Individuals with disabilities and their families often begin to explore various housing options as part of the transition from high school to the adult life. But know this: it is never too early to start! Many housing options and supports for home living involve meeting eligibility criteria, timelines, waiting lists, and limited availability to obtain financial assistance. One way to help your son or daughter is to begin planning early. Whether you are in the “shopping stage”, “exploring possibilities stage”, or “ready to act stage”, finding the perfect place to call home will require time, energy, and creativity to come up with the perfect plan.
As you begin to explore housing options for your son or daughter, it will be beneficial to know about the wide array of possibilities and supports. It will also be important to know what is important to your child. Preparing for home living means more than simply finding a place to live. Preparing for home living is also about having a life and a home. What does “home” mean for your son or daughter? What are the everyday rituals and routines that provide him or her with consistency, comfort and control? What supports and services are needed? Who will provide them and how will they be funded? Person-Centered Planning can help you discover and gather this information.
What does your child’s home look like?
Housing options generally fall into the following categories…
- Cooperative Housing
- Family Consortium
- Family’s, Friend’s or Relative’s Home
- Home and Community-based Services (HCS) Residential Settings: Host Home & Companion Care, Group Home
- Individualized Housing Options: Home, Townhome, Condominium, Duplex or Apartment Rental or Ownership
- Intermediate Care Facility for Individuals with an Intellectual Disability – (ICF-IID)
- Privately Funded Communities
Let’s take a closer look…
Cohousing is an intentional community of private homes clustered around shared space. Each attached or single family home has traditional amenities, including a private kitchen. Shared spaces typically feature a common house, which may include a large kitchen and dining area, laundry, and recreational spaces. Shared outdoor space may include parking, walkways, open space, and gardens. Neighbors also share resources like tools and lawnmowers.
Individuals interested in home ownership may organize to form a kind of corporation called a cooperative or co-op. Members don’t own their individual units; rather, they own one share in the cooperative. The co-op may be eligible for low-cost loans from the government. Section 213 of the National Housing Act (12 U.S.C. 1715e). Regulations are at 24 CFR part 200, subpart A, and part 213.
Family consortiums are typically formed by a small group of parents who pool their resources together to provide a home for their children. Homes (house, condominium, apartment, etc.) may be bought or rented. Support services are managed together. Check out this example of a family consortium agreement for additional information.
A person who has a disability may choose to live at home with his or her family for a variety of reasons. Regardless of why the decision is made, it will be important for family members to encourage responsibility and independence as much as possible. All members of the family should contribute to the household. Families may need to talk about household rules and each member’s responsibilities. It is fair to expect a young person who is working and receiving a Supplemental Security Income (SSI) check to share in the cost of food and household expenses. SSI rules can be complicated. For instance, people who live at home with their family will have their SSI check reduced by approximately one-third. However, their SSI check will not be reduced if parents notify the Social Security Administration they are charging their son or daughter their fair share for room and board.
Home and Community-based Services (HCS) Program Residential Settings
The HCS program can provide 24-hour residential assistance for people with intellectual disabilities or related conditions who live in a group home or a host home and companion care setting. Residents of a host home/ companion care setting or an HCS residence pay for their own room and board.
- Although there is not a specific legal definition of a “group home,” that term has come to commonly refer to group residential environments for individuals who have a disability. Texas’ privately operated group homes of four or fewer people are referred to as an HCS (Home and Community-based Services) group home.
- A Host Family home provides 24-hour supervision as well as support, structure, and guidance toward achieving individualized goals within a family home environment. Host care providers serve individuals who have a disability in need of a long-term supportive environment. There are two kinds of host family homes: corporate or family.
As of June 2019 151,295 people are waiting on an “interest list” for HCS services.Contact your Local IDD Authority (LIDDA) to place your child on the HCS interest list. Find your LIDDA’s contact information. Learn about your rights in an HCS program.
Individualized Housing Options: Home, Apartment, Condominium, Duplex, and Townhome Rental or Ownership
Greater opportunities now exist for individuals with disabilities to rent or own apartments, condos, townhomes, duplexes, or homes and receive the services and supports they need in the location of their choice.
Some home ownership and rental assistance resources are listed below.
- The Home Of Your Own (HOYO) program provides assistance for individuals interested in becoming a home owner.
- The Refinance and Mortgage Guide for People with Disabilities seek not only to provide the reader with the most relevant and essential resources needed to navigate processes regularly associated with real estate purchases; it also aims to educate the reader.
Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities – ICF/IID
Texas’ ICF/IID program provides residential and habilitation services to people with intellectual disabilities or a related condition.
There are two categories of ICF/IID in Texas:
- A community-based ICF/IID provides 24 hour residential services. Residents have access to comprehensive and individualized services and supports in their community. Most community-based ICFs/IID serve people in home across Texas that accommodate up to 6 residents; however, a few are larger. There is no waiting list or interest list for a community-based ICF/IID. However, the owner/operator of each ICF/IID can determine additional admission criteria for its facility (for example, age or gender limitations) and can maintain its own interest list based on occupancy rate. A person can select a particular ICF/IID; however, the ICF/IID must have a vacancy and the provider must approve the admission.
- State Supported Living Centers (SSLCs) provide 24 hour care to approximately 60-460 residents per center. There are 13 SSLCs across Texas. Centers are located in Abilene, Austin, Brenham, Corpus Christi, Denton, El Paso, Longview, Lubbock, Lufkin, Mexia, Richmond, Rio Grande, San Angelo & San Antonio. The Mexia SSLC serves primarily as a forensic unit for offenders and alleged offenders. Beginning in July 2010, and at six-month intervals thereafter, formal compliance reviews are being conducted at each facility as part of a settlement agreement with the Department of Justice (DOJ). Read the DOJ complaint here.
Learn about residents rights in an SSLC.
Privately Funded Communities
Privately funded communities are large group residential and vocational facilities for individuals with disabilities. Cost of care is not covered through Medicaid waiver funding. All services are paid through private funding, SSI, etc.
Funding supports and services, new initiatives & protections
New initiatives & protections
The Olmstead Decision & HCBS Settings Rule
Exciting new changes in the way a person with a disability can access housing and services have emerged, and others are being developed. A new system is evolving of self-directed models or “supportive housing.” These new models seek to provide the same supportive services for a person with disabilities in more integrated settings in the community. This new emphasis is actually a renewed government commitment to implement the “Olmstead Decision.” Living in the community is more satisfying for people and is more cost effective than living in institutions.
In 1999, the U.S. Supreme Court in the Olmstead v. L.C. decision interpreted the Title II of the Americans with Disabilities Act (ADA) to include supporting individuals with disabilities in the most integrated setting possible. A major barrier to states complying with Olmstead is a lack of affordable accessible housing, and access to home and community-based services to support community-based living. The decision applies to people of any age who have a disability.
Concurrently with the Olmstead Plan implementation, the federal government’s Centers for Medicare & Medicaid Services (CMS) released the Home and Community-Based Services (HCBS) settings rule, which says that all people in the United States receiving publicly paid long-term services and supports must receive those supports in the most integrated setting and have full access to the benefits of community living.
The Home and Community-Based Services (HCBS) settings rule requires that a person with a disability and his or her legal representative:
- have enough information to make informed choices about the type of services he or she receives
- are treated with respect and in a person-centered way so he or she can make decisions about how, when, and where to receive services
- have the opportunity to be involved in his or her community, including living and working in integrated settings and coming and going when and where he or she wants
The rule’s aim is to create higher standards for new settings and services and encourage the development of alternative approaches that support inclusive community models.
Institutional settings like hospitals, ICFs/IID and nursing facilities are not considered home and community-based. Examples of settings that have the effect of isolating people are: Farmsteads or disability-specific farm communities; gated or secured “communities” for people with disabilities; residential schools; and multiple settings that are co-located or operationally related and congregate a large number of people with disabilities together and provide for significant shared programming and staff, so that people’s ability to interact with the broader community is limited.
A key requirement for states is to create a “transition plan” to come into compliance with the new Home and Community-Based Services (HCBS) rule and decide if settings have institutional qualities, including where they are located and if they isolate people from the broader community.
Additional requirements apply to provider owned or controlled residential settings (corporate host or companion care or “group homes”), that relate to qualities such as community integration, rights and informed choice. Just as people without disabilities can enjoy housing of their choice, your son or daughter must have a lease or similar legally enforceable agreement that includes the same responsibilities and protections from eviction as all tenants in their jurisdiction enjoy. This means that your daughter or son should not be at risk for losing her or his housing due to disability discrimination. These rules are required to assure that your son or daughter has control of their own home.
A community living setting must allow your daughter or son to:
- have a lease or other legally enforceable agreement
- have privacy in their unit: lockable doors, choice of roommates, and freedom to furnish or decorate the unit
- have control of his or her own schedule, including access to food at any time
- have visitors at any time
- have a physically accessible setting
It is important to note that any modification of the above must be supported by a specific assessed need and documented in the person-centered service plan.
The new rule also applies to non-residential day services provided through a Home and Community-Based Waiver, including day training and habilitation and pre-vocational services.
CMS requires each state to create a transition plan detailing how the state will come into compliance with the requirements for home and community-based settings by March 17, 2019.
Fair Housing Act
The Fair Housing Act protects people from discrimination when they are renting, buying, or securing financing for any housing. The prohibitions specifically cover discrimination because of race, color, national origin, religion, sex, disability and the presence of children.
Independence is not measured by the number of tasks we can do without assistance, but the quality of life we can lead with assistance. – American’s with Disabilities Act (ADA) of 1990
Supports and services & funding resources
Federal Medicaid pays for medical services for individuals with disabilities and families with low incomes, including children, pregnant women, and people over the age of 65. The federal Centers for Medicare and Medicaid Services (CMS) administers Medicaid nationwide, provides funding, approves state plans, and ensures compliance with federal regulations.
Texas Health and Human Services (HHS) provides a range of Medicaid funded services and supports to Texans with disabilities. The Explanation of IDD Services and Supports (PDF) describes programs to help persons with IDD live in their own home or community home.
The home and community-based waiver program comparisons below describe the similarities and differences among the Texas Health and Human Services Commission (HHSC) waiver program services and eligibility criteria.
Texas Medicaid State Plan Services and Supports
- Community Attendant Services (CAS)
- Community First Choice (CFC)
- Day Activity and Health Services (DAHS)
- Nursing Facility (NF)
- Primary Home Care (PHC)
- Programs of All-inclusive Care for the Elderly (PACE)
Texas Long-term Services and Supports Waiver Programs
- Community Living Assistance and Support Services (CLASS)
- Deaf Blind with Multiple Disabilities (DBMD)
- Home and Community-based Services (HCS)
- Medically Dependent Children’s Program (MDCP)
- STAR+PLUS HCBS
- Texas Home Living (TxHmL)
Some community-based services and supports have interest lists because of funding limitations. People on the interest list have waited up to 17-18 years for services. While we don’t want to tell you what to do, we strongly encourage you to place your child on the interest list sooner than later. You can always decline services when offered if you determine that are not needed. People who are now receiving particular services or supports may add their names to the interest list for other services and supports.
The Housing Choice Voucher Section 8 Housing Choice Voucher program provides rental assistance payments on behalf of low income individuals and families, including the elderly and persons with disabilities. Qualified households may select the best available housing through direct negotiations with landlords to ensure accommodations that meet their needs. TDHCA pays approved rent amounts directly to property owners.
The Project Access Program utilizes Section 8 Housing Choice Vouchers administered by TDHCA to assist low-income persons with disabilities in transitioning from institutions into the community by providing access to affordable housing.
Social Security Disability Insurance (SSDI) is a program that workers and employers pay for with their Social Security taxes. Eligibility for these disability benefits is based on work history, and the amount of benefit is based on an individual’s earnings.
Supplemental Security Income (SSI) is a program that pays benefits based on financial need to children and adults who have disabilities, low income, and limited resources.
There is nothing more important that a good, safe, secure home.Rosalyn Carter
Here are some additional resources to assist you in your journey to find or create a place to call home.
How AT supports independent living: A Joint ITU/G3ict Toolkit
Personal Assistive Technology (AT) devices can help people with disabilities live more independent lives in their communities.
Diversion Slots, a Way of the HCS Waiting List
John Schneider shares his family story and what it meant to receive a Targeted Diversion slot.
Comprehensive Energy Assistance Program (CEAP)
CEAP is a utility assistance program. CEAP is designed to assist low income households in meeting their immediate energy needs and to encourage consumers to control energy costs for years to come through energy education.
Consumer Directed Services (CDS)
Consumer Directed Services allows people who receive services from the Texas Health and Human Services Commission (HHSC) to hire and manage the people who provide their services.
HCBS Advocacy Coalition
This site is a continuously evolving platform for aging and disability communities to post information and resources regarding the new HCBS settings rule and what each state is doing to meet these requirements.
HCS Group Home with Vacancies Search
This is an online searchable data base designed to identify HCS group home vacancies in Texas.
Housing Options, Resources, and Possibilities
This video explores housing options outside of the family home.
Long Term Care Provider Search
Visit this site for information about residential and home or community-based providers and facilities across the state of Texas.
Office of the Independent Ombudsman for the SSLCs
This office serves as an independent, impartial and confidential resource, assisting SSLC residents, their families and the public with services and related complaints and issues, which deal with the State Supported Living Centers. Reports, contact information and more can be found here.
Olmstead: Community Integration for Everyone
This site provides detailed historical and current information about the “Olmstead Decision.”
Supplemental Nutrition Assistance Program (SNAP)
SNAP offers nutrition assistance to eligible, low-income individuals and families.
Targeted Home and Community-based Services SSLC Diversion Vacancy Protocol
This document outlines the protocol for determining eligibility for a diversion slot.
Through Asking the Right Questions… You Can Reach Your Destination Guide
This guide walks individuals with disabilities and family members through a series of questions to consider so they will have the information needed to make informed decisions about residential support services.
Weather Assistance Program (WAP)
WAP is designed to help low income customers control their energy costs through installation of weatherization materials and education.
Once you make a decision, it may take time to pull all the components of your plan together. Limited funding availability of supports, services, and affordable housing may affect your options. Be creative. Remain flexible. Expect that there will be challenges along the way, but don’t be discouraged. With your commitment and careful planning, you can help pave the way for your child to live in the home of his or her choice.