COMING HOME Presentation to the Council of State Community Development Agencies September 16, 2008 ~ Williamsburg, Virginia Julie A. Stanley, Director of Community Integration for People with Disabilities Office of the Governor, Commonwealth of Virginia

National long-term care policy for seniors and people with disabilities is changing rapidly and dramatically from institutional to community living. States are rebalancing their entire systems of funding and delivery of long-term services and supports— and they face enormous challenges in assuring a supply of affordable, accessible community housing.

Even though thousands of new units of affordable and accessible housing have been developed, there remains an undeniable lack of integrated, affordable, accessible, and visitable housing from which people with disabilities and seniors may choose.

The lack of affordable, accessible housing is frequently cited by a wide range of organizations and individuals as the single largest barrier to full inclusion and community integration of persons with disabilities. Why? Individuals with disabilities often have extremely low incomes and cannot even afford most government- assisted housing produced today.

Breaking down housing barriers for individuals with disabilities and seniors is one the most important community development needs of our time.

The Need Becomes More Urgent Every Day One in five individuals living in the United States has one or more disabilities.  Many of these individuals live in institutions, yet many want to come home, and states have an obligation to offer them an opportunity to do so.  More and more wounded warriors are coming home to live with permanent disabilities. In the Iraqi War alone, as of this summer over 31,000 had come home wounded. By the year 2020, one in six Americans will be 65 years or older. The nation's stock of public housing for seniors and persons with disabilities is aging -- along with all of us.

At the Federal Level… In a $1.75 billion initiative, the Centers for Medicare & Medicaid Services (CMS) awarded “Money Follows the Person” funding to 31 states to assist over 37,000 people to move from institutions to the community in the next four years. CMS identified housing as a critical element for state systems that support individuals moving to the community. HUD asked PHAs to collaborate with state HFAs, CMS, and local disability organizations to provide integrated, affordable, and accessible community housing options. PHAs were specifically encouraged to set local preferences and use public housing units, Housing Choice Vouchers, and Mainstream Vouchers to support people with disabilities and seniors in their move to the community… …But no HUD funding has been targeted for these individuals.

In Virginia…. 1,041 seniors and individuals with disabilities will come home under “Money Follows the Person” to a:  Home  Apartment  Setting in which no more than four unrelated persons live To increase options:  Governor Kaine personally contacted PHAs in Virginia  Secretaries of Health and Human Resources and Commerce and Trade appointed a Housing Task Force to recommend ways to increase accessible, affordable housing for these individuals

Also in Virginia… Medicaid-reimbursed home modification funding is being made available to thousands of individuals who had no access to it previously Virginia Department of Housing and Community Development is working with the State Medicaid agency in its Money Follows the Person Project, contributing $0.5 million per year for:  Home modifications that exceed the $5,000 per year maximum Medicaid amount  Temporary rent between signing a lease and completion of modifications

And More in Virginia… Over $3 million in Federal Part B funding was set aside by the State Independent Living Council to work with PHAs and other housing agencies to positively impact local housing policies for seniors and individuals with disabilities Ongoing and sustained efforts to break down communication barriers between housing and health and human service worlds Easy Living Coalition

COSCDA Can Help People Come Home By… Advocating for the integration of the needs of seniors and individuals with disabilities in the community development goals of the states and at the federal level Developing policies and recommendations on how states can best accomplish this integration Supporting the Frank Melville Supportive Housing Investment Act of 2008 (HR 5772) Helping states creatively use funds that come from the National Affordable Housing Trust Fund to increase affordable and accessible housing Keeping your members informed about federal and state developments in policies related to long-term care for seniors and people with disabilities

Resources You Can Use Public Housing: Distressed Conditions in Developments for the Elderly and Persons with Disabilities and Strategies Used for Improvement. Government Accounting Office, GAO , ACCNO A42937 (12/09/2005) PRICED OUT IN 2006:The Housing Crisis for People with Disabilities. Ann O’Hara, Emily Cooper, Andrew Zovistoski, and Jonathan Buttrick (April 2007) Funding Sources Successfully Used by States to Support Development of Integrated, Affordable, and Accessible Community Housing. Independent Living Research Utilization (November 2007) The Hidden Housing Crisis: Worst Case Housing Needs Among Adults With Disabilities. Kathryn P. Nelson (April 2008)

For More Information One Community—Virginia’s Community Integration Initiative Virginia’s Money Follows the Person Project Virginia’s Office of Community Integration (804)