Current Trend Toward Community Living

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Current Trend TowardCommunity Living

• Fewer People Living in State Institutions
• Closure of State Institutions
• Lucille C. and Elaine W. vs. Olmstead
• Presidents Executive Order and New Freedom
  Initiative
• System Change Grants on Community Living
• Medicaid Community-based Services and Supports
  Act (MiCASSA)

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Fewer People Living in State Institutions
1977 149,892 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.
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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.
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Supreme Court on Community LivingLucille C.
Elaine W. vs. Olmstead

• Unjustified placementconstitutes 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 States
  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.

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New Freedom Initiative

• Presidents 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

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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

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Medicaid Community-basedServices 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)

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Three things people with disabilitiestell us
about community living
I do not want to live in some one elses
community living project I want to live in
my own home not somebody elses home If I need
personal assistance then I want to determine how
much I get, when I get it, and where I get it!
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Housing Leased orOwned 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

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In Housing Leasedor Owned by Occupant

• Not moved
• Support is personalized
• Mailbox, Lease, Registry of Deeds Tax Bill
• Renter, Tenant, or Owner
• Junk Mail
• Neighbor

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How do people get housingthat 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

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How do people get housingthat 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)

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How do people get housingthat 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

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People Live in Poverty

• Affordable Housing is a Community Issue
• Build Coalitions
• Creative Solutions Why Not?

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Flexible Personal AssistanceServices 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

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How People Get PersonalAssistance 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

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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

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