Pennsylvania

Pennsylvania currently has four waivers that serve children, all of which are home and community based 1915(c) waivers. All waive parent income when determining eligibility. See Pennsylvania's Medicaid Waiver page for more information. Pennsylvania also has a state-based program that is much like a TEFRA program and provides coverage to any child in the state with a disability.

Pennsylvania also has many adult-only waivers, including Attendant Care, HCBW for Individuals Aged 60 & Over, AIDS, Community HealthChoices, Independence, Adult Autism, and OBRA.

Pennsylvania Advocacy Organizations:

Programs in Pennsylvania

CONSOLIDATED WAIVER
  • Target Population: Children and adults who have a developmental disability, intellectual disability, or autism.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child's income only.
  • Waiver Type: 1915(c)
  • Spots: 18,209
  • Expiration Date: 6/30/2022
  • Description from medicaid.gov: Provides community participation support, education support services, homemaker/chore, in-home and community support, residential habilitation, respite, supported employment, supports coordination, specialized supplies, therapy services, supports broker services, advanced supported employment, assistive technology, behavioral support, benefits counseling, communication specialist, companion, consultative nutritional services, family/caregiver training and support, home accessibility adaptations, housing transition and tenancy sustaining services, life sharing, music therapy, art therapy and equine assisted therapy, shift nursing, small group employment, supported living, transportation, vehicle accessibility adaptations for individuals with autism (all ages), individuals with developmental disabilities ages 0-8, and with intellectual disability (all ages). This waiver has no annual budget cap.
  • Online State Information: Consolidated Waiver
  • Official Federal Information
  • How to Apply: Call the Customer Service Hotline at 1-888-565-9435 or contact your county Mental Health / Intellectual Disabilities Office.
  • Waiting List: There are 9728 people with developmental disabilities on Pennsylvania's waiting list, but they are primarily adults.
PERSON/FAMILY DIRECTED SUPPORT
Also called PFDS Waiver
  • Target Population: Children and adults who have a developmental disability, intellectual disability, or autism.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child's income only.
  • Waiver Type: 1915(c)
  • Spots: 14,720
  • Expiration Date: 6/30/2022
  • Description from medicaid.gov: Provides community participation support, education support services, homemaker/chore, in-home and community support, respite, supported employment, supports coordination, specialized supplies, therapy services, supports broker services, advanced supported employment, assistive technology, behavioral support, benefits counseling, communication specialist services, companion, consultative nutritional services, family/caregiver training and support, home accessibility adaptations, housing transition and tenancy sustaining service, music therapy, art therapy and equine assisted therapy, participant-directed goods and services, shift nursing, small group employment, transportation, vehicle accessibility adaptations for individuals with autism (all ages), individuals with developmental disability ages 0-8, and with intellectual disability (all ages). Individual cost limit of $33,000 per person per fiscal year. The limit can be exceeded by $15,000 for Advanced Supported Employment or Supported Employment services.
  • Online State Information: Person/Family Directed Support
  • Official Federal Information
  • How to Apply: Call the Customer Service Hotline at 1-888-565-9435 or contact your county Mental Health / Intellectual Disabilities Office.
  • Waiting List: There are 9728 people with developmental disabilities on Pennsylvania's waiting list, but they are primarily adults.
COMMUNITY LIVING WAIVER
  • Target Population: Children and adults who have a developmental disability, intellectual disability, or autism.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child's income only.
  • Waiver Type: 1915(c)
  • Spots: 1050
  • Expiration Date: 12/31/2022
  • Description from medicaid.gov: Provides community participation support, education support services, homemaker/chore, in-home and community support, life sharing, respite, supported employment, supports coordination, specialized supplies, therapy services, supports broker service, advanced supported employment, assistive technology, behavioral support, benefits counseling, communication specialist services, companion, consultative nutritional services, family/caregiver training and support, home accessibility adaptations, housing transition and tenancy sustaining service, music therapy, art therapy and equine assisted therapy, participant-directed goods and services, shift nursing, small group employment, supported living, transportation and vehicle accessibility adaptations for individuals with autism and intellectual disability, ages 0 - no max age, and individuals w with developmental disabilities, ages 0-8. Individual cost limit of $70,000 per person per fiscal year.
  • Online State Information: Community Living Waiver
  • Official Federal Information
  • How to Apply: Call the Customer Service Hotline at 1-888-565-9435 or contact your county Mental Health / Intellectual Disabilities Office.
  • Waiting List: There are 9728 people with developmental disabilities on Pennsylvania's waiting list, but they are primarily adults.
MEDICAID WAIVER FOR INFANTS, TODDLERS AND FAMILIES
  • Target Population: Young children who have a developmental or intellectual disability.
  • Ages: 0-2
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child's income only.
  • Waiver Type: 1915(c)
  • Spots: 5500
  • Expiration Date: 6/30/2021
  • Description from medicaid.gov: Provides special instruction for individuals with IID/DD ages 0-2.
  • Online State Information: Infants and Toddlers and Families Waiver
  • Official Federal Information
  • How to Apply: Call 717-346-1119, or call the Customer Service Hotline at 1-888-565-9435, or contact your county Mental Health / Intellectual Disabilities Office.
  • Waiting List: There are 9728 people with developmental disabilities on Pennsylvania's waiting list, but they are primarily adults.
PH-95 LOOPHOLE

This state-based program grants Medicaid coverage to more than 60,000 children of all incomes in Pennsylvania, including children with autism, developmental disabilities, and complex medical needs.

  • Target Population: Any child with a disability as defined by Social Security Disability criteria.
  • Ages: 0-18
  • Levels of Care: not applicable
  • Income Waiver: Yes, the waiver is based on the child's income only.
  • Waiver Type: state-based
  • Spots: unlimited
  • Expiration Date: NA
  • Description: Medicaid coverage only.
  • Online State Information: See this overview from the state or this independent guide on the PH-95 Loophole.
  • How to Apply: Apply for Medicaid using a paper application or online.
  • Waiting List: none
OTHER PROGRAMS