I have been a mental health professional for over 20 years. I provide case management services for people with developmental disabilities.
One of the most difficult times a parent of a special needs child experiences is when their child becomes a young adult and needs transition services. It’s a time of extreme anxiety as they see their child age out of the comfort and security of the school system—and into the new world of adult services. One of the toughest decisions a parent can make is to place their child in a facility outside of the home.
Virginia’s Medicaid Intellectual Disability Waiver provides two forms of residential placement options. These options include group home placement and sponsored residential services. We will explore each of these options and discuss their benefits and limitations. Group homes have been the primary form of community-based residential services. However, sponsored residential services are rapidly becoming an alternative for families who wish to keep their loved ones at home.
When people think of outside residential placements, they usually think of a group home setting. A group home is a residence that serves individuals with intellectual disabilities and is staffed 24 hours a day. These homes are licensed and regulated by the state. Providers are reimbursed through Medicaid funding. Group homes are the primary form of outside residential placement in VA. Staff are usually trained to give medication, CPR, First Aid, and behavioral management. Group home staff provides all of the direct care services and provide all transportation to appointments and community outings. Group homes play a vital role in providing services to individuals in the community who might otherwise be placed in a state institution or more confined facility. Group homes are even more important now that Virginia is moving to downsize institutions and implement more community- based housing options.
However, there are some limitations to group home placements. Any time you live in close quarters with others, there is an increase in the chances of illness. Staffing may also impact the level of community integration. If there are not enough staff on duty, opportunities for community outings will be limited. The group home setting also provides limited one on one attention due to the needs of the other residents. Group homes also tend to have a high turnover rate. This could negatively impact the overall quality and consistency of care. As with just about any service, there are some good group homes and some group homes that do the bare minimum to keep their license. I encourage families to tour as many homes as possible, research, and ask questions before making any final decision on a placement.
Group home placements are not inexpensive but they do cost less than state institutions. Based on current reimbursement rates in Virginia, the average group home placement costs the state around $90,000 a year. This figure is what Medicaid reimburses the provider for staffing the home. This does not account for room and board which can range from $500-$700 per month.
Sponsored Residential Services
Sponsored residential services are an interesting alternative to the group home setting. Sponsored residential services are often compared to adult foster care in that it provides an opportunity for an individual to live with a private family or single caregiver instead of a home with other residents. Caregivers are hired and trained through agencies that are licensed by the state. These caregivers or “sponsors” provide all of the direct care just as the staff in the group home. Sponsors also have the flexibility of providing more one-on-one attention and more opportunities for community integration.
Another unique aspect of sponsored residential services is that parents and family members can also be certified to be sponsors and get paid for caring for their disabled family member. Some are opposed to family members getting paid to be caregivers but I think it’s a great idea. The program was originally established for rural areas of Virginia where there were limited service providers. It was actually less expensive to train family members and caregivers than to put people in facilities. In addition, the money that the family makes balances out because many parents of special needs children (or adults) have a difficult time maintaining a regular job due to the constant doctor appointments, therapy sessions, and meetings centered around services. Family members would have a better knowledge of the individual’s needs than staff in a group home. This option would also be most appropriate for individuals with specialized medical needs that can be best managed by a family member.
The average cost of sponsored residential is around $50,000 per year. Room and board costs are usually cheaper than that of a group home. Another advantage of sponsored residential services is that the income the caregiver makes is TAX-FREE. Caregivers do not have to file taxes for any income earned for providing these services.
I work with several clients and families that use this service and they have nothing but positive feedback. Clients reported that they have more freedom than they did in the group home setting. One family told me that this program has allowed their family to have the ability to go on vacations and enjoy life just like any other family. Families also point out that this program allows their loved one to receive care from people who have a personal connection with them as opposed to someone they don’t know. There is also a high turnover rate in group homes and they could have different care staff each day. High staff turnover diminishes the overall quality of care.
The sponsored residential program does have its limitations. Sponsor homes face the same regulations as group homes. They have to be approved by the fire marshal and the state licensure department. Personal homes may not be approved if they are not up to code.
The sponsor has to be able to complete documentation as if they were staff in a group home. A case manager with the sponsoring agency can assist with this documentation. This can be a difficult transition for families not use to documenting everything they do throughout the course of a day.
The sponsored residential program is not appropriate for everyone. Some family members start the program but later realize it was just too much work. Keep in mind this is a 24-hour-a-day job. Some situations call for a more structured environment due to certain behavioral and medical needs.
Group homes and sponsored residential services provide a vital service for people with intellectual and developmental disabilities. These services allow people with special needs to enjoy the same freedom to live in a normal neighborhood and community just like the rest of society. Unfortunately, institutions are the only option in some situations. However, more people are enjoying life in the community because of these community-based programs.
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2013 Martin D Gardner
Dave M on July 27, 2020:
Could you, please, tell me how often a supports coordinator checks with their residential sponsors?
Martin D Gardner (author) from Virginia Beach on January 25, 2019:
Virginia is the only state I know of that offers this type of service. There may some adult foster care options.
Ms. Jackie Wilson on January 23, 2019:
I am a therapeutic foster parent in Lima, Ohio. I am interested in becoming a Sponsored Residential Care Provider. Is there a network in Ohio so I can apply?
Martin D Gardner (author) from Virginia Beach on February 16, 2018:
He would still be able to attend a day program with sponsored residential services.
Laurie midkiff on February 16, 2018:
If I turn my home into a sponsored residential home does this disqualify my son for day support services out in the community?
Terri on August 15, 2017:
My son has been in group homes since 2005 I am considering bringing him home!
Angela on July 21, 2017:
Yes I just took on the responsibility of my 25 year old cousin and I was wondering how can I go about becoming a sponsor
Mike Washington on July 08, 2017:
Really great info, it has helped my fiance and I alot because her and I would like to work with children in our home, even though we probably won't make a dent into all the people who needs services but at least it's a start. Thank you
Martin D Gardner (author) from Virginia Beach on April 23, 2016:
Thanks S. Nicole. Because I’m still a case manager I’m not allowed to show preferential treatment to any specific providers. I would encourage you to review the providers in your area and get with your case manager (I assusme you have one) to determine which provider works best for you. Hopefully some of these changes with the state will open up more slots for people in the future. No one really knows at this point.
S. Nicole on April 21, 2016:
Thank you for the great article! I'm considering pursuing tho option for my 20 yr old special needs foster daughter w/ID, who has been with me for a few years. We are currently waiting to see if she will be awarded an ID waiver. I have been a TFC foster parent for a little over 10 years; so I feel like I have a solid foundation to build upon. Do you have an agency preference? If yes, why?
Martin D Gardner (author) from Virginia Beach on January 29, 2016:
Thanks for stopping by Chantelle. We have a similar situation in VA. I'm not sure if it's 21,000 but the amount of funding allocated each year is only a drop in the bucket for what's needed. And with more people added to the waitlist each year, it's a never ending cycle. There's really no excuse for people to have to wait years (some over a decade) for basic services.
Chantelle Porter from Ann Arbor on January 29, 2016:
Thank you for writing this article. So many people are not familiar with the treatment and associated costs of supporting adults with disabilities. In my state, we have 21,000 adults waiting for help. (I live in Illinois). It is a disgrace.
Sylvia N on December 15, 2015:
Loved your article. It is very informative. Thanks
Martin D Gardner (author) from Virginia Beach on May 03, 2015:
Thanks for the resource JD!
JD on May 03, 2015:
Leah, check out wallresidences.com. They are a great agency!
Martin D Gardner (author) from Virginia Beach on April 23, 2015:
Leah contact Serenity C&C, Inc. The contact number is in my previous comment.
Leah Bell on April 22, 2015:
If been looking into opening my home and becoming a sponsor. Do you know of any good agencies im the Richmond or Chester area?
Martin D Gardner (author) from Virginia Beach on March 20, 2015:
Hi Annette. Serenity C&C, Inc. is the only sponsored residential program that I know of that works with children. Contact their Chester office at (804) 681-0256. Most providers are only licensed to serve age 18 and up. Good Luck.
annette on March 20, 2015:
I'm trying to sponsor my child 14 with an ID waiver. So that I can spend more time with he needs. I live in the Richmond VA area
Can you help me
Andy Hullender on February 25, 2015:
If these funds are coming from a federal source, which they are, and you have less than 10 ind. under 19 or 5 over 19, these are considered "difficulty of care" payments by the IRS. Refer to IRS Pub 17, Chapter 12. This however may not be the case for state taxes and hence the 1099. However this is income exclusion only, FICA still applies.
Darwyn on March 12, 2014:
Call mr lee price director of special needs programming in Richmond, he's your guy and you should have a case manager who is your go to. Remember you do not work for them, they work for you. They are what's referred as a pass through. They get paid a fee to take care of paper work and training that's it
Elizabeth on December 27, 2013:
Thanks for your post. We are in the Central part of the state with very few agencies who serve our area. I have been trying to get an answer from the state 'powers that be,' with no success... but will keep trying.
Martin D Gardner (author) from Virginia Beach on December 18, 2013:
If he is in the Medicaid Waiver program you DO NOT have to pay taxes on that income. Some agencies have started to do this and it has caused a lot of problems. I'm not a tax expert but I would strongly recommend looking into another agency. If you live in the Hampton Roads/VA area I have an idea who might be your agency. I would recommend the UP Center, Blue Ridge Residential Services, or Support Services of VA. Hope that helps.
Elizabeth on December 17, 2013:
I am a parent and a sponsored family residential provider for my son. The agency is telling us that we do NOT qualify for the tax free status and are issuing 1099's causing us to have to file tax returns. Any info out there to help us argue against the 1099?
Denise W Anderson from Bismarck, North Dakota on August 27, 2013:
Thanks for pointing out some possible options we may need to pursue in the future. Our daughter with special needs is currently residing in our home, however, if the need arises for her to have 24 hour care, and a group home or hospital setting are not appropriate for her, I have considered the possibility of turning my home into a care facility where I would be paid to provide care for her and others, if necessary.
Elizabeth Parker from Las Vegas, NV on August 26, 2013:
I don't have children, but this is valuable information for those who do have special needs children. Thanks for sharing!
Martin D Gardner (author) from Virginia Beach on August 26, 2013:
Thanks for the input. It is very expensive but I think the quality of life it provides is worth every penny.
Dora Weithers from The Caribbean on August 26, 2013:
Thank you for dealing with this very important issue. There are no sponsored residential services in my country, and group homes are few and expensive. Still, it's good to be aware of what's happening in other places.