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Article: Guide to Community-Based Living

Inclusive Programs/Activities

Table of Contents
  1. Individualized Planning
  2. Case Management Services
  3. Community-Based Programs for People with Disabilities and Elderly
  4. Inclusive Programs/Activities
  5. Personal Assistance
  6. Self Determination
  7. In-home Services
  8. Service Animals

Adult Day Programs
Youth/After School Programs
H&CBS Programs
Independent Living Programs/Services

Inclusive programs and activities refer to those programs and activities that are designed for all individuals. This is different than a program that is designed to serve persons with disabilities exclusively. Inclusion is both a belief and a movement based on the principle that communities are better when everyone is involved. All evidence has demonstrated this to be true. The contributions that people with disabilities have made are remarkable. Inclusion is also usually more cost-effective, as the creation of separate services and supports requires more funding and often duplicate what already exists.

There are many community programs, services, and activities enjoyed by the larger community. Although they may be appropriate, many of them do not include people with disabilities. However, with some small adjustments, it would be possible for many of these programs to accommodate people with disabilities. In many cases if an individual is willing to advocate for his needs he can find inclusive resources immediately.

TASH, an international association of people with disabilities and their supports, believes that including people with developmental disabilities in society is good for everyone. Established in 1974, the organization has a multitude of resources for a person seeking more information about inclusion.

The Center on Disability and Community Inclusion
The Center on Disability and Community Inclusion is a University of Vermont resource. It has information on projects, resources, conferences, and products that promote the inclusion of people with disabilities.

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Adult Day Programs

Adult Day programs are exclusively for adults and typically designed for people with developmental disabilities. These programs usually provide services Monday through Friday during daytime hours. Activities at an Adult Day Program will vary greatly, but all have the common goal of teaching and developing a variety of skills to help the participant live a more independent or satisfying life.

Many Adult Day programs are funded through Federal Medicaid Programs. These Medicaid programs are also known as Home and Community-Based (H&CBS) Programs. H&CBS Programs have specific admission and eligibility requirements. Other Adult Day programs may have different requirements and fees. Many of these programs often have waiting lists so it is important to plan ahead.

Upon admission to a program, a plan is created that outlines the specific services a person will receive. This plan should be developed together with the person and their personal supporters including family, friends, case manager and day program staff. The plan should reflect the goals and interests of the participant. Many programs are now using Person-Centered Plans. Regardless of the type of plan used, it should describe exactly how the goals will be met, including how often activities and training will be held and when progress will be measured. For example, a goal could be to cook meals at home independently. There may be additional steps needed to meet this goal, such as learning to shop at the local market or developing kitchen safety skills. Different programs will vary in the type of activities and the type of training they provide. Before choosing a program it is worthwhile to visit and learn more about each program to determine which one is right for you.

National Adult Day Services Association
The National Adult Day Services Association is a membership organization providing advocacy, education and technical assistance for adult day programs across the nation.

ABCs of Respite
ARCH National Respite locater looks at adult day care facilities as a respite option for elderly adults. They answer common questions about adult day care and provide some tips on finding a provider near you.

Services for Older Adults
Easter Seals is a nationwide organization. One of its many programs is to provide adult day services. Access their national webpage to find an Easter Seals program in your community.

Johnson Adult Day Center
This website provides information on its program activities, health education, and support for adults with memory loss and their caregivers.

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Youth/After School Programs

Youth programs are generally designed to serve teens and children and have a variety of activities, services and supports from which to choose. Many of these programs focus on recreational activities. Another added benefit of youth programs is that they provide opportunities for youth to socialize. They have a chance to get together and interact with others in structured and unstructured settings. Youth programs usually build on skills and experiences of the individual to help develop independence and self-esteem.

There is usually a fee to participate in youth programs. Some may have scholarships or other forms of assistance to help those in need. Programs vary dramatically in the types of activities and services that are offered, so care should be taken to ensure that there is a good match between the individual and the program.

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H&CBS Programs

Home & Community-Based Services (H&CBS) represent some very specific programs and services. Federal and state Medicaid programs fund these services. To be eligible for these services you must be eligible for Medicaid Waiver, a special section of the Medicaid program reserved for those needing long term care. Long term care can mean slightly different things from state to state. It usually refers to a person who will need help in performing activities of daily living such as self-care with the understanding that the need for help is not expected to change in the near future. Because H&CBS services programs are only for people who are eligible for Medicaid, these programs are free for participants.

Although Medicaid Waiver is a federal program, each state is allowed to set up rules on how it works and who can participate. The specific eligibility requirements for each state are set by the State's Legislature and can be found at the CMS site.

To qualify for participation in a waiver program, individuals should:

  • Be determined by the Department of Human Services to be eligible for federally funded Medicaid assistance.
  • Be certified by the Department of Human Services, through the preadmission screening process, to be in need of acute, skilled nursing facility, intermediate care facility, or intermediate care facility for the mentally retarded level of care.
  • Choose to remain in the community with the provision of home and community-based waiver program services as an alternative to institutionalization.

The Centers for Medicare & Medicaid Services
The Centers for Medicare and Medicaid Services (CMS) is a federal agency that works with states to administer Medicare, Medicaid and other health insurance programs. They also work with states on HIPAA and quality standards for health care facilities through surveying and certification processes.

Home and Community-Based Services
Home and Community-Based Services (HCBS) is a national organization that provides a clearinghouse for the sharing of information on H&CBS programs across the nation. On this site you will find data and resources related to each state's resources and efforts.

Program of All Inclusive Care for the Elderly
PACE (Program of All Inclusive Care for the Elderly) is a managed care benefit for the frail elderly. It uses a multi-disciplinary team approach to provide a total package of care for those individuals needing long-term care. Services can be provided by a not-for-profit or public organization. In many cases, this comprehensive care system permits individuals to live at home rather than in institutions.

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Independent Living Programs/Services

The "Independent Living" movement began as a grassroots effort led by people with disabilities and their advocates. It supports the philosophy that people with disabilities should have more control over their lives. More recently, independent living has become a mainstream issue with legislative support.

Independent living programs and services typically provide training and support to maximize the independence of the individuals they serve. People of all ages with disabilities qualify for these programs, although a majority of the services tend to be specifically for adults. The goal of Independent living programs is to have individuals perform as many of the activities of daily life as possible, with the least amount of support, in the least restrictive environment.

Independent living services include a variety of services and activities. They often contain a training component. This may be a one-on-one training with a counselor or a support worker, or small group training in a classroom format. The focus of the training can range from learning basic life skills such as cleaning, dressing, and cooking, to more complex skills such as renting an apartment, negotiating with a landlord, or creating a monthly budget. Services can include providing work-related skills such as preparing a resume, dressing for success, and interviewing, to more challenging issues such as computer use, workplace advocacy, or co-worker relationships.

Independent living services may additionally focus on providing supports rather than training. These work very well for people who know what their needs are and routinely use services to accomplish regular tasks. For example, a transportation service may help an individual to get around town to take care of errands. Other services might include a personal assistant who may help with home cleaning or running errands. People with disabilities can use these types of services to maximize their independence.

The Research Information for Independent Living
The Research Information for Independent Living (RIIL) is dedicated to finding easy to understand research on independent living and disability issues. Their site can be searched using keywords, or full-text.

Independent Life Resources
Independent Life Resources provides a "world of resources" for persons with disabilities and their advocates. Visit this site to find out more about their training services. There are also links and articles related to independent living.

Independent Living Research Utilization
Independent Living Research Utilization (ILRU) helps to put the growing body of research on independent living into practice. Their site contains links to various resources including policy information and analysis.

Through the Looking Glass
Through the Looking Glass is a non-profit organization that promotes an empowering model of serving people with disabilities. They provide research, training and service information related to independent living.

Independent Living USA
Independent Living USA is an online publication with news, links and advertisements related to and supporting independent living across the nation. There are articles by some of the leading disability columnists, writers, and reporters with disabilities. Access the classified ads or read more light-hearted articles in the "Lite Side" section.

RaggedEdge Online
RaggedEdge Online is a publication related to disability issues. Learn more about the history of the independent living movement in this article "The Origins of Independent Living".

Last Updated on 10/23/2015