Three Challenges to Expanding Community Housing Access

This June marked the 20th anniversary of Olmsted v. L.C., a landmark U.S. Supreme Court ruling that established the right of people with disabilities to live within the community, rather than in an institution. Although progress has been made to integrate individuals with I/DD into the larger community, several obstacles remain. Here, we explore three major issues that are prohibiting complete access to community housing.

1. The Disability Integration Act

In January 2019, Representative Jim Sensenbrenner of Wisconsin, introduced to Congress a new bill known as the Disability Integration Act, or H.R. 555. The bill, co-sponsored by 236 lawmakers and supported by close to 900 advocacy groups, aims to increase access to community-based services for people with disabilities. The legislation is specifically designed to protect long-term care services and supports (LTSS) by ensuring states and insurers cannot impose waiting lists, price caps, policies or other limitations that are different from those used for institutional care.

Despite bipartisan support, the bill has stalled in the House Energy and Commerce Committee. Similar legislation was introduced in the Senate by Charles Schumer and Cory Gardner; however, it remains unclear when the bill might come up for a vote. Although many advocates and supporters remain hopeful that the Disability Integration Act will eventually pass the House, it could be a year or more before individuals and providers experience the benefits of the law.

2. Shifting Policy

The Justice Department has traditionally been considered an integral force for implementing and enforcing the American with Disabilities Act (ADA). By enforcing community integration and utilizing consent decrees, the Justice Department has upheld civil rights for people with disabilities at the federal and state levels. However, two recent shifts in Justice Department policy are likely to affect community housing.

First, the Justice Department has decided to limit the use of court monitors, who are individuals or teams appointed by the court during a civil suit to oversee compliance with community integration laws for state and local government entities. Instead, the Department will oversee compliance itself for most cases. Some advocates believe this is troubling because the process of changing existing systems that disenfranchise individuals with disabilities often requires independent or external oversight.

Second, the Justice Department has created a new provision that independent reviewers and court monitors involved in compliance cases must be replaced every two years. Advocates believe this may impact the effectiveness of those roles and the ability to ensure lasting compliance by decreasing familiarity with the cases and continuity of enforcement.

3. Soaring Housing Costs

The 2019 housing market has been affected by increased demand and rising costs that have shut out many buyers, despite declining mortgage rates. Although some experts believe the housing market will remain strong through the rest of the year, providers of home- and community-based services (HCBS) in California have been particularly hard-hit by rising housing costs.

In San Francisco, the issue has been studied by the Long-Term Care Coordinating Council, which published a report in January 2019 highlighting the challenges faced by assisted living facilities that serve low-income populations, including Residential Care Facilities for the Elderly (RCFEs) and Adult Residential Facilities (ARFs).

According to the study, over one third of licensed residential facilities who serve people under age 60 are shutting their doors in the wake of skyrocketing housing costs. For those serving clients older than 60, San Francisco has lost over a quarter of licensed facilities. In both cases, these homes are typically small, community-based group homes that primarily serve individuals with severe mental illnesses. Since many residents are low-income, losing their homes could result in homelessness or incarceration.

Taking Action

While things may have improved in the wake of Olmsted, a U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee report from 2013 stated that the number of individuals with disabilities under the age of 65 who were living in institutions had actually increased. The report concluded states had failed to provide services that allowed people with disabilities to live within the community.

To better support efforts that will expand access to community services and housing for individuals with disabilities, here are three strategies to consider:

Advocate: Individuals, providers, and others affected by obstacles to community housing can join in advocacy efforts to support the Disability Integration Act and encourage lawmakers to pass legislation as soon as possible.
Follow Policy Changes: Because federal and state policies shift throughout the year, it’s vital to follow laws and policies that can impact HCBS. Consider identifying and following thought-leaders within the industry who are aware of policy changes and updates, in order to be as knowledgeable as possible and adapt accordingly.
Consider Leasing: Housing prices are likely to keep increasing in key markets, and economic shifts may impact those looking to procure community housing facilities. Providers may find it helpful to work with a trusted partner to lease homes, rather than purchasing, so that funding reserves can be protected to better serve clients.

Sources: