FROM THE STACKS

EDITOR’S NOTE:  There are literally thousands of journals published around the world that relate to the disability community.  It is virtually impossible to capture even a fraction of them. HELEN receives "stacks" of journals and selectively earmarks what we feel are "must read" articles of interest for our readers. It's a HELEN perk!

HUD Takes Action to Support Community Living for People with Disabilities

New Mainstream Voucher flexibilities designed to help people with disabilities choose where they live

On the heels of the 34th anniversary of the Americans with Disabilities Act and the 25th anniversary of the landmark Supreme Court decision on Olmstead v. L.C., the U.S. Department of Housing and Urban Development (HUD) is taking policy actions to support community living for people with disabilities. Specifically, HUD published guidance that creates new alternative requirements and waivers that enable public housing agencies (PHAs) to better utilize Mainstream Vouchers to help persons with disabilities transition from and avoid institutional settings, in furtherance of the goals of Olmstead.

“Affordable and accessible housing is essential to realizing the goals of Olmstead,” said HUD Acting Secretary Adrianne Todman. “The flexibilities we are providing today will further enable local leaders to support the housing needs of people with disabilities”.

HUD’s Mainstream Vouchers are one of the most important federal programs that provide housing assistance to people with disabilities. The program provides funding to housing agencies to provide rental assistance to non-elderly persons with disabilities, who are at least 18 years old and not yet 62 years old, who are transitioning out of institutional or other isolated settings, at serious risk of institutionalization, homeless, or at risk of becoming homeless. Under the Biden-Harris Administration, HUD has expanded the Mainstream Voucher program by over 20,000 vouchers and awarded additional extraordinary administrative fees.

“Mainstream Vouchers are important to make communities more accessible and diverse and to make affordable housing in areas of opportunity a reality for all Americans,” said Rich Monocchio, Principal Deputy Assistant Secretary for the Office of Public and Indian Housing. “Though we’ve seen great success with these vouchers to date, the flexibilities we’re announcing today will further improve its efficiency and in turn better serve people with disabilities to find homes in their community that meet their needs and preferences.”

The PHAs who administer Mainstream Vouchers can coordinate with Centers for Independent Living, state protection and advocacy agencies, Medicaid agencies, Continuums of Care, and other agencies that assist people with disabilities to receive referrals, provide housing search assistance, and coordinate the provision of supportive services. The alternative requirements and waivers announced today enable PHAs to strengthen their partnerships with these agencies that support community living.

The policy changes announced today include:

  • Alternative Requirements:

    • The minimum initial search term will increase from 60 to 120 days, giving participants more time to search for housing before they need to request an extension.

    • The process for requesting search extensions requires PHAs to approve all initial extension requests which will be for a minimum of 90 days.

    • PHAs will not be permitted to exercise a residency preference for Mainstream Vouchers because applicants who are experiencing homelessness or residing in an institution may be doing so outside of the PHA’s jurisdiction .

  • Discretionary Waivers:

    • PHAs may adopt a separate Mainstream Voucher waiting list. PHAs with high utilization of their Mainstream vouchers may find it unnecessary to establish a separate waiting list, but some may choose to do so to reduce burden in identifying eligible applicants. 

    • PHAs may adopt admissions preferences that prioritize direct referrals from health care and disability agencies that support community living, so long as the referral source is not serving one specific disability type. PHAs can choose to adopt these preferences only for Mainstream Vouchers or to their overall Housing Choice Voucher program.

The Mainstream Voucher waivers and alternative requirements announced today help address some of the barriers to housing search among non-elderly people with disabilities identified in a study published by HUD last month.

The study, “Housing Search Assistance for Non-Elderly People with Disabilities,” found that people with disabilities face a variety of challenges in searching for housing. They exhibit difficulty securing services and supports before their voucher expires, navigating the housing search process and overcoming screening requirements, accessing reasonable accommodations or necessary modifications that exceed what a landlord is required to provide, and covering moving and initial living expenses.

Under the Biden-Harris Administration, HUD has expanded the Mainstream Voucher program by over 20,000 vouchers and awarded additional extraordinary administrative fees. Since Mainstream Vouchers were first awarded in 1997, HUD has awarded over $500 million in funding to public housing agencies (PHAs) to support over 71,000 new Mainstream Vouchers.

For more information on the Mainstream Voucher Program, click here.

HUD's mission is to create strong, sustainable, inclusive communities and quality affordable homes for all.
More information about HUD and its programs is available at
www.hud.gov and https://espanol.hud.gov.

You can also follow HUD on Twitter and Facebook or sign up for news alerts on HUD's Email List.

Learn More About HUD's Property Appraisal and Valuation Equity Work

August 2024

Informing creation of the FEEDS Toolkit to support parent-delivered interventions for eating, drinking and swallowing difficulties in young children with neurodisability: intervention use by neurodevelopmental diagnosis and healthcare professional role

 2024 Aug 24;8(1):e002394.

 doi: 10.1136/bmjpo-2023-002394.

Emogene Shaw 1 2Lindsay Pennington 1 3Morag Andrew 1 3Helen Taylor 1Jill Cadwgan 4Diane Sellers 5Christopher Morris 6Deborah Garland 7Jeremy Parr 8 3

Affiliations 

PMID: 39181695

DOI: 10.1136/bmjpo-2023-002394

Abstract

Background: The FEEDS (Focus on Early Eating, Drinking and Swallowing) study focused on interventions used to improve feeding for children with neurodisability and eating, drinking and swallowing difficulties (EDSD), and the outcomes viewed as important by healthcare professionals (HPs) and parent carers. The FEEDS Toolkit was created subsequently as an intervention decision aid to be used collaboratively by parent carers and HPs. This study aimed to inform on current intervention practices and influence toolkit design by ascertaining whether specific intervention use varied by a child's main diagnosis and by specific HP role.

Methods: FEEDS survey data were grouped by child's main diagnosis and HP role. Main diagnoses included autism spectrum disorder (ASD) n=183; Down syndrome (DS) n=69; cerebral palsy (CP) n=30). HPs included were speech and language therapists (SLT) n=131; occupational therapists (OT) n=63; physiotherapists (PT) n=57; paediatricians n=50; dieticians n=40; nurses n=32 and health visitors n=14.

Results: Most interventions were used commonly across diagnoses. However, some interventions were used more commonly with specific conditions, for example, positioning (CP 85%, DS 70%, ASD 23%, strategies/programmes aimed at changing behaviour at mealtimes (ASD 52%, CP 8%, DS 11%); visual supports (ASD 58%, CP 0%, DS 21%). HPs reported using a broad range of interventions, SLTs (mean=13.9), dieticians (12.3), OTs (12.7) and paediatricians (11.1). There was overlap between intervention use and HP role, for example, positioning (100% PT, 97% SLT, 94% OT, 73% paediatricians and 69% nurses).

Conclusions: Interdisciplinary working is common when managing EDSD, with all HP types using multiple interventions. A child's main diagnosis does not substantially influence intervention use, and the individual context of each child requires consideration in intervention selection. Study findings have supported development of the FEEDS Toolkit for use in feeding services.

 

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