Community and Choice Housing needs for people with disabilities in Delaware

April 16, 2012

Agenda

• Housing Needs

• Recommendations

• Next Steps

• Secretary Landgraf and Director Ben Addi

Housing

Needs

Delawareans with Disabilities

• 36.4 million in U.S. with disabilities (11.9%)

• Estimated 108,500 Delawareans with disabilities (12.3%)

• Mental health, physical disabilities, intellectual/developmental, sensory, ADLs (“Self-care”), IADLs (“Independent living”)

Type of Disability

10.9%

1.9%

1.7%

4.6%

5.5%

1.7%

3.2%

0% 2% 4% 6% 8% 10% 12% 14% 16%

Any Disability

Hearing Difficulty

Vision Difficulty

Cognitive Difficulty

Ambulatory Difficulty

Self-Care Difficulty

Independent Living Difficulty

Prevalence by Type of Disability, Population 18-64, Delaware, 2010

Source: 2010 American Community Survey

Any Disability by Age Group

4% 6%

13%

21%

45%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

<18 18-34 35-64 65 - 74 75+

Prevalence of Any Disability by Age Group Delaware, 2010

Source: 2010 American Community Survey

Aging Population

+10.8% +11.2% +6.1%

+116.9%

0%

20%

40%

60%

80%

100%

120%

140%

Under 18 18 to 44 Years 45 to 64 Years 65+ years

Projected Change in Population by Age Delaware: 2010 - 2040

Source: 2011 Delaware Population Consortium Population Projection Series

Delawareans over 65

2010: 130,861

2040: 283,887

Poverty

16.7% 10.5%

22.7%

14.4%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

With a Disability With No Disability

Percent of Population In Poverty and Near-Poverty By Disability Status, Delaware 2008-2010

<100% of Poverty Level 100-200% of Poverty Level

Source: 2008-2010 American Community Survey

39.4%

24.9%

Housing Challenges for all Delawareans

• Approximately 25,000 households on waiting lists for public housing, Housing Choice Vouchers, and privately-owned subsidized housing.

• 12,845 severely cost-burdened extremely low income (<30% AMI) renter households in DE.

• Estimated 54% of renters in Delaware cannot afford the 2 BR fair market rent.

Accessibility – Rental Housing

• Data challenges

• Mismatches

▫ Units are there, but:

Challenge is matching people to them

People who rely on SSI/SSDI or are otherwise extremely low-income can not afford even income-restricted units.

Long waits for tenant-based subsidies and subsidized sites.

Possible size and location mismatch

Accessibility - Homeowners

Estimates of Low Income Homeowner Households with Members who have a Disability or who are Elderly

10,940 Low income homeowners (<80% AMI) with a mobility or self-care disability

52% With housing problems (cost-burden, inadequate condition, overcrowding)

17,690 Very low income (<50%) elderly homeowners

25% Cost-burdened (paying more than 30% of income for housing costs)

6,156 Very low income (<50%) elderly homeowners with any disability

Source: 2006-2008 HUD CHAS Data

Increasing Accessibility Needs

Needs assistance with ADLs

• As a resident of the home: 60%

• As a visitor to the home: 91%

• As a resident of the home: 25%

• As a visitor to the home: 53%

Has any physical limitation

Probability that a newly built single family home, over the course of its useful life, will be used by

someone who:

Source: “Aging and Disability: Implications for the Housing Industry and Housing Policy in the United States,” Journal of the American Planning Association, 2008

$209

$284

$372

$380

$832

$0 $100 $200 $300 $400 $500 $600 $700 $800 $900

Supplemental Security Income …

1-person 2010 Poverty Threshold

Minimum Wage (DE)

30% of AMI (DE, 1 person)

2010 1 BR Fair Market Rent

Affordable Rents and 1-BR Fair Market Rent

Rents Out of Reach

Delaware Local Data

Population Need

Substance Abuse/ Mental Health

882 - in institutional settings, homeless, or unknown housing situation

Elderly or Adults with Physical Disabilities

300 – diversions & transitions from LTC facilities 100 – transitions from DHSS LTC facilities 250 – Other DSAAPD referrals

Intellectual/Developmental Disabilities

150 – at risk due to aging caregivers

HIV/AIDS 250 on TBRA waiting list

Total 1,932

Worst Case Housing Needs

• HUD-defined term to identify most vulnerable households, annual report to Congress on Worst Case Housing Needs

• Renter households with very low incomes (<50% AMI) with no rental subsidy and severe housing problems

▫ Severe housing problems: inadequate kitchen or plumbing, overcrowding, or severe cost burden (>50% of income for housing costs)

Worst Case Housing Needs

U.S. (2009): Delaware (2010, estimate):

• 7.10 million households with worst case needs.

• 987,000 households with at least one nonelderly member with a disability with worst case housing needs.

• 619,000 households with an elderly member with a disability with worst case needs.

• 18,235 households with worst case needs.

• 4,500households with at least one nonelderly member with a disability with worst case housing needs.

• 1,600 households with an elderly member with a disability with worst case needs.

Source: HUD 2009 Worst Case Needs Report to Congress

Community Care

• 2010 Census: 4,591 people in nursing facilities or skilled nursing facilities in Delaware

• Settlement Agreement: U.S. Department of Justice & State of Delaware

• Reforming systems to prioritize community care.

• 2011 DHSS average daily census

▫ All DSAAPD facilities: 380

▫ Delaware Psychiatric Center (DPC): 160

▫ Stockley Center: 68

Imbalance in Community Care

44.0%

66.2%

36.1% 35.2%

76.2%

12.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

All LTSS ID/DD LTSS Elderly/Adults with Disabilities LTSS

Percent of Medicaid Funding for Long-term Services and Supports (LTSS) on Non-institutional Services,

U.S. and DE, FY 2009

U.S. Delaware

Source: Thomson Reuters, Medicaid Expenditures for Long-term Services and Supports: 2011 Update

SRAP Successes

Systems: Focus Group Feedback

• Six focus groups with consumers, providers, advocates and others in 2011

• Major themes

▫ Choices and options

▫ Getting the right help the first time

▫ Scarcity of resources

▫ Successes

Recommendations

Recommendations

Accessibility Affordability

Community Systems

Accessibility

Increase the availability of and

access to rental and

homeownership opportunities with

accessibility features.

Develop real-time information on

accessible, affordable units.

• Searchable by location, vacancies, and accessibility features

Reduce fair housing barriers.

• Targeted for audiences (case managers, property owners, consumers)

• Right to reasonable accommodations

Fair Housing Education

• Tenant based rental assistance (TBRA)

• Reliance on federal income supports (SSDI, SSI)

Source of Income

Discrimination

Increase prevalence of basic access

features in new homes.

• Majority of DE housing stock is single family homes

▫ Total stock: 73% is single family

▫ Rental housing: 39% is single family

• Improving accessibility for everyone who is likely to use a home

• Easier modification later to meet specific needs

Expand and coordinate resources for

accessibility modifications.

• Many programs

• Homeowners with multiple needs

• Important strategy to keep people in their homes.

Affordability

Increase the availability of and

access to affordable housing for

people with disabilities.

Increase availability of LIHTC units for

people with disabilities.

Units Afford-

able People

Expand incentives for basic access and

universal design.

• Incentives to increase accessibility in affordable housing have focused on full accessibility.

• Explore incentives for basic access and universal design features.

Invest in permanent supportive housing.

Permanent supportive

housing is a vital strategic

response to ending

homelessness.

Improve asset-building opportunities.

• Improve access to financial literacy, credit repair, asset-building, homeownership counseling and tax preparation programs.

• Specialized loan and savings programs.

• Financial case management/coaching services.

Community

Build a community-based system

of care with a range of housing

options for consumers.

Prioritize community-based care.

• Redirect resources to community-based care.

• Provide for housing needs to ensure living and receiving care in the community is realistic and sustainable.

36%

13%

U.S. DE

% of Medicaid Spending for Elderly/ Physical Disabilities

on HCBS, 2009

Source: www.longtermscorecard.org

Housing options and meaningful choices

Private Rental Housing

Home-ownership

Shared Housing

Group homes Supervised Apartments

Diversion and transition strategies

• Prevent unnecessary institutionalization and reduce readmissions

• Diversion works:

▫ Pilot DHSS diversion program extremely successful

▫ In first 6 months, 83% of participants avoided entering institutional settings

Source: DHSS

Implement discharge planning.

No person should leave a hospital, nursing home, or residential treatment program without:

• Permanent or transitional housing. Housing

• Entitlement or employment income to pay for it. Income

• Services to sustain it. Services

Community-based care requires a

community.

Integration into communities isolated by poverty, transportation and lack of opportunity is not success.

Improve community planning to improve quality of life for all residents.

Walkability, design that encourages interaction with our neighbors and communities; opportunities for work, volunteer and civic engagement, recreation.

Systems

Improve the affordable housing

and disabilities services systems

that serve people with disabilities.

Work together better.

Continue to develop partnerships between the housing and disabilities services systems.

Improve cooperation among and with Delaware’s public housing authorities (PHAs).

Improve cross-communication between the different housing and disabilities planning processes.

The right help the first time.

Improve triage assessment of housing needs.

Implement housing matrix questionnaire across DHSS

Improve data collection

Improve communication with consumers and more accessible, centralized, user-friendly sources of information.

Coordinate resource guides and websites

Next Steps

Next Steps: Comprehensive Housing

Plan for Delaware

• Statewide planning effort to address housing needs of Delawareans, especially cost-burdened households and those living with disabling conditions

• Lead collaborators: Homeless Planning Council of Delaware and Delaware Housing Coalition

▫ Statewide community partners and stakeholders

• Three year process

▫ Year 1: Planning vision and review of existing conditions and trends

▫ Year 2: Data collection, analysis and recommendations

▫ Year 3: Draft final report and adopt plan

Next Steps: Comprehensive Housing

Plan for Delaware

2011 Accomplishments 2012 Goals

• Steering committee with statewide representation

• Planning vision, framework, and scope

• Target populations

• Database to track current information

• Land use workgroup

• Housing Needs for People with Disabilities Study

• Synthesize information from 2011 research

• Identify gaps in data and areas of further study

• Assess targeted populations and housing options

▫ Manufactured housing, homeless populations, alternative rental and homeownership models

• Inventory existing housing options

• Compile housing funding matrix