We’re beginning to see big changes in the housing world as states ramp up efforts to move people with disabilities out of institutions and into communities. For the bulk of the 20th century, adults with mental, physical and developmental disabilities needing day-to-day care and support faced limited choices in where they could live. The Americans with Disabilities Act, a landmark law prohibiting discrimination against people with disabilities, was a turning point. Enacted by Congress in 1990, the ADA established the right of people with disabilities to live and receive care in their communities. The Supreme Court’s 1999 Olmstead v. L.C. decision reinforced this right and made it clear that states have an obligation to provide community-level housing opportunities and supports for people with disabilities.
Today, we’ve seen over a dozen states become subject to Olmstead-related legal settlements, including Georgia, Illinois, Pennsylvania, and New York, which are holding policymakers accountable for providing community-based health care and housing for people with disabilities living in institutions or at risk of institutionalization. Even states without Olmstead-related lawsuits are taking steps to create community-based housing and care options for high-need populations.
Long-term care for people with chronic healthcare needs, in their communities, is also a banner priority for the Obama administration, which declared 2010 the ‘Year of Community Living.’ The last decade has witnessed unprecedented collaboration between federal housing and healthcare agencies. At the same time, policymakers at all levels of government have responded to the call to implement innovative ways to support people with chronic care needs in their communities—including people with disabilities, individuals experiencing long-term homelessness, and older Americans.
Efforts to provide community-based supportive housing have trickled down to the state and local level, and we see the impacts in many aspects of our work. Almost every state has some form of tax credit incentive for supportive housing developments—housing matched with voluntary supportive services—and several states have created specialized vouchers, Medicaid waivers, and new tenant placement infrastructure that helps people with disabilities find stable housing and services.
Mission-driven housing providers, including nonprofits, are positioned to be key partners as states move to expand community-based housing options for people with disabilities. My organization, Housing Partnership Network, produced an issue brief on Olmstead, community-based care and housing for people with disabilities as a guide for nonprofit housing providers, advocates, and private- and public-sector partners. The issue brief focuses on the challenges and opportunities to housing providers arising from reforms to federal, state, and local infrastructure for long-term care, services, and housing.
The issue brief also showcases ways that three HPN members, IFF in Illinois, Common Ground in New York, and Gulf Coast Housing Partnership in Louisiana, are using these new systems to innovate, support, and scale their missions to serve people with disabilities in their communities. IFF worked with Access Living, a local Center for Independent Living, to launch Home First, a program to develop and manage integrated, scattered-site condominium units in for people with disabilities in Cook County, Illinois. Common Ground developed a mixed-income multifamily property in the Bronx, New York, in part with capital funds from the state’s new Medicaid Redesign Team, which will provide integrated housing and services to people with persistent mental illness. Gulf Coast Housing Partnership created the One-Stop Homeless Services Center in Baton Rouge, Louisiana, which serves chronically homeless individuals—many of whom struggle with physical and mental disabilities—with permanent supportive housing and an on-site service center with staff providing case management, legal services, and assistance with Medicaid enrollment.
As states respond to Olmstead settlements and related efforts, housing providers should take note of the policy reforms and new programs coming their way. A new report by Regional Housing Legal Services and ACTION-Housing takes a look at new supportive housing opportunities at the local level in Allegheny County, Pennsylvania.
In the midst of these changes, we have a chance to bring a renewed focus to the benefits of community-based, integrated supportive housing for people with disabilities. Let’s seize this opportunity by:
- Talking with state and local health agencies as they coordinate housing and services for people with disabilities moving out of institutions.
- Seeking out new partnerships with health and service providers to serve our residents and community members with long-term care needs, as well as arrangements with Medicaid agencies and managed care providers to pay for those services.
- Exploring ways to ensure that people with disabilities have a broad range of choices in where to live while accessing high-quality services in their communities.
(Photo credit: Rendering of an IFF Home First Illinois property, courtesy of Housing Partnership Network)