Family Living Model Service Design
Keystone Institute India, a project of Keystone Human Services International, serves as a catalyst for developing supportive services in India that respect the voices and perspectives of people with disability and their families, and facilitates India’s movement toward a society where all people matter, and all people belong. Building on the powerful ideas and principles within Social Role Valorization as our underlying theory of practice, we provide education and consultation in inclusive practices and developmental approaches to transform people’s lives.
To take this vision and mission forward, Keystone Human Services, with support from Rural India Supporting Trust and Government of Uttarakhand, have been working since 2015 to promote de-institutionalization and community living for the people with intellectual and developmental disabilities as well as psychosocial disability.
We support people to live their best lives in the community, as we work with and for people with disabilities to leave congregated, segregated settings and move into regular homes in the community full of meaningful opportunities to explore their interests, pursue their dreams, and achieve their goals. We believe that the welfare of all is vested in the welfare of each one.
Many people with disabilities live on the margins of society and may actually be entirely segregated from everyday people and typical life. Many are separated from society by being placed in institutions or group homes, while others may be completely isolated within their family homes. Families are stretched in their resources with little or no support from the society around them, and communities do not include them. At the same time, we believe that the Indian culture of hospitality, family support and societal support to one’s own community people, can open paths for persons with disabilities to be a part of the community.
We believe that people belong to their families, homes, and communities. Everyone needs to experience a full rich and meaningful life filled with all the joys and struggles that everyone faces. To be part of the community, involved fully in its life and responsibilities is a goal increasingly shared by Indian people.
It is seen that persons with disabilities, especially those living in institutions for a long time, do not have the experience of being a part of a family and the larger community in itself.
One of the pathways to exit institutions to help persons with disabilities live full and rich lives within community, is a program type called Family Living.
Family living is a concept where a person with a developmental disability is paired with a family to live with them as a member of the family. The person with disability stays with them and takes part in all the activities of the family. There are many proven benefits to this life-sharing model.
1. Family living provides a safe space for the person with disabilities to learn the skills needed to live within a community. This is especially important for people who have lived in institutions for most of their lives.
2. Family Living helps people to put down roots within the community that they may be living in, long term.
3. Family Living builds an inclusive community where there is room for each member of society to live and contribute and are interdependent on each other.
4. Family living tends to be a cost-efficient way to support people with developmental disability within a typical family.
How DoeS tHiS proceSS work
1. The process begins with a person with a developmental disability who desired to live within a natural family setting.
2. Potential families that might be willing to include the person are identified. Time is spent with the family and the family is appraised of what is involved regarding rights, responsibilities, and other information they may need to support the person with disabilities.
3. The person with a disability is then matched with an existing resilient family to share life alongside and with them, as full members of the family.
4. The Family Living match is designed for long term or even lifelong support, though it can be for a shorter time, depending on the needs and desires of the person and the host family.
5. A modest compensation is provided to the family as well as significant support, oversight, and guidance. A coordinator visits the family home on a regular basis and provides support to both the family and the person they are sharing their home with.
6. Additional support in the form of employment, home renovations, benefit entitlements, goal planning, and skill building may be provided and supported.
This service model was pioneered in the United States and Canada, and has since been successfully developed in Europe, Australia including less resourced countries such as Republic of Moldova with success.
For some people with intellectual and developmental disability across India, living with family members such as parents or siblings is not a desirable possibility. Perhaps family does not exist or is unknown, or the person or the family does not desire this, or there are significant barriers which cannot be overcome. Family living thus would be a good alternative for them, rather than placing them in an institution.
wHo MigHt be ServeD in FaMiLy Living?
• It is appropriate for children or adults for whom life embedded within an extended or non-relative family is desirable and feasible.
• If it is a child who is served, the adult family members would be considered parental figures.
• It is appropriate for people with all degrees of developmental disabilities, including those with high support needs.
How are FaMiLieS recruiteD?
Possible host families who might be interested are recruited through community groups, local organizations, and through existing friendships, networks and connections the focus person or the people who genuinely care for them may have.
wHat SaFeguarDS are proviDeD?
• An application by the family head expressing the desire to have a person with intellectual disability to stay with them is submitted.
• A full background check is conducted on all family members residing in the prospective family living home.
• A home study is conducted to ascertain good conditions within the home, prior to placement.
• An extensive and ongoing training is provided to the potential host family.
• An annual support plan is developed with the person and the family to decide on necessary support such as employment, renovations, personal care support, etc.
• Full consent is taken from the individual after trial visits, including overnight visits, have taken place.
• A responsible and well-qualified Family Living Coordinator is assigned to support each Family Living Arrangement, with each Coordinator assigned to no more than 5 Family Living arrangements.
• An annual contract is signed with the host family, with the anticipation that, assuming the match is positive, it will be renewed year-to-year. Our expectation is that these family living matches will endure over time.
• Monthly monitoring will be conducted at the home to assure standards in safety and quality of life.
• Prior to placement, a back-up family household will be identified, which will serve as occasional respite for the person and the family for a designated period each year. This family will also serve as a possible primary Family Living family should there be a need for transition.
• To preserve the integrated nature of Family Living, a host family may not serve more than two people at the same time under the Family Living program.
renuMeration
Although this is intended to provide authentic householder life, renumeration is provided to the host family. Opening an existing household to a person with a disability who will need some specialized support, perhaps a great deal, requires real adaptation by the family. Adding to the family income may mean one family member does not need to generate income, and so is available to support the person. It may create new freedoms for family members which enable them to extend care and support. The renumeration amount will vary from location to location, and by the amount of support required for the focus person. The host family is expected to not be financially dependent on the renumeration for Family Living, and any renumeration should be supplemental to household income earned elsewhere.
SuMMary
The Family Living Model is different from other service models such as group homes and assisted living facilities. It allows people with disabilities to experience authentic family life, while still having the support they require. It also builds into the Indian culture of hospitality and extended family and support which prioritizes a connected community life, and a rich normative course of life, while still focusing on developmental growth and focused goals. This results in authentic relationships which grow over time, within a highly individualized, community based flexible supportive service.
Family Living program provider Family application
Persons interested in sharing their home and family life with a person with disabilities will complete and submit a Family Living Provider application.
The process of approving applicants for Family Living consists of assessments or home studies of the applicant, the applicant’s family, and the applicant’s home environment to determine whether the home would be safe and appropriate for the individual requiring support.
Onsite home visits are conducted to assess the suitability of the home to accommodate the needs of all family members, including the individual. The condition of the home is evaluated to determine whether it is clean, safe, and comfortable. In addition, the Family Living Service Director will conduct interviews with the applicants and all adult family members to assess their suitability to provide appropriate high-quality services and supports.
Personal references are contacted for further information.
To ensure that the Family Living Providers are healthy enough to provide appropriate care, they are required to complete a physical examination. Checks of State and National criminal records and child abuse clearance records of the Family Living Provider, their Alternate and all adults residing in the potential Family Living Provider home are also included in the study.
FaMiLy Living proviDer approvaL proceSS
Application will be approved when the results of the home study indicate that the applicant is well suited to provide Family Living Services. Some specific grounds for approval include the following:
• The applicant meets the family income requirement. (Additional household income is required).
• The applicant or any family member is found to be of suitable character to provide safe and appropriate care.
• The applicant’s home is found to be safe or adequate to provide for the needs of the individual in care.
• The applicant experiences no physical or mental health condition that would interfere with providing appropriate care to the individual.
• The applicant is found to have provided truthful information on their application.
• The applicant or any member of the household has no record of a criminal conviction of a nature that could put the individual at risk.
• The applicant or any member of the household has no record of substantiated child abuse or neglect.
provider application
Applicants are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status or the presence of a medical condition or disability unless it interferes with the ability to provide appropriate care to the individual.
generaL inForMation
Date of Application:
Primary Family Living Provider Name:
Address:
Email id:
Phone No.: Mobile:
How long have you been staying at your current address?
alternate Family Living provider: (Spouse, household member, extended family member or neighbor)
Name: ........................................................................................ Relationship to Primary Provider: ..................................
Address:
Email ID:
Phone No.:
other adults/children living in Home: please list their first and last name, date of birth, relationship to you.
if you are a caregiver, parent or guardian of any other individual (child or adult) who is not living in your home, please list below:
perSonaL inForMation
Date of Birth / / / /
AADHAAR Number
PAN Number
Indian Citizen YES or NO
Marital Status Single Married Single Married
Date of Marriage (if applicable) / / / /
Religious Affiliation (optional)
education:
Highest Education Completed
Intermediate
College/University Degree
Other Training
work experience: Please begin with the most recent employment
Job Title
Employer Name & Address
Normal Work Hours
Length of Employment
Monthly Net Income
Job Description/duties
Reason for Leaving
related training/volunteer experience: Please list any schooling, experience, volunteer work, training or certification which relates to the Family Living role including experience in the field Disabilities, Medical Care, Child Care, or other engagements with vulnerable people.
type of Home:
(please circle applicable)
Single House Flat/Apartment Farm Other
How long have you lived here? .......................................................................................................................................
Do you? (Choose one) Own Rent if renting, lease expiration
Number of stories (include basement) ..........................................................................................................................
Total number of rooms: # of Bathrooms # of Bedrooms
Do you have any pets? How many? Type of Pet?
planned occupancy: Please provide information below of people who you expect to move in or out of the home. (Aging parent, student returning from school, family member returning from active duty etc.)
Yes or No
Yes or No
Yes or No
Yes or No
Yes or No
What would be the bedroom/sleeping arrangement for the person with disability living with you?
Are you willing to transport an individual to necessary appointments?
Is there public transportation available in the area? Yes ....................... No .......................
If yes, what type and how close?
Do you have a support network (family, friends) who would be willing to provide backup care for the person with disabilities who lives with you? Please describe:
Why would you like to be a Family Living Provider?
Are you now or have you ever in the past provided residential/foster care in your home for children or adults? Yes No
If yes, please give dates, number and type of children/adults served:
references: Please provide information for 3 non-family personal references and 1 professional reference. We will contact them for a reference.
professional reference: name & address
Do you allow Keystone Human Services to check your references from the above named people? Yes No
were you or any other adult living in the home ever convicted of a criminal offense?
Primary Family Living: Yes ................... No ...................
Other Adults: Yes ................... No ...................
Alternate Family Living: Yes ................... No ...................
were you or any others living in the home hospitalized within the last 10 years?
Primary Family Living: Yes ................... No ...................
Other Adults: Yes ................... No ...................
Please describe:
Alternate Family Living: Yes ................... No ...................
were you or any others living in the home treated for Substance abuse or addiction in the last 10 years?
Primary Family Living: Yes No
Other Adults: Yes No
Alternate Family Living: Yes No
are you involved with any judicial proceedings, and are there any criminal charges against you now pending? (omit minor traffic violations and anything prior to your 18th birthday)
Primary Family Living Applicant: Yes No
Alternate Family Living Applicant: Yes No
Other Adults Living in the Home: Yes ................... No ...................
If you answered Yes to any of the questions above, please provide details below (use a separate sheet if needed), and include a copy of the details. Conviction of a criminal offense will not necessarily disqualify you in all cases. Each case is considered on its own merit.
please initial next to each item below giving your acknowledgement/consent.
The information on this application is true to the best of my knowledge. I understand that any false statement or omission of material/fact may disqualify me from further consideration from becoming a Family Living Provider.
I understand the information shared on this application is solely for the purpose of matching compatibility and determining eligibility as a Family Living Provider.
.........................................................................................................
I understand that this application is not for agency employment purposes and only for purposes of a potential contract with the agency as a provider of Family Living Services.
I understand that completion of this application does not constitute an agreement for authorization to provide services in my home.
I agree to allow a study and inspection to be made of my home to ascertain my qualifications and compliance with Family Living Program requirements.
I consent to allow the agency to contact my references provided for a reference check.
.........................................................................................................
I understand that the Family Living Agency or the applicant can discontinue the application process at any time.
Primary Applicant Date
Alternate Applicant Date
Family Living Home Study
Date of home study:
Person doing home study:
Name of Applicant:
Address: Landmark:
Transportation - Public, private (car, motorcycle etc.), what is used in case of emergency:
Income of the family: name place of work income per month
Why do you want to be a Family Living Provider:
Have you, at any time, provided Family Living or other foster care services If yes, when - (year) For how long reason for leaving ...........................................................................................
Current family ties (siblings, relatives who are frequent visitors, friends): ......................................................................................................................................................................................................
Attributes of Primary Family Living applicant and other household members: name relationship to primary applicant attributes
How did the family respond to the decision of the primary applicant:
How do family members respond in case of a conflict:
What kind of stress has the family experienced in the last year:
How did you handle the stress:
What does an average day look like: ...................................................................................................................................................................................................... ......................................................................................................................................................................................................
How do you feel about the Agency or Government officials visiting your home:
What kind of relationship does the applicant and their family have with their neighbours:
Who do the applicant and their family consider as their own community? How are they involved with them: ...................................................................................................................................................................................................... ......................................................................................................................................................................................................
How do you feel about an individual with disabilities sharing your home:
How does the applicant feel about the individual with disabilities sharing their home, having a different religion? ......................................................................................................................................................................................................
How would they support the individual to follow her own religion, which may be different from theirs:
......................................................................................................................................................................................................
......................................................................................................................................................................................................
How would the applicant handle a situation where the individual is upset about something and is unable to or does not want to talk about it:
How would the applicant respond if the individual refuses healthy food choices and wants to eat snacks instead: ...................................................................................................................................................................................................... ......................................................................................................................................................................................................
certification
This is to certify that I have completed the home study of the prospective provider and his/her home and the information I have conveyed through this home study is accurate and complete to the best of my knowledge.
Signature: Date:
Name: Place:
Designation: ........................................................................
Family Living program transition planning worksheet
Name of Focus Person:
Name of Primary Family Living Applicant:
Name of Alternative Family Living Applicant:
Section 1:
Review FLP Standards and Policies: FLP Coordinator: Date:
Review and approve Application: FLP Coordinator: Date:
Reference Checks Completed and Documented: FLP Coordinator: Date:
Home Study Completed: FLP Coordinator: Date:
Section 2:
introductory Meetings, trial visits, and overnight visits : Document dates and outcomes below
Date of Visit: ....................................................................................
Time Period of Visit:
Notes on Visit:
Any Concerns or problems?
Signature: .................................................... Name: ......................................................................... Date: .........................
Section 3: consent and agreement
1. Focus person has expressed clear agreement to continue pursuing moving in with this family based on visits, description of the program, and long-term permanency of the placement
FLP Coordinator: Date:
Focus Person: Date:
2. Family Living Provider Family has agreed to provide Family Living Services and has signed the contract, agreeing to renumeration, responsibilities, and safeguarding the focus person’s well-being.
FLP Coordinator: Date:
Family Living Provider: Date:
3. Approval of guardian, if applicable, verified by FLP Coordinator:
FLP Coordinator: Date:
4. Transition Planning Meeting date set:
5. Estimated Move Date:
Section 4: required pre-Service training for Family Living providers:
Health and Safety Training:
Abuse Awareness:
Trainer: Date:
Trainer: Date:
Documentation Methods: Trainer: Date:
Emergency Procedures: Trainer: Date:
Disability Awareness:
Trainer: Date:
Person-Centered Thinking: Trainer: Date:
Medication Training: Trainer: Date:
Community Inclusion:
others:
Stress Management:
Trainer: Date:
Trainer: Date:
Positive Behaviour Supports: Trainer: Date:
Family Living contract
This contract will be between the Government of Uttarakhand, The Hans Foundation, Keystone Human Services India Association and Herbertpur Christian Hospital - represented by the Family Living Coordinator( FLC) and the Family Living Provider (FLP):
• The FLP shall invite the individual with disabilities to live in their home as a family member, being involved in all activities including vacations, travel within community and all other activities etc.
• The provider shall provide all safety measures within the house (fire extinguisher, smoke alarm etc.)
• Furniture for the house and the room for the individual.
• Strict confidentiality of all information regarding the individual will be maintained.
• Documentation will be maintained for the individual.
• All medication will be kept in a locked cabinet.
• The provider will support any visits from the government officials and the Family Living coordinator.
• The provider is not a member of staff of any organization, nor is it allowed to have benefits as a member of staff.
• They will maintain and safeguard all the funds of the individual and allow them full access to it.
• The individual will be given full freedom to follow any religion she wants to without any coercion from the FLP.
The Party promises to provide:
• A monthly stipend to the FLP to support the individual.
• An Individual Support Plan (ISP) and transition plan will be made by the Family Living Coordinator (FLC) and shared with the Family Living Provider (FLP).
• An initial weekly visit by the FLC. After 2 months, it can be monthly and thereafter quarterly.
• Respite care will be provided to the FLP once a month for 2 days.
Signed Signed (Family Living Provider) (Family Living Coordinator)
Name: ........................................................................... Name: ............................................................................
Date: Date: