Service Navigator

Service Models

Comprehensive Massachusetts DDS Support Programs

Four service paths move around one practical question: what mix of clinical support, community access, transportation, and day-service structure fits the person's plan right now?

The service ecosystem

Brief Overview of Services

01

Day Habilitation

Day Habilitation is a center-based MassHealth service that also includes community participation as part of the person's plan. The interdisciplinary team commonly includes nursing, speech-language, occupational and physical therapy, and developmental supports. Eligibility is determined by MassHealth clinical criteria and prior authorization under 130 CMR 419.000 — DDS eligibility on its own does not authorize Day Habilitation.

02

Community-Based Day Supports (CBDS)

CBDS programs support individuals in accessing volunteer work, education, and community-based enrichment. Less clinically intensive than Day Hab, CBDS emphasizes choice, skill-building, and inclusion.

03

Transportation & PT-1

Transportation is often available to and from Day Hab via MassHealth PT-1 authorization. CBDS often relies on family or provider transportation, though some individuals may receive MassHealth or DDS-funded transportation depending on authorization. Discuss options with your care manager or program representative.

04

ABA & Clinical Services

Applied Behavior Analysis (ABA) and BCBA-driven supports may be available within adult day programs — most commonly inside Day Habilitation, where behavioral and clinical staff are part of the program team. These services focus on teaching adaptive skills, reducing barriers to participation, and supporting safety through evidence-based methods. (This site covers day-service settings only; ABA delivered in residential or in-home settings is out of scope here.)

Side by side

Compare the day-service models

Comparison of Day Habilitation, Community-Based Day Supports, and Supported Employment
FeatureDay HabilitationClinical day serviceCommunity-Based Day SupportsCommunity & skill-buildingSupported EmploymentA real job, with support
Main goalHealth, skill maintenance, and daily-living skills with clinical supportCommunity participation, skill-building, and steps toward employmentGetting and keeping a paid job in the community
Who funds itMassHealthDDSDDS
Where it happensA licensed day-hab center, with community tripsCommunity-based — libraries, gyms, volunteering, classes; a home baseA community workplace, at prevailing wage
Clinical supportYes — nursing oversight plus therapies (OT, PT, speech) built inNo clinical component; staff support, not nursingNo clinical component; a job coach provides support
Governed by130 CMR 419.000DDS-funded (101 CMR 415 rates)DDS-funded (101 CMR 419 rates)
Learn moreRead about Day HabRead about CBDSRead about Employment

Which one fits?

Answer what you can. This highlights the model your answers point toward — it is a starting point for a conversation with your team, not a decision. Eligibility is determined by DDS and MassHealth.

Does the person need nursing or therapy support during the day?
Is a paid job in the community a current goal?
Is the priority community activity and building skills, without a clinical need?

This compares service models, not providers. To find and evaluate a specific program, see how to research providers below.

Find a program

Researching providers

This site does not rank or rate individual providers. What it can do is point you to the official public record, which is more reliable than a star rating — and show you how to read it.

  1. Find who serves your area

    Providers are organized by region. Your DDS area office can tell you which agencies operate the service you need in your city or town, and can make a referral.

    Department of Developmental Services — area offices

  2. Read the provider's licensing & certification report

    This is the closest thing to an official review. DDS surveys each provider on a two-year cycle and publishes the findings — what was compliant, what was cited, and the provider's follow-up. It is public, specific, and dated.

    DDS provider licensing & certification reports

  3. Understand what the survey measures

    The Office of Quality Enhancement explains how the licensing and certification survey works, so you can read a report knowing what a finding does — and does not — mean.

    DDS Office of Quality Enhancement

  4. For a nonprofit, check the Form 990

    Most Massachusetts day-service providers are nonprofits, and every nonprofit files a public Form 990 — size, finances, and leadership pay. It won't tell you about care quality, but it tells you who you are dealing with.

    ProPublica Nonprofit Explorer

  5. Read online reviews with a skeptical eye

    Google and Yelp reviews are unverified and self-selected — people rarely post about an ordinary good day. Treat them as anecdotes, weigh them against the official survey findings, and never let a star average outweigh a documented safety citation.

  6. Visit, and bring questions

    Nothing replaces seeing a program and talking to staff and families. Bring the questions worth asking to a tour, and gather what you learn.

    Use the planning checklist

Links go to official or public records. This is guidance for your own research, not an endorsement of any provider, and not legal or benefits advice. If you believe a program is unsafe, see who to contact.

Chapter 01

Day Habilitation (DH) Programs

MassHealth Coverage Rules & Service Levels

Day Habilitation is governed by 130 CMR 419.000 (Day Habilitation Center Services). MassHealth uses a Day Habilitation Leveling Tool to assign each member a payment Level (1, 2, 3, or 4). Providers must obtain prior authorization at admission, again every two years, and on a significant change in need.

  • Billing units defined in 101 CMR 348.00: per diem (service greater than three hours), half per diem (between 1.5 and three hours), and quarter per diem (less than 1.5 hours). 130 CMR 419 does not impose a minimum operating schedule, so programs vary in how many days and hours they offer.
  • Required hiring screens for direct care staff include CORI, SORI, the DDS National Criminal Background Check (fingerprint, 115 CMR 12.00), and a check against the DPPC Abuser Registry (Nicky's Law). MassHealth-funded roles also require an OIG exclusion check.
  • CARF or Council on Quality and Leadership (CQL) accreditation is not required, but providers must make accreditation correspondence available to MassHealth on request (130 CMR 419.416).
  • Records must be kept consistent with the controlling rule for each record type (130 CMR 450.000 for MassHealth records; 115 CMR 4.00 for DDS-side records).

Required Staff & Ongoing Training

  • 130 CMR 419.416 requires a full-time program director, a registered nurse health care supervisor available whenever members are present (on-site within 30 minutes during core hours), a designated administrator, and access by direct hire or contract to physical therapy, occupational therapy, speech-language pathology, behavioral, and nursing disciplines. A Day Habilitation Service Manager (DHSM) oversees individual service plans.
  • Staff training expectations cover mandated abuse and neglect reporting, first aid, infection control, human rights, and Positive Behavior Supports — see DDS Office of Quality Enhancement guidance for the current set.

Documentation, Audits & Oversight

  • MassHealth and DDS conduct periodic reviews. Records commonly examined include the Day Habilitation Service Plan (DHSP), Service Needs Assessment (SNA), attendance, incident reports, and transportation logs.
  • Non-compliance with 130 CMR 419 can lead to repayment, corrective action, or contract / participation actions.
Chapter 02

Community-Based Day Supports (CBDS)

Eligibility & Service Focus

  • CBDS is a DDS contract service for adults who meet DDS eligibility under 115 CMR 6.00. It typically begins after a person leaves school or turns 22, when adult DDS supports become primary.
  • CBDS focuses on community integration: volunteering, community membership, social and self-advocacy skills, and pathways into employment.
  • CBDS is a separate service from MassHealth Day Habilitation, with different funding, rules, and documentation.

Provider Standards & Oversight

  • CBDS providers are licensed and certified by DDS under 115 CMR 8.00. The DDS Office of Quality Enhancement (OQE) conducts the licensure and certification reviews.
  • DDS service standards in 115 CMR 7.00 apply to DDS-funded day and employment supports such as CBDS. Day Habilitation is excluded from 115 CMR 7.00 and is governed by 130 CMR 419 instead.
  • Each person has an individualized plan tied to community participation and, where appropriate, employment goals. Staffing levels are set by the person's assessed need and the provider's contract — no single statewide ratio is fixed in regulation.

Employment Pathways

  • Massachusetts follows an Employment First approach. Activities can include internships, volunteering, job exploration, and skill-building toward integrated employment. Supported employment rates live in 101 CMR 419.00.
Chapter 03

Transportation Contracts and Requirements

MassHealth PT-1 (Non-Emergency Medical Transport)

  • Members get a ride to MassHealth-covered services through the Prescription for Transportation (PT-1) request, submitted online by the member's MassHealth provider through the MassHealth provider portal (fax and mail submissions are no longer accepted).
  • Rides are coordinated through the Human Service Transportation (HST) program. HST assigns one of two brokers — MART or GATRA — based on the member's city or town.
  • PT-1 requests must be renewed per the approval period shown in the MassHealth response.

DDS-Funded Transportation

  • DDS may separately fund transportation tied to a person's service plan (often community participation or employment travel for CBDS).
  • Drivers in DDS-funded or DDS-licensed roles are subject to the hiring screens that apply across DDS providers — CORI, SORI, the DDS National Criminal Background Check (fingerprint, 115 CMR 12.00), and a check against the DPPC Abuser Registry (Nicky's Law). Specific training requirements (such as wheelchair securement, first aid, or mandated reporting) depend on the funding source, vehicle type, and role.

Records, Reviews & Safety

  • Providers keep trip logs, attendance, and authorization records that can be cross-referenced during MassHealth or DDS reviews.
  • Incidents involving transportation are documented and reported through the applicable DDS or DPPC channels.

Need Help Getting Started?

Contact your DDS care manager or reach out to program representatives to discuss which services best meet your individual needs and eligibility requirements.

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