In April of 2016, Autism Housing Pathways posted a series of Tweet length “Autism Month Housing Thoughts of the Day”. They comprised a mini-tutorial on housing for individuals with autism and other developmental disabilities, including housing subsidies and supportive services. They are updated (as of 2022) and republished here, with three additional comments to add information on Medicaid waivers. Acronyms are spelled out here, as they were not in the original Tweets. To learn more about many of the services mentioned, check out our Turning 18 checklist. Translations of “Housing in a Month’s Worth of Tweets” are available on our Translations page.
- Of those with family involvement, only about 12% will be both eligible and prioritized for Community Based Residential Services through the Department of Developmental Services (DDS) at age 22.
- It frequently takes 5-10 years to plan and implement a housing strategy; start at 18 if the goal is independent living by 30.
- The housing equation is: bricks & mortar + food + services = housing. There are subsidies for all, but not all can be combined.
- Supplemental Security Income (SSI)* can be used for any part of the housing equation. People can apply based on their own income at 18.
- SSI has asset and income caps; other income can reduce benefits. Try to avoid assets in the person’s own name.
- SSI makes someone automatically eligible for MassHealth (Medicaid). Medicaid is the main way to pay for services.
- Social Security Disability Insurance (SSDI)* can be used for any part of the housing equation. Assets and unearned income do not affect benefits.
- SSDI makes you eligible for Medicare (not Medicaid) after 2 years. Medicare can’t be used for long-term services.
- For those disabled before 22, SSDI can be based on their own income or a parent’s, once the parent retires.
- Try not to retire until your child receives SSI as an adult. Otherwise, they may not qualify for MassHealth.
- Those who don’t qualify for MassHealth can qualify for CommonHealth if they work 40 hours/month.
- People can also qualify for CommonHealth by meeting a one-time spend-down.
- The most important housing subsidy is Section 8. Apply at age 18. Go to www.18section8.org to learn how.
- The wait for a Sec. 8 voucher can be up to 12 years. Apply at 18.
- A family member can be the Sec. 8 landlord for a person with a disability. But they can’t live in the same unit.
- Someone who needs a live-in aide can get a 2-bedroom Sec. 8 voucher. But the aide can’t be immediate family.
- Food stamps and Sec. 8 will not result in a reduction of SSI benefits. People usually qualify for food stamps at age 22.
- The food stamp recipient needs to buy and prepare food “substantially separately” from the rest of the household.
- MassHealth State Plan Services are the main way to pay for long-term services and supports.[Addendum: other than Medicaid waivers — waivers are addressed below.]
- MassHealth State Plan Services are entitlements. There are no waiting lists if you qualify.
- Adult Foster/Family Care (AFC), Personal Care Attendant (PCA), and Group AFC (GAFC) are state plan services.
- You can’t combine AFC, PCA, and GAFC. Pick one.
- AFC pays a stipend to a caregiver who lives with the person. A parent who is not a guardian can be a caregiver.
- Consider saving the AFC stipend while waiting for a Sec. 8 voucher. It goes a long way toward a down-payment.
- AFC generally can’t be combined with food stamps.
- GAFC can only be used in assisted living or subsidized housing – not with a mobile Sec. 8 voucher.
- DDS individual support hours can be used with AFC, PCA, or GAFC.
- DDS housing dollars can only be used in settings with 5 people or less under one roof.
- Families can borrow from the Home Modification Loan Fund to help create an accessory apartment. A bill in the state senate (S2132) would make creating accessory units a by-right zoning use.
- Housing + Living Skills = Independent Living: https://autismhousingpathways.org/independent-living-skills-the-horse-that-pulls-the-housing-cart/
- Bonus day: Our “Thinking about housing” webinar is archived at https://www.youtube.com/watch?v=YXtTx6CYdr0&t=3780s
Addendum — Medicaid waivers:
- Those receiving services from DDS can apply for a Medicaid waiver. The feds reimburse the state for half the cost of waiver services.
- Waiver services are portable, meaning the dollars are attached to the person on the waiver, and can move with the person.
- There are three kinds of waivers: Intensive Supports, Community Living, and Adult Supports. https://www.mass.gov/eohhs/docs/dmr/hcsis/hcbs-brief.pdf
* Emergency Aid to the Elderly, Disabled, and Children (EAEDC) is a cash benefit available to some Massachusetts residents who do not qualify for SSI or SSDI.
Translations of these Housing Tweets are available on our Translations page.