1. “ACT NOW “ Discussion for MFP grantees and HUD vouchers Center for Medicare and Medicaid Services September 30, 2009 2:00pm – 3:00pm EST

2. 2 Background On June 22, 2009, HUD posted in the Federal Register, a draft, proposed Notice of Funding Availability (NOFA) of $30M for: 4,000 new Housing Choice Vouchers 4,000 new Housing Choice Vouchers 1,000 of these vouchers target non-elderly persons with disabilities transitioning out of institutional settings. 1,000 of these vouchers target non-elderly persons with disabilities transitioning out of institutional settings.

3. Federal Register/Vol 74,No. 118/Monday, June 22, 2009/Notices 3 Background HUD’s Preference Language for PHAs: HUD’s Preference Language for PHAs: Persons Transitioning from Institutional Settings: Under the category of local preferences, a PHA may choose to provide a preference to people transitioning from institutional settings into independent, community-based living. Institutional settings include hospitals, nursing homes, and institutions for individuals with developmental disabilities. Some people transitioning may reside in one of the 29 States or the District of Columbia that have received specific funding for transitioning persons from institutions through a demonstration called Money Follows the Person (MFP). MFP is administered by the Centers for Medicare & Medicaid Services. The demonstration provides the necessary health and social services that people will require upon transitioning from an institution and thereafter to live independently in the community.

4. 4 ACT NOW A pproach the PHAs C ontact your Resources T rain your Coordinators N etwork with your Stakeholders Open doors to Communication Work to make it happen

5. 5 A pproach the PHAs Initiate conversations with PHA Partners about these opportunities. Initiate conversations with PHA Partners about these opportunities. Use Steering Committee members affiliated with housing as a foot in the door. Use Steering Committee members affiliated with housing as a foot in the door. Make sure that people seeking transitions are on the PHA waiting list where possible. Make sure that people seeking transitions are on the PHA waiting list where possible. Attend Public Housing/Community meetings to become familiar with the local staff. Attend Public Housing/Community meetings to become familiar with the local staff.

6. 6 C ontact your Resources Evaluate your own network of providers – where are your most effective programs? Evaluate your own network of providers – where are your most effective programs? Look at list for your state of PHAs, and match PHAs with your best programs. Look at list for your state of PHAs, and match PHAs with your best programs. Help local folks make the connection with the PHA. Help local folks make the connection with the PHA.

7. 7 T rain your Coordinators Prepare a general template, applicable to any community likely to participate. Prepare a general template, applicable to any community likely to participate. Assess the readiness of transition coordinators and case managers to make successful applications for Housing Choice Vouchers. Assess the readiness of transition coordinators and case managers to make successful applications for Housing Choice Vouchers. Obtain Needed documentation (i.e. award letter, birth certificates, review background check) Obtain Needed documentation (i.e. award letter, birth certificates, review background check) Complete application. Complete application. Provide training and support where needed. Provide training and support where needed.

8. 8 N etwork with Stakeholders Involve your MFP Stakeholders. Involve your MFP Stakeholders. Work with your Housing Task Force. Work with your Housing Task Force. Reach out to affordable housing coalitions. Reach out to affordable housing coalitions. Make connections with local and state housing organizations. Make connections with local and state housing organizations.

9. 9 O pen Doors to Communication Spread the word about this opportunity. Spread the word about this opportunity. Seek out allies to share information. Seek out allies to share information. Be specific about your needs. Be specific about your needs. Reassure potential PHAs that you can provide the supports. Reassure potential PHAs that you can provide the supports.

10. 10 W ork to Make It Happen Identify someone to support your efforts at the state level. Identify someone to support your efforts at the state level. Learn to talk HUD language. Learn to talk HUD language. Build relationships with the key people in your housing agencies. Build relationships with the key people in your housing agencies. Identify potential “qualified residences” to accept vouchers. Identify potential “qualified residences” to accept vouchers.

11. Why should MFP partner with PHAs? Housing is one of the biggest barriers to realizing the Rebalancing of Long-Term Care Services and Programs. Housing is one of the biggest barriers to realizing the Rebalancing of Long-Term Care Services and Programs. Successful implementation of the Money Follows the Person requires housing. Successful implementation of the Money Follows the Person requires housing. Without Housing – There is NO Transition. Without Housing – There is NO Transition. 11

12. Why should MFP partner with PHAs? Medicaid waivers and other Medicaid-funded coordinated services can assure funding for supports and services. Medicaid waivers and other Medicaid-funded coordinated services can assure funding for supports and services. Transition coordinators and other service providers can ensure necessary supports and services. Transition coordinators and other service providers can ensure necessary supports and services. Medicaid-funded case managers and transition coordinators will bring qualified customers with well-prepared applications for consideration; alleviating any additional burden on PHA staff. Medicaid-funded case managers and transition coordinators will bring qualified customers with well-prepared applications for consideration; alleviating any additional burden on PHA staff. 12

13. 13 Why should PHAs Participate? This activity helps them meet their legal and ethical obligations under Olmstead. This activity helps them meet their legal and ethical obligations under Olmstead. National Movement towards Home and Community- Based Health Care and Living. National Movement towards Home and Community- Based Health Care and Living. Compliance with Americans with Disabilities Act. Compliance with Americans with Disabilities Act. It’s the right thing to do. It’s the right thing to do.

14. Ask Yourself… How many people are ready to exit the institution and lack ONLY funding for housing? How many people are ready to exit the institution and lack ONLY funding for housing? How many people plan to transition within the next 90 days, and lack ONLY funding for housing? How many people plan to transition within the next 90 days, and lack ONLY funding for housing? These two groups provide a reasonable estimate of the number of vouchers that could be used within the time frame. These two groups provide a reasonable estimate of the number of vouchers that could be used within the time frame.

15. Estimating your Need Accurate estimation of the number of vouchers your state might be able to use, within the timeframe, is important. It is possible to estimate using two sources of data: The number of persons to be served, including information about their preferences, and The performance of transition coordinators or case managers in the field.

16. Estimating your Need Your OP estimate for next fiscal year is 100 people. Your housing plan offers Qualified Resident choices of: – – assisted living, – –adult foster care, and – –regular housing. The preference data you are able to gather indicate: – –40% of persons might choose assisted living, – –20% might choose adult foster care, and – –40% might choose regular housing. Just on this information, you might estimate the Need for 40 vouchers next fiscal year, across the state.

17. Estimating your Need Your performance data suggest that the largest number of successful transitions to date have been made by Provider X. That provider helps people make transitions at the average rate of 5 people every six months.

18. Estimating your Need In this example, you would approach your most efficient provider, averaging 5 people every six months and ask two questions: Is their local PHA approachable? If so, what is their estimate of the number of people they could help with the addition of the vouchers?

19. Estimating your Need In this example: Your best estimate might be that for Provider X, with the addition of housing choice vouchers, the expectation is that 8 persons will be able to use vouchers in the coming fiscal year. Your estimate needs to be balanced with actual performance data. “It’s better to underestimate than to overestimate.”

20. TAC Newsletter (www.tacinc.org) HUD's Section 811 Supportive Housing for Persons with Disabilities program On July 22, 2009, the Frank Melville Supportive Housing Investment Act (H.R. 1675) passed in a bi- partisan vote in the U.S. House of Representatives. The Section 811 is the only HUD program exclusively serving people with the most significant and long-term disabilities. If signed by the President, this legislation (H.R 1675 and S. 1481) will revitalize and reinvigorate Section 811, and could help produce thousands more permanent supportive housing units every year without any increase in Section 811 appropriations.