RESIDENTIAL SUPPORT SERVICES PROVIDER IN PENNSYLVANIA

Fatumata Kaba
Oct 7
3 min read

PROVIDING PERSON-CENTERED HOUSING SUPPORTS TO PROMOTE INDEPENDENCE, STABILITY, AND COMMUNITY INCLUSION

Residential Support Services in Pennsylvania are Medicaid-funded programs that offer 24/7 or intermittent supervision and assistance for individuals with intellectual or developmental disabilities (IDD). These services help individuals live safely in community-based settings while receiving the daily supports they need to develop life skills, maintain health, and participate meaningfully in society. Residential supports are funded under the Consolidated and Community Living Waivers through the Office of Developmental Programs (ODP).

1. GOVERNING AGENCIES

Agency: Pennsylvania Department of Human Services (DHS) – Office of Developmental Programs (ODP)

Role: Certifies, funds, and monitors residential service providers for individuals with IDD.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal regulation and oversight of Medicaid waiver services, including residential options.

Agency: Administrative Entities (AEs) / County MH/ID Offices

Role: Coordinate local provider qualification, service authorizations, and quality monitoring.

Agency: Pennsylvania Department of State

Role: Handles legal business registration for residential service providers.

2. RESIDENTIAL SUPPORT SERVICES OVERVIEW

Residential support includes individualized services delivered in certified homes to help people live with dignity, autonomy, and access to community life.

Approved providers may deliver:

Community Homes (licensed): 24/7 support in small group homes for 1–4 individuals.
Life Sharing (unlicensed): Individuals live with host families and receive supports in a shared environment.
Supported Living (unlicensed): Support for individuals living in their own apartment or home.
Daily Living Support: Assistance with cooking, hygiene, laundry, medication, and household management.
Community Participation Support: Outings, recreational activities, and social engagement.
Health and Safety Monitoring: Oversight to ensure medical, behavioral, and nutritional needs are met.
Documentation: Shift notes, ISP tracking, medication logs, and Medicaid billing records.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Pennsylvania Department of State.
Obtain an EIN and Type 2 NPI.
Qualify as a provider through the ODP’s Home and Community Services Information System (HCSIS).
Obtain Chapter 6400 licensure from ODP (for licensed community homes).
Meet Life Sharing or Supported Living guidelines (for unlicensed options).
Maintain liability and workers’ compensation insurance.
Develop a Residential Services Policy & Procedure Manual based on ODP and CMS standards.

4. PENNSYLVANIA PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and acquire EIN, NPI, and insurance.

Step 2: Apply for provider qualification through HCSIS and complete all required documents.

Step 3: If offering licensed homes, complete the Chapter 6400 facility licensing application.

Step 4: Complete fire safety, environmental inspection, and staff clearances.

Step 5: Receive approval and begin receiving referrals through County MH/ID and Supports Coordinators.

5. REQUIRED DOCUMENTATION

Articles of Incorporation and business registration
EIN and NPI confirmations
Chapter 6400 license (if operating a licensed community home)
Insurance certificates
Residential Support Services Policy & Procedure Manual including:
- Individual Support Plan (ISP) implementation procedures
- Medication administration and incident reporting
- Staff supervision and ratio standards
- Participant rights, grievances, and confidentiality safeguards
- Safety drills and emergency preparedness protocols
- Daily documentation templates and shift notes
- Billing forms and audit readiness tools

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)

Requirements: Background checks, orientation training, First Aid/CPR, and ODP-mandated competencies.

Role: Residential Program Supervisor

Requirements: Oversees compliance, staff scheduling, documentation, and resident well-being.

Role: Medication Administrator (optional)

Requirements: Completed Medication Administration Training (ODP-certified).

All staff must complete:

ODP-approved orientation and annual refresher training
Person-centered planning and ISP implementation
Abuse prevention and incident management
HIPAA and documentation compliance training
Emergency response and behavior support (if applicable)

7. MEDICAID WAIVER PROGRAMS

Residential support is funded through:

Consolidated Waiver (ODP):
- Community Homes (licensed)
- Life Sharing
- Supported Living
Community Living Waiver (ODP):
- Supports individuals in shared or individual residences without 24-hour residential services
Note: The Person/Family Directed Support (P/FDS) Waiver does not cover residential services.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Policy Manual Creation

Timeline: 1–2 months

Phase: ODP Qualification & Licensure (if required)

Timeline: 3–4 months

Phase: Staff Hiring, Credentialing & Training

Timeline: 30–60 days

Phase: Referral Coordination & Home Activation

Timeline: Begins once licensing is approved and ISP authorizations are received

9. CONTACT INFORMATION

PA DHS – Office of Developmental Programs (ODP)

Website: https://www.myodp.org

PA HCSIS Provider Portal

Website: https://www.hcsis.state.pa.us

Chapter 6400 Licensing & Guidance

Website: https://www.dhs.pa.gov/providers

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

PA Department of State – Business Services

Website: https://www.dos.pa.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — PENNSYLVANIA RESIDENTIAL SUPPORT PROVIDER

WCG supports providers with everything needed to launch successful, compliant residential programs that prioritize person-centered living in Pennsylvania.

Scope of Work: