You've spent years caring for your adult child with special needs. Now you're worried about what will happen when you can no longer provide care. Where will your son or daughter live? Who will support them?
Choosing the right residential option is one of the most important decisions a family can make. The Paoli estate planning attorneys at Ruggiero Law Offices help Pennsylvania families explore special needs housing options that match their loved one's needs while protecting their financial security and benefit eligibility.
Pennsylvania Residential Options for Adults With Special Needs
Pennsylvania offers several residential housing choices, each with distinct benefits and support levels. The Office of Developmental Programs (ODP) oversees these service models within the Pennsylvania Department of Human Services, which maintains a directory of Administrative Entities (AEs) to help families identify their local contact.
Group Homes
Community homes provide residential settings where adults with disabilities receive round-the-clock staff support. These facilities serve individuals with intellectual disabilities or autism. Capacity is set by each home's individual license and can range from small settings to homes serving nine or more individuals.
Staff help residents with meal preparation, medication management, personal care, and household tasks. They also support community participation and life skill development.
Supported Living Arrangements
Supported living allows adults with disabilities to live in their own apartments while receiving assistance based on their Individual Support Plan (ISP). Staff help with budgeting, meal planning, medication reminders, and transportation. Support hours vary according to assessed needs. Residents maintain control over their space and daily routines.
Pennsylvania residents access these services through Medicaid waivers, including the Community Living Waiver, Consolidated Waiver, and Person/Family Directed Support (P/FDS) Waiver. The Adult Autism Waiver provides additional options for eligible individuals. This option works well for adults who need assistance but can handle many daily activities independently.
Life Sharing Arrangements
Life sharing places an adult with disabilities in a trained caregiver's home for long-term placement. Host families receive compensation for providing room, board, and support. These arrangements must meet Pennsylvania licensing requirements.
Life sharing benefits adults who thrive on close personal relationships and prefer family settings. Finding the right match requires careful consideration of personalities, interests, and care needs.
Intermediate Care Facilities
Intermediate Care Facilities (ICFs) provide 24-hour skilled care for individuals with intellectual disabilities who require intensive support and medical supervision. Licensed under federal standards, ICFs offer a higher level of nursing care and therapeutic services than group homes. While less common than other residential options, ICFs serve individuals with significant medical or behavioral needs.
Personal Care Homes
Personal care homes provide room, board, and assistance with daily living for adults who need more support than independent living offers but don't require skilled nursing care. Licensed facilities help with bathing, dressing, medication management, and meals.
Support levels fall between the independence of supported living and the intensive care at intermediate care or skilled nursing facilities.
Continuing Care Retirement Communities
While Continuing Care Retirement Communities (CCRCs) are primarily designed for older adults over 55, some families consider these options for adults with special needs approaching or at retirement age.
CCRCs offer graduated levels of support from independent living to skilled nursing on one campus. However, CCRCs are not part of the ODP service system and typically require substantial entrance fees and monthly costs that may not be covered by Medicaid waivers.
Evaluation Factors When Choosing Special Needs Housing
When comparing residential options, families should assess multiple dimensions of care and quality.
- Level of care and support. Match support levels to your loved one's actual needs. Can they manage personal hygiene independently? Do they need medication reminders?
- Location and community integration. Consider proximity to family, day programs, and public transportation. Look for nearby parks, libraries, and community resources.
- Staffing quality and training. Watch staff interactions with residents. Ask about training programs, especially specialized training relevant to your loved one's needs.
- Cost and funding sources. Most Pennsylvania residents with disabilities can access services through Medicaid waiver programs after navigating the waitlist process.
- Quality of life. Resident rights include freedom from abuse, respect for dignity, control over finances, and community access. Talk with current residents and families about their experiences.
Estate Planning and Residential Care Decisions
Residential care decisions connect directly to broader estate planning strategies that protect your loved one's financial security and benefit eligibility.
Special Needs Trusts
Special needs trusts provide supplemental support without disqualifying beneficiaries from means-tested benefits. While shelter expenses may affect SSI, food costs no longer do under updated regulations. Trusts can cover housing-related expenses like adaptive equipment, furniture, utilities, and supplemental services.
Guardianship Considerations
Adults with significant disabilities may require guardians to make residential placement and medical decisions. Pennsylvania courts prefer limited guardianship to preserve individual autonomy when possible.
Estate planning documents should name successor guardians who will assume responsibilities after the parents' deaths. Choose individuals who share your values, understand your child's needs, and have the commitment to serve.
Ongoing Review
Review your estate plan every three to five years or when significant changes occur. Residential needs evolve as individuals age and develop different care requirements. Plans must remain flexible to accommodate changing circumstances. If an arrangement doesn't work, changes can be made.