1. Current Trend Toward Community Living Fewer People Living in State Institutions Closure of State Institutions Lucille C. and Elaine W. vs. Olmstead President’s Executive Order and New Freedom Initiative System Change Grants on Community Living Medicaid Community-based Services and Supports Act (MiCASSA)

2. Fewer People Living in State Institutions 1977149,892 2000 47,374 Braddock, D., Hemp, R., Rizzolo, M., Parish, S., and Pomeranz, A. (2002). The State of States in Developmental Disabilities 2002 Study Summary. Denver, Colorado: Coleman Institute for Coleman Institute for Cognitive Disabilities and Department of Psychiatry, The University of Colorado.

3. Closure of State Institutions 1970 to Present 125 Closures in 37 States Braddock, D., Hemp, R., Rizzolo, M., Parish, S., and Pomeranz, A. (2002). The State of States in Developmental Disabilities 2002 Study Summary. Denver, Colorado: Coleman Institute for Coleman Institute for Cognitive Disabilities and Department of Psychiatry, The University of Colorado.

4. Supreme Court on Community Living: Lucille C. & Elaine W. vs. Olmstead “Unjustified placement……constitutes a form of discrimination” “Institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life” The Court concluded that: “under Title II of the ADA, States are required to provide community- based treatment for persons with mental disabilities when the State’s treatment professionals determine that such placement is appropriate, the affected persons do not oppose such treatment, and the placement can be reasonably accommodated, taking into account resources available to the State and the needs of others with mental disabilities.”

5. New Freedom Initiative President’s Executive Order 13217, "Community-Based Alternatives for Individuals with Disabilities," issued on June 18, 2001. Order mandates that the federal government assist states and localities to swiftly implement the Olmstead decision: "The United States is committed to community-based alternatives for individuals with disabilities and recognizes that such services advance the best interests of the United States." HHS Agency Reports of Actions to Eliminate Barriers and Promote Community Integration, a compilation of reports from all participating federal agencies, presented on March 25, 2002

6. System Change Grants on Community Living HHS awarded nearly $125 million in 2001 & 2002 to 48 States, DC,Guam & the Common Wealth of Northern Marina Real Choice System Change Community-integrated Personal Assistance Services and Supports Nursing Facility Transition National Technical Assistance Exchange for Community Living

7. Medicaid Community-based Services & Supports Act Senate bill S 1298 and House bill HR 3612 To amend title XIX of the Social Security Act to provide individuals with disabilities and older Americans with equal access to community- based attendant services and supports, and for other purposes. Sponsored by 11 members in Senate and 77 in House (as of September)

8. Three things people with disabilities tell us about community living “I do not want to live in some one else’s community living project” “I want to live in my own home not somebody else’s home” “If I need personal assistance then I want to determine how much I get, when I get it, and where I get it!

9. Housing Leased or Owned by Occupant Not Linked to Personal Assistance House, Duplex, Apt, Condo, Townhouse, Modular, Co-op, Co-Housing Affordable Accessible Integrated Occupant Controlled Relevant Information to Occupant Common Experiences

10. In Housing Leased or Owned by Occupant Not moved Support is personalized Mailbox, Lease, Registry of Deeds & Tax Bill Renter, Tenant, or Owner Junk Mail Neighbor

11. How do people get housing that they lease or own? Blend Resources Tenant Based Section 8 Vouchers Consolidated Planning HOME Community Development Block Grants (CDBG) Rural Housing Service (RHS) State Housing Finance Agencies Public Housing Agencies Community Reinvestment Act (CRA) Federal Home Loan Bank Homeownership Opportunities Housing Trusts

12. How do people get housing that they lease or own? Lenders Federal and State Tax Credits Neighborhood Housing Services Community and Religious Organizations Medicaid Waivers Neighborhood Revitalization Forums for Landlords/Property Managers etc Awareness of Housing Discrimination Pilot Projects Funds Re-allocated from Congregate and Segregated Housing Live-in Care Provision Individual Development Accounts (IDAs)

13. How do people get housing that they lease or own? Generic Community Resources  community action programs  utility companies  state vocational rehabilitation  vocational school programs  construction apprentices  day labor  building supply companies  building associations  job corps  Habitat for Humanity  United Way Day of Care  Americorps  Christmas in April  Weatherization  energy conservation programs  Homebuyer clubs  credit counseling agencies  friends, family members, and neighbors

14. People Live in Poverty Affordable Housing is a Community Issue Build Coalitions Creative Solutions: Why Not?

15. Flexible Personal Assistance Services and Supports No Limit on Tasks Assistants Perform (includes housing) Need-Based and Available to People of All Ages Assistance As Needed Up to 24 hours a day Participants Decide How Much Direct Control They Exercise Opportunities to Hire, Fire, Train, Supervise, and Mediate Conflict Contingency Plans for Back-up Assistance in Place Amount of Assistance Can Increase (or Decrease) as Needs Change Simple Technology Can Be Used to Access Personal Assistance

16. How People Get Personal Assistance Services & Supports Medicaid Wavier Services Medicaid Waiver Personal Care Option Medicaid Home Health Card Services State Funded Personal Assistance Services Centers for Independent Living Area Agencies on Aging PASS (Plan for Achieving Self-Support) Funds Re-allocated from Congregate and Segregated Services Pilot projects Neighbors, Friends, Relatives, and Roommates Generic Community Services

17. People in neighborhoods act and think differently Love, Lust, and Convenience Interdependence Citizens: Pay Taxes, Contribute to Economy Share the “American Dream” Common Experiences & Ordinary Stories

18. Center for Housing and New Community Economics CHANCE Website: chance.unh.edu Toll-free Information Line 800-220-8770