By Carli Friedman, CQL Director of Research
Natural supports are unpaid relationships (for example, friends, family, neighbors, community members) who support people with intellectual and developmental disabilities (IDD) in their communities and natural environments. Natural supports can improve people’s relationships and community integration. It has also been suggested that natural supports could also result in more cost-effective service delivery.
The purpose of this study conducted by CQL | The Council on Quality and Leadership was to examine not only how being connected to natural support networks can improve people with IDD’s quality of life, but also to see the impact it has on service expenditures. To do so, we analyzed Personal Outcome Measures® and service expenditure data from 251 people with IDD.
Only 32% of people with IDD in our sample were connected to natural support networks (had the outcome present). Yet, we found that when people were connected to natural support networks, they had a significantly higher quality of life, regardless of their support needs or other demographics (11.1 out of 20 versus 9.3 out of 20).
In addition to leading to improved quality of life, people with IDD who were connected to natural support networks also had significantly lower service expenditures compared to people who were not connected to natural support networks, regardless of their support needs or other demographics ($100,185 versus $120,531; see figure).
The Relationship Between Natural Support Networks and Service Expenditures
“When utilized properly, natural supports can substitute for some formal services because of their association with non-disability specific services and community and family supports, and thus produce cost savings… However, there is danger in utilizing natural supports in lieu of providing formal services solely for cost-cutting – we do not believe our findings should be interpreted to mean natural supports should replace all formal services and supports… Instead, we argue natural supports should embrace interdependence… Interdependence challenges deficit-based understandings of disability, and puts the person with disabilities in the driver’s seat of their own lives because by its very nature it focuses on strengths and relationships, and is person-centered… Embracing natural supports, and by extension interdependence, also reflects the values of self-advocacy and disability culture, which have long incorporated interdependence into their tenets… As such, we believe natural supports should be utilized more frequently with people with IDD, particularly in a way that embraces interdependence, empowerment, and self-determination” (Friedman, 2020, pp. 13-19).