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Residential choices can be instrumental in achieving certain life goals. This category lists some common housing-related goals of individuals with neurodiversities, but there are many more possibilities. When looking at housing options, individuals and their families can consider whether the lifestyle, supportive amenities, physical amenities, etc. align with their goals. If applicable, they can also consider whether/how an LTSS provider and LTSS delivery model align with their goals. Listed in order of inward- to outward-facing goals.
Learn life skills
The individual aims to learn, practice and eventually master skills that they need or want in order to participate in everyday life. Examples include grocery shopping, taking public transit, cooking, financial management and social skills.
Grow in independence
The individual aims to learn and practice self-sufficiency in activities of daily living and to depend less on in-person support.
The individual aims to learn skills and have opportunities to meet new people and maintain relationships.
Get and maintain a job
The individual aims to secure and retain employment.
Participate as a member of the greater community
The individual aims to be integrated into the social fabric of the greater community to the degree the individual desires through hobbies, volunteering, civic engagement, recreational activities, etc.
The individual aims to find a home and communities that provide them with a daily sense of comfort, belonging and safety, from which they can engage positively in daily life.
Be safe at home
The individual aims to have access to support(s) needed for specific impairments (visual notifications of gas leaks, anti-scald devices, etc.), challenging behavior (self-injurious behavior, pica, etc.) and difficult decision making (predatory relationships, etc.).
Find a permanent home
The individual aims to find a home where an individual can live comfortably, with the support(s) they need, for the remainder of their life. This is often an important consideration while planning for when parents, family members or other providers of natural supports are no longer able to provide the level of care an individual needs due to advanced age or death.
Support needs refers to the level of individualized LTSS for activities of daily living that an individual with a disability needs for personal wellness and community integration. Support needs are characterized by both the frequency of care and the nature of care needed (behavioral, medical, etc.) . When identifying their support needs, individuals and their families should consider their needs on a typical day and their worst day. They can align their support needs with the LTSS delivery model and provider that best suits them. When looking at housing options, individuals and their families can consider whether a property, including the supportive and physical amenities, works with their support needs. Direct Support Professional (DSP) refers to the provider of individualized support for the person with an intellectual or developmental disability (I/DD) and/or other disability. The following are listed by increasing level of support.
No support needs
Not all neurodiverse individuals need long-term services and supports for activities of daily living.
The individual needs a DSP to check in with them every few days or as requested; the individual is self-sufficient the majority of the time.
The individual needs a DSP to support them with a few tasks each day but can be self-sufficient for most of the day.
The individual needs a DSP periodically throughout each day but can be self-sufficient for several hours at a time.
The individual has access to a DSP at all times, but the DSP may be shared with others; they are not the only person receiving support from the DSP the majority of the time.
Daily medical support
The individual needs the attention of a medically trained/certified provider to safely complete daily routine care, such as assistance with eating, breathing (including durable medical equipment), etc.
Due to symptoms of dementia or Alzheimer’s disease, the individual needs a safe environment, with extra structure and support to navigate the day.
High behavioral support
The individual needs specialized support(s) to mediate severe challenging behavior, significant adaptive skill deficits and medical/behavioral issues to participate safely in home and community life. Examples of severe challenging behavior include aggression, self-injury, pica, elopement and property destruction.
The individual needs the full attention and in-person support of at least one DSP at all times.
This category includes common methods for delivering Long-Term Services and Supports (LTSS) to individuals with intellectual and developmental disabilities (I/DD) . LTSS is individualized support for activities of daily living, such as meal preparation, hygiene, recreation and more. Individuals and their families can fund LTSS delivery with Medicaid or private pay; access and eligibility varies by state (see “Funding Options for LTSS” below). Individuals and their families can match their support needs and funding options for LTSS with the LTSS delivery model that best suits their needs. The following are listed in alphabetical order.
Agency-based rotational staffing
An individual who needs LTSS selects an agency that provides LTSS to recruit, hire, train, schedule and fire support staff for them.
An individual with LTSS needs lives in the home of their LTSS service provider. As a provider-controlled setting, the LTSS provider (host) can ask the individual to move. This is also referred to as adult foster care or the family teaching model , .
Intermediate Care Facilities for Individuals with Intellectual Disability (ICF/ID)
This optional Medicaid benefit provides comprehensive, individualized health care and rehabilitation services to individuals in need of active treatment services. ICF/IDs are provider-controlled settings that provide both housing and LTSS to residents .
Services and supports are provided by person(s) such as family, friends, neighbors and/or community members for no financial payment. Natural supports may be reciprocal, where supports, services and/or non-financial benefits (such as cookies and/or friendship) are exchanged instead money.
Not all neurodiverse individuals need LTSS for activities of daily living and therefore do not need LTSS delivery.
A person who lives on the same property (but not in the same home) as an individual with LTSS needs, who can offer LTSS on a scheduled or on-call basis. This is also referred to as a resident assistant.
When possible, an individual may have their LTSS needs met via remote service, using technologies such as video conferencing, smart-home devices and other enabling technology.
Residential transition program
An individual who needs LTSS may participate in a one- to five-year residential program that teaches greater autonomy in activities of daily living and life skills for maintaining relationships and employment. The goal of the program is for the individual to rely less on LTSS in the future. It is also referred to as a post-secondary transitional program.
An individual who needs LTSS is given a budget to spend on their LTSS based on an assessment of their support needs. They are responsible for recruiting, hiring, training, scheduling and firing support staff. Some states allow family members to be hired as support staff.
An individual with LTSS needs invites a person or family member(s) to live in their home to provide LTSS. Because private homes are consumer-controlled settings, the individual can ask their LTSS provider to move .
First Place–Phoenix, the first property of developer First Place AZ, offers 55 private apartments, along with active living and life-skills training for neurodiverse residents in a consumer-controlled setting. This intentional community and mixed-use development is also home to the First Place Transition Academy (a two-year program that helps neurodiverse adults build crucial skills for independent living and career-readiness) and the First Place Leadership Institute (a multidisciplinary, hands-on training center for professionals, educators, support staff and medical personnel, as well as a site for research and advancements in public policy). Thoughtful building design includes sensory-friendly and accessible qualities, relaxation and recreation spaces, transit access and security features.
First Place provides various supportive amenities, including community life and health and fitness activities. In partnership with leading educational institutions, the First Place doctoral and postdoctoral fellowship for autism research supports scholars working in applied research, assessment and intervention, family support, service coordination, community integration, community development and public policy. As residents, fellows enjoy the benefits of a First Place home—a living, learning laboratory and an enriching life experience. First Place–Phoenix is a supportive, inclusive community where residents can make friends, have fun, live independently—and have a place of their own to call home.
PBS NewsHour Special
The intentional community of 29 Palms is an apartment property for adults with autism who have graduated from the First Place Transition Academy and seniors (55+) who do not have autism. Senior residents (who live in 15 of the 21 units) and Academy graduates (who live in the remaining six units) demonstrate the spirit of community through natural supports (e.g., residents with autism helping seniors with heavy items or offering technology assistance with cellphones, apps, computers; seniors helping residents with autism with cooking or problem solving when “life happens”). The renovated property includes sensory-friendly design, adaptable features, smart home technology and convenient access to public transit. The project is a collaboration between the Foundation for Senior Living and First Place AZ.
Spring Valley, California
Individuals with I/DD are living longer than ever before , , but may need age-related memory care for dementia and Alzheimer’s disease as early as their forties , . In 2016, Noah Homes developed two 5,000-square-foot memory care homes for up to 20 people with I/DD, the first of their kind in the U.S. The memory care homes have a staff-to-resident ratio of 1-to-2, state-of-the-art technology, and opportunities to participate in groundbreaking techniques to fight Alzheimer’s, dementia and other age-related challenges.
The Yellow House is a single-family home located in the rural community of Carbondale, Colorado near Aspen in the Rocky Mountains. A family purchased an existing home for their young adult son with autism and renovated it in 2014 to meet his sensory and behavioral needs. Property management, residential support and day services are provided by Ascendigo Autism Services.
The Yellow House is located in a quiet residential neighborhood that is walkable to recreational amenities (parks, recreation center, bike and hiking trails) and to Main Street with restaurants, shops, creative spaces, a movie theater, public transportation and other small-town amenities. The house has three bedrooms, each with its own full bath, and design features for sensory comfort, safety, independence, privacy and ease of maintenance. An accessory dwelling unit (ADU) is rented to an Ascendigo employee who provides on-call backup and property oversight. The landscaped yard has swings, vegetable gardens, a pond, spa and patio. The original residents were three adults with autism whose families shared equal operational control through a cooperative-ownership LLC. Currently, one person resides there, but the goal is to have up to three residents living and thriving in the house together.
New Haven, Connecticut
Chapel Haven Schleifer Center offers student-housing apartments for young adults enrolled in the Center’s unique transitional programs designed for those with intellectual and developmental disabilities and other neurodiversities. Programs include the REACH program for adults with developmental disabilities and autism, and the Asperger Syndrome Adult Transition (ASAT) program for adults with social communication disorders. Each program has a unique set of supportive amenities. Chapel Haven recently added the Schleifer Adult Independent Living (SAIL) campus, an intergenerational apartment complex for program graduates who want or need lifelong support. SAIL enables residents to comfortably age in place in a non-institutional setting. This $45 million campus was built with universal design and, more specifically, sensory issues in mind. Chapel Haven also has a campus in Tucson, Arizona called Chapel Haven West, which offers a program for adults with social communication disorders.
The Arc Jacksonville Village is one of the first consumer-controlled planned communities for adults with I/DD in the U.S. Developed by the nonprofit The Arc Jacksonville, it offers affordable apartments with accessible design, smart home technology, and multiple recreation spaces and common areas. Residents have the opportunity to live independently in an inclusive and supportive residential community with peer-to-peer support. They enjoy robust on-site and off-site recreation options with walkable access to the broader community and public transit.
Fort Wayne, Indiana
CASS Housing is a nonprofit developer that provides consumer-controlled, customizable, affordable housing with onsite supports for residents with neurodiversities and I/DD. Each property consists of a single-family home with three accessory dwelling units (ADUs) or single room occupancy (SRO) units (depending on zoning in the local jurisdiction), a common space and communal kitchen. A neurotypical steward (resident assistant) lives in the house (with their family as applicable) and adults with neurodiversities and/or I/DD live in the ADUs. Each ADU is a private residence with its own bedroom, bathroom and kitchenette. Residents choose their preferred LTSS providers. The steward checks in with residents once a day and cultivates community life through weekly shared meals and monthly outings. All CASS Housing properties currently offer an independent living model. In the next five years, the plan is to develop a planned community offering family living and family-plus models for adults with additional support needs. This expansion has been facilitated by impact investments, including from a CASS Housing resident and several residents’ families.
Allendale, New Jersey
Crescent Commons is an affordable residential complex of the nonprofit developer Bergen County’s United Way/Madeline Housing Partners LLC. The complex has 17 affordable-lease apartments, six homeownership townhouses and a three-bedroom licensed group home. In this hybrid setting, LTSS in the group home is provider controlled, while LTSS in the apartments and townhouses is consumer controlled. The property is a short walk from downtown Allendale, Crestwood Lake and public transit (train and bus). Residents currently include families and neurodiverse adults.
Our Home – Cathedral Park (OHCP) is a cohousing-inspired community developed by the nonprofit Our Home, Inclusive Community Collaborative for people with diverse abilities, ages and income levels. With an anticipated completion date of 2022, OHCP will offer studio, one-, two- and three-bedroom condominiums architecturally designed to promote community connection and interaction, as well as the privacy of individual homeownership. The property offers both conventional market-rate ownership and subsidized units for qualified individuals. People who experience disability will live in 20-25% of the 28 units as homeowners or tenants. OHCP emphasizes community connection, belonging, cooperative decision-making, sharing, respect, diversity, reciprocity based on individual strengths and interests, and more. Its location offers convenient access to urban amenities, nature, public transit and Portland’s Cathedral Park.
The Marbridge campus offers a variety of residential options for adults with I/DD in a provider-controlled setting. Residents can maintain their preferred activities and friendships as their support needs change with age. The Village at Marbridge emphasizes independent and semi-independent living in a shared single-family home. Each cottage in the Village has three two-bedroom suites, a living area, kitchen, dining area and laundry room. Instructors provide training and oversight for independent living skills like shopping and cooking.
The Ranch at Marbridge offers assisted living. Residents can live in a private bedroom in one of The Ranch’s four lodges or in a shared room in a dorm setting. There are several communal areas, including living rooms, dining rooms and an enrichment center. Staff help with activities of daily living and are available around the clock. The Villa at Marbridge offers 24-hour skilled nursing care in spacious shared bedrooms. This faith-based community offers community life, activities on and off campus, health and fitness activities, relaxation spaces and more.
The Faison Residence is an apartment community where a third of the units are rented to adults with autism and other developmental disabilities who are generally independent but need occasional assistance and supervision. The remaining units are rented to the general public. The property was developed by the Faison Center—a school for children and adults with autism—that wanted graduates to have more options for housing and services.
As a hybrid setting for LTSS delivery, residents with autism and I/DD have access to smart home technology and other supportive in-home services in a provider-controlled setting while they transition from home-based services to more independent adulthood. The remaining units are consumer controlled. Neighbors look out for each other at this intentional and active-living community. The retail space of this mixed-use development is home to a health clinic, sandwich shop and salon, with security systems throughout the building. In addition to the on-site patio, community room and fitness center, residents have access to the Faison Center’s 10,000-square-foot, state-of-the-art community center for physical activity and entertainment.