If you are planning to develop housing for persons with disabilities, whether it is a building or rent assistance vouchers, you should also consider if the targeted population will need supportive services to help them live successfully in the community. Supportive service needs vary by the individual and can change over time, so it is important to make sure the services are flexible and individualized. The services do not have to be offered on site, unless necessary. Offering services off-site make it easier to zone the development and to provide a housing environment that is more compatible to other neighborhood-based housing. Some housing programs now offier services through a mobile, multi-disciplinary team, such as the "ACT Team" model, which is useful for persons that are housed throughout the community through rental vouchers, and may be less inclined to coming in for services or need closer supervision. Home-based medical services may also be appropriate for persons with mobility impairments.
Common types of social services that may be needed include:
Case Management: coordination of services, information and referral for needed services and assistance in applying for benefits.
Employment: assistance in finding a job or linkage to supportive employment programs for persons with disabilities.
Education: can include assistance in getting a high school diploma or equivalency diploma, a vocational program, or enrolling in college.
Mental Health Treatment: counseling, psychiatric medication management, recovery groups, etc.
Substance Abuse Treatment: in-patient or out-patient treatment, AA/NA Groups, one-on-one counseling.
Primary Care Health Services: primary care medical services. If population is uninsured, tried to link them with a federally qualified health center in your area that is funded by U.S.Department of Health and Human Services/HRSA grants for Community Health Centers and Health Care for the Homeless. Having a nurse available as a member of a multi-disciplinary team may also be useful.
Other services: transportation, legal services, immigration services, financial assistance for food, furniture, utilities.
Planning for the costs of Supportive Services:
Costs can vary depending on individual need. Can be $2,500 to $10,000 per person a year
Some services can be paid for through alternative funding sources such as Medicaid, SAMHSA Grants, private foundation grants, etc.
Using Medicaid to Pay for Services:
Medicaid can be used to pay for supportive services. For an introduction to Medicaid, you can read the attached Medicaid Primer for Housing Officials developed by the National Academy for State Health Policy.
There is a new Medicaid option for States now to help pay for services to help persons in psychiatric institutions move into community based housing. This is similar to existing "waiver" or "diversion" options for the elderly and persons with developmental disabilities. In this new option under 1915(i), States can develop a budget-neutral program to pay for community based services for persons in supportive housing. The State can select the target population and cap the number of participants. The Bazelon Center for Mental Health Law is available for technical assistance to States. Bazelon has developed the attached presentation for more information.
Remember there are Medicaid variations from state to state. Contact your local State's Medicaid Director for further information.