““ACT NOW “ ACT NOW “ Discussion for MFP grantees Discussion for MFP grantees

and HUD vouchersand HUD vouchersCenter for Medicare and Medicaid Services Center for Medicare and Medicaid Services

September 30, 2009September 30, 2009

2:00pm – 3:00pm EST2:00pm – 3:00pm EST

22

BackgroundBackground

On June 22, 2009, HUD posted in the Federal On June 22, 2009, HUD posted in the Federal Register, a draft, proposed Notice of Funding Register, a draft, proposed Notice of Funding Availability (NOFA) of $30M for: Availability (NOFA) of $30M for:

4,000 new Housing Choice Vouchers4,000 new Housing Choice Vouchers

1,000 of these vouchers target non-elderly 1,000 of these vouchers target non-elderly persons with disabilities transitioning out of persons with disabilities transitioning out of institutional settings.institutional settings.

Federal Register/Vol 74,No. 118/Monday, June 2Federal Register/Vol 74,No. 118/Monday, June 22, 2009/Notices2, 2009/Notices

33

BackgroundBackground

HUD’s Preference Language for PHAs:HUD’s Preference Language for PHAs:

Persons Transitioning from Institutional Settings: Persons Transitioning from Institutional Settings: Under the category of local preferences, a PHA may choose Under the category of local preferences, a PHA may choose to provide a preference to people transitioning from to provide a preference to people transitioning from institutional settings into independent, community-based institutional settings into independent, community-based living. Institutional settings include hospitals, nursing living. Institutional settings include hospitals, nursing homes, and institutions for individuals with developmental homes, and institutions for individuals with developmental disabilities. Some people transitioning may reside in one of disabilities. Some people transitioning may reside in one of the 29 States or the District of Columbia that have received the 29 States or the District of Columbia that have received specific funding for transitioning persons from institutions specific funding for transitioning persons from institutions through a demonstration called Money Follows the Person through a demonstration called Money Follows the Person (MFP). MFP is administered by the Centers for Medicare & (MFP). MFP is administered by the Centers for Medicare & Medicaid Services. The demonstration provides the Medicaid Services. The demonstration provides the necessary health and social services that people will require necessary health and social services that people will require upon transitioning from an institution and thereafter to live upon transitioning from an institution and thereafter to live independently in the community.independently in the community.

44

ACT NOWACT NOW

AApproach the PHAspproach the PHAs

CContact your Resourcesontact your Resources

TTrain your Coordinatorsrain your Coordinators

NNetwork with your Stakeholdersetwork with your Stakeholders

OOpen doors to Communicationpen doors to Communication

WWork to make it happenork to make it happen

55

AApproach the PHAspproach the PHAs

Initiate conversations with PHA Partners Initiate conversations with PHA Partners about these opportunities.about these opportunities.

Use Steering Committee members affiliated Use Steering Committee members affiliated with housing as a foot in the door.with housing as a foot in the door.

Make sure that people seeking transitions are Make sure that people seeking transitions are on the PHA waiting list where possible.on the PHA waiting list where possible.

Attend Public Housing/Community meetings Attend Public Housing/Community meetings to become familiar with the local staff.to become familiar with the local staff.

66

CContact your ontact your ResourcesResources

Evaluate your own network of providers – Evaluate your own network of providers – where are your most effective programs?where are your most effective programs?

Look at list for your state of PHAs, and match Look at list for your state of PHAs, and match PHAs with your best programs.PHAs with your best programs.

Help local folks make the connection with the Help local folks make the connection with the PHA.PHA.

77

TTrainrain your your CoordinatorsCoordinators

Prepare a general template, applicable to any Prepare a general template, applicable to any community likely to participate. community likely to participate.

Assess the readiness of transition coordinators Assess the readiness of transition coordinators and case managers to make successful and case managers to make successful applications for Housing Choice Vouchers.applications for Housing Choice Vouchers.

Obtain Needed documentation (i.e. award letter, Obtain Needed documentation (i.e. award letter, birth certificates, review background check)birth certificates, review background check)

Complete application.Complete application. Provide training and support where needed.Provide training and support where needed.

88

NNetwork with Stakeholdersetwork 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 Make connections with local and state housing organizations.housing organizations.

99

OOpenpen Doors to Doors to CommunicationCommunication

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 Reassure potential PHAs that you can provide the supports.the supports.

1010

WWork to Make It Happenork to Make It Happen

Identify someone to support your efforts at Identify someone to support your efforts at the state level.the state level.

Learn to talk HUD language.Learn to talk HUD language.

Build relationships with the key people in Build relationships with the key people in your housing agencies.your housing agencies.

Identify potential “qualified residences” to Identify potential “qualified residences” to accept vouchers.accept vouchers.

Why should MFP Why should MFP partner partner

with PHAs?with PHAs? Housing is one of the biggest barriers to Housing is one of the biggest barriers to

realizing the Rebalancing of Long-Term Care realizing the Rebalancing of Long-Term Care Services and Programs.Services and Programs.

Successful implementation of the Money Successful implementation of the Money Follows the Person requires housing.Follows the Person requires housing.

Without Housing – There is NO Transition. Without Housing – There is NO Transition.

1111

Why should MFP Why should MFP partner partner

with PHAs?with PHAs? Medicaid waivers and other Medicaid-funded Medicaid waivers and other Medicaid-funded

coordinated services can assure funding for coordinated services can assure funding for supports and services.supports and services.

Transition coordinators and other service Transition coordinators and other service providers can ensure necessary supports and providers can ensure necessary supports and services. services.

Medicaid-funded case managers and transition Medicaid-funded case managers and transition coordinators will bring qualified customers with coordinators will bring qualified customers with well-prepared applications for consideration; well-prepared applications for consideration; alleviating any additional burden on PHA staff.alleviating any additional burden on PHA staff.

1212

1313

Why should PHAs Why should PHAs Participate?Participate?

This activity helps them meet their legal and This activity helps them meet their legal and ethical obligations under Olmstead. ethical obligations under Olmstead.

National Movement towards Home and National Movement towards Home and Community-Based Health Care and Living.Community-Based Health Care and Living.

Compliance with Americans with Disabilities Compliance with Americans with Disabilities Act.Act.

It’s the right thing to do.It’s the right thing to do.

Ask Yourself…

How many people are ready to exit the How many people are ready to exit the institution and lack ONLY funding for institution and lack ONLY funding for housing?housing?

How many people plan to transition within How many people plan to transition within the next 90 days, and lack ONLY funding for the next 90 days, and lack ONLY funding for housing?housing?

These two groups provide a reasonable These two groups provide a reasonable estimate of the number of vouchers that estimate of the number of vouchers that could be used within the time frame.could be used within the time frame.

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.

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.

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.

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?

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.”

TAC Newsletter (www.tacinc.org)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.