Housing Solutions to Support Independent Living for People with Disabilities
Israel Unlimited helps people with disabilities experience life independently by providing them options for independent living in the community. Supported Housing and Expanded Supported Housing offer participants support and practical mentoring every step of the way in obtaining independent living opportunities. Affordable Housing holds the promise of a long term, stable home, and Smart Homes utilizes technological solutions to enhance personal safety and autonomy.
Israel Unlimited strives to reduce gaps between people with and without disabilities and to increase the autonomy of people with disabilities on a national scale. The barriers that prevent people with disabilities from living in an inclusive society according to their needs and wishes negatively affects their quality of life and Israeli society as a whole. So many Israelis with disabilities living in government-supported institutions has led to fractured society, one that has economic and moral implications. Moving people from the institutional system to independent living decreases costs and creates larger scale impact. It simply costs less to include people with disabilities in communities.
Today, some 27,500 people with disabilities in Israel still live in government housing solutions (10,500 in large institutions and 17,000 in hostels/group homes). Israel Unlimited has inaugurated four ground-breaking initiatives aimed at reversing this trend.
Through Supported Housing, people with disabilities receive a holistic basket of support services that allow them to transition to independent housing in the community. Care coordinators prepare the participants and their families for the move, help participants find and adapt an apartment, ensure full exercise of rights, and provide life skills training. Once a participant moves to his or her own apartment, Supported Housing continues to reach out with social activities, mentoring, assistance with home maintenance, and emergency medical services. As of the end of 2019, seven organizations were involved in running Supported Housing in 12 regions and 36 local authorities nationwide. Over the past year, Israel Unlimited has been working intensively to lay the groundwork for transitioning Supported Housing to the Ministry of Labour, Social Affairs, and Social Services by the end of 2020.
An extension of this programme, Expanded Supported Housing is designed for people with more severe and profound disabilities, including people with a medium level of intellectual disability, people on the autism spectrum at a medium level of functioning, and adults currently living in nursing homes due to the high level of care they require. The pre-pilot for Expanded Supported Housing was launched in northern Israel in 2019; by the end of the year, there were two active participants and six candidates. Israel Unlimited intends to expand the program to Jerusalem in the coming year, and to enroll a total of 16 participants, who will be referred by local social services and housing institutions.
Many landlords in Israel refuse to sign long-term leases and/or to rent their properties to people with disabilities. Affordable Housing is a new project that aims to ensure that people with disabilities who are not eligible for public housing and who do not have the resources to buy their own home have a stable housing solution for the rest of their lives. Participants will use the rent subsidies they receive from the Ministry of Housing and some of their benefits from the National Insurance Institute (NII) as well as pooling resources from government, banks, insurance companies, and impact investing. In 2019, Israel Unlimited signed a contract with an operating agency to procure the first few apartments for this initiative. A married couple with disabilities was selected to purchase the first apartment, which they chose in coordination with programme staff. Negotiations have begun with the Tel Aviv municipality to buy several more apartments. Additional operational models will be piloted in 2020 that look to ensure long term sustainable financing, not just through philanthropic support. The pilot of Affordable Housing is for the purchase of 25 apartments.
Giving people with disabilities the capacity to function more independently within their personal space enhances their sense of personal safety and autonomy and boosts their self-confidence. Israel Unlimited’s innovative Smart Homes project achieves this by utilizing user-friendly systems that allow a person with disabilities to control electronic and technological devices, such as thermostat, lighting, home security system, stereo, and computer. A small sampling of such devices includes Sesame Enable (touch-free smartphones), the Grid 3 smartbox, and the Foxifinder smart watch with built-in GPS and panic button. A pre-pilot programme for 50 people with disabilities, ages 18-65, was launched in early 2019. All participants – who were in various stages of needs assessment and technology acquisition as of the end of the year – had at least one disability, ranging from mental health disabilities to intellectual disabilities to physical disabilities and autism. They were selected in consultation with social service supervisors, housing frameworks, local authorities, and service providers. The full-scale pilot will begin in 2020, encompassing 100 people across Israel. Myers-JDC-Brookdale Institute will carry out an evaluative research study.
What Makes Your Project Innovative?
Even people with the severest disabilities should have the option of living independently. Being fully integrated into the community has been a primary goal of people with disabilities, their families, and advocates for decades. Yet in Israel, as in many countries, housing options – outside of a government-funded institution or nursing home – are extremely limited. Over the past few years, Israel Unlimited has developed a continuum of independent living solutions for people with every type of disability from physical or sensory disability to intellectual and developmental delay, autism, and mental health disability. Supported Housing and Expanded Supported Housing provide tailored baskets of services and a network of support that help participants every step of the way. Affordable Housing offers people with disabilities the promise of a permanent home. Smart Homes gives people with disabilities the capacity to function more independently within their personal space, wherever that is.
What is the current status of your innovation?
Our housing pilot programmes are at various stages of implementation. Supported Housing, operating since 2012, has achieved full capacity. In 2019, Israel Unlimited began creating a knowledge kit to facilitate handover to the Government of Israel in late 2020. Another important step: several independent living counselors with disabilities were hired (one has cerebral palsy and one is hearing impaired and speaks sign language). Given the success of Supported Housing, Israel Unlimited is advancing the expanded model, which reaches out to people with more complex levels of functioning. Affordable Housing is also in early stages; Israel Unlimited is working with a variety of partners to amass the resources necessary to purchase apartments, creating long term, stable, and independent housing for people with disabilities. Finally, Smart Homes – which exemplifies Israel Unlimited’s person-centered approach by utilizing assistive technologies – will transition into a larger pilot in 2020.
Collaborations & Partnerships
The main partners in these housing programmes include the National Insurance Institute; Ministry of Labour, Social Affairs, and Social Services; and Ministry of Construction and Housing, all of which can leverage the resources necessary to create an infrastructure for Supported Housing/Expanded Supported Housing, and to procure apartments for Affordable Housing. Partners in Smart Homes also include the Ministry of Finance and Digital Israel, a branch of the Ministry of Social Equality.
Users, Stakeholders & Beneficiaries
Beneficiaries of Israel Unlimited’s independent living programmes are people with all types of disabilities who would otherwise find it difficult, if not impossible, to live in their own homes within the community; these programmes provide participants with the wherewithal to live independently in the community. Families of people with disabilities are supported in what can be an emotionally difficult transition. And communities become more inclusive and accepting of people with disabilities.
Results, Outcomes & Impacts
To date, 350 people with disabilities have participated in Supported Housing and another 105 candidates are undergoing intake; 52 participants have moved into their own homes and progressed enough to “graduate”. Expanded Supported Housing is in early stages and has only two active members in northern Israel; the programme will be expanded to Jerusalem in 2020, with plans to enroll a total of 16 participants before embarking on a larger pilot of 100 people. Affordable Housing is also still in the development stage, with only the first two apartments acquired so far. Smart Homes is in the pre-pilot stage and no evaluative results are available. User research conducted on Israelis with disabilities found that while only 44% used assistive technologies, 68% of those reported that the device had improved their independence. The programme aims to raise awareness among people with disabilities about the benefits of assistive technologies and then provide them with the ability to acquire them.
Challenges and Failures
Our most pervasive challenge has been the need to change attitudes and mindsets. There is still a general belief in Israel that living in institutions is the best solution for people with disabilities. The Ministry of Finance thinks it is more economically efficient and municipalities think the programmes are too burdensome. Landlords are reluctant to rent to people with disabilities and family members are afraid of letting their siblings and children live alone and navigate independently through life. These mindsets are even more entrenched when it comes to people with more severe disabilities. And in the geographic periphery, where families and municipalities have fewer resources, it is even harder for them to accept the premises of the innovation. Israel Unlimited's response has been to change attitudes by showing, not just telling. Organisers have seen significant changes in mindset take place in the communities that have partnered with them in implementing their programmes.
Conditions for Success
A basic condition for the success of our programmes is affordability. The Israeli housing market makes it extremely difficult for someone with low income to rent an apartment due to the high rents, the fact that landlords typically only sign year leases, the scarcity of studio apartments, and that government subsidies are granted in higher proportion to institutional living arrangements. In response, the JDC developed the Affordable Housing program in order to facilitate access to long term independent living.
Another condition for success is that our government partners need to be on board with our innovations. Israeli government ministries tend to work in silos; people with disabilities receive benefits and services from the ministries of housing, welfare, and social security, separately. Organisers need to bring these ministries together to work holistically. They need them to work together to change funding policy to afford people the opportunity to live in the community instead of institutions.
As mentioned above, Israel Unlimited is taking steps to turn Supported Housing over to the Ministry of Labour, Social Affairs, and Social Services in late 2020. The staff has begun development of a knowledge kit: a writer has been selected, meetings have been held to define the goals of the kit, and focus groups with regional and local professionals have been convened. Moreover, the proficiencies and tools developed for the programme have been adapted to the International Classification of Functioning, Disability, and Health (ICF). Finally, intensive discussions have been held with various regional and local agencies to discuss the transition process. Once the feasibility of Expanded Supported Housing is verified, a similar process will be followed for government handover. Because of its scope, Affordable Housing is being implemented in full partnership with the Ministry of Housing and options for scale-ability are being explored. Smart Homes is in pre-pilot with the goal of replication.
Listen to people with disabilities and their families. They have the knowledge of what they need. As an example, organisers learned from the families that caregiving was an area of service that needed improvement, as caregivers would sometimes leave without warning. Caregivers needed professional development, and organisers needed to facilitate knowledge exchanges within the caregiver community for them to learn and support one another.
Don't be afraid. Someone who tries to develop something new must be brave enough to try and maybe fail. When organisers started the programme, everyone told them that people with disabilities cannot live independently. People said they were wrong to want to take people out of institutions, that it would never work. They had fears that not only would their attempt not work, but that it would make things worse for people with disabilities. But since starting, organisers have successfully brought 60 people out of institutions. They will continue to do so, with greater confidence that they are on the right path. They realised that the same fearlessness must apply to their outlook toward people with disabilities themselves.
Always be learning. See what is happening around the world. Go and learn new models. Get in touch with other organizations. Be curious. Organisers visited the U.S. to see their models. They made connections with experts there and in Europe, who they can now reach out to with questions. Organisers learned about technology—what was available, how to utilize it, and how it could increase economic efficiency by displacing caregiver costs. The whole notion that it would be more effective to transition people from institutions into the community despite it being more costly in the short term was something that organisers learned abroad. It was these sorts of insights that they learned from mentors and partners abroad that gave them the courage to lead the change at home.
Supported Housing was selected as a Zero Project innovation in the past.