Funding for Residential Support Services

Housing and Residential Supports Tool Kit

Most families cannot afford to privately support an adult with significant behavioral and/or medical needs. Therefore, it is critical to consider the support services that the individual will need to determine if appropriate and sufficient funding is available.

Families should discuss funding options with the state agency responsible for serving adults with developmental disabilities. In most states, individuals who need residential support will need to be eligible for Medicaid – a program designed to pay for intensive services. In the past, Medicaid funding was limited to those who lived in certain types of facilities. But now, through the use of Medicaid Home and Community‐Based Waivers, people with autism and other disabilities can use these funds more flexibly. For more information on Medicaid and Medicaid Waivers, click here.

As stated earlier in this tool kit, many families are surprised to learn that the adult service system is not one of entitlement, but rather eligibility for services. Unlike special education services under the Individuals with Disabilities Education Act (IDEA), Medicaid Waiver services allow states to keep a waiting list, and allow states to limit the number of people served.

To find out about your state’s Medicaid Home and Community‐Based Waivers, click here, or contact your state’s disability services agency.

Medicaid Benefits

Individuals who qualify for SSI are eligible to receive Medicaid. Medicaid pays for a wide array of services for people with disabilities and provides government‐funded health insurance for children and adults with disabilities who have limited financial resources. Medicaid also provides government funding for long‐term services and supports, including institutional care in nursing facilities and, in some cases, non‐specialized placements for people with disabilities.

To be eligible for Medicaid, a person must fit in a specific category of coverage (i.e. age 65 or above, blindness, disabilities), and meet income and assets requirements.

Medicaid Home and Community‐Based Waiver Services

Waiver services are an option available to states to provide integrated community‐based longterm care services and supports to qualified Medicaid recipients. The programs “waive” some of the rules of Medicaid to serve children and adults otherwise requiring an institutional level of care who can instead be served at home or in the community. Medicaid is a state‐administered program and each state sets its own guidelines.

These programs may provide a combination of both traditional medical services (i.e. dental services, skilled nursing services) as well as non‐medical services (i.e. respite care, case management and/or environmental modifications). Family members and friends may be providers of waiver services if they meet the specified provider qualifications. For more information, click here.

Other Funding Methods for Support Services

There are other methods of funding services that do not require a Medicaid Waiver, but the available funds are limited and usually unable to support the full scope of services that an adult with autism needs.

These include:

  • Family support dollars
  • Private funding
  • Private health insurance
  • State‐only funding
  • Local funding
  • Grants and foundations

Regardless of the funding mechanisms available, planning is crucial.

Read more in the Autism Speaks Housing and Residential Supports Tool Kit.