Finding the right home care provider can already feel overwhelming for families supporting a loved one with intellectual and developmental disabilities (IDD). But one thing many people do not realize right away is that home care services can look very different depending on the state you live in.
While Pennsylvania, New Jersey, Connecticut, Massachusetts, and Ohio all provide support for individuals with IDD through Medicaid-funded programs and community-based services, each state has its own systems, eligibility requirements, waiver structures, and service models. Understanding these differences can help families make informed decisions and better navigate the support process.
In this guide, we will break down how home care services differ across these five states, what families should know, and why person-centered support remains essential no matter where services are provided.
What Are Home Care Services for Individuals With IDD?
Home care services for individuals with intellectual and developmental disabilities are designed to help people live safely, independently, and comfortably within their homes and communities.
These services may include:
- In-home and community supports
- Personal care assistance
- Respite care
- Behavioral support services
- Nursing services
- Supported employment
- Transportation assistance
- Independent living skills training
- Day and community participation services
The goal is not simply supervision. Quality IDD home care focuses on improving independence, daily living skills, community involvement, communication, and overall quality of life.
Learn more about disability inclusion and person-centered support practices through the CDC’s Disability and Health Resources.
Pennsylvania Home Care Services
Pennsylvania’s ODP Waiver System
In Pennsylvania, most IDD home care services are overseen by the Office of Developmental Programs (ODP). ODP provides waiver-funded supports that allow individuals to receive services in home and community settings instead of institutional environments.
The most common waivers include:
- Consolidated Waiver
- Community Living Waiver
- Person/Family Directed Support (P/FDS) Waiver
Each waiver offers different levels of support depending on the individual’s needs.
Common Services Available in Pennsylvania
Pennsylvania offers a wide range of services, including:
- In-home supports
- Companion services
- Community participation support
- Respite care
- Nursing services
- Behavioral support
- Transportation assistance
- Assistive technology
One unique aspect of Pennsylvania is its strong emphasis on community integration and individualized planning through Supports Coordinators (SCs).
Families often work closely with Supports Coordinators to build service plans tailored to the individual’s goals and daily routines.
Explore OneWell Health Care’s Pennsylvania IDD Services to learn more about available in-home and community-based supports.
New Jersey Home Care Services
New Jersey’s DDD System
In New Jersey, IDD services are managed through the Division of Developmental Disabilities (DDD). Eligibility and funding structures can differ significantly from Pennsylvania.
New Jersey uses Medicaid-based programs and support budgets that allow individuals greater flexibility in selecting providers and services.
Key Differences in New Jersey
Compared to Pennsylvania, New Jersey often places stronger emphasis on:
- Self-directed services
- Community inclusion
- Employment-focused supports
- Flexible budgeting models
Services frequently available include:
- Individual supports
- Community-based supports
- Respite services
- Supported employment
- Day habilitation
- Behavioral supports
The transition into adult services in New Jersey can also involve additional assessments and planning processes through the DDD eligibility system.
Families moving from another state are often surprised by how different terminology and approval timelines can be.
Connecticut Home Care Services
Connecticut’s DDS-Focused Support Model
Connecticut’s home care and IDD support system is overseen by the Department of Developmental Services (DDS).
The state is known for promoting highly individualized services that encourage independence, skill-building, and community involvement.
Services Commonly Available in Connecticut
Connecticut providers may offer:
- Individualized home supports
- Independent living assistance
- Employment services
- Behavioral support
- Assistive technology
- Transportation services
- Family support services
Connecticut also emphasizes blended support models, where individuals receive both in-home care and community-based support depending on their goals and routines.
This flexibility can be especially valuable for adults transitioning into more independent living arrangements.
Learn more about OneWell Health Care of Connecticut Services and how person-centered supports can adapt to different levels of independence.
For more information about Home & Community-Based Services (HCBS), visit the Medicaid.gov HCBS Resources page.
Massachusetts Home Care Services
Massachusetts DDS and Family-Centered Planning
Massachusetts provides IDD home care services through the Department of Developmental Services (DDS).
One important characteristic of Massachusetts is its strong focus on family involvement and long-term planning.
Families often work closely with DDS Case Managers to coordinate services, monitor goals, and ensure continuity of care.
Services in Massachusetts
Common services include:
- Adult family care
- In-home support services
- Community participation
- Employment services
- Behavioral services
- Day programs
- Respite support
Massachusetts also places significant attention on transition planning for young adults entering adulthood and independent living services.
Another difference families notice is the strong collaboration between providers, DDS case managers, and families throughout the support process.
Providers that maintain consistent communication and person-centered planning often stand out within Massachusetts’ system.
Ohio Home Care Services
Ohio’s DODD Waiver Programs
Ohio home care services for individuals with IDD are overseen by the Department of Developmental Disabilities (DODD).
Like other states, Ohio uses Medicaid waivers to provide community-based services.
Common waivers include:
- Individual Options (IO) Waiver
- Level One Waiver
- SELF Waiver
Each waiver provides different funding levels and service structures depending on the individual’s needs.
What Makes Ohio Different?
Ohio’s system often emphasizes:
- Community participation
- Self-direction
- Flexible staffing supports
- Employment and independence goals
Services can include:
- Homemaker/personal care
- Transportation
- Behavioral support
- Nursing services
- Vocational habilitation
- Respite care
- Remote support technologies
Ohio families may also encounter county board systems that play a major role in coordinating local services and referrals.
This local-level coordination can create different experiences depending on the county where services are received.
Explore OneWell Health Care Ohio Services to learn more about home care and IDD support options available across Ohio.
Major Differences Families Should Know
Although all five states aim to support individuals with IDD in community settings, there are several important differences families should understand.
1. Different State Agencies
Each state uses different agencies and terminology:
| State | Main Agency |
|---|---|
| Pennsylvania | ODP |
| New Jersey | DDD |
| Connecticut | DDS |
| Massachusetts | DDS |
| Ohio | DODD |
This can make moving between states confusing for families.
2. Different Waiver Structures
Every state uses different Medicaid waiver systems with varying:
- Funding levels
- Waitlists
- Eligibility requirements
- Service limits
- Assessment processes
Some states offer more flexibility with self-direction, while others rely more heavily on agency-managed services.
3. Different Access to Services
Certain services may be easier to access depending on the state.
For example:
- Some states may have longer waitlists
- Some may prioritize employment supports
- Others may emphasize family-directed care
- Availability of nursing or behavioral supports can vary
Local provider networks also impact service availability.
4. Different Approaches to Independence
Connecticut and Ohio may emphasize flexible independence-building models, while Pennsylvania and Massachusetts often focus heavily on coordinated long-term planning and structured supports.
New Jersey frequently stands out for flexible self-directed service options.
Why Person-Centered Care Matters in Every State
Even though systems differ, one thing remains consistent: individuals deserve support that reflects their goals, preferences, strengths, and routines.
Person-centered home care means:
- Listening to individuals and families
- Supporting independence
- Adapting services over time
- Encouraging community involvement
- Building trust and consistency
The best home care providers do not simply deliver services. They create support systems that help individuals feel empowered, respected, and included.
This becomes especially important for individuals with IDD, where trust, routine, communication, and consistency can significantly impact quality of life.
Choosing the Right Home Care Provider
No matter which state you live in, families should look for providers that prioritize:
- Clear communication
- Consistent staffing
- Person-centered planning
- Strong compliance practices
- Community involvement
- Flexibility in support models
It is also important to ask providers how they coordinate with case managers, support coordinators, nurses, therapists, and family members.
The strongest providers work collaboratively instead of treating services as isolated tasks.
Final Thoughts
Home care services across Pennsylvania, New Jersey, Connecticut, Massachusetts, and Ohio may operate under different systems, agencies, and waiver structures, but the overall mission remains the same: helping individuals with intellectual and developmental disabilities live meaningful, supported lives within their communities.
Understanding state-specific differences can help families better navigate the process, ask informed questions, and find services that truly fit their loved one’s needs.
As home care continues evolving, families are increasingly looking for providers that combine flexibility, consistency, compassion, and person-centered support — regardless of which state they call home.