[Federal Register Volume 65, Number 244 (Tuesday, December 19, 2000)]
[Notices]
[Pages 79698-79700]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-32259]
[[Page 79697]]
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Part V
Department of Housing and Urban Development
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Notice of Public and Indian Housing: Access Housing 2000 Initiative;
Notice
Federal Register / Vol. 65 , No. 244 / Tuesday, December 19, 2000 /
Notices
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DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
[Docket No. FR-4641-N-01]
Notice of Public and Indian Housing: Access Housing 2000
Initiative
AGENCY: Office of the Assistant Secretary for Public and Indian
Housing, HUD.
ACTION: Notice of proposed national initiative--access housing 2000.
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SUMMARY: This notice provides information on Access Housing 2000, a
proposed national initiative that will assist persons with disabilities
to transition from nursing homes into the community by providing
improved access to affordable housing and necessary personal assistance
and supportive services. HUD is partnering with the U.S. Department of
Health and Human Services (HHS) and the Institute on Disability (IOD)
at the University of New Hampshire to carry out this initiative.
Using Section 8 housing vouchers in conjunction with supportive
services available under the Medicaid program, the proposed initiative
presents an opportunity to design and implement innovative housing and
supportive service strategies. If successful, these strategies could
expand the availability of accessible, affordable housing in the United
States, including homeownership opportunities for persons with
disabilities, and assure that such individuals receive the assistance
and the ongoing supportive services necessary to make a smooth and
successful transition to living in the community.
DATES: Comments Due Date: February 20, 2000.
ADDRESSEES: Interested persons are invited to submit comments regarding
this notice to the Regulations Division, Office of General Counsel,
Room 10276, Department of Housing and Urban Development, 451 Seventh
Street, SW, Washington, DC 20410. Communications should refer to the
above docket number and title. Facsimile (FAX) comments are not
acceptable. A copy of each communication submitted will be available
for public inspection and copying between 7:30 a.m. and 5:30 p.m.
weekdays at the above address.
FOR FURTHER INFORMATION CONTACT: Rod Solomon, Deputy Assistant
Secretary, Office of Policy, Program and Legislative Initiatives,
Office of Public and Indian Housing, Department of Housing and Urban
Development, 451 Seventh St., SW, Room 4116, Washington, DC 20410;
telephone (202) 708-0713 (this is not a toll-free number). Persons with
hearing or speech impairments may access that number via TTY by calling
the Federal Information Relay Services at (800) 877-8339.
I. Introduction
On July 26, 2000, the Administration announced several new
initiatives designed to promote the delivery of home and community-
based services for persons with disabilities of all ages. These
initiatives are part of the tenth anniversary of the passage of the
Americans with Disabilities Act of 1990 (ADA). One of these initiatives
is Access Housing 2000, a unique partnership focusing on providing a
national coordinated response to the Supreme Court's decision in
Olmstead v. L.C. (527 U.S. 581 (1999)). That decision, issued on June
22, 1999, was a result of a lawsuit brought by two mentally disabled
women who sought placement in the community rather than being
institutionalized at a hospital psychiatric unit. The decision
concluded that under the ADA, states are required to provide services
to persons with disabilities in community settings rather than
institutions when treatment professionals determine that community
placement is appropriate, the individual does not object to this
determination, and it can be reasonably accommodated.
At the heart of Access Housing 2000 is a proposed five-year
national initiative designed to serve as an approach for using existing
federal authority and appropriations to facilitate the successful
transition from nursing homes to community living for persons with
disabilities. This initiative will begin with approximately 400
beneficiaries residing in targeted regions, with a goal, depending upon
available resources, of reaching 2000 beneficiaries at its full
implementation. Participants will include persons with disabilities who
have very low incomes and who currently reside in nursing homes. The
initiative is targeted to reach a broad geographic sweep of up to forty
states and territories at full implementation, with a goal of
approximately fifty beneficiaries per state or territory. The
initiative will use HUD Section 8 housing vouchers, HHS Nursing Home
Transition Grants, Medicaid funds, and other resources to better help
persons with disabilities make the transition from nursing homes to
community living.
HUD is promulgating this Notice pursuant to section 470 of the
Housing and Urban-Rural Recovery Act of 1983 (Pub. L. 98-181), which
states that no HUD demonstration program not expressly authorized in
law may begin until a description of the program is published in the
Federal Register, and that a comment period of 60 calendar days
following the date of publication shall be provided, in which the
Secretary shall fully consider any public comments submitted with
respect to the program.
II. Design of the Initiative
A. HUD's Responsibilities
HUD's responsibilities under the proposed national initiative
include the provision of Section 8 vouchers to selected PHAs, which
will partner with State Medicaid agencies in order to assist persons
with disabilities in transitioning from nursing homes into the
community. HUD will make available, through its funding award process,
approximately $2.5 million initially to fund 400 Section 8 vouchers
targeted for use by persons with disabilities and families of children
with disabilities who currently reside in nursing homes. On August 10,
2000, HUD published a notice in the Federal Register (65 FR 49003)
which informed the public that it intends to use a portion of the
remaining unobligated Fiscal Year 2000 funds from two Section 8 voucher
programs--Rental Assistance for Non-Elderly Persons with Disabilities
Related to Certain Types of Section 8 Project-Based Developments and
Section 202, 221(d) and 236 Developments (Certain Developments) and
Rental Assistance for Non-Elderly Persons with Disabilities in Support
of Designated Housing Plans (Designated Housing)--for this initiative.
The vouchers will be administered by the selected PHAs and will be used
by persons with disabilities to rent apartments in privately-owned
buildings, assisted living facilities, or residential facilities, or to
eventually own accessible and affordable homes. Subject to
appropriations, HUD also will provide technical assistance to the
selected sites.
In the proposed initiative's first year, approximately ten PHAs
will receive Section 8 vouchers. It is expected that for at least half
of the PHAs chosen for the initiative, vouchers will be used in
conjunction with HHS Nursing Home Transition grants, which are
administered by State Medicaid agencies, and support states in
identifying and assisting current nursing home residents who wish to
transition to home and community-based settings. The remaining PHAs
will draw upon State and local resources. (See Section
[[Page 79699]]
II.C.--PHA, State Medicaid Agency, and Joint Responsibilities--for
further requirements applicable to these entities.) Working in
consultation with HHS and IOD, HUD will select the sites that will
receive the Section 8 vouchers. Although HUD is not undertaking a
competition between PHAs for the available vouchers, interested PHAs
may submit in writing to HUD, during the comment period, any reasons
they have for desiring to become part of the initiative, including
their capacity to undertake such a project and the specific steps they
have taken or will take to coordinate with State Medicaid agencies, so
that these agencies will fulfill the responsibilities described for
them in this Notice.
B. HHS's Responsibilities
HHS's responsibilities under the proposed national initiative
include the provision of Nursing Home Transition (NHT) Grants to
selected State Medicaid agencies. These grants focus on assuring that
persons leaving nursing homes will have adequate personal assistance
services and support to meet their needs. HHS's intent with its Nursing
Home Transition Grant program is to foster the development and sharing
of innovative and effective methods to eliminate the barriers that
prevent beneficiaries from living independently in their own homes and
communities. In Fiscal Year 2000, four State Medicaid agencies each
received first-time Nursing Home Transition grants in the amount of
$500,000. It is expected that Congress will provide HHS with increased
funding for another round of Nursing Home Transition grants in Fiscal
Year 2001 as well. Subject to appropriations, HHS also will provide
technical assistance to the selected sites.
C. PHA, State Medicaid Agency, and Joint Responsibilities
PHA Responsibilities. PHAs that are selected for the initiative
will be responsible for administering the Section 8 vouchers. The usual
voucher program requirements will apply. Those PHAs that receive
vouchers to be used in conjunction with Nursing Home Transition grants
administered by State Medicaid agencies must demonstrate the commitment
and capacity to coordinate and work with these Medicaid agencies, as
well as independent living centers and other organizations to
facilitate the use of the initiative's Section 8 vouchers by persons
with disabilities leaving nursing homes.
PHAs that are located in States whose Medicaid agencies did not
receive nursing home transition grants still may qualify to obtain
housing vouchers through this initiative by demonstrating the ability
to meet the preceding criteria. It should be noted that PHAs in States
taking this course will need to show that they will be able to use
available Medicaid, State, and local resources to carry out transition-
related activities. HHS will provide additional details on how State
Medicaid agencies in both categories--those that receive nursing home
transition grants and those that do not have such funding--can express
interest in participating with PHAs that receive vouchers under this
initiative (either from the 400 vouchers currently available or from
any vouchers that may be made available in the future for this purpose)
in HHS's upcoming Fiscal Year 2001 Request For Proposals (RFP)
regarding this grant program. HHS will also communicate with State
Medicaid agencies regarding the Access Housing 2000 initiative.
State Medicaid Agency Responsibilities. A State Medicaid agency
will be considered for participation in the Access Housing 2000
initiative if it demonstrates a clear commitment and capacity in the
areas of (1) collaborating and coordinating with PHAs and other
agencies, (2) assuring that a nursing home resident has a choice about
whether to transition from a nursing home into the community and the
services and activities that are provided, and (3) strengthening and
improving community-based supportive services.
Interagency collaboration and coordination. State Medicaid agencies
will be expected to demonstrate the commitment and capacity to:
Actively foster and engage in collaborative efforts with
PHAs, independent living centers, and other organizations in order to
identify and implement strategies for obtaining accessible, affordable
housing and supportive services for those leaving nursing homes;
Assure the meaningful participation of persons with
disabilities (including current and former nursing home residents) and
others in the design and implementation of a comprehensive, effective
plan for transitioning individuals from nursing homes, both during and
after the grant period, in an attempt to improve access to home- and
community-based services to those needing such services.
Nursing home residents' choice. State Medicaid agencies will be
expected to demonstrate the commitment and capacity to:
Identify and educate nursing home residents and their
families about the alternatives available to them should the resident
desire to return to the community.
Assure that each resident (or legal guardian acting on
their behalf) has the opportunity, information, and tools to make an
informed choice about whether to transition into the community or
remain in a nursing home.
Assure that those residents who choose to transition into
the community have maximum possible control over individualized
budgeting, planning, and coordination activities.
Overcome any resistance and barriers which may impede a
resident's decision to exercise his or her choice to transition into
the community.
Strengthening and improving community-based supportive services.
State Medicaid agencies will be expected to demonstrate the commitment
and capacity to:
Ensure that individuals leaving nursing homes for
community living arrangements will receive the necessary ongoing
supportive services that will allow these individuals to remain in
their communities.
Tap the experience of independent living centers, area
agencies on aging, and similar networks in identifying and
transitioning persons with disabilities from nursing homes into their
communities (through the use of formal agreements, etc.).
Work with other organizations to develop the necessary
community infrastructure and supports to enable former nursing home
residents to live safely and with dignity in their communities.
Work with PHAs and other housing organizations to identify
and/or modify housing that is or can be made to be accessible and
affordable within a reasonable distance of a person's family or social
support network.
Joint Responsibilities. PHAs and State Medicaid agencies also must
coordinate and work with one another and with other resources--both
public and private--within their communities to facilitate the use of
the initiative's vouchers by persons with disabilities leaving nursing
homes and to ensure the success of this initiative. It is expected that
a Memorandum of Understanding or some other basic agreement between the
PHA and the State Medicaid agency, describing specific roles,
responsibilities, and activities to be undertaken by the parties, would
be prepared at the outset.
In addition, PHAs and State Medicaid agencies that participate in
the proposed national initiative will be expected to work with HUD,
HHS, and IOD by: (1) Joining local coalitions created to build ground-
level support for the initiative
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and to assist in its implementation; (2) participating in case studies
aimed at understanding the effectiveness of strategies developed during
the initiative and disseminating best practices; (3) contributing to
research that examines the process for, benefits of, and barriers to
the implementation and accomplishment of the objectives of Access
Housing 2000; (4) taking part in determining whether the strategies
developed during the initiative can be replicated on a large-scale
basis; and (5) cooperating with the analysis of Federal and State
policy affecting the implementation of this initiative.
D. IOD's Responsibilities
Subject to the availability of resources and to further definition
by HUD and HHS, IOD will create a center to: (1) Build broad-based
partnerships and collaborations in both the public, private, and
advocacy sectors; (2) conduct outreach to create local coalitions
consisting of public, private, and advocacy organizations to build
ground-level support for the initiative and to assist in its
implementation; (3) evaluate the efficacy of the strategies developed
during the initiative and the dissemination of best practices; (4)
conduct research that examines the process for, benefits of, and
barriers to the implementation and accomplishment of the objectives of
Access Housing 2000; (5) examine whether the strategies developed
during the initiative can be replicated on a large-scale basis; (6)
analyze Federal and State policy affecting the implementation of this
initiative; (7) develop a means of ensuring that the experience of the
initiative receives broad attention and review, e.g. creating a
website.
Dated: December 13, 2000.
Harold Lucas,
Assistant Secretary for Public and Indian Housing.
[FR Doc. 00-32259 Filed 12-14-00; 1:11 pm]
BILLING CODE 4210-33-P