Housing

Perhaps the most critical need for people moving out of institutions is a decent place to live. The Supreme Court itself was concerned that the L.C. ruling not lead to further homelessness.

Federal programs are available to help people with very low incomes live in decent, safe and sanitary housing while paying only 30 percent of their income for rent. According to a recent report,⁽¹⁸⁾ people with mental illnesses are among the poorest in the nation. If they leave state institutions with no other resources beyond federal SSI disability payments, they cannot afford even modest rental housing. In most communities across the country, their rent burden would be more than 50 percent of their monthly SSI benefit. Clearly, successful transition to community living will require rental subsidies or other resources to assure decent housing.

The federal government provides two forms of assistance that states can tap into for housing for people with mental illnesses: mainstream federal public and subsidized housing programs and specialized programs, such as "elderly and disabled" housing and the Section 811 Supported Housing program.

Although access to these housing opportunities has been diminished in the 1990s by policy changes and funding cuts, the Section 8 tenant-based program is the primary mainstream resource available for people with disabilities and remains an important potential resource. Despite policies that permit subsidized housing to be designated as "elderly only" and other cutbacks in funding for housing for people with disabilities, state mental health authorities can be active partners with Public Housing Authorities and nonprofit groups to secure Section 8 vouchers to support community integration under L.C.

Section 811 Supportive Housing For People With Disabilities

The Section 811 Supportive Housing for People with Disabilities program is similar to, and in fact grew out of, the Section 202 program (Supportive Housing for the Elderly). Section 811 is intended to allow individuals with disabilities to live independently by increasing the supply of rental housing with supportive services and related facilities. The program also allows the sponsor to get project rental assistance, which can cover any part of the HUD-approved operating cost of the facility that is not met from project income.

The program provides grants to nonprofit organizations to develop and construct or rehabilitate rental housing with supportive services for very low-income individuals with disabilities. Section 811 provides funds for housing for very low-income people between the ages of 18 and 62 who have disabilities, including people with physical or developmental disabilities or chronic mental illnesses and disabled families. A companion Mainstream Program awards funding for Section 8 rental vouchers and certificates to very low-income people with disabilities.

Any public housing authority (PHA) established under state law can apply for up to 100 Section 8 rental vouchers or certificates under the Mainstream Program.

Community Development Block Grant and Home Programs

Communities have the authority, although it is rarely exercised, to expend federal grant funds under the Community Development Block Grant (CDBG) and HOME programs to support the development of new housing and to provide rental assistance for people with disabilities. Because each community's funds are allocated through the local and state Consolidated Plan processes, it is essential that mental health departments articulate the need generated under L.C. by formally participating in these processes. Earlier this year, HUD Secretary Andrew Cuomo issued new instructions to HUD staff and grantees to take further steps to include people with disabilities and their advocates in the planning process.

McKinney Homelessness Programs

While many individuals with mental illnesses are at imminent risk of homelessness, HUD policy currently excludes those in psychiatric hospitals longer than 30 days from the eligibility definition of "homeless individual." This means that people with longer-term hospitalizations are ineligible for any housing resources under the Stewart B. McKinney Homeless Assistance Act.⁽¹⁹⁾ HUD's interpretation further states that the only people who have been hospitalized for more than 30 days who can still meet the eligibility definition of "homeless individual" are those whose planned discharge date is within the next seven days and who will be discharged to the streets or to a shelter due to lack of housing.

This policy encourages irresponsible and clinically inappropriate discharge planning. It is a significant problem that people with long-term hospital stays are being denied these options, particularly because much of the McKinney-funded housing is more integrated, less restrictive housing. Advocates continue efforts to amend this law to make these programs more accessible to people with disabilities who are leaving long-term institutional placements.

Nonetheless, McKinney Act homeless programs may still be a significant resource for individuals at risk of long-term institutionalization, but who have not just been released from a hospital stay as long as 30 days or more.

Next: Supplemental Security Income