Housing Options: Choice vs. Regulations
To meet the requirement of Section III.D.3 of its Settlement Agreement with the U.S. Department of Justice (DOJ) that the state move residents with intellectual and developmental disabilities out of the current training centers and into community based settings, the Commonwealth of Virginia plans to close four of the state operated training centers and add 4,170 new ID Waiver slots. The Southeastern Virginia Training Center will remain open and provide 75 residential beds.
The plan has sparked a statewide discussion among advocacy groups such as the New Voices Initiative(sponsored by the Partnership of People with Disabilities) http://www.partnership.vcu.edu, housing and service providers such as Virginia Supportive Housing and of course, various government agencies, to name a few.
Generally www.cdc.gov, we have been hearing more and more discussions about what these housing options “should look like.”
They include living at home with family, alone in small apartments, or in two- or three-person group homes. I’m also hearing opinions that these individuals “should” not have roommates and “should” be out of the home working each day. Most of these comments come from policy makers and individuals who enforce our regulations. Often, the discussions imply we need to limit, rather than expand options for consumers.
But I believe all of the options mentioned are excellent choices, and each can represent a vital part of a continuum of care in Virginia. As a family member of a consumer, I wanted my loved one living at home with family and supports in place. However, as my loved one’s medical needs became more complicated, I was just as appreciative of a higher level of care that could meet her medical needs.
We should be encouraging new staffing and residential models and discussing how to incorporate smart technology into the various levels of care. Based off of current reimbursement rates, most homes are staffed with Direct Support Professionals (DSP) instead of clinical professionals. However, by increasing clinical expertise in the residence, we may be able to decrease the total number of DSP’s required to staff residential settings. Homes staffed with therapists, board certified behavior analysts, and behavior specialists would add a level of clinical support not currently seen in most models. Smart home technology should also be discussed prior to the “optimal” number of residents in a home. This has the potential to be one of the largest drivers to increase functional autonomy. Maybe we should be looking at funding residential options with increased clinical expertise and smart home technology instead of discussing “how many” residents should live in one home. If we truly want to provide the best residential options to the citizens of Virginia, we should consider funding for improving current options as well as exploring new options. Virginia does not have enough housing options to meet the current demand. We should not be discussing what limits we should impose on our levels of care, but rather, how we can expand and improve our current options.
Consumer choice should be the determining factor of where the consumer lives, who the consumer lives with, and type of environment the consumer lives in. We can make these determinations in each client’s person-centered planning meetings. Some consumers want an actual roommate while others prefer a room to themselves. Some might want to live with one or two housemates, while others might prefer four or five.
We should spend more time respecting individual choice instead of trying to regulate and dictate what environment we think our consumers “should be” living in. Bottom line, we should never support housing policies that limit client choice. www.autismspeaks.org