The Independent Living Continuum- Adult Housing Support Types
The question every parent or caregiver, of someone with a disability, asks themselves at some point is…”will my child need to live in a group home? Will they live with me forever?” etc. This resource guide outlines all of the possible options for independent living for adults with disabilities
and the spectrum of independent options available, as well as funding and additional resources that you should know of, when looking at living options.
Need to Know Acronyms/Terms Found in the Article:
Before diving in, here is a small Glossary of terms or acronyms found within the article to familiarize yourself with, or reference back to.
HCBS- Home and Community-Based Services: Disability services provided in someone's home or community rather than an institution
LTC- Long-Term Care: Ongoing supports for people with disabilities, older adults, or others who need assistance with daily living
CBRF-Community-Based Residential Facility: Residential facility providing care/support to multiple residents; can provide 24-hour supervision
SSI-Supplemental Security Income: Federal income-support program for people with qualifying disabilities and limited income/resources
SSDI-Social Security Disability Insurance: Federal disability income program based primarily on a person's work history
The resources provided below, are in order starting with “more support needed” and ending with “more independence”
24/7 Group Home
Highest Level of Residential Support
This is appropriate for someone who needs substantial assistance throughout the day and/or cannot safely live alone. Staff may assist with:
Bathing, dressing, toileting
Medication administration
Meal preparation
Cleaning and laundry
Transportation
Community access
Behavioral support
Safety monitoring
Money-management support
Appointments
Social/recreational activities
Overnight needs
Funding: Usually Family Care or Medicaid funding for the eligible support services. Private-pay arrangements are also possible. Important to note that Medicaid will typically not cover room and board- just the support services themselves.
2. Adult Family Home (1-2 bed)
This is a really interesting middle ground because the individual can receive very significant support while living in a much smaller, home-like environment.
A person might live with a provider/caregiver and another resident rather than living in a larger group home.
Funding: Medicaid LTC can cover eligible services. Individual pays: Room and board.
3. Adult Family Home (3-4 bed)
Similar concept, but with up to four unrelated adults living in the home.
This can provide:
24/7 staffing
Personal care
Medication assistance
Meals
Transportation
Supervision
Community activities
Daily living skills
Behavioral support
4.Residential Care Apartment Complex
This is a significant step toward independence.
Think: "My own apartment, but inside a community where support is available."
The person may have their own apartment while receiving assistance with things like:
Medication
Meals
Personal care
Housekeeping
Transportation
Emergency response
Community activities
5.Supported Independent Apartment-High Support
This is where you start getting into true independent living. The person has their own apartment and their own lease, but disability-support staff come to them.
For example:
Monday–Friday
7:00 AM — staff helps with morning routine
8:00 AM — staff leaves
3:00 PM — staff returns
5:00 PM — grocery/meal support
7:00 PM — staff leaves
The person is technically living independently but receives substantial support.
Some states specifically recognize independent apartments where the person has their own lease and independently arranged services as a setting that doesn't itself require residential licensure.
Funding could include:
IRIS
Family Care
Medicaid-funded personal/supportive home care
Private pay
Funding: IRIS, for example, can include supportive home care, life-skills training, transportation, assistive technology, and other supports within the person's approved budget.
6.Supported Independent Living-Moderate Support
Here, the person might need only a few hours of assistance per day or several visits per week.
For example:
Staff Monday/Wednesday/Friday
Grocery shopping
Meal planning
Laundry
Budgeting
Cleaning
Medication organization
Staff Tuesday
Appointment/community transportation
Staff Saturday
Community activity
The person spends the majority of their time without staff.
This can be an excellent model for someone who has learned many independent living skills but still needs periodic assistance.
7.Low Support Independent Living
The individual essentially lives independently but receives skill-building and maintenance support.
Staff might visit:
Once a week
A few times a month
As needed
Services could focus on:
Budgeting
Apartment maintenance
Meal planning
Scheduling appointments
Transportation planning
Employment support
Social/community participation
Problem solving
Maintaining routines
This is especially appropriate when the goal is maintaining independence rather than providing hands-on care.
8.Independent Apartment + On-Call Support
This is one of the most independent models.
The person has:
Their own apartment + their own lease + their own schedule + no regularly scheduled staff.
But they have a support system they can access if something comes up.
For example:
"I don't need staff to come over every day, but if my refrigerator breaks, I need help figuring out who to call."
Or:
"I can take my medications independently, but I need someone to help me if my medication changes."
Or:
"I can grocery shop myself, but I occasionally need transportation."
Funding: Depending on eligibility, specific services may be funded through IRIS/Family Care, while other things would be personally paid. IRIS is specifically designed to allow eligible adults to select and manage services within an approved budget.
