CREATING LIVABLE COMMUNITIES

National Council on Disability
1331 F Street, NW, Suite 850
Washington, DC 20004

October 31, 2006

This report is also available in alternative formats and on the award-winning National Council on Disability (NCD) Web site (www.ncd.gov).

Publication date: October 31, 2006

202-272-2004 Voice
202-272-2074 TTY
202-272-2022 Fax

The views contained in this report do not necessarily represent those of the Administration as this and all NCD documents are not subject to the A-19 executive branch review process.

Letter of Transmittal

October 31, 2006

The President
The White House
Washington, D.C. 20500

Dear Mr. President:

On behalf of the National Council on Disability (NCD), I am very pleased to submit a report entitled, Creating Livable Communities.

This report is the sequel to an earlier report entitled, Livable Communities for Adults with Disabilities, which NCD submitted to you in December 2004.

Communities in the United States are faced with increasingly difficult choices and decisions about how to grow, plan for change, and improve the quality of life for all citizens including children, youth, and adults with disabilities. As we mentioned in our previous report, we believe that for the promise of full integration into the community to become a reality, people with disabilities need: safe and affordable housing, access to transportation, access to the political process, and the right to enjoy whatever services, programs, and activities are offered to all members of the community by both public and private entities.

Nearly every initiative included in the report has depended, to one degree or another, on strategic partnerships that have worked together to achieve the following goals: (1) leverage resources, (2) reduce fragmentation in the service delivery system, (3) address consumers' needs in a coordinated and comprehensive manner, (4) provide choice, and (5) implement policies and programs that help people remain independent and involved in community life. To maximize the potential for success, communities should use one or more of the following strategies and policy levers as well as develop all-important partnerships. These strategies and policy levers can and should be used at every level of government including federal, state, county, and local to affect change.

Our recommendations are in line with the focus of your New Freedom Initiative's emphasis on community integration, participation, and enhancement of the independence of people with disabilities at home, at work, and throughout the course of their daily lives. NCD stands ready to work with you and stakeholders inside and outside the government to see that the agenda set out in the attached report is implemented.

Sincerely,

John R. Vaughn

Chairperson

National Council on Disability Members and Staff

Members

John R. Vaughn, Chairperson
Patricia Pound, First Vice Chairperson
Glenn Anderson, Ph.D., Second Vice Chairperson

Milton Aponte, J.D.
Victoria Ray Carlson
Chad Colley
Robert R. Davila, Ph.D.
Barbara Gillcrist
Graham Hill
Young Woo Kang, Ph.D.
Kathleen Martinez
Lisa Mattheiss
Anne M. Rader
Marco Rodriguez
Linda Wetters

Staff

Jeffrey T. Rosen, General Counsel and Director of Policy
Julie Carroll, Senior Attorney Advisor
Joan M. Durocher, Senior Attorney Advisor
Martin Gould, Ed.D., Director of Research and Technology
Geraldine Drake Hawkins, Ph.D., Senior Program Analyst
Allan W. Holland, Chief Financial Officer
Pamela O'Leary, Sign Language Interpreter
Mark S. Quigley, Director of Communications
Mark E. Seifarth, Congressional Liaison
Brenda Bratton, Executive Assistant
Stacey S. Brown, Staff Assistant
Carla Nelson, Secretary

Acknowledgments

The National Council on Disability deeply appreciates the incisive policy research undertaken by Mia R. Oberlink of the Center for Home Care Policy and Research in the writing of this report.

Table of Contents

Executive Summary

Definition of a Livable Community
Six Strategies to Improve Community Livability
Recommendations for Action

Chapter I Introduction

Background
Strategies to Promote Cooperation and Collaboration and Recommendations for Action

Chapter II Strategy One: Agreement on Changes in the Collection and Management of, and Access to, Multiple Agency Information about Programs and Benefits in Order to be Consumer Responsive

Aging and Disability Resource Centers

Background
Examples of ADRCs in Action
Looking Forward
Additional Resources for More Information

Consolidating Access to Information and Services: Learning from the States

Background: The 2-1-1 Information and Referral System
2-1-1 in the States
Funding and Cost-Savings

Resources

Chapter III Strategy Two: Utilization of Favorable Tax Treatment (e.g. tax credits) to Stimulate Change in Individual and Corporate Behavior that Encourages Investment in Livable Community Objectives

Low Income Housing Tax Credits

Program Background
Program Description
Resources Used
State Examples
Additional Opportunities: The Homeownership Tax Credit
Resources
Other Resources

Expanding the Supply of Affordable, Accessible Housing: Learning from Kentucky

Background
Developing Universal Design Principles
Tying Universal Design Policy to Funding Resources
Success Stories

Chapter IV Strategy Three: Agreement on Common Performance Measures Across Multiple Federally Funded Programs

The Program Assessment Rating Tool (PART)

Program Background
Program Description
Lessons Learned
Example
PART and People with Disabilities
Conclusion
Resources
Measuring Results: Learning from the Administration on Aging-State Collaboration to Develop Model Performance Outcome Measurement Systems
Background: The AoA Performance Outcomes Measure Project (POMP)
Key Features of the Project
The National POMP

Chapter V Strategy Four: Utilization of Private Sector Match to Competitively Secure Public Funding and Stimulate Public-Private Sector Partnerships

Individual Development Accounts

Background
Historical Progression of IDAs, Barriers, and Solutions
How IDAs Work
Lessons Learned
Resources Used to Fund IDAs

Implementing IDAs in the States: Learning From Iowa

Iowa
The Future of IDAs
Additional Resources for More Information

Chapter VI Strategy Five: Agreement on Changes in Infrastructure to Consolidate Administration of Multiple Programs and Improve Ease of Access

Workforce Investment Act (WIA)

Program Background
Program Description
Lessons Learned
Conclusion
Resources

United We Ride: Learning From and Helping the States to Create Coordinated Transportation Systems

Program Description
Arizona Rides
Other State Transportation Coordination Efforts
North Carolina
Maryland
Central New York, NY

Chapter VII Strategy Six: Utilization of Waiver Authority to Promote State Options to Advance Consumer Choice and Community Participation

Medicaid and Social Security Waiver Authority

Medicaid Program Background
Program Description
Independence Plus Waivers
Conclusion

Resources

Learning from the States

Implementing the 1915(c) Waiver Through Maryland's New Directions Program
The Florida Freedom Initiative: Self-Directed Services with a Work Incentive Plan
California's Independence Plus Section 1115 Demonstration
Conclusion

Additional Resources

Chapter VIII Recommendations for Action

Recommendations

References

Appendix A

Executive Summary

Creating Livable Communities is an outgrowth of the National Council on Disability's (NCD) interest and recent work in the topic of livable communities for people with disabilities. The main impetus for this interest is threefold: 1) the prospect of a growing population of people with disabilities as the baby boom generation ages, 2) the desire that people with disabilities-indeed, all people-have to live in their own homes and communities and maintain their self-determination, dignity, and independence for as long as possible, and 3) the pressures that these factors will exert on local communities that strive to become livable for people of all ages and abilities. Two research reports recently published by NCD thoroughly examine these challenges, as well as promising practices in addressing them: Livable Communities for Adults with Disabilities (2004) and The State of 21st Century Long-Term Services and Supports: Financing and Systems Reform for Americans with Disabilities (2005). The findings in these reports motivated NCD to delve deeper into the topic of livable communities, identify barriers to developing them, and shed light on potential methods for overcoming these barriers.

Disability prevalence is rising in the under-age-65 population and, although it has decreased slightly for people aged 65 and older, it will begin to rise sharply as the current senior population of 34 million doubles over the next 20 years. In light of these demographic developments, communities will face significant challenges as they strive to address consumers' needs in a coordinated and comprehensive manner, reduce fragmentation in the service delivery system, provide consumer choice, and implement policies and programs that help adults with disabilities remain independent and involved in community life.

As the findings from the two reports mentioned above suggest, collaboration and coordination among federal agencies, as well as between these agencies and the states, can support communities as they build and sustain key elements of livability.

Creating Livable Communities presents six strategies or policy levers, gleaned from the two previous research reports, that can be implemented on the federal and local levels to promote collaboration and coordination and support livable community objectives. Each of these strategies is illustrated by actual promising practices at both the federal and state levels that can be adapted and replicated elsewhere. It should be noted that these general policy levers and specific illustrative examples were selected from a vast array of actions that can be taken to address the various elements of community livability.

Definition of a Livable Community

The definition of "livable community" used here is derived from the National Council on Disability's earlier report entitled Livable Communities for Adults with Disabilities:

A livable community:

• Provides affordable, appropriate, accessible housing
• Ensures accessible, affordable, reliable, safe transportation
• Adjusts the physical environment for inclusiveness and accessibility
• Provides work, volunteer, and education opportunities
• Ensures access to key health and support services
• Encourages participation in civic, cultural, social, and recreational activities

Within each of these six areas, a livable community strives to maximize people's independence, assure safety and security, promote inclusiveness, and provide choice.

While no one community in the United States has addressed all six of these livability goals to equal degrees, many states, counties, and local communities have made extraordinary improvements in their livability for people with disabilities in one or even several of these areas. Their experiences and achievements can serve as inspiration and provide replicable "best practices," which other communities can emulate as they strive to become more livable.

Six Strategies to Improve Community Livability

Strategy One: Agreement on changes in the collection and management of, and access to, multiple agency information about programs and benefits in order to be consumer responsive

As the examples in this section illustrate, this strategy can help ensure that older people and people with disabilities have access to key health and supportive services that enable them to continue living in the community as independently as possible.

Examples

• Aging and Disability Resource Centers (ADRC) are community-based centers that centralize information about long-term support options in the community. ADRC programs provide information and assistance to both public and private pay individuals and serve as the entry point to publicly administered long-term supports, including those funded under Medicaid, the Older Americans Act, and state programs.
• 2-1-1 is a phone number designated by the Federal Communications Commission to be used exclusively for community information and referral purposes. There are 157 active 2-1-1 systems in 32 states that provide consumers with centralized information and referral to basic human needs resources; physical and mental health resources; employment support; support for older people and people with disabilities; as well as support for children, among other services.

Strategy Two: Utilization of favorable tax treatment (e.g. tax credits) to stimulate change in individual and corporate behavior that encourages investment in livable community objectives

The availability of appropriate and affordable housing choices is one of the most important measures of community livability. As the examples below illustrate, Strategy Two can be used to expand such housing opportunities for people with low incomes and/or people with disabilities and ensure that the housing is affordable and accessible.

Examples

• The Low Income Housing Tax Credit provides states with a financial "carrot" to encourage development of housing without having to allocate direct federal expenditures. It is a significant source of financing for developers seeking to construct and rehabilitate housing for people with disabilities.
• The Kentucky Housing Corporation (KHC) is Kentucky's state housing finance agency that administers and monitors a number of federal and state affordable housing programs and sets state policy on housing. One of its objectives is to build partnerships with state and local housing agencies to ensure that new housing is fully accessible and incorporates universal design principles. The KHC has developed universal design requirements that are mandatory for any projects that receive a certain amount of debt or subsidy financing from the Corporation. It also provides technical assistance to developers to ensure they are meeting all building requirements, including the universal design guidelines, and inspects and certifies buildings once they are built.

Strategy Three: Agreement on common performance measures across multiple federally funded programs

There is an enormous variety of programs that are designed to help older people and people with disabilities live independently in the community. But how effective are these programs? Do they respond to people's actual needs and support their aspirations? Strategy Three is one way to begin addressing these questions. The initiatives illustrating this approach include developed tools that facilitate measurement of performance and outcomes. These tools can be applied to a variety of programs that serve people with disabilities and older people.

Examples

• The Program Assessment Rating Tool (PART) was developed by the Office of Management and Budget to assess and improve program performance so that Federal Government programs can achieve better results. PART reviews help identify the various strengths and weaknesses of federal programs to inform funding and management decisions aimed at making the programs more effective.
• The Administration on Aging (AoA), an agency within the U.S. Department of Health and Human Services, is collaborating with more than 20 states to develop standardized performance outcome measures and data collection instruments to evaluate programs funded by the AoA, such as congregate nutrition programs, information and assistance, and transportation services. In addition, the Federal Interagency Forum on Aging Related Statistics is a group of 11 collaborating agencies that has established a set of key indicators that describe the status of the U.S. population aged 65 and older.

Strategy Four: Utilization of private sector match to competitively secure public funding and stimulate public-private sector partnerships

Livable communities ensure that all residents, regardless of ability, are able to participate in the community's economic, civic, and social life. The examples included under Strategy Four illustrate how public-private sector partnerships can promote asset development and financial independence among people with low incomes and people with disabilities. When people with low incomes and people with disabilities are able to accumulate income to continue their education, buy homes, and/or start businesses, they not only enrich their own lives, they help support the economy of the communities in which they live.

Examples

• Individual Development Accounts (IDAs) are "asset development tools," one of many economic development programs created by Congress to provide savings incentives among selected populations. It is a successful policy mechanism that has helped thousands of people who are low-income wage earners build their personal assets, live independently, and contribute to their communities' economy in the same ways that millions of other citizens do.
• Iowa is one of the many states that has passed IDA legislation in ways that minimize restrictions and facilitate program delivery. Iowa was one of the first states to pass IDA policy as part of its sweeping welfare reform bill. The five-year program, called Iowans Save!, has created thousands of IDAs for individuals with low incomes, including people with disabilities.

Strategy Five: Agreement on changes in infrastructure to consolidate administration of multiple programs and improve ease of access

Livable communities provide residents with access to employment opportunities and transportation options. But access to employment and transportation-which are inextricably linked-is among the most vexing barriers that people with disabilities face, partly because of lack of coordination among the various agencies and programs involved. The examples in Strategy Five illustrate how consolidation and coordination can improve access to these key livable community objectives.

Examples

• The Workforce Investment Act (WIA) was passed by Congress in 1998 to better serve job seekers with and without disabilities as well as employers through a new framework that brings together multiple federal employment and training programs into a unified system of support. The single system is anchored by comprehensive One-Stop centers in each workforce investment area in all fifty states. While WIA allows states and local governments the authority to design how best to implement the One-Stop system, the guiding principles of the Act require a focus on streamlined and integrated service with an emphasis on improved coordination and collaboration across agency lines.
• United We Ride (UWR) is a relatively new program that provides information, technical assistance, and grants to states to develop and implement comprehensive action plans for coordinating human service transportation to make it more cost-effective, accountable, and responsive to consumers who are "transportation disadvantaged." UWR promotes education and outreach to transportation providers and consumers; consolidation of programs; reduction of restrictive and duplicative laws, regulations, and programs; and coordinated planning.

Strategy Six: Utilization of waiver authority to promote state options to advance consumer choice and community participation

The primary objective of the livable community concept is to provide people with disabilities choice and support to live independently in the community. The examples in Strategy Six illustrate long-term services and supports policies that support this objective. Many people believe that long-term services and supports alternatives like state Medicaid waiver programs should be the rule rather than the exception.

Examples

• Medicaid and Social Security offer two important sources of funding for support of individuals with disabilities. Over the past 25 years, significant expansion of Medicaid has occurred through the creation of waiver authority, which allows states to apply to the Centers for Medicare and Medicaid Services for approval of different amendments to their state plans that may impact who is eligible for services, what services may be covered, and the limits of coverage. Similarly, the Social Security Administration (SSA) has waiver authority it can grant to states on a case-by-case basis to modify existing policies and procedures and encourage testing alternative policies and procedures that promote independence and self-sufficiency for individuals with disabilities and their families. These current waiver programs constitute the principal way that states can offer services and supports that are consumer-centered and promote independence and community participation among people with disabilities.
• Maryland's New Directions Program, the Florida Freedom Initiative, and California Independence Plus are examples of state waiver programs that are rebalancing Medicaid's original institutional bias and, instead, are providing self-directed home and community based services with expanded control by and flexibility for people with disabilities and low-income older people, enabling them to remain in their own homes and communities for as long as possible. The Florida Freedom Initiative also includes an SSA waiver to increase asset limits. The results are producing enhanced consumer choices and satisfaction.

Recommendations for Action

The selected strategies and examples in this report offer possibilities to change the way government organizes and manages resources, interacts with the business community and community developers, and responds to the expectations of evolving consumer interests, needs, and preferences for more choice and control in the delivery of support services. The recommendations for action included in the report offer multiple, complementary options for the legislative and executive branches of the Federal Government as well as states to proactively adopt strategies and policy levers that invest in livable community outcomes. With the aging of America and the challenges of disability in over 20 percent of families nationwide today, and possibly a greater percentage tomorrow, it is vital to focus on knowledge utilization and transfer from best practice examples.

Recommendation 1: Issue a new Executive Order to charge the Office on Disability of the Department of Health and Human Services to chair a time-limited workgroup (six months, for example) on livable communities that would adopt and promote the strategies in this report. The workgroup would include representatives of the Departments of Housing and Urban Development (HUD), Transportation, Education, Labor, and Treasury, the Social Security Administration, the Centers for Medicare and Medicaid Services, the Administration on Aging, the Administration on Developmental Disabilities, and the Office of Community Services within the Department of Health and Human Services.

Recommendation 2: Modify federal requirements for allocation of low-income housing tax credits so that, in making awards to developers, all states require a) the adoption of universal design standards, and b) documentation of approaches to allow a minimum of ten percent of units in multifamily affordable housing developments to be affordable to individuals with disabilities on fixed incomes (i.e. SSI/SSDI recipients).

Recommendation 3: Modify current performance measures being used to assess individual program strengths and weaknesses to focus on cross department and agency collaboration to enhance livable community outcomes.

Recommendation 4: Utilize grant funds from the Centers for Medicare and Medicaid Services, Social Security Administration, and Departments of Labor, Commerce, Health and Human Services, Transportation, and Housing to offer a consolidated Livable Communities Program Initiative that streamlines 1) a single application for funds, 2) utilization of waiver authority, 3) consolidation of program management and service delivery, and 4) use of tax credits to reengineer the delivery of long-term supports, transportation, housing, employment, education, and cultural, social, and recreational opportunities at a community level.

Recommendation 5: Expand tax incentives to promote matched savings plans for low-income wage earners across the life span.

Recommendation 6: Utilize and leverage community service opportunities and volunteers to support livable community objectives.

Recommendation 7: Focus on the Gulf Coast recovery and rebuilding to promote livable community outcomes.

Recommendation 8: Establish a National Resource Center on Livable Communities to educate policymakers, government administrators, community developers, people with disabilities, and the public about best practices in policy development and program implementation.

The recent Hurricane Katrina and Rita disasters demonstrated that lack of cooperation and coordination at all levels of government can have disastrous effects on people of all walks of life, particularly those who are among the most vulnerable. These events and their aftermath bring a new sense of urgency to the need to promote cooperation and coordination among agencies as well as adoption of livable community principles for the benefit of all Americans.

Creating Livable Communities

Chapter I

Introduction

Background

In the past two years, the National Council on Disability (NCD) has published two groundbreaking research reports that have elucidated the elements that make communities livable for people with disabilities, barriers to developing livable communities, and strategies to overcome these barriers.

Published in December 2004, the first report, Livable Communities for Adults with Disabilities, identifies:

1. The key elements of communities that promote the health, well being, and independence of adults with disabilities, or at risk of developing disabilities, across the age spectrum. These elements include:

• Providing affordable, appropriate, accessible housing
• Ensuring accessible, affordable, reliable, safe transportation
• Adjusting the physical environment for inclusiveness and accessibility
• Providing work, volunteer, and education opportunities
• Ensuring access to key health and support services
• Encouraging participation in civic, cultural, social, and recreational activities

2. Communities that have incorporated one or more of these elements into their physical, social, and service systems and the strategies and interventions they have employed to do so,

3. The major challenges and barriers that communities face in moving toward greater livability for persons with disabilities, as well as factors that facilitate positive change, and

4. Promising policy levers and policy changes that, if adopted, would facilitate communities' capacity to enhance their livability for their residents.

Published in December 2005, the second report, The State of 21st Century Long-Term Services and Supports: Financing and Systems Reform for Americans with Disabilities, is an in-depth examination of the current status of long-term services and supports (LTSS) for people with disabilities and contains recommendations for reducing the fragmented nature of service and support delivery systems. The report points out that:

1. There is a lack of a coherent public policy regarding national long-term services and supports for people with disabilities

2. Service and support delivery systems are fragmented, with uneven access and service provisions

3. There are more than 20 federal agencies and almost 200 programs that provide a wide range of assistance and services to people with disabilities, yet no single federal program, agency, or congressional committee has responsibility for the management, funding, and oversight of LTSS

4. The current LTSS system is funded primarily by state and federal programs, but there is no portability provision across states and usually no single entry point at the community level for individuals with disabilities and seniors to learn about and access service and support options

5. The costs of LTSS, which make up 22 percent or more of state budgets, are becoming unsustainable, and there is need for systems reform

While these two reports focus on different, though closely related, topics-the first on livable communities, the second on community-based long-term services and supports for people with disabilities-they come to many of the same conclusions about what people with disabilities want and need in order to live as independently as possible, for as long as possible, in the community. For example, both reports note that:

1. People with disabilities, like all people, want to live in supportive communities that facilitate their independence, help them maintain self-determination, and integrate them fully into community life

2. People with disabilities desire and deserve choices, whether they are seeking health and support services, transportation or housing options, work and education opportunities, or civic, social, or recreational activities

3. In the health and supportive services arena, people's desire for independence and control is more likely to be satisfied when health care systems a) are consumer directed, b) provide care coordination, c) allow "money to follow the person" to eliminate barriers to care and provide consumers with choice over the location and type of services provided, d) provide high-quality, seamless, consumer-centered, and continuous care across settings and providers, and e) provide support services that are linked to housing to increase the availability and efficiency of service provision

4. People with disabilities and their caregivers need and want access to timely, understandable, and culturally appropriate information that helps them navigate through the maze of health care, supportive services, housing, transportation, and other systems and make informed choices

Both reports also point out that there are considerable barriers to fulfilling these desires and needs. They note, for example, that:

• Coherent, comprehensive federal policies are lacking, leading to fragmentation in service and support delivery systems and frustration for people with disabilities and their caregivers
• Scant resources or funding "silos" that restrict how funds can be used contribute to the fragmentation of these systems
• Multiple, disparate resources frequently overlap and other times leave big gaps in service
• Accountability and quality control are hampered by lack of uniform performance measures across systems and programs
• Access to information is made unnecessarily difficult because it is neither centralized nor shared among agencies
• Collaboration among agencies is more the exception than the rule

As a result of this work, NCD was motivated to examine these barriers further and identify strategies, policy levers, and promising practices that will inspire and demonstrate the value of multiple agency collaboration at both the federal and state levels in order to achieve livable community objectives. This is in keeping with NCD's overall purpose to promote policies, programs, practices, and procedures that guarantee equal opportunity for all individuals with disabilities and to empower individuals with disabilities to achieve economic productivity, independent living, inclusion, and integration into all aspects of society.

Strategies to Promote Cooperation and Collaboration and Recommendations for Action

The two NCD reports mentioned above identified a set of six strategies or policy levers that can be applied at the federal and state levels to facilitate much-needed cooperation and collaboration among agencies. Creating Livable Communities presents these six strategies, each illustrated with in-depth reviews of selected federal and state programs that have been or are being successfully implemented for the benefit of people with disabilities. Each of these examples addresses one or more livable community objectives, including access to information, affordable and accessible housing, work, education, transportation, and appropriate health and long-term services and supports. These strategies and "promising practice" examples are ones that can be adapted or replicated in other contexts.

In addition to these six strategies and "on the ground" examples of federal and state programs that are actually addressing and/or overcoming barriers to building livable communities, we present eight recommendations to stimulate action in the legislative and executive branches of the Federal Government to further the livable community agenda and improve quality of life for people with disabilities and their families.

In 2005, in the aftermath of Hurricanes Katrina and Rita, the nation witnessed the sad consequences of the lack of cooperation and coordination among federal, state, and local agencies that were responsible for evacuating people who lived in the path of the storm and resettling them. Not surprisingly, the most vulnerable residents of the affected areas-people with disabilities and older people, particularly those in hospitals and nursing homes-were among those who suffered the most during and after the storm. These unfortunate events reminds the nation that we need to redouble our efforts to remove the barriers that prevent agencies at all levels from working together to safeguard our citizens and communities as well as support independent living among people with disabilities and promote their inclusion in all aspects of society.

Chapter II

Strategy One: Agreement on Changes in the Collection and

Management of, and Access to, Multiple Agency

Information about Programs and Benefits in Order to be Consumer Responsive

As the examples in this section illustrate, this strategy can help ensure that older people and people with disabilities have access to key health and supportive services that enable them to continue living in the community as independently as possible.

Aging and Disability Resource Centers

Long-term service and support systems in many states are fragmented and disjointed, with many public and private programs and services delivered by a variety of agencies and organizations. The navigation of the long-term services and support system can be confusing and frustrating for older people and people with disabilities of all ages and their family members. The Aging and Disability Resource Center grant program (ADRC) was established to pilot new approaches to interagency coordination that improve access and the availability of information to meet the needs of the target populations.

The ADRC program is part of the President's New Freedom Initiative, which aims at overcoming barriers to community living for people of all ages with disabilities. The ADRC program is the collaborative effort of the U.S. Department of Health and Human Services' Administration on Aging (AoA) and the Centers for Medicare and Medicaid Services (CMS). The ADRC program takes an important step towards meeting AoA's vision for long-term services and supports:

• Affordable choices and options that promote independence and dignity for individuals
• Consumer control and meaningful involvement in the design and delivery of the programs and services that affect their lives
• Information that empowers people to make informed decisions
• Easy access to a range of health, long-term services, and environmental supports
• Support for family caregivers
• Assurances that people are receiving the highest quality care available

Ready access to consolidated information and referral services helps make communities more livable for residents of all ages and abilities.

Background

ADRC programs provide information and assistance to both public and private pay individuals and serve as the entry point to publicly administered long-term supports including those funded under Medicaid, the Older Americans Act, and state revenue programs.

History

Research into the delivery of long-term support services revealed many troubling facts. Long-term support services are sustained by numerous funding streams, administered by multiple agencies, and have complex, fragmented, and often duplicative intake, assessment, and eligibility functions. People who qualify for publicly-funded supports are often frustrated by the complexity of the system and its disconnected points of entry and different rules of eligibility. Individuals are often channeled towards skilled nursing facilities without being made aware of other available supports that may assist them in remaining in the community.

ADRCs were established to help consumers overcome these problems by providing "one-stop shopping" for information, counseling, and access on all long-term support programs and services. Resource Centers will also improve the states' ability to manage public resources and monitor program quality through centralized data collection and evaluation.

Target Population for Assistance

States must target ADRC services to the elderly population and at least one additional population (i.e., individuals with physical disabilities, serious mental illness, and/or mental retardation/developmental disabilities).

ADRC programs serve individuals who need long-term support, their family caregivers, and those planning for future long-term support needs, regardless of income. The Centers also serve as a resource for health and long-term services and supports professionals and others who provide services to the elderly and to people with disabilities.

Location of ADRCs

ADRCs are presently in operation in these 43 states and in Guam, the District of Columbia, and the Northern Mariana Islands:

2003 ADRC Grantees
Louisiana
Maine
Maryland
Massachusetts
Minnesota
Montana
New Hampshire
New Jersey
Pennsylvania
Rhode Island
South Carolina
West Virginia

2004 ADRC Grantees
Alaska
Arkansas
California
Commonwealth of the Northern Mariana Islands
Florida
Georgia
Illinois
Indiana
Iowa
New Mexico
North Carolina
Wisconsin

2005 ADRC Grantees
Alabama
Arizona
Colorado
District of Columbia
Guam
Hawaii
Idaho
Kansas
Kentucky
Michigan
Mississippi
Nevada
Ohio
Tennessee
Texas
Vermont
Virginia
Washington
Wyoming

Stakeholder Involvement

Stakeholders are involved in the planning, implementation, and evaluation of ADRCs. Most ADRCs follow AoA and CMS's recommendation to include stakeholders from the following list:

In addition, states operating ADRCs establish or designate an Advisory Board to assist in the development and implementation of their program and advise the lead state agency on: (a) the design and operation of Resource Centers; (b) stakeholder input; (c) the state's progress toward achieving the goal and vision for ADRCs; and (d) other program and policy development issues related to the state's Resource Center program.

Services Offered

As an information clearinghouse, the ADRCs offer advice and assistance to individuals with disabilities across the age spectrum as well as to physicians, hospital discharge planners, and other professionals who work with older people or people with disabilities. Services offered through the single entry point can be grouped into six areas:

1. Information and Assistance. Provide information to the general public about services, resources, and programs in areas such as: disability and long-term related services and living arrangements, health and behavioral health, adult protective services, employment and training for people with disabilities, home maintenance, nutrition, and family care.

2. Long-Term Services and Supports Counseling. Offer objective information, consultation, and advice about the options available to meet an individual's long-term services and supports needs.

3. Benefits Counseling. Provide accurate and current information on private and government benefits and programs.

4. Emergency Response. Ensure that people are connected with someone who will respond to urgent situations that might put someone at risk, such as a sudden loss of a caregiver.

5. Prevention and Early Intervention. Promote effective prevention efforts to keep people healthy and independent and offer both information and intervention activities that focus on reducing the risk of disabilities.

6. Access to Family Care Benefit. Administer the long-term services and supports Functional Screen to assess the individual's level of need for services and eligibility for the Family Care benefit.

Resources

Former Secretary of Health and Human Services, Tommy Thompson, announced the funding of 12 state grants to develop ADRCs in September of 2003. Twelve additional ADRC grants were announced in April of 2004. Eighteen states and Guam were funded in 2005.

Each project is funded for a period of up to three years. The maximum total Federal award for the entire three year period is $800,000 per project. Grantees are required to make a non-financial or cash recipient contribution (match) of five percent of the total grant award.

States may use funds awarded through the ADRC grants program to better coordinate and/or redesign their existing systems of information, assistance, and access. ADRC functions are performed in a single location in some communities. Other communities decentralize ADRC functions. In the latter case, ADRCs may have multiple sites and organizations involved in performing the information and access functions. Some communities have different access points for different populations.

Examples of ADRCs in Action

Alaska

Alaska will establish five regional ADRCs operated by the State Centers for Independent Living (SILC) to provide citizen-centered "one-stop shopping" entry to long-term support services for seniors and people with disabilities statewide. The ADRCs will offer information and referral services, eligibility screening, assistance in gaining access to long-term support services for private pay consumers, comprehensive assessment for those seeking publicly funded services, programmatic eligibility determination for long-term support services, and access to the Division of Public Assistance for Medicaid financial eligibility determination. The SILC will work with the Division of Senior and Disability Services and the Senior Housing Office to develop a management information system that tracks consumer intake, needs assessment, care plans, utilization, and costs. Formative and summative evaluations will be conducted by the Center for Human Development.

Florida

Florida will develop and implement ADRCs operated by area agencies on aging in at least two Planning and Service Areas (PSAs) for both publicly and privately funded services for the elderly and individuals with mental illness. Florida will co-locate Information and Referral, screening and assessment, access to crisis intervention, medical and financial eligibility determination, and long-term services and supports counseling. It will establish a single administrative structure accessible through multiple locations (senior centers, Area Administration on Aging, housing authorities, mental health centers, etc.) in each of the ADRC communities. Access to ADRC services will also be available by phone and the Internet. The ADRC program will benefit from a current state project designed to merge existing program information and management databases. Since the announcement of the 2004 ADRC grant, the Florida Legislature passed statutory changes to implement Aging Resource Centers (ARCs) statewide for the aging population only. Only adults 60 and older will be targeted for service in the ADRC's first year. Adults 60 and older and adults 18 and older with severe mental illness are targeted for service in the ADRC's second and third years.

Wisconsin

The Wisconsin DHFS will expand geographic coverage of their full-service Aging and Disability Resource Centers, develop capacity for all target groups to be served, and develop an infrastructure to support ultimate expansion to all parts of the state. Five local agencies will be selected through an RFP process to develop new full-service ADRCs. DHFS will develop state-level infrastructure to support current and future development of a statewide system of full-service ADRCs that serve elders and at least one other target population of individuals with disabilities and have a strong collaboration with local programs. The state infrastructure will include:

• Two toolkits, one to promote public awareness and one for long-term services and supports options counseling;
• Identification of information management system solutions to meet state and local needs for consistent data collection and reporting;
• Ability to provide technical assistance in adding new target populations, including people with mental illness; and
• Technical assistance in identifying and accessing funding sources and in accessing services already available.

Looking Forward

AoA and CMS will evaluate whether the ADRCs increase informed decisionmaking and consumer satisfaction with access to needed long-term supports and services in the most integrated setting. Over a three-year period, each of the pilot states is expected to have at least one operating center that demonstrates improvements in the state's ability to manage public resources, monitor program quality and costs, and improve assessment of need and effective coordination of services to limit unnecessary use of high cost options, including nursing facilities.

Additional Resources for More Information

Aging and Disability Resource Centers, Background Information on ADRCs, available at: http://www.aoa.gov/prof/aging_dis/background.asp.

Centers for Medicare and Medicaid Services New Freedom Initiative website, available at: http://www.cms.hhs.gov/newfreedom.

ADRC Technical Assistance Exchange website, available at: http://www.adrc-tae.org.

Questions and Answers about the Aging and Disability Resource Center Grants Program, created by the Administration on Aging and Centers for Medicare & Medicaid Services, available at: http://www.aoa.gov/prof/aging_dis/AoACMSQA%20071403.pdf.

Fact Sheet on the Aging and Disability Resource Centers, created by the U.S. Department of Health and Human Services, Administration on Aging, available at: http://www.aoa.gov/press/fact/pdf/fs_aging_disability.pdf.

Consolidating Access to Information and Services: Learning from the States

The AdvantAge Initiative 2003 National Survey of Adults Aged 65 and Older asked respondents across the country many questions about their physical and mental health, their knowledge about and use of services in their communities, their physical and social activities, and aspects of their communities that make them "livable" for older people, as well as areas that need improvement. One of the questions they were asked was, "What is the best resource, such as a person or an organization, in your city, town, or county to get information on various services," and in response, fully 20 percent, or one in five, older people said "I don't know." This 20 percent represents 6.7 million Americans aged 65 and older who don't know where to turn when they need information and services.

There are almost 900,000 non-profit organizations in the U.S. plus scores of government agencies that provide services. People looking for assistance have trouble navigating this complicated web of health and human service programs; often people don't even know where to begin. To help remedy this situation, in recent years states across the U.S. have been making progress toward consolidating disparate information and referral services using an easy-to-remember three-digit dialing telephone code reserved by the Federal Communications Commission (FCC) for this purpose.

Background: The 2-1-1 Information and Referral System

Community Information and Referral, often referred to simply as I&R, has been a staple of the health and human services industry for the past 50 years. Comprehensive and specialized I&R agencies provide linkages between individuals and the often daunting maze of services available in their communities. I&R services help people living in the community negotiate this maze by maintaining comprehensive databases of resources and making them available by telephone, the internet, and through paper directories or handbooks. I&R specialists are trained professionals who work with callers to find the help they need. They assess callers' needs and help them determine their options and best courses of action. I&R specialists also are trained to intervene in crisis situations, determine whether a caller is eligible for programs, and advocate on behalf of the caller.

In the past, most I&R telephone help lines have been 10-digit local telephone numbers or toll-free numbers serving a circumscribed area. But on July 21, 2000, the Federal Communications Commission assigned the dialing code 2-1-1 to be used exclusively for community information and referral purposes, and in many communities this central phone number has replaced individual agency help lines as the source of choice for residents seeking information and referral.

While the specific services offered through 2-1-1, as well as the degree of accessibility of 2-1-1's telephone and website services for people with disabilities, vary from community to community, in general 2-1-1 offers information about and referral to the following types of services:

• Basic human needs resources: food banks, clothing, shelters, rent assistance, utility assistance
• Physical and mental health resources: medical information lines, crisis intervention services, support groups, counseling, drug and alcohol intervention, rehabilitation, health insurance programs, Medicaid and Medicare, maternal health, children's health insurance
• Employment support: unemployment benefits, financial assistance, job training, transportation assistance, education programs
• Support for older Americans and persons with disabilities: home health care, adult day care, congregate meals, Meals on Wheels, respite care, transportation, and homemaker services
• Support for children, youth, and families: quality childcare, Success by Six, after school programs, Head Start, family resource centers, summer camps and recreation programs, mentoring, tutoring, protective services
• Volunteer opportunities and donations

2-1-1 in the States

The 2-1-1 help line was first launched by the United Way of Metropolitan Atlanta in 1997-several years before the FCC made the number universal. United Way chapters around the country have a long tradition of funding I&R services in their respective communities and since 1997 have continued to be involved in starting up and supporting 2-1-1 services in states around the country.

There are now 157 active 2-1-1 systems covering all or part of 32 states, Washington, D.C., and Puerto Rico and serving 40 percent of the U.S. population. In some parts of the country 2-1-1 is a well-known and well-used resource. Puerto Rico and 13 states have implemented 2-1-1 statewide, so that residents across each of these states have access to 2-1-1 information systems. In many other parts of the country, however, 2-1-1 is just in the planning stages. Many, but not all, of the existing 2-1-1 lines in the states that have them are available 24 hours per day, 7 days per week. Some locales have made their databases available on the internet so that people may access information at times of the day when 2-1-1 is not available.

Connecticut was the first state in the country to implement 2-1-1 statewide. The number-called 2-1-1 Infoline-went into effect in March 1999, replacing a toll-free number. Infoline can be accessed from anywhere in Connecticut. Help is available 24 hours a day, every day of the year. Infoline has multilingual caseworkers and is accessible by TTY to people who are deaf or hard of hearing. Infoline has developed the most comprehensive database of human service resources in the state of Connecticut. The database is continually updated and is also available on CD-ROM and the Internet. Caller demographics and problems collected by 2-1-1 provide valuable information to state agencies, which use the information to understand the overall problems facing Connecticut residents and assess needs in the state. Since Connecticut switched to 2-1-1 from a 10-digit, toll-free number, the volume of calls increased from 200,000 in 1999 to over 320,000 in 2003. Top service requests were for utilities/heat, housing, mental health services, financial assistance, and health care. Not all the statewide 2-1-1 information lines are as well developed as Connecticut's, largely due to lack of sufficient funding and legislative support.

Aloha United Way was launched in Hawaii in July 2002, making Hawaii the second state in the nation with statewide 2-1-1 service. People can call 2-1-1 from all islands 24 hours a day, 7 days a week for information on more than 4,000 government and non-profit programs and services. New Jersey's statewide 2-1-1 service came on line in February, 2005 and is available to all New Jersey residents, including cell phone users. The Idaho 211 project is using AmeriCorps and AmeriCorps VISTA Volunteers to identify community resources through community asset mapping activities, and this information will be integrated into Idaho CareLine's (Idaho's official 2-1-1 call center) databases. Vermont's collaborative partners in their statewide 2-1-1 line include the Vermont Agency of Human Services, area agencies on aging, Vermont Department of Libraries, Vermont E-911, Vermont Emergency Management, Vermont Network Against Domestic and Sexual Violence, and information and referral/assistance providers statewide. In Texas, the State Legislature is encouraging all state agencies to coordinate their I&R services with Texas's statewide 2-1-1. For information about the status of other state 2-1-1 efforts, see www.211.org.

Funding and Cost-Savings

The 2-1-1 call centers are generally supported through a combination of funding sources, including local United Way chapters, community foundations, and federal and local governments. However, this patchwork of funding is often insufficient to start up or maintain full-service 2-1-1 call centers.

Senators Elizabeth Dole (R-NC), Hillary Rodham Clinton (D-NY), and Richard Burr (R-NC) and Representatives Michael Bilirakis (R-FL9) and Anna Eshoo (D-CA14) have introduced the Calling for 2-1-1 Act that would authorize $150 million for two years, and $100 million for the next three years, in federal funds to assist states with implementing and sustaining 2-1-1 statewide. This federal investment would need to be leveraged in states with a minimum of 50 percent of program funding from state and local government and private sources such as corporate, foundation, and United Way dollars. The rationale behind this cost-sharing is that

2-1-1 is most effective when built on solid public/private partnerships and with a diverse and sustainable funding base. The Act closed the 108th Congress with 182 bi-partisan congressional sponsors.

A national cost benefit analysis conducted by the University of Texas estimates a net value to society of a national 2-1-1 system approaching $130 million in the first year alone and a conservative estimate of $1.1 billion over ten years. Savings include time saved, tax assistance and recovery, volunteer recruitment, around the clock service, a reduction in the number of

1-800 numbers, and a reduction in non-emergency calls to 9-1-1.

Resources

As the first state to implement 2-1-1, Connecticut helps other regions develop their own 2-1-1 call centers (see www.infoline.org for more information)

www.211.org and www.airs.org are comprehensive websites that provide a variety of information about 2-1-1 and tools for starting up and maintaining 2-1-1 lines

Chapter III

Strategy Two:

Utilization of Favorable Tax Treatment (e.g. tax credits)

to Stimulate Change in Individual and

Corporate Behavior that Encourages Investment in

Livable Community Objectives

The availability of appropriate and affordable housing choices is one of the most important measures of community livability. As the examples below illustrate, Strategy Two can be used to expand such housing opportunities for people with low incomes and/or people with disabilities and ensure that the housing is affordable and accessible.

Low Income Housing Tax Credits

Housing is a cornerstone of livable communities and the demand for affordable, accessible housing for people with disabilities has not gone unaddressed by the Federal Government. As part of the Tax Reform Act of 1986, the Federal Government created the Low Income Housing Tax Credit (LIHTC) to encourage the production and redevelopment of livable, affordable rental housing across the nation.

The Low Income Housing Tax Credit is a way for states to encourage private investment in sustainable, livable communities for people with disabilities without having to allocate direct federal expenditures. The LIHTC is a significant source of financing for developers seeking to construct and rehabilitate housing opportunities for people with disabilities.

Virtually all people with disabilities receiving Supplemental Security Income (SSI) are theoretically eligible for the affordable housing units in LIHTC properties because they have incomes far below 50 percent or 60 percent of area median income. On average, the national income of a person receiving SSI is equal to 18 percent of area median income. However, the problem for many people with disabilities is that, given their income, the tax credit rents for the affordable units in LIHTC properties are too high. In certain localities with relatively low tax credit rents, if two people with disabilities are willing to share a unit, or if both members of a two-person household receive SSI, the tax credit rent may be affordable. But in many localities, the tax credit rent charged in a LIHTC property may be higher than a person's entire SSI monthly income.

Why should the disability community care about this complicated program if it doesn't provide units that are affordable to people with disabilities receiving SSI? There are at least three reasons:

• The owners of LIHTC-financed properties are required to accept Section 8 vouchers.
• States are increasingly using LIHTC in combination with an array of other affordable housing resources in order to achieve what is called "deeper income targeting," which means that they are trying to serve people with much lower incomes than 50 percent or 60 percent of area median income.
• The LIHTC program is being used more and more to create permanent supportive housing for people with disabilities, including chronically homeless people with disabilities.

Program Background

Under the LIHTC program, states are authorized to issue federal tax credits for the acquisition, rehabilitation, or new construction of affordable rental housing. The credits can be used by property owners to offset taxes on other income, and are generally sold to outside investors to raise initial development funds for a project.

To qualify for credits, a project must have a specific proportion of its units set aside for lower income households. Rents and utilities in these units, which are classified as general household expenses, are limited to 30 percent of the qualifying income. The amount of the credit that can be provided for a project is a function of development cost (excluding land), the proportion of units set aside, and the credit rate (which varies based on development method and whether other federal subsidies are used). Credits provide equity into a project, and they are provided for a period of 10 years.

As of 2004, the LIHTC program generated $6 billion in housing investments and created more than 115,000 affordable rental housing units nationwide each year for low-income families, seniors, the homeless, and people with disabilities. The program's structure allows developers to raise equity through partnerships with tax credit investors, leverage private and public funds, and secure additional funding to cover construction and permanent costs. These costs include loans and grants to create, for example, child care facilities and accessible community rooms.

The Federal Government allocates to each state a certain number of budgeted LIHTCs that are issued by each state's housing agency to developers of qualified low-income housing. The credits are allocated based upon the cost of property, less land and non-eligible expenses. The property generates tax credits once construction is completed and the property is occupied by the required number of qualified tenants. So long as the property remains in use to rent to qualified tenants for the requisite period of time, that property will generate a steady flow of tax credits for ten consecutive years.

Program Description

The Internal Revenue Service (IRS) oversees LIHTC compliance to ensure that states and investors do not use more tax credits than authorized. The U.S. Department of Housing and Urban Development (HUD), though not formally responsible for program oversight, monitors and analyzes the tax credits because of the program's important role in providing for the housing needs of low-income people.

Program Overview

Each state receives an allocation of LIHTCs on a per capita basis. In 2004, the limit was $1.80 multiplied by the state's population, with a minimum of $2,075,000 per state. The credits are competitively awarded under Section 42 of the Internal Revenue Code and the state's Qualified Allocation Plan.

Developers who receive tax credits may syndicate (sell) the credits to raise equity (cash) for development. In exchange for receiving long-term income in the form of an allotment of LIHTCs, the developer agrees to comply with pre-determined rent restrictions. Each dollar of LIHTC allocated entitles the syndicator to one dollar of credit against their corporate income tax every year for ten years.

State housing agencies put each development through three separate, rigorous financial evaluations to make sure the development receives only enough credits to make it viable as long-term, low-income housing. Only investors in properties that pass all three reviews, complete their developments, and actually rent them to low-income families can claim the credits.

At a minimum, either 20 percent or more of the units in a given development must be occupied by individuals whose incomes are below 50 percent of the area median income, or at least 40 percent of the units must be occupied by individuals below 60 percent of the area median income. LIHTC financed units must remain affordable to low-income people for at least 30 years, and many are permanently dedicated to low-income use.

On average, LIHTCs generate over 40 percent of development costs. Remaining financing typically comes from market-rate first mortgages and low or no-interest second mortgages, often from HOME or other public sources.

Calculating the Credit

The credit is based upon prevailing Treasury interest rates. The "9% Projects" credit is calculated so that the present value of the annual credits over the 10-year period equals 70 percent of the building costs. The "4% Projects" credit is available for new construction and substantial rehabilitation projects. 4% Projects are often awarded to projects that utilize mortgage revenue bond financing, also known as non-competitive credits. A developer cannot use both 4% and 9% credits. A project must use one or the other, or the LIHTC can be combined with Historical Rehabilitation Credits and New Markets Tax Credits.

Applying the Credit

The LIHTCs that may be claimed are calculated by multiplying the applicable credit percentage by the building's "qualified basis." The first step in making this calculation is determining a building's "eligible basis," i.e. the cost for the entire building, including non-low-income units if the quality of those units is comparable to that of the low-income units. The eligible basis is determined at the end of the first year of the credit period (subject to reduction for federal subsidies). Only building costs are included, not land costs.

For acquisitions, only depreciable property is included in the basis. Projects involving substantial rehabilitation may include only expenditures within a 24-month period that can be capitalized. "Substantial rehabilitation" means that rehabilitation expenses either must equal at least 10 percent of the building's adjusted basis at the beginning of the 24-month period or cost at least $3,000 per unit, whichever is greater. For new construction, only costs that can be capitalized are included. Also, the eligible basis may be increased to 130 percent for new construction in areas of difficult development or high-cost adjustment.

The building's qualified basis is then calculated as the portion of the eligible basis that is used for low-income tenants, based on the percentage of total units or floor space, whichever is less. The initial qualified basis is determined on the last day of the first year the building is placed in service or, at the owner's election, on the last day of the following year. The owner must maintain the initial qualified basis throughout the 15-year compliance period.

Syndicating the Credit

Developers and sponsors of projects that win the 9% Project credits through the competitive process will sell or syndicate the credits to individuals and companies who invest cash into the project in exchange for the tax credits. The credits can be sold and structured as an equity fund, generally financing multiple projects. Alternatively, the credits can be sold directly to individual investors or corporations, generally on a project-specific basis. The money raised by the sale of the tax credits is project equity, thereby reducing the financing needs and costs of the project, with the resulting cost savings going to the residents.

Developers sell to investors the right to take these credits over ten years. The price paid for the credits reflects the value of the real estate, quality of development, and net present value of the 10 years worth of credits. Tax credits are sold on the basis of their present value, so are discounted to 75-80 cents on the dollar. For example, $1 million in tax credits would generate about $750,000 to $850,000 in equity for the project developer. Maryland's $10.5 million allocation of LIHTC, for example, raises $80 to $90 million in private money for affordable housing annually.

Generally, the sale of the credits is accomplished through a third party syndicator who sells the credits to companies or individuals in need of tax relief (i.e. the investors). The investors then form a limited partnership with ownership interest in the project, while the sponsor (developer) is the general partner with responsibility for project management, construction, and compliance to tax credit restrictions. As an alternative, an investor may purchase credits in a pool or fund, and the revenues generated will provide equity for a number of different projects. Syndicators establish discrete funds as investment opportunities, with responsibilities for selling the credits, evaluating eligible projects and making awards, and assisting through the construction and compliance stages of the project. Each investor enjoys a pro-rata share of the credits consistent with its percentage of ownership in the pool.

The Role of States in Shaping Rental Housing Policy for Persons with Disabilities

Each state receives an annual "budget" of tax credit authority that can be used to reduce the federal tax liability of investors in affordable rental developments. The state passes on this tax credit authority to individual developments, based on a Qualified Allocation Plan (QAP). The QAP establishes criteria for the annual selection of developments around the state that will be built or preserved using LIHTC.

Through the QAP and review of individual proposals for housing developments, state policy-makers shape the way in which affordable rental housing is distributed geographically and to different types of families and individuals, including persons with disabilities. The QAP is developed through a consultative process that also gives advocates at the state level an opportunity to affect housing policy.

QAPs vary widely from state to state over time. Many states hold competitions based on set-asides of the tax credit to specific metropolitan and non-metropolitan areas within the state, while most others establish preferences for specific types of geographic areas. Sometimes sub-allocation follows population types and needs, while sometimes areas are believed to have greater relative need for affordable housing and, as a result, are favored. The state QAP has a base-line point value that developers must meet in order to be considered. States award additional points to applications based on state priorities.

The success of a developer's proposal to use LIHTCs allocated through a QAP can be greatly affected by a small number of points at the margin when all applications are similar for low-income rental developments. States tend to allot between 1.5 and 3 percent of the available points in a QAP to proposed developments that specifically provide affordable, accessible housing to people with disabilities. Thus, developers who develop this kind of housing will receive an additional allotment of credits. State LIHTC allocations tend to emphasize developing geographic areas that have both needy households and shortages of rental housing.

Resources Used

The LIHTC program has recently been amended to give States the equivalent of nearly $5 billion in annual budget authority to issue tax credits. As a housing-related tax expenditure, the LIHTC does not require direct appropriations. The estimated cost to the federal treasury in FY 2003 was $6.2 billion.

In 2000, Congress increased the LIHTC annual cap by 40 percent to restore purchasing power lost to inflation since Congress imposed the cap in 1986 and indexed the cap to inflation beginning in 2003. The 2004 limit is $1.80 multiplied by state population, with a minimum of $2,075,000 per state.

When the LIHTC program was made permanent in 1993, corporations began acquiring the credits directly and through syndication funds. Corporations now constitute virtually the entire market of LIHTC investors and include banks and insurance companies as well as Fannie Mae and Freddie Mac.

In 2004, States allocated over $504 million in tax credits and allocated over $533 million in 2005. The allocation of credits ranged from just under $2 million worth of credits in Delaware to $50 million in credits in California.

It is clear that through the QAP or through the selection of individual LIHTC developments, state policymakers are making critical choices about rental housing policy that affects the well-being of individual households and the economic health of the state's metropolitan areas. These choices will help create public-private investments and partnerships and accelerate the development of sustainable, livable communities for people with disabilities and their families.

State housing planners are in a particularly good position to design housing options for people with disabilities, since other support systems for the same populations are funded and regulated at the state level. Through both QAPs and the selection of individual LIHTC developments, state housing program administrators can encourage the development of housing that fills gaps in the current system of housing alternatives, including alternatives to rental housing funded by the federal Section 811 program.

States that ensure point allotments through subcategorizing "Housing for People with Disabilities" in their QAP "Special Needs Housing" category are in the best position to ensure that LIHTCs will be used by developers to construct affordable, accessible, and integrated housing for people with disabilities.

State Examples

Iowa

The State of Iowa is an example of how a state can use the tax credits program to achieve a policy of expanding affordable, accessible housing opportunities for people with disabilities.

The Iowa Finance Authority (IFA, www.ifahome.com) oversees Iowa's distribution of LIHTCs. IFA established that 30 percent of all the LIHTCs issued by IFA are used as equity investments in affordable, accessible, and integrated housing developments.

To qualify for this set-aside: (1) 25 to 49 percent of the units in the proposed project must be set aside for people with disabilities within an integrated setting or a setting that promotes homeownership, or (2) 50 to 100 percent of the units must be set-aside for people with disabilities within a single-purpose setting. Any unused tax credits remaining from the set-aside are returned to the general pool and allocated in the current year. To receive an allocation of the credits, a developer must submit a supportive services plan in addition to the application.

IFA allocates tax credits from this 30 percent set-aside based upon the QAP. Service-enriched housing projects are scored with all the projects except that the 30 percent set-aside is available in its entirety until the set-aside is fully allocated. If the set-aside is exhausted, projects proposed for the service-enriched housing set-aside are permitted to compete in the set-asides for which the project is eligible.

In addition to the set-aside for projects that create accessible, affordable, and integrated housing, IFA has taken another substantial step to aid in the construction or rehabilitation of housing for people with disabilities. Under IFA's current project scoring criteria, projects designed to serve a special needs population receive 30 points out of a possible 325 points, or 9.2 percent of the available points, as opposed to the usual 5 to 10 points, or between 1.5 and 3 percent of available points, in the majority of states.

In 2005, Iowa financed 19 projects for a total of $40,159,320 in credits. Two hundred and eleven of the 533 units constructed with LIHTCs in Iowa are for people with disabilities. Seven of the 19 funded projects are for service-enriched housing, which will provide new and preserve existing housing opportunities for people with disabilities.

Maryland

The State of Maryland is another example of how states are allotting their LIHTCs. The Maryland Department of Housing and Community Development (www2.dhcd.state.md.us/Website/home/index.aspx) oversees Maryland's distribution of tax credits.

Unlike Iowa, Maryland does not have a set-aside for projects that construct or rehabilitate affordable, accessible housing for people with disabilities. Maryland's legislature recognizes that people with disabilities are historically "isolate[d], and. . . such forms of discrimination against individuals with disabilities [will] continue to be a serious and pervasive social problem." Like many other states that recognize this need, Maryland has not yet fully leveraged their LIHTCs as a means to accelerate the development of housing for people with disabilities.

Current statistics indicate that nearly 157,000 residents of Maryland will have a need for some form of affordable, low-income housing over the next ten years. Statistics further indicate that, over the next ten years, approximately 29,000 residents with disabilities in Maryland will need some form of affordable, accessible housing.

Maryland's QAP makes "Housing for Disabled or Other Special Needs Linked to Supportive Services" a single category. Maryland awards a maximum of 10 points, 1.5 percent of the total available points, for "Housing for Disabled or Other Special Needs."

In 2004, Maryland allotted nearly $10 million in tax credits. Sixty-seven of the units that received LIHTCs are accessible for people with disabilities. Thirty-seven of those 67 units are only available to elderly Marylanders. In 2003, Maryland awarded LIHTCs to 26 projects with 207 units considered accessible for people with disabilities. Seventy-four of those accessible units are only available to elderly Marylanders. Maryland is moving forward to explore new ways to use LIHTCs to accelerate the development of appropriate housing for these populations.

Additional Opportunities: The Homeownership Tax Credit

Proposed in mid-March of 2005, the Homeownership Tax Credit (HOTC) would increase housing opportunities for working families by helping to bridge the gap between what it costs to build homes in lower-income neighborhoods and the price that buyers in those neighborhoods can afford to pay. The HOTC is another lever through which public-private investments can be created that accelerate the development of sustainable livable communities.

The HOTC is generally targeted to census tracts with median incomes of 80 percent or less of the area or state median income. Areas eligible under federal rural housing programs and Native American areas are eligible as well. States are able to use a portion of their credit authority in other economically distressed areas. Eligible buyers generally are those whose incomes do not exceed 80 percent of area median income. In certain distressed neighborhoods, eligible buyers can earn up to 100 percent of the greater of area median income.

The program is structured in such a way that states will receive annual allocations of credit authority starting at $1.75 per capita and rising with inflation. States will award credits to developers under a competitive process in accordance with annual plans for meeting state home ownership needs. Developers that receive credit allocations will be allowed to sell them to investors and use the proceeds to bridge the gap between the development costs and the sales price of homes they develop. The credit will cover up to 50 percent of acquisition and development costs for either new construction or substantial rehabilitation.

The HOTC will help produce roughly 250,000 new homes, almost all for low-income people, over a five year period, at a federal cost of just over $2.5 billion. This activity will help generate more than half a million jobs, $20 billion in wages, and $10 billion in federal, state, and local revenue. The development and economic activity that the HOTC will generate will also help close minority and low-income homeownership gaps and stabilize struggling neighborhoods.

Resources

United States Department of Housing and Urban Development

Office of Policy Development and Research. http://www.huduser.org.

Low income Housing Tax Credits Data Sets. Available at: http://www.huduser.org/datasets/lihtc.html.

United States Department of Housing and Urban Development, Office of Policy Development and Research, Updating the Low income Housing Tax Credit Database: Projects Placed in Service Through 2001. available at: http://www.huduser.org/Datasets/lihtc/report9501.pdf.

Fair Housing and Equal Opportunity Office. http://www.hud.gov/offices/fheo/index.cfm.

Memorandum of Understanding Among the Department of the Treasury, The Department of Housing and Urban Development, and The Department of Justice. Available at: http://www.hud.gov/offices/fheo/lihtcmou.cfm.

Office of Community Planning and Development. http://www.hud.gov/offices/cpd/index.cfm.

HOME and Low Income Housing Tax Credits, available at: http://www.hud.gov/offices/cpd/affordablehousing/training/lihtc/index.cfm

LIHTC Basics, available at: http://www.hud.gov/offices/cpd/affordablehousing/training/lihtc/basics/index.cfm.

How do Housing Tax Credits Work?, available at: http://www.hud.gov/offices/cpd/affordablehousing/training/lihtc/basics/work.cfm.

Allocating Housing Tax Credits, available at: http://www.hud.gov/offices/cpd/affordablehousing/training/lihtc/basics/allocating.cfm.

Eligibility, available at: http://www.hud.gov/offices/cpd/affordablehousing/training/lihtc/basics/eligibility.cfm

Syndication, available at: http://www.hud.gov/offices/cpd/affordablehousing/training/lihtc/basics/syndication.cfm.

State Housing Agencies

Alabama http://www.ahfa.com/
Alaska http://www.ahfc.state.ak.us/
Arizona http://www.housingaz.com/
Arkansas http://www.arkansas.gov/adfa/
California http://www.hcd.ca.gov/
Colorado http://www.dola.state.co.us/doh/Index.htm
Connecticut http://www.chfa.org/MainPages/default.asp
Delaware http://www2.state.de.us/dsha/
District of Columbia http://dhcd.dc.gov
Florida http://www.floridahousing.org/
Georgia http://www.dca.state.ga.us/
Hawaii http://www.hawaii.gov/portal/
Idaho http://www.ihfa.org/
Illinois http://www.ihda.org/
Indiana http://www.state.in.us/ihfa/
Iowa http://www.ifahome.com/
Kansas http://www.kshousingcorp.org/
Kentucky http://www.kyhousing.org/
Louisiana http://www.lhfa.state.la.us/
Maine http://www.mainehousing.org/
Maryland http://www.dhcd.state.md.us/
Massachusetts http://www.mass.gov/dhcd/
Michigan http://www.michigan.gov/mshda
Minnesota http://www.mhfa.state.mn.us/
Mississippi http://www.mshomecorp.com/firstpage.htm
Missouri http://www.mhdc.com/
Montana http://housing.state.mt.us/
Nebraska http://www.nifa.org/
Nevada http://nvhousing.state.nv.us/
New Hampshire http://www.nhhfa.org/
New Jersey http://www.state.nj.us/dca/hmfa/
New Mexico http://www.nmmfa.org/
New York http://www.dhcr.state.ny.us/ocd/progs/lihc/
ocdli0.htm and http://www.nyhomes.org/default.htm
North Carolina http://www.nchfa.com/
North Dakota http://www.ndhfa.state.nd.us/
Ohio http://www.odod.state.oh.us/ohfa/
Oklahoma http://www.ohfa.org//
Oregon http://www.ohcs.oregon.gov/
Pennsylvania http://www.phfa.org/
Rhode Island http://www.rihousing.com/
South Carolina http://www.sha.state.sc.us/
South Dakota http://www.sdhda.org/
Tennessee http://www.state.tn.us/thda/
Texas http://www.tdhca.state.tx.us/
Utah http://www.utahhousingcorp.org/
Vermont http://www.vhfa.org/
Virginia http://www.vhda.com/vhda_com/front_page/default.asp
Washington http://www.wshfc.org/
West Virginia http://www.wvhdf.com/
Wisconsin http://www.wheda.com/
Wyoming http://www.wyomingcda.com/

Other Resources

Websites

1. The Affordable Housing Resource Center, http://www.novoco.com/resource.shtml.

Articles

1. National Council on Disability, Reconstructing Fair Housing, available at: http://www.ncd.gov/newsroom/publications/2001/pdf/fairhousing.pdf#search=

'reconstructing%20fair%20housing' (last viewed February 21, 2005).

2. Denise DiPasquale and Matthew E. Kahn, Measuring Neighborhood Investments: An Examination of Community Choice, 27 Real Estate Economics 389 (1999), available at: http://www.cityresearch.com/pubs/Measuring%20Neighborhood%20Investments1.pdf (last viewed January 13, 2005).

3. Denise DiPasquale, et. al, Comparing the Costs of Federal Housing Assistance Programs, FRBNY Economic Policy Review 147 (June 2003), available at:http://www.cityresearch.com/pubs/NY%20Fed%20Cost%20Paper.pdf (last viewed January 13, 2005).

4. Jean Cummings and Denise DiPasquale, Building Affordable Rental Housing, February 1998, available at: http://www.cityresearch.com/lihtc/cr_lihtc.pdf (last viewed January 13, 2005).

5. Jean Cummings and Denise DiPasquale, The Low income Housing Tax Credit: An Analysis of the First Ten Years, 10 Housing Policy Debate 251, available at: http://www.cityresearch.com/pubs/cummings.pdf (last viewed January 13, 2005).

6. Alan Mallach, Toward a Policy Framework for the Allocation of Low income Housing Tax Credits, available at: http://www.njisj.org/reports/framework_report.html. (last viewed February 21, 2005).

Expanding the Supply of Affordable, Accessible Housing: Learning from Kentucky

As the description of low income housing tax credits demonstrates, "financial carrots" are effective in stimulating the development of affordable housing. Incentives can also be used to encourage the adoption of universal design principles in the building of affordable housing. In Kentucky, builders and developers whose rental housing and/or single family home construction or rehabilitation projects are partially (50%) or wholly financed by the Kentucky Housing Corporation (KHC), must follow KHC's Universal Design Policy. This policy, in effect since 1993, is designed to "ensure that much of the housing produced with KHC financing meets the needs of the greatest number of people for the longest period of time."

Background

The Kentucky Housing Corporation (KHC) is Kentucky's state housing finance agency. It was created in 1972 by the state's General Assembly and is a self-supporting public corporation of the Commonwealth of Kentucky, administratively attached to the Finance and Administration Cabinet. A portion of KHC funds is derived from the interest earned through the sale of tax-exempt mortgage revenue bonds, which has enabled thousands of low and moderate-income Kentucky families to find and live in affordable homes. KHC also receives fees for administering federal housing programs that make affordable housing available to low-income families.

KHC administers and monitors a number of federal and state affordable housing programs, such as:

• The HOME Program, a federal program that provides funding for various types of affordable housing production and rehabilitation (KHC also assists with the state matching funds requirement in the HOME Program)
• The Affordable Housing Trust Fund, a state program that supports the acquisition, rehabilitation, and new construction of very low-income housing units and provides matching funds for federal housing programs requiring a state or local match
• The Small Multifamily Affordable Loan Program (SMAL), a state program designed to increase the supply of affordable rental housing for lower-income individuals, particularly in rural areas of the state
• The Housing Development Fund, a state program that provides flexible, low-interest rate construction loans for new construction, rehabilitation, site or land development, acquisition, or construction of prototype affordable housing
• A number of other financing mechanisms that are designed to increase affordable and accessible housing stock in the state, including a new program called the Permanent Supportive Housing Initiative that provides non-profit and for-profit housing developers a zero percent revolving loan fund to cover predevelopment costs as well as grants to fund supportive services.

In 1996, the Kentucky General Assembly established a state policy on housing. The Commonwealth of Kentucky Housing Policy Act sets a number of objectives, including the following:

• Identify the basic housing needs of all Kentuckians, including the elderly, persons of low and very low-income, the disabled, the homeless, and single-parent households
• Coordinate housing activities and services among state departments and agencies to ensure program flexibility and comprehensive housing production
• Remove administrative and regulatory guidelines to ensure compatibility in the development of affordable housing for all Kentuckians
• Encourage and strengthen collaborative planning and partnerships among social service providers, all levels of government, and the public and private sectors, including for-profit and non-profit organizations, in the production of affordable housing

In 2001, Kentucky became one of the first states to receive a Real Choice Systems Change Grant for Community Living from the Centers for Medicare and Medicaid Services (CMS), the federal agency that administers the Medicare and Medicaid programs. The purpose of the grant program is to build infrastructure that will result in effective and enduring improvements in community long-term service and support systems. These systemic changes are designed to enable children and adults of any age who have a disability or long-term illness to:

• Live in the most integrated community setting appropriate to their individual support requirements and preferences
• Exercise meaningful choices about their living environment, the providers of services they receive, the types of supports they use and the manner by which services are provided
• Obtain quality services in a manner as consistent as possible with their community living preferences and priorities.

Two of the long-term services and supports system problems Kentucky identified in its Real Choice grant application were related to housing:

• Lack of funding for transition programs and limited housing options to allow individuals to live in community-integrated settings
• Lack of communication among local public housing agencies, service providers, and advocates about the housing needs of people with disabilities

To remedy this situation, Kentucky proposed to increase the stock of new, affordable, and accessible housing options, facilitate transitions to community living for people with disabilities and, "through partnerships with state and local housing agencies, ensure that new housing is fully accessible and incorporates universal design principles."

Developing Universal Design Principles

With support from the CMS Real Choice grant and input from the public through public hearings and partners across the state, the Department of Design and Construction Review of the Kentucky Housing Corporation developed a Universal Design Handbook for use by builders and developers in the construction and reconstruction of affordable housing. The Universal Design Policy went into effect on January 1, 2003.

While housing that incorporates universal design can clearly benefit people with disabilities, the Department of Design and Construction Review's definition of universal design does not target any group in particular. In fact, their definition is all-inclusive and stresses the wide-ranging and lifelong benefits of housing built according to universal design principles:

"Universal design is a building concept that incorporates products, general design layouts, and characteristics into residences in order to:

• Make the residence usable by the greatest number of people
• Respond to the changing needs of the resident
• Improve marketability of the residence"

The Universal Design Handbook prescribes the following design guidelines:

1. Finished hallways should be 42" wide

2. All doorways, including closet doors and entry doors, should be 32" wide at minimum. Specifications for entry platforms are also included

3. Ground level and elevator accessible units must have a minimum of one full universally designed bathroom

4. Single lever or ADA-approved faucets must be installed at all sinks, showers, and tubs

5. Electrical outlets have to be installed at a minimum height of 15" and light switches, fan switches and thermostats at a maximum height of 48"

6. All units must have at least one universally designed bedroom on the ground level or elevator accessible floor

Specifications for exterior accessibility, including parking areas and walkways, are also included and, as an acknowledgment of the fact that more and more members of the population own and regularly use personal computers, cabling for high-speed internet access is also required.

Tying Universal Design Policy to Funding Resources

There are several ways that universal design guidelines are promoted at the federal, state, and local levels. Federal regulations, for example, set accessibility standards for large, new or rehabilitated multifamily housing built with the help of federal funds, but not for smaller projects. Some states, such as Georgia, and cities, such as Irvine, CA, have developed their own accessibility guidelines that builders and developers may voluntarily adopt, although these guidelines apply mostly to privately funded projects. In Kentucky, the Kentucky Housing Corporation has tied its universal design policy to its housing finance programs. Thus KHC universal design requirements are mandatory for any projects that receive debt or subsidy financing from KHC equal to 50 percent or more of the total cost of new construction (or reconstruction) of single-family or multi-family housing. The Department of Design and Construction Review offers a full array of technical assistance and likes to begin working with developers right from the inception of the project to ensure that they are meeting all building requirements, including the universal design guidelines. Once the project is built, the Department's inspectors inspect the buildings and certify them.

Many developers and builders around the country have been reluctant to incorporate universal design features into their projects because they believe the cost is prohibitive. Consumers buying new homes are also reluctant to request the features because they fear these features will add substantially to the cost of the housing. But several studies have shown that the added cost of universal design features is very modest. In Kentucky, KHC's Department of Design and Construction Review has polled developers of multifamily and single-family dwellings and has found that, as a result of its Universal Design Policy, additional building costs for a two-bedroom unit are between $900 and $1,500. "Retrofitting," or renovating, homes after they are built to accommodate the occupants' changing physical needs is considerably more expensive.

According to the Department of Design and Construction Review, since the Universal Design Policy went into effect in 2003, at least 500 units have been built that meet universal design requirements.

Success Stories

Housing corporations around the U.S. have given thousands of Americans access to affordable housing. In the past 31 years, Kentucky Housing Corporation has helped countless families find affordable rental housing, and its homeownership programs have assisted over 55,000 families in becoming homeowners, making Kentucky's home ownership rate (74 percent) considerably higher than the overall national rate of 67.8 percent, according to 2001 U.S. Census data. Whether they own or rent, not only do more people have access to affordable housing, with KHC's Universal Design Policy in full effect, they will have housing that will meet their needs for a long time to come. Here are a couple of examples of recent projects built according to the Universal Design Policy guidelines.

• Hilton and Lively Partnership is a builder of affordable housing in central and western Kentucky, and many of their clients are single parents, seniors, and people with disabilities. Hilton and Lively receives some financing through KHC, so it has to comply with KHC's Universal Design Policy. The firm works with manufactured housing, which does not normally incorporate universal design principles, such as wider hallways, generous space in bathrooms, and so on. But it has found a housing manufacturer willing to revise their construction plans to meet the universal design requirements and the firm is standing behind the quality of the homes they build by providing warranties, construction reinforcements, a traditional-looking roof pitch, a permanent foundation, and higher insulation standards compared to other similar homes.
  Hilton and Lively's most recently funded project, the Hilton and Lively Homeownership Program, is building affordable (manufactured) housing with the basic features of universal design in Grayson County's Big Clifty. The project received KHC financing through the HOME Investment Partnership Program and the Housing Development Fund.
• Another project built with funds from the HOME Investment Partnerships Program is the South Main Street Apartments in Edmonton, Kentucky, which will serve older people with incomes at or below 50 percent of the average median income for the area, which is currently $32,500 a year. Funds from the state's Small MultiFamily Affordable Loan Program (SMAL) were also used to build the one-story, 11-unit complex.

Chapter IV

Strategy Three: Agreement on Common Performance

Measures Across Multiple Federally Funded Programs

There is an enormous variety of programs that are designed to help older people and people with disabilities live independently in the community. But how effective are these programs? Do they respond to people's actual needs and support their aspirations? Strategy Three is one way to begin addressing these questions. The initiatives illustrating this approach have developed tools that facilitate measurement of performance and outcomes. These tools can be applied to a variety of programs that serve people with disabilities and older people.

The Program Assessment Rating Tool (PART)

The Office of Management and Budget (OMB) developed the Program Assessment Rating Tool (PART) to assess and improve program performance so that the Federal Government can achieve better results with its programs. A PART review helps identify a program's strengths and weaknesses to inform funding and management decisions aimed at making the program more effective. PART therefore looks at factors that affect and reflect program performance, including program purpose and design; performance measurement, evaluations, and strategic planning; program management; and program results. PART allows programs to show improvement over time. It also allows comparisons between similar programs because it includes a consistent series of analytical questions.

PART's current approach to individual program evaluation is just a starting point, however. To effectively measure programs that serve people with disabilities, the system must also evaluate the real impact that these programs have on the people they serve as well as the extent of collaboration among federal agencies to advance the overall goals of social and economic independence and community inclusion for people with disabilities. To achieve these valued outcomes, federal agencies will need to improve coordination across program lines to:

• Provide affordable, appropriate, accessible housing;
• Ensure accessible, affordable, reliable, safe transportation;
• Adjust the physical environment for inclusiveness and accessibility;
• Provide work, volunteer, and education opportunities;
• Ensure access to key health and support services; and
• Encourage participation in civic, cultural, and recreational activities.

When agencies and programs coordinate and work together, it is more likely that these desired results will be achieved.

Program Background

In July 2002, Mitch Daniels, Director of the Office of Management and Budget, announced the PART program as a tool for formally evaluating the effectiveness of federal programs. Mr. Daniels said that this "program assessment effort presents an opportunity to inform and improve agency GPRA [Government Performance and Results Act of 1993] plans and reports, and establish a meaningful systematic link between GPRA and the budget process."

OMB's guidance describes PART as part of a "systematic method of assessing the performance of program activities across the Federal Government."

Program Description

Overview of the Program Structure

PART is a rating tool designed to hold agencies accountable for accomplishing results. PART is a diagnostic tool and the main objective of the PART review is to improve program performance. PART assessments help link performance to budget decisions and provide a basis for making recommendations to improve results. Programs are rated from effective to ineffective, and the ratings and specific findings produced are used to make decisions regarding budgets and policy.

PART places the burden of proving effectiveness with the federal managers responsible for operating the program under review. The PART program provides meaningful evidence to Congress and other decision-makers to help inform funding decisions and identify flaws in underlying statutes that undermine effectiveness.

History

Previous administrations grappled with