Questions Families Should Ask Before Choosing an ID/DD Residential Provider

Prepare with the adult who will live there

Before the visit, ask the person what they want to learn about the home and how they would like to participate. Bring communication tools, a preferred support person, or written questions if helpful. The goal is not to quiz someone about their abilities; it is to understand whether the setting can support their choices and needs.

Use the same core questions with each provider and record what was answered, what was uncertain, and what requires follow-up. Separate an observation during a short tour from a verified service commitment. Virginia’s person-centered planning requirements and HCBS guidance make individual preferences, dignity, and choice central to the discussion.

Official guidance: Virginia Administrative Code: Individual support plans (12VAC30-122-190) · DMAS HCBS Toolkit: General Requirements for All Settings

Ask about the exact service, license, and individual fit

Ask, ‘What service are you licensed to provide at this address?’ Request current licensing information and confirm the service with the support coordinator. Supported Living and Group Home Residential have distinct definitions and waiver coverage. A website description does not establish that every support a person needs is available at the home.

Ask how the provider assesses whether it can safely meet individual needs, what information is required, and how that information should be shared. Discuss clinical or specialized support questions through appropriate professionals and a suitable private channel, not an ordinary website contact form. Request a clear explanation if a service or need falls outside what the provider can offer.

• What exact residential service would be offered here?
• Which waiver and service authorization would apply?
• How is individual fit assessed, and who participates?
• What must be confirmed before a move-in decision?

Official guidance: Virginia Administrative Code: Supported living residential service (12VAC30-122-540) · Virginia Administrative Code: Group home residential service (12VAC30-122-390)

Ask how support works at different times of day

Ask when staff are physically present, how a resident requests help, and how timely responses are arranged. Supported Living’s rule describes around-the-clock staff availability; Group Home Residential’s rule describes paid staff physically present for continuous service up to 24 hours per day. Do not assume these descriptions mean identical staffing in every setting.

Ask how staff learn the person’s communication preferences and ISP goals, how training and supervision are handled, and what happens if support needs change. Rather than seeking a promise that no problem will occur, ask about the process for raising concerns, reviewing incidents, and coordinating with the support team.

• How would help be available overnight or during an unexpected need?
• How are staff prepared for the person’s assessed supports?
• Who should a resident or family contact with a concern?
• How does the provider coordinate changes with the support coordinator?

Official guidance: Virginia Administrative Code: Supported living residential service (12VAC30-122-540) · Virginia Administrative Code: Group home residential service (12VAC30-122-390) · Virginia Administrative Code: Individual support plans (12VAC30-122-190)

Ask about privacy, choices, and relationships

Ask what happens when a resident wants a different meal, a quiet evening, a visitor, or an activity that other housemates do not choose. DMAS HCBS guidance emphasizes privacy, dignity, autonomy, community access, and choice of services and providers. A shared home does not mean everyone must have the same schedule or goals.

Ask to review the residency agreement and how individual rights are explained in an accessible way. If restrictions are proposed, ask how they are individually assessed and reviewed within applicable requirements rather than accepting a blanket house rule. Explore how a resident can voice dissatisfaction or request a change without losing their role in decisions.

Official guidance: DMAS HCBS Toolkit: General Requirements for All Settings · DMAS: Home and Community-Based Services Toolkit

Ask how daily goals and community connections are supported

Request an explanation of how personal goals become practical daily supports and how progress is reviewed. Ask how the provider distinguishes doing a task for someone from helping them learn or retain a skill. Independence can include asking for assistance and making choices; it is not a requirement that a person complete every task alone.

Discuss existing friendships, family visits, work, recreation, and familiar places. Ask who would arrange transportation and whether any costs apply. A calendar of outings does not show whether each person has meaningful choices or sustained relationships. No specific outing, employment outcome, or transportation arrangement should be assumed from general marketing.

Official guidance: Virginia Administrative Code: Supported living residential service (12VAC30-122-540) · Virginia Administrative Code: Individual support plans (12VAC30-122-190) · DMAS HCBS Toolkit: General Requirements for All Settings

Ask for written costs and a realistic transition plan

For Supported Living, room and board are outside the waiver service. Ask for written housing charges and other expenses, the agreement’s terms, and responsibilities at move-in or departure. Discuss these separately from Medicaid service authorization.

Confirm availability directly and ask what remains before admission. At MSL, referrals require an active, eligible Virginia DD Waiver and individualized assessment in accordance with the ISP. Our home is in Manassas; a tour or inquiry neither reserves a place nor guarantees acceptance. Families can start with a general question and ask for an appropriate way to share assessment information later.

Official guidance: Virginia Administrative Code: Supported living residential service (12VAC30-122-540)