In the United States
Supported living has been defined in diverse ways in the US, including early conceptualization in New York as integrated apartment living, and one early definition by the state of Oregon: "Supported living is defined as persons with disabilities living where and with whom they want, for as long as they want, with the ongoing support needed to sustain that choice." "Supported living...its simplicity is elegant. A person with a disability who requires long-term publicly funded, organized assistance, allies with an agency whose role is to arrange or provide whatever assistance is necessary for the person to live in a decent and secure home of the person's own."O'Brien, J. (1993). "Supported Living: What's the Difference?" Lithonia, GA: Responsive Systems Associates. As a form of community living development, supported living became identified with certain approaches to services and community, including the own home initiatives. These services involved an understanding of "formal" and "informal support" (and their relationship), and changes from "group thinking" approaches (e.g., ten intermediate care facilities for 15 persons each) to planning services for, with and by the person "targeted to be served."Taylor, S., Racino, J., Knoll, J. & Lutfiyya, Z. (1987). "The Nonrestrictive Environment: On Community Integration for Persons with the Most Severe Disabilities." Syracuse, NY: Human Policy Press. For example: "Supportive living represents a movement within the (intellectual and) developmental disabilities field to provide support services in regular housing to adults with disabilities. Direct support services can be provided by paid staff, including live-in roommates or boarders, paid neighbors, a person hired as an attendant, a support worker or personal assistant, as well as more traditional agency and (modified) shift(live-in) staffing. Professionals, friends, families, and other "informal supports" can also assist people to live in their homes. Supported living may be joined to a movement toward decent, affordable and accessible housing." Supported living in the US has multiple known origins, including: * The development of a service category of community living for people deemed capable of more independent living (also known as semi-independent living). * As a major reform initiative in the US to provide more choices, more integrated and more regular homes and apartments for people with the "most severe disabilities". * As part of organizational studies during that period (i.e., programs, agencies, and to some extent, state, regional and county systems), including differentiating family support for children and supportive living for adults.Racino, J. (1991). Organizations in community living: Supporting people with disabilities. "Journal of Mental Health Administration", 18(1), 51-59. * As state reform and development to a supportive living approach, involving new service structures, program development and financing.Racino, J., O'Connor, S., Shoultz, B., Taylor, S.J. & Walker, P. (1989). "Moving into the 1990s: A Policy Analysis of Community Living Arrangements for Adults with Developmental Disabilities in South Dakota." Syracuse, NY: Syracuse University, Center on Human Policy, Research and Training on Community Integration. * As a federal initiative to define and fund supportive living (and services and supports, such as personal care, respite care, environmental modifications, case management, chore services, companion services, skilled nursing, supportive living coach). * As provider and agency accounts, and organizational development (e.g., leadership, person-centered, individualized and flexible support services). * As part of the movement toward direct support professional and community support workers in the US and other countries such as Canada. * As parent and "service user" accounts of supported living, homes and support services, and as linking with self-advocacy efforts in states in the US. * As linking with independent living as supportive living in the community for "special population groups" or persons then "deemed in need of institutional settings", including nursing homes. * Finally, as federal, state and provider term applying to "all sorts" of community based living services (i.e., intellectual and developmental disabilities field). Recently, in one state that term even referred to a segregated residential campus, including for children, the antithesis of supportive living ideals and principles.Evolution of the concept
Supported living also developed along different trend lines in the US, two of which included a broadening of the community living concepts in the new community paradigms of community membership of support and empowerment of conversion from an institutional to a community paradigm of person-centered planning of community regeneration (and neighborhood assets) and the service system change to housing, homes and personal assistance and supports in quality community living. Supportive living was an ally ofCommunity participation
First, part of leadership (e.g., federal financing, state leaders, agency providers, knowledge dissemination networks) was back to the broadened concept of "community living" based on emerging concepts and practices in "community participation." Supported living linked with the concepts of integrated recreation, inclusive education with community opportunities, community membership, self-determination, "community seeding", "person-centered", and personalized supports. This resulted in projects such as the Community Opportunities Project of the Louisiana Developmental Disabilities Council, which were based on roles and relationships such as: Paul becoming a church member, fiancée, health club member, good neighbor, regular at Fred's Country Western and coffee shop, and self-advocate with statewide recognition.Supportive living
Second, the concept of supportive living was broadened from a service category of a residential program (i.e., facility-based program model with bundled services) to bridge the gap toward the independent living concept of housing and personal assistance services (health-funded), the concept of regular homes with the availability of "intensive support services" (special population groups, "severe disabilities"), a "range of community support services" (e.g., community counseling, recreation support personnel), decent community life (e.g., community employment, financial security), and principles of community and self-determination/choice. This agency and systems change work was based on the identification of leading practice of organizations supporting people with disabilities in the community, including the following program design components: the separation of housing and support, home ownership and leasing, individualized and flexible supports, and individual choice. This program design requires "service coordination/case management/service broker/support facilitator", "individualized funding" and "person-centered approaches to planning and supports". This framework has been used in the design of a person-centered course in community services and frames the supported/ive living approach of university doctoral students to graduates.Housing and "homes of our own"
Generally, though the focus remained on making people's places into "homes of their own" which became a federal initiative to also explore other housing and support options on the local levels. On the service configuration and program design levels, a multi-case study research design was used to explore the five identified characteristics of a "housing and support" approach: the separation of housing and support, "home ownership", including tenancy, close tie among assessment, individual planning and individualized funding, and flexible and individualized support services, and choice. Separate developments were proceeding on personal assistance services which began with the independent living movement led by leaders such as now Honorable Judith E. Heumann and late Ed Roberts; it remains current today (E.g., Center for Personal Assistance Services in the US of San Francisco State University, California; then the Rehabilitation Research and Training Center on Center for Personal Assistance Services of the World Institute on Disability, 1990). A state policy study inCommunity support standards in the US
Supportive living in the US is an important movement within the context of decades of federal policies, sometimes reluctantly, for community support services in communities nationwide as part ofCommunity living
The term community living was an outgrowth of the development of "residential services" in the communities in the US (e.g., Wolfensberger, Racino, Bersani, Nisbet, Taylor, and Bogdan of Syracuse University, Graduate Studies in Education, 600), and a departure from the development of institutional facilities. As part of this development and growth, different typologies of these services occurred beginning with group homes, staffed apartments, foster care, and then a variety of new and innovative services such as early intervention, family support services, supportive living and "related services" (e.g., supported employment, supported housing). Today, community living may involve over 43 residential typologies (e.g., Pynoos, Feldman & Ahrens, 2004), including board and care homes, personal care homes, nursing facilities, independent living facilities, supportive living and homeownership, family caregiving, personal assistance services, medical homes, and for elders, assisted living facilities.In the United Kingdom
Supported living is the term given by local authorities in theTeams in the UK
Local supported living teams can advise what supported housing is available in any given area. Other assistance may include: * a personal assistant or other care services *International collaborations
As Linda Ward (1995) wrote in her edited text on "Values and Visions: Changing Ideas in Services for People with Learning Difficulties", "the flaws of the "group home model" were recognised sooner in the USA than the UK." (p. 12). Termed "supportive living", she says these developments have been richly documented by Racino, Walker, O'Connor, & Taylor (1993). Written at the time of the nine-state pilots by the federal government on Community Supported Living Arrangements in the US, she noted great interstate variability in what it was and did identify the primary principles near the 1991 national organizational study (separation of housing and support, one individual at a time, full user choice and control, rejecting no one, and a focus on relationships, with maximum use of informal support and community resources). For comparisons, about the same time, Paul Williams (1995) identified the residential services available in Great Britain, including life sharing, hostels, staffed houses, living alone, lodgings, family placements, group homes, living with families, short-term care, hospitals and village communities, among others. One of the most important initiatives of the 1980s and 1990s on homes and community living in the United Kingdom was the "influential paper "An Ordinary Life"" which was shared in the US through our internationally known colleague David Towell, then of the King's Fund and Great Britain's National Development Team. One of his books, ''An Ordinary Life in Practice'', was paired with his strategic framework for principled national change. Within the comprehensive book (1988), Richard Brazil and Nan Carle describe an ordinary home life, Linda Ward describes developing opportunities for an ordinary community life, Paul Williams and Alan Tyne values for service development (normalization-based,References
{{reflist Disability Housing