Housing For Individuals with Disability: A 2-Sided Debate

 December 11, 2014
Posted by M&LAdmin4

Thursday, December 11th, 2014

Here at M&L Special Needs Planning, LLC, we wholeheartedly support an individual’s right to choice, in all aspects of daily life. This includes the right to choose where they want to live, who they want to live with, and – for individuals with disabilities – how they receive supports that they need to live independently (if supports are needed). That’s why on March 5th, M&L became one of 40 organizations to join ranks with and pledge support to the Coalition for Community Choice (CCC). By choosing to support the CCC, M&L aligned themselves with the organization’s goal to “advance the principle that community can be experienced in all residential settings.” To read more about the CCC, please click here to access a blog we published last March.

We bring this up today because there is currently a debate happening in the disability housing community. This debate surrounds a rule change put forth by the Centers for Medicare & Medicaid Services (CMS) that defines the settings that individuals with disabilities can use for their Home and Community-Based Service (HCBS) waivers. Please join us for a discussion of this rule change, an overview of the debate currently ongoing, and information as to how the CCC is fighting to ensure that this rule change doesn’t result in a lack of living choices for individuals with disabilities in our communities.

CMS Rule Change

The rule change, which was implemented January 10th, 2014, affects CMS 2249-F and CMS 2296-F. According to an information sheet published on the Federal Register website, the new rule “amends the Medicaid regulations to describe state plan section 1915(i) home and community-based services (HCBS) under the Social Security Act (the Act) amended by the Affordable Care Act. This rule offers states new flexibilities in providing necessary and appropriate services to elderly and disabled populations.”

The CCC’s explanation is perhaps a little more clear: “The new rule defines what CMS considers to be characteristics of community living and vocational opportunities for people with intellectual and developmental disabilities (I/DD) and person centered planning requirements for the purposes of receiving funding via Medicaid’s 1915© HCBS waiver program, 1915(i) HCBS State Plan Option and 1915 (k) Community First Choice.”

In other words, the new rule change provides a definition and states exactly what sorts of living settings are considered “communities” – this definition now allows for parameters to exist that can be called upon when considering an individual or organization’s request for funding. Note: To read more about this rule change, and what it means for those receiving HCBS waivers, please click here.

The Debate

This CMS rule change has incited an outpouring of criticism from individuals with disabilities, organizations that serve individuals with disabilities, and disability advocates from across the United States. It has also sparked a heated debate in the disability housing community, with supporters firmly agreeing that all “institution-type” settings should be excluded from the definition of community. Conversely, organizations that raise concerns about the change, such as the CCC, argue that the definition could also exclude intentional communities and housing models where individuals with disabilities choose to live among peers.

An article in the Wilmington News Journal summarizes the two sides of the debate perfectly:

On one side are those who want a lot of different housing choices to be eligible for government support — including “congregate” settings such as group homes, villages, farmsteads, and other collective arrangements. Many are parents, worried about the future care of children with significant intellectual and/or developmental disabilities such as autism or Down syndrome. On the other side of the debate are those like Emmanuel Jenkins, 30, of Harrington, who say government money should support only residential settings that are fully integrated in the community. Many are civil rights advocates who say people with disabilities have suffered grievous harm in the way society has treated them, grossly underestimating their abilities and shunting them to a sequestered life where they often had little say in any area of their lives.”

To read this article in full, please click here.

CCC’s Fight

Over the last few months, state agencies that are responsible for the administration and distribution of the HCBS waivers have been amending their policies in accordance with the new rule. As the CCC stated in a recent email, “many states may be changing policy to restrict the use of HCBS waivers in congregate settings despite the fact that the intent of the Final Rule was to ensure quality based on outcome-oriented criteria and the experience of individuals with disabilities.”

As a result, the CCC will be reaching out to express their concerns with these policy revisions, and asks supporters and leaders to lend their voice to the fight to ensure that individuals with disabilities retain the right to choose a home, community, and workplace from an array of options.  If you would like to join with the CCC to support their advocacy efforts, please email the organization directly.

Would You Like More Information?

If you would like to learn more about the housing debate, or the work that the CCC is doing to ensure that the rights of individuals with disabilities are protected, please contact the organization directly. For any questions about living options, housing models, or HCBS waivers in general, let us know! We can be reached via phone, email, or social media – we love hearing from our readers.

Thanks so much to you all for taking the time to visit our blog during the busy holiday season. We pride ourselves on being a reliable source of information from the disability community, and we strive to ensure that we are covering current events in a timely and responsible manner. Please forward any blog topic suggestions, questions, or concerns to kate@specialneedsplanning.net.

Thanks again everyone – see you all next week!

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