Yes, group homes for autistic adults exist across the United States, and they are one of several residential options available depending on the level of support a person needs. Most are funded through Medicaid waiver programs, though private-pay options also exist. The bigger challenge isn’t whether group homes are out there, but getting into one: the average wait time for Medicaid home and community-based services is 32 months nationally as of 2025.
Types of Residential Options
Group homes are small residential settings, typically housing between three and eight people, where staff provide daily support with things like cooking, personal care, medication management, and transportation. They sit in the middle of a spectrum of housing options for autistic adults. On one end, some people live independently with minimal check-ins from a support worker a few times a week. On the other end, intermediate care facilities provide round-the-clock nursing and structured care for people with the highest support needs.
Between those extremes, you’ll find several variations. Supervised group homes offer 24-hour staffing and structured routines. Supported living arrangements place a person in their own apartment or shared housing with staff who help as needed but aren’t always on-site. Some families also explore host family or adult foster care models, where an autistic adult lives with a trained caregiver’s family in their home. The right fit depends entirely on how much support the person needs with daily activities and how much independence they want.
Intentional Communities and Farmsteads
A growing alternative to traditional group homes is the intentional community model. These are planned neighborhoods or campuses where autistic adults (and sometimes adults with other disabilities) live alongside neurotypical peers in a shared environment. Some focus on agriculture: Homesteads for Hope, for example, was founded in 2013 and operates on 55 acres along the Historic Erie Canal in New York, combining a 25-acre community farm with plans for a 30-acre housing village. Residents learn, work, and live in an integrated setting.
These communities vary widely. Some look like small apartment complexes with shared social spaces. Others are rural properties built around farming, animal care, or artisan work. They tend to emphasize meaningful daily activities and social connection rather than just custodial care. The Autism Housing Network maintains a searchable directory of these types of communities across the country.
How Group Homes Are Funded
Medicaid is the primary funding source for most group homes. Specifically, Home and Community-Based Services (HCBS) waivers allow states to pay for residential supports that keep people out of larger institutions. Each state runs its own waiver programs with different names, eligibility rules, and services covered. In Michigan, for instance, the Children’s Waiver Program covers individuals with autism, developmental disabilities, or intellectual disabilities who meet a certain level of care need. The Habilitation Supports Waiver covers community living supports, overnight health and safety staffing, and supported employment for people with developmental or intellectual disabilities.
To qualify for these waivers, a person generally needs to meet two criteria: a clinical determination that they need the level of care typically provided in an institutional setting, and financial eligibility under Medicaid’s income and asset limits. The specific thresholds vary by state. If your family member doesn’t qualify for Medicaid, private-pay group homes are an option, but they can cost $2,000 or more per month. Some families combine private funds, Social Security benefits, and special needs trusts to cover costs.
The Waitlist Problem
Even after qualifying for a Medicaid waiver, getting a spot can take years. Across all HCBS waiver programs nationally, people wait an average of 32 months to begin receiving services. Some states have significantly longer waits, particularly for waivers that cover residential placements. The good news is that most people on a waitlist are still eligible for other types of home care and support services while they wait. But families should apply as early as possible, ideally well before the autistic person ages out of school-based services at 21 or 22.
What Federal Law Requires
Two major legal frameworks shape what group homes look like today. The first is the Olmstead decision, a 1999 U.S. Supreme Court ruling that found unjustified segregation of people with disabilities violates the Americans with Disabilities Act. Under Olmstead, states must provide community-based services when community living is appropriate, the person doesn’t oppose it, and the accommodation is reasonable given available resources. This ruling is the legal foundation for the shift away from large institutions and toward smaller, community-integrated settings like group homes.
The second is the HCBS Settings Rule from the Centers for Medicare and Medicaid Services. This rule requires that any setting receiving Medicaid HCBS funding must give residents full access to the benefits of community living. It also mandates person-centered planning, meaning the individual (not just their family or provider) directs the process of choosing where they live, what services they receive, and what goals they’re working toward. The rule uses an outcome-based definition of community integration, so a group home can’t simply be located in a neighborhood and call itself community-based. It has to actually function that way, with residents having opportunities to interact with people without disabilities, control their own schedules, and have privacy.
Staffing and Quality of Care
Unlike nursing homes, group homes and other residential care facilities have no minimum federal staffing standards. States set their own licensing requirements, and most give facilities flexibility to adjust staffing based on residents’ needs rather than mandating specific ratios. On average, residential care facility residents receive about 2.3 hours of direct care per person per day, most of it from personal care aides rather than nurses. Residents who need help with three or more daily activities (bathing, dressing, eating, toileting) live in facilities averaging closer to 2.9 hours of direct care per day, while those who are more independent receive about 1.8 hours.
About 20 percent of residential care facility residents live in settings with no licensed nursing staff at all. For autistic adults with complex medical needs, this is worth investigating carefully. Residents with cognitive support needs do tend to live in facilities with higher staffing levels, but the variation from one home to the next is significant. When evaluating a group home, asking about staff-to-resident ratios during daytime, evening, and overnight hours gives you a clearer picture than relying on averages.
How to Find a Group Home
There’s no single national database that lists every available group home bed, but several resources can help narrow the search. Your starting point should be your state’s developmental disabilities agency (sometimes called the Department of Intellectual and Developmental Disabilities or a similar name). Every state has one, and they administer the Medicaid waiver programs that fund most placements.
If your family member already receives services, their supports coordinator or case manager is the most direct route to finding openings. Supports coordinators handle the primary work of locating, coordinating, and monitoring services. In Pennsylvania, for example, the state maintains both a Services and Supports Directory and a Provider Licensing Directory that families can search directly.
Beyond state resources, the Autism Housing Network (run by the Madison House Autism Foundation) maintains a national directory of residential options specifically for autistic adults, including group homes, intentional communities, and supported living programs. The Autism Society’s website also describes different supportive housing settings and can connect families with local chapters that know what’s available in their area. Starting the search early, even a few years before a placement is needed, gives you time to visit homes, get on waitlists, and compare options rather than making a decision under pressure.