Showing posts with label group homes for autism. Show all posts
Showing posts with label group homes for autism. Show all posts

Thursday, March 18, 2010

Autism Housing: What are the Options?

Here we provide a description of the types of of group homes, supportive living, supervised living, farmstead programs, community living options, family teaching model, cooperatives, shared housing and other residential models. For a state by state listing of group homes and residential service providers, go to www.myarchway.org and to talk with other parents who want to discuss this topic, go to www.myarchway.ning.com

Supported Living: Provides residential services to adults with developmental disabilities who are able to live in self-owned or leased homes in the community. Programming and instruction are directed by the consumer, not the program. Much emphasis in on community integration. Staff may help with some assistance in daily living. Supported living models may be more suited for individual with an established repertoire of life skills and those who do not engage in significant levels of challenging behavior.

Supervised Living: A residential model designed to provide services with greater oversight and direction than might be provided in a supported living context, but less than a group home. Homes may be self-owned or leased, usually with one or two adults with ASD per residence, there may be a number of such residences scattered though out the building or housing complex, allowing for greater staff accessibility oversight. Crisis support is available 24 hours/day. Daily schedules are generally provided, with input from the individual consumer, and staff is available to provide direct instruction or support.

Group Homes: Provides residential services in more typical homes in the community setting. Ownership of the house usually lies with the provider agency, as do staffing decisions. Most have fewer than 6-8 consumers living in one residence and in most states, there is a recent trend where developmental disabilities service systems will not provide funding support for group homes who house more than, three-four consumers. A primary goal of group home living is to promote increasingly greater levels of independence in the residents. Instruction is provided in daily living and self help skills including meal preparation, laundry, housecleaning, home maintenance, money management, hygiene, and showering, dressing and appropriate social interactions are provided by agency staff. Staff may be trained in behavior management interventions.

Farmstead Program: A residential model set within the context of a working farm. While isolated by nature farmstead programs endeavor to meet the complex needs of adults with ASD and other developmental disabilities through the development of individually designed instructional programs focused on farm living. Vocational training is generally limited to farm-related work (e.g., horticulture, greenhouse management, woodworking, animal care, landscaping, etc.) although other opportunities may be available in nearby communities. Residents work along with staff at tasks relevant to the care and maintenance of the grounds and the farm. There is often little in the way of community integration or community based-instruction and life skill instruction is generally provided relevant only to those skills associated with life within the farmstead community. Bittersweet Farms, in Whitehouse, Ohio was the first Farmstead Program for people with ASD established in the United States and remains the most widely recognized model for this, very specific, category of residential services.

Teaching Family Model: A specialized model of group home service provision where usually a married couple lives in the house in separate quarters rent-free and provides supervision to other members of the treatment team and direct service to residents.

Shared Equity Models – Co-ops and Co-housing
There are variety of shared equity strategies such as cooperatives, to help many families take their first steps to home ownership. A cooperative (co-op) is an autonomous association of persons united voluntarily to meet their common economic, social and cultural needs and aspirations. Cooperatives are member-owned and democratically controlled enterprises. Members may unite in a cooperative for many reasons--to get services otherwise not available, to get quality supplies at the right time, to have access to markets or for other mutually beneficial reasons.

These paths can lead to home ownership opportunities for those otherwise unable to afford to buy. In exchange for this opportunity, the new homeowner agrees that when they sell in the future, they will receive only a portion of the equity appreciation. This will keep the property affordable and enable future buyers the opportunity for home ownership. Over the last few years, strategies including community land trusts and affordability restrictions related to inclusionary housing, along with cooperative housing, have substantially increased the availability of shared equity options for both developers and government policy makers to enable low- and moderate-income families to become homeowners.

The National Capital Bank: Capital Impact group has an excellent manual called Home Base: The Playbook for Cooperative Development which lays out a full understanding of the basics of cooperatives, and provides a step by step process for developing co-ops. NCP Capital Impact integrates their efforts with Community Development Corporations and Community Based Organizations, government agencies, investors and foundations. Their mission is pulling together private and public resources to fully leverage resources for the communities we serve. They have worked extensively with the Department of Developmental Disabilities in Maryland, but provide assistance on a national level.

These are some models that they offer expert technical assistance in:

Co-Housing
The underlying components of cohousing include optimal community engagement, communal design features, resident management, common facilities, private multifamily units, lessened impact on infrastructure and lower energy costs. Cohousing units are generally more affordable than conventional housing units due to the multifamily nature of units, but also because a core component to cohousing is to control costs. Cohousing units tend to be studio, 1-bedroom and 2-bedroom units. Buildings are clustered, and therefore use less land. Shared utilities or facilities, like shared water or gas mains and laundry facilities, utilize less energy.

As cohousing is resident-led, volunteer groups may be established to provide aid to seniors while certain services may be conducted by contracted service providers. Cohousing designed for people with disabilities and seniors may pay more attention to ease of access for all levels of physical ability and incorporate universal design elements. Cohousing communities may include optional studio residences in or near the common house to provide living quarters for service provides/home health aides, allowing for partial or full 24-hour services provision.

Limited Equity/Shared Equity Housing Cooperative
You may also want to consider a limited or shared equity housing cooperative for the project. This would provide an opportunity for people with autism and the moderate/low income direct care workers to come together to cooperatively own a multi-family building. By forming a cooperative there is a shared ownership structure that can provide limited equity to perpetuate affordable housing and community living options for a variety of populations. You may want to look at consumer controlled housing models found in Minnesota - http://rtc.umn.edu/guide/

Community Land Trusts (CLTs)
CLTs are membership-based non-profit organizations that own the land under the housing in order to preserve affordability of these homes for future residents. I am not certain if CLTs can be owned/operated by a government entity but I don't see why the state couldn't be a member of the organization to preserve the use of the land for affordable community living. This model provides a long term lease or in some cases covenants on the title of the housing property to ensure the CLT is consulted and involved every time a home is sold. This model could be used in conjunction with both the Cooperative and Co-housing models but you would want to get a consultant to advise you of the best structure to maximize ownership and control by the residents.

Please also see a new paper on housing options for adults with autism on the SAARC website.

Help for Autism: Creating a Good Quality of Life for Adults with Autism

To find out more about how you can improve the quality of life for adults with autism, go to www.myarchway.org

Quality of Life may be defined as the degree to which a person enjoys the important possibilities of his or her life. Quality of Life for people with autism spectrum disorder consists of the same aspects of life as for all other people. But people on the autism spectrum have their own specific needs that must be met to ensure a good quality of life, to include the quality of the environment (group homes, residential facilities and community living options) in which the person with autism lives.

Quality of Life for adults with autism always starts with dignity and respect for each person, but in addition, there are also specific needs for an adult on the autism spectrum that must be met to ensure a good quality of life.

Dr. Susan Bryson wrote about the central needs of adults with autism and the essential qualities that need to be part of any services and supports for adults with autism to ensure a quality life. She summarizes the major needs of people with autism as:

The need to communicate wants and desires and to interact meaningfully with others;
The need for highly structured, predictable and familiar surroundings;
The need for work and recreational-leisure activities to give meaning to existence and provide a sense of accomplishment and being valued by others;
The need for a safe and caring place of residence chosen from options along a continuum of residential services;
The need for adequate and sensitive health services;
The need for advocates to ensure that rights and needs are respected and not violated, and that existing services are appropriate and adequate for each individual.
Regarding quality of life issues, the declaration by The Autism and Asperger's Syndrome Independent Living Association (whose majority membership are adults with autism) states:

Measuring “quality” assures standards that exceed current professional practice and calls for periodic redefinition of "best practices." Any measurement of quality should consider "the satisfaction and preferences of the individual with autism and Asperger's Syndrome first and foremost and the satisfactions of family, friends and advocates as secondary." Supports and services for people on the autism spectrum are said to have quality when:

They are designed with maximum control by people with autism and Asperger's Syndrome;

They would be acceptable to people without disabilities;
They are delivered in settings people without disabilities would use;
They are individualized and relevant to individual needs;
They are changed as the needs of individuals change;
They are adequately funded;
They help people develop maximum independence;
They respect the dignity and privacy of individuals.
To improve the quality of life for adults on the autism spectrum, the quality of their living environment, i.e., community housing options, residential facilities, residential programs, residential schools, group homes, supported housing, and housing alternatives should be carefully considered.

A quality environment:
Provides basic needs including healthy and appealing food, shelter, safety and social contact;
Provides a caring place of residence chosen from options along a continuum of residential services;
Provides a range of opportunities within the individual’s potential;
Provides control and choice within that environment;
Provides proper autism treatment for consumers and autism-specific training of direct support staff and their supervisors to ensure a proper understanding of the issues that affect adults with autism spectrum disorder; and
Provides augmentative communication tools, technology and related services to help consumers with autism communicate wants and desires and interact meaningfully with others.
Overall findings on Quality of Life (QOL) issues were reported in Quality of Life – Dream or Reality? Life for People with Developmental Disabilities in Ontario by Ivan Brown, Dennis Raphael and Rebecca Renwick (Quality of Life Research Unit, Centre for Health Promotion, University of Toronto, 1997).

Overall QOL scores were found to be "poor" (indicating a strong need to improve QOL) for people in large institutional settings and large residential facilities and residential schools for nonverbal people everywhere. People with autism are "nonverbal" in that they either do not use speech at all, or they do not use functional speech as compared with typical people. Moreover, adults with autism have seldom been appropriately supported with augmentative and alternative means of communication. The factors involved in QOL may be expressed more positively.

People with higher QOL were associated with the following characteristics:

Living in community settings;
Having verbal skills;
Having higher functional abilities;
Not seeing a psychiatrist or taking psychotropic medications;
Not having complex medical needs;
Nonverbal people with higher QOL were associated with:

Having an occupational activity of some kind;
Not having marked behavior problems;
Having leisure activities in community;
Having community access;
Being more independent;
Making own decisions;
Having opportunities available from which decisions can be made;
Having practical support from other people;
Having emotional support from other people.
Quality of life for people with autism spectrum disorder and other developmental disabilities consists of the same aspects of life as for all other people. But adults on the autism spectrum, many of whom can not effectively communicate their needs, have specific needs that must be met to ensure a good quality of life. Many of these needs center on a range of sensory integration issues they struggle with, and those need to be recognized and appropriately addressed by caretakers.

Quality of life for people with autism and other developmental disabilities is based on common aspects of life for all humans, but it also reflects, from person to person, varying degrees of importance placed on those aspects of life. Quality of life for all people reflects how satisfied they are with aspects of life that are important to them. People live in environments. Thus, quality of life results from the interconnection between people and the environments in which they live.

To find more information on how you can help improve the quality of life for adults with autism spectrum disorder and other pervasive developmental disorders, contact the www.myarchway.org

Also see our public service announcement on You Tube with Annie Potts called “A Perfect Storm” on developing community housing options for adults with autism http://www.youtube.com/watch?v=Jtdo6Zh4ok4

Autism Housing: What are the Options?

Here we provide a description of the types of of group homes, supportive living, supervised living, farmstead programs, community living options, family teaching model, cooperatives, shared housing and other residential models. For a state by state listing of group homes and residential service providers, go to www.myarchway.org and to talk with other parents who want to discuss this topic, go to www.myarchway.ning.com

Supported Living: Provides residential services to adults with developmental disabilities who are able to live in self-owned or leased homes in the community. Programming and instruction are directed by the consumer, not the program. Much emphasis in on community integration. Staff may help with some assistance in daily living. Supported living models may be more suited for individual with an established repertoire of life skills and those who do not engage in significant levels of challenging behavior.

Supervised Living: A residential model designed to provide services with greater oversight and direction than might be provided in a supported living context, but less than a group home. Homes may be self-owned or leased, usually with one or two adults with ASD per residence, there may be a number of such residences scattered though out the building or housing complex, allowing for greater staff accessibility oversight. Crisis support is available 24 hours/day. Daily schedules are generally provided, with input from the individual consumer, and staff is available to provide direct instruction or support.

Group Homes: Provides residential services in more typical homes in the community setting. Ownership of the house usually lies with the provider agency, as do staffing decisions. Most have fewer than 6-8 consumers living in one residence and in most states, there is a recent trend where developmental disabilities service systems will not provide funding support for group homes who house more than, three-four consumers. A primary goal of group home living is to promote increasingly greater levels of independence in the residents. Instruction is provided in daily living and self help skills including meal preparation, laundry, housecleaning, home maintenance, money management, hygiene, and showering, dressing and appropriate social interactions are provided by agency staff. Staff may be trained in behavior management interventions.

Farmstead Program: A residential model set within the context of a working farm. While isolated by nature farmstead programs endeavor to meet the complex needs of adults with ASD and other developmental disabilities through the development of individually designed instructional programs focused on farm living. Vocational training is generally limited to farm-related work (e.g., horticulture, greenhouse management, woodworking, animal care, landscaping, etc.) although other opportunities may be available in nearby communities. Residents work along with staff at tasks relevant to the care and maintenance of the grounds and the farm. There is often little in the way of community integration or community based-instruction and life skill instruction is generally provided relevant only to those skills associated with life within the farmstead community. Bittersweet Farms, in Whitehouse, Ohio was the first Farmstead Program for people with ASD established in the United States and remains the most widely recognized model for this, very specific, category of residential services.

Teaching Family Model: A specialized model of group home service provision where usually a married couple lives in the house in separate quarters rent-free and provides supervision to other members of the treatment team and direct service to residents.

Shared Equity Models – Co-ops and Co-housing
There are variety of shared equity strategies such as cooperatives, to help many families take their first steps to home ownership. A cooperative (co-op) is an autonomous association of persons united voluntarily to meet their common economic, social and cultural needs and aspirations. Cooperatives are member-owned and democratically controlled enterprises. Members may unite in a cooperative for many reasons--to get services otherwise not available, to get quality supplies at the right time, to have access to markets or for other mutually beneficial reasons.

These paths can lead to home ownership opportunities for those otherwise unable to afford to buy. In exchange for this opportunity, the new homeowner agrees that when they sell in the future, they will receive only a portion of the equity appreciation. This will keep the property affordable and enable future buyers the opportunity for home ownership. Over the last few years, strategies including community land trusts and affordability restrictions related to inclusionary housing, along with cooperative housing, have substantially increased the availability of shared equity options for both developers and government policy makers to enable low- and moderate-income families to become homeowners.

The National Capital Bank: Capital Impact group has an excellent manual called Home Base: The Playbook for Cooperative Development which lays out a full understanding of the basics of cooperatives, and provides a step by step process for developing co-ops. NCP Capital Impact integrates their efforts with Community Development Corporations and Community Based Organizations, government agencies, investors and foundations. Their mission is pulling together private and public resources to fully leverage resources for the communities we serve. They have worked extensively with the Department of Developmental Disabilities in Maryland, but provide assistance on a national level.

These are some models that they offer expert technical assistance in:

Co-Housing
The underlying components of cohousing include optimal community engagement, communal design features, resident management, common facilities, private multifamily units, lessened impact on infrastructure and lower energy costs. Cohousing units are generally more affordable than conventional housing units due to the multifamily nature of units, but also because a core component to cohousing is to control costs. Cohousing units tend to be studio, 1-bedroom and 2-bedroom units. Buildings are clustered, and therefore use less land. Shared utilities or facilities, like shared water or gas mains and laundry facilities, utilize less energy.

As cohousing is resident-led, volunteer groups may be established to provide aid to seniors while certain services may be conducted by contracted service providers. Cohousing designed for people with disabilities and seniors may pay more attention to ease of access for all levels of physical ability and incorporate universal design elements. Cohousing communities may include optional studio residences in or near the common house to provide living quarters for service provides/home health aides, allowing for partial or full 24-hour services provision.

Limited Equity/Shared Equity Housing Cooperative
You may also want to consider a limited or shared equity housing cooperative for the project. This would provide an opportunity for people with autism and the moderate/low income direct care workers to come together to cooperatively own a multi-family building. By forming a cooperative there is a shared ownership structure that can provide limited equity to perpetuate affordable housing and community living options for a variety of populations. You may want to look at consumer controlled housing models found in Minnesota - http://rtc.umn.edu/guide/

Community Land Trusts (CLTs)
CLTs are membership-based non-profit organizations that own the land under the housing in order to preserve affordability of these homes for future residents. I am not certain if CLTs can be owned/operated by a government entity but I don't see why the state couldn't be a member of the organization to preserve the use of the land for affordable community living. This model provides a long term lease or in some cases covenants on the title of the housing property to ensure the CLT is consulted and involved every time a home is sold. This model could be used in conjunction with both the Cooperative and Co-housing models but you would want to get a consultant to advise you of the best structure to maximize ownership and control by the residents.

Please also see a new paper on housing options for adults with autism on the SAARC website.