Transcript HOUSING AND TRANSPORTATION Integrating Strategies Within Virginia’s Cross-Governmental Strategic Plan for Continued Community Integration (Olmstead Plan) and the MFP Demonstration Operational Protocol… …with support and assistance.

HOUSING AND
TRANSPORTATION
Integrating Strategies Within
Virginia’s Cross-Governmental Strategic Plan for Continued
Community Integration (Olmstead Plan)
and the MFP Demonstration Operational Protocol…
…with support and assistance from the
Statewide Plan for Independent Living
April 24, 2008
Virginia’s Cross-Governmental Strategic Plan
for Continued Community Integration is a
comprehensive, ongoing plan, updated every
year, designed to provide individuals with
disabilities of all ages more opportunities to:
• choose to move from institutions to appropriate,
more integrated, settings, and
• avoid unwanted institutionalization.
Money Follows the Person is a 4-year
Demonstration program designed to assist
seniors and individuals with disabilities who
currently live in institutions to transition to
the community if they wish to.
The Money Follows the Person
Demonstration Program
will help Virginia implement the
Cross-Governmental Strategic Plan for Continued
Community Integration
Both the Money Follows the Person
Demonstration Program
and the
Cross-Governmental Strategic Plan for Continued
Community Integration
contain multiple strategies to address housing and
transportation needs of individuals with
disabilities
Statewide Plan for Independent
Living, Goal 2
Work in conjunction with the Office of
Community Integration to assist in
implementing the housing and transportation
initiatives identified in the Strategic Plan and
the Money Follows the Person
Demonstration
Overview:
Strategic Plan
What is the Strategic Plan?
• 2003: The Olmstead Task Force recommended that Virginia develop a
blueprint for implementing the recommendations contained in the Task
Force Report. “For this to happen, State administrators, policy
makers, and agency officials must work together, with people with
disabilities and service providers, to consistently collaborate; make
needed changes in practices, policies, regulations, and legislation;
and assure sufficient funding to implement the recommendations
contained [in the] Report.”
• 2004-2005: Executive Orders 61 and 84 responded to this
recommendation by establishing:
– A multi-agency, multi-secretariat Implementation Team
– A cross-disability, multi-stakeholder advisory group
– A Director of Community Integration for People with Disabilities
What is the Strategic Plan?, continued
• 2006: Governor Kaine issued Executive Order 2,
continuing the Olmstead initiative and directing the
Implementation Team to work with the stakeholder
advisory group (now the Community Integration Advisory
Commission) to develop a cross-governmental strategic
plan for continued community integration.
• 2007: Governor Kaine issued Executive Directive 6,
which directs state agencies and entities to be involved
with the implementation of Olmstead and to annually
update the strategic plan and report on progress in
implementing it.
What is the Strategic Plan?, continued
• In 2007, Governor Kaine invited representatives
of six organizations to join the Team:
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Virginia Association of Centers for Independent Living
Virginia Association of Community Services Boards
Virginia Association of Counties
Virginia Association of Local Human Services Officials
Virginia First Cities
Virginia Municipal League
What is the Strategic Plan?, continued
• The Strategic Plan is developed with all state
and local disability stakeholders working
together as a Team.
• The Team develops the Strategic Plan in close
coordination with the Community Integration
Advisory Commission.
• The Team and Commission jointly adopted the
Plan in 2007.
Strategic Plan Goals
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#1: Create opportunities for individuals
of all ages to leave institutions if they
want to live in the community
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#2: Assist individuals of all ages who live
in the community to avoid unwanted
institutionalization.
Strategic Plan Critical Success Factors
• The Strategic Plan is organized into seven “Critical
Success Factors” that reflect the seven major
premises of the Olmstead Task Force Report’s
Vision and Goals Statement. Virginians with
disabilities should be able to:
– #1 Plan, fully understand and choose among services
and supports they need, self-directing them to the
extent possible
– #2 Choose among individuals and agencies qualified
to provide the services and supports they select
– #3 Locate and obtain housing appropriate to their
needs and preferences
Strategic Plan Critical Success Factors,
continued
– #4 Locate and obtain a job, if appropriate.
– #5 Access transportation appropriate to their
needs.
– #6 If they lack capacity to make decisions, have the
same choices, options and benefits as other
Virginians with disabilities through a surrogate
decision-maker qualified to act on their behalf.
– #7 Access ongoing supports in order to stay in the
most integrated setting of choice, self-directing them
to the extent possible.
Strategic Plan – Getting the Work Done
• Action Plans developed for each Critical Success Factor
serve as a template for agency program and policy
development, review and development of regulations,
coordination with other agencies, and participation in
federal initiatives. The Action Plans include:
– Expectations of individuals with disabilities
– Strategies to meet those expectations
– Measurable outcomes
– Multiple implementation steps with projected due
dates and responsible state agencies
Strategic Plan – Current Activities
• In March 2008, the Team adopted
proposed updates to the 2007 Strategic
Plan.
• The Commission will consider these
updates in May.
• A public comment period on the proposed
updates is expected this summer.
Overview:
Money Follows the
Person (MFP)
Demonstration
MFP is a Federal Initiative
• Centers for Medicare and Medicaid Services
• Largest investment ever in Medicaid Long Term
Supports ($1.75 billion)
• 37,000+ individuals to transition nationally
• Designed to eliminate “institutional bias” in the
Medicaid program
• HUD Secretary Alfonso Jackson contacted
public housing agencies twice last year
about the importance of the Demonstration
MFP is a State Initiative
• Demonstration awarded in May 2007 to Virginia’s
Department of Medical Assistance Services
• Eight state agencies (including VHDA, DHCD,
DPOR’s Fair Housing Office and DRPT) have
been working closely for 10 months to prepare for
transitions to begin this summer
• Governor Kaine contacted public housing
agencies in Virginia last Fall to underscore
importance of the MFP Demonstration
MFP is a Community Initiative
• Local service agencies have partnered
with state agencies and others to plan the
transition process
– Centers for Independent Living
– Community Services Boards Local
– Area Agencies on Aging
– Departments of Social Services
MFP is a Personal Initiative
• In Virginia, over 1,000 people are projected to
move to the community from nursing homes, longstay hospitals and Intermediate Care Facilities for
Individuals with Intellectual Disabilities (formerly
Mental Retardation)
• Participation is completely voluntary—each
individual’s choice
• Each person will have an individual plan, services
and supports that they need, and someone to
work with them before and after they
transition
MFP Services and Supports
• Case manager, health care coordinator or transition
coordinator to plan and assist in transitions
• Personal assistance services
• Assistive technology
• Personal Emergency Response Systems
• Supported employment
• Environmental (home) modifications
• Rent during modifications period if necessary
• Payment of utility and security deposits and
other up-front household expenses
• Medicaid transportation
Where Will People be Living?
• Under MFP, each individual who
transitions must move to a “qualified
residence” in the community
– Home owned or leased by the individual or a
family member
– Apartment leased by the individual or a family
member
– Setting in which no more than four unrelated
individuals reside
Qualified Residences in Virginia
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Homes
Apartments
Group homes (4 or fewer beds)
Sponsored residential settings
4-bed Assisted Living Facilities
Adult Foster Care
Why are Housing and Transportation Important?
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For individuals transitioning from institutions (under
MFP or not), renting a house or apartment may be the
best - or only - option
Homes and apartments may - or may not - be located
on public transportation routes
Many individuals transitioning are expected to have
very low income
There are no funds available under the MFP
Demonstration to pay for ongoing rental expenses or
non-medical transportation
What Are We Doing to Address the
Housing and Transportation Challenges?
• Action plans within Strategic Plan
– Housing Accessibility, Availability, and Affordability
– Transportation Accessibility, Availability, and Education
• Money Follows the Person
– Puts in place environmental and supplemental home modifications,
rent during modifications period, and transition services
– Creates Housing and Transportation Task Force under Secretaries
of Health and Human Resources and Commerce and Trade
• Includes federal, state, local, private, and self-advocate partners
• Will develop annual housing and transportation action plan this
spring
What the SPIL is Doing to Address the
Housing and Transportation Challenges
• Determine local housing capacity needs and develop
and pursue strategies to address those local housing
needs with appropriate local, state and federal
policymakers
• Improve housing policy on the local and state levels by
ensuring that the housing needs of people with
disabilities moving from institutions to the community are
included in local plans and planning processes
• Enhance the knowledge of HUD and local housing
authorities on the housing/community living needs and
preferences of people with disabilities
What the SPIL is Doing to Address the
Housing and Transportation Challenges
• Create a mechanism to track local changes in
public policy and relate ongoing needs/solutions
to statewide and national housing funding
agents and authorities
• Support development of the MFP Operational
Protocol to identify means of informing residents
of institutional settings of community living
options and assist them in becoming better selfadvocates when they make the transition into
the community
Let’s Talk About Housing
Housing Accessibility Strategy
• Eliminate physical, social and other barriers that
impede a person’s ability to live in the most
integrated environment possible.
– Accessibility means different things for different
people. For a person with a mobility limitation the
elimination of structural barriers might result in
accessibility. For a person with a developmental
disability, accessibility might be a system of supports
that reduce limitations and perhaps include a
congregate living model.
Housing Accessibility Action Steps
• Work with MFP Housing Task
Force to standardize data
collection
• Identify barriers and how to
address them
– Building Code compliance
– Universal Design
• Evaluate need for new
resources
• Monitor work of the MFP
Housing Task Force
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Add environmental mods to waivers
Provide supplemental DHCD mods
Provide rent during mods period
Provide housing education—in
person, on Easy Access, and
through interactive map
Review housing plans
Develop strategies for increasing
adult foster care
Develop strategies for auxiliary
grant portability
Encourage use of accessva.org
Housing Affordability Strategies
• Produce more units for people above 60%
of the area median income (AMI) that can
be occupied using no more than 30% of
their available income.
• Provide income supplements to people
below 60% of the AMI such that no more
than 30% of their available income is
spent for housing.
Housing Affordability Action Steps
• Determine people needing
affordable housing
• Determine number of units
needed
• Evaluate need for additional
program subsidies
• Preserve affordable housing
where it exists
• Develop affordable housing
where it does not exist
• Add transition benefits to
waivers
• Provide housing education—in
person and on Easy Access
• Educate and develop
partnerships with public
housing agencies
• Document changes in public
policy as they relate to housing
for people with disabilities
• Explore community living
supplement
Housing Availability Strategies
• Make specific financing resources
available.
• Increase local capacity to undertake
development.
• Insure appropriate enforcement of laws
and regulations.
Housing Availability Action Steps
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Assure Consolidated and Public
Housing Agency Plans address
needs
Work with local agencies to
determine local housing capacity
needs
Provide outreach and awareness
on applicable laws
Develop methods of enhancing
enforcement of laws and
regulations
Ensure citizen participation in
housing planning
Expand www.vaaccess.org
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Provide housing education–in
person, on Easy Access and
through an interactive map
Explore amendments to QAP
Explore below-market loans
Increase housing stock
Create incentives
Insure citizen participation in
housing planning
Determine local housing capacity
needs
Remove prohibition against waiver
users living in ALFs and adult
foster care
Let’s Talk About Transportation
Transportation Education Strategy
Educate and publicize available
transportation options to people with
disabilities
Transportation Education
• Examine existing data and
determine its usefulness
• Support DRPT in coordinating
local plans
• Develop a mechanism to
educate people with disabilities
and other stakeholders about
transportation access and
opportunities
• Make recommendations for the
use of vouchers and other
incentives for transportation
• Create User’s Guide to
Logisticare
• Provide transportation
education—in person, on Easy
Access, and through
interactive map
• Disseminate New Freedom
Grants information
• Provide orientation to
transportation planning
Transportation Training Strategy
Train CILs, CSBs, AAAs, ESOs, case
managers and other key personnel to
train end users
Transportation Training Action Steps
• Identify training needs; create
a training model and tools
• Train CILs, CSBs, AAAs,
ESOs, case managers and
other key personnel, to train
end users on how to use
existing transportation and
how to file complaints
• Identify processes to redress
ADA violations
• DMAS will train case
managers and transition
coordinators to give
comprehensive information to
individuals who transition
• Provide transportation
information, including how to
file a complaint—in person and
on Easy Access
• Logisticare User’s Guide will
contain information on how to
file a complaint
Transportation Availability Strategy
Coordinate transportation services to
maximize efficiencies to support
additional transportation services
Transportation Availability Action Steps
• Identify needs and barriers
• Improve efficiencies
• Develop State Human
Services Transportation Plan
• Establish mobility goals for
statewide Transportation Plan
• Develop accountability
strategy for failure to provide
agreed services
• Consider incentives for
providers
• Add environmental mods to
waivers -- primary vehicle
• Use Transportation and
Housing Alliance Toolkit
• Recommend incentives for
coordination across
geographic boundaries, door
through door, housing
developments on public
transportation routes, and
voucher system
Accomplishments to Date:
Tools We Can Use
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Secretary Jackson’s letters to PHAs
Governor’s letter to Virginia PHAs
Presentations to PHAs
MOU on human services transportation coordination
Medicaid Primer for Housing staff
THA Toolkit
Virginia Easy Living Coalition
Easy Access
211 Virginia
www.accessva.org
User’s Guide to Logisticare
ABC’s of Transition
PHAs’ Involvement in MFP Annual
Housing and Transportation Action Plan
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Centers for Independent Living will contact PHAs to ask them to
partner with them and other local agencies to support individuals
transitioning under MFP. They will:
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offer assistance to PHAs in understanding community living needs and
preferences of people with disabilities and seniors
assess local housing capacity needs and work with PHAs to develop
strategies to address the needs identified in future plans and planning
processes
document local changes in public housing policy, and work with PHAs to
foster and sustain increased housing options
A directory of services agencies will be disseminated, along with a
Medicaid services primer, to all housing agencies
How Will This Benefit PHAs?
• Opportunity to play a valued and integral role in a national long-term
support systems change initiative that can influence development of
a housing policy for the disability and aging communities in Virginia
• Existing communication and policy gaps between some service
providers and some housing agencies can be bridged
• PHAs can gain increased knowledge about the housing choices,
preferences and barriers faced by people with disabilities and
seniors who are of low income, while educating Medicaid and long
term support systems advocates and professionals about the
housing barriers they face as well as their current practices and
policies
• Medicaid services will be offered not only to individuals in
institutions, but also to individuals currently using Medicaid “waiver”
services in the community, thereby benefiting people already living
in the community who may have an existing relationship with a PHA.
For Further Information
Visit the Olmstead Website—”One Community”
http://www.olmsteadva.com
E-mail [email protected]
Visit the Money Follows the Person Website
http://www.olmsteadva.com/mfp/
E-mail [email protected]