11 minutes
The most integrated setting Understand what the most integrated setting requirement obliges the state to do, and what it looks like when a service technically complies and still narrows a life.
What you’ll be able to do Explain the most integrated setting requirement in your own words and identify one current arrangement where a person's real options are narrower than the requirement intends. Compare the responses to this question and explain your choice: How should the move be described in a progress update? Document a next step for The most integrated setting: Pick one service you know well and ask what proportion of a participant's week is spent only with paid staff and other people with disabilities. What the requirement says, and what it asks of us Public entities must administer services in the most integrated setting appropriate to the needs of the person. The reasoning that produced this requirement is worth stating: unjustified segregation of people with disabilities is itself a form of discrimination, because it deprives people of ordinary community life on the basis of disability. Minnesota carries this forward through its Olmstead Plan, which commits the state to supporting people to live, learn, work and participate in the most integrated setting.
For a person administering services, the requirement translates into a habit of asking what a person's real options are, not what options exist in principle. A choice between one group home and no service is not a choice. A community activity that only happens when staffing allows is a possibility rather than an option. The requirement is interested in what the person can actually do.
Integrated in form, or integrated in practice? A house on an ordinary street where all six residents go out together, with staff, once a week.
Choose a category Integrated in form only Integrated in practice Neither A person who works two shifts a week alongside colleagues who do not have disabilities and eats lunch with them.
Choose a category Integrated in form only Integrated in practice Neither A day program on a commercial street where participants remain inside from nine until three.
Choose a category Integrated in form only Integrated in practice Neither A person who chose their apartment, has a neighbor they see socially, and uses support to get to a choir practice they picked.
Choose a category Integrated in form only Integrated in practice Neither A residential facility on the grounds of a former institution, with its own recreation building.
Choose a category Integrated in form only Integrated in practice Neither Check matches Reset Measure the week, not the address What you can change You control which measure appears in your reporting: the setting's category, or how much of a person's week involves people outside the service.
What to watch for Do not let a change of building be recorded as a change of life. It flatters the report and leaves the person where they were.
Your next step Add one question to a review you already run: in an ordinary week, whom does this person spend time with who is not paid to be there?
The question is not whether the setting is in the community. It is whether the person is.
A working restatement of the requirement Carry this forward Public services must be offered in the most integrated setting appropriate to a person's needs — the setting that allows the fullest interaction with people who do not have disabilities.
Unjustified segregation of people with disabilities is discrimination, not merely an unfortunate outcome of how services happen to be organized.
A setting can satisfy the letter of the requirement and still be segregating in practice: a group home on a residential street where no resident leaves it without staff is integrated only on a map.
A scenario decision, a sort separating integration in form from integration in practice, and a knowledge check.
Pick one service you know well and ask what proportion of a participant's week is spent only with paid staff and other people with disabilities.
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