Part two of this blog post will address the HCBS Housing Choices” draft policy and procedures, which, unlike the Contribution to Costs policy, are wide open for comment and revision. (Refer to https://drive.google.com/drive/folders/1h6PCyTDF7rPUxgOl5ntF2f0Ws71CvLu8?usp=sharing for the set of proposed housing policies and procedures.) The Housing Choices policy and procedures lay out what is supposed to happen in the future if people receiving residential supports want to live with people other than DDS-designated roommates or in a rental unit that exceeds the rent cap established by DDS. To an extent the choices offered in this policy already exist, but entail individual negotiation with DDS. This policy would standardize the options available to people and – most importantly - shift the risks of these arrangements onto the people receiving supports. As the procedures (2.C.3.) state, “the person…accepts the associated risks, including financial risks and facing eviction for non-payment of rent.”
This is a real departure from past practice, and it’s why a great deal of caution and deep thought are needed. Since there is no real time urgency for implementing this policy, DDS should take the time needed to responsibly think through the implications along with stakeholders. The next opportunity for discussion will be Monday, January 7 at 2:00 in the Joy Evans conference room at DDS headquarters and at Project Action’s January meeting.
Let’s look first at who this applies to - only those receiving residential supports (supported living or residential habilitation) services under the DDS-administered I/DD Medicaid waiver. A lot of people in the Supporting Families meeting on the 13th were confused about this. To be clear, the policy applies only to those receiving intensive supports in a home owned or leased by a residential-services agency or the person being supported. (Some of the proposed changes are make things more confusing, though, as discussed below.)
Now let’s look at why this is happening: D.C. rents are rising astronomically, and people are getting priced out of the local housing market. Some folks who have been living for a long while in a particular building have been forced to move because their rents have risen above the DDS rent limit. So more and more people are having to move where rents are less expensive, mostly out of the city and into Prince George’s County. (I discussed this in my post, “D.C. Housing News You Can Use,“ on August 9.) People just starting to get supports are also being moved out of the city. So those who can do so are looking at other options if they want to stay in familiar neighborhoods and not lose their ties to D.C. and their community (including voting in the District, which our citizens with disabilities have been encouraged to do).
Finally, let’s look at some of the details, and where – based often on direct personal experience - I see bumps along the road if DDS moves to implement the Housing Choices policy and procedures without further thought and discussion:
- In the policy (3.D. under “Standards”), DDS assumes that a person “has the option to choose to become either a sole lessee or a lessee with one or more consenting third party co-signers.” Unfortunately, this option does not necessarily exist. If a person has no credit record – which is the case for many people with disabilities who have not held paid work - then some (maybe most) landlords will not allow the person to be a lessee – not even a co-lessee. They will only allow someone else – usually parents or other family members - to be the lessee, with the person being listed on the lease as the resident in exactly the same way they are when a provider agency does the leasing. DDS will quickly need to decide whether an apartment rented by a parent for a person getting supports then becomes a “natural home” and whether, if it does, the person can still qualify for the “housing choices” being offered. The existing standard for who can own or rent a supported-living residence – section 1934.7 in http://dcrules.elaws.us/dcmr/29-1934 - suggests an inconsistency here that needs to be addressed.
- The Housing Choices policy (Standards, 3.E.) further calls for DDS to pay the residential provider an amount up to its rent limit. Currently, when family or others pay above the rent cap, the provider combines both payments and the landlord receives a single payment. Under the proposed approach, it appears there would be two payments to the landlord, one from the provider (the DDS payment), and another from the person or their family for the balance. If this is the intent, then does DDS know that all landlords would accept such an arrangement, and how would the lessee be sure the accompanying DDS payment would occur on time (see below in the discussion of risks)?
- The policy assumes that all risks can be shifted onto the lessee, but in at least one regard this is not the case. Landlords often require renter’s insurance, but - based on my direct personal experience - an insurance company will not cover liability for staff who work in the apartment under such a renter’s policy – they will only cover the lessee and named resident. This means that the provider agency still will bear the risks for the actions of its own staff and will need to carry applicable liability insurance.
The above considerations apply to landlords’ and insurance companies’ requirements, but as it moves to shift the risks of housing arrangements onto the people it supports, DDS must mitigate risks over which it has control, for example:
- DDS is not always timely in its payments to provider agencies, and some providers are also late in their own payments. If the person or their family is on the lease, and the DDS/provider portion of the rent is paid late, that will affect the credit rating of the person or family member on the lease, and if paid very late or not paid at all, could cause a person to be evicted. There need to be ironclad assurances by DDS and provider agencies that payments will be made to landlords by the 5th of the month so that delays on their part will not negatively affect others’ credit ratings.
- The new procedures (“The Process for Making Housing Choice,” 3.E.6.) lay out an approval process by DDS for any proposed living situation before the lease can be signed. Landlords may be willing to hold an apartment while this process takes place if a DDS provider agency is the one who’s renting, but it isn’t clear that a landlord will hold an apartment for a person or family if the DDS approval process takes a while, so DDS should commit to getting this done within a specified period.
- Section 3.H. (under “Standards”) of the policy addresses what happens in case a person opting for a nontraditional housing choice is evicted, and goes on to describe a process for either placing the person into an existing vacancy in provider housing or, after further discussion, allowing them to choose another nontraditional living situation. An eviction can happen quickly, and the process described takes time. DDS should plan to have a clearly defined respite space for people in these circumstances, to ensure they do not wind up on the street in the meantime.
I know I haven’t thought of everything. Other unforeseen issues will arise, along with financial consequences such as those I discussed on part one of this blog post. This calls for DDS to have a core of dedicated troubleshooting staff who can step in quickly to assist when the requirements of landlords and insurance companies don’t align with DDS expectations and are beyond the capabilities of service coordinators to resolve. Housing decisions must often take place quickly, and lengthy delays will only ensure that desirable apartments go to someone else while details are worked out.
The procedures also state (section 1.) that “DDS will post information on its website about DDA residential supports and rental limitation rates.” DDS also needs to post a clear discussion of likely risks and what it intends to do to mitigate risks over which it has control, as discussed above. Many issues can be foreseen, and I’ve called attention above to a number of them. DDS needs to try to sort these out before moving forward so that all the learning doesn’t take place at the expense of people and their families.