Shared living

What the manual describes

What this service can help with

• A family-style or companion-style home with personal guidance and attention
• Personal care, grooming, medication support, health monitoring, meals, laundry, and essential household tasks
• Safety supervision and help attending medical or other appropriate appointments
• Skill development, greater independence, and community integration
• Participation in family, cultural, neighborhood, and community activities
• Transportation included as part of the residential service

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 identify why a host-family or companion model fits the person's assessed needs, preferences, relationships, culture, routines, and community goals.

   Evidence: manual 6.29 availability and service description
2. 2

   Choose between Host Home and Companion services.

   Clarify whether the person wants to move into a caregiver's home or receive support from a companion in the person's own home. Document location, privacy, bedroom, accessibility, household, and relationship preferences.

   Evidence: manual 6.29 service description
3. 3

   Define the support, cost, and safety plan.

   Document personal care, medication, health, supervision, meals, household skills, transportation, community participation, emergency coverage, and the room-and-board or personal costs that are outside the service payment.

   Evidence: manual 6.29 service description and limitations
4. 4

   Compare qualified caregivers or agencies for compatibility.

   Confirm the Department contract and certification or accreditation. Meet possible hosts or companions when feasible and compare household expectations, relationships, communication, routines, other residents, rights, transportation, community life, and backup arrangements.

   Evidence: manual 6.29 service description and provider requirements
5. 5

   Authorize the chosen arrangement before relying on it.

   Record the selected home and provider, daily supports, objectives, health and medication procedures, transportation, room-and-board responsibilities, backup coverage, and start or move plan in the person-centered service plan.

   Evidence: manual 6.29 service description, limitations, billing, and documentation

Important boundaries

Limits that may affect fit or authorization

• Shared Living is available through the Comprehensive Waiver only and is provided as Host Home or Companion services in a private home certified by the Division of Developmental Disabilities.
• No more than three supported individuals may share a Shared Living location, counting recipients across waiver, private-pay, foster-care or other funding sources. This refers to people receiving support, rather than a total of every household member. Each Host Home recipient generally has a private bedroom unless they choose otherwise.
• A parent of a minor child, legal guardian, or spouse cannot provide Shared Living to that child, ward, or spouse.
• Personal Assistant, Individualized Skill Development, and Community Networking are included components and cannot be separately authorized with Shared Living. A person receiving Shared Living is also ineligible for Medicaid state-plan personal care.
• The payment does not include room and board, items of comfort or convenience, or home maintenance, upkeep, and improvements. These costs must be addressed separately.
• Transportation is included in the Shared Living rate. Hospital support can address only needs the hospital cannot provide and cannot replace hospital obligations.
• The manual lists one Shared Living unit per day. Certification does not establish a compatible match, current opening, or available caregiver.
• 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