Spotlight on Housing Rights of People with Disabilities Training Clinical Partners in Advocacy

1. Spotlight onHousing Rights of People with DisabilitiesTraining Clinical Partners in Advocacy Rebecca Diamond, JD – Housing March 2011

2. Objectives • Identify key links between appropriate housing and the health of people with disabilities • Screen patients with disabilities for their ability to use and enjoy their current housing units • Deploy basic advocacy skills in consultation with MLP | Boston, to help disabled people exercise their rights to obtain or keep appropriate housing

3. Aggravates physical & mental disabilities Overcrowding Mold, Pests, Carpeting, High-Dry Heat Asthma Mobility Disabilities Stairs, narrow doorways, high cabinets, small bathrooms PTSD Common Housing Problems Faced By People with Disabilities: Violent Neighborhood

4. Important Terms • ISD – Inspectional Services Department: Bostonagency that enforces the sanitary code • PHA – Public Housing Agency: Includes the Boston Housing Authority (BHA) and mobile subsidy voucher administrators (Section 8) • Reasonable Accommodation (RA): Physical changes to dwelling and/or common areas, or flexibility about how rules are applied, so that People with Disabilities can equally access and enjoy their homes. • Housing Search: Free professional search services for people looking for affordable and/or handicap accessible housing

5. Healthy Housing:Rights & Responsibilities People with Disabilities have specific rights with respect to housing: • To search for and obtain a home without being subjected to discrimination; • To obtain reasonable accommodations including physical changes to housing units or flexibility in the manner in which rules are applied; • To qualify for certain preferences and priorities for accessing affordable housing programs; and • To be eligible for discount rates and shut off protection from utility companies.

6. Reasonable Accommodation: What is a Disability? • Based upon a mental or physical impairment that substantially limits one or more life activities: • Physical: blindness, cerebral palsy, asthma, sickle cell, deafness • Mental: depression, ADD/ADHD, learning disorders, mental retardation • Life Activities: walking, learning, working, caring for oneself

7. Wider doorways, lower cabinets Patient in wheelchair Asthma Separate bedroom Emergency Transfer PTSD (witnessed local violence) Separate Bedroom Types of Reasonable Accommodations Behavioral Disorder

8. Case Example Mrs. A suffers from lupus, which is triggered by stress. Mrs. A’s current apartment is very small and her teenage children share a room and fight often. Mrs. A has complained to the PHA about the size of the unit but the PHA told Mrs. A that teenagers fight and she should just “get over it.” What can you tell this parent about her family’s housing rights?

9. Advocacy Treatment Plan 1. Patient may have a right to Reasonable Accommodation to separate bedrooms for her sons. 2. Consult with MLP | Boston to complete written reasonable accommodation request.

10. Reasonable Accommodation: Doctor’s Letter • Complete certification of need form (BHA) or write a letter on official letterhead stating: • The patient is disabled. • The RA is “medically necessary”; • How the current unit exacerbates tenant’s health; i.e., the link between the unit and the health problem

11. Case Example Mrs. B’s son has spina bifida and has used a wheelchair since he was a child. For years, Mrs. B has carried her son up the 7 steps leading into their apartment, which was obtained through the Section 8 program. Now 13, Mrs. B’s son is the same size as Mrs. B and his wheelchair is much larger and heavier, making it nearly impossible for Mrs. B to carry him up the stairs. Mrs. B has asked her Landlord to install a ramp into their home but he has refused. She has never asked her PHA. What can you tell this parent about reasonable accommodation?

12. Advocacy Treatment Plan 1. Patient may have a right to Reasonable Accommodation: (a) have a ramp installed, or (b) break her lease and move into a handicapped-accessible unit. 2. Consult with MLPC to draft written request to landlord and doctor’s letter supporting reasonable accommodation request by stating that a ramp is medically necessary and explaining how the failure to provide a ramp is making it difficult for Mrs. B’s son to access his home.

13. BHA Housing Preferences & Priorities • BHA Priority – Inaccessibility of a critical part of a housing unit • If any member of household is unable to access a critical element AND Landlord is not obligated to make a RA • BHA Preference - Disabled Non-Elderly • Only applies if the head or co-head of household is disabled • BHA Elderly/Disabled Housing Complexes • Head or co-head of household must be disabled or [at least 60 years old (62 for federal housing)

14. Take-Home Messages • People with disabilities have specific housing rights • It is illegal to discriminate against people with disabilities when making housing available • This is opposite of other discrimination laws requiring equal treatment. Here treatment must be different to achieve an equal result. • People with disabilities have the right to require their landlords to make “reasonable accommodations” to their home even if a certain housing condition does not violate state law. • If your patient encounters housing problems, consult with MLP | Boston for follow-up

15. MLP | Boston Case Consults Text Pager: (617) 638-5795 • ID#: 6664 • M-F 9:00am- 5:00pm Phone: • BMC: (617)414-7430 • Include: Name of referrer and pager #, child PCP or other provider, clinic name, parent name, child’s name