[Federal Register Volume 65, Number 244 (Tuesday, December 19, 2000)]
[Notices]
[Pages 79698-79700]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-32259]



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Part V





Department of Housing and Urban Development





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Notice of Public and Indian Housing: Access Housing 2000 Initiative; 
Notice

  Federal Register / Vol. 65 , No. 244 / Tuesday, December 19, 2000 / 
Notices  

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DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT

[Docket No. FR-4641-N-01]


Notice of Public and Indian Housing: Access Housing 2000 
Initiative

AGENCY: Office of the Assistant Secretary for Public and Indian 
Housing, HUD.

ACTION: Notice of proposed national initiative--access housing 2000.

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SUMMARY: This notice provides information on Access Housing 2000, a 
proposed national initiative that will assist persons with disabilities 
to transition from nursing homes into the community by providing 
improved access to affordable housing and necessary personal assistance 
and supportive services. HUD is partnering with the U.S. Department of 
Health and Human Services (HHS) and the Institute on Disability (IOD) 
at the University of New Hampshire to carry out this initiative.
    Using Section 8 housing vouchers in conjunction with supportive 
services available under the Medicaid program, the proposed initiative 
presents an opportunity to design and implement innovative housing and 
supportive service strategies. If successful, these strategies could 
expand the availability of accessible, affordable housing in the United 
States, including homeownership opportunities for persons with 
disabilities, and assure that such individuals receive the assistance 
and the ongoing supportive services necessary to make a smooth and 
successful transition to living in the community.

DATES: Comments Due Date: February 20, 2000.

ADDRESSEES: Interested persons are invited to submit comments regarding 
this notice to the Regulations Division, Office of General Counsel, 
Room 10276, Department of Housing and Urban Development, 451 Seventh 
Street, SW, Washington, DC 20410. Communications should refer to the 
above docket number and title. Facsimile (FAX) comments are not 
acceptable. A copy of each communication submitted will be available 
for public inspection and copying between 7:30 a.m. and 5:30 p.m. 
weekdays at the above address.

FOR FURTHER INFORMATION CONTACT: Rod Solomon, Deputy Assistant 
Secretary, Office of Policy, Program and Legislative Initiatives, 
Office of Public and Indian Housing, Department of Housing and Urban 
Development, 451 Seventh St., SW, Room 4116, Washington, DC 20410; 
telephone (202) 708-0713 (this is not a toll-free number). Persons with 
hearing or speech impairments may access that number via TTY by calling 
the Federal Information Relay Services at (800) 877-8339.

I. Introduction

    On July 26, 2000, the Administration announced several new 
initiatives designed to promote the delivery of home and community-
based services for persons with disabilities of all ages. These 
initiatives are part of the tenth anniversary of the passage of the 
Americans with Disabilities Act of 1990 (ADA). One of these initiatives 
is Access Housing 2000, a unique partnership focusing on providing a 
national coordinated response to the Supreme Court's decision in 
Olmstead v. L.C. (527 U.S. 581 (1999)). That decision, issued on June 
22, 1999, was a result of a lawsuit brought by two mentally disabled 
women who sought placement in the community rather than being 
institutionalized at a hospital psychiatric unit. The decision 
concluded that under the ADA, states are required to provide services 
to persons with disabilities in community settings rather than 
institutions when treatment professionals determine that community 
placement is appropriate, the individual does not object to this 
determination, and it can be reasonably accommodated.
    At the heart of Access Housing 2000 is a proposed five-year 
national initiative designed to serve as an approach for using existing 
federal authority and appropriations to facilitate the successful 
transition from nursing homes to community living for persons with 
disabilities. This initiative will begin with approximately 400 
beneficiaries residing in targeted regions, with a goal, depending upon 
available resources, of reaching 2000 beneficiaries at its full 
implementation. Participants will include persons with disabilities who 
have very low incomes and who currently reside in nursing homes. The 
initiative is targeted to reach a broad geographic sweep of up to forty 
states and territories at full implementation, with a goal of 
approximately fifty beneficiaries per state or territory. The 
initiative will use HUD Section 8 housing vouchers, HHS Nursing Home 
Transition Grants, Medicaid funds, and other resources to better help 
persons with disabilities make the transition from nursing homes to 
community living.
    HUD is promulgating this Notice pursuant to section 470 of the 
Housing and Urban-Rural Recovery Act of 1983 (Pub. L. 98-181), which 
states that no HUD demonstration program not expressly authorized in 
law may begin until a description of the program is published in the 
Federal Register, and that a comment period of 60 calendar days 
following the date of publication shall be provided, in which the 
Secretary shall fully consider any public comments submitted with 
respect to the program.

II. Design of the Initiative

A. HUD's Responsibilities

    HUD's responsibilities under the proposed national initiative 
include the provision of Section 8 vouchers to selected PHAs, which 
will partner with State Medicaid agencies in order to assist persons 
with disabilities in transitioning from nursing homes into the 
community. HUD will make available, through its funding award process, 
approximately $2.5 million initially to fund 400 Section 8 vouchers 
targeted for use by persons with disabilities and families of children 
with disabilities who currently reside in nursing homes. On August 10, 
2000, HUD published a notice in the Federal Register (65 FR 49003) 
which informed the public that it intends to use a portion of the 
remaining unobligated Fiscal Year 2000 funds from two Section 8 voucher 
programs--Rental Assistance for Non-Elderly Persons with Disabilities 
Related to Certain Types of Section 8 Project-Based Developments and 
Section 202, 221(d) and 236 Developments (Certain Developments) and 
Rental Assistance for Non-Elderly Persons with Disabilities in Support 
of Designated Housing Plans (Designated Housing)--for this initiative. 
The vouchers will be administered by the selected PHAs and will be used 
by persons with disabilities to rent apartments in privately-owned 
buildings, assisted living facilities, or residential facilities, or to 
eventually own accessible and affordable homes. Subject to 
appropriations, HUD also will provide technical assistance to the 
selected sites.
    In the proposed initiative's first year, approximately ten PHAs 
will receive Section 8 vouchers. It is expected that for at least half 
of the PHAs chosen for the initiative, vouchers will be used in 
conjunction with HHS Nursing Home Transition grants, which are 
administered by State Medicaid agencies, and support states in 
identifying and assisting current nursing home residents who wish to 
transition to home and community-based settings. The remaining PHAs 
will draw upon State and local resources. (See Section

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II.C.--PHA, State Medicaid Agency, and Joint Responsibilities--for 
further requirements applicable to these entities.) Working in 
consultation with HHS and IOD, HUD will select the sites that will 
receive the Section 8 vouchers. Although HUD is not undertaking a 
competition between PHAs for the available vouchers, interested PHAs 
may submit in writing to HUD, during the comment period, any reasons 
they have for desiring to become part of the initiative, including 
their capacity to undertake such a project and the specific steps they 
have taken or will take to coordinate with State Medicaid agencies, so 
that these agencies will fulfill the responsibilities described for 
them in this Notice.

B. HHS's Responsibilities

    HHS's responsibilities under the proposed national initiative 
include the provision of Nursing Home Transition (NHT) Grants to 
selected State Medicaid agencies. These grants focus on assuring that 
persons leaving nursing homes will have adequate personal assistance 
services and support to meet their needs. HHS's intent with its Nursing 
Home Transition Grant program is to foster the development and sharing 
of innovative and effective methods to eliminate the barriers that 
prevent beneficiaries from living independently in their own homes and 
communities. In Fiscal Year 2000, four State Medicaid agencies each 
received first-time Nursing Home Transition grants in the amount of 
$500,000. It is expected that Congress will provide HHS with increased 
funding for another round of Nursing Home Transition grants in Fiscal 
Year 2001 as well. Subject to appropriations, HHS also will provide 
technical assistance to the selected sites.

C. PHA, State Medicaid Agency, and Joint Responsibilities

    PHA Responsibilities. PHAs that are selected for the initiative 
will be responsible for administering the Section 8 vouchers. The usual 
voucher program requirements will apply. Those PHAs that receive 
vouchers to be used in conjunction with Nursing Home Transition grants 
administered by State Medicaid agencies must demonstrate the commitment 
and capacity to coordinate and work with these Medicaid agencies, as 
well as independent living centers and other organizations to 
facilitate the use of the initiative's Section 8 vouchers by persons 
with disabilities leaving nursing homes.
    PHAs that are located in States whose Medicaid agencies did not 
receive nursing home transition grants still may qualify to obtain 
housing vouchers through this initiative by demonstrating the ability 
to meet the preceding criteria. It should be noted that PHAs in States 
taking this course will need to show that they will be able to use 
available Medicaid, State, and local resources to carry out transition-
related activities. HHS will provide additional details on how State 
Medicaid agencies in both categories--those that receive nursing home 
transition grants and those that do not have such funding--can express 
interest in participating with PHAs that receive vouchers under this 
initiative (either from the 400 vouchers currently available or from 
any vouchers that may be made available in the future for this purpose) 
in HHS's upcoming Fiscal Year 2001 Request For Proposals (RFP) 
regarding this grant program. HHS will also communicate with State 
Medicaid agencies regarding the Access Housing 2000 initiative.
    State Medicaid Agency Responsibilities. A State Medicaid agency 
will be considered for participation in the Access Housing 2000 
initiative if it demonstrates a clear commitment and capacity in the 
areas of (1) collaborating and coordinating with PHAs and other 
agencies, (2) assuring that a nursing home resident has a choice about 
whether to transition from a nursing home into the community and the 
services and activities that are provided, and (3) strengthening and 
improving community-based supportive services.
    Interagency collaboration and coordination. State Medicaid agencies 
will be expected to demonstrate the commitment and capacity to:
     Actively foster and engage in collaborative efforts with 
PHAs, independent living centers, and other organizations in order to 
identify and implement strategies for obtaining accessible, affordable 
housing and supportive services for those leaving nursing homes;
     Assure the meaningful participation of persons with 
disabilities (including current and former nursing home residents) and 
others in the design and implementation of a comprehensive, effective 
plan for transitioning individuals from nursing homes, both during and 
after the grant period, in an attempt to improve access to home- and 
community-based services to those needing such services.
    Nursing home residents' choice. State Medicaid agencies will be 
expected to demonstrate the commitment and capacity to:
     Identify and educate nursing home residents and their 
families about the alternatives available to them should the resident 
desire to return to the community.
     Assure that each resident (or legal guardian acting on 
their behalf) has the opportunity, information, and tools to make an 
informed choice about whether to transition into the community or 
remain in a nursing home.
     Assure that those residents who choose to transition into 
the community have maximum possible control over individualized 
budgeting, planning, and coordination activities.
     Overcome any resistance and barriers which may impede a 
resident's decision to exercise his or her choice to transition into 
the community.
    Strengthening and improving community-based supportive services. 
State Medicaid agencies will be expected to demonstrate the commitment 
and capacity to:
     Ensure that individuals leaving nursing homes for 
community living arrangements will receive the necessary ongoing 
supportive services that will allow these individuals to remain in 
their communities.
     Tap the experience of independent living centers, area 
agencies on aging, and similar networks in identifying and 
transitioning persons with disabilities from nursing homes into their 
communities (through the use of formal agreements, etc.).
     Work with other organizations to develop the necessary 
community infrastructure and supports to enable former nursing home 
residents to live safely and with dignity in their communities.
     Work with PHAs and other housing organizations to identify 
and/or modify housing that is or can be made to be accessible and 
affordable within a reasonable distance of a person's family or social 
support network.
    Joint Responsibilities. PHAs and State Medicaid agencies also must 
coordinate and work with one another and with other resources--both 
public and private--within their communities to facilitate the use of 
the initiative's vouchers by persons with disabilities leaving nursing 
homes and to ensure the success of this initiative. It is expected that 
a Memorandum of Understanding or some other basic agreement between the 
PHA and the State Medicaid agency, describing specific roles, 
responsibilities, and activities to be undertaken by the parties, would 
be prepared at the outset.
    In addition, PHAs and State Medicaid agencies that participate in 
the proposed national initiative will be expected to work with HUD, 
HHS, and IOD by: (1) Joining local coalitions created to build ground-
level support for the initiative

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and to assist in its implementation; (2) participating in case studies 
aimed at understanding the effectiveness of strategies developed during 
the initiative and disseminating best practices; (3) contributing to 
research that examines the process for, benefits of, and barriers to 
the implementation and accomplishment of the objectives of Access 
Housing 2000; (4) taking part in determining whether the strategies 
developed during the initiative can be replicated on a large-scale 
basis; and (5) cooperating with the analysis of Federal and State 
policy affecting the implementation of this initiative.

D. IOD's Responsibilities

    Subject to the availability of resources and to further definition 
by HUD and HHS, IOD will create a center to: (1) Build broad-based 
partnerships and collaborations in both the public, private, and 
advocacy sectors; (2) conduct outreach to create local coalitions 
consisting of public, private, and advocacy organizations to build 
ground-level support for the initiative and to assist in its 
implementation; (3) evaluate the efficacy of the strategies developed 
during the initiative and the dissemination of best practices; (4) 
conduct research that examines the process for, benefits of, and 
barriers to the implementation and accomplishment of the objectives of 
Access Housing 2000; (5) examine whether the strategies developed 
during the initiative can be replicated on a large-scale basis; (6) 
analyze Federal and State policy affecting the implementation of this 
initiative; (7) develop a means of ensuring that the experience of the 
initiative receives broad attention and review, e.g. creating a 
website.

    Dated: December 13, 2000.
Harold Lucas,
Assistant Secretary for Public and Indian Housing.
[FR Doc. 00-32259 Filed 12-14-00; 1:11 pm]
BILLING CODE 4210-33-P