Issues in Creating Livable 

Communities for 

People with Disabilities: 

 Proceedings of the Panel 

National Council on Disability 

October 1, 2007
2 

National Council on Disability

1331 F Street, NW, Suite 850 

Washington, DC 20004 

Issues in Creating Livable Communities for People with Disabilities: 

Proceedings of the Panel 

This paper is also available in alternative formats and on the awarding-winning 

National Council on Disability (NCD) Web site (www.ncd.gov). 

Publication date: October 1, 2007 

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. 
3 

National Council on Disability Members and Staff 

Members

John R. Vaughn, Chairperson 

Patricia Pound, First Vice Chairperson 

Milton Aponte, J.D. 

Victoria Ray Carlson 

Chad Colley 

Robert R. Davila, Ph.D. 

Graham Hill 

Marylyn Howe 

Young Woo Kang, Ph.D. 

Kathleen Martinez 

Lisa Mattheiss 

Lonnie Moore 

Anne M. Rader 

Cynthia Wainscott 

Linda Wetters 

Staff 

Michael C. Collins, Executive Director 

Martin Gould, Ed.D., Director of Research and Technology 

Mark S. Quigley, Director of Communications 

Julie Carroll, Senior Attorney Advisor 

Joan M. Durocher, Senior Attorney Advisor 

Geraldine Drake Hawkins, Ph.D., Senior Program Analyst 

Mark E. Seifarth, Congressional Liaison 

Pamela O’Leary, Sign Language Interpreter 

Brenda Bratton, Executive Assistant 

Stacey S. Brown, Staff Assistant 

Carla Nelson, Secretary 
4 

Acknowledgments 

The National Council on Disability deeply appreciates the policy research 

undertaken by Mia R. Oberlink of the Center for Home Care Policy and Research 

in the writing of this proceedings paper. 
5 

I. Introduction 

On October 31, 2006, the National Council on Disability (NCD) released a report 

entitled Creating Livable Communities at an event co-hosted by NCD and AARP 

at AARP world headquarters in Washington, D.C. The event included two expert 

panel discussions. Panelists commented on the report findings and shared their 

views about what adults with disabilities and seniors need in order to live in the 

community with independence, choice, and control, and what the public and 

private sectors as well as consumers can do to help communities become more 

livable. 

The event’s NCD/AARP co-sponsorship underscores the point that the disability 

community and aging network have much in common. By 2030, one in five 

people in the United States will be over the age of 65. Currently, more than 4.7 

million Americans aged 65 years or older have a sensory disability involving sight 

or hearing, and more than 6.7 million have difficulty going outside the home. As 

the population of elders grows, it is likely that the number of people aged 65 and 

older with disabilities also will grow, particularly among those 75 years of age and 

older.1 Thus, it makes sense for the disability community and aging community to 

work together, align goals, and share resources to address the challenges 

ahead. 

NCD and AARP agree that the livable community concept is central to the goal of 

fostering independence, choice, and control for people with disabilities and 

seniors. The livable community concept has been a key focus of NCD’s recent 

work. Communities in the United States are facing increasingly difficult choices 

and decisions about how to grow, plan for change, and improve the quality of life 

for all citizens, including people with disabilities. NCD believes 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 
6 

activities are offered to all members of the community by both public and private 

entities. 

Livable communities are also a focus of AARP’s Social Impact Agenda, which 

covers in three broad areas: economic security, health and social services, and 

livable communities. For AARP, the definition of “livable community” includes 

affordable and appropriate housing, adequate mobility options, and supportive 

community features and services, which together facilitate personal 

independence and the engagement of residents aged 50 and older in civic and 

social life. Thus, there is significant overlap between the two organizations’ 

agendas. 

This publication provides background information about the livable community 

concept, a summary of the main findings and recommendations of NCD’s reports 

on livable communities, and a summary of the lively and insightful panel 

discussions that took place at the NCD/AARP event. 

II. Background 

Livable Communities for Adults with Disabilities 

Disability prevalence is rising in the population under age 65 and, as mentioned 

in the introduction, predictions are that disability prevalence also will rise sharply 

among people aged 65 and older as the current senior population of 34 million 

doubles over the next 20 years.2

 In light of these demographic developments, 

communities will face significant challenges as they strive to address consumers’ 

needs, respond to their preferences, and implement policies and programs that 

help adults with disabilities remain independent and involved in community life for 

as long as possible. The National Council on Disability has released two reports 

in the past few years that discuss how the livable community concept can help 

government at all levels reconceptualize and address these challenges. These 
7 

reports also present a variety of strategies that communities can use to become 

more livable for adults with disabilities and seniors. 

In the first report, Livable Communities for Adults with Disabilities, a framework 

for defining the term “livable community” was introduced. According to the 

framework, a livable community for adults with disabilities 

• Provides affordable, appropriate, and accessible housing 

• Ensures accessible, affordable, reliable, and safe transportation

• Adjusts the physical environment for inclusiveness and accessibility

• Provides work, volunteer, and education opportunities

• Ensures access to key health and supportive services

• Encourages participation in civic, cultural, social, and recreational 

activities

A number of steps can be taken to make improvements in these areas and make 

communities more livable for adults with disabilities and seniors. According to the 

Livable Communities for Adults with Disabilities report, 

• The availability of affordable, appropriate, and accessible housing is 

crucial for people with disabilities; those who have stable housing are able 

to achieve other important life goals, such as obtaining an education, job 

training, and employment. Yet people with disabilities face a crisis in the 

availability of decent, safe, affordable, and accessible housing. To 

increase the stock of such housing, the housing system and the disability 

community need to work together. Additional steps include providing 

developers incentives to maintain existing affordable housing units and/or 

increase them; providing tax credits to help individuals with disabilities and 

seniors remain in the homes where they currently live; and expanding 

awareness and encouraging incorporation of universal design and 

accessibility features into existing or new housing stock. 
8 

• Nearly 6 million people with disabilities have difficulty getting the 

transportation they need because public transportation where they live is 

limited or nonexistent, they don’t have a car, their disability makes 

transportation difficult to use, or no one is available to assist them. Access 

to affordable, safe, and reliable transportation is necessary if people with 

disabilities and seniors are to participate fully in community life. Ways to 

improve transportation systems include combining all the disparate 

transportation services and funding streams into one system that is more 

efficient, cost-effective, and universally accessible; computerizing and 

centralizing dispatch systems to make on-demand transportation more 

efficient for consumers; and exploring the use of new technology to help 

people with disabilities and seniors navigate their community’s 

thoroughfares and transportation options. 

• Despite the many accommodations that have been made since the 

passage of the Americans with Disabilities Act (ADA), improving access to 

the physical environment is still a work in progress. Steps that some 

communities are taking to raise awareness about and accelerate work to 

improve access include increasing awareness among community 

members by providing them with sensitivity training so that they can 

experience firsthand the access problems people with disabilities face; 

educating city planners and public officials about how lack of access 

affects elders and adults with disabilities and what they can do as 

professionals to improve the situation; and modifying local laws, 

ordinances, and regulations that stand in the way of improving access to 

buildings, streets, services, and so on for people with disabilities. 

• Unemployment among adults with disabilities remains unacceptably high; 

working-age adults with disabilities are half as likely as working-age adults 

without disabilities to be employed. Yet Title I of the ADA says that adults 
9 

with disabilities who are qualified and want to work must have an equal 

opportunity to work. Some ways to increase employment opportunities for 

adults with disabilities include using technology to facilitate education and 

training programs and expand telework opportunities; increasing 

awareness among community members about the value of employing 

people with disabilities; setting an example by hiring people with 

disabilities for positions within government agencies; helping businesses 

make reasonable accommodations for employees with disabilities; and 

removing any remaining disincentives to work, such as the potential loss 

of health care or other entitlements. 

• Adults with disabilities face a fragmented health care delivery system that 

does not always respond to their wishes or needs. Remedies include 

designing health care systems that are consumer directed and provide 

care coordination to ensure that the right kind of care is provided to 

beneficiaries; allowing “money to follow the person” to the most 

appropriate and preferred care setting to create a more equitable balance 

between institutional and community-based services, eliminate barriers to 

care, and provide consumers with choice over the location and type of 

services provided; integrating the delivery of acute and long-term care 

services to provide seamless, high-quality, consumer-centered, and 

continuous care across settings and providers; and providing support 

services that are linked to housing to increase the availability and 

efficiency of service provision. 

• Adults with disabilities are more likely than people without disabilities to 

feel isolated and participate in fewer community activities. Offering 

activities and providing people with information about these activities is 

just the first step. Community organizations also need to actively reach out 

to people with disabilities to include them in activities and ensure that they 
10 

have access to all of the opportunities that are offered to other members 

of the community. 

The Livable Communities for Adults with Disabilities report proposes four general 

strategies that can be used at every level of government to facilitate change in 

these six areas: 

• Consolidating administration and pooling funds of multiple programs to 

improve ease of access to and information about benefits and programs 

for consumers 

• Using tax credits and other incentives to stimulate change in individual 

and corporate behavior and encourage investment in livable community 

objectives 

• Providing a waiver or other authority to help communities blend resources 

from multiple public funding streams to provide and coordinate different 

services 

• Requiring or encouraging a private sector match to leverage public 

funding and stimulate public-private sector partnerships 

Creating Livable Communities 

In NCD’s second report, Creating Livable Communities, these recommendations 

are expanded upon and considered in greater detail. The report argues that 

communities are now facing, and will continue to face, significant challenges to 

addressing consumers’ needs in a coordinated and comprehensive manner, 

reducing fragmentation in the service delivery system, providing consumer 

choice, and implementing policies and programs that help adults with disabilities 

remain independent and involved—all factors that add to the livability of 

communities. The report presents six general policy levers or strategies that can 

be implemented on the federal and local levels to support livable community 

objectives. These strategies offer opportunities to change the way government 
11 

organizes and manages resources, interacts with the business community, and 

responds to consumers’ evolving interests, needs, and preferences: 

• Agreement on changes in the collection and management of, and access 

to, multiple agency information about programs and benefits in order to be 

responsive to consumers 

• Utilization of favorable tax treatment (e.g., tax credits) to stimulate change 

in individual and corporate behavior that encourages investment in livable 

community objectives 

• Agreement on common performance measures across multiple federally 

funded programs 

• Utilization of private sector match to competitively secure public funding 

and stimulate public-private partnerships 

• Agreement on changes in infrastructure to consolidate administration of 

multiple programs and improve ease of access 

• Utilization of waiver authority to promote state options to advance 

consumer choice and community participation 

The report also proposes a set of specific recommendations that, if implemented, 

could facilitate the creation of livable communities. These recommendations call 

for the following: 

• Issuing a new Executive Order to charge the Office on Disability of the 

Department of Health and Human Services to chair a time-limited (six 

months, for example) workgroup on livable communities that would adopt 

and promote the strategies described in the NCD report. The workgroup 

would include representatives of the departments of Housing and Urban 

Development, Transportation, Education, Labor, and Treasury, the Social 

Security Administration, the Centers for Medicare and Medicaid Services, 

the Administration on Aging, the Administration on Developmental 
12 

Disabilities, and the Office of Community Services within the Department 

of Health and Human Services. 

• Modifying federal requirements for allocation of low-income housing tax 

credits so that, in making awards to developers, all states require (1) the 

adoption of universal design standards and (2) documentation of 

approaches to allow a minimum of 10 percent of units in multifamily 

affordable housing developments to be affordable to individuals with 

disabilities on fixed incomes, in other words, Supplemental Security 

Income (SSI) and Social Security Disability Insurance recipients. 

• Modifying performance measures being used to assess individual program 

strengths and weaknesses to focus on collaboration across departments 

and agencies to enhance livable community outcomes. 

• Utilizing 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. 

• Expanding tax incentives to promote matched savings plans for lowincome wage earners across the life span. 

• Utilizing and leveraging community service opportunities and volunteers to 

support livable community objectives. 

• Focusing on the Gulf Coast recovery and rebuilding to promote livable 

community outcomes. 

• Establishing 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. 
13 

Panel Discussions 

At the October NCD/AARP event, participants in the panel discussions were 

asked to comment on the policy levers and recommendations in the Creating 

Livable Communities report and to provide additional suggestions for action to 

improve community livability for adults with disabilities and seniors. The 

participants touched upon a wide range of issues related to community livability, 

and their discussions are summarized below. 

Panelists 

Day Al-Mohamed American Council of the Blind 

Yerker Andersson National Association of the Deaf 

Curt Decker Consortium for Citizens with Disabilities 

Elinor Ginzler AARP 

Andrew Kochera AARP 

James Koski Congressional Livable Communities Task 

 Force 

Sandy Markwood National Association of Area Agencies on 

 Aging 

Michael Morris NCB Development Corporation 

Mia Oberlink Center for Home Care Policy and Research 

Patricia Pound National Council on Disability 

Larry Roffee Access Board 

Nancy Starnes National Organization on Disability 

Janna Starr United Cerebral Palsy 

David Warner Social Security Advisory Board 

III. Living in the Community with Independence, 

Choice, and Control 

“We believe that the quality of our lives is a function of the communities we live 

in. Appropriate housing, transportation options, and ways to be engaged with 

fellow members of the community are all part of living in a vital community. They 

are all things that need to be nourished and encouraged by policy in both the 

public and private sectors.” 

--John Rother, AARP 
14 

Essential Components of a Livable Community 

Panelists discussed the factors that facilitate community living for people with 

disabilities and seniors. Overall, they agreed that affordable, accessible housing 

and employment opportunities are scarce for people with disabilities and that 

accessing information is difficult. They also agreed that housing, employment, 

and information are all “high-leverage” areas, where a concerted effort by the 

public, private, and voluntary sectors to improve access could make major 

differences in the lives of adults with disabilities and seniors. 

A number of supports need to be in place to enable people with disabilities and 

seniors to live in the community with independence, choice, and control. It is not 

just a matter of ensuring compliance with the Americans with Disabilities Act—

although that is a good place to start. As panelist Larry Roffee of the Access 

Board pointed out, adjusting the environment to make it more accessible and 

inclusive is crucial, but it is only one part of making communities more livable for 

people with disabilities. Access to affordable, accessible housing and 

transportation, employment, and education opportunities, appropriate health care 

and supportive services, and civic and social activities is just as necessary if 

people with disabilities and seniors are to live successfully in the community. 

Elinor Ginzler, director of the livable communities section of AARP’s Social 

Impact Agenda, put it succinctly when she said that making a community livable 

means providing “for all citizens of all ages and all abilities so that they can carry 

out their everyday lives” and participate in the community’s economic, civic, and 

social life. Livable communities recognize that people with disabilities make many 

contributions to the community, just as people without disabilities do. Panelist 

Nancy Starnes of the National Organization on Disability, which presents awards 

to communities that have successfully implemented measures to become more 

livable for people with disabilities, mentioned that some communities actively 

reach out to and attract people with disabilities because they “recognize the 
15 

economic, social, and cultural value that people with disabilities can contribute to 

the community,” and that these communities should serve as national models for 

others to emulate. 

“In reading the NCD report, I couldn’t help but notice that the explanations and 

recommendations about housing took up a lot more pages than anything else in 

the report....and I think that this reflects the complexity that people have to 

endure to get affordable, accessible housing.” 

--Janna Starr, United Cerebral Palsy 

In most conversations about livable communities, affordable and accessible 

housing quickly becomes the focus of conversation because it is so fundamental 

to people’s lives and, unfortunately, lacking for many people with disabilities. But 

appropriate housing may be even more difficult to find for particular subgroups of 

people with disabilities. A member of the audience, for example, reminded 

attendees that available housing rarely, if ever, accommodates people who need 

live-in assistance. She called for housing units that are set aside for just such 

situations, as well as a “new kind of congregate apartment where people have 

privacy, but two units share one kitchen where people can assist each other.” 

Janna Starr, with the United Cerebral Palsy organization, pointed out that only 

1.5 percent to 3 percent of affordable, accessible housing goes to people with 

disabilities, “and a much lower percentage, if you’re talking about people who are 

SSI recipients and have an extremely low income. It takes about 108 percent of 

an SSI recipient’s monthly income to rent a studio apartment in a major city in the 

United States.” Curt Decker, of the Consortium of Citizens with Disabilities, 

concurred and added that another group—people with cognitive and mental 

disabilities—should have access to public housing opportunities as well. 

As a housing specialist in AARP’s Public Policy Institute, Andrew Kochera spoke 

of the vital role that tax incentives, particularly low-income housing tax credits, 

play in the development and availability of housing. As part of the Tax Reform 

Act of 1986, the Federal Government created the Low-Income Housing Tax 
16 

Credit (LIHTC) to encourage the production and redevelopment of livable, 

affordable rental housing across the nation. This tax credit is a significant source 

of financing for developers seeking to construct and rehabilitate housing 

opportunities for people with disabilities. According to Kochera, the LIHTC is an 

example of a policy decision that has had an immediate and major impact on the 

market. “In 2005, there were about 120,000 multifamily units of all kinds built in 

the U.S. Of that 120,000, more than 70,000 can be tracked back to the LIHTC, 

and that is remarkable.” Furthermore, in developments designated as primarily 

for seniors, people with disabilities, and other special populations, attention is 

being paid to incorporating architectural features that improve accessibility. 

However, Kochera conceded, there is a long way to go before universal design 

features, such as lever door handles instead of doorknobs, will be routinely 

incorporated into both multifamily housing and in the 2 million single-family 

homes that are built each year. 

“My organization hears from people with disabilities that they want to work and 

that they would buy their own housing and health care if they had a job.” 

--Curt Decker, Consortium for Citizens with Disabilities 

For people with disabilities, employment may be just as hard to find as affordable 

and accessible housing ,if not harder. Although there has been a small increase 

over the past decade in the percentage of adults with disabilities who are 

employed, the unemployment rate among adults with disabilities is still high. The 

2004 National Organization on Disability/Harris Survey of Americans with 

Disabilities shows that working-age adults with disabilities are half as likely as 

working-age adults without disabilities to be employed (35% versus 78%), and 

people with severe disabilities are less likely to be employed than those with 

slight disabilities (21% versus 54%). Sixty-three percent of unemployed adults 

with disabilities say they would like to work, but obstacles to finding appropriate 

employment abound.3
17 

As in the housing arena, there is a role for tax incentives to increase employment 

opportunities for adults with disabilities. Tax incentives such as the Disabled 

Access Tax Credit, the Tax Deduction to Remove Architectural and 

Transportation Barriers to People with Disabilities and Elderly Individuals, and 

the Targeted Jobs Tax Credit have encouraged some employers to employ 

people with disabilities. 

When businesses and the federal, state, and local governments actually employ 

people with disabilities, they set an example for others and also demonstrate that 

people with disabilities and seniors are desirable employees. Elinor Ginzler of 

AARP said that her organization changed its name from the American 

Association of Retired Persons to AARP because most of its members are 

working and say that, as they get older, they have every intention of staying in 

the workforce. In addition, said Ginzler, “the reality is that we have workforce 

shortages across this country in a variety of fields because there aren’t younger 

people coming into the work environment in the same numbers. So there is an 

incentive to develop policies and supports to keep workers who are mature and 

experienced, and possibly disabled now or in the future, in the workforce.” 

Curt Decker pointed out that the private sector is a critical player in efforts to help 

people with disabilities achieve economic self-sufficiency. “I think that the 

disability community sometimes has relied too much on government programs, 

but of course it had to because of the need for a safety net,” Decker said. 

“Clearly, we need buy-in from the private sector, especially in the area of 

employment, or we will never make that leap to income security.” 

“A central repository of information that pulls together many sources and where 

people with disabilities and others can go to learn about housing or employment 

or anything else they might need would be fantastic. It’s one-stop shopping.” 

--Nancy Starnes, National Organization on Disability 
18 

The establishment of a National Resource Center on Livable Communities to 

provide easier access to information for adults with disabilities and their 

caregivers and to disseminate information to planners and other professionals in 

local and state governments was enthusiastically supported by Nancy Starnes, of 

the National Organization on Disability, and Sandy Markwood, of the National 

Association of Area Agencies on Aging. Markwood noted that the recent 

reauthorization of the Older Americans Act included, for the first time, expanded 

community planning language to help build bridges between the aging network 

and local governments—bridges that are needed to improve community livability 

for older adults. Markwood stressed that the action should not be on the federal 

level only. “As we address the issue of livable communities,” said Markwood, “we 

need to make sure that we also focus on state and local governments, which 

have purview over such things as land use and zoning ordinances. At the local 

level people are looking for information, technical assistance, best practices, and 

ways to come together around livable community goals,” which a National 

Resource Center could provide. 

Ultimately, suggested Markwood, the pivotal question is, “What does it take at 

the community level to enable people to successfully live and age in that 

community? Much planning goes on at the community level, including land use, 

transportation, and capital improvements planning, but it’s going on in a vacuum 

because the assumption is that all community residents are young and ablebodied families with two kids and no disability needs. This is happening not 

because planners at the local level are intentionally leaving out the aging or 

disability community, but because they do not know about the needs of our 

populations. The livable community concept is holistic. It includes housing 

development, transportation, workforce development, public safety, parks and 

recreation, civic engagement, volunteerism, land use, and economic 

development. It’s everything a community does.” 
19 

It is not always easy, however, to effect change at the local or state level to make 

communities more livable for people with disabilities. Yerker Andersson, board 

member of the National Association of the Deaf, related an example of a current 

legal issue being played out in Maryland, where the state legislature has 

introduced a bill to require visual fire alarms in condominiums, and where a task 

force convened to study the issue, with representation from the deaf community, 

has released a comprehensive report supporting the proposed measure. So far 

the report’s positive recommendations have been met with some resistance from 

the private sector because of fears that the proposed visual fire alarm measure 

will be too expensive to implement. 

“As the nation’s largest employer and landlord, the federal government is in a 

position to create the momentum for change. It needs to lead by example and be 

a good partner with local and state governments to support community livability.” 

--James Koski, Congressional Livable Communities Task Force 

The Role of the Federal Government in Creating Livable Communities 

In addition to acknowledging the key role that local governments play in 

supporting livable community objectives—because it is on the local level that 

many decisions affecting community livability are made—panelists agreed that 

the Federal Government also has an important role to play. While there are many 

examples of federal initiatives that address various community livability issues, 

there has not yet been a coordinated, comprehensive effort to tackle them, nor is 

there always agreement about how to proceed. Evaluation of the administration 

of federal disability and aging programs must take into account not only how well 

individual programs are being administered, but also how these programs affect 

and support the real day-to-day lives of people with disabilities and seniors. 

Panelist James Koski, deputy chief of staff for Rep. Earl Blumenauer (D-OR), the 

founder of the Livable Communities Task Force in Congress, provided several 

examples showing that the Federal Government is taking steps to support livable 

community objectives both on its own and in cooperation with state and local 
20 

governments. For example, the Department of Defense is helping to clean up 

closed military bases to prepare them for redevelopment, and the General 

Services Administration has an urban development and good neighbor program 

that has worked with local governments to support central business districts and 

preserve historic properties. However, these efforts and others are “scattershot,” 

said Koski, and a more comprehensive approach to supporting community 

livability on the part of the Federal Government is needed. Koski praised the 

Creating Livable Communities report because “it is another step in helping build 

a consensus and giving communities the resources and recommendations they 

need to take progressive steps. It is exactly the kind of thing that helps Congress 

address these livability issues as well.” 

Several of the panelists pointed out that one livable community issue where the 

Federal Government must play an active role is disaster preparedness. Sandy 

Markwood spoke of the lack of planning for the evacuation of people with 

disabilities and older people in the aftermath of Hurricane Katrina. Referring to a 

recommendation in the Creating Livable Communities report, which called for 

focusing on the Gulf Coast recovery and rebuilding to promote livable community 

outcomes, Nancy Starnes commented, “If a community is being rebuilt, and what 

is being built is not accessible, it sends a very strong message that mobilityimpaired people are not wanted in this community. And if accessible housing for 

people with disabilities and seniors is being built in flood plains, the message that 

sends is that these populations are expendable should something like Katrina 

happen again.” 

In the discussion about the Federal Government’s role, a lively debate ensued 

about the Office of Management and Budget’s (OMB) Program Assessment 

Rating Tool (PART), which the Federal Government uses to evaluate federal 

agencies’ administration of federal programs. Some observed that what might 

have started as a tool to evaluate agencies’ administration of programs has, in 

fact, become a tool to evaluate the programs themselves. Several panelists 
21 

commented that evaluations use inappropriate performance measures, resulting 

in many disability programs receiving low to moderate ratings. Janna Starr 

pointed out that one goal of PART is to standardize outcome measures across 

programs, but “one size does not fit all and there isn’t an outcome measure that’s 

common to all of the kinds of government programs there are.” In fact, said Starr, 

effective programs that serve people with disabilities have to be highly 

customized and do not lend themselves to this kind of measurement. Curt 

Decker added that “some of the great outcomes for people with disabilities and 

the elderly are not that tangible. A good outcome for a person with a disability 

might be that he or she got representation and had a chance to challenge the 

system. There is now no way to measure that.” 

Others expressed the opinion that accountability is needed in government-funded 

programs, and the best way to ensure that evaluators’ outcome measures 

accurately reflect what disability programs do is for people who work in those 

programs to get engaged in defining appropriate outcome measures, rather than 

leave it to examiners who have little or no knowledge or experience with disability 

programs. Sandy Markwood cited the example of the Administration on Aging, 

“which had a negative reputation with OMB on outcome measures for aging 

programs. Over the course of the past three years, however, they have turned 

that around by helping Area Agencies on Aging and State Units on Aging 

understand that they need to get involved in helping to define what those 

outcome measures should be. Instead of saying outcome measures are bad or 

outcome measures don’t tell the story of our programs, you need to turn that 

around and make sure that they do.” 

Michael Morris summed up the skepticism expressed by most panelists about 

current evaluation methods when he said, “We’re probably in our infancy in terms 

of understanding what might be appropriate performance measures,” and he 

enumerated the important questions that still need to be considered: “What are 

our methods of evaluation? What is our measurement system? What should be 
22 

the indicators that we use for evaluation of cross-government programs?” But 

Morris also challenged panelists to think about performance measurement in a 

new way, using the comprehensive livable community concept as a framework. 

“This broader concept,” explained Morris, “would help us understand what really 

happens to people in their communities and across government programs by 

including qualitative measures in addition to strictly quantitative ones,” which do 

not, everyone agreed, tell the full story. 

“Introducing things like tax incentives and zoning standards is great, but you also 

have to enforce them.” 

 --Day Al-Mohamed, American Council of the Blind 

The Role of Advocacy in Creating Livable Communities 

Several panelists pointed to what they considered an omission from the Creating 

Livable Communities report: the important role that advocacy plays in ensuring 

that statutes are enforced. Without advocacy and enforcement, there can be no 

guarantee that livable community measures will be implemented. 

Curt Decker made a clear and succinct statement about the important role that 

advocacy plays in ensuring that legislation intended to facilitate livable 

community objectives and improve the quality of life of people with disabilities 

and seniors actually is enforced: “It’s naïve to think that any statutes are selfenforcing. Everyone knows that without strong advocacy, both legal and 

nonlegal, and enforcement from the Federal Government, none of this happens.” 

To illustrate these comments, Decker related his organization’s frustrating 

experience with the trailers that were made available as temporary housing to 

some survivors of Hurricane Katrina: “We had to sue FEMA to make sure that a 

certain percentage of those trailers were accessible for people with disabilities. 

Having programs isn’t enough. The advocacy component is just as important.”
23 

In addition, Decker referred to the need for advocacy related to two other 

initiatives: the Workforce Investment Act (WIA), which was included in the 

Creating Livable Communities report as a positive example of consolidating 

multiple programs to improve ease of access, and Medicaid waivers, also 

included in the report as a positive example of options that advance consumer 

choice and community participation. WIA was passed in 1998 to better serve job 

seekers and employers through a new framework that brings together multiple 

federal employment and training programs into a unified system of support. This 

single system is anchored by comprehensive One-Stop Centers in each 

workforce investment area in all 50 states, 80 percent of which serve people with 

disabilities as well as people without disabilities. While Decker noted that the 

One-Stop concept seems like a positive support for people with disabilities, at 

least on the surface, “what we find is that money is being raided from the 

disability programs to support general One-Stop services, so we end up with 

One-Stops that are located far from people with disabilities, who have to travel 

miles to get there, and then once they are there, they can’t get in because there 

are stairs. This is a nice concept on paper, but in reality it doesn’t work so well for 

people with disabilities.” As for Medicaid waivers, Decker said that while they can 

be a useful tool to break down barriers and allow Medicaid money to be used for 

community living, there is potential danger that these “waivers can be used to 

undercut entitlements.” In both cases, said Decker, "there needs to be advocacy 

to make sure that such things don’t happen.” 

Putting these concepts into everyday human terms, Day Al-Mohamed said that 

people with disabilities cannot necessarily count on the good intentions of 

policies or programs to get their needs met. What happens, for example, if a 

person with disabilities tries but cannot get his or her housing needs met in the 

community? “I would like to believe that it’s a wonderful world and incentives will 

make everything possible for people with disabilities. But where should people go 

when they get stuck? There needs to be a fallback position, something people 

can do when things don’t happen as they should.” 
24 

Michael Morris seconded this viewpoint and summed up the discussion in this 

segment by saying that “civil rights protection and an advocacy component” must 

be at the core of any livable community definition. “It has to be part of the 

overarching framework,” he said. 

“There is a partnership opportunity between the aging network and the disability 

community around the livable community concept—a livable community that 

supports people’s independence and helps them live and age successfully.” 

--Sandy Markwood, National Association of Area Agencies on 

Aging

Themes and Recommendations 

The theme to which panelists returned again and again is the need for and 

importance of collaboration at all levels to achieve livable community goals. 

Referring to the Federal Government’s role, James Koski of Congressman 

Blumenauer’s office said that the livable community concept is something that 

both Democrats and Republicans can work on together: “This doesn’t have to be 

a partisan issue.” In addition to “reaching across the aisle,” Koski said that the 

Federal Government’s best role is not necessarily to solve livable-communityrelated issues itself, but rather “to be a good partner with local governments” and 

provide funds and support to local government-led, livable-community-related 

initiatives. 

Collaboration with the private sector is a related theme that surfaced several 

times during the panel discussions, particularly when the topic of employment for 

people with disabilities and seniors came up. Tari Hartman, an audience 

member, said that “building strategic alliances with the business community, like 

the U.S. Business Leadership Network” (a national business organization that 

uses a business-to-business strategy to promote inclusion of people with 

disabilities in the workforce) is necessary to give people with disabilities 

opportunities to work and achieve economic self-sufficiency. 
25 

Finally, several panelists stressed the need to build alliances between the 

various groups that work on aging issues and those that work on disability 

issues. Michael Morris said that the comprehensive livable community framework 

included in NCD’s reports is a “unifying and universal construct” that both the 

aging and disability communities can rally around and use to further their 

common agendas. “The framework redefines how we look at the things people 

with disabilities and seniors need to live in the community and how these things 

are funded. It’s not just health care, or education, or housing, or employment 

alone, but understanding holistically what makes up quality of life, whether you’re 

older or younger, whether you have one challenge related to daily living or you 

have more significant disability. The comprehensive livable community 

framework challenges the Federal Government not to look at just one program at 

a time, but to move outside the little tunnels of authority. It gets people thinking 

about such things as combining federal and state resources and public and 

private sector resources across the aging and disability authorities, and 

recognizes that there may be new ways to do things.” 

To enable this to happen, consumers have to get involved. “There needs to be 

grassroots support for the livable community concept, for the idea that a livable 

community is a community that values people of all ages and abilities,” said 

Sandy Markwood. “People need to start asking whether they live in a community 

that is a good place for people to grow up and grow old in, regardless of ability.” 

This requires empowering consumers to make assessments of their communities 

by providing education, such as through the National Resource Center on Livable 

Communities, one of the recommendations in NCD’s Creating Livable 

Communities report; tools such as checklists to help them evaluate housing, 

transportation, services, and other aspects of their communities; and support to 

help them take action to make their communities more livable. 
26 

Judging by the enthusiasm exhibited by panel participants and audience 

members in these discussions and their insightful comments, it seems fair to say 

that the livable community concept has real potential to help people think 

creatively, identify and collaborate around common issues, and improve quality 

of life for people of all ages and abilities. 

 

1

 National Council on Disability (2004). Livable Communities for Adults with 

Disabilities, p. 7. Washington, D.C.: National Council on Disability. 

2

 National Council on Disability (2005). The State of 21st Century Long-Term 

Services and Supports: Financing and Systems Reform for Americans with 

Disabilities, p. 15. Washington, D.C.: National Council on Disability. 

3 Livable Communities for Adults with Disabilities, p. 84.