2012 Mfp Project Directors Meeting

2012 MFP PROJECT DIRECTORS MEETING BASICS OF HOUSING SESSION

NOVEMBER 14, 2012

HILTON BALTIMORE HOTEL

BALTIMORE, MD

* * * * *

EMILY COOPER

MODERATOR

1 CONTENTS

ITEM: PAGE ------

Welcome - *Emily Cooper, Moderator 3

Presenter - Emily Cooper, Boston, MS 5

Presenter - Liz Prince, Washington State 11

Presenter - Kim Donica, Ohio 16

Question/Answer 21

2 PROCEEDINGS

MS. COOPER: I am Emily Cooper. I'm with the Technical Assistance Collaborative and this is the Basics of Housing Program session. I just got off a plane, so I like to say if you are in the wrong session you can now leave. You know how when they get on the plane; if your plans do not include coming to Baltimore, please get off the plane. So if your plans do not include housing today, you are welcome to see yourself out. Basics of Housing program is part of the housing track that they give here at the conference, and I know that I'm excited. I heard that other folks this morning are excited to have a housing track. It does show the importance and the appreciation for housing in the world of MFP. You are going to hear from myself today and two other folks who are MFP project directors. And we will be telling you a little bit about ourselves. But I thought it might help also to spend just a minute to talk to people about who you are. We're not going to do introductions. But if I could see a show of hands for folks who are housing coordinators for the MFP program in their states. Okay Program directors. Okay. Anybody who is brand new to housing. It's okay. I won't call on you later. Anybody who has been doing this so long that when my feet start hurting you can come up and do it for me? All right. Well, I know a few people are just being modest. I work, as I said, for a Technical Assistance Collaborative or TAC. And we are actually a nonprofit organization based in Boston that works to bridge the gap between the housing world and the disability world. And we do that through a variety of ways. One of which is through a contract that we have to help support HUD and CMS in building capacity around housing and being, as someone once said, a bridge spanner; or building bridges across the world. As you know, if you have done any bit of work -- even just gone to a housing meeting, there are acronyms that come up and you have no idea what they're saying. Right? It took me -- I'm not a houser by trade. I'm not sure how one -- I don't even know if there is a degree in housing. Everybody sort of comes about to it. It is sort of like suddenly you are a case manager, and the person you are working with needs housing and you are a housing person. But I remember when I first started they

3 kept talking about Section 8. And all I knew was that thing that Klinger wanted in Mash. Bucking for a Section 8 out of the Army. Which, I guess, is how you get discharged if you have emotional disturbance. So I had no idea that Section 8 was actually a housing voucher. So it took a while and you see how different things are. This terminology is so much. And learning to speak the same language is the hardest part. I'm going to do a very cursory glance at the Basics of Housing programs. You should have realistic expectations that you will not become an expert when you walk out of here in a hour and half later. But you will, hopefully, know a little bit more about what programs are out there, who the players are in your community, and what other MFP programs have done to start working on this, make inroads on this issue. Am I talking too fast? My mother told me if I met the Queen she would never know what I'm saying. But the odds of me meeting the Queen are slim. Also, supposedly I speak so fast that when they make transcripts it's very hard to figure out what I'm saying too, so. So this is kind of preaching to the choir. Everybody knows that people who receive SSI or federal disability benefits are on the lower income. And, you know, just -- we have done some studies that show if the median income is there, 18.7 percent of median income is where people on SSI fall. So when you think about median -- you know, I took stats a few times. I think I got this part right, median is the middle, right? You line everybody up, the middle. Okay. So these folks are way below the middle. A lot of people talk about housing that's affordable. And sometimes that means 50 percent of median income, or even 80 percent of median income. What we're talking about is extremely low income people under 30 percent of median. They're so low income once you get below 30 they don't discriminate anymore, because you just don't have any resources. TAC does a study every two years. The one we'll do for 2012 is coming up. But on average, if you were a person with a disability receiving SSI you had to pay 112 percent of your income to rent a one bedroom unit across the nation, which is not a possibility, right? You can't do that. And, actually, the federal standard for housing that's affordable is paying 30 percent of your income towards rent. So clearly, it doesn't -- housing is not just a disability issue. It's really actually an income issue for many people. And then, you know, figuring out how people live independently in the 4 community is a separate issue. But housing really when you start talking about it we're talking about income. There's not one single housing market in the United States in 2010 where a person could afford to live and pay only 30 percent of their income if they received SSI. So rural areas, you know, urban areas you think that there would be some place, there is not one place. So people with disabilities actually need help paying their rent. And that's just because of their income. And there are a variety of resources out there. So you have public housing authorities who have resources. There are resources that are controlled by state and community development officials. There are other programs that go to nonprofits in the area, then there is some rural housing. It's a whole quagmire. And you know what, it's different in Baltimore City than it is in Baltimore County than it is in Cumberland County, than it is in the state of Maryland. Because it would be too easy if it was all the same every where. So just if you learn -- if you zone out at some point, that's fine. But if you learn nothing today take away this thing, there are two ways of doing housing if you want to speak housingees. There is tenant based and project based. Now, that's a big simplification. But if you want to be able to go out there and talk to somebody about housing, you need to know that tenant based is like a gift certificate. And that goes to the person. And they go out and find housing that meets whatever standards in the community. And then if they want to move, they can take that gift certificate with them. Now, that's, again, a huge generalization because there are nuances to that. But in general that's what tenant-based housing is. It looks like a Housing Choice Voucher, which is the same thing as Section 8. I sat in a meeting once and everybody said -- about the Housing Choice Voucher program. And at the end somebody said, well, I'm on a Section 8, how do I get a Housing Choice Voucher? But it's the same thing. It's like Kentucky Fried Chicken and KFC. They just renamed the Section 8 program the Housing Choice Voucher program, so just so you know. That's one of the biggest tenant-based programs -- housing programs there is in the nation. The project-based housing is housing where you need to live in a specific unit or a building to get help paying your rent. And if you move out you don't get to take it with you. That's like public housing. When your -- the buildings that are out there you don't get to take that with you. You have to live there to get the help. There is tenant 5 based and project based. And there is a variety of that that goes on in your communities. There is also the term "affordable housing." You want to know when you are talking to people about affordable housing that we're talking about housing -- what you are talking about is housing for people at very low income. As I said, 18, 19 percent of income. Because if you pick up your local paper, your local, you know, need of times it will say, oh, we got affordable housing coming. And if you were to call and ask it would be for 60 percent, 80 percent of median. It's not affordable to the folks you are talking about. And to make the housing affordable to those folks, you need to commit more money to bring the rents down, because they can't afford to pay that much. I don't know if you all can see this. And I know that this is a paperless conference, so I don't know if you downloaded it. But this is sort of it in a nutshell. You think I can go mobile? So HUD headquarters at the top, and they are the major housing agency in the nation. They have a variety of offices at the federal level, and they have regional offices, and they have local offices. So there are a bunch of offices there. And they give money to a variety of agencies in different ways. Some of it is block grants. Some of it is competitive. So they're PHAs, which is a Public Housing Authority or Public Housing Agency. They're state and local community development officials. They're what they call HUD assisted housing providers, which are usually, in many cases, nonprofits or property owners. And then there is actually state and local fair housing agencies that do a fair amount of work as well. There are programs that each one of these agencies get. And there are also plans that control the resources. So there is -- they have to say what they're going to do with the resources. So who here has ever talked to a public housing authority -- wait. Are there any public housing authorities in the room? Okay. I always like to know who is in the audience. Who here has ever talked to one? Did it make sense, the conversation? Yep. It's all crystal clear now, right? No, probably not. But the fact that you have talked to one you have figured out -- who here can name the housing authority that's in their local town, knows where it is? Great. Because that's one of the first steps. That's your homework, was to go out and figure out who that is. 6 There are over -- close to 3500 housing authorities in the nation. And it ranges from, I think, you know, New Hampshire might have 12 to Texas has like -- I don't want to say 400, but I don't think it's that high. And everyone is designed a little bit differently. It's created through federal and state laws. It could be governed by a board, an executive director. It could be part of a city agency. So the city of Des Moines is a housing authority, has a department there. Or it is a state agency. For some reason I'm stuck on New Hampshire. New Hampshire Housing Finance Agency. So there are a variety of different configurations of housing authorities. Some communities don't have a housing authority, and some states have housing authorities that cover those areas, but only covers certain areas. Arizona Housing Authority for the state only operates in one county, for example. Housing authorities can administer vouchers, I talked about. They can administer public housing. A variety of other acronyms up there, Shelter Plus Care and Section 8 Mod Rehab are for homeless people. HOME, you might have heard about. That's not an acronym, actually. That's a block grant program. HOPWA is a program for people with AIDS. They must complete a plan to say how they're going to use these resources. There is a one year and a five year plan. It must be consistent with other plans for their area. And they must get input into that plan. So, you know, when I start making my list of things to do for the new housing coordinator, find out who your housing authorities are in your area, ask them for a copy of their PHA plan. I would also ask them for a copy of their Section 8 administrative plan. Those are your key documents that tell you how the housing authority operates. I know somebody is going to tell me, well, the Section 8 waiting list are closed. Their waiting lists are, you know, years long. Section 8, in particular, is the -- it makes up half of HUD's budget. And it is the largest federal affordable housing resource out there. It is not the only one, but it is a large game in town to shut the door on by saying, you know what, I'm not even going to learn about it because it's a waiting list. So I encourage everybody to find out more about their program in their local area. There are vouchers targeted to people with disabilities. They're called NED vouchers, which stands for Non-Elderly People with Disabilities. There are specific ones that you are going to hear -- actually, both in Ohio and Washington they have specific NED-2 vouchers, which are for people with disabilities coming out of institutions and nursing homes and other restrictive settings. 7 And there is about 28 housing authorities across the nation that administer those vouchers. And then there is also mainstream vouchers, which are vouchers for people with disabilities, but you don't have to be non-elderly. If you go to the web site at the bottom we have a database that lists all the housing authorities in the nation and whether or not they have these vouchers. So that would be -- if I'm making my homework step, step four is to go on the database, find out if any housing -- which housing authorities in your community, state, locality have these vouchers. Contact them and ask them what they're doing with those vouchers. Can you help them? When is the waiting list open? How are they taking referrals, et cetera? State and local, meaning city, county officials also get block grant dollars. And they get to choose how to use them. And the block grant dollars, again, can be for higher income people -- when I say higher income it's still not that high, but it's not the folks you are talking about. They can use it for home ownership. They can use it to build new street lights or they can use it to do rental housing, which you might -- or rental subsidies or things like that. They can use it for accessibility modification. They must also complete a plan called a consolidated plan, which lays out how they're going to use these resources. A consolidated plan is a five year master plan for how the locality is going to use the resources. So number five or six -- I have lost count -- on your homework is to find out where -- get the copy of the state consolidated plan, because every state puts it together. And go online and figure out if your city or county develops a consolidated plan and where to get a copy. All that information is available on the HUD web site. Or you can always e-mail me or e-mail the folks here, and we can get you an e-mail for them. There are laws requiring citizen participation in these -- in these plans. In Texas many, many -- anybody here from Texas? No. In Texas many, many years ago a bunch of people in wheelchairs showed up at one of the hearings that they had to do for one of these plans, said you are not doing enough for people with disabilities. Texas is now held up as a model -- I'm not sure if it's probably because of that. But Texas is now held up as a model for doing housing for people with disabilities because they started saying, okay, we need to do something, because they got input into this plan -- into this planning process. I'm going to go through these resources, but you don't need to know everything about it. I 8 would suggest that you sort of print it out and have it somewhere in case somebody says CDBG to you, which stands for Community Development Block Grant. And it's a block grant that goes to these states and cities. And you can do a variety of things with it. The blue ones at the bottom are the ones you are really going to want to care about, which are the -- use, create accessibility. And you can do public services, which could range. It could be housing outreach or housing search or developing -- we're going to talk about it in a few minutes -- develop a housing tool for determining where -- online where affordable housing resources are, or where accessible units are. So there are a variety of things you can do with that. Another resource controlled by these folks is the HOME dollars. HOME is bricks and mortars. You can build housing or you can do home ownership things. And city or states get to choose how to use it. I have again highlighted rental housing production -- you can't really see the highlights. I apologize. Tenant-based rental assistance. That's two areas where you want to see if your community is doing work around those areas. And if not, why not? A lot -- there is no new money out there right now, except for one thing I'm going to tell you about. So folks are always saying well, we're doing it this way and we can't not do it this way, because then we're kind of robbing Peter to pay Paul. But we also talked about what I laid out to you in the beginning is about income, right? So these resources, you know, if you are going to say they go to the poorest of people, then the people you are serving are the poorest of people. So the one new resource that's out there is the Section 811 Program. Anybody heard about that? Yeah. Getting a lot of press, a lot of folks. That was new money that was out there. Applications were due this summer. Hopefully in the next month or so before the end of the calendar year we will have some responses. Thirty-five, I think housing authority -- excuse me, 35 states applied, including many who decided to target this resource to people on MFP, or to give them an incentive. And in this case Section 811 has been reformed and there are variety of options available under it. But basically, the idea is to create integrated rental housing for people with disabilities that is affordable to them in the long term. So what do you do when you leave here? You find out -- I've given you a few key steps. You want to engage your housing officials. You want to find out who they are. You might even know them. 9 You might be surprised that the commissioner or the board of directors is somebody in your town. So it's not just looking at the executive director. Housing and these partnerships are often people based. And I think we're going to hear that from the folks at MFP, in that you find the one person who goes oh, yeah, that makes sense; and then it starts happening. So you want to ask questions. What resources are currently used for people with Disabilities? You know, the dollars, the units. Do you plan to use your resources to house people with disabilities? You know, the question is, if not, why not? You need to come with your own data that says, here are my MFP folks and they need housing. And here is where they are, and here is the kind of housing they need, and here is why they need help with housing. Their income is such that. And that the fourth thing you need to say, which is very important to housing folks, is don't worry about the services. We will take care of that. You get them a place to live, we will take care of the rest. Because that's the part that scares them. Are existing prohibitions based on policy and regulations. How many people are on your waiting list? And offer to help. And be kind, but be persistent. Because there is a lot of staff turnover. There is a lot of competing priorities. There is a lot of -- well, we just got this thing that came down from HUD. And we got -- you know, we have less money for this or that. If you can help them in any way, you know, free help is always good. So that's what I would suggest. Okay. So that's all I have for a presentation. I want to know am I okay with time? I think I'm okay with time. I'm going to take one or two questions, and then we will hand it over, if anybody has any. If you have them I guess we have to go to the mike or we can bring the mic to you, I guess. Yes. Go ahead. MR. BENNETT: Thanks. My question is could you speak a little bit about flexibility of the housing authorities in relationship to 30 percent of the person's income and fair market rent? Because I think there is some wiggle room or whatever. MS. COOPER: Yep. You are on the record, so I don't want to put you -- but can you tell me who you are, where you are from. MR. BENNETT: My name is Paul Bennett, and I'm from Illinois. MS. COOPER: Okay. Thanks, Paul. That's interesting. I have been e-mailing with Dan Burke from Illinois about this issue. 10 Let me just say PHAs have flexibility period. So although, there are regulations that are this deep in Section 8, in 1998 federal government said, you know what, you design programs that work for you. So they set out standards and a framework for the Section 8 Program, but a lot of it is up to the housing authority. Certain things are not. How much you pay towards rent is statutory. It's a law. So that can't be changed. So you are going to start out by saying a person pays a certain percentage, which is usually 30 percent -- 30 to 40 percent towards rent on the Section 8 program. And then as far as how much the housing authority gives towards rent, that can be flexible. And what you want to familiarize yourself with is a concept called reasonable accommodation, which is part of the federal fair housing law, which require that agencies that receive federal funds make accommodations in their policies and practices to allow for equal participation by people with disabilities. So when something is not working for one of your consumers or one of your clients, the folks you are working with, the first thing you do is say I want a reasonable accommodation. I want to talk to you about how we can do things differently. And you having to start a dialogue and discussion around that. So how much the housing authority gives can vary based on if you ask for a reasonable accommodation, then you can get more money from them. That's sort of the simplistic way. All right. So I'm going to hand it over to Liz. I'm going to get her slides up here. This is Liz Prince from Washington State. She is the State's Money Follows the Person program director. She is going to give us food. Wow, you are going to make the rest of us look bad. She spent over 20 years working community based mental health and senior service programs in the San Francisco Bay area. That was prior to joining the Washington State Aging and Disability Services. She is a northwesterner, and she brings food. MS. PRINCE: So given our recent elections I know you were probably hoping for some different kinds of treats, but I didn't bring that. I don't know yet whether you can travel on the plane with your one ounce or less. All right. The mike is here. I am notoriously bad with mikes. Can you hear me? Yes? No? All right. There we are. So we're here to talk about Housing Basics. And I have to tell you that the name of the workshop left me a little scared, because to me 11 there is really not much that's basic about housing at all, except that we all need it. And when you start doing the overlay between subsidized housing and moving people out of institutional settings, it gets really complicated. So I've put together a few slides. They probably don't fall together too well. But my purpose is to just kind of give you an overview of how we have set up our MFP housing program in Washington state, and a little bit about some of the -- the things that we have learned basic and not so basic. So Washington state is divided up into three regions in our DSHS world. And so we -- when the administrative funding became available through MFP we brought on three housing specialists, one for each region. And they -- I live in our Olympia headquarters office. But the housing specialists live out in the regions that they work in. And we have phone meetings every week. And we get together at least once a month to talk. And it has actually been a really good learning experience for all of us, and I think good to have a little team. Because you can support each other and you can find out, you know, what's going on in other parts of the state, different ways that people interpret different things. So our housing specialists at that level are really geared towards developing capacity. And so they are doing a lot of what Emily talked about and kind of learning who is who and, you know, who has access to what resources in their regions. And then we come together and figure out how to target that across the state, because some of those resources are statewide as well. And the other way that we use the demonstration is that we have a demonstration service. It's called a Community Choice Guide. And that person is -- can be brought on to help individuals find housing, and actually help them figure out where they might want to move, what they might need. Very much like a transition coordinator, except we do have folks that specialize in housing. And if you have the ability in your state to do something like this I recommend it, because there are a lot of folks out there that -- that know a lot more about housing than most of us in the social service world. And they can -- they can really help you get out there. And the flip side of the -- you know, getting to know the commissions and the boards and all the agency folks is to get down at the very ground level and get to know landlords. Because they -- the project-based housing that they have access to, that they control, there is probably more capacity there than you might think. And when you 12 hear oh, yeah, I have a three year waiting list or whatever, once you -- if you really get in there and you really start talking with these landlords you find out that that may be true, they have 400 names on a list. But when they make -- when they start making a call because they have one or two vacancies they can go through, you know, 300 of them in a day. So don't go by the number of names on a list or how long you think the wait list is. As you develop relationships with these folks, it can get you a long way towards finding very specific resources for very specific folks. So we applied for the NED-2 vouchers, as was referred to before. Those were the non-elderly disabled vouchers that can only be used for folks coming out of institutions. And we thought when we got them, cool. Everybody needs housing. This is going to be a slam dunk. And then found, oops, there were a lot of things that we were not counting on. And so we actually had to learn a lot of lessons in distributing those vouchers and our learning goes on. So I just threw a few things up here that we actually didn't expect to hit. The different systems Emily referred to. Every housing authority is very different. And they all have their own paperwork. And they all have their own application process. And you have to get to know how they work or you won't get anybody through the process with that particular housing authority. In our particular system we do transition a lot of folks, but not so much into independent living, I think, because -- I think everybody is so convinced that there isn't independent housing to be had out there. That there is so little subsidized housing that we sometimes don't try as hard as we can. So it actually took us a long time to find enough case managers to refer enough folks to actually use our vouchers, which just floored us. The whole safety issue, you know, risk. That is an issue in MFP no matter what you are doing, and especially when it comes to folks living in their own homes. Everybody's tolerance for risk is very different at the individual level, at the agency level. You know, we have some public housing authorities that just jumped right in. You know, said we're going to partner up with you. And others who said well, who are we talking about housing here? And we just had to deal with kind of the shear volume of vouchers that we got. And our -- it kind of overwhelmed our case management system. And I will talk a little bit more about that in a minute. One of the other things that we probably should have been expecting, but were not, is that a 13 lot of the folks that were brought forward as candidates to use these vouchers had much lower care needs than many of the folks that we transition on a regular basis out of our nursing homes through MFP. It was -- it's -- in some ways if you have kind of a together enough system that you have access to enough medical supports and case management and things like that, you can move folks with some very complex needs. But what we saw in this group was an overwhelming number of folks with criminal history that really ranged from almost nothing to, you know, a lot of felonies. I think we had somebody that had -- I think it was like 98 misdemeanors. And this stuff -- when you go into the subsidized housing world that doesn't fly too well. So we had to learn and also get more resources on board to help us deal with the kind of advocacy that you have to do in order to help these folks get hold of a voucher. Very time consuming, and -- and it doesn't always work. Although, I would say we have been able to -- if we pursue it, we're able to get many, many people through that process even with felonies. I think we have housed a couple of folks who were arsonist. I mean, folks that you would not expect housers to, you know, jump at. And you know, with the right supports you can do it. And with reasonable accommodations you can do it. A lot of folks with poor payment and credit history -- and that also is something that is very time consuming to deal with. We do use MFP funds to help pay down any old debts that people might have. We have learned to be very good negotiators so we get it down to as low as we can go. But if they have, you know, an old electric bill that's on -- that is unpaid, the housing authority is not going to issue a voucher. So you're going to have to find a way to make that go away. And we have been able to use supplemental funds through the MFP program to do that. Lots and lots of drug and alcohol issues. And I would say that's -- at least in Washington, that's one of the harder issues for us to grapple with. I think that's one of our next pushes is going to have to get better at working with folks with substance abuse issues. And I don't say that because of the recent election, actually. It's very different. But not -- all of these things are not things that have anything to do with personal care, or, you know, things that you -- that at least in Washington we can bring resources in to help remedy, to help make things work. So without that level of care that you have to put into the situation a lot of the folks that are eligible for vouchers, need vouchers, need housing, it gets very hard to provide those services. 14 And so, you know, I have -- I have learned to be a little more careful with landlords and PHAs. And we try not to say anymore that don't worry about the services. Because I think it's -- I think it's a real concern. And I was talking to our project officer, Kate King, just the other day. And we were talking about how, you know, not everybody who uses a voucher, not everybody who is eligible for a voucher is an MFP client, or is within their demonstration here. And in truth, in the waiver world pure housing services, good luck finding a way to provide those, you know, except in that very early transition phase. It's very hard to do housing services and call them out that way. So you can get creative, and we have; but it's a definite issue. And I was talking to Kate about, you know, what should we do now that, you know, we have got 215 people vouchers. And now they're all coming up on the end of their year and there is recertifications, which is another whole round of paperwork that will -- if the client can't or doesn't know how to deal with it, will get them evicted very quickly. We find that there is -- there are a lot of situations where if you aren't able to intervene immediately the person is very much in danger of losing their voucher and getting evicted. And if they get evicted they will never get another housing voucher. I mean, that will be the end of their history of being able to have subsidized housing in that way. So it's a tough one. And I am a big MFP advocate, and there is a whole lot of stuff you can do through MFP. But the sustainability of the housing work -- I think, folks were talking about it this morning at the panel also -- there is a lot of work that's going to need to be done between a lot of big systems to help us figure out how you -- how you make your way between, you know, the housing issues and the care issues, because they don't always -- they don't always fit together very well. This is what I mentioned before that all of our housing authorities had different requirements for paperwork. We have been able to work with housing authorities to get them to speed up our applications. And that took going in and meeting with them and saying, let's see your packets. Do we really have to have this? Can we use this instead of that? And you can really -- our experience was our housing authorities really worked very, very well with us and worked hard to speed up their process so that we could get people out of the nursing home. You also want them to speed up their denial process, because sometimes you can't move 15 forward unless they say to you no, this won't work because of this reason. And then you can either go for a reasonable accommodation -- and never underestimate the power of reasonable accommodation. We have actually used it in a lot of cases. And it's -- it can be fabulous. We do our -- for the most part, we do our briefings -- our voucher briefings in the nursing home, which was very shocking to the PHAs. And they either will send somebody to a nursing home, or we get ourselves trained on how to brief people and we go out and do it, because it can be a big, big road block to have to have somebody go into the PHA office, which is very much what they expect. Outreach to landlords, I talked about. And the other things. I actually think that that's pretty much it. So I can take a couple of questions now. Is that -- MS. COOPER: Why don't you take a couple. MS. PRINCE: Okay. And then hopefully later we will have more or a discussion. Any questions? People need more chocolate. Where did it land? I see it. I see where it landed. Okay. MS. COOPER: Kim. I forgot to tell you, you have index cards on your table. So if you have questions or you have feedback that you want to give that can shape further TA, to write it down and we will gather it later. And I think it's going to be gone through on Friday -- on Friday they're going to have a read everybody's index card moment. All right. Why don't you introduce yourself. MS. DONICA: So I'm Kim Donica, and I'm from Ohio. I do not have snacks. If I was better prepared I guess I could have brought you all buckeyes. Which if you have ever had a buckeye they're the most fabulous thing. The peanut butter dipped in the chocolate. Oh, they are really good. I don't make them. My husband makes them. I could have brought them, though. So I feel like Liz and I are living in the same world, because a lot of the things that she said, I could be like oh, yeah. That really, you know, is how it works. So I want to talk to you -- and I was talking we only have one housing guy in Ohio, but I think we need more. And he is fabulous. And I will tell you that one of the best things that we did is we actually hired a housing person. Because we figured we can teach them all the social work and stuff, but he came from our housing finance agency. And you know, those people -- I mean, they're kind and lovely, but that is a whole another world. And they're all about the deal, you know. 16 If you ever get together -- it's true, you know. You get together with these housing people and they're talking about the deal, and putting the deal together. And so we got Adam, our housing guy, to come in, and he works at the housing finance agency. So he knows all about the deal and can speak that speak when those folks do. So this is Ohio data and it shouldn't really be a surprise to any of you that housing continues to be the biggest barrier to transition for folks. And that's just a little bit of information for you all to look at. And then, of course, us using the TAC survey to just, again, illustrate the challenges that we have in that the consumers and the individuals that we are working with they're people who are very, very, very poor. And housing is very, very, very expensive. And so we have a huge discrepancy between a fair market rent and what individuals can afford to pay. So here is what happened in Ohio. And I think probably it's happened in other states too. So I would tell Adam -- I'm like, Adam, we need housing. We need housing. We need places. We need places. We need places. And so he was a diligent guy, and, you know, did all of his work and here are some places, you know, for you to get a subsidy through HUD, through HOME, through 811, all of that. And then low and behold we got units, and we got NED-2, and it was like oh, crap, what do we do now? Because we thought that was the magic bullet. That we would get these NED-2 vouchers, that we would get -- we got some set asides and some buildings with some developers that he had talked to during the deal. And we thought, oh, my gosh, it's a Christmas miracle, you know, folks are just going to move. And what we learned is that it is a lot more complicated than that. Because of all of the issues that Liz talked about, because of criminal histories. Because of -- we have folks -- they have no income at all. Zero. So they're in that Social Security disability determination appeal loop that can go on for years and years and years, because of issues related to substance abuse. Just a whole myriad of issues. We just thought we would get these vouchers and through our kind of natural supply and demand process we would get them filled. Well, it didn't really work like that. And as Adam tells me housing people are very, very risk adverse. And they like to get their units filled. And so they don't really care if -- but you don't understand. I have got to work through this issue. I have got to do this. I have got to do that in order to get somebody ready, so 17 that they can lease out a voucher, or lease up a unit. And so we would have people that we had identified as potential candidates, but it took a while to get them through the process. Again, like Liz said, every PHA has their own process. They have their own packet. It sounds like, perhaps, they're a little more flexible in Washington than they are in Ohio where they really are about doing their forms and their process and their way. And so we had people, housing authorities and then some developers who had agreed to do set asides for us getting irritated with us because they wanted those units filled and they wanted them filled now. And so Adam does this train analogy, the transition train, where he talks about the housing provider as really the engine that keeps the train moving or keeps the transition moving. And one of the things, you know, they're taking -- they're taking a lot of risks when they're -- they're working with us. And then he talks about the coal car being the transition coordinator. And those are the people that are really helping to identify the folks and get all the pieces and parts. And one of the things that we learned through this process on housing authorities and developers getting irritated with us because they didn't think we were filling their units quick enough, is that we really in this train or this team -- we needed to bring the team together. And so we needed to bring the transition coordinator, the housing person, whether it be the PHA or the developer themselves, the individual, our housing person at the state together to talk about process, and to talk about people. And to talk about, okay, what do we need? And here are the missing pieces and parts. I cannot emphasize enough the need to have really, really good communication with, again, either your housing authority or if you are working directly with the developer around what it is that's still needed in order to complete the application process. I think that's really, really crucial. And so it's important that that information be fed and shared by everyone. So the passenger car are the agencies that help support our individuals. And you know, I think that, generally speaking, housing authorities and developers do like working with MFP, because there is a certain reassurance about services that people are going to be able to receive. There are challenges. Particularly -- we have challenges with substance abuse in Ohio also. But I think generally speaking, that provides a level of reassurance to the housing provider. But one of the other things that we found 18 again even -- even if we could -- because we had one -- I think in Hamilton County, which is Cincinnati, in Ohio they got 100 NED-2 vouchers, which, you know, that's a lot. And by the way, we're all filled. Yay. But it took work. And one of the things we ended up having to do in Cincinnati is we actually had to do and use our Section Q data to help identify folks and do targeted outreach so that we could make sure that we were filling those vouchers in the time lines that the housing authority was expecting. Because we found that we did not have enough legitimate candidates for those vouchers, because we do have some people who had barriers particularly around criminal history that we just could not overcome. I mean, there were some things that we just could never overcome related to some specific convictions. So we ended up having to do some targeted outreach using our Section Q data to try to identify folks to kind of get in the voucher pipeline. And it worked. And that was happy. We think, though, that from a consumer perspective it's really, really important for folks to understand that a lot of this kind of front end activity, you know, is happening kind of behind the scenes and not -- we try not to stress our folks who were working with -- out about some of the logistics related to getting the voucher leased up. Obviously, they're involved in the process. Obviously, we need to get information from them. But I'm sure you all have figured this out. There is quite a bit of politics involved in the housing world. And so we try to not get the consumers that we're working with involved in kind of the politics of making things happen. You know, I think it's really important that the data and the information in keeping the housing provider fed with good information regarding like likely candidates and potential problems. And so if you can have your -- whoever does the work, whether it's transition coordinators or -- I like your idea -- what did you call them? Community choice guides. I say I might have to steal that if that's okay. But whoever it is that's helping to support people through these processes. It's really, really important for you to be able to know up front what the potential barriers are. You know, is there a criminal conviction that's going to be a barrier? Is there a past bill that's a barrier? Does the person have income? I mean, those kinds of things. Before you get too far on -- down a path to housing, you need to know that information early and you need to know it up front so that you can begin to address those issues. Again, I think the challenges is that from 19 a PHAs perspective and a developer's perspective they're only -- my experience has been they're only going to be able and willing to wait for so long. Because -- again, I learned this from housing people -- the longer that vacant -- that unit sits vacant or whatever, they're losing money. And so it's in their best interest to get that leased up. Now, they want to get it leased up with somebody who they can sustain over time. So, you know, we have had situations where we have had to say to people, you know, we're not able to secure this for you, because you have barriers that we can't overcome. And the developer is not willing to wait and hold the unit for you, even with a little bit of accommodation discussion we have had situations where the barriers have been too great. The coordination is really key. And so making sure that your -- your team is talking to one another. And so, ultimately, what ended up happening with our NED-2 vouchers is that we had weekly calls with the housing authority, with the transition coordination agencies that were supporting those people, with our housing guide, the state where they -- you know, weekly where are we at? What are our numbers? What are the barriers? And, you know, it was a labor intensive process. But ultimately resulted -- because we had 100 in Hamilton County, and we have 75 in Toledo. So we had 175 NED-2 in Ohio. And, ultimately, were able to successfully lease those up. But I think it -- it took a lot more work than we initially thought it was going to. So I guess my message to you is you need to think about, you know, not only we need vouchers, we need units, we need help; but you need to think about the infrastructure that you have within your own state to be able to get people into those units. And to get people into those vouchers in a manner that's going to be satisfactory to the housing authority or to the developer. So whatever kinds of prescreening processes, team meetings, whatever it's going to take for you to be able to do that, I think, is going to be really, really important to your success. Because it's just not enough to say, well, I needs vouchers. I need vouchers. And then when you get them, you know, you have got to be able to have an infrastructure that's going to react to that. So if that -- if you don't, then, this is what happens. And we certainly don't want that to happen. So this is our housing guy in Ohio, Adam. And so feel free to contact him. He is a really, really, really good guy. And, you know, I don't know about you all, but this 811 announcement needs to come soon. 20 Because it was suppose to be October, and now it's November. And I know they gave everybody an extension. MS. COOPER: I think it's mid-December. MS. DONICA: I'm just irritated about the whole thing, because I just want to know. And it is all about me. UNIDENTIFIED FEMALE: Can you read Adams's e-mail address out. MS. PRINCE: Oh, Adams's e-mail address. So it's Adam "dot" Anderson at JFS "dot" Ohio "dot" gov. He is a really good guy. If you haven't hired housing people yet consider stealing somebody from your housing finance agency, because, you know -- I mean, I can teach them Medicaid. You know, I can teach people first language. I can teach them all that. But since he -- and I don't know, it may not be this in other states, but in Ohio it is all boys, you know. It is. I don't mean to be sexist. But it's a lot of boys. MS. COOPER: Any questions for Kim? MS. DONICA: Any questions? Wow, that's fabulous. MS. COOPER: Any questions for anybody on the Panel or -- MR. GREATHOUSE: Hi, I'm Jerome Greathouse from Atlanta Money Follows the Person housing manager. I wanted to know specifically -- I forgot your name in the middle. MS. PRINCE: Liz. MR. GREATHOUSE: Liz. -- about the reasonable accommodations. Like I want to understand what you were saying about the reasonable accommodations to help move a person in if they have a barrier. MS. PRINCE: So you can request a reasonable accommodation for a whole lot of things. If the person has a lot of equipment and they need an extra bedroom you can -- we can request that. You can request an additional bedroom if they need -- if they need a live in caregiver. Help me out, Emily. MS. COOPER: Extra housing search time. More money towards the housing subsidy. Extra utility allowance if they have medical equipment. Renting from a relative. That's not allowed in the Housing Choice Voucher Program, but it is for this. Using your voucher in special housing types like in a shared living situation, or a single room occupancy. Anything about the application process. So if you need somebody to come to your nursing facility to do the briefing, or some people are doing it by Skype, I think, in California; or you need to get your application done in alternative formats; or, you know, pretty much -- and then there 21 is accommodations for actually property owners. So if you need change in the rule about having pets because you have a service animal. You need to be near a certain entrance because of ramps and wheelchair curb cuts. You have some disability that needs some adaptation to the unit. So I mean, none of it -- all of it is a discussion. So part of it is, as you said, to speed up the denial. So once they say no, I can't do it, you get to say, but I need you to change -- you know, why can't you do it? Oh, it's a policy. Well, I need you to change that policy. So it's on an individual, case by case basis. MS. PRINCE: We have also been able to use vouchers outside of the PHAs jurisdiction. So to get it ported to another place, because that's where the person's support is. And that's been really useful. MS. STURGIS: Hi, my name is Palisa Sturgis, and I'm from Nevada. We do not have a housing coordinator. We are going to be pursuing that. But I was interested in knowing how soon does your housing specialist or coordinator meet with the MFP participant prior to them transitioning? Do they go out to assess them while they're in the nursing home, or is it after the transition occurs? How does it usually occur? MS. PRINCE: So our housing specialists actually are not the folks that do the case management work. Now, the providers -- the contracted providers that we bring, our community choice guides, they will go in as soon as somebody indicates that they're interested in moving. Because the sooner you start to know what those preferences are, and what the barriers are, the more you -- you know, the more time you have to work on the plan. So from that standpoint we're talking about housing from the get go. MS. COOPER: Do you want to add anything? MS. DONICA: A similar kind of situation in Ohio. So our housing guy, Adam, doesn't meet one on one with consumers, but rather provide support. Our transition coordinators are the ones who help support folks with the housing selection process. That starts pretty quickly after we get a referral, and, again, to start identifying preferences. I think one of the challenges that we have also is that we do have some people who have some very specific ideas about where they want to live. And so -- I mean, down to I must live on this street in this building. And so that can be very challenging in terms of transition time for folks, because it -- our ability to affect a specific location for a specific person can sometimes be limited. So our housing person in the state he will 22 get involved in individual cases if there are specific issues or challenges. But typically, we have our transition coordinators do that work. MS. PRINCE: We at some point learn to limit the choices because people can't keep turning down units that you have found. You know, I think they have a right, certainly, to say "no" to a particular unit, but we have also seen that process go way too long. And all of us have to, you know, make some accommodations in terms of what our ideal is and what we can live with. MS. DONICA: And so do you drop them from the program? MS. PRINCE: No. MS. DONICA: Or you just keep them? MS. COOPER: The little conversation was Kim asking Liz if she drops those people from the program. And Liz said "no." MS. PRINCE: We just say here are your choices. We're not going to look anymore for you. You can do it yourself. MS. DEMERS: My name is Rio Demers from the state of Vermont. I was curious, though, do you have any information on whether the places these people are going are they apartment complexes? Are they individual's houses? Are they relative's houses? Are they -- because in Vermont they have got something that -- if people have a spare room or something and they're willing to open it up to these people, participants even, they're -- within guidelines they are allowed to do that. Do you notice any particular trends? Is it overwhelmingly apartments that your people are going to? MS. PRINCE: Using the Housing Choice Voucher it is mostly apartments. We do have some folks who will share housing. And you can do that with the vouchers as well, but it's usually apartments. MS. DONICA: I think, though, across the board -- anybody here from Mathematica, the MFP program in general the majority of folks have gone to homes, which would be somebody's own home or family's home, right. And then assisted living, and then, I think, group homes, and independent living, like in that order. MS. DEMERS: And a quick follow-up to that. Are you -- for those that are going to the apartments, are these apartments already accessible or are there some that they're willing to take the people and they're not accessible and they have to deal with who is going to pay for making them accessible in every way? MS. PRINCE: You can use MFP dollars to do the accommodations. So -- sometimes they don't want to, right. Yeah. But a lot of people -- depending 23 on what it is, we have had pretty good luck in getting the units adapted. MS. DONICA: And landlords, again, are required in most cases to allow somebody to make changes to the unit. They don't have to pay for them. A landlord doesn't have to pay for it. And the landlord may say, you know, I want it done, you know, up to a certain code. And I want -- you know, they could even say I want you to put it back when you leave. But that doesn't happen that much, thankfully. But they can't refuse. They can -- it's just a matter of who pays for it. MS. COOPER: Any other questions? STEPHANIE MENSH: I'm going to just step in for one second and to point out in the back of your agenda book you will see a resource page, and it says "additional resources." And on there you will see the HHS, HUD Partner, Housing Capacity Building Initiative for Community Living Project. That's not exactly the right title, but that's what Barbara Edwards and Henry Claypool were speaking about this morning. And we -- we're helping to staff these housing sessions for the next two days; today, and tomorrow, and Friday. And if you go to this web site you will see a lot of information, including a paper that TAC did under our project on reasonable accommodations with sources of funding for some of the modifications. There is information on the voucher program and a lot of basic information on housing programs also, links, and things like that. And over the next couple of months we're developing additional resources. So I just wanted to sort of put a plug in for that. When you get back, some additional places to look for information. MS. COOPER: Any other questions? So thank you, everybody. I guess if you are -- we have until 4:10 for the next session. So you can make your way there. If you are staying for housing, I guess we're still in this room, the Housing Tools. If you have any questions or ideas you want to put them on an index card, I guess you can just leave it on the table, we will pick it up. Thank you.

(Whereupon, the proceedings concluded.)