Silver Pilot Program

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Dear Congressional Representatives:

Advocates from the disability and aging communities support the Emergency Coronavirus Relief Act of 2020 - and call on Congress to ensure that at least $25 million of the funds be dedicated to the "Save Institutional Lives Via Emergency Relocation" (SILVER) program. The SILVER Pilot Program is a nationwide test project that will provide emergency relocation options and supports to residents of congregate care facilities facing high COVID risks. Channeled through the Administration for Community Living, and administered by recognized national networks of service and advocacy organizations, this pilot will develop and model safe, orderly programs designed to dramatically reduce rates of infections and deaths in institutional settings. People living and working in congregate care facilities – which include nursing homes, rehabilitation centers, long-term psychiatric facilities and various group settings for people with intellectual and developmental disabilities – are at far greater risk of infectious outbreaks than people in non-congregate settings. These institutions require residents to live in close quarters, share sleeping, dining and activity spaces, while staff move from person to person in quick succession. Such routines make congregate care less safe, resulting in inordinately high rates of infection amongst both residents and staff. Shelter-in-place strategies during the Coronavirus pandemic have failed to save over 100,000 lives in these facilities, 40% of the total deaths in the country. National data from many other kinds of congregate settings have yet to be systematically collected, much less analyzed and reported. Safe emergency relocation strategies could have spared many from avoidable infections and death this past year and, implemented now, could help prevent significant numbers of future fatal infections.

• Providing protective gear, training and testing has not done enough to reduce the inordinate rate of spread in these settings. For example, people living in nursing homes are still 5 times more likely to contract Covid-19 than their neighbors in non-congregate settings. Nationally, nearly 7% of facility residents have died so far, compared to 0.09% of the overall national population. Each new outbreak sees far higher rates of resurgence in institutions than in the community at large.

• Relocation efforts in other congregate settings have been proven effective. Infection rates have dropped dramatically in homeless shelters that implement relocation programs. After about 1,800 individuals were relocated from Chicago shelters, the positivity rates in those shelters dropped from 50% to 2%. Many congregate care settings have resorted to ad hoc evacuations, putting residents and workers into unnecessary risks, ones that planned relocations would avoid.

• Denying people in institutional settings opportunities for safe refuge deprives over two million Americans of their human and civil rights. The SILVER Pilot Program will:

• Activate community transition and support agencies (such as Centers for Independent Living, self-advocacy and psychiatric survivor organizations) to work in concert to offer high-risk congregate care residents the option to take refuge in temporary non-congregate settings;

• Provide technical assistance to organizations working with underserved congregate care populations that may seek emergency relocation options;

• Provide funds for temporary housing, healthcare and social support services, transportation, essential equipment, food and other basic necessities;

• Coordinate ongoing supports from Medicaid, Long-Term Services & Supports, Federal Emergency Management Agency, and other federal, state and local resources, and;

• Develop benchmarks to assess outcomes and provide relocation guidance for federal, state, and local emergency operation plans. Please designate funds for the SILVER Pilot Program in the upcoming Federal Relief Package. Sincerely,