Fifty years ago, most people with even moderate special needs were institutionalized throughout their adult lives. Now, thanks in part to societal changes and decades of litigation, most people with special needs, including those with very severe special needs, live in some type of community setting.

In fact, the U.S. Supreme Court has specifically ruled that people with special needs who receive government benefits must be housed in the least restrictive possible setting. Here are some of the most popular housing options for adults with special needs.

Living With Parents or Other Family Members

Many adults with special needs, especially young adults, may live with their parents or other family members. People with special needs who live with their parents don’t have to experience the sometimes stressful transition into a different type of housing when they become adults, and they are usually surrounded by caregivers (their family members) who have experience with their specific special needs. In many cases, Medicaid funds can be used to pay family members who provide care for their children in their own homes.

But as any young adult will probably tell you at one point or another, living with one’s parents is not always a great solution. In some cases, the child’s special needs will be more difficult than what the parents can handle. In other cases, a child’s parents may be a bad influence on the child or may even abuse the child or steal his government benefits. Depending on the person with special needs’ level of social interaction, they may not have the opportunity to meet a lot of other people if they are constantly surrounded with the same family members.

In addition, as parents age, it may become impossible for them to care for their child anymore, and the transition from a lifelong residence could be more traumatic for the child than if they had moved out when they were younger.

Section 8 Housing

The Section 8 program provides vouchers for people with low incomes to obtain housing in the community. In general, a Section 8 recipient has to pay approximately one-third of their monthly income toward rent, and the voucher pays for the rest.

Many people with special needs who receive Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) benefits as their sole source of income will likely qualify for Section 8 as well. In theory, Section 8 landlords must meet certain standards in order to rent their units to Section 8 tenants, but in reality whether a unit meets these standards is rarely monitored closely.

Section 8 vouchers can allow people with mild or moderate special needs and low incomes to live on their own in the community. However, it usually takes years to obtain a Section 8 voucher and, once acquired, there may not be any available Section 8 units for rent in the individual’s community. Section 8 housing is also not appropriate for people with more complicated special needs who can’t live on their own.

Group Homes / Supportive Housing

Many people with special needs choose to live in supportive group homes with several other people with special needs. Depending on the program, these homes could be staffed with counselors and other workers who help the residents live on their own, or, in some cases, the residents live without live-in assistance. Group homes come in many varieties and can be paid for in many ways, including private payment or state programs for people with disabilities.

Group homes are great options for people with special needs who don’t require more advanced care but who cannot live independently. In many cases, group homes also provide a social setting for the residents that they would not otherwise have if they lived with parents or on their own.

Assisted Living Facilities

Some people with special needs, especially older individuals, live in assisted living facilities. Although the term “assisted living” has come to mean a lot of things, in general assisted living facilities house residents in their own apartments within a building or complex of buildings.  The residents can cook in their units or eat in a communal dining hall, and they receive nonskilled care in their units, including assistance with bathing, cleaning, and sometimes administration of medicine.

Some assisted living facilities specialize in treating people with dementia or other neurological conditions.

Skilled Nursing Facilities (Nursing Homes)

If a person with special needs requires around-the-clock skilled medical care, he may need to live in a skilled nursing facility if it is impossible to provide that care at home. Although nursing homes are the last resort for most families, in some cases they can be the most appropriate option for a person with severe special needs because there is constant supervision of care and the person’s family members do not have to spend all of their time caring for their loved one.

Skilled nursing facilities are incredibly expensive, often costing more than $10,000 a month. In many cases, an individual with severe special needs and minimal assets will qualify for Medicaid coverage that will pay for care in a skilled nursing facility.

Special Needs Trust Ownership of a Home / Payment of Rent

Special needs trusts can own homes for their beneficiaries or pay for a beneficiary’s rent in a private apartment.  n many cases, this is a very flexible option for the beneficiary, since the trust can also pay for services to help the beneficiary live independently. However, home ownership by a trust comes with a large set of responsibilities. Read more on special needs trusts and home ownership.