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Supported Living Guidebook

Through Supported Living, individuals with developmental disabilities are able to live fully in the community. This includes living where any citizen in the community may live, developing relationships with people who do not have disabilities and are not paid staff, making daily decisions regarding how they will spend their time, and having control over future plans.

NEW web resource for North Carolina NCDHHS Inclusion Connects.

 

 

Chapter 1: What Is Supported Living?

Supported Living is an NC Medicaid Innovations Waiver service available to Innovations Waiver recipients. Supported Living services, by definition, are intended to provide people with any level of disabilities, the opportunity to live in their own home while receiving the services and support they need to live their lives. Supported Living and NC Medicaid Waiver services are administered by the NC Department of Health and Human Services (NCDHHS) and implemented by the regional Managed Care Organizations (MCO’s). The current and complete array of NC Innovations Medicaid Waiver services is identified in NC Medicaid Clinical Coverage Policies 8P. The policies include service descriptions, requirements, and qualifications for all Medicaid Waiver services, including Supported Living Levels 2 and 3.

Read Chapter 1

Chapter 2: Where To Start

Supported Living helps people with disabilities live independently in their own homes by offering them support. Here’s how to get started.

  1. Choosing a Care Manager
    First, you’ll need to meet with a Care Manager at your local management organization. They will explain what Supported Living services are available and help you understand how you can start using these services. They can also provide a list of agencies that provide these services.
  2. Choosing a Provider
    Next, choose a provider from the list. Talk to several agencies to find one that best first your needs and is taking new clients. Ask about the types of support they offer, how they involve you in planning your services, and their plans for emergencies.
  3. Plan with Your Team
    Once you’ve chosen a provider, you’ll meet with your care team to plan your move to Supported Living. This meeting will include your family, the provider, and the Care manager. They will help you figure out a timeline for moving and setting up your new home.
  4. Find and Set Up a Home
    You’ll need to find a home or apartment where you can live independently. This place should be rented or owned in your name, not the provider’s name. After finding a home, you’ll need to set up utilities, buy necessary household items, and plan your move.
  5. Organize Support and Staffing
    Finally you will arrange the support and staffing you need. This can be tailored to help you with daily activities and ensure you live comfortably in your new home.

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Chapter 3: How to Find a Home

Finding affordable housing is a challenge for individuals with IDD in North Carolina seeking independent living through Supported Living. Key points and options for housing are essential.

  1. Affordable Housing Costs:
    A household should spend no more than 30% of its total income on rent and utilities. For example, the typical cost for a two-bedroom apartment in North Carolina in 2023 is $1,023.
  2. Income Challenges:
    Many individuals with disabilities earn below the poverty level, making it diffi cult to aff ord regular market rents, which limits their housing options.
  3. Housing Assistance Programs:
    • Housing Choice Voucher Program (Section 8): This federal program helps low-income families, the elderly, and the disabled afford safe private housing. It has long waiting lists.
    • Public Housing: Managed by local housing authorities and funded by HUD, it’s available only to low-income families and individuals.
    • Permanent Supportive Housing: Offers long-term, affordable housing with supportive services for people with serious disabilities.
    • Targeting Program: Partners with local housing and health services to set aside housing units for people with disabilities.
    • USDA Rural Development Program: Provides affordable housing in rural areas for very low- and low-income tenants.
    • Check out various supports for purchasing a home including down payment programs and low interest loans.
  4. Legal Protections:
    The Fair Housing Act protects against discrimination in housing based on disability. It allows for:

    • Reasonable Accommodations: Changes in policies or services to help people with disabilities use and enjoy their home.

https://youtu.be/gbONoMkgc7s?si=ATzz91c-OtCmK8rA

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Chapter 4: Planning For the Move

Finding affordable housing is a challenge for individuals with IDD in North Carolina seeking independent living through Supported Living. Key points and options for housing are essential.

  1. Before the Move:
    • Team Collaboration: Everyone involved, including family and support staff, must work together to plan effectively. This helps ensure that the individual moving feels comfortable and that their needs are fully understood and met.
    • Setting Up Services: Make sure all necessary support services are ready and available before the move. This includes fi guring out daily needs, health requirements, and community participation.
    • Emotional Preparation: Address any worries or concerns the person and the family might have about the move, like dealing with new people or managing at a new place.
  2. Steps for Transition:
    • Assess Housing and Community Needs: Consider factors like transportation, proximity to work, and community accessibility
    • Financial Planning: Determine housing budgets and the potential need for roommates.
    • Explore Housing Options: Visit potential homes and neighborhoods. Get on waiting lists for affordable housing.
    • Finalize Housing: Once a place is chosen, complete all necessary paperwork, set a move-in date, and prepare for initial expenses like deposits and first month’s rent.
    • Plan for Moving Day: Arrange for moving services, pack belongings, and plan transportation for the move day.
    • Set Up Essentials: Open necessary bank accounts, buy household items, and transfer medical prescriptions.
  3. After the Move:
    • Settling In: Unpack, go grocery shopping, and get to know the new neighborhood.
    • Building a Support Network: Introduce yourself to neighbors and explore local community resources.
    • Ongoing Planning: Continue to review and adjust support plans as needed.

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Chapter 5: Who Pays for What?

When someone chooses Supported Living, they are responsible for their own living expenses like rent or mortgage, utilities, groceries, and home supplies. Here’s a simple breakdown of what costs are covered by whom and what financial supports are available:

  1. Individual Responsibilities:

    • Housing Costs: The person in Supported Living pays for their own housing and utilities.
    • Household Needs: They also cover groceries and any other household necessities.

  2. Service Provider Responsibilities: If the person or their family member is not the Employer of Record (EOR), the service provider handles the payment of staff wages and benefits.

  3. Financial Supports Available:

    • Innovations Waiver Services: May cover some costs related to setting up a home, like security deposits or essential furnishings.
    • Assistive Technology Equipment and Supplies (ATES): This can help pay for items that promote safety or independence.

  4. Community Transition Service: This service helps with initial costs when moving from a more restrictive setting (like a group home) to a Supported Living arrangement. It can include expenses like security deposits and setup fees for utilities.

  5. Managing Finances: Many individuals in Supported Living receive income from sources like Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). A representative payee, often a family member or a guardian, may help manage these funds and ensure financial eligibility for continued benefits.

Note on Budgeting: It’s crucial to maintain a secure management of financial tools like bank cards and ensure transparency during transactions. Regular budget planning is important to make sure the individual can afford their ongoing and planned expenses.

https://youtu.be/u4MsT9RRr9E?si=2QyndLX1TwMP-gwc

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Chapter 6: Working with a Provider Agency

When you use supported living services, the provider’s role is to support the lifestyle and personal choices of people with developmental disabilities, not to change them. Here’s how it works:

  1. Supporting Personal Preferences:
    The provider should respect and support the individual’s choices about how and where they want to live. This includes being flexible and finding creative solutions to meet their unique needs.

  2. Provider Responsibilities:
    The agency cannot own the home where services are provided and must respect the individual’s right to change providers without having to move. Providers must offer 24-hour support, including emergency backup, and should use technology and other methods to ensure safety when staff are not present.

  3. Staffing Plan:
    An individualized staffing plan is created based on the person’s needs, preferences, and a risk assessment. This plan includes regular and backup staffing to ensure the person’s health and safety.

  4. Role of the Direct Support Professional (DSP):
    DSPs assist with daily activities like meal prep, personal hygiene, medication, budget management, and more. They also help the individual participate in community activities, manage their health, and use any necessary mobility devices or technology.

  5. Overall Responsibilities of the team:

    • Communication: Building trust through clear and respectful interaction.
    • Person-Centered Practices: Helping individuals make choices and achieve their goals.
    • Evaluation and Observation: Monitoring health and wellbeing and adjusting services as needed.
    • Crisis Prevention: Identifying and managing risks to prevent crises.
    • Professionalism and Ethics: Maintaining confidentiality and respecting rights.
    • Health and Wellness: Supporting physical and emotional health.
    • Community Inclusion: Assisting individuals in becoming active community members.
    • Cultural Humility: Respecting cultural differences and adjusting services accordingly.
    • Education and Training: Continuously improving skills and knowledge.

  6. Partnership with the Team:
    The team members should view themselves as partners with the people they support, working creatively to solve problems and adapt to individual needs. They should maintain clear communication with everyone involved in the supported living arrangement and help the individual manage their life effectively.

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Additional Resources

This is a list of additional resources that could be helpful on your Supported Living journey.

 

Chapter 1:

 

Chapter 2

 

Chapter 3

 

Chapter 4

 

Chapter 5

 

Chapter 6