Staff Updates Washington, D.C. Disability Policy Seminar February 14-16, 2011 SESSION I MONDAY,...

Staff Updates

Washington, D.C.Disability Policy Seminar February 14-16, 2011

SESSION IMONDAY, 11:00 AMFEBRUARY 14, 2011EMPLOYMENT AND

AFFORDABLE CARE ACT REVIEW

Employment

Too many people with intellectual and developmental disabilities are underemployed, in segregated settings, and earn very little money 424,000 earning sub-minimum wages (GAO) limited exposure to the workforce, reduced expectations,

lack of access to jobs Workforce Investment Act and Vocational

Rehabilitation agencies under-funded and under-trained

Major changes are needed legislatively and administratively to turn the system around

Disability Policy Seminar February 14-16, 2011

Washington, D.C.

Employment cont.

Sen. Harkin, HELP Committee Chairman, developing legislation

Recommendations: Need recommendations to made general workforce

programs accessible Incentivize states to change Medicaid and other

systems to embrace “employment first” policies Support model transition services that ensure that

youth transition to good jobs and postsecondary opportunities, not segregated settings


Washington, D.C.

Health Care Reform: 2 Laws

Patient Protection and Affordable Care Act (P.L. 111-148)

Health Care and Education Affordability Reconciliation Act (P.L. 111-152)

“Affordable Care Act”http://www.heathcare.gov

For health insurance information by state Comprehensive ACA implementation

4Washington, D.C.Disability Policy Seminar February 14-16, 2011

http://www.heathcare.gov/

Groundbreaking Legislation

Expand Coverage and Access to Care 32 million uninsured will be covered

New insurance exchange with premium sharing subsidies, and cost sharing caps

Large expansion of Medicaid eligibilitySignificant insurance market reforms

Completes the ADAPrevention, research, Medicare and others Long term services and supports expansions


ACA Implementation

Phased in over next several yearsAwaiting regulations and guidance on many

key issuesRegulations arriving at a steady paceStates working on implementing legislationNumerous threats to the ACA


Insurance Reforms In Effect Now

Means for plan years beginning on or after September 23, 2010

Eliminates pre-existing condition exclusion for under age 19

Lifetime limits not allowedPhase-in of elimination of annual limitsRescissionsAccess to doctorsEmergency room Appeals


Full repeal passed in the House –failed in the Senate

Lawsuits pendingPartial repeal votes expectedIf politically unpopular aspects repeal has cost

implicationsDefunding implementation and specific

programs

Threats to ACA


Highly politically charged debateOur organizations long term supporters of

health care reform and long term services and supports expansions

Not a partisan choiceRely on credible, non-partisan sources of

information

Political Climate


Premiums

Secretary can’t set premiumsTransition period until 2014$250 million over 5 years for states to build

capacity for rate reviewMedical Loss Ratio

85% of premiums spent on benefits Hotly debated


Grandfathered Plans

Grandfathered plans—plans in existence on March 23, 2010

Most health insurance through large employers (100 or more workers) will not see major changes to their coverage

Routine changes allowed: Keeping pace with medical inflation Adding new benefits Modest adjustments to existing benefits Voluntarily providing new consumer protections


Applies to Grandfathered Plans?

YESPre-existing condition

exclusions (EXCEPT individuals plans)

Lifetime and Annual Limits (EXCEPT individual plans)

RescissionsDependent Care

extension (EXCEPT if other employer-sponsored)

NOAccess to DoctorsEmergency room Appeals changes


Insurance Reforms in 2014

Can’t consider health status when calculating premiums

Prohibit discrimination based on health status

Eliminate use of annual limits for all Guaranteed issue and renewability


Individual Responsibility

Tax penalties for no coverage-administered by IRS 2014-- $95 2015--$325 2016-- $695

Percent of household income 1% in 2014, 2% in 2015 2.5% in 2016 and after

Exempts individuals with incomes too low to pay taxes


Need all people to be covered by insuranceShares the risk for insurersHelps keep premiums lowerGuarantee issue requirements and other

reforms cannot work without greater coverage

Why is this important?


Temporary Pre-Existing Conditions Plans Now until 2014

Coverage for Dependents (age 26) Effective now

Medicaid Expansion Effective 2014 but states can begin early

Health Insurance Exchanges Effective 2014 –can be state, regional or

run by the federal government

Expanding Coverage


Medicaid Expansion

Expands Medicaid eligibility to 133 % of Federal Poverty Line (2014) - • approximately $14,600/ individual; • $29,400/family of 4 (2009 FPL Guidelines)

New method of disregards brings it up to 138% of Federal Poverty Level

No asset test for eligibility


Medicaid Expansion, cont.

People with disabilities likely to benefit People receiving SSDI and in the 2-year

Medicare waiting period People who do not meet Social Security

disability standard and are low income People who meet the disability standard

but income or assets are too high


Medicaid Expansion, cont.

Federal Share (FMAP):• 100% for 2014 – 2016 (3 years)• Phases down to 90% for 2020 and

subsequent yearsCMS guidance--States can start earlier and

phase it inBy 2019 CBO estimates 16 million new

enrollees Maintenance of effort requirements


Health Insurance Exchanges (2014)

Provide coverage, increase competition, lower costs to small employers and individuals without access to affordable employer coverage

“Marketplace”: Private insurance plans that meet minimum standards on benefits and cost-sharing set forth in regulations

Multi-state Exchanges run by HHS for states that choose not to operate their own Exchange

Subsidies to low income individuals


Hospitalization, emergency services, ambulatory (i.e. outpatient) services

Prescription drugs and laboratory services

Rehabilitative and habilitative services and devices

Mental health and substance abuse disorder services including behavioral health treatment

Essential Benefits Package for Exchange Plans

Preventative and wellness services and chronic disease management

Pediatric services including dental and vision care

Maternity and newborn care


Essential Benefits, cont.

LAW REQUIRES:Appropriate balance among the categoriesCannot discriminate against individuals

because of their age, disability or expected length of life

Must take into account the health care needs of diverse segments of the population including women, children, persons with disabilities and other groups


Challenges to the Essential Benefits

Comprehensive benefits versus costsWhat do the key terms mean?

What is essential? What is appropriate balance? How should medical necessity be defined?

What coverage limits are allowed? What is the scope of each benefit categoryWhat is covered in a typical employer plan?


Rehabilitative and Habilitative Services and Devices

Broad category -- everything from therapies to wheelchairs

Medicaid definition of habilitationImportance of acquiring and maintaining skillsNo limitation on scope or settingPowerful opposition to the disability position


Autism Services

Mental health and substance use disorder services, including behavioral health treatment

Autism Speaks –this includes autism services Primarily concerned about Applied Behavior Analysis

(ABA) State coverage mandates for autism are often broader

and include habilitation May be an issue in states with mandates


Challenges to the Exchanges

Grants to states to plan the exchangesEnforcement responsibilitiesLevel insurance playing fieldEnsuring accessibilityQualified plans (sufficient providers etc.)Seamless interplay with Medicaid and CHIPHelpful services to employers who use itAdvocates need to be involved


Impact on Employers

Designed to build on employer-sponsored insurance

Impact varies by the size of the employer

Pay roll tax deduction available for small employers who provide health insurance


Summary Slide

Grandfathered plansLarge employersPart-time employeesPenalties for unaffordable or non-coverageCredits and subsidies for very small

employersFree choice vouchersFraud provisions


Disability and aging communities worked together

Goal – Ensure two-pronged inclusion of LTSS in health reform: National LTSS insurance program – avoid

impoverishment Improve Medicaid – eliminate institutional bias

Inclusion of Long Term Services and Supports in Health Care Reform


Accomplished: ◦ CLASS Act◦ Improvements to Medicaid

Community First Choice Option; Improving existing Section 1915(i) option; New state balancing incentives; Spousal impoverishment protections; Extend Money Follows the Person demonstration; Expand Aging and Disability Resource Centers

Long Term Services and Supports in Health Care Reform


New national LTSS insurance program Based on voluntary payment of premiums

◦ through employer or directly◦ Nominal premium for full-time students and

people with income below poverty levelVesting after 5 years of premium paymentsWork requirement

Community Living Assistance Services and Supports (CLASS) Act Plan


No exclusions based on pre-existing conditions

Benefits eligibility is based on functional need ◦ Need for assistance with activities of daily living or

equivalent

CLASS Act Plan, cont.


Cash benefits for maximum consumer and family control ◦ No impact on federal benefits eligibility• SSI and Medicaid

No “means-testing” – income is not considered ◦ No need for lifetime impoverishment ◦ Individual can continue to work

Advocacy and advice/assistance available



Separate CLASS Independence Trust Fund Secretary of HHS to develop the Plan Plan can pay for itself AND take pressure off

the Medicaid program Important for future of Medicaid program



The need for change: Institutional Bias within Medicaid

Nursing homes mandatory Community-based services optional or

waiver People with disabilities and their families

do not have an equal choice Long waiting lists for community-based

services and supports

Improving Long Term Services and Supports in Medicaid


Improving LTSS in Medicaid, cont.

Disability Community Long Term Goal: Enact the Community Choice Act

Would mandate Medicaid community-based attendant services and supports

Too costly and politically impossible to enact a mandate to states

Worked with White House and Congressional Sponsors on a first step in that direction – Community First Choice Option


• New state Medicaid plan option included in health reform law

• Comprehensive home and community based services for people eligible for an institutional level of care (nursing home, intermediate care facility (ICF), or IMD)

• States receive 6 percent additional federal match for CFC services

• Permanent provision in Medicaid program – does not “sunset”

Community First Choice (CFC) Option


• Included services and supports:– Assistance with activities of daily living (ADLs)– Assistance with instrumental activities of daily

living– Assistance with health-related tasks– Acquisition, maintenance, and enhancement of

skills necessary for the individual to accomplish the above

– Back-up systems or mechanisms (such as beepers, electronic devices)

– Voluntary training on how to select, manage, and dismiss attendants

CFC Option, cont.


• Manner of service provision:– Hands-on assistance– Supervision– Cueing

• Other permissible services – transition costs (first month’s rent and utility

deposits, bedding, kitchen supplies, etc.) – needs identified in person-centered plan that would

increase independence or substitute for human assistance

CFC Option, cont.


• Eligibility is based on functional need (not age, diagnosis, etc.)

• Allows people with incomes up to 300 percent of the SSI level to be eligible (depending on state rules)

CFC Option, cont.


States must: – provide services in a home or community setting – provide consumer-controlled services, statewide, in the

most integrated setting appropriate– create a Development and Implementation Council –

majority of members must be people with disabilities, elderly individuals, and their representatives

– establish a comprehensive quality assurance system using feedback from consumers, families, providers

CFC Option, cont.


Available beginning October 1, 2011 Advocates should be working with states now

CFC Option, cont.


Home and Community Based Services (HCBS) State Plan Option (Section 1915(i))

Medicaid 1915(i) Option States can provide services without a waiver States must establish eligibility that is less strict

than for institutional and HCBS waiver services – states serve people who are not eligible for the state’s HCBS waiver

Very few states took up this option to expand community-based services


ACA improved it to:– Allow states to provide full range of services allowed

in HCBS waiver –including “other services approved by the Secretary”

– Remove the authority for states to cap services, limit services to certain sections of the state, and maintain waiting lists

– Align income eligibility criteria with other HCBS programs – allows people with incomes up to 300 percent of the SSI level to be eligible

Amendments to HCBS Option(Section 1915(i))


Amendments to HCBS Option(Section 1915(i)), cont.

States may target certain populations in need for 5 years

CMS letter to State Medicaid Directors: August 6, 2010 http://www.cms.gov/smdl/downloads/SMD10015.pdf

Effective Date: October1, 2010


http://www.cms.gov/smdl/downloads/SMD10015.pdf

http://www.cms.gov/smdl/downloads/SMD10015.pdf

• Department of Health and Human Services

• CLASS Act Plan– Design/implementation of programs/public education

• Centers for Medicare and Medicaid Services (CMS)

• Community First Choice Option; Section 1915(i); State Rebalancing; Money Follows the Person

– Guidance to states– Funding decisions

• Will need your input and responses to alerts on regulations, etc.

Federal Implementation


• Implementation of Medicaid Long Term Services and Supports changes

• States have many choices– Community First Choice Option– Section 1915(i) option– Other new provisions

• Work with Governor, State Legislature

State Implementation


Message to Congress

Full Implementation – No RepealSupport the CLASS program

Oppose repeal Support full implementation of the Communty

First Choice Option and other Medicaid long term services improvements


Q & A


SESSION IITUESDAY, 9:00 AM

FEBRUARY 15, 2011BUDGET OVERVIEW, SOCIAL SECURITY,

MEDICAID, HOUSING AND AUTISM

Staff Updates


Budget and Appropriations process

In general…

President’s Budget – First week of FebruaryBudget Resolution – sets overall blueprint for

spending (March-April)12 Annual Appropriations bills – May – Sept.

Discretionary vs. authorizationOct. 1 New Fiscal Year

However, this year’s a little different…


Political Climate

Elections – Major Political Shift Over 100 new Members

94 new Representatives – 85 Republican 13 new Senators – 12 Republican

House shift to Republican majority: 242 to 193 Senate – Democrats now have narrow majority: 53 to 47

New House leaders - Speaker John Boehner (OH) Eric Cantor (VA) Majority Leader

Highly partisan, difficult to pass anythingAlready preparing for 2012 presidential elections Need to develop Republican disability champions


Washington, D.C.

New Republican Agenda

Smaller, more accountable governmentLower taxesRepeal and Replace “job-killing

health care” lawFiscal responsibility Protecting life, American values, and the

ConstitutionProviding for a robust national defense


Washington, D.C.

Debt, deficit, global recession, high unemployment, uninsured

Highly partisan e.g. Sens. Coburn (R-OK) and DeMint (R-SC) vow to block all future bills that aren’t “paid for”

Commission on Fiscal Responsibility & Reform: “Moment of Truth”

Republican Study Committee recommendationsPaul Ryan (R-WI), new Budget Chairman- RoadmapNew Appropriations Chairman Harold Rogers (R-

KY) “biggest cuts in our history”


Washington, D.C.

Budget and Appropriations Context

Fiscal Commission: Moment of Truth

Chairmen Erskine Bowles and former Senator Alan Simpson (11 to 7 vote)

$200 billion in discretionary cutsPlace dual eligibles in Medicaid managed care.

This would save $1 billion by 2015 $260 million cuts in Medicaid administrative costs Place a global cap on all health care spending,

which could include Medicaid block grantsReform or eliminate CLASS ActReduce the Cost of Living Adjustment (COLA) in

Social Security and other cutsWashington, D.C.Disability Policy Seminar February 14-16,

2011

Current Year Appropriations

FY 2011 appropriations not completed. CR until March 4 at level funding.

New overall House cap for HHS released Sets non-security discretionary spending level at

$420 billion, $43 billion less than the current level. Appropriations subcommittees received new

allocationsExpecting $7B cuts to Labor, HHS, ED funding billSpecific cuts to be made public the week of Feb. 14


Washington, D.C.

FY 2012 Appropriations

President sends budget request to Congress week of Feb. 14

House Budget Committee plans to cut back to pre-Recovery Act, FY 06 or 08 levels for the next decade

New House budget rules such as Cut-As-You-Go, Budget Chairman alone sets overall budget caps

Attacks on entitlement programs


Democrats Republicans

Harkin (IA), Chair Inouye (HI) Kohl (WI) Murray (WA) Landrieu (LA) Durbin (IL) Reed (RI) Pryor (AR) Mikulski (MD Brown (OH)

Shelby (AL), Ranking Cochran Hutchison (TX) Alexander (TN) Johnson (WI) Kirk (IL) Graham (SC) Moran (KS)

Senate Appropriations L-HHS-ED Subcommittee


Republicans Democrats

Rehberg (MT), Chair Lewis (CA) Alexander (LA) Kingston (GA) Granger (TX) Simpson (ID) Flake (AZ) Lummis (WY)

DeLauro (CT), Ranking Lowey (NY) Jackson (IL) Roybal-Allard (CA) Lee (CA)

House Appropriations L-HHS-ED Subcommittee


What to say on the Hill

Must put these cuts in Human terms! These cuts will do more harm than good!

What will happen if:IDEA, early intervention, or Head start funds

are cut by 20-40 percent or more?Title V Block Grant eliminated?Medicaid block-granted and capped?Health Care reform with Prevention Trust

Funds, Community First Choice, Money Follows the Person, CLASS Act – REPEALED? OR DEFUNDED?


Washington, D.C.

Combating Autism Act (PL 109-416)

Expanded research and coordination at the National Institutes of Health (NIH)

Increased awareness and surveillance at the Centers for Disease Control (CDC), and

Expanded the interdisciplinary training of health professionals to identify and support children with ASD and their families


Washington, D.C.

Combating Autism Act Successes

“These collaborative and coordinated efforts have served well to identify promising ASD research areas as well as to pinpoint both best-practices and gaps in ASD research and supports.”

“Recent highlights in ASD research include the development of new diagnostic tools, identification of novel genetic and environmental risk factors, clinical trials of interventions, and measures of the efficacy and cost-effectiveness of evidence-based services for people with ASD.”

Source: Office of Autism Research Coordination, National Institute of Health, Report to Congress on Activities Related to Autism Spectrum Disorders and Other Developmental Disabilities Under the Combating Autism Act of 2006 (FY 2006 – FY2009), December 2010


Washington, D.C.

Combating Autism Act Successes

But, significant gaps remain in access to evidence-based interventions, education, supported employment, family supports, and transition services across the lifespan

Progress made under CAA in increasing the capacity of professionals and service systems to address these gaps must be sustained and expanded


Washington, D.C.

Reauthorization of CAA

This law must be reauthorized or it will expire Sept 2011 because of sunset provisions

Former Sen. Dodd (D-CT) introduced a reauthorization bill before he retired

Repeals sunset, demos for services, expands P&A services, and training and technical assistance using the UCEDD network, new NIH Institute

Sen. Menendez (D-NJ) interested in championingReps. Doyle (D-PA) and Smith (R-NJ), Co-chairs of

Autism CaucusPolitical climate is challenging for anything new


Washington, D.C.

Social Security Is More Than Just a Retirement Program

Social Security - Old Age, Survivors, and Disability Insurance (OASDI) programs established in Title II of the Social Security Act.

Insurance programs – protecting against poverty – in retirement years; when disability may limit the ability to work; and for dependent survivors.

People with disabilities and their families receiving Social Security include:• Disabled workers and their dependents,• Retirees with disabilities,• Disabled dependents of retirees,• Disabled survivors, and• Disabled adult children and disabled widow(er)s.


Social Security Funding

Two Trust Funds Old Age and Survivors Trust Fund Disability Trust Fund

Usually treated as one Trust FundTrust Funds are financed through payroll taxes

– FICA taxesTrust Funds are currently running a planned

$2.6 trillion surplus, rising to $4.2 trillion by end of 2024


Long Term Solvency

Goal - Trust Fund solvency over the next 75 years

Projected shortfall of less than 1 percent of gross domestic product (GDP)

As a result of the current recession, Social Security’s FICA tax income is down – that is seen as temporary.

After surplus is spent, full scheduled benefits until 2039; 80 percent in 2040; and 76 percent in 2084.


Modest Changes Are Needed

Modest changes now can impact the shortfall.There is no need for major cuts in benefits or

changes in the structure of the program.National Commission on Fiscal Responsibility

and Reform, private commissions, and Members of Congress are calling for major changes in Social Security.

Major cuts will harm people with disabilities and their families and are not needed.


Some Elements of Reform Proposals

Change formula to reduce benefitsReduce Cost of Living Adjustments (COLAs)Raise the full retirement ageRasie the FICA tax rateRaise the earnings cap on FICA taxesExtend coverage to all government workersCreate private accounts


Social Security Solvency

Message: Congress should - Ensure solvency through limited or modest

changes which spread the costs widely Prevent depletion of, or privatization of, Trust

Funds Request a beneficiary impact statement on all

proposals


Improvements to SSI and Social Security Disability Programs

Many areas of Supplemental Security Income (SSI) and Social Security disability programs need improvement, including:

Increase the substantial gainful activity (SGA) levelIncrease the SSI asset limits and income exclusionsEliminate marriage penaltiesEliminate 2-year waiting period for MedicareMessage: Congress needs to make improvements to

thesecritical programs


Medicaid

Maintenance of Effort on Eligibility in ACA Adults - 1/2014 Children - 9/30/2019 Intended to prevent states from scaling back Cannot impose new paperwork requirements Cannot drop lawfully residing immigrants


Washington, D.C.

Medicaid MOE

EXCEPTION: states that already cover adults above 133% of poverty can change if state deficits are high

Cannot scale back for people with disabilities or pregnant women

CMS can withhold federal share if states violate

Has worked as intendedGovernors want relief from requirementArizona has requested a waiverDisability Policy Seminar February 14-16, 2011

Washington, D.C.

FMAP

Increased federal match phased outEnds June 30, 2011Vital to preventing deeper cutsShould continue until ACA is fully

implementedPolitically difficult


Washington, D.C.

Deficit Reduction Threats

President’s National Commission on Fiscal Responsibility and Reform

Basis for many deficit reduction negotiationsProposals for Medicaid

Provider tax Duals in managed care Reduced administrative funding More waivers


Washington, D.C.

Deficit Reduction Threats Continued

Key Medicare Proposals Raise deductible to $550 for Part A and B combined 20% coinsurance across the board Restrict supplemental policies from covering the first

$500 in co-insurance No specific mention of changes to low income subsidy

programs


Washington, D.C.

Deficit Reduction Threats Continued

Global budget for total health care spendingEstablish a process to review and limit

spending If spending grows faster than the economy

President and Congress required to take action

Aging population and higher health costs will continue to increase spending

Tremendous pressure to reduce spending


Washington, D.C.

Global Health Care Spending Cap

Major structural changes would likely resultMedicaid block grantsMedicare premium vouchersEnd to entitlement


Washington, D.C.

Other Deficit Proposals

“The Commitment to American Prosperity Act” (CAP Act)

Introduced by Senator Bob Corker (R-TN) and Claire McCaskill (D-MO)

Sets a cap on all entitlement and discretionary spending

If exceed cap, triggers automatic spending cuts across all programs

Includes Social Security spending


Washington, D.C.

Other Deficit Proposals Continued

If cap is exceeded biggest cuts come from Medicaid, Medicare and Social Security

Unlike previous deficit reduction laws no protections for these and other low income programs

Expect increased attention to federal balanced budget proposals

Imbalance in savings from revenue and spending cuts


Washington, D.C.

Summary

Expect there will be legislation introduced to block grant Medicaid and create vouchers for Medicare

Congress needs to understand the importance of these programs to the lives of people with disabilities

Already disparities in access to health care for people with disabilities

Deep cuts put the health of people with disabilities at risk and jeopardize our community services and supports


Washington, D.C.

HOUSING AFFORDABILITY GAP

The affordability gap for housing for people with disabilities has exponentially worsened in recent years.

According to Priced Out in 2008, a report by the Technical Assistance Collaborative, on a national average, over 4 million Americans with disabilities who rely on federal Supplemental Security Income (SSI) of $674 per month would have to pay 112% of their income to rent a modest one-bedroom unit or 99.3% for a smaller efficiency.


Washington, D.C.

MELVILLE ACT IS A HUGE VICTORY

After many years of effort by the disability community, the Frank Melville Supportive Housing Investment Act was passed by Congress last year and signed by President Obama on January 4th 2011.

The Melville Act is designed to streamline the Section 811 program of the Department of Housing and Urban Development (HUD) to increase the supply of integrated supportive housing for people with disabilities.


Washington, D.C.

MELVILLE ACT IS A HUGE VICTORY cont.

A great deal of credit goes to many people, including

Republican and Democratic sponsors of the Melville Act :

Congresswoman Judy Biggert (R-IL) & Congressman Christopher Murphy (D-CT)

Senator Mike Johanns (R-NE) & Senator Bob Menendez (D-NJ)

Banking Committee in the last Congress.


Washington, D.C.

MELVILLE ACT IS HUGE VICTORY contd.

Key Committee leaders:

Congressmen Barney Frank (D-MA) & Spencer Bachhus (R-AL), Chair and Ranking Member of the House Financial Services Committee, and

Senators Chris Dodd (D-CT) & Richard Shelby (R-AL), Chair and Ranking Member of the Senate


Washington, D.C.

How the Melville Act Helps

It reforms Section 811 to enable creation of thousands more units of integrated, permanent supportive housing every year.

Section 811 is a Department of Housing and Urban Development (HUD) program that assists the lowest income people with the most significant and long-term disabilities to live in the community by providing affordable housing linked with in-home or community-based services and supports.

Streamlines administrative processes for non-profit housing developers.

Creates incentives for integrated Section 811 units in non-profit owned multi-family rental developments funded by federal Low-Income Housing Tax Credits, HUD HOME funds and bond financing.


Washington, D.C.

How the Melville Act Helps cont.

Creates a new “Project Based Rental Assistance” (PRAC) on a stand-alone basis to enable state and local governments to integrate supportive housing into larger rental housing developments units. PRAC is essential because it covers operating costs (e.g. insurance, maintenance, etc.) that are not covered by tenant rents.

No more than 25% of the units in any one project can be set aside for people with disabilities


Washington, D.C.

SUPPORT HOUSING PROGRAMS

Congress should provide:• $1 billion for the National Affordable Housing Trust

Fund, which would be the first appropriation for this 2008 law – designed to develop 1.5 million new units of rental housing affordable to very low-income and extremely low-income households.

• At least level funding of $300 million for the FY 2011 Section 811 program –to create as many as 3,000 new supportive housing units – which are badly needed by many people with disabilities with very low incomes.


Washington, D.C.

Support Section 8 Funding

At a minimum, Congress should ensure full renewal funding for existing Section 8 Housing Choice Vouchers and renew all existing Section 8 Project-Based Contracts in FY 2012 to ensure that all vouchers are renewed and that no tenants are displaced and to protect and preserve this valuable subsidized housing for the lowest income households.

Congress should provide$30 million in new funding for new Housing Choice Vouchers targeted to non-elderly people with disabilities who are institutionalized or at risk of institutionalization.


Washington, D.C.

Q & A


Staff Updates Washington, D.C. Disability Policy Seminar February 14-16, 2011 SESSION I MONDAY,...

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