Friday, January 18, 2019

Time to Do the Right Thing on Housing Choice

In my December 28 blog post (“Housing Changes That Could Change Your Life, Part Two”), I wrote about the fact that DDS increasingly is moving people it supports out of the city to keep their rents below the rent cap – resulting in people being uprooted from their communities, and from the city itself – even as they continue receiving D.C. supports and services.  Solutions are definitely needed, but the current DDS “Housing Choices” policy and procedures, even as revised on January 12 ( and, really don’t do much to create new choices for people receiving residential supports from DDS.  What they do is shift the risks onto the people it supports and their supporters.  So there remain an awful lot of outstanding questions, and many of these were raised at the January 7 meeting I attended along with other advocates, family members, and representatives of provider agencies. At that meeting, Liz Seaton ( tried very hard to keep people focused on line-by-line feedback on the procedures, but there were many, more fundamental, issues that people wanted to raise, and for the most part Liz had to answer that she would check and get back to us (the same thing I’ve heard in each of the sessions so far on these policies).  I did get one answer when Erin Leveton ( briefly called in and stated unequivocally that if a person’s credit record prevents them from assuming the lease and a family member or other individual is leaseholder, with the person supported as the resident, they still would qualify for residential services such as supported living.  It was good to get that clarification, but it needs to be explicit in the policy and still is not.

That was just about the only concrete answer provided, so that leaves a lot of room for clarification, and even after a further session at Project Action! on January 12, things still are murky.  Several key disability organizations have issued this joint statement - (full disclosure:  I serve on the board of the Quality Trust and have recently become chair of the D.C. Developmental Disabilities Council).  I was glad to see that this statement picked up on some of the concerns I raised in  my earlier blog post, such as the need for a troubleshooting team for the inevitable complexities that are going to arise and the need for concrete DDS commitment to on-time payment (since its failure will affect others’ credit ratings and perhaps also prompt evictions). The DDC/QT/ULS statement contains many other questions but is not intended to be comprehensive and specifically calls for more in-depth, two-way dialogue (not just input sessions) with stakeholders.  This is crucial, because so far, DDS has demonstrated that it doesn’t know what it doesn’t know, and plans simply to learn by doing. 

In addition to the issues I’ve raised that were picked up in the joint statement, there are other concerns I have, such as the need for DDS to post on its website the foreseeable risks to which it’s exposing people, providers and family.  Beyond that, other questions I believe DDS needs to be aware of and address before publishing the policy and procedures include:

-          Eviction dangers.  The joint statement talks about the significant dangers of eviction to which the new policy would expose people, and there are fundamental questions that DDS needs to answer here.  In addition to those questions, I continue to maintain that DDS should plan to have a clearly defined and available respite space for people who are evicted, for whatever reason, to ensure they do not wind up on the street in the meantime.

-          Appeal process.  An issue that I didn’t mention in my last blog post, but which came through clearly from other advocates in the January 7 meeting, is the need for the DDA complaint system to be in place before this policy, or the accompanying Contribution to Costs policy, is finalized.  Unlike the current court-based appeal process, a new complaint process is intended to offer a far more accessible and evenhanded way for people to appeal DDS determinations.

-          The mechanics of payment.  The normal practice with rent top-ups has been for the provider to collect DDS’s funds up to the cap and the balance from the family, making a single payment to the landlord.  Since providers would not be the leaseholders under the proposed arrangements but still would be handling the DDS payment, presumably landlords would be in a position of receiving payments from two sources each month.  It isn’t clear that landlords will find this acceptable.

-          Lengthy DDS approval procedures.  It’s one thing for a landlord to hold an apartment during DDS examination and approval of a prospective apartment if the DC government is the effective renter (by way of the provider agency), but it still 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.

Other issues I’ve raised, such as the fact that insurance companies won’t cover the provider's staff under renters’ insurance, will no doubt be considered by DDS to be the family’s and the provider’s problem, but this is an example of the type of complexity on which troubleshooting staff should be prepared to advise people after the policy takes effect.

I’m certain that some form of this policy and procedures will eventually be finalized, and there is indeed a need for more standardized and transparent approaches to people’s housing choices.  Given that DC citizens with disabilities are increasingly being priced out of the DC housing market, though, it would be timely and desirable for DDS to coordinate with other parts of the DC government to ensure that more housing options are available, whether people are receiving residential services from DDS or not.  Above all, I’d like to see DDS taking more leadership in sensitizing the entire DC government to the needs of this segment of the city’s population at a time when Mayor Bowser is focusing so specifically on affordable and accessible housing options.

When you contact DDS, please reference the joint statement and the need for further dialogue on these important changes.  And I’m happy to include DDS comments on and responses to issues raised above and in the joint statement in a future blog post. I’ve just learned that DDS has promised a further public forum to elicit feedback, but another session in which DDS asks for input, gets many of the same questions and answers few of them, won’t really do the job.  Real transparency, and dialogue, are needed.

Thursday, January 17, 2019

Revisiting the DDS Contribution to Costs Policy and Procedures

I made a mistake when I wrote that there was no room for further debate or discussion with respect to the current version of the DDS policy and procedures on contribution to costs of care (“Housing Changes That Could Change Your Life, Part One,” December 28, 2018).  On further review, it’s clear that not everything in the policy and procedures was already fully spelled out in the law and regulations.  Even though the Contribution to Costs regulations were already published in the DC register ( and new versions of the policy and procedures were distributed last weekend at the Project Action! Meeting ( and - safe links to my Google Drive account), there are lingering issues that DDS still needs to acknowledge, discuss further with public advocacy groups, and address before finalizing the policy and procedures.  These issues (with references to key sections of the policy, but necessitating changes to other parts of the policy and procedures) include:

-             The need to air more fully and consider the implications of 3.B. of the policy (made even more explicit in the January 12 revision) which makes the residential provider (along with guardian if applicable) fully responsible for ensuring a person has applied for applicable public benefits, with no apparent DDS responsibility.

-             In 3.C. of the policy, the need to include, in addition to the statement that “DDS will not require a person to contribute more than the actual cost of their DDA residential supports,” a more specific statement that the person will not be expected to contribute to the costs of their staffing or other Medicaid-reimbursed supports.

-             The need to state clearly in 3.C. and 4.O. of the policy that, if a person is receiving residential supports and already contributing to his or her own cost of occupancy, e.g. by paying utility or cable bills, that that amount should be deducted from the total amount the person is expected to pay to the residential provider.

-             The need to recognize, in 3.D. of the policy, that if a person’s SSI is decreased due to third-party housing assistance, the amount of that assistance will not be available to the person in order to compensate the difference up to the maximum SSI amount, and that they should therefore still continue to receive their full $100 allowance.

-             The need to acknowledge, with respect to section 3.G. of the policy, that merely documenting the contribution to costs of residential supports in the Individual Financial Plan is inadequate.  People have legal rights to formal written notice individualized to the person's specific financial circumstances and stating what the person is to be charged, how that was calculated, what the relevant laws and policies are, what the consequences are of not paying, and how to appeal the determination (see below).

-             The need to ensure, with respect to 4.P. and 4.Q. of the policy, that people will not be unduly punished by the threat of discharge from residential services because a representative payee or guardian has failed to ensure payment of their contribution to the cost of residential supports.  DDS and providers should instead turn to other less punitive remedies, such as seeking (after discussion and via a transparent and fair due-process approach) to have the delinquent representative payee or guardian replaced.

-             With respect to section 4.J. of the policy, DDS should wait until the DDA Complaint System is operational before putting this policy and procedures into effect.  Otherwise there is no formal recourse in the earliest months of implementation, when many of the most significant unforeseen consequences will become evident.

-             Finally, what is addressed nowhere is the need for troubleshooting staff which I referenced in my December 28 blog post on this issue.  Having such staff will avoid the need for regular recourse to the Complaint System once it is in place, by ensuring that service coordinators, who will not be in a position to address or adjudicate many of the issues in the policy and procedures, will have easy recourse to in-house expertise.

I hope that DDS will slow the train down and take the time to fully consider the above, as well as other issues raised in the Project Action! meeting on January 12, before putting the Contribution to Costs policy and procedure into final form.