Where should people with disabilities live?
For most of United States history, the answer has been simple: somewhere else.
That was our answer when institutional care was the sole option for people with physical, cognitive and behavioral health disabilities. Institutions were generally built in rural areas, segregated from communities, ensuring that people without disabilities didn’t have to see, hear or think about the housing or support needs of people with disabilities.
The reality of institutions is grim. They have been notorious hosts of neglect and abuse. Even the best examples of institutions merely house people – they are not designed for people to thrive and connect.
Most states have moved away from institutional, large congregate settings as the standard of care for people with disabilities, although they were still the norm for people with intellectual disabilities through the end of the 20th century.
For the past 30 years, group homes have become the most recognizable option for people with disabilities who need support outside the family home. Though more individualized than institutions, group homes still have tended to segregate residents from their communities. Group home residents live together, eat together and often work and recreate together with limited authentic interactions with neighbors and other community members.
Colorado has been one of the lead states in developing and implementing the host home model, which operates similarly to foster care. In this model, a person with a disability lives in someone else’s home, paying rent and helping with food and utilities. A state program then pays for the person’s care.
The host home model is more individualized than the previous models, with usually one or two people with a disability living in a home with the host family. They are integrated into the family’s home and social lives.
But that can be the drawback – it is easy to fall into a pattern of including the person with a disability into the interests of the host home, rather than the other way around.
The latest model that is gaining popularity and enthusiasm is the concept of villages. In the village model, small homes or apartments are built in a small area with some shared supports and facilities, usually with shared staff living on-site. These settings have the advantage of giving the person with a disability some autonomy and independence while offering the efficiency of shared services, support for health and safety, and an approximation of typical community living.
That’s also the problem. It’s merely an approximation.
The real answer to the question of where people with disabilities should live is simply: anywhere.
The barriers aren’t surprising: lack of affordable housing, lack of accessible housing, high rent prices, no path to home ownership. When you factor in access to supervision or daily supports, you end up with these contrived settings.
We’re making progress. But getting closer to the goal isn’t the same thing as hitting the target. The ultimate win is people with disabilities in accessible, affordable housing with the supports and living situation they choose.
Tara Kiene is president/CEO of Community Connections.
