Just Below the Line: Disability, Housing, and Equity in the South

8. Redefining Policy and Practice

Congress acknowledged that society’s accumulated myths and fears about disability and disease are as handicapping as are the physical limitations that flow from actual impairment. —WILLIAM J. BRENNAN JR., associate justice of the Supreme Court of the United States1 The interrelationships between health and housing are not tacitly obvious, yet their reciprocity is substantial. As previously stated, one of the primary purposes of this book is to illustrate the synergistic relationship between these fields, that housing design affects physical and psychosocial well-being, while personal health influences needs and preferences in housing. The policies and practices that underlie the health and housing industries, however, still remain predominantly autonomous and struggle for broad societal impact. More than a decade ago, Johnny Cash observed, Apart from the Vietnam War being over, I don’t see much reason to change my position today. The old are still neglected , the poor are still poor, the young are still dying before their time, and we’re not making any moves to make things right. There’s still plenty of darkness to carry off.2 Consistent with the “Man in Black’s” sometimes austere perspective , this critique of health and housing policy is still made today by advocates of such diverse perspectives as AARP and ADAPT. The U.S. Government’s role in housing policy dates primarily from two critical points in the nation’s history. First, at approximately the turn of the present century, tenement reform laws set the precedent that local governments would set standards and be the primary regulators of housing safety. Second, 207 8Redefining Policy and Practice BRENT T. WILLIAMS, KORYDON H. SMITH, AND JENNIFER WEBB during the New Deal Era of the 1930s, the public housing program and banking reform established the precedent for a federal role in homeownership generally and in providing housing subsidies to poor residents in particular.3 From the New Deal Era through the 1970s, U.S. housing policies were based on the belief that solutions to the nation’s housing problems required the direct assistance of the federal government. Through policy pledges that guaranteed every American decent housing (e.g., Housing Act of 1949), and by federal policies that stabilized the banking industry, thus giving lenders incentives to make longterm loans to home buyers, the federal government played an ever-expanding role in housing issues. As Washington provided subsidies to local public housing authorities and private developers for low- and moderate-income housing, politicians, lenders, property owners, and real estate agents largely agreed on the basic premise that the federal government had key responsibilities and a central role to play in housing policy. Regarding governmental structures, housing and healthrelated agencies emerged separately and have continued to remain autonomous in the legislation and practices that underlie them. Housing is principally in the purview of the Department of Housing and Urban Development, whereas health policy and funding is chiefly administrated by the Department of Health and Human Services. “Because the current systems of health and housing services were conceived in isolation, so remain their respective funding sources, performance standards and regulatory bodies.”4 Due to various social and political changes, these independent agencies have held disparate, if not conflicting, agendas and practices. In the business realm, housing and health practices have also remained separate due to the specialized knowledge necessary to operate in each field, though synergies between health and housing have recently emerged. As such, the goals of this chapter are to assess current policies and practices and to provide recommendations for change. The summative purpose is to illustrate how individual quality of life may be improved and government fiscal efficacy may be enhanced. The intention of this chapter is not to delve deeply into the fine points of housing legislation. Nevertheless, legislation influences both policies and practices and even at times establishes administrative agencies. The U.S. Access Board, created by the Overview of Housing Policies and Practices 208 REDEFINING POLICY AND PRACTICE Rehabilitation Act of 1973, is one example. The immediate purpose here is to provide the reader with a general understanding of the most significant pieces of legislation that influence housing for people with disabilities and low-income families, the programs associated with these legislative acts, and the agencies who supervise these programs. As housing programs change often, and for purposes of clarity, not all programs are discussed. In addition, more than other chapters, this chapter places equal focus on disabilityrelated...