Enabling disabled individuals to live independently and more cost-effectively: “Honoring that choice”
Julie was born with a severe form of muscular dystrophy. At 61, her disease continues to progress. As a quadriplegic, Julie relies on caregivers for her survival. But she is determined to keep her independence as much as she can, and to continue to live in her own apartment for as long as she can. Her story highlights how formidable the challenges are for someone in her position to secure affordable independent housing—but it’s also a story of her courage and persistence in the face of truly difficult circumstances.
About eight years ago, Julie lost her subsidized apartment after getting very sick, and ended up in a succession of nursing homes. “I was in four nursing homes over about two and a half years. There was really bad abuse in two of them,” she says. Julie feared that she’d be stuck in nursing homes for the rest of her life. But in 2014, she managed to get into her own apartment, thanks to some benefits she received from her estranged husband’s pension.
Fast forward to September 2017. “Every year my rent had gone up a little bit, and a year ago, it was going up beyond what I could afford,” Julie says. Although her caregiving costs are subsidized and capped at one-third of her income, that takes a huge bite out of her monthly budget. Julie relies on caregivers 12-13 hours per day. “I’ve got to straddle shifts so I get the care I need,” she says. Julie could not afford an extra dime for rent. If she couldn’t find a solution, and quickly, she would end up back in a nursing home.
Julie’s case manager referred her to Daniel Ruddell, a housing program manager for the Aging and Long-Term Support Administration at DSHS. Daniel works across the Spokane region with disabled people of all ages as well as seniors, seeking out housing solutions. In Julie’s case, he explains, as a result of painful contortions of federal government rule-making, Julie was ineligible for subsidized HUD 811 (disabled) housing because she receives a “too high” monthly disability benefit (SSDI) that puts her at about 50% of AMI.
Daniel points out that “the only way I could get Julie housed was through the RVP. That’s why this program has been such a critical success for Julie and others like her, who for whatever reason don’t qualify financially for HUD 811 or other housing assistance programs despite a very clear need.”
There’s a big irony here, one that’s not lost on either Julie or Daniel. Enabling Julie to remain in her own apartment is considerably less expensive. In Spokane, Daniel says, the typical cost for Medicaid clients to stay in a skilled nursing facility is $7,000 a month. “It makes sense from all perspectives to honor Julie’s choice to live independently. We can provide the exact same level of support in her apartment as we can in a skilled nursing facility and cut the expense to taxpayers by 70 percent.”
He adds, “The majority of the clients on my wait list for housing currently reside in skilled nursing facilities or assisted living facilities and they want more independence—all we’re trying to do is honor that choice.”
Daniel says he worked closely with SHA before the RVP pilot was launched. “Pam sought out input from a lot of us. I was one of those folks who wasn’t afraid to chip in and provide some input and direction. I absolutely love the RVP Program. In fact it’s at the top of the list as far as a favorite. But I have way too many clients to house and I need more resources.” Currently, Daniel says, his waitlist for the RVP vouchers allocated to his division runs through 2020.
As for Julie, she did have to wait several months for an RVP voucher to become available. “Dan kept reassuring me, saying, ‘things are looking good, keep hanging in there,’ and sure enough, in April I got that phone call.” Julie has built a support network in her apartment building. “When I knew I’d be able to stay in this place that is safe for me … I am very, very thankful for where I am right now.”