Autism Residential Placement Options

Are you considering residential placement options for your loved one? No matter how much we love our child, teen or adult family member, and make every effort to care for her at home, a person with autism may need higher levels of specialized care, supports and supervision, which may better meet their needs in a residential setting.

Yet, coming to terms about finding safe and suitable residential placement options for your child or loved one outside the home and into a supportive community residence can be distressing and hard to do.

Learning what residential placement options exist and are available, and other information can help to reduce some of this stress. Remember to reach out or call upon your support system to help you and your family through what may be a difficult time.

There are various types of residential placement options available depending upon the level of care a person may need.

For information on how to start the process to obtain residential placement for your loved one contact the Developmental Disabilities Services Office (DDSO) in your state. Click here for contact information to a DDSO in New York State.

Contact your local school district for its assistance in this process. Particularly if a child is making poor progress in a day school, or home program, and residential placement is being considered or recommended for a child's Individualized Education Plan or IEP.

Traditional Certified Residential
Placement Programs

Traditional residential programs are established models of service, which provide a set of services based upon regulatory requirements. Three types of housing options are available: Traditional Certified Residential Options, Assistance and supports in non-certified settings; and assistance with Home Ownership.

A brief description of autism residential placement programs available in New York State are listed below.

Intermediate Care Facility (ICF)

An ICF facility usually range in size from 10 to 24 beds. This model provides 24-hour intensive support with medical and/or behavioral services and daily living skills training. ICF programs include room and board, continuous 24-hour supervision, and professionally developed and supervised activities, experiences or therapies developed for each individual by an interdisciplinary team. Services include occupational, physical, and speech therapy, and psychology, social work, nursing, nutrition and recreation.

Supervised Community Residence or Individual Residential Alternative (IRA)

An IRA model provides housing, supplies and services for persons with developmental disabilities who require 24-hour assistance and training in daily living skills. In addition, individuals receive assistance with supportive interpersonal relationships and supervision.

Community residences are designed to provide a home environment and a setting where persons can acquire the skills necessary to live as independently as possible. These residents provide housing with practice in independent living and individually determined amounts of oversight delivered in accordance with the individual's need for such supervision. Supervised community residence usually range in size from 4 to 14 people.

Family Care

Family care is a regulated program in which families or individuals are certified by the New York State Office of Mental Retardation and Developmental Disabilities (OMRDD) to provide care in their own homes to persons with developmental disabilities.

Extended family members may become a certified familly care provider for their own family member who has a developmental disability.

Supportive Apartment

This model provides housing, supplies and services for persons with developmental disabilities who require semi-independent living with less than 24-hour assistance and supervision. In addition, individuals receive assistance with supervision and training in activities of daily living. These residences are designed to provide a home environment and a setting where persons can acquire the skills necessary to live as independently as possible. These residences provide housing with practice in independent living and individually determined amounts of oversight delivered in accordance with the individual's need for such supervision. Generally, supportive apartments house two or three people.

Alternative Residential
Placement Options

A person with a developmental disability may live on their own or with friends with the support of residential habilitation, room and board supports and other generic services in an apartment, condominium, or house.

Residential Habilitation

Residential Habilitation at home includes assistance with acquiring, retaining or improving skills related to life safety and fire evacuation; to daily living activiities, such as personal grooming and cleanliness, bed making and household chores, eating and the preparation of food; and social and adaptive skills necessary to enable the person to reside in a non-institutional setting.

These services are distinct from any programming provided as day habilitation but will in some circumstances involve the person's involvement in learning situations outside of the home. The training and skills acquired is offered in and around the person's home, in the family home, their own home or home shared with friends.

Residential Habilitation may also be provided in a structured, supervised group home setting known as an Individual Residential Alternative (IRA).

Room and Board Supports

Room and board supports apply to persons living alone, with family or with others. The site may be a family home, a single-family residence or an apartment, owned or leased. A variety of other private or public sources of funding may be available to supplement the person's living costs.

The services provided under room and board cover the basic living needs. Room and board supports could be supplemented through affordable housing such as HUD Section 8, Rural Rental Assistance, and other rent subsidies, and Individual Support Services (ISS).

Other available programs to assist in room and board costs are the low-income home energy assistance (HEAP) and food stamp programs. Services provided include such items as: food, household supplies, furniture, utilities, telephone, insurance, home repairs, and rent.

Other Alternative
Residential Options

Home of Your Own Project (HOYO)

In New York State,
OMRDD can assist low to moderate income first-time home buyers who have a disability with the information and referrals necessary to purchase their own home in NYS.

How May Housing Needs Be Accessed?

In some areas, people in need of housing must first make a referral, usually through a state Developmental Disabilities Services Office or OMRDD to get on the waiting list. Once on the list, opportunities can become available in two ways:

Opportunities in Existing Homes

When a vacancy in an existing home or supervised apartment becomes available, the waiting list is reviewed. Those people with the greatest need for immediate housing that are an appropriate match are contacted.

What is an appropriate match? Several factors are considered in matching someone from the waiting list to a vacant bed. In most existing homes, bedrooms are shared, so most vacancies have a gender requirement.

Also, existing homes and supervised apartments have certain fixed staff ratios and levels of supervision. A persons with a need for intensive supervision and training will require a bed in a home with the appropriate level of staffing.

There is also an age factor in matching people with available homes. A young active adult would not be an appropriate match to a home with elderly, frail people. Consumers using wheelchairs and those with ambulatory difficulties must be matched with an environment in which there are few stairs or a wheelchair accessible environment.

A person may be asked to come to the house for a dinner visit and an overnight or weekend visit before any decision for admission is made. If the house does not "feel" right, a person can decline an offer without any negative affect on their waiting list status.

Creation of a New Home or Apartment with Supports

In New York State, a new housing option may be created through the "New York State Cares" program produced to do away with the waiting list by funding new development of housing options. This plan presents an exciting opportunity for individuals or small groups of friends to choose an agency to work with and create a housing option that's right for them.

Using a person-centered approach, a person and their family can work together to develop the housing and supports to meet their needs and choices.

Whatever option is selected -- moving into an existing home or creating something new -- people can and should continue spending time with relatives back at the family home, in the person's new home, meet for dinner and a movie or vacation together.

Source: Orange County Government, OC Department of Mental Health/DDSO Division

Selecting a Residential Placement
Service Provider

As you begin making your calls to potential residential placement service providers, have a notepad and pencil handy to jot down their answers to questions which can help you rule out providers who do not meet your standards.

Questions for Potential Residential Placement
Service Providers

How much experience does the agency have in working with persons who are developmentally disabled?

How much experience does the agency have in providing a residential service?

Where are the agency's group homes located? Can I visit any of these homes?

What does your agency do to make the transition as smooth as possible for my family member? Can my family member visit and participate in activities at the home prior to moving there?

Can I talk to any family members of the individuals living in a home being considered for a residential opportunity in order to get their views on the operation of the home?

If the home being considered for your family member is already opened, what is the appearance of the home, inside and outside? Or, if the agency is proposing to purchase or build a home, how long does that process take?

What kind of training does staff receive?

How many staff are on duty during the day, evening, nights, and on weekends and holidays?

What happens if someone calls in sick for work?

What is the rate of staff turnover? What are the reasons for staff turnover?

What kind of background checks or reference checks done on new employees?

Does the staff speak the language of the persons who reside in the home?

What is the condition of the agency vehicles? Are any equipped with lifts for persons who use a wheelchair?

What is your budget for program equipment and supplies, such as recreational equipment, exercise equipment, or other items?

How does staff deal with medical or other types of emergencies? Will I be advised of any emergencies involving my family member? How and how quickly?

What do the persons who live in the home do each weekday?

What activities take place at home or in the community during the week? On weekends or holidays? Are inclusive community activities promoted?

How would your agency work with persons who have part-time jobs or flexible employment?

How would your agency work with someone who has no day service?

If my family member were to be placed in one of your group homes, could I visit unannounced?

Special Considerations For Parents of
School-Aged Children

Each of your children has a particular teaching strategy that works for them. The group home staff needs to follow the same teaching strategy. You want to ask agencies what they know about that strategy and how they plan to put implement it.

Some agencies do not have any experience at all with children so you might want to find out why they think they could do it and what they would do differently in providing housing to children?

  • What are the key areas of training (not routine) that they will need to provide to serve your child?
  • How do they view their relationship with your child's teacher and Committee on Special Education?
  • What will they do to make that relationship positive?
  • How will they staff school breaks?
  • If the house will have a respite bed, how do they envision how the respite bed will work to minimize disruption to the household?
  • How do they envision parent involvement in this house?
  • Ask them to share their last certification deficiences.
  • Ask about their administrative structure.

Selecting an Agency for Residential
Placement Support

As you proceed in the process of selecting an agency interested in furnishing support and residential opportunity for your loved one, the degree of questioning becomes more specific to whether the agency can help meet the needs of your family member.

Questions to Consider Asking an Agency Interested in Providing a Residential Opportunity for Your Family Member

How is the plan of services developed for my family member, and how will the family be involved in the creation and updating of this plan?

Who can be contacted to discuss concerns about the plan once it is implemented?

What ideas do you have for working with parents/family members as involved partners?

How do you determine if additional services are needed for a consumer, or if a different residence is needed, for a person whose medical or behavioral condition changes?

What do you do to promote someone moving to a more independent living situation?

Can I review any reports, either from the agency or the DDSO, to review any trends in incidents that might have occurred in the home? What is your agency's procedure for addressing any serious concerns a family member raises about any aspect of the home (such as the condition of the home or issues with staff?

How would your agency handle parent suggestions or requests for change or improvements?

Try also to get a sense of the following:

  • Do the persons living in the home appear to be well-dressed and involved in activities?

  • Was the attitude of the staff you met with positive, negative, or neutral?

  • Did you get a sense of confidence from the staff with whom you met?

  • Did you get a feeling of warmth during the visit?

  • Does the home have a "home-like" feel?

  • Do the staff and the individuals living in the home appear to get along well?
Source: Hudson Valley DDSO

Other Residential Option Questions
to Consider

What rights or power to choose will my child have here?

Will s/he have a roommate or private room?

Who will supervise my child, what is the staff to consumer ratio?

What happens if my child is not feeling well and wants to stay in bed? Would s/he have to be moved somewhere else or can s/he stay in their own bed?

What clinical staff do you have to meet my child's needs i.e. nurse, social worker, psychologist, speech, OT, PT and recreation therapist? How often do they provide services?

What social activities does the group usually do for fun or entertainment?

Must all the consumers go to every activity together? Or do you provide individual services? What programs do you offer, both inside and outside the group home?

Is there a House Person, cook, or housecleaner? How often is this person available?

What about my child's special meals or diets?

Does my child have a choice on what s/he can eat for meals and snacks?

Is there daily living skill training available so my child can learn to become more independent? Will my child be able to get a job s/he can perform?

Is there a job coach available for him/her?

Residential Placement Concerns

Parents For Residential Reform (PFRR) is a project of the Federation for Children with Special Needs, that provides support, information, referral, and other information to parents and professionals regarding residential educational settings and group home care. PFRR has developed a network of families in similar situations throughout MA and now nationwide.

Parents and caregivers with questions or a loved one in residential placement and has experienced abuse or need help call the PFRR hotline toll-free at 1-800-672-7084 or visit their website.

Residential Placement Resources

For more information on
residential placement planning click here. Also, see our Autism Action Plan page for information, tips and ideas to help you access benefits, services and supports for your loved one.

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