Best practices and regulations recognize that both housing and services are essential for individuals with disabilities and that these two items should be delivered independently of one another. Regulations like the Home and Community Based Services Settings Rule recognize the challenges posed when the same agency or individual provides (or controls) housing and services for a person with disabilities. If an individual’s service provider is also their landlord, it makes it very difficult and almost impossible for them to fire or change their support team without also putting their housing at risk. Decoupling housing and services means that people with disabilities have more choice and autonomy, and it allows programs to better address the diversity across disability through support individualization.
In housing, we should consider both design features, design values and elements, and how a building is operated. Specific design features of the space— bathroom layout, number of bedrooms, counter heights, or similar— can be designed to support specific access needs. Those often need to be individualized and should be created to support diverse needs and preferences. Values were more universal. Our workshop data—including people with and without disabilities— showed individuals value the same basic principles in where they want to live. Our research showed that the majority of all participants desired somewhere clean and well-maintained, with natural light and access to green space. Safety and clear navigation also came up as universal preferences to make living easier. Flexibility to adapt spaces for personal use or need were also a common theme, whether to add a space to work at home or adjust a kitchen to support wheelchair access.
Where we saw the biggest variation was not in physical housing preferences, but in service needs. It is clear that service needs and preferences are incredibly individualized, and vary distinctly from person to person. Some people use no services, other access just a few hours of support a week, and others use staff 24/7. People utilize multiple and diverse service systems. Some people pay for their services privately and others use public programs and agency-funded supports. The diversity of service needs and preferences only increases with programs like self-determination. Recognizing and understanding the distinction between housing preferences and services needs, we should develop housing and services independently. This independent but simultaneous development of housing and services means that we can achieve scale with more universal housing interventions while keeping services robust and personalized.
As we develop housing and services independently and allow individuals to make distinct choices about both, it is helpful to consider how service needs can impact housing preferences and how an individual’s physical space can impact their ability to receive services or live most independently. It is also important to consider how an individual is able to direct their services in a way that allows their housing to be a place where they can most thrive. It’s also important to ensure those developing, designing, and operating housing consider the diverse service systems an individual might access or the kinds of supports they’ll use once they live there. Decoupling housing and services doesn’t mean the two can’t be reinforcing to support the highest level of access, inclusion, and self-determination.
While housing and supportive services elements are fundamental, we believe that these two elements are actually necessary to support a crucial third element: community life. The Kelsey’s view is that a disability inclusive housing project is not just about the physical space or the supportive services, but about how those two things work in tandem to allow people to experience thriving community life. If we stop and think about it, this isn’t a disability-specific issue. All people need a place to live alongside certain services and programs that are specific to their needs and interests. People enjoy different physical spaces and need different types of supports, but what is universal is how the combination of physical space and services enable a larger external community life.
If we build housing and develop services without thinking about community life—key facets like relationships, employment, recreation, spirituality, and connection—there will never be true inclusion and autonomy for individuals with disabilities. We express this idea through a triangle visual, in which accessible and affordable housing and individualized supports and services provide the foundation that allows for thriving community life. Affordable and diverse housing coupled with robust services and supports isn’t the end, but a means to an end. Thriving, meaningful, rich community life is the end goal we should be working towards for all people with and without disabilities.