Inclusive Housing Coalition Housing and Support Goals
In Colorado, approximately 127,000 persons with autism and intellectual and developmental disabilities (A/I/DD) have requested services and many more are uncounted. Housing continues to be a top concern for this population and their families.
Several existing barriers and issues press on the systems meant to assist these people and could force individuals with A/I/DD to live in overly restrictive settings, institutionalization or even homelessness. Like many seniors, individuals with A/I/DD should have the opportunity to live in settings that may provide daily support and engagement in activities.​
The following identifies issues to be addressed in the coming 1 to 3 years:
​​Shortage of Affordable Housing that is Cognitively Accessible:
People with A/I/DD are able to and desire to live independently in a variety of settings and there varying levels of supportive needs. However, finding these appropriate settings is challenging and made more so by the ongoing issue of housing unaffordability in Colorado. According to studies, Colorado faces a shortfall of approximately 100,000 units and record numbers of lower-income Coloradans are housing cost-burdened, meaning that more than 30% of income is needed for housing costs. Many individuals with A/I/DD struggle to find an affordable setting that provides support for their needs.
​
Suggested Actions:
Inclusion of A/I/DD needs as a consideration in the use of new and existing affordable housing finance resources.
​
Introduction of new financing resources including a potential state housing tax credit for affordable housing that includes A/I/DD units and programming.
​
Include A/I/DD in the implementation of recently passed legislation such as SB24-174 regarding housing assessments and action plans and HR24-1360 concerning the Colorado Disability Opportunity Office.
Aging Parent/Caregivers:
More than 72% individuals with A/I/DD live with family and more than 20,000 of those individuals in Colorado currently live with parents or caregivers over the age of 60. This has the potential to cause a “cliff” situation of people without an appropriate alternative residential setting. Caregivers are deeply concerned that there may not be appropriate care for their loved ones once they are no longer able to continue to provide care.
​
Suggested Actions:
Prioritization of housing vouchers for individuals with A/I/DD who may be in danger of homelessness or institutionalization due to living with an aging caregiver.
​
Implementation of a process to ensure that individuals living with aging caregivers have a supportive housing option available through creation of new housing.
Preservation of Existing Housing and Services for Persons with Higher Needs:
For different reasons including insufficient reimbursement rates, service providers have been unable to serve higher-need individuals in 24-hour staffed settings such as Personal Care Alternative and Group Home residences, which play an important role in allowing adults with I/DD to be part of a community. In recent years several group homes have closed as a result of an inability to fund services.
​
Suggested Actions:
In addition to the Alliance Colorado recommendations to the MPRRAC to increase Group Residential Services and Supports rates for support levels 1-6 by at least 10%, we suggest considering flexibility for housing vouchers for individuals who lose group home settings due to closure.
Support service providers who are seeking innovative ways to use existing owned real estate for the benefit of adults with A/I/DD in need of neuro-inclusive housing with supports.
Availability and Flexibility of Housing Vouchers:
State and locally administered Housing Voucher programs serve as a critical source of rental support for many low-income individuals. Individuals with A/I/DD, service providers and housing providers have found that the system for allocation of vouchers is not always well suited to meet the needs of the population, is difficult to navigate, particularly for individuals with cognitive disabilities, and often does not provide a needed level of flexibility.
​
Suggested Actions:
Consider creating a state position that helps individuals navigate housing issues such as vouchers and other requirements that come with accessing affordable housing.
​
Allocation of vouchers should include individuals with A/I/DD who are at a high risk of becoming homeless or institutionalized, including those living with a parent or caregiver over the age of 60. Implementation of a statewide housing navigation system for individuals with A/I/DD and/or their caregivers.
The following identifies issues in service provision that have an impact of housing for people with A/I/DD:
Waitlists for Medicaid Waivers:
For individuals who do locate an affordable and accessible setting, many still require in-home Long Term Support Services to help with various needs through the Home and Community Based Developmental Disability waiver. Waitlists for the waiver remains extensive with a timeframe of six months for approximately 3,338 individuals.
​
Suggested Actions:
Develop a strategy to end the waitlist for the HCBS-DD waiver. It is the only waiver with a waitlist and the only one that provides 24/7 access to support for people with A/I/DD.
​
Identify ways to enhance the overall waiver process. Remove remaining silos between waiver funding sources and make the full range of Medicaid waiver services available under a small number of waiver programs from which people can prioritize and customize their personal package of support, including a possible avenue for supportive housing.
​
Resolve the inconsistencies with individual-preferred settings that might be strictly defined as segregated and conflict with settings rules.
Reimbursement Rates for Service Providers:
Behavioral related services, personal care, and supported employment can be critical to an individual with A/I/DD living independently in the community. Nearly all service providers rely on Medicaid reimbursement to cover costs. Despite some recent increases, Medicaid reimbursement rates still fall well below the average cost to provide services. Also, the current reimbursement structure makes hiring and retaining staff difficult in a competitive labor market.
​
Suggested Action:
We support Alliance Colorado’s recommendations to the Medicaid Provider Rate Review Advisory Committee (MPRRAC) that certain services that fall below 100% of the benchmark established by MPRRAC should be increased to 100% of the benchmark.