Supporting the Home and Community Based Services Access Act

image of disability rights march with black disabled man in wheelchair at from with white man pushing him. There looks to be over 100 people present

Submitted: April 26, 2021

Dear Sens. Hassan, Brown, and Casey and Rep. Dingell,

Thank you for your tremendous leadership and for this opportunity to comment on your discussion draft of the Home and Community Based Services Access Act (the “HAA”). The Kelsey is in strong support of this legislation, with its potential to transform our country’s care infrastructure and help to ensure that the promise of the landmark Olmstead decision is fully realized for all Americans with disabilities.

The Kelsey pioneers disability-forward housing solutions that open doors to more affordable homes and opportunities for everyone. We have 240 homes in our pipeline and lead advocacy initiatives to support market conditions to make inclusive housing the norm. In defining the housing needs nationally for people with disabilities, we understand the challenge as threefold: affordability in people with disabilities disproportionately living in poverty and living with lower incomes and needing housing priced and financed accordingly; accessibility in how buildings and communities are designed and located to accommodate diverse access needs including mobility, sensory, support needs, medical needs, and cognitive supports, among others; and inclusivity in ensuring people are truly included and integrated in their communities and able to access the services and support they need to not only survive but thrive.

The HCBS Access Act, and the ability for people to access Home and
Community Based Services (“HCBS”) is a fundamental part of creating and supporting housing options that are non-institutional for people with disabilities.
Medicaid continues to hold certain institutional bias that requires coverage of congregate housing options but fails to support home and community-based services. The HAA would change this by making HCBS a mandatory Medicaid service. In doing so, the HAA would:

  • build on the promises of the Americans with Disabilities Act and the
    Supreme Court’s Olmstead decision and provide the Federal Medicaid
    resources necessary for states to fulfill those promises;
  • deliver on the advocacy of disabled leaders and allies to ensure people are
    able to live in the community of their choices;
  • ensure access to safe and supportive living environments for people with
    disabilities and not require people’s housing options to be limited to
    congregate housing which data shows are more expensive, less desired,
    and less able to keep people healthy in times like COVID-19

We believe in people with disabilities being able to make meaningful, informed choices to decide where they live and how they are supported to live there. But, historically and presently housing options that include more robust service and supports or that were available to people without a waitlist continue to be disproportionately congregate or institutional. People with disabilities haven’t to date been given a true choice in how and where they want to live because their options are limited by their ability to access services. HAA would provide that true choice, by permanently and meaningfully investing in HCBS infrastructure, workforce, and industry capacity.

HAA is also an incentive for housing developers, both affordable and mixed
income, to develop housing that is inclusive of people with disabilities. Knowing future residents have access to adequate services helps mitigate risks for property managers and owners – residents will be able to retain their housing, live safely in their homes, and have the supports that are individualized to their needs. Housing developers and property managers could also leverage HCBS funding for housing-related services, as a further incentive to increase the availability of and quality of inclusive housing supply. Accessible housing is extremely limited within the existing housing stock; by encouraging housing builders to focus on this underserved population, the HAA can make a considerable difference to accessible, inclusive housing availability.

Passing the HAA is an important first step in ensuring a future where people with disabilities have access to community living. HAA should be coupled with federal investment in housing infrastructure that is accessible, affordable, and inclusive of people with disabilities. This includes: subsidies for disability-forward housing models (models that meet affordability, accessibility, and inclusivity needs) and housing vouchers for people with disabilities, financing incentives for inclusive housing developments that reserve homes for people with disabilities who use HCBS services, incentivizing through federal funding and policies funding for
accessible, affordable, and integrated housing development, among additional key housing protection and preservation efforts that include and center people with disabilities.

In conclusion, we strongly support the HAA and believe that the success of the HAA is deeply connected to the Biden-Harris Administration’s commitment to $400 billion HCBS investment in the American Jobs Plan. Therefore, along with the HAA, we ask that $400 billion HCBS investment be fully realized in this session of Congress.

Sincerely,

Micaela Connery
CEO & Co-Founder

Allie Cannington
Manager, Advocacy & Organizing

Advocacy