TAC Report

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Assessment of Housing Opportunities for People with Severe Disabilities in Maryland

Prepared by the Technical Assistance Collaborative, Inc.
Boston, MA
November 2001

Executive Summary
In 1999, as part of the Olmstead vs. L.C. decision, the U.S. Supreme Court affirmed that under the Americans with Disabilities Act (ADA) states may no longer confine people with disabilities unnecessarily in "restrictive settings" such as institutions or segregated facilities.  As a result of the Olmstead decision, states – including Maryland - are exploring ways to incorporate the ADA "integration mandate" into their delivery of medical and other support services for people with disabilities in the United States who are ready to move from hospitals into the community or who are at-risk of institutionalization.

A key question central to Olmstead-planning efforts is "where will people with disabilities live?"  As a result of the Olmstead decision, certain people currently living in "more restrictive settings" such as public institutions and nursing homes – as well as people at-risk of living in such settings –  must be offered housing and community based supports that are consistent with the integration mandate of the ADA.  The Olmstead decision offered guidance for states by suggesting that states develop "comprehensive, effectively working plans" to ensure community integration. It has become clear that comprehensive planning activities should address the availability of permanent, affordable, accessible, and integrated housing.

Researchers and practitioners have demonstrated repeatedly that people with severe disabilities – including many people currently living in institutions – can live successfully in homes of their own in the community.  To succeed, they need decent, safe, affordable and accessible housing that is separate from – but provides access to – the community based supports and services they want and need to live as independently as possible.

Unfortunately, people with disabilities are disproportionately poor – particularly the 72,000 disabled people in Maryland who receive federal Supplemental Security Income (SSI) benefits worth approximately $520 per month. Because of their extreme poverty, people with SSI level incomes are facing significant challenges in locating safe, decent and affordable housing.  In 2000, SSI benefits were equal to 13 percent of median income in Maryland.  On average, in 2000 a person receiving SSI in Maryland had to spend 117 percent of their monthly benefits to afford a modest one-bedroom apartment – literally an impossibility. Without some type of housing assistance – such as government-funded subsidized housing - low-income people with severe disabilities are unable to afford decent and safe housing of their choice in the community.

Maryland has recognized that affordable and accessible housing is a critical component of Olmstead planning and community integration strategies.  Already, state officials, advocates, and providers are working collaboratively to begin to assess the impact of Olmstead, and have garnered substantial support and funding to be directed towards this effort. 

As part of the state's Olmstead planning efforts, the Maryland Department of Health and Mental Hygiene (DHMH) requested that the Technical Assistance Collaborative, Inc. (TAC) assist state officials to develop a "multi-pronged, proactive strategy to address the critical issue of affordable, accessible community based housing for people with disabilities to ensure that people move into the community at a reasonable pace."  This report includes TAC's specific recommendations to implement such a housing strategy.

The recommendations are the outcome of a comprehensive assessment conducted between August and October of 2001 that included a review of Maryland's housing and service systems and resources, numerous on-site visits, interviews with state and local officials, as well as over 40 key stakeholders across the state.

TAC's assessment determined that at the state level, and in some localities across the state, there is a growing commitment among government officials, funders, disability providers, and housing agencies to work together to implement a comprehensive housing strategy for people with severe disabilities. However, much more needs to be done for the goal of a "comprehensive effectively working plan" to be achieved.

In order to assist the state to expand decent, safe, affordable, accessible, and integrated housing consistent with the principles of the ADA, TAC has made the following recommendations:

1. Develop a state level cross-disability coalition and offer incentives for the development of similar coalitions at the local level.  For Olmstead planning purposes, it is important that the disability community in Maryland  "speak with one voice" to housing officials and funders.  To achieve this objective, TAC recommends developing a cross-disability coalition at the state level  - made up of representatives from DHMH's Mental Hygiene and Developmental Disabilities Administration, the Department of Human Resources and the Governor's Office for Individuals with Disabilities, as well as DHCD - to work to promote change in housing policies and model more effective strategies for using government housing programs for people with severe disabilities.
2. Target Section 8 vouchers to people with disabilities through the development of a statewide Bridge subsidy program and partnerships with PHAs.  People with SSI level incomes need subsidized housing resources such as Section 8 vouchers available through PHAs.  A state sponsored Bridge Subsidy Program could provide temporary rental assistance until a person receives a Section 8 voucher and leverage hundreds of new Section 8 vouchers appropriated by Congress.
3. Develop and fund new financing model(s) to ensure affordability of rental housing for people with severe disabilities.  TAC recommends that DHCD work in partnership with DHMH and other state officials to develop and implement a new housing production strategy linked to rent or operating subsidies that will increase the supply of rental housing units targeted to people with disabilities with SSI level incomes.
4. Continue the state's homeownership activities for people with disabilities with an emphasis on appropriate income targeting and linkage to Section 8 vouchers for homeownership assistance.  TAC is pleased to endorse the new program design and guidelines, and believes that – with the potential availability of Section 8 vouchers for homeownership assistance – the outcomes for this three year initiative could easily surpass the results achieved over the past several years.
5. Create a statewide computerized interactive accessible housing registry.   Currently, Maryland does not have an efficient strategy to link people who need accessible housing with available barrier-free units. TAC recommends that Maryland implement an interactive statewide computerized database of barrier-free subsidized housing similar to those developed in other states such as Massachusetts.  As part of this effort, the state could explore whether the reasonable accommodations provisions of the FHA could facilitate the cooperation of subsidized housing owners and developers.
6. Consider the development of a state-sponsored demonstration program that could "package" two or more of the recommendations above.  A demonstration program implementing several of the above recommendations could serve as a policy framework to implement "promising practices" on a broader scale.  TAC believes that structured demonstration programs can be extremely valuable to promote systems change and integration, particularly when focused on housing production and new financing models.

Inevitably, innovation in affordable housing practices benefiting people with disabilities will also depend on intangibles, including a culture of innovation and change, and the leadership it takes to sustain the process of systems change.  TAC firmly believes that these dynamics can be fostered and enhanced in Maryland by implementing the recommendations outlined above.