Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Adults with Developmental Disabilities


The most common type of residential care facility serving adults with developmental disabilities is the group home. Group homes are generally operated by agencies that both own the settings and provide the support staff assisting the residents.

Based on the state’s policy goals and the interests and preferences of stakeholders, group homes may also be made available to other populations, such as children with developmental disabilities or serious emotional disturbances. As with adult and child foster care, waiver services provided in group homes and other residential care facilities for persons with developmental disabilities are subsumed under the waiver service category of residential habilitation. CMS provides a general definition of residential habilitation but states have the flexibility to adopt this suggested definition or create a completely different definition crafted to suit the state’s services system and array of settings.26

States may establish highly specialized group homes to serve specific populations, such as individuals with autism spectrum disorders, intensive medical support needs, or challenging behaviors. These specialized settings may have additional requirements, such as specialized training, and may receive additional reimbursements due to the nature of the services provided.

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