Group home supports

What the manual describes

What this service can help with

• Daily care, supervision, and support in a staffed residential setting
• Self-care, communication, mobility, health, socialization, money-management, and household skills
• Community participation and nonmedical transportation
• Staff support and professional management matched to the person's assessed level of need
• Separate residential nursing oversight when it is identified and authorized
• Specified support during a hospitalization when the hospital cannot meet a documented disability-related need

Source-backed working pathway

To establish you'll probably need:

These steps translate the cited manual section into a practical review sequence. Confirm the current local process before acting.

1. 1

   Confirm the residential need and Comprehensive Waiver pathway.

   Work with the support coordinator and planning team to document why a staffed provider-controlled home is being considered, what less intensive options were explored, and which daily, overnight, health, behavioral, communication, and community supports are needed.

   Evidence: manual 6.13 availability and service description
2. 2

   Identify the required staffing and residential features.

   Describe the person's supervision level, mobility and medical needs, behavioral supports, private-space preferences, accessibility needs, transportation, nursing oversight, and the staffing category or individualized pattern needed to provide safe and effective support.

   Evidence: manual 6.13 service description, provider staffing model, and nursing oversight
3. 3

   Compare qualified homes and exercise informed choice.

   Confirm each candidate provider's Department of Mental Health contract and certification or accreditation. Visit possible homes when feasible and compare location, housemates, rights, routines, staffing, community access, transportation, health support, and how the setting meets home-and-community-based requirements.

   Evidence: manual 6.13 setting and provider requirements
4. 4

   Separate included supports from other costs and services.

   Confirm what the Group Home rate includes, what room-and-board and personal costs remain, whether nursing or transportation needs separate authorization, and which Personal Assistant, Individualized Skill Development, or Community Networking requests would duplicate the residential service.

   Evidence: manual 6.13 service description, limitations, and billing information
5. 5

   Finalize authorization, transition planning, and the start date.

   Document the chosen home, staffing and supervision, objectives, health and medication supports, transportation, emergency coverage, move plan, and separately authorized nursing or other services in the person-centered service plan before relying on the placement.

   Evidence: manual 6.13 service description, billing information, and documentation

Important boundaries

Limits that may affect fit or authorization

• Group Home is available through the Comprehensive Waiver only and is delivered in a provider-owned or provider-controlled setting that must meet federal home-and-community-based settings requirements.
• The residential payment does not cover room and board. Families should confirm the person's separate responsibility for housing, food, utilities, and personal expenses.
• Personal Assistant, Individualized Skill Development, and Community Networking are already components of Group Home and cannot be separately authorized at the same time.
• Immediate family members cannot be paid directly or indirectly to provide Group Home supports.
• Nonmedical transportation is included in the Group Home rate. Additional waiver transportation may be authorized for work or day habilitation when it does not duplicate the residential payment. Medical services themselves remain the responsibility of the Medicaid state plan or other applicable coverage.
• Hospital support may address only needs the hospital cannot provide, must be identified in the person-centered service plan, and cannot replace services the hospital is legally required to provide.
• The manual lists one Group Home unit per day. A provider's enrollment does not establish an opening, suitable housemate match, staffing capacity, or appropriate placement.
• Comprehensive and Community Support waivers remain under a temporary renewal extension through December 27, 2026, or until CMS grants final approval. Confirm the currently approved rules with the support coordinator; proposed renewal changes are not automatically active.

Do not assume this part

Questions to confirm locally