Massachusetts Group Homes and Shared Living for Adults with Disabilities
Residential Options Through DDS
When an adult with an intellectual or developmental disability needs more support than their family can provide at home, Massachusetts DDS funds two primary residential models: group homes (also called residential habilitation) and shared living arrangements. Both require DDS eligibility and a funded HCBS waiver, typically the Community Living or Intensive Supports Waiver.
These are not options a family can purchase or arrange independently through DDS. Placement depends on the individual's priority level, waiver funding, and regional provider capacity.
Group Homes: Residential Habilitation
A DDS-funded group home is a staffed residential setting where a small number of adults with disabilities (usually 3 to 6 residents) live together with paid staff. Group homes are operated by DDS-contracted provider agencies, not by DDS directly.
Staff in group homes assist with daily living tasks — meal preparation, medication management, personal hygiene, household chores, and community outings. The level of support ranges from light overnight supervision to full 24-hour hands-on assistance, depending on the residents' needs and the waiver tier funding the placement.
Group homes are funded through the Community Living Waiver (for moderate support needs) or the Intensive Supports Waiver (for individuals requiring 24/7 supervision due to significant behavioral, medical, or physical needs).
The reality families need to understand: group home placements in Massachusetts are in chronic short supply. New placements depend on a current resident leaving and on provider capacity. Families assigned Priority 2 status may wait years for a group home placement.
Shared Living: A Different Model
Shared living is an alternative to the group home model. Under shared living, the individual with a disability lives in the home of a trained caregiver (called a "shared living provider"). The provider is typically not a family member — they are a community member who has been recruited and trained by a DDS-contracted agency.
The shared living provider provides housing and supports through the DDS-contracted service arrangement. The individual becomes part of the provider's household, sharing meals, living spaces, and daily routines.
Shared living works well for individuals who thrive in a family-style environment and do not need the intensity of a staffed group home. It offers more personal attention than a group home (the provider typically supports one or two individuals rather than a group), and it tends to feel less institutional.
The trade-off: shared living placements depend entirely on the availability and stability of individual providers. If a provider decides to stop hosting, the individual must be matched with a new provider or moved to a different residential model. Provider turnover can be disruptive.
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Who Qualifies for Residential Placement
DDS residential services are reserved for individuals who meet both clinical and administrative criteria:
- DDS clinical eligibility under 115 CMR 6.00 (documented intellectual or developmental disability)
- MassHealth Standard enrollment (required for HCBS waiver participation)
- An HCBS waiver slot — either Community Living or Intensive Supports, both of which include residential services in their service arrays
- Priority determination that justifies residential funding — Priority 1 cases (caregiver death, homelessness, abuse/neglect crisis) are funded first; Priority 2 cases enter the waitlist
The practical threshold is this: if the individual is safe and adequately supported at home with family, DDS is unlikely to prioritize residential placement unless the family demonstrates that the current arrangement is unsustainable.
How to Request Residential Supports
The process starts with your DDS service coordinator. If your family member is DDS-eligible and you believe residential placement is needed, request a formal review of their priority level and discuss residential options during the annual Individual Service Plan meeting.
Document the case thoroughly:
- Medical records showing increased care needs
- Evidence that the primary caregiver's capacity has declined (their own medical records, if they consent)
- Behavioral incident reports demonstrating safety concerns
- A letter from the family describing why the current arrangement is no longer sustainable
If the priority level does not warrant immediate residential funding, keep documenting. Priority reassessments can occur at any time when circumstances change.
The Massachusetts SSI at 18 & Adult Disability Benefits Guide covers how residential placements interact with SSI payments, MassHealth coverage, and ABLE accounts — including how moving into a group home may change the SSI living arrangement category and state supplement amount.
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