1. Program Definition and Services
Residential Support Services in Pennsylvania deliver structured personal care, life skills training, and 24/7 or intermittent habilitative community supervision to waiver participants with intellectual disabilities or autism.
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Community Homes (Licensed): Operating continuous, 24/7 structural care and safety supervision within small group residential properties serving 1 to 4 residents
- Lifesharing (Family Living): Structuring arrangements where an individual occupies a bedroom within a host family's private residence, receiving shared community living support
- Supported Living (Independent Habilitation): Providing localized, drop-in task supervision (such as financial budgeting, medication management, and grocery shopping) for individuals living in their own private apartments or homes
2. Regulations
Residential providers operating across the Commonwealth are bound by strict administrative requirements.
3. Licensing or Certification
Licensing criteria are tied to the selected housing setting:
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Community Homes: Operating a standard group living site requires a formal Chapter 6400 Community Home License issued by the Department of Human Services (DHS) Bureau of Human Services Licensing
- Lifesharing/Supported Living: These models are technically exempt from standard Chapter 6400 physical facility licensing but must pass thorough environmental health reviews and programmatic certifications under Chapter 6500 standards or specialized ODP check-offs
4. Responsible State Agency
Regulatory monitoring, licensing site inspections, and program quality validations are co-managed by the Pennsylvania Department of Human Services (DHS) through the Office of Developmental Programs (ODP).
5. Application Process
The onboarding sequence follows a strict regional framework:
- Experience Verification: Per ODP policy mandates, new organizations are generally required to demonstrate a minimum of two years of clear, active experience providing non-residential waiver care prior to pursuing residential services
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Needs Assessment & Qualification: Apply during open Request for Application (RFA) periods by submitting your agency profile via the Home and Community Services Information System (HCSIS)
- Licensing & System Link: Undergo on-site environmental safety checks to clear your Chapter 6400 facility certificate, then link the completed file into the state's electronic PROMISe™ Medicaid Portal under Provider Type 51 (Home and Community Habilitation)
6. Required Documentation
Applicants must compile and upload a formal verification package, including:
- Active Pennsylvania Bureau of Corporations Business Registration (PennFile)
- IRS Employee Identification Number (EIN) validation page
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Type 2 Organizational National Provider Identifier (NPI) verification
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Approved Chapter 6400 Facility License certificate (if applicable)
- Three years of certified corporate financial statement history or structural audits
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Certificates of active Workers' Compensation and Commercial General Liability insurance
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An agency-specific Residential Policy Manual featuring explicit behavioral support guidelines, restrictive procedure prohibitions, human rights committee setup workflows, and Enterprise Incident Management (EIM) procedures
7. Timeline for Approval
Navigating localized AE reviews, architectural floor plan reviews, fire safety inspections, and the final state PROMISe™ software system link requires a launch runway of 4 to 6 months.
8. Pre-Application Process
Before approaching state human service departments, founding executives must file their corporate architecture with the Pennsylvania Department of State, secure their EIN from the IRS, sign a commercial deed or lease for an accessible residential property matching municipal zoning laws, and establish their corporate Type 2 NPI.
9. Pre-Application Training
Agency operators must successfully complete the mandatory ODP New Provider Orientation Training and designated residential service series on the MyODP system.
10. Additional Notes
- Securing an active PROMISe™ credential profile does not result in automated resident matching or steady participant placement volumes from county case managers
- Residential services are reimbursed using a specialized Performance-Based Contracting (PBC) tier framework, which links your agency's payment caps to your compliance with clinical staffing, Board inclusion metrics, and Health Risk Screening Tool (HRST) integration
- Funding under these waivers strictly isolates service care costs; Medicaid waiver dollars cannot be used to pay for a participant's basic housing room and board, which must be collected through individual SSI allotments or private rent agreements
Why Choose Waiver Consulting Group?
Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.
With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.
To get started, click the link to request portal access.