Helpful Independent Resource for Department of Developmental Services (DDS),
MassHealth, and Waiver Services

The Quest Begins

Mary, a 21-year-old student, is preparing to transition out of her specialized educational program, which extended her high school experience from ages 18 to 22 with continued training and supports. As she approaches her 22nd birthday in three months, she and her Independent Educational Plan (IEP) team must explore and identify a suitable Day Program that aligns with her goals, interests, and support needs.

While she has met some local providers at a **Transition Fair** hosted by her high school, the Department of Developmental Services (DDS) has also provided her and her guardians with an extensive list of additional providers. To ensure a smooth transition, her team must coordinate program visits, assess available services, and determine the best fit for her long-term success.

The Approach

With the information gathered from the Transition Fair and recommendations from DDS, Mary’s guardians coordinated tours of five different Day Programs. During each visit, she had the opportunity to observe program activities, interact with staff and participants, and assess the level of support offered.

After careful consideration and discussions with her team, Mary selected a program that offered a **comprehensive blend of services** tailored to her needs, including:

• **Day Habilitation (Day Hab):** Therapeutic supports focused on skill development and personal growth.
• **Community-Based Day Supports (CBDS):** Engaging activities that promote independence and community integration.
• **Group Employment:** Structured employment opportunities with job coaching support.

Transportation Solution

To facilitate a smooth transition, her family secured **PT-1 transportation approvals** for travel to and from her **Day Habilitation program**. Additionally, **DDS-funded transportation** was arranged for **community outings and employment-related activities**, ensuring that Mary had reliable access to all aspects of her chosen program.

The Reward

Mary successfully adjusted to her new program, gradually building confidence, social connections, and practical skills. The combination of services provided her with **a structured yet flexible environment**, enabling her to develop greater independence and actively participate in her community.

Through **CBDS and Group Employment**, she engaged in meaningful activities, learned job-related skills, and established **natural support systems** within her community. Her transition highlights the importance of early planning, informed decision-making, and personalized programming in supporting young adults as they move from school-based services into adult disability services.

The Quest Begins

Carlos, a 43-year-old individual with an intellectual disability, had a strong desire to enter the workforce but faced significant challenges in accessing job training and securing employment. While his Community-Based Day Supports (CBDS) program provided social and vocational activities, Carlos and his team recognized the need for additional structured employment services.

Working collaboratively, his Day Program submitted a Service Change Form to the Department of Developmental Services (DDS) to request Independent Employment hours, ensuring Carlos could receive the necessary support for job placement and retention.

The Approach

Carlos continued participating in his CBDS program while also transitioning into employment-focused training through Independent Employment hours. His individualized employment plan included:

• Job shadowing to observe various workplace environments.
• Resume-building workshops and interview preparation sessions.
• Volunteering and hands-on job skills training.
• Comprehensive career assessments and exploration.
• Supported employment opportunities tailored to his strengths and interests.

To enhance his transition, Carlos worked closely with Job Developers and Job Coaches throughout the week, refining his workplace skills, building confidence, and preparing for the demands of an independent job setting.

Transportation Solution

Transportation was a key component of Carlos' employment plan. Through a DDS-funded provider, he received dedicated transportation services to ensure he could reliably attend job interviews, vocational training sessions, and ultimately, his new workplace.

Additionally, he met regularly with a Job Developer or Job Coach, who provided ongoing support during job interviews, the hiring process, and onboarding at his new workplace.

The Reward

After six months of intensive training and coaching, Carlos successfully secured a part-time job in a supportive work environment. With continued job coaching, he has gained independence, improved his workplace skills, and achieved greater financial stability. His success highlights the effectiveness of CBDS-to-Independent Employment transitions, reinforcing the value of structured support in helping individuals with disabilities achieve their career goals.

The Quest Begins

Susan, a 58-year-old individual, requires a higher level of care than her current day program can provide. She has medical needs, including a feeding tube that requires nursing oversight, and requires ADL (Activities of Daily Living) support using a Hoyer lift for safe transfers. Given these needs, Susan and her guardian have agreed to explore Full-Time Day Habilitation (FTDH) programs that can better support her daily care and enhance her overall well-being.

The Approach

With guidance from her care team and guardian, Susan toured several FTDH programs, prioritizing options that provide:

• On-site nursing support for medical needs, including feeding tube care.
• Proper ADL assistance, including a Hoyer lift for safe transfers.
• Structured daily activities tailored to her interests and abilities.
• A safe, engaging environment with individualized care.

Transportation Solution

Susan's transportation is coordinated through a PT-1 authorization, ensuring reliable access to and from her new FTDH program.

The Reward

Susan successfully transitioned to a Full-Time Day Habilitation program that meets her medical and personal care needs. With appropriate nursing support, ADL accommodations, and engaging activities, she can enjoy a fulfilling daily routine in a safe and supportive environment.

The Quest Begins

Billy is a 21-year-old student preparing to exit his school district’s special education services under the 688 transition plan. He has a documented intellectual disability and a history of high-risk behaviors, including episodes requiring physical restraints at school. With just three months until he turns 22, his IEP team, guardians, and DDS Service Coordinator are working to find a Day Program that can safely continue the behavioral supports and progress already achieved in school.

The Approach

The IEP team coordinated with multiple Day Habilitation providers offering behavioral clinical support and low staff-to-individual ratios (1:1 or 1:2). Billy toured two facilities with his guardian and school liaison. He connected positively with a Developmental Specialist and expressed interest in activities involving physical movement and puzzles.

• Recommended service model: Full-time Day Habilitation with limited CBDS hours as tolerated.
• Program committed to following existing behavior support plan and crisis de-escalation strategies.
• Behavior clinician will be on-site for at least 15 hours per week with quarterly data reviews.

Transportation Solution

Due to his behavior history, Billy is eligible for supervised, DDS-funded transportation. A specialized provider with trained escorts was selected.

The Reward

Billy began transitioning gradually into the program with a 1:1 DSP and consistent visual schedules. Over time, his outbursts decreased and he began using his coping tools. Quarterly reviews show significant stability and increased participation in structured CBDS activities. The team is now exploring adding music-based group sessions to support his regulation and communication.

The Quest Begins

Janice is a 45-year-old woman currently enrolled in a Full-Time Day Habilitation program that offers only limited community engagement. She enjoys bowling, mini golf, and visiting museums but feels stuck in a daily routine of in-building activities. She and her guardian approached DDS requesting a new program with greater community access and fun outings.

The Approach

Janice toured two blended programs offering both Day Hab and CBDS hours. She chose one that offers:

• Daily community integration: CBDS hours every afternoon.
• A rotating activity calendar with museum trips, game days, and social outings.
• Flexible support staff to assist with planning and transitions.

Transportation Solution

PT-1 and DDS-funded community transportation were authorized, including mileage to off-site activities.

The Reward

Janice is now accessing the community 4 out of 5 days per week. Her weekly highlights include art museum visits and bowling with peers. She continues to receive therapeutic supports in the morning through Day Hab. Her happiness and attendance have significantly improved.

The Quest Begins

Kelvin, a 58-year-old man with no medical needs, is seeking a CBDS-only program that allows him to avoid being inside a facility altogether. He enjoys fishing, going to the gym, and being outdoors. He lives independently and requested a program that offers a “without walls” model where participants go straight into the community.

The Approach

Kelvin and his DDS Service Coordinator toured 3 programs offering community-based services. One provider stood out by offering:

• Transportation directly from home into daily outings (e.g., parks, gyms, libraries).
• No building-based time—staff clock in/out with participants in the field.
• Fishing trips, gym memberships, and peer-led recreation groups.

Transportation Solution

The program coordinates DDS-funded pickup and drop-off directly from Kelvin’s home, aligning with his goals of avoiding buildings entirely.

The Reward

Kelvin reports improved mood, physical health, and enjoyment. His week includes gym workouts, fishing spots, and small groups of friends with shared interests. He is a strong advocate for this model and now helps new program participants learn the ropes.

The Quest Begins

Laura, a 70-year-old woman experiencing early dementia symptoms, is looking for a safe, part-time Day Habilitation program. She enjoys arts & crafts, Bingo, and dancing while seated (chair Zumba). Her family wants to maintain her social skills and prevent isolation while ensuring safety and support for memory loss.

The Approach

Laura’s guardian worked with DDS and the Aging & Disability Resource Center to identify a program that offers:

• FTDH with a specialized memory-care track and dementia-informed staff.
• Two-day attendance with activities focused on sensory stimulation and safe engagement.
• Small-group crafts, games, and accessible fitness opportunities.

Transportation Solution

PT-1 transportation was authorized for two days per week with wheelchair-accessible service and caregiver assistance.

The Reward

Laura is now attending her FTDH program every Tuesday and Thursday. She looks forward to Bingo, crafts, and social lunches with peers. Her family reports improved mood, cognitive engagement, and peace of mind knowing she is in a dementia-aware environment.

The Quest Begins

Robert, a 33-year-old male, is currently in a CBDS-only program. However, due to recent medical changes, he now requires consistent OT and PT services. His care team determined that a blended program with both CBDS and Day Habilitation hours would better meet his ongoing therapeutic and support needs.

The Approach

Robert's team submitted a program change request through DDS and explored local blended programs offering:

• Licensed therapists on staff for ongoing OT/PT needs.
• Daily skill-building activities under Day Hab services.
• Community engagement hours through CBDS.

Transportation Solution

PT-1 transportation was approved to and from the new program five days per week, with additional community-based mileage funded through DDS for CBDS activities.

The Reward

Robert now receives consistent therapy and is showing improved functional gains. He participates in a daily walking group and enjoys painting during CBDS time. His ISP team has noted better mood and progress toward mobility goals.

The Quest Begins

Jennifer has been volunteering successfully but her current program lacks active job coaches due to staffing shortages. Her DDS team decided it's time to help her access a more supportive setting focused on group-supported employment opportunities.

The Approach

Jennifer and her guardian met with programs offering:

• Active job developer and group employment placements.
• Structured volunteering hours as a job-readiness path.
• Weekly job coaching and soft skills support.

Transportation Solution

Jennifer’s new program arranged PT-1 to support in-building services.

The Reward

Jennifer now works twice a week with a group at a local animal shelter. Her job coach reports she is thriving and expressing readiness for more independence.

The Quest Begins

Sammy recently moved to Massachusetts from a state with limited adult services. She is looking for a Full-Time Day Habilitation (FTDH) program where she can work on her walking gait with PT and continue communication goals with speech therapy.

The Approach

Sammy and her guardian explored programs offering:

• Daily PT and SLP services onsite.
• Recreational activities like puzzles and painting.
• Structured peer interaction in social groups.

Transportation Solution

Sammy was approved for PT-1 rides to the FTDH program.

The Reward

Sammy is now walking longer distances with PT support and participating in social activities, including painting groups and Bingo. Her speech therapist reports progress on articulation goals.

The Quest Begins

Bran, age 44, refuses to attend or participate in his current CBDS program. He frequently expresses dissatisfaction and paranoia, sometimes becoming aggressive. His guardian and DDS team agreed it is time to transition him to a more structured, therapeutic Full-Time Day Habilitation (FTDH) program.

The Approach

Bran’s team toured programs offering:

• Full-time Day Hab with behavioral clinician onsite.
• 1:1 staffing during adjustment period.
• Activities tailored to Bran’s interests to build trust.

Transportation Solution

Due to safety concerns, a specialized DDS transportation vendor with trained escorts was arranged. No CBDS hours are used currently.

The Reward

Bran has begun to attend with improved consistency. His clinician has identified preferred calming activities, and data shows reduced incidents of aggression during structured routines.

The Quest Begins

Bri is a 28-year-old woman who enjoys using social media but lacks safety awareness online. Her guardians requested a CBDS program focused on technology safety, peer relationships, and boundaries. They do not want her working until she demonstrates improved judgment and digital safety.

The Approach

Bri toured CBDS-only programs offering:

• Weekly lessons on online safety and digital citizenship.
• Small peer discussion groups on boundaries and friendships.
• Volunteering in a group setting to build social confidence.

Transportation Solution

PT-1 transportation was approved completed by the new day program.

The Reward

Bri is now demonstrating better online habits and seeks adult guidance when unsure. She participates in group discussions on boundaries and is building peer connections through volunteering at a senior center.

The Quest Begins

Paul is a 41-year-old male with chronic pain and a G-Tube. He is NPO and reacts strongly to food smells, often becoming aggressive or engaging in SIB. He has attempted to drink unsafe liquids and requires 1:1 eyes-on supervision at all times.

The Approach

His team is seeking a new program offering:

• Strict protocol adherence for G-Tube feedings.
• BCBA support and behavior data tracking.
• Staff consistency and low exposure to food items during the day.

Transportation Solution

Paul’s new program arranged trained transportation aides through a PT-1.

The Reward

Paul has shown reduced aggression and reports feeling calmer. He enjoys individualized sensory activities and has expressed appreciation for a quieter space.

The Quest Begins

Cathy is a cheerful 33-year-old woman who enjoys child-like play and frequently brings toys to program. Her team would like her to expand into more age-appropriate activities while supporting her social growth.

The Approach

Cathy’s ISP team sought a Full-Time Day Hab (FTDH) program with:

• Gentle exposure to adult social groups and interests.
• Support for self-expression in a safe, nonjudgmental setting.
• Structured, exploratory activities focused on peer engagement.

Transportation Solution

Cathy’s PT-1 rides was submitted by her new program and approved.

The Reward

Cathy is now participating in music and crafting clubs. She enjoys telling staff about her day and has started initiating conversations with new peers.

The Quest Begins

Bret engages in head-hitting SIB behaviors when upset and has a protocol involving helmet use. His team believes that a more engaging schedule will help reduce triggers and self-injury episodes.

The Approach

Bret toured Day Habilitation programs with:

• Smaller groups and low-noise environments.
• Staff trained in ABA and SIB redirection strategies.
• Activity choice boards with clear visual supports.

Transportation Solution

Transportation included staffed that were trained on his Behavioral Plan approved through a PT-1.

The Reward

Bret now participates in a daily drumming group and sensory crafts. His incidents of head-hitting have decreased, and he wears his helmet less often.

The Quest Begins

Sal is relocating to a new group home and can no longer commute to his current day program. He is seeking a blended CBDS and Day Hab program close to his new residence and needs a gradual transition schedule.

The Approach

His team created a soft-start plan and toured programs offering:

• Progressive weekly attendance increase from 2 to 5 days.
• Peer mentor assignments to help him adjust.
• Dedicated support for building peer relationships.

Transportation Solution

PT-1 arranged transportation with coordination with the group home on pick up and drop off times.

The Reward

Sal has begun making friends and participates in board game groups. He now attends 5 days a week and no longer clings to staff for social comfort.

The Quest Begins

Kelly, age 63, exhibits attention-seeking behaviors and emotional dysregulation. Her current program is not supportive, and she is unaware that peers often bully her. Her team agrees that a fresh start after 15 years is needed.

The Approach

Her team found a blended program offering:

• Social coaching and emotional expression activities.
• Bullying prevention and staff-led peer modeling.
• Rotating weekly activities to maintain engagement.

Transportation Solution

Kelly’s PT-1 rides continued uninterrupted with her new route updated through MassHealth.

The Reward

Kelly has made new friends and enjoys staff-led yoga and journaling groups. She reports feeling happier and more included at her new program.

The Quest Begins

Carol enjoys cooking and baking but her current program cut those activities due to staffing. The daily schedule has become repetitive and lacks enrichment. Her team is searching for a CBDS/DH program that supports her hobbies and adds variety.

The Approach

The team explored programs offering:

• Hands-on cooking classes and food prep labs.
• Volunteering in local kitchens and senior centers.
• New weekly clubs and peer-led hobby groups.

Transportation Solution

Carol’s program submitted a PT-1 that was approved.

The Reward

Carol now bakes weekly with her peers and leads a snack group. She says the new activities make her feel proud and helpful.

The Quest Begins

Jose spends most of his time doing sensory-based activities, which he enjoys. However, his team is concerned about a lack of communication skill development and access to therapeutic services. His current program does not have OT, PT, SLP, or BCBA on staff.

The Approach

Jose’s team sought a program offering:

• Therapists (SLP, OT, PT, BCBA) employed onsite with ongoing service delivery.
• Structured sensory stations with communication goal prompts.
• Social skills and AAC integration support.

Transportation Solution

Jose's new day program submitted a PT-1 that was approved and the new transportation provider was trained on his communication device.

The Reward

Jose now works with his SLP three times a week and is using picture cards to make snack and break choices. His sensory needs are still supported, but with more skill-building embedded throughout the day.