

try

Gift C

ard

Food

Vou

cher

s

Home

Deliv

ered

Mea

ls

Nutrit

iona

l Sup

plem

ents

Not A

pplic

able

Food

Sta

mps

0

5

10

15

20

25

30

35

40

ALWAYS

MOST

OF TH

E TI

ME

SOMET

IMES

NOT VER

Y OFT

EN

NEVER

NOT APP

LICABLE

0

5

10

15

20

25Type of Service Accessed

How often are you able to obtain the amount of food that you need?

Food and Nutritional Services

Very

Satis

fied

Satis

fied

Not S

atisfie

d

Very

Unsat

isfie

d

Not A

pplic

able

0

5

10

15

20

25Satisfied w/quality of food?

Alway

s

Mos

t of t

he ti

me

Som

etim

es

Not v

ery

ofte

n

Never

Not a

pplic

able

0

2

4

6

8

10

12

14

16

18

20

How often is the food beneficial to you during

difficult times?

HIV Related information found at provider agencies

Alway

s

Mos

t of t

he ti

me

Som

etim

es

Not v

ery

ofte

n

Never

Not a

pplic

able

0

5

10

15

20

25

How often does agency have up to date information available?

Very

Muc

h

Som

e

A littl

e

Not a

t all

Not A

pplic

able

0

5

10

15

20

25

30

35

How helpful is the information?

HIV Related information found at provider agencies

Very Much Some A little Not at all Not Applicable0

5

10

15

20

25

30

35

Has it helped you reduce or eliminate risk behaviors?

Impact of Nancy’s House closing

6; 43%

2; 14%

4; 29%

1; 7%1; 7%

Chattanooga CARESChannels Of LoveBothBoth and other agencyNeither

If so, please tell us with which agency/agencies you either have or

intend to make contact .

11; 14%

57; 72%

11; 14%

YesNoNo Response

Have you been impacted by the closing?

COMMENTS My sincere thanks to CARES, Dept of Health, RW Program, etc and everyone that has

helped maintain good health and quality of life not only to myself but others as well.

Keep CARES staff as it was. Transportation to Dr. visits other than CARES.

I am very satisfied with all of the services in TN and I try to be very understanding when there is a lack of funds or help b/c I know there are a lot of us out here that need help. I pray everyday that my agency will always be able to stabilize themselves in order to help me and that RW continues to provide my medication cause I wouldn't know how else I will get it.

I'm very grateful to have Dr. Hill as my ID doctor.

I really need housing assistance and now the maximum is half what it was last year. I hope it gets better. Maybe a little note to Elton John would turn things around.

Need to know some places where you can get household and hygiene stuff from when needed

I get good care. Don Ellis has been very helpful to me. I don't attend any support groups. I have a church family and a lot of personal support. I get fed spiritually so I'm good. I do need my own place to live, but am working on that, just waiting. I am so thankful for Ryan White. I would have died without them. I started out with Channels of Love and all the people I used to be in support group with have died. I usually attend their Christmas Party, but I don't make it to the support groups. I am usually babysitting. It's hard for me to get there, but I like Channels. They are wonderful people.

I can't get no help from Section 8 housing . I got in touch with the MAC people. I need to know where I stand in the program of section 8 housing my name is on the front of this letter.

COMMENTS The only service I need, but don't receive, is eye care exams. If you cannot see it is hard to read

and get around.

I think the RW program is great. It helped me get glasses and getting my dental work done. If it was not for the program I would not have glasses or get dental work done. They also helped me with rent one time. Thanks a lot for the program. I hope it stays around to help others in need.

Would like contacts for people, #s to contact in case of need and what services are offered.

SE TN needs more services for HIV/AIDS in the rural areas.

I am very satisfied with my services with CARE and Channels of Love. If it was not so, then a lot of times I wouldn't make it. The Doctors are great and the staff at both places are the bomb. And I thank Ryan White foundation for all the help too.

Staff needs to be trained better on services available and more resources available in lobby. Update POZ magazines available. Spend money wisely. Get a newsletter and send out to keep clients updated. We need to strive, not just survive.

I don't mind answering questions or asking them. I feel if I need anything or anyone, the agency will help me.

If it wasn't for the RWF, I wouldn't be able to get my medicine, because my insurance was cut in 2003.

Legal services would be helpful and appreciated . Thank you.

Wish we had assistance w/larger procedures, like colonoscopy to check for colon cancer, etc.

Have gave up on help living in a rural community and this is the way it has been for a long time.

My biggest problem is low income after retirement. Food and supplements could be a problem in the future if we don't get a S.S. increase soon

Documents

2010 Client Survey Synopsis Southeast Tennessee Region