Opening Doors, November
2006, Issue 29
Best Practice
Principles for Achieving Civil Rights in Permanent Supportive Housing
By Henry Korman
Introduction
The January 2003 issue of Opening
Doors, “Permanent Supportive Housing: A Proven Solution to Homelessness”
introduced the idea of permanent supportive housing as a solution to
homelessness. There is no single definition of “supportive housing.” Many
housing providers think of it as nothing more than a model for combining
supportive services and affordable housing for people with special needs,
especially people with significant disabilities, in community-based settings.
Approaches that combine housing and
community-based services are also used by state agencies working to implement
the directive of the Supreme Court in Olmstead v. L.C. Described in
detail in the December 2000 issue of Opening Doors, the Olmstead
decision says that unjustified isolation and segregation of people with
disabilities is discrimination and violates the Americans with Disabilities Act
(ADA). Olmstead requires states to develop comprehensive plans to assure
that people with disabilities in institutions and at risk of
institutionalization receive supportive services in the most integrated setting
appropriate to their individual needs. States responding to the Olmstead
decision are seeking strategies to combine affordable housing and supportive
services through models that promote true community integration.
Olmstead
makes it clear that there is an important civil rights dimension to the link
between community-based supportive services and affordable housing for people
with disabilities. The responsibility to provide services in the most
integrated setting extends to community-based services. However, the simple
combination of housing and services in community-based settings does not
necessarily result in “integration.” A true definition of supportive housing
must therefore articulate a vision for delivering needed supports and permanent
housing in a manner that responds to the integration imperatives of the
Nowhere is this challenge more
evident than when it is necessary to combine service funding with mainstream
affordable housing resources to create supportive housing. Rules governing
supportive services funding usually target services at people with a specific
type of disability. Conversely, civil rights requirements in mainstream housing
programs often forbid tenant selection based on category of disability. This
conflict between the categorical approach to funding community-based services
and the non-categorical requirements of housing programs sometimes proves to be
a barrier to the development of permanent supportive housing for people with
disabilities.
Of course, not all people with
disabilities need or desire permanent housing linked to services. This issue of
Opening Doors discusses why permanent supportive housing is an important
option for some people with disabilities, and explores the difficulties in coordinating
the categorical approach to providing services with the housing system’s
general prohibition on category-specific tenant selection practices. This issue
includes a discussion of best practice principles that can be used to achieve a
vision of supportive housing that comes closer to an ideal: permanent affordable, integrated,
community-based housing where the right to occupy the housing unit is based on
standard landlord-tenant laws, and in which flexible, on-demand supportive
services are available and controlled by the tenant.
Who Needs Supportive Housing and Why?
Many people with disabilities do
not need supportive housing. Nevertheless, a large number of people with
disabilities are people with long-term conditions that affect their activities
of daily living. People with significant physical disabilities may require the
removal of architectural barriers, and may need assistive technology and
adaptive equipment. Many people need personal care assistance with activities
such as eating, getting in and out of bed or a chair, bathing, dressing, etc.
Some people with serious mental illnesses need periodic assistance with money
management, medication management, vocational support, skills training,
socialization, housing search, and crisis support, especially to prevent
re-hospitalization. Some people with developmental disabilities may require
similar services, and may also benefit from case management, adaptive skills
training, and habilitation services that assist with socialization.
As a group, people with
disabilities are disproportionately poor compared to their counterparts without
disabilities. According to the 2000 U.S. Census, the poverty rate for people
with disabilities is two-thirds higher than the poverty rate for people without
disabilities. Sixty-one percent of families with a household member with
disabilities receive Social Security benefits, needs-based Supplemental
Security Income (SSI), or public assistance, compared to 17.8 percent of
families where there is no person with a disability.
Housing resources that serve all
low-income people are scarce, and that scarcity is particularly burdensome for
people with disabilities. Reports by the U.S. Department of Housing and Urban
Development (HUD) document that very low-income people with disabilities have
the highest rate of worst case housing needs, compared to very low-income
elders and families with children. The October 2005 edition of Opening Doors,
entitled “Priced Out in 2004,” details the particularly harsh affordability
conditions for people receiving SSI. In 20 states, the Fair Market Rent
standard used by HUD for a modest one-bedroom apartment exceeds the entire
amount of an individual monthly SSI payment. There is no state in the nation
where the Fair Market Rent is less than 71 percent of monthly SSI
benefits. The federal standard for
housing affordability suggest that people with SSI level income should pay no
more than 30 percent of monthly income for housing costs.
The combination of the need for
supportive services and for accessible and affordable housing means that
independent living is accomplished by many people with disabilities only when
subsidized housing and supportive services are both available. Supportive
housing is a key strategy to meeting that need.
Civil Rights, Institutions, and the Emergence of Group
Residential Facilities
Historically, models for delivering
supportive services have isolated people with disabilities in institutions,
including state psychiatric hospitals, nursing homes, state schools, and
intermediate care facilities for the mentally retarded. These places are
usually operated by agencies identified by category of disability, such as
State Departments of Mental Health or Mental Retardation. As late as the 1970s,
people confined to institutions were forced to live in inhumane conditions
where physical, emotional, and sexual abuse, and
physical and medical neglect were the common experiences. Civil rights lawsuits
have improved living conditions, and in some cases succeeded in closing the worst
of these places, although both institutions and the reports of poor living
conditions persist.
The civil rights lawsuits also
resulted in the creation of smaller group residential facilities like community
residences and group homes intended to house people formerly confined to
institutions. These facilities are usually operated by providers under contract
to state human service agencies. For that reason, they generally serve people
with a single type of disability. In the group residential model, housing and
services are “bundled” and delivered in a range of settings from most
restrictive to least restrictive based on the extent and nature of an
individual’s disability. Often, to move from a more restrictive setting to a
less restrictive setting an individual must establish that he or she has
developed independent living skills and must show a reduced need for services.
These facilities are also the model for housing other groups receiving
community-based services. For example, individuals with substance abuse
problems often are served in settings like halfway houses and group residences.
Disability Rights
The early lawsuits challenging
institutional conditions preceded the enactment of the
Community-Based Services Funding Streams
The Supreme Court Olmstead
decision drew on the
Most Medicaid funded
community-based services are offered as an option of participating states. One
mechanism available to states is the Medicaid Home and Community-Based Care
Services (HCBS) waiver program. States with approved HCBS waiver programs are
permitted to waive the “comparability” rule, which requires states to provide
an equal level of services to all qualified participants, without regard to
diagnosis. The program allows states to offer a variety of community-based
services, including adult day care and health services, habilitation services,
assistive technology and adaptive equipment, case management, personal care
attendants, respite care, and vocational services. States participating in the
program are allowed to target waiver services to categories of people with
disabilities, such as frail elders, people with physical disabilities, people
with developmental disabilities, individuals with traumatic brain injury, and
people who have AIDS. States may also vary the types of benefits they offer by
category of disability.
States may choose to make
supportive services available to people with mental illnesses using another
feature of the Medicaid program for provision of community-based services, the
state option program. Under Medicaid option programs, states provide services
like personal care assistance, targeted case management, clinic services, and
psychiatric rehabilitation services. Like HCBS waivers, Medicaid options are
exempt from the Medicaid comparability requirement, and many states elect to
target optional services based on category of disability, including mental
illness.
The approach that targets
supportive services by category of disability is not limited to Medicaid. The
systems that provide mental health and substance abuse services are also characterized
by a history that begins with institutional forms of treatment and a shift to
community-based options. Like other forms of supportive services, treatment for
mental health or substance abuse are also made available through funding
streams such as the federal Substance Abuse Treatment Block Grant and the
Mental Health Block Grant, which are restricted to those people with diagnoses.
All of these approaches target
community-based services based on the category of disability. There are
practical reasons for this result. Supportive service expenditures exert
tremendous fiscal pressures on state and federal budgets. In an environment of limited financial
resources, virtually all states focus available supportive services on those
individuals who are still living in institutions, or who are most at risk of
being institutionalized. Because people with disabilities are confined to
institutions based on diagnosis and served by community agencies, which receive
these categorical funds, virtually all community-based services remain targeted
to people based on category of disability.
Linking Supportive Services to Housing Programs
Medicaid and other supportive
service funding pay for the service component of supportive housing. To create
supportive housing opportunities, it is essential to find ways to assure that
people with disabilities can access mainstream affordable housing programs.
Civil rights-related rules associated with affordable housing programs often
conflict with the rules of supportive services programs. While federal housing
programs permit admissions and selection preferences under an all-inclusive
definition of disability, they tend to prohibit restrictions that limit
eligibility or preferences to categories of people with disabilities (for
example, only people with mental illness, or only people with
mental retardation/developmental disabilities). For example, the federal
public housing, tenant-based Section 8 Housing Choice Voucher, and multifamily
subsidized housing programs administered by HUD permit selection preferences
favoring all people with disabilities in general, but forbid preferences that
are targeted to people with a specific category of disability.
Other HUD programs are more
flexible, particularly when supportive services are part of the program design.
However, there is no consistent policy across programs, and sometimes policy
within a single program is inconsistent.
The April 2006 edition of Opening Doors discussed in detail the
ways in which HUD’s new Section 8 Project-Based Voucher (PBV) Program can
create new supportive housing opportunities for people with disabilities. An
owner may advertise a PBV unit as offering services for a particular type of
disability. However, the housing must be open to all otherwise eligible persons
with disabilities who may benefit from services provided in the housing.
Preferences that base admission on establishing need for services are only
permitted in order to serve individuals: 1) with disabilities that
significantly interfere with their ability to obtain and maintain themselves in
housing; 2) who, without supportive services, will not be able to obtain or
maintain themselves in housing; and
3) for
whom services cannot be provided in a integrated setting.
There is precedent for this
service-related tenant selection process. The federal Section 811 Supportive
Housing for Persons with Disabilities program (Section 811) creates housing
linked with supportive services for people with physical, mental, or emotional
impairments, and individuals with developmental disabilities. Section 811
providers may, with the approval of HUD, limit occupancy to people with
disabilities who have similar disabilities. However, the owner must permit
occupancy by any qualified person with a disability who could benefit from the
housing and services, without regard to the person’s disability.
Supportive housing is often funded
by programs administered through HUD’s Office of Community Planning and
Development (CPD). CPD programs include the McKinney-Vento homeless programs,
HOPWA, and the HOME program. It is within these programs that HUD policies
display the greatest inconsistency. The statute governing the Housing
Opportunities for Persons with AIDS (HOPWA) program requires that the program
serve only people with AIDS and related disorders. Similar statutory provisions apply in the
McKinney-Vento Shelter Plus Care program. HUD rules
interpret the Shelter Plus Care statute to say that
providers may establish a preference for groups such as people with serious
mental illnesses, chronic substance abuse, or AIDS. However, a provider is
permitted to exclude other homeless people with disabilities only when there is
sufficient demand for the housing within the target population, and the other
homeless people cannot benefit from the services offered by the provider.
Current rules in the Supportive Housing Program (SHP) also allow targeting of
units to designated populations of people with disabilities.
Rules in the HOME program display
the most inconsistencies. HOME funds
used for tenant-based rental assistance may use selection preferences for a
specific category of individuals with disabilities when the participating
jurisdiction’s HUD-mandated Consolidated Plan says that the preference is
needed to narrow a gap in benefits and services to that group of people. There are no comparable standards for capital
use of HOME funds. Early guidance from 1997 indicates that while HOME program selection
preferences may be offered to a category of people with disabilities, eligibility
cannot be limited to a category of people with disabilities, and a project may
not be filled exclusively through referrals from a single social service
agency. In 2005, HUD issued HOME program fair housing guidelines saying that in
special needs housing for people with disabilities, the housing must be
marketed to all individuals with disabilities and cannot be restricted to
persons with specific types of diagnoses or subclasses of persons with
disabilities.
The Low Income Housing Tax Credit (LIHTC)
program, described in the April 2005 issue of Opening Doors, is another
mainstream housing program that is available to create housing opportunities
for people with disabilities. Supportive housing is a permissible use of tax
credits. Civil rights requirements in the LIHTC program are embodied in a rule
under which dwelling units qualify for credits only if they are “available for
use by the general public.” To meet this standard, the unit must be rented in a
manner consistent with HUD non-discrimination rules. In the supportive housing
context, IRS interpretive rulings say that low rent units qualify for tax
credits where, for example, they are part of a project for homeless individuals
with a selection preference for people with alcohol and chemical dependencies.
Such selection preferences are permitted only when units are also available to
all homeless applicants, without regard to disability.
Disability Rights in Housing Linked to Services
Section 504 and the
When both housing and services are
dedicated to particular categories of people with disabilities served by
particular agencies in the community, decisions about choice of housing and
control over supportive services may not be based on the needs or desires of
the individual, but instead may be based on group characteristics. Categorical
housing programs often require people with disabilities to live in places
segregated by disability, in locations they might not choose, outside of the
communities with which they identify, and, in group home or congregate
settings, with people they do not select as roommates.
Rights of equal treatment, privacy,
autonomy, and liberty can be undermined when housing is contingent on
acquiescence to a treatment plan, or when the ability to retain possession of
the housing is not protected by standard landlord-tenant laws. Some federal
programs allow providers to enter into license agreements with occupants,
instead of leases or rental agreements. License agreements can be terminated
with very little advance notice and without the opportunity for judicial
oversight that is characteristic of standard rental housing. Still other
programs condition occupancy on participation in a service plan approved and
overseen by the service provider.
Focus on the Person and the Place
Individuals with disabilities
seeking affordable housing and community-based supports face a practical
dilemma: supportive services programs – including Medicaid – are in the process
of casting off old, discriminatory practices that isolate people with
disabilities in segregated, institutional settings by category of disability.
However high levels of poverty combined with the absence of affordable housing,
have forced supportive service providers to continue to command housing and
service resources following the old institutional patterns – by category of
disability. The basic understanding of disability rights that emerges from the
civil rights laws suggests an answer to this dilemma. A system of housing and
supportive services must first proceed with respect for the desires and needs
of the individual person, not the imperatives of the service provider, nor the
category of disability served by the provider. The design of the supportive
housing must preserve and enhance human relationships, and nurture full and
integrated participation in family relations, social contacts, work options,
economic independence, educational advancement, and cultural enrichment.
A supportive housing system that
reflects these values would be based on the following principles:
Supportive Housing Within a Larger
Framework of Meaningful Choice
People with disabilities generally
want the same kinds of housing that other citizens want: independent,
affordable apartments or houses, with voluntary access to support.
One measure of progress towards
integration is the achievement of conditions where individuals of similar
incomes have a like range of housing choices available to them regardless of
their race, color, religion, sex, handicap, familial status or national origin.
This understanding of integration derives from the obligation to affirmatively
further fair housing under the Fair Housing Act. The responsibility to further
fair housing is one that is also imposed through program statutes and agency
regulations on virtually every recipient of federal housing funds, including
recipients of HUD housing subsidies and capital advances, HOME funds, and
LIHTC.
At the state and local level in
particular, the obligation to further fair housing and assure equal choice is
one part planning and one part action. Olmstead planning groups are one
venue to carry out these activities.
State housing finance agencies also have the obligation to further fair
housing. They can do so through the Qualified Allocation Plans that federal law
requires for the distribution of LIHTC. Public Housing Agencies (PHA) must
develop PHA Plans for the use of federal public housing subsidies and Section 8
Housing Choice Voucher funds. State and
local recipients of HOME funds, Community Development Block Grants, and some
homeless funding operate under similar responsibilities to develop five-year
Consolidated Plans. Both PHAs and state and local
jurisdictions must complete an Analysis of Impediments to Fair Housing Choice
within these planning processes, under which they identify barriers to equal
opportunity and take action to remove those barriers.
So far, few state Olmstead
planning groups include representatives of housing agencies. However, all of
these planning mechanisms require public participation. It is imperative that
people with disabilities and advocates use these tools to promote not just
supportive housing opportunities for people with disabilities, but also full
access to a wide range of affordable housing opportunities not linked directly
to supportive services.
Necessity and Efficacy in the Link Between
Housing and Supportive Services
Segregated housing for people with
disabilities, including housing identified by category of disability, is
permissible under the
The first priority of Housing First
is to stabilize people in the short-term through the immediate provision of
housing. The model provides a subsidized apartment without any prerequisites
for treatment or sobriety. Participants are offered treatment by the program’s
support service staff, often utilizing a team-approach such as an Assertive
Community Treatment (ACT) team. Comparing outcomes for participants in
Continuum of Care programs with those of participants with mental illnesses in
a Housing First program, one study found that Housing First participants
experienced a greater decrease in psychiatric symptoms and smaller proportions
of time homeless even though the participants also reported lower utilization
of supportive services.
While some Housing First programs
serve all homeless people as the target population, others are aimed
exclusively at people with mental health and substance abuse issues.
Nevertheless, Housing First qualifies as a supportive housing program that is
consistent with civil rights principles for at least three reasons: 1) the
characteristics of the housing are the same as the sort of housing available to
the general public; 2) supportive services are voluntary; and 3) when
participation is limited to people within a category of disability, that
limitation is effective in reducing barriers to stable housing for people whose
disabilities might otherwise be a barrier to equal access.
Matching People to Services, Not Disabilities to Units
Disability discrimination laws
require that decisions about the distribution of housing and services must be
based on facts applicable to individuals and not on presumptions as to what a
class of individuals with disabilities can or cannot do. In practical terms,
this principle means that applicants for supportive housing should qualify for
admission not because of their relationship to a diagnosis-identified service
provider, but instead because they can benefit from the services offered in
connection with the housing. They should not be refused admission because they
are not clients of the service agency at the time of application and selection.
A related concept is that people with multiple disabilities must not be
excluded because they have some other disability in combination with the disability
for which the services are primarily designed.
Services are Voluntary and Separate from Housing
The Housing First model, which
services are voluntary and follow the person to their home, is also responsive
to the ideas of privacy and autonomy. It is based on research findings that a
lack of personal control and choice is associated with the experience of
psychiatric symptoms. Models that make housing contingent on giving up control
of decisions about daily living, treatment, and services have been shown to
have the effect of eroding coping tools. Programs that are designed to preserve
choice and personal control are more successful in the reduction of psychiatric
symptoms.
The Housing First approach
understands that housing needs are separate from needs for treatment. It aims
for an individualized set of service relationships with individual consumers
living in various housing situations. It means that services are voluntary, and
that they are flexible, portable, and available on demand.
Rights of Occupancy are Not Diminished
Closely associated with the concept
that services should be voluntary is the idea that people with disabilities
should not be subjected to different terms and conditions and lesser privileges
of occupancy simply because their housing is also a place where they might
receive services. Housing linked to services often violates this principle by
diminishing the rights of program participants to possess the units they occupy
through the use of agreements that allow for termination of tenancy with little
or no procedural protections. Using mainstream housing resources in supportive
housing can protect these rights simply because rules in the HOME,
Project-Based Voucher, LIHTC, and similar programs require the use of leases,
guard against eviction except for good cause, and forbid summary eviction,
including summary eviction without process for failure to comply with program
requirements. A principle of supportive housing is that the housing is
permanent, and continued occupancy is based on standard landlord-tenant law,
instead of an individual’s qualifications as a participant in a program of
supportive services.
Site Selection, Concentration, and Design
Recent studies of homeless programs
concluded that the environment in which supportive housing is located,
including such factors as crime and drug activity in the building and at the
neighborhood level influence the decisions of homeless people with disabilities
to stay in or leave supportive housing because of the effect such conditions
have on sobriety, and the capacity for managing stress.
In the context of race
discrimination, it is recognized that design, choice of location, and the
density and configuration of housing result in significant fair housing
consequences. HUD civil rights-related program requirements generally forbid
site selection in areas with high concentrations of poverty and racial
segregation, and require PHAs to adopt admissions
practices that serve to deconcentrate poverty.
Assisted housing must also promote greater choice of housing opportunities, and
be accessible to amenities like schools, retail facilities, health centers,
public transportation, and employment.
Supportive housing can benefit from
lessons learned in the race context with more robust standards aimed at
reducing isolation, preventing segregation, and avoiding differential
treatment. Units scattered within a larger housing development, integrated by
income, and occupied by people with and without disabilities are preferred over
facilities serving only people with disabilities. Housing should be built on
sites that are part of vibrant communities, located near educational,
commercial, and health facilities, public transportation and employment
opportunities, and away from crime, poverty, drugs, and racial segregation.
Units should be designed as apartments and homes, not as beds in a congregate
facility. The housing also must be sited, designed, and constructed in a manner
consistent with uniform architectural standards that make them usable and
accessible to people with mobility and sensory impairments. The best
integrative model for supportive housing is the one that people without
disabilities expect will apply to their own life situations: scattered-site
housing models with supports that may or may not be provided in the person’s
home.
Race and Ethnicity
Discrimination and segregation
based on race and ethnicity have long plagued public and assisted housing programs, some of it caused by histories of deliberate
segregation and deprivation of housing opportunity for people of color, and
some of it the result of benign but persistent neglect of racial
considerations. There is growing evidence that race, ethnic background, and
culture all play a role in preventing people of color and people whose first
language is not English from gaining access to health care and supportive
services. There is a higher prevalence of poverty and disability among
households of color than among white households. There is also a substantially
higher rate of poverty among disabled families of color compared to white
disabled households. Government studies document the existence of “striking”
disparities for minorities in access to mental health services, and the quality
of care. At least one study observed that the race or ethnicity of the
individuals with disabilities needing long-term supports may influence the
decisions of states to use Medicaid HCBS waivers. As a result, some states
serving high numbers of people of color with disabilities elect against
community-based services and instead continue to limit choice to institutional
forms of long-term care.
Olmstead’s
conclusion that institutional isolation is a form of disability discrimination
is directly connected to an earlier history of civil rights cases focused on
race in which it was understood that discrimination and segregation cause
long-lasting, stigmatizing injury. The obligations to further fair housing, to
affirmatively market to racial and ethnic minorities, and to refrain from
racial discrimination embedded in the Fair Housing Act and related laws apply
with full force to supportive housing. It is incumbent on supportive housing
providers to attend to these issues.
New Tools and Better Approaches
The issues of scarcity, poverty,
and discrimination that make it necessary for people with disabilities to seek
government funded housing and service resources are not about to vanish, and
will require setting aside housing resources specifically for people with
disabilities for the foreseeable future. Those issues and the imperatives of Olmstead
are also likely to force the continued practice of dedicating resources to
people with specific disabilities. If supportive housing is located within a
larger fabric of opportunity for people with disabilities in the same housing
that is available to the general public; if the features of supportive housing
resemble the apartments, homes, and rights of tenancy also available to the
general public; and if access to and utilization of services is a function of
individual needs, desires, and choice, then it should not matter whether
eligibility for housing is identified by category of disability.
Systems of supportive services are
in fact moving towards models that do not restrict eligibility based on
category of disability, connection to institutions, or control of services by
providers. Recent amendments to the Medicaid statute create opportunities not
yet realized to deliver services based on individual need, and not on category
of disability. The changes may allow states
to provide home and community-based services to elders and people with
disabilities without need for a federal waiver, and without the necessity of
proving that the provision of HCBS would be less costly than institutional
care. Under the new law, people with disabilities would qualify for services
based on an individualized assessment of need, services would be based on an
individualized care plan, and states would have the option to provide
self-directed services under the direction and control of the participant.
Other amendments codify as a pilot program the idea that in funding supportive
services “the money follows the person.”
Affordable housing programs are
also moving towards more flexible standards that permit different models of
supportive housing. The recent amendments to HUD’s PBV regulations reflect this
trend. Services may be provided at the site of the housing, or off-site,
independent of the dwelling units. The new rules match people to services based
on individual need by permitting supportive housing providers to offer
selection preferences to people with disabilities who need services offered at
a particular project. The rules work to preserve autonomy by mandating that
residents shall not be required to accept the supportive services offered at
the project. They honor the concept of separate housing only when needed to
achieve civil rights goals by limiting segregated settings only to those
circumstances where there is no other means to meet the housing needs of people
with significant disabilities. Perhaps the most important feature of the PBV
program from a civil rights standpoint is the central role of individual choice
and housing opportunity embedded in the program. After one year of occupancy in
a project-based development, participants can request and receive a portable,
tenant-based voucher in exchange for the project-based assistance. Once issued,
the tenant-based voucher enables a participant to leave the supportive housing
environment and rent a unit of their choosing in the private market.
Even with these new standards of
flexibility, the gap between housing programs and service programs is not yet
completely closed. The PBV rule retains the prohibition on selection
preferences for people with a category of disability. The recent changes to the
Medicaid statute still permit supportive service providers to limit access to
community-based services to target populations based on type of disability.
There is concern among some advocates that the flexibility afforded under the new
law will lead to more rather than less fragmentation in services. Under these
circumstances, housing opportunities for people with disabilities, especially
the people with significant disabilities that stand to benefit from Olmstead,
will depend on the ability of people with disabilities to state their demands,
and the concomitant ability of service and housing providers to respond by
developing supportive housing with operational hallmarks that further civil
rights in order to achieve true integration.
This issue of
Opening Doors is adapted from a longer article entitled, “Clash of the
Integrationists: The Mismatch of Civil Rights Imperatives in Supportive Housing
for People with Disabilities,” to be published in a winter symposium edition of
the St. Louis University Public Law Review commemorating the February 2006
Conference on Homelessness co-sponsored by the St. Louis University School of
Law and the Affordable Housing Forum of the American Bar Association. The
cooperation of the editors of the Public Law Review is gratefully acknowledged.
Protections
available under the Americans with Disabilities Act (
• Non-Discrimination
Discrimination is prohibited. “Discrimination” is any delay,
denial, exclusion or limitation of opportunity, and any different or unequal
treatment, based on disability.
• Integration
Programs must be administered in the most integrated setting
appropriate to the needs of the individual. Different or separate benefits to
people with disabilities or to any class of people with disabilities are
prohibited, except when necessary to provide services that are as effective as
those provided to others. People with disabilities may not be denied the
opportunity to participate in programs that are available to the general public
despite the existence of separate or different programs or activities that may
be targeted solely to people with disabilities.
• Equal
Opportunity and Choice
Housing and services must afford people with disabilities an
equal opportunity to obtain the same result, or gain the same benefit as that
provided to people without disabilities. In addition, the overall design of
housing programs and services must assure that individuals with disabilities
have a similar and complete range of housing choices available to them
regardless of disability.
• Privacy,
Concepts of privacy, liberty, and property capture a number
of important rights. Privacy and liberty mean that the person controls their
own behavior largely free of constraint. People cannot be deprived of liberty,
either committed to an institution or limited in their activities, without good
reason, and without sufficient legal process. Rights of privacy and liberty
also protect the physical person against intrusion, meaning, among other things,
that an individual cannot be forced to receive medical or therapeutic treatment
without their consent. These same principles recognize that an individual holds
a property interest in his/her home. That interest cannot be diminished or
terminated without appropriate legal process.
• The
Individual, Not the Group
A fundamental purpose of disability discrimination law is
the reversal of limitations and unequal treatment based on stereotypical
assumptions. Achieving this purpose means that services should be provided
based upon the needs of the individual, and not because of membership in a
category of people with disabilities.
Since 2002, the North Carolina Housing
Finance Agency has partnered with the North Carolina Department of Health and
Human Services to facilitate the inclusion of people with disabilities within
properties funded by the federal Low Income Housing Tax Credits (LIHTC)
program. All tax credit properties must
develop a Targeting Plan that makes 10 percent of the units available to
extremely low-income people with disabilities, including those people who are
homeless. Since 2002, an estimated 900
units of high quality affordable rental housing linked with voluntary services
and supports for people with disabilities have been funded – and an additional
200+ new units are added each year.
Tenants for the targeted units are
selected on the basis of income and disability, but not because they have a
specific type of disability. Tenants
sign leases and are treated like any other resident. The Key Program, a state funded demonstration
rental assistance program, is available to ensure that the targeted units are
affordable to people receiving SSI payments.
In addition to the 10 percent set-aside, other units in the tax credit
property may also be rented to people with disabilities who can afford to pay
the tax credit rent or who may have a Section 8 voucher.
The Department of Health and Human
Services facilitates a partnership between the property owner/manager and a
local lead agency that represents the local human service system – acting as
provider, coordinator, and/or referral agent for the range of community
services available to people with disabilities in their community.
Attention Opening Doors Subscribers!
Starting in the Spring of 2007,
Opening Doors will no longer be published in print format. We will continue to produce electronic issues
of the newsletter, which will be available to download from our website at
www.tacinc.org. We will also continue to
send announcements to our email list when each new issue is published. To sign up for the email list, please visit
www.tacinc.org/Forms/emaillist.htm. We
will publish one more printed issue (available in early 2007), after which we
will switch to the electronic-only format.
Be sure to sign up for the email list!
As always, the Technical Assistance Collaborative will
strive to continue providing important information on affordable housing issues
to people with disabilities, their families, advocates, and service providers
across the