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Independent Living News & Policy from the National Council on Independent Living

NCIL 2017 Independent Living Funding Talking Points

Centers for Independent Living stand ready to take on the challenges and opportunities of integrating the additions and changes included in the Workforce Innovation and Opportunity Act. In order to effectively carry out the additional core service, as well as to meet increasing demand and overcome years of devastating cute, it has been determined that additional funding of $200 million will be required.

We are requesting $200M in additional funding in the 2017 budget for the Independent Living line item.

Centers for Independent Living (CILs) are grassroots, advocacy-driven organizations run by and for people with disabilities. CILs envision a society in which people with disabilities are valued equally and participate fully. In order to accomplish this vision, CILs support consumers moving out of nursing homes and into the community, and advocate for individuals facing discrimination in employment, education, housing, transportation, and healthcare to ensure equal opportunity for people with disabilities as citizens of our democratic nation.

The additional core service authorized by WIOA in Title V is Transition; as defined:

  1. Facilitate the transitions of individuals with significant disabilities from nursing homes and other institutions to home and community based residences;
  2. Provide assistance to individuals with significant disabilities who are at risk of entering institutions so that the individual may remain in the community; and
  3. facilitate the transition of youth (including students) who are individuals with significant disabilities, who are eligible for individualized education programs under section 614(d) of the Individuals with Disabilities Education Act (20 U.S.C. 1414(d)), and who have completed their secondary education or otherwise left school, to post-secondary life, including employment

The Independent Living program has had tremendous influence for systems change in the delivery of cost effective long-term care services using home and community based services and transition of youth. For decades, the Independent Living Program has been woefully underfunded and has not received additional funding. Conversely, Vocational Rehabilitation agencies routinely receive increases of $365M in COLA every year. Due to state budget constraints, state VR agencies have returned over $80M to the treasury because they are not able to match with state funds. Clearly, investing in Centers for Independent Living makes sense.

This $200M funding request will restore devastating cuts to the Independent Living Program, makes up for inflation costs and address the increased demand for independent living services.

According to data collected by the Rehabilitation Services Administration, during fiscal years 2012-2014, Centers for Independent Living:

  • Provided the core services of advocacy, information and referral, peer support, and independent living skills training to nearly 5 million individuals with disabilities
  • Attracted over $2.26 billion through private, state, local, and other sources, and;
  • Moved 13,030 people out of nursing homes and institutions, saving states and the Federal government over $500 million, not to mention improving people’s quality of life.

In that same period, Centers provided other services to hundreds of thousands of individuals with disabilities in their respective communities that included:

  • Personal assistance services to nearly 184,240 people with disabilities;
  • Assistance to 145,937 people in securing accessible, affordable, and integrated housing;
  • Assistance with Assistive Technology for 171,441 people with disabilities;
  • Vocational and employment services to 96,492 people with disabilities;
  • Transportation services to over 103,175 people with disabilities, and;
  • Services to over 35,137 youth with disabilities.

Independent living through home and community-based services (HCBS) saves taxpayer dollars. Home and Community-Based Services (HCBS), accessed through Medicaid or the private sector, allow people with disabilities (including the ever-growing senior population) to remain in their homes rather than living in nursing homes or other institutions. HCBS Medicaid Waivers allow recipients to spend their Medicaid funds on case management, home health aides, personal care attendants, health and other services. According to research funded by the National Institute on Disability and Rehabilitation Research (NIDRR) and the Kaiser Commission on Medicaid and the Uninsured In 2006:

  • Medicaid HCBS expenditures for personal care services, home health, and 1915c waivers were $39 billion ;
  • Medicaid HCBS waiver expenditures were $25 billion ;
  • Medicaid institutional costs were about $60 billion ;
  • National average waiver costs per participant were $43,039 compared with $125,019 in institutional costs ;
  • After including average Community Living Costs of $14,308 a year, waiver recipients spent $67,672 less than a resident in a facility ;
  • Including average Community Living Costs (room, food and other), waiver recipients spent $44,992 a year, compared to nursing homes costs of $63,095 ;
  • Community-Based Services are at least 29% (21%) less expensive than nursing homes, saving taxpayers $18,103 a year per participant.

The President, OMB, and Congress want Federal programs to measure their outcomes, not just their activities or outputs, and Centers for Independent Living agree. This network of local centers, funded by the Department of Education to help persons with disabilities remain as independent as possible, agrees that programs cannot improve unless they know their current effectiveness. On their own initiative, Centers have worked with an independent evaluator for the past four years to develop ways to measure their outcomes, and they have now succeeded. This is a rare and exciting accomplishment for a Federal program.

The National Council on Independent Living (NCIL) has led a nationwide effort to develop outcomes, indicators, measurement tools, and ways to gather, analyze, and interpret outcome data. The Rehabilitation Services Administration within Education and all segments of the independent living community of practice have been closely involved at every step. Centers have field-tested their outcomes for each of the past two years. The findings from 2011 are presented below.

What did we learn about Centers?

  • 85% of at-risk clients are kept out of institutions
  • 30% of institutionalized clients move back into the community
  • 72% of callers receive the information they requested
  • 52% of callers use a new resource they learned from the Center
  • 70% of all clients have new skills, knowledge, or resources because they contacted the Center
  • 51% are more independent as a result of using Center services
  • 58% are now able to speak up for themselves
  • Most Centers also identify barriers and problems in their communities, develop plans to address them, and successfully engage with decision-makers

NCIL respectfully requests your careful consideration to increase funds for the Independent Living line item for the 2017 budget.

Comments

  1. Benjamin McMullan says

    I am contacting you from Center for Independence of Individuals with Disabilities. I am ask that the amount of $200 Million to Independent Living Centers is re-allocated in next year’s budget cycle. This will make up for monies that were due to us that we ultimately did not receive. When ILC’s transferred from Rehabilitation Services Administration to the Administration on Community Living (ACL) these funds were not properly transferred. In order to remedy this situation ACL attempted to reimburse the 2015 funds with those allocated for 2016. ACL told us that they meant to inform us at the time of the decision, but they ultimately failed to do so.

    What this means is RSA made a mistake by telling CILs they could be reimbursed after the expiration date. ACL then made a decision to use Independent Living funds to fix the mistake, and they forgot to inform us of the decision. We still do not know how they decided which ILC’s would receive cuts or how much those cuts would amount to. What we do know is that the mistake will result in lost jobs and decrease the ability to serve consumers. That is why we ask that the amount of $ 200 M is re-appropriated to fund VII C- funded centers

  2. Judy Blunk says

    I am contacting you from the Southeast Kansas Independent Living S.K.I.L. I am asking that the $200 million for Independent Living to be re-allocated into the budget cycle. According to the facts, it would be cheaper to have the monies put back into the budget and allow the people decide wheather they want to live in nursing homes or in their own homes. In my opinion, I don’t think the government should be able to tell anyone that they have to be in a nursing or institution. I believe as long as one person in the family says they will take care of them that should be alright.