Xiaolin Xu, Caitlin Piccone, Meghan Burke, Tom Collier, Aleminew Mekonen, Tiffany Dean, Tara Verse, Heather M. Aldersey
As disability services in the United States continue to shift toward community-based care, integrating formal and natural supports has become increasingly important for individuals with intellectual and developmental disabilities (IDD) and their families. However, limited research has examined how organizations facilitate this integration. This study explores how Community Choices, a cooperative human services organization in Illinois, enables integrated supports for adults with IDD. Data were collected from semi-structured interviews with eight family caregivers, seven persons with IDD, and nine staff members, as well as organizational and public documents. Data were analyzed using reflexive thematic analysis. Findings were organized into four themes: (1) “with you, not for you,” a philosophy that positions formal supports as a bridge to independence and community connection; (2) flexibility and risk-taking, enabled by small organizational size, leadership promoting collaboration, and flexible funding; (3) the value of the cooperative model, which fosters shared ownership and peer support; and (4) areas for improvement, including future planning, growth tensions, self-advocate leadership, and equitable representation. This study has implications for designing disability services that integrate formal and natural supports. It demonstrates the value of cooperative, person-centered models and identifies growth tensions and gaps in future planning and in supporting individuals with intensive support needs.