A philosophical critique of United States housing policy for adults with intellectual disabilities

Abstract

In the United States, as in other developed nations, housing for adults with intellectual disabilities has shifted from institutions to the community. Community services, however, often function in institutional ways. This is true in the United States and internationally. In the United States, the ‘Settings Rule’ aims to correct the institutional nature of community living by restricting funding to integrated locations with personalized supports. While the policy is well-intentioned, multiple philosophical shortcomings (conceptual, epistemic, moral and political) suggest it will not achieve its desired effects of inclusion and choice. The limitations of US policy and practice have relevance for other jurisdictions working to enhance the experience of community living for adults with intellectual disabilities.

Points of interest

• Many countries have moved adults with intellectual disabilities out of large institutional facilities into small community homes. Yet community housing often operates in the same way as institutions, with services that are socially segregated and the same for all individuals.

• In the United States, new nationwide regulations found in the Settings Rule aim to correct the institutional nature of community services. It only pays for small group homes and requires supports designed to meet diverse individual needs.

• Settings Rule housing policy aims for good outcomes, but several problems suggest that it will not achieve what it desires in the everyday lives of people with intellectual disabilities.

• The limitations in United States housing policy have relevance for other nations that promote community living.

Keywords:

• adult disability services
• disability policy
• housing
• intellectual disability
• Settings Rule

Disclosure statement

No potential conflict of interest was reported by the author(s).