DevelopingResidentialOptions for Individuals with Disabilities. Are you ready? Are they ready?







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Developing Residential Options

for Individuals with Disabilities


Toward Independent Living and Learning (TILL), Inc


, is a

private, human service agency established in 1980. The

mission of Toward Independent Living and Learning is to

develop and operate innovative services for individuals of

all ages and abilities which maximize their potential for

personal growth and independent living. We realize this

mission through individualized residential, vocational,

therapeutic, and support service opportunities in one’s



Individuals supported

Include people with



Mental Retardation

Autism Spectrum

Disorders including

Asperger’s Syndrome


Physical Disabilities

Learning Disabilities

Auditory and Visual


Behavioral Health


TILL’s Residential Services

TILL currently operates 45

group residences, 34

Enhanced Family Care homes,

and 11 Life share

arrangements. They take place

in a variety of settings

including urban locations with

access to public transportation

and amenities; in suburban

settings; as well as in more

rural areas.

Essential to the development

of each of these arrangements

is ensuring the participation of

the individual who is

ultimately going to live there

as well as the family members

who were going to be a part of

their lives.

Situations which are initiated

by families, it is almost as

important to match the

families as it is to match the

individuals who will be living



Clinical Services

Support and specialized

services offered include:


Occupational Therapy

Speech Therapy

Direct Support


Physical Therapy

Behavioral Specialists

Recreational Specialists

Vocational Specialists

Behavioral Health specialty

areas include:


Social Workers





Residential Models of

Services-different states call these models by

different names

Group residences have regularly scheduled hours of

staffing and structured activities and routines. Typically up to five people live together.

Enhanced foster care model-existing family unit which take the person into their home. Can be a single or married couple with or without children

Independent living arrangement in which the person is in his/her own apartment, condominium or house with up to 15 hours

Life Share-a model whereby the person could live in his/her own apartment, can have a non disabled companion who gets room and board and no pay or room with stipend, or board, with stipend. It could be one or two or even three people living together with the life share provider per week for assistance in daily living skills.

Any of these models can take place in the city, in the country, in the suburbs and can be a condominium, apartment, small house, owned by the individual, the parent (s), friend, other relatives

The physical site does not determine the model. Any one of the models can be sited anywhere depending on the right match to the personalities

• There are many creative arrangements which can be developed once the best model is chosen depending on a person’s assessed needs and abilities and interests.

• We have developed homes in cooperation with families on a farm, in an urban area with public transportation, with combined public and privately funded individuals. Only one’s imagination limits how the home will be developed but the first step must be determining how many people one will do best with, how much staff is needed, how much structure, etc.


In response to people’s varying and unique needs, TILL

operates many different types of residential programs.

Each setting is attractive and comfortable and reflects

individual personalities and choices. Essential to all of

our services is the investment in community connections,

friendships and opportunities for growth and new

experiences and challenges.

Program Models include:

Community Residences (group homes)

Life Shares

Creative Living Options (CLO)

Individualized Residential Supports

Specialized Home Care (foster homes)


What will it look like?

A residential arrangement will always fit into the

street and neighborhood in which it is located.

The standards for upkeep of yard maintenance,

exterior painting, etc. should be similar if not

higher than the surrounding homes

If a ramp or other accessible adaptation is

needed, it should be aesthetically done so that it

does not detract from the home or


The size of the home and the style can take many


Community Connections

Living in the community means being

connected through activities which are fun,

suit your needs and interests and allow for

the development of new friendships and

natural ways of teaching decision making





participating in bowling, softball, basketball

going to dance/social clubs, taking adult

education classes, community outing clubs,

trips and vacations.


Where to begin?

The first step in determining what type of

residential arrangement is best is to obtain an

assessment of needs and abilities which cover

very practical information leading you to decide:

The best model of service suitable

The staffing needed

The number of people who might live together


So you have an assessment…now what

do I do?

Decide whether you are in the “shopping stage”, “exploring

possibilities stage” or “ready to act stage”

Depending on which applies to your situation at this time (this is a

dynamic process and changes over time and circumstances),

contact others who might be in the same stage as well as the public

funding source in your state and area. In Massachusetts for

example, the state agency responsible for people with

developmental disabilities is the Department of Developmental

Services (DDS)

If your family member is still at school age, ask that a transition

services coordinator be assigned to you as early as possible so that

s/he can become familiar with your needs and interests, can do the

necessary testing to determine eligibility for funding and services if

you expect or want public funding, and can advocate for services

when the time is right.


Who should operate the residential


The decision as to who will operate the residential arrangement for your family member is one which should be made on the basis of personal situation, how much time you want and can devote to the management of the arrangement, your administrative talent in doing so, your financial capacity etc. “Most” families are seeking an outside professional agency which specializes in operating such services so that they can continue to be a loving support to their family member yet not have the primary responsibility for staffing and managing their services. Some families wish to run the services themselves and may form a corporate entity to

do it, since many states will not give funds directly to individuals and or families. In some states, families can receive funds through a fiscal intermediary agency even or a consumer driven model.

Some examples of both situations will be reviewed including ones in which TILL has consulted with families to develop the service after which the families manage them, as well as other situations in which TILL has worked with the families in the initial stages and then continues to be the service provider which runs the service. In both cases, the individual and his or her family is key to having input about the operations of the home.


Creating Residential Options

It is never too early to start thinking about it

One size does not fit all

The model you choose now will not be the model forever-life is dynamic, people change and

acquire new skills and develop different needs and interests. A person at 25 will be very different at 45. Don’t try to predict services for a lifetime; you will just be depriving yourself of the benefit of change and the fun of growing as new experiences form new skills and friendships.

Don’t get involved in a group setting with other families if you are not ready to compromise some

of the things you want and expect for your family member. This has to be a cooperative arrangement. Decide your priorities! They should not all carry equal weight. It will cause

complications in the family relationships and can spill over to the living arrangement and house members.

Don’t start until you are ready but do not necessarily wait until your child is ready. Typically one

party or the other is ready before the other party.

Even though a professional assessment is a very useful tool, make sure that you spend the time

using your own knowledge of your family member in thinking about what will and will not work. Refer to the Issues to Consider which follows to help you assess the model and elements which will make it successful. Do this together with your family member who will ultimately live there.

Purchasing the physical site before you have a group or specific plan in place can be problematic

since part of the success of developing a residential option is the excitement which is generated when everyone feels a part of the process. If only one person or family owns it, it is difficult to feel complete equality and investment in the project. It also limits the people who might want to join and be part of the household because they are not interested in the location you have selected.


Budget development

Staffing is the most expensive part of any residential


Remember that there are 168 hours in a week and that a

40 hour work week is all that is allowed without going into

overtime (very costly). If it is determined that 24 hour

staffing is needed, then it will be an expensive program and

you will probably need several people living together in

order to make it somewhat affordable.

Include in your budget development, staffing, occupancy

costs, e.g. rent and or debt service payments, food,

utilities, cable, transportation, insurance.


Issues to Consider

In helping you to decide if you are in a position to manage the services

yourself rather than through an agency, consider:

How much time do you have to devote to this venture?

What else are you giving up in your life to do this?

Can you handle staffing and recruitment as staff change and leave?

Can you handle the supervision and create a work environment

which encourages staff retention and growth?

Do you want the liability of personnel and real estate?

Do you have the funds to manage and cover expenses during

vacancies, increased needs even if temporary, etc.?

Can you be objective enough to ensure that your family member’s

needs do not take precedence over the others in the residential

arrangement thereby creating inequities which aren’t beneficial for

the long term living situation?


Staffing-the most expensive and

essential part of the program budget

Several factors enter into determining how much staffing is needed

Behavioral needs of the individualPsychiatric/emotional needs

Physical mobility needs requiring special physical assistance for daily living

Medical management issues. Can the person self medicating or requires assistancePersonal safety skills. Assess the risk and safety skills in the community

Activities of daily living skills and abilities e.g. cooking, shopping, dressing, money


Community safety skills

Based on an assessment of the above areas, one can determine whether 24 hour staffing or less is needed. Typically a Safety/Home Alone assessment is useful to determine the level of support needed. In most cases, it is difficult for a parent to accurately assess their child’s independence in these areas as they do not realize how much they do subtly to get the person through the routines of a day. By the same token, they don’t always see the person’s potential for acquiring these skills to a greater level of independence because it is hard to envision what living


Grouping of compatible housemates

Variables to consider

Age span-typically within a 10-15 year span makes sense

Mobility-not necessarily a factor to consider other than it might involve limitations

on which kind of housing one needs to find as well as consideration if it will impede the level of activity of other housemates

Location-the one item which is typically non negotiable for many families. Cost-willingness or ability of potential families to pay

Number of people living together-determined in part by the assessment

suggesting whether living alone, with few or many companions is best

Willingness of the potential residential candidate-are they ready or are you ready?

Often the two do not match. Don’t wait until both match. If the timing is right, then orchestrate enough situations which introduces the potential applicant to social situations which would encourage them to try moving and to feel

comfortable and eventually excited with the idea.

Visit other social situations, begin meeting with other families and their children

so that activities and relationships become the focus and the planning for the residential arrangement becomes a familiar idea and a fun project in which the family and individual can become excited and envisioning for themselves.


For more information and consultation regarding

developing and operating residential options


Dafna Krouk-Gordon

President, TILL, Inc.

20 Eastbrook Road

Dedham, MA 02026






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