Overview
We all deserve our independence. The PFDS Waiver might be able to help you or your loved one achieve independence through effective community support and services.
The name “waiver” means the federal government waives Medicaid rules for institutional care so the state government can use the same money to provide support for people who need services closer to home in their own communities.
What Services are covered?
The Person/Family Directed Support Waiver provides a variety of services that promote community living, employment, communication, self-direction, choice, and control. They include but are not limited to:
- Assistive Technology
- Behavioral Support
- Benefits Counseling
- Community Participation Support
- Consultative Nutritional Services
- Education Support
- Family/Caregiver Training and Support
- In-Home and Community Support
- Respite
- Shift Nursing
- Supports Coordination
- Transportation
Eligibility
In Pennsylvania, the Department of Human Services (DHS) administers multiple Medicaid waivers. Each waiver has its own unique set of eligibility requirements and services.
To be eligible for the Person/Family Directed Support Waiver, you must meet the following requirements:
Level of Care:
- Recommended for an intermediate care facility (ICF) level of care based on a medical evaluation
- You must receive a diagnosis of an intellectual disability, developmental disability, or autism.
Diagnosis and Age requirements:
- Individuals of any age with an intellectual disability (ID) or autism.
- Children with a developmental disability under age 9 with a high probability of resulting in an ID or autism diagnosis.
- Individuals under age 22 with a developmental disability due to a medically complex condition.
Other requirements:
- Recommended for an intermediate care facility (ICF) level of care based on a medical evaluation.
- Found eligible for Medicaid in Pennsylvania.
- Meet the financial requirements determined by your local County Assistance Office (CAO)
- Individual cost limit of $41,000 per person per fiscal year (does not include supports coordination or supports broker). The limit can be exceeded by $15,000 for Advanced Supported Employment, Benefits Counseling, or Supported Employment services.
Apply for Medicaid
You can apply online, in-person, on the phone, or through the mail.
Apply for an ODP Waiver
Call your local County Office of Mental Health and Intellectual Disabilities (MH/ID) Program to apply for ODP supports or services.
Frequently Asked Questions
Visit ODP’s website to find useful information about available services and supports.
Each waiver has a limited number of people that can be served. There are waiting lists to enroll in waiver services. Priority for waiver enrollment is given to people with the most emergent needs.
All individuals with an intellectual disability and other individuals who meet waiver eligibility requirements will receive case management services, referred to in ODP as Supports Coordination. County MH/ID Programs also have limited funding to provide services through block grants or state funding referred to as base funding.
School age children receive most needed services through other programs such as Medicaid, their school district, and the Office of Vocational Rehabilitation. Children who need services not covered through other programs can receive services through a waiver.
Contact ODP
Do you have questions? Contact the ODP Service Team.
Questions relating to specific situations will be referred to the appropriate ODP regional office or subject matter expert. The caller will be contacted by the end of the next business day to obtain additional follow-up information.