When a parent asks "where will my adult child live when I can't do this anymore?" — this is the question underneath it. Group-home and supported-living options for adults with autism or an intellectual or developmental disability (IDD) do exist, but the path is specific, and the biggest mistakes are made by waiting too long.
The funding is almost always a Medicaid waiver
Residential support for adults with IDD is generally paid by a Medicaid Home and Community-Based Services (HCBS) waiver — often called a DD, IDD, or (by various state names) a "comprehensive" waiver. It pays for the support; the resident's SSI generally covers room and board. The home itself must be licensed for this population, with staff trained for it.
The waiver almost always has a waiting list, and it does not move until you are on it. In some states the wait is years. This is the single most important action a family can take: request a level-of-care assessment and get on the list now, even if the person lives at home today and won't need placement for years. Details on the waiver waitlist.
What a good IDD home looks like
- Predictable routine and staffing matched to each person's support level.
- Awake overnight staff if the person needs help at night — ask this directly; it's a different service.
- Real day activity — work, a day program, community connection. Housing without a life attached to it is only half the answer.
- Attention to dietary and choking safety, communication supports, and sensory environment.
- Behavior support done right — any restriction must be in a written, individualized plan, never a blanket house rule.
Plan the legal and financial side early
Before the 18th birthday, and long before placement, families should look at guardianship vs. supported decision-making, a special needs trust, and a letter of intent. These protect the person's benefits and document your wishes. Terms like ISP, level of care, and HCBS are decoded in our glossary.
How to start
Contact your state's developmental-disability agency, ask for an eligibility determination and level-of-care assessment, and get on the waiver list. A support coordinator or case manager can then help identify homes licensed for IDD. General questions about cost and admission are answered in our FAQ, and the agencies that can help by state are on our resources page.
Where Mai Heaven fits
Adults with IDD are a core population Mai Heaven is being built for — small homes where staff know each person, not a facility. We're pre-licence and not yet admitting residents. What we can do now is add someone to a waiting list a real person reads, and reach out as homes come online. For how families work with us, see families & residents.