When planning for the future, one of the questions that parents of intellectually disabled children will need to consider is where the child is likely to live as an adult, and who will pay for it. If the child will need life-long support and will not able to live on his or her own, some governmental assistance may be provided, but how much?
This article describes the assessment process that the Department of Developmental Services (DDS) uses to determine who is entitled to receive financial support for housing. Note that those who do not receive full funding for an out-of-home residential placement still have other ways to obtain partial financial support for housing and care costs.
In general we have found that a child who is still productively living at home when he or she turns 22 (and leaves the educational system) is unlikely to be prioritized for a group home upon their 22nd birthday. This is because Massachusetts provides group homes to those who need to be in a group home in order to “protect the health and safety of the individual or others.” Children who did not need to be in a group home before turning 22 are unlikely to need one right after they turn 22, although they may need one later on.
Having said that, how does DDS decide which intellectually handicapped children and adults are entitled to a state-funded group home? In order to qualify for any supports from DDS, including but not limited to housing, an individual must complete an intake process and be determined eligible for services from the Department. In order to even apply, the person must be domiciled in Massachusetts and have a diagnosis of mental retardation as defined in Department regulations. Mental retardation means significantly subaverage intellectual functioning existing concurrently and related to significant limitations in adaptive functioning.
Assuming the person qualifies for services and requests housing, the next step is to undergo the MASSCAP (the Massachusetts Comprehensive Assessment Process) assessment, used by DDS in order to determine what types of services the person needs. In particular, MASSCAP addresses the question of “Who needs DDS funded residential supports, defined as 24/7 out-of-home, 24 hour, 7 days a week?” DDS provides people with the greatest functional and cognitive limitations with residential support options ranging from an array of supports in the family or individual’s home to out-of-home placement. DDS’s policy is to consider the least restrictive potential options when considering appropriate supports, using a rule-out strategy before offering a more intensive support. MASSCAP also addresses the question that if an individual does not need 24/7, out-of-home residential supports, what other types of supports would meet the person’s need.
The MASSCAP process consists of two major components: the Inventory of Client and Agency Planning (ICAP), and the Client and Caregiver Assessment (CCA) profile. ICAP assesses the functional limitations of an individual, and CCA assesses the home situation and caregiver capacity to provide care, since an individual’s need for 24/7 out-of-home residential support is an interaction between the person’s needs and the ability of the family/caregiver(s) to provide care.
Once the assessments are made, the person will be prioritized for housing as either Priority One, Priority Two, or No Priority.
“Priority One” means that the person needs a residential placement, usually to be provided within 90 days. DDS works with the family to find the right home for the child, and preferably this planning should start well before the home is actually needed.
“Priority Two” means that the person could benefit from a residential placement, but there is no immediate need. For most Priority Twos, DDS will engage in active planning with the family or individual, exploring other services and supports that can benefit the individual while they are waiting for the prioritized service, and continually monitoring the current situation to ensure that health and safety issues are appropriately addressed. Persons assigned a Priority Two must be willing to accept the service when offered.
“No Priority Assigned” means either that the individual does not qualify for the service (i.e., does not have an assessed need for the service, as reflected by the MASSCAP) or, that the request is for a service at least two years in the future, and the individual or family has relayed that they would not be willing to accept services sooner than that.
A person’s prioritization can change in the future, so that if they are considered a Priority Two or No Priority when they turn 22, they can become a Priority One if and when there are significant changes in the clinical functioning of the individual, the age and health of caregivers, or the caregiver’s capacity to ensure the health or safety of the individual or others. Decisions regarding prioritization for services are only made when a service request is received. If no service request is made, no prioritization determination will be issued.
The MASSCAP is completed at the time of the initial eligibility determination. Approximately 18 months prior to graduation, DDS reviews and updates the MASSCAP, and a prioritization for services is made that is effective upon completion of school services. This ensures that the information is accurate and reflects the current functioning of the individual and the caregiver and enables the Individual Transition Team and Area Office staff to plan for adult services for the individual.
For legal assistance in connection with special needs housing, contact Karen B. Mariscal.