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House and Senate 2016 Budget Resolutions Are an Affront to the Disability Community

The Senate passed its Fiscal Year (FY) 2016 Budget Resolution early this morning, following the House’s approval of its own resolution earlier this week. Budget resolutions set the boundaries for federal spending and tax priorities for the fiscal year and the implications are very scary for people with intellectual and developmental disabilities (IDD) and their families this year.

The House resolution seeks to balance the budget within nine years by cutting $5.5 trillion, while the Senate resolution would balance it in ten years by cutting $5.1 trillion, reflecting differences that could well be resolved in a conference committee. Substantial portions of these cuts come from block granting the Medicaid program (called “flexible state allotments”) and privatizing the Medicare program. Should a conference agreement pass in both chambers, a process known as budget reconciliation could be triggered to make the proposed changes in the entitlement programs and the tax code alike. This process would likely unravel the social insurance and safety net for our nation’s most vulnerable citizens while simultaneously reducing taxes for those who least need it.

“Bake sales and car washes are simply not an option. Our social insurance and safety net programs require appropriate levels of funding that can only come from the taxes that we pay and from a bipartisan commitment to people with disabilities,” stated Peter V. Berns, CEO of The Arc. “Most Americans support a balanced approach to deficit reduction, and disability is a bipartisan issue. But the budgets approved in Congress don’t reflect that reality with a ‘cuts only’ approach. Creating even larger wealth inequality in this country through the spending and tax policies promoted in these budgets is an affront to people with IDD, many of whom are already at the bottom rung of the economic ladder. Our government policies should be lifting people up, not pushing them further down.”

To get involved in protecting the rights of people with IDD, sign up for The Arc’s Action List.

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Planning for the Future: How Does the First Party Special Needs Trust Fit in the Plan?

Third in a Three-Part Series

By Laurie Hanson, Esq., Special Needs Alliance

There are an estimated 600,000-700,000 adults with intellectual and developmental disabilities (IDD) in the United States who are living with aging family members and with no plan in place for their future. Below, our colleagues from the Special Needs Alliance emphasize the importance of planning and trusts.

With the launch of the Center for Future Planning, The Arc is shining a spotlight on the need to encourage and support families to create person-centered future plans. The Center provides practical assistance and resources on future planning items such as assisting the individual with daily and major life decision-making; housing and residential options and supports; financial planning; special needs trusts; and employment and other daily activities.

In the first installment of our series, we discussed the importance of planning for a person living with a disability. In our second installment, we discussed how the third party special needs trust (SNT) is currently the best tool for parents to provide for a person with a disability at the parents’ death. We defined basic trust terms, the importance of choosing a trustee wisely, how much money should be placed into the trust, and more. In this third installment, we will be discussing the first party SNT.

What is an SNT? A trust is a legal arrangement by which a person or financial institution, called the “trustee,” holds legal title and manages money for the benefit of a person called the “beneficiary.” An SNT, if established and administered correctly, allows a person with a disability to place his or her own money in the trust and remain eligible for Supplemental Security Income (SSI) benefits and/or Medicaid. This only works if the SNT:

  • is established by a parent, grandparent, guardian, or court
    • for the benefit of a person who is living with a disability as defined by the Social Security Administration;
    • for a person who is under age 65;
    • using assets belonging to the person with a disability; and
  • is irrevocable; and
  • has a provision stating that at the death of the beneficiary, any remaining trust assets must be distributed first to the state as repayment for any Medicaid received by the beneficiary.

When is an SNT used? Individuals living with disabilities who depend on SSI and/or Medicaid to meet basic needs may have only limited assets – for instance, in most states, a person on SSI and Medicaid may have only $2,000 in cash and other “countable assets”. If a person inherits money or receives money from a lawsuit, he or she will no longer be eligible until the assets are reduced to the eligibility standard (e.g., $2,000 for the SSI program.). The SSI and Medicaid programs treat an inheritance or personal injury settlement as income in the month of receipt and an asset thereafter. Thus, upon receipt of the inheritance, the individual must either go off the program or reduce assets by the month after the month of receipt in order to remain eligible. To reduce assets without affecting eligibility, the individual may:

  • purchase assets that are not counted toward the $2,000 eligibility standard, such as a home, household goods, personal items like a computer or bicycle, an automobile, or a burial plot; and/or
  • prepay funeral expenses in a way that qualifies for an MA and/or SSI exclusion; and/or
  • fund an ABLE account if the disability was diagnosed before age 26 and the amount to be reduced is $14,000 or less – when ABLE accounts become available in his/her state of residence; and/or
  • place the assets in a special needs trust; and/or
  • place the assets in a special needs pooled trust sub-account.

Here are some examples:

Beth Jensen is a young adult living with a developmental disability who has a guardian. She lives in a group home and her support services are paid by a Medicaid waiver. She also receives SSI. Her father died without doing any planning (see installments 1 and 2!) and so she is about to inherit $300,000. Beth qualifies to be a beneficiary of an SNT because she is under age 65 and she has a disability according to SSA criteria, as evidenced by her receipt of SSI. The trust can be established by her guardian, and the inherited money can be transferred to the trust. She will remain eligible for SSI and MA as long as the trustee distributes the funds for Beth’s sole benefit. Any money left in the SNT at her death will be paid back to the state up to the amount of Medicaid benefits paid on Beth’s behalf.

Beth’s guardian could also establish a special needs pooled trust sub-account for Beth’s benefit. A pooled SNT is a master trust established by a non-profit corporation to hold assets for the benefit of a person with a disability. Here is a link to pooled trusts run by, or affiliated with, chapters of The Arc. The funds are pooled for investment purposes, but a sub-account is maintained for each beneficiary. A sub-account can be established by the individual with the disability, a parent, grandparent, guardian, or court. The trustee makes distributions from Beth’s sub-account for her sole benefit. At Beth’s death, a portion of the remaining assets may be retained by the pooled trust for trust administration purposes or to support other people with disabilities. Beyond what remains with the pooled trust, remaining assets are to be paid back to the state to reimburse the state for Medicaid benefits paid on Beth’s behalf. If any funds remain after payment to the state, funds may be paid to a remainder beneficiary named when the account was established. . Just how much money the pooled trust retains, and how much must be paid to the government, varies from state to state.

What can the trustee buy for the beneficiary with trust money? Guidelines are broad and, in general, the trustee may pay for goods and services that enhance the beneficiary’s quality of life. Examples of valid expenditures include extra therapy or personal assistance services, books, consumer electronics, musical instruments, travel and education, recreation and entertainment, pets, and some home maintenance, such as gardening and snow removal. In most cases, the trustee cannot give the beneficiary cash. If the beneficiary is on SSI, payment for food and/or shelter will reduce the beneficiary’s income by up to one third. Ensuring that the distributions do not jeopardize the beneficiary’s benefits is an important part of the trustee’s job.

SNTs can be complicated and state Medicaid agency requirements vary, so families should work with professionals who are experienced with the nuances of changing government regulations. The SNT can be a wonderful tool for those who rely on public benefits for basic needs to enhance their quality of life.

The Special Needs Alliance (SNA) is a national non-profit comprised of attorneys who assist individuals with special needs, their families and the professionals who serve them. SNA is partnering with The Arc to provide educational resources, build public awareness, and advocate for policies on behalf of people with intellectual/developmental disabilities and their families. This article does not constitute legal advice, and individuals should consult legal counsel concerning their specific situations.

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Preventing Falls for People With Intellectual Disability

Falls can cause injuries that make it hard to live as independently as possible. Equally important, many people who fall once develop a fear of falling. This fear may cause them to be inactive, which only increases risk of falling in the future.

According to findings from over 1,400 adults with ID, 18 percent* fell at home in the past year. While many consider falling an issue only for older adults (ages 65 or older), of whom 33 percent report falling each year, these findings came from respondents ages 14 or older. This implies that people with ID of all ages may be more likely to fall and may need more help to avoid falls at home.

Luckily, falling is preventable.

There are many steps that people with ID, family, friends, and staff can take to decrease the chance of falling.

  1. Exercise, exercise, exercise – Doing exercises that improve leg strength and balance are especially beneficial for reducing rates of falls. Tai Chi programs are especially helpful. The National Center on Health, Physical Activity and Disability (NCHPAD) and Disabled Sports USA offers examples of Tai Chi movements for people with disabilities.
  1. Review medications with doctors/pharmacists – Medicines may be causing side effects like dizziness or drowsiness that may cause people to fall.
  1. Visit the eye doctor – Having eyes checked and a prescription updated once a year can help ensure that a person sees any potential falling hazard in his/her way.
  1. Make the home and The Arc safer – Adding grab bars inside/outside a tub or shower and next to a toilet, adding railings on both sides of the stairways or improving lighting in a home or building can lessen the risk of falls.
  1. Connect with falls prevention programs – One great resource center is the National Falls Prevention Resource Center, which provides falls prevention materials for families and professionals. This Center also supports grantees addressing falls prevention issues in local communities. Any chapter of The Arc interested in falls prevention for people with ID is encouraged to connect with these grantees to find out more on how to work together to prevent falls in local communities!

*These findings come from The Arc’s HealthMeet project.

HealthMeet aims to reduce health disparities experienced by people with intellectual or developmental disabilities (IDD) so they can live a longer and healthier life. Through free health assessments and training, HealthMeet helps people with IDD learn about their health needs. HealthMeet also offers training to improve public, health professional, and caregiver awareness of health issues faced by people with IDD. HealthMeet is supported through at $1 million cooperative agreement with the Centers for Disease Control and Prevention. For more information on the HealthMeet project, contact Jennifer Sladen at sladen@thearc.org.

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When We Move Forward Together, Anything Can Happen

This is a guest blog post by Mardra Sikora.

A few years ago, my son and I sat backstage during the Broadway Across America national tour performance of Mary Poppins. The cast sang, “Anything Can Happen, if You Let it,” and danced across the stage exuberantly pursuing their point. I believed them, because Marcus would soon be on stage singing right alongside them. This was in 2011 and the opportunity came from an auctioned event. Since then, his ambition to write his own musical and perform on stage has continued to grow. In fact after telling one actor at a community theater that he wanted to play the leading role, that actor reminded Marcus of the quote, “The greatest of journeys starts with a single step.”

The Next Step

MarcusMarcus keeps taking steps. His latest endeavors have netted a short play which is being produced this month at a local public high school. The show is called “Cassie Through the Closet Door.” The role of Cassie was inspired by an actress who Marcus worked with while participating in a project called the Art of Imagination. A program developed by our local chapter of The Arc, the Ollie Webb Center. Marcus has taken beginning acting classes through this program and hopes to move on to advance acting and then classes within the community next. These classes teach craft and understanding theater, but his innate talent is as a storyteller. Coming up next is the release of his children’s book entitled Black Day: The monster rock band, with a read along animated short to follow on DVD this fall.

Dreams Take a Village

There are still some who can’t believe what Marcus can achieve, but frankly Marcus doesn’t care what they think. That is perhaps one key to his continued ambition and potential for success. But it’s more than that, it’s also a community, a team effort. Ask any Olympian if they did it alone. There’s a reason award acceptance speeches are so long, the list of “Thank You’s” include many supporters within their community. Many people have to come together to teach, support, encourage, and enable anyone to reach their dreams.

Menschen cardMarcus also has some great role models breaking the social barriers. Connor Long, is one example of a young adult self-advocate who is following his acting aspirations. He’s already received accolades and awards for his role in the live action short Menschen. Which The Arc is sponsoring shows in cities across the country. The most recent list is at the end of this review, check back for updates. (Be sure to talk to your local arc to bring the show to your town.) Connor is busy with local theater at events and is also in production of his next film project, Learning to Drive, another example of a writer-director with a personal story to tell.

These two young men are just the tip of the iceberg, there are so many self-advocates taking steps to achieve their dreams. With their actions they are teaching communities, and because our communities are growing more inclusive, they continue to move forward. Let us all keep moving forward together, sharing, teaching, and learning that together, “Anything Can Happen, if You Let it!”

Bio: Mardra Sikora believes in the power of words and uses both fiction and non-fiction to advocate for and with her adult son Marcus. You can find her and Marcus on the blog Grown Ups and Downs, Facebook and Twitter as well as on various blog networks including The Huffington Post.

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The Arc Joins Over 70 National Organizations to Speak Out Against Attacks on Social Security, SSDI

Social Security and its disability program are incredibly important to people with IDD, providing modest support to make living independently a reality.  But this vital system is under attack in Washington, DC. Today, The Arc joined other major national organizations to release a letter with Senator Sherrod Brown (below) to oppose any cuts to the program.  Sign up for The Arc’s action center to stay informed and act to stop Congress from making cuts.

March 17, 2015

The Honorable Orrin Hatch

Chair, Committee on Finance

U.S. Senate

219 Dirksen Senate Office Building

Washington, DC 20510

 

The Honorable Sam Johnson

Chair, Subcommittee on Social Security

Committee on Ways and Means

U.S. House of Representatives

B317 Rayburn House Office Building

Washington, DC 20515

 

The Honorable Paul Ryan

Chair, Committee on Ways and Means

U.S. House of Representatives

1102 Longworth House Office Building

Washington, DC 20515

The Honorable Jeff Flake

U.S. Senate

368 Russell Senate Office Building

Washington, DC 20510

 

The Honorable Joe Manchin

U.S. Senate

306 Hart Senate Office Building
Washington, DC 20510

 

RE:      Opposition to proposals to eliminate or reduce concurrent Social Security Disability Insurance (SSDI) and Unemployment Insurance (UI) benefits

Dear Chairman Hatch, Chairman Johnson, Chairman Ryan, Senator Flake, and Senator Manchin:

The undersigned members of the Consortium for Citizens with Disabilities (CCD), the Coalition on Human Needs, and the Strengthen Social Security Coalition write to express our opposition to proposals to eliminate or reduce concurrent Social Security Disability Insurance (SSDI) and Unemployment Insurance (UI) benefits, including the “Social Security Disability Insurance and Unemployment Benefits Double Dip Elimination Act of 2015” (S. 499; H.R. 918) and the “Reducing Overlapping Payments Act of 2015” (S. 343).

SSDI and UI are vital insurance systems established for different purposes. Receiving UI and SSDI concurrently is legal and appropriate. This has been the long-standing position of the Social Security Administration and of the courts. Individuals qualify for SSDI because they have significant disabilities that prevent work at or above Social Security’s Substantial Gainful Activity level (earnings of $1,090 per month, in 2015). At the same time, the Social Security Act encourages SSDI beneficiaries to attempt to work, and those who have done so at a low level of earnings but have lost their job through no fault of their own may qualify for UI. As highlighted in a 2012 Government Accountability Office report, less than one percent of individuals served by SSDI and UI receive concurrent benefits, and the average quarterly concurrent benefit in fiscal year 2010 totaled only about $3,300 (or an average of $1,100 per month).

These extremely modest benefits can be a lifeline to workers with disabilities who receive them, and their families – and as permitted by law are neither “double-dipping” nor improper payments. We are deeply concerned by any prospect of worsening the economic security of workers with disabilities and their families.

In addition, proposed cuts to concurrent benefits single out SSDI beneficiaries with disabilities, treating them differently from other workers under the UI program.

Finally, proposed cuts to concurrent benefits create new disincentives to work for SSDI beneficiaries, by penalizing individuals who qualify for both SSDI and UI because they have attempted to work, as encouraged by law. The creation of a new work disincentive runs directly counter to our shared goal of expanding employment opportunities for people with disabilities.

For these reasons, the undersigned national organizations strongly oppose the “Social Security Disability Insurance and Unemployment Benefits Double Dip Elimination Act of 2015” and the “Reducing Overlapping Payments Act of 2015.” We urge Congress to reject these bills and any similar legislation.

Sincerely,

9to5

ACCSES*

AFL-CIO

Alliance for Retired Americans

Alliance for Strong Families and Communities

American Council of the Blind*

American Federation of Government Employees (AFGE)

American Federation of State, County and Municipal Employees (AFSME)

American Foundation for the Blind (AFB)*

Americans for Democratic Action (ADA)

Association of Assistive Technology Act Programs*

Association of University Centers on Disabilities*

Autism National Committee*

Autistic Self Advocacy Network (ASAN)*

B’nai B’rith International

Brain Injury Association of America*

Campaign for America’s Future

Center for Community Change Action

Center for Effective Government

Coalition on Human Needs

Community Legal Services*

Disability Rights Education and Defense Fund*

Easter Seals*

Equal Rights Advocates

Every Child Matters Education Fund

Food Research & Action Center (FRAC)

Goodwill Industries International*

Health & Disability Advocates*

Justice in Aging*

Latinos for a Secure Retirement

Lupus Foundation of America*

Lutheran Services in America Disability Network*

MomsRising

NAACP

National Advocacy Center of the Sisters of the Good Shepherd

National Alliance on Mental Illness*

National Association of Councils on Developmental Disabilities*

National Association of Disability Representatives*

National Association of State Directors of Special Education*

National Association of State Head Injury Administrators*

National Committee to Preserve Social Security and Medicare*

National Council of Jewish Women

National Council on Aging*

National Council on Independent Living*

National Disability Rights Network (NDRN)*

National Down Syndrome Congress*

National Employment Law Project

National Employment Lawyers Association

National Industries for the Blind*

National Multiple Sclerosis Society*

National Organization for Women

National Organization of Social Security Claimants’ Representatives*

National Priorities Project

National Respite Coalition*

National Women’s Law Center

NETWORK, A National Catholic Social Justice Lobby

OWL-The Voice of Women 40+

Paralyzed Veterans of America*

Provincial Council of the Clerics of St. Viator (Viatorians)

Racial and Ethnic Health Disparities Coalition

Social Security Works

SourceAmerica*

Special Needs Alliance*

Strengthen Social Security Coalition

The Arc of the United States*

The Jewish Federations of North America*

The John O’Leary Organization

The Judge David L. Bazelon Center for Mental Health Law*

Union for Reform Judaism

United Cerebral Palsy*

United Spinal Association*

United Steelworkers (USW)

USAction

Vietnam Veterans of America (VVA)*

World Institute on Disability*

 

CC:

 

Original cosponsors, S. 499

The Honorable Daniel Coats

The Honorable James M. Inhofe

The Honorable James Lankford

The Honorable Tim Scott

 

Original cosponsors, H.R. 918

The Honorable Todd C. Young

The Honorable Mike Kelly

The Honorable Patrick J. Tiberi

The Honorable Diane Black

The Honorable David G. Reichert

The Honorable Charles W. Boustany, Jr.

The Honorable Adrian Smith

The Honorable James B. Renacci

The Honorable Tom Reed

The Honorable Aaron Schock

 

Members, U.S. Senate

Members, U.S. House of Representatives

 

* Members of the Consortium for Citizens with Disabilities (CCD).

 

The CCD is a coalition of national organizations working together to advocate for federal public policy that ensures the self-determination, independence, empowerment, integration, and inclusion of the approximately 57 million children and adults with disabilities in all aspects of society.

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Calling It Modern Doesn’t Make It Good: No “Modern Asylum” Will Benefit This Generation of People With Disabilities

Recently, Dr. Christine Montross made what The Arc believes to be a deeply flawed argument in favor of institutionalization for individuals with intellectual and developmental disabilities (IDD), or as she put it, “a modern asylum”. Dr. Montross failed to address a number of key factors in her piece, but what was most disturbing was the complete lack of reference to the desires of individuals with IDD.

When The Arc was founded, nearly 65 years ago, it was all too common for doctors to tell parents that the best place for their child with IDD was in an institution. Emboldened by their collective desire to raise their children as part of their families and communities, and their refusal to accept institutionalization as the only option, The Arc’s founders fought for inclusion. To this day, The Arc stands by the belief that all people, regardless of disability, deserve the opportunity for a full life in their community where they can live, learn, work and play through all stages of life.

The vast body of research on deinstitutionalization has established that moving from institutional settings and into smaller community-based ones leads to better outcomes for people with IDD (Kim, Larson, & Lakin, 1999; Larson & Lakin, 1989, 2012). In fact, studies continue to show that people with IDD benefit from moving to the community from an institutional setting. More powerful than any of the research are the stories from individuals who transitioned from institutions into the community. These stories breathe life into this research and The Arc’s mission.

Dr. Montross’ op-ed offended many readers, but it did highlight a systemic issue. Many health care providers will not accept people with IDD as clients, or do not feel that they have the expertise to appropriately serve them. Furthermore, there are practitioners who will not accept clients who are reliant on Medicaid as their primary payer of health care services due to low reimbursement rates. Combined, these issues create a system that doesn’t always adequately serve all people with IDD.

Weaknesses in the ability of some community-based mental health treatment systems to adequately meet the needs of clients does not necessitate the return of people to archaic institutional settings. Instead, it should lead to a public outcry for vast and immediate improvements in the capacity of communities to provide mental/behavioral health care to those who need it. The Arc strongly believes that the solution is not to move back to antiquated institutions. The way forward does not, as Dr. Montross states, “[include] a return to psychiatric asylums.” The way forward includes serving all citizens and demands an evolution in the attitudes of health care practitioners which includes the belief that all people, regardless of disability, deserve the same opportunities to enjoy full lives in their communities.

While there is no denying the issues she references, as often as possible the choice of where to live must be made by the individuals who will be impacted. And, as history has shown, the approach suggested by Dr. Montross has been attempted in the past and it resulted in Willowbrook and countless other atrocities in the name of “patient care.” While community supports for individuals with IDD can benefit from improvement, we have come too far to take a step back towards segregated settings.

We welcome a discussion with Dr. Montross. Our hope is next time she has a national platform like the New York Times she chooses to consider the desires of individuals with IDD and the history of isolation and oppression they faced in institutions before making suggestions about what is best for them.

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DPS 2015: Get Involved and Get the Facts

This year’s Disability Policy Seminar is coinciding with some remarkable anniversaries. In 2015 we are set to celebrate the 25th anniversary of the passage of the Americans with Disabilities Act and the 50th anniversary of Medicaid and Medicare. The passage of this transformative legislature would not have been possible without the hard work of congressional leaders and disability advocates, like you! We can celebrate these monumental achievements, but we can’t stop there.

We need everyone who can to attend DPS so that every congressional district is represented. We have to keep the momentum going and strengthen our relationships with members of congress so that we can work together to advance our public policy agenda. This year’s Disability Policy Seminar is taking place April 13-15, in Washington, DC at a new location: Renaissance Washington, D.C. Downtown Hotel. Come and be a part of the solution by registering today! Early bird registration and discounted pricing is set to end on March 13th. In order to get the most out of hill meetings, you must come to DPS. On the first day of DPS, you’ll be treated to an informative opening session from Rud Turnbull. During his session, Families Making a Difference: How Advocacy Advanced Civil Rights, Rud will explain his family’s journey in gaining meaningful changes in federal disability policy. This session will explore advancing civil rights though the concepts of empathy, compassion, dignity, and the ethical community. It is the perfect opening session to get you prepared for the next three days.

This year’s program is designed to prepare you and give you an accurate sense of what is happening in Congress. We want to show Congress that the disability advocacy network is strong and vast. Visit www.disabilitypolicyseminar.org to get full program information and to register.

Get involved and get the facts!

Hosted by: The Arc, United Cerebral Palsy (UCP), Association of University Centers on Disabilities (AUCD), American Association on Intellectual and Developmental Disabilities (AAIDD), National Association of Councils on Developmental Disabilities (NACDD), and Self-Advocates Becoming Empowered (SABE)

Promotional Support Provided by: Sibling Leadership Network and the American Association of People with Disabilities (AAPD)

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Advances in Affordable Housing: The Arc Applauds $150 Million in New Funding for States

Washington, DC – The Arc released the following statement in response to the U.S. Department of Housing and Urban Development’s (HUD) announcement of awards totaling $150 million to 24 states and the District of Columbia to develop an estimated 4,584 units of inclusive, affordable supportive housing in the community for people with significant disabilities and extremely low incomes. HUD awarded the funds through the recently-modernized Section 811 Supportive Housing for Persons with Disabilities Project Rental Assistance (PRA) program. The Section 811 PRA program is designed to assist state housing agencies to expand integrated, supportive housing opportunities for people with the most significant and long term disabilities, and was the centerpiece of the Frank Melville Supportive Housing Investment Act of 2010.

“Like all Americans, people with intellectual and developmental disabilities deserve the opportunity to live independently in the community with their peers. Unfortunately, across our nation low-income people with disabilities face a severe shortage of accessible and affordable housing. The money being awarded by HUD will continue the progress and promise of the Melville Act, allowing thousands of individuals to live in the community, where they belong. For many, this announcement is the difference between life in an institution and inclusion in their communities,” said Peter V. Berns, CEO of The Arc.

Section 811 is the only HUD program dedicated to producing affordable, accessible housing for non-elderly, very low-income people with significant disabilities. The Frank Melville Supportive Housing Investment Act of 2010 modernized Section 811 to make the program more efficient and effective. Today’s awards are the second round of funding under the new Section 811 PRA program, which will create integrated housing linked with community-based services for low-income adults with significant disabilities.

Along with the District of Columbia, states receiving awards are: Alaska, Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Maryland, Maine, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, New Mexico, Nevada, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas, and Wisconsin.