CONSIDERATIONS IN IMPLEMENTING
SUPPORTED LIVING

Supported living represents a new way of thinking about people with disabilities and the provision of services. In the movement to develop services that are more responsive, new ideas have emerged that are worthy of consideration. As described below, housing alternatives, support, person-centered planning, individualized funding strategies and service brokerage potentially offer new opportunities for people. These are, however, new ideas and the practical implications for people are only beginning to be understood.

Housing

Supported living is grounded in the principle that all people with developmental disabilities have the right to lease or own their own homes. Within the past few years, there have been many developments in the area of home ownership. Successful efforts have been possible through collaboration among individuals, their families, advocates, service providers, non-profit housing organizations, bankers, and other interested community members who have been willing to look at housing in alternative ways.

These efforts have been guided by the principles that housing must be stable, controlled by the individual, and integrated in the general community. One of the lessons learned from these efforts is the importance of separating housing and support services. When housing and support services are tied together, individuals are vulnerable to funding changes and other pressures effecting the agency providing support. Furthermore, people are less free to change agencies from which they receive support services.

There are now numerous alternatives to pursue in assisting a person with a disability to acquire a home including the use of trust funds, housing co-operatives, subsidies and other creative funding strategies. Opportunities exist and can be created to meet an individual's preferences and circumstances. Because the idea of home ownership is so new, it is helpful to learn from others' experiences. The last section of this packet contains several resources that should be helpful.

Support

Traditionally, people with developmental disabilities have received most of their assistance from formal service providers. In addition, this assistance has been heavily influenced by funding, existing service arrangements and practices, and the fact that many people lack relationships with people outside of the service system.

In creating the opportunity for individuals with developmental disabilities to live as integrated members of their community, the term "support" has come to mean a different way of developing assistance. The support a person receives might come from service organizations or from informal and personal relationships. In most cases, it is a combination.

For people whose assistance has come solely from the service system, a first step in arranging support is to create the opportunity for people to get involved in their communities and to develop personal relationships. It takes a great deal of time, attention, and flexibility to facilitate informal support. But, in many cases, individuals are getting assistance in more natural ways and are less reliant on the service system. Informal supports, however, should not be used simply to avoid obstacles within the service system or to shift responsibility to people's families and friends. Many people will always need and choose to have formal services. Services that are based on a support approach are often described as "self-determined," "person centered," or "consumer controlled." This reflects the need to shift control so that the people receiving services are directing them.

Person Centered Planning

Person centered planning basically refers to a process of assisting people with developmental disabilities to identify and get the supports and services they need to live in their own homes, work, develop personal relationships, and get involved in their communities. It is distinguished from planning that is traditionally conducted and controlled by services organizations. Person centered planning is based on the assumption that what people want and need requires change within service organizations and communities and is designed as one tool to facilitate change.

An increasing number of service providers are attempting to implement this planning approach. Those that are successful take into consideration the great amount of resources, commitment, and change that it requires and are implementing it with small numbers of people at a time. Other agencies are adapting the approach for large numbers of people. In these cases, the process and outcomes are not significantly different from traditional planning. For an overview of the different types of person centered planning and a discussion of its benefits and limitations, see Finding a way toward everyday lives: The contribution of person centered planning (O'Brien & Lovett, 1992) that is listed in the annotated bibliography section.

Individualized Funding

In a few states (New Hampshire and Connecticut are examples), individualized, person-controlled funding is made available to at least some people. In contrast to the traditional rate-setting approaches used in most states, individualized approaches include developing a person-centered plan with people who care about the individual; based on that plan, developing a budget to cover the unique supports the individual needs; exercise of a variety of means by which the person or his/her representative can purchase the supports identified in the plan; and openness to flexibility and change so that as plans and needs change, supports can change as well.

This approach is so new that not much has been written about it as yet. States are discussing various means of implementing the approach, including direct cash payments and vouchers. The key is that the individual and/or his or her support network must control what supports are purchased and how they are organized. We believe that more states will experiment and move toward full implementation of an individualized funding approach.

Service Brokerage

While most systems utilize the traditional case manager or service coordinator to assist people in obtaining services, some are looking at the "service broker" or "resource consultant" as a person who could assist individuals and their networks to create a support package. This person could have a number of functions: teaching people and their networks about the resources and choices they have; helping people and their networks to develop their individualized plan and budget; assisting people and their networks in negotiating contracts or in other ways spending the support dollars that have been committed to them; and monitoring to ensure that people's choices are being honored and to assist if changes must be made. The service brokerage concept was developed in Canada, has been tried in England, and is under intense discussion in this country.

Return to Table of Contents