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Supported Living: A How-to Guidebook

Money Follows the Person Demonstration Project logoThis initiative is made possible through a collaborative relationship between the NCCDD and North Carolina Money Follows the Person Project (NC MFP), a Medicaid project that assists Medicaid-eligible North Carolinians who live in inpatient facilities to move into their own homes and communities with supports.

This initiative will build upon the existing Supported Living Guidebook/Resource Manual developed by NCCDD’s Supported Living: Making the Difference initiative: https://nccdd.org/supported-living-making-the-difference.html. The purpose of this new initiative is to create a how-to guidebook to help individuals with the highest level of needs successfully access and use the Supported Living Innovations Waiver service that helps individuals with I/DD live in a home of their choice in the community with supports.

Why is NCCDD funding this initiative?Goal2

  • Supported Living provides an opportunity for individuals with complex needs for support to participate in community life.
  • While opportunities exist for these individuals to receive funds through a Home and Community Based waiver to supports complex needs, providers and families would benefit from a guidebook to implement and operationalize Supported Living in North Carolina.  In the absence of practical guidance on the implementation of supports and approaches to overcoming commonly recognized barriers, individuals with I/DD, families, and providers become reluctant to use the service.
  • A how-to guidebook is needed to operationalize the supports, staffing, and community integration of individuals with complex needs as well as to identify approaches to barriers that arise from a variety of factors in the provision of Supported Living for individuals who have the highest levels of need (Levels 2 and 3).
  • This initiative supports NCCDD's Goal 2 of the current Five Year Plan: Increase community living for individuals with I/DD.

What are the major goals and objectives?

  • Develop a “nuts and bolts” guidebook with practical guidance for individuals with I/DD, families, providers, Direct Support Professionals (DSPs), and policymakers.
  • Identify systemic barriers that continue to exist related to Supported Living, particularly for individuals with the highest levels of need, and share these barriers and any suggested recommendations for systemic change with the Council and its partners.

What activities has the intiative accomplished?

  • Create, convene, and facilitate a workgroup or workgroups to provide advice to this initiative and review outlines and drafts of the guidebook.
  • Conduct focus groups for individuals with I/DD and their families, providers, DSPs, agency leaders, and policymakers to understand the barriers, opportunities, and best practices related to the provision of Supported Living Level 2 and 3 services as well as the diverse needs of individuals using these services or who are considering using these services.
  • Collect, review, and identify best practices, content, and format ideas from relevant resources from other states, experts, and organizations who have experience with Supported Living.
  • Identify five or more successful examples of people in North Carolina received Supported Living Level 2 and 3 services to embed as illustrative stories through each of the steps, including barriers they faced and how they were able to overcome the barriers.
  • Develop worksheets (print and on-line) and activities that readers can use to both transfer their learning and capture their support needs from each step of the process to their own unique circumstances in taking their own action in moving Supported Living Levels 2 and 3 forward.
  • Prepare the draft guidebook in a simple and cognitively accessible format that incorporates principles of plain language and/or the easy read format to make it easy for individuals with I/DD and their family members to read and understand.
  • Field test the draft guidebook with stakeholders and experts in Supported Living and incorporate feedback throughout the development of the guidebook.

What has been achieved to date?

  • Contractor, Liberty Corner Enterprises, participated in NCCDD’s Supported Living: Making the Difference initiative and participates in quarterly Level 2 & 3 Stakeholders meetings and Level 2 & 3 Action Team meetings.
  • Identified guidebook content important to individuals with I/DD, families and providers of Supported Living.
  • Hosted monthly workgroup meetings for providers of Supported Living Level 2 and 3 to provide feedback on the guidebook’s content.
  • Identified two individuals receiving Supported Living services to share their Supported Living story during NCCDD’s Draft Olmstead Plan Virtual Forum on October 18, 2021.
  • A draft guidebook was unveiled at the Supported Living Level 2 & 3 Stakeholders meeting on September 28, 2023 and is available at www.SLNC4.me.
  • Captioned videos of individuals receiving Supported Living Level 2 and 3 are available on the website. A third, long video discussing how Supported Living 2 and 3 is provided is in development for inclusion on the website.
  • A hybrid Supported Living – NC Innovations – Learning and Living Together Conference occurred on April 20, 2023 in Asheville with at least 47 in-person participants.
  • The initiative presented Supported Living Lunch and Learn sessions in July and August 2023 with at least 88 and 91 participants at each one, respectively.
  • NCCDD staff and stakeholders have identified important Supported Living topics to create plain language and easy-to-read one-pagers to share this information.
  • NCCDD has contracted with FIRSTwnc, a provider organization, to revise and finalize the draft Guidebook and improve the readability and usability of information on the Guidebook website.
  • FIRSTwnc and NCCDD met with North Carolina Medicaid staff to discuss clarifying the language used to describe each level of Supported Living to help providers more effectively deliver Supported Living services.

What are the expected system change?

  • More individuals with I/DD, particularly those individuals with the highest level of support needs, will be able to successfully access and utilize Supported Living services.
  • More families of individuals using Supported Living will understand how to do it successfully.
  • The Supported Living Innovations Waiver service will expand sustainably in North Carolina as more individuals with I/DD access and use it and as more provider agencies better understand how to provide this service successfully.
  • More individuals with I/DD will live in a home of their choice in the community with the supports they need.
  • More individuals with I/DD will be fully included, respected, valued, and supported in their communities.

Liberty Corner Enterprises, Inc. logo

Liberty Corner Enterprises, Inc.: https://lcewnc.org/

Who can I contact for questions?

Grantee: Greta Byrd, Executive Director, [email protected] 

NCCDD: Philip Woodward, Systems Change Manager, [email protected] 

Additional Resources

Download a PDF of this initiative: Supported Living: A How-to Guidebook

Download a PowerPoint presentation from February 2022 for this initiative.

Download a PowerPoint presentation from May 2022 for this initiative.


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North Carolina Council on Developmental Disabilities

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This project was supported, in part by grant number 2001NCSCDD-02, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.

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