| Home and Community Based Services
Home and Community Based Services (HCBS) Waiver Programs provide qualified individuals with disabilities or chronic health care needs the care, supports, and services they need to remain living independently in their home or community. Pennsylvania currently has 13 HCBS Waivers and a number of other state-funded programs that provide supportive services to older adults and people with disabilities.
Individuals who qualify for any of the 13 HCBS Waiver programs can receive various in-home services that allow them to remain living in their home and/or community (such as personal assistance services, home modifications, specialized medical equipment and supplies). The services an individual Waiver recipient gets depends on the services available under her specific Waiver program and on her individual needs. In addition to in-home services, all Waiver recipients receive full Medical Assistance coverage-comprehensive health care coverage that can be someone's primary insurance or secondary insurance if they have other coverage such as Medicare.
The 13 HCBS Waiver programs available currently are:
Waivers for Older Adults
Aging Waiver (for those 60 and older) LIFE Program (for those age 55 and older)
Waivers for Persons with Physical Disabilities
AIDS Waiver
Attendant Care Waiver
COMMCARE Waiver
Elwyn Waiver
Independence Waiver
Michael Dallas Waiver
Waivers for Persons with Developmental Disabilities
OBRA/CSPPPD Waiver Infants,Toddlers, and Families Waiver
Consolidated Waiver
Person/Family Directed Support (PFDS) Waiver
Waiver for Persons with Autism Autism Waiver
For information about eligibility and services available under most of these programs, see Home and Community Based Services (HCBS) Waiver Programs: A Manual for Consumers and Advocates (pdf, May 2009). Please note that even though this manual was created for consumers, families and advocates in Southwestern PA , most of the information applies statewide. The only information that is specific to Southwestern PA is the contact information for the various Waiver programs. See below for information about the HCBS Waiver programs that are not discussed in the manual (Elwyn Waiver and Infants, Toddlers, and Families Waiver).
PHLP has developed new factsheets about HCBS waivers:
Can Family Members Be Paid Caregivers Under HCBS Waiver Programs?
Some of the HCBS Waiver programs allow certain family members to be paid for providing certain Waiver services to the consumer. The Waiver programs that allow family members to be paid caregivers include: Aging, Attendant Care, OBRA, COMMCARE, Independence , PFDS, and Consolidated. Generally speaking, family members can only be paid to provide services such as personal assistance services. However, each Waiver program decides which services can be provided by a paid family caregiver. For more information about family members being paid caregivers for a Waiver recipient, please see our HCBS Manual (page 15).
Is there opportunity for Consumer Direction Under the HCBS Waiver Programs?
Most of the waiver programs allow consumers to receive certain services under a Consumer Directed Model where the consumer (or their representative) hires, trains, schedules and supervises their own workers. Please see pages 16-36 of our HCBS Waiver Manual to learn which Waiver programs allow consumers to choose the Consumer Directed Model to receive certain specified waiver services.
Description of HCBS Waiver Programs Not Included in the HCBS Waiver Manual
Elwyn Waiver : This Waiver program provides services to individuals age 40 and older who are deaf, blind, or deaf and blind.
To qualify for the Elwyn Waiver, an individual must:
• Be age 40 or older and deaf, blind or deaf and blind;
• Reside in Delaware County ;
• Be determined Nursing Facility Clinically Eligible;
• Meet the waiver income and resource limits (see pages 9-10 of the HCBS Waiver Manual mentioned above).
Services available:
- Personal Care Services
- Counseling Services
- Home Health Services
- Therapeutic Social and Recreational Programming
- Special Medical Equipment and Supplies
- Transportation Services
To learn more about the Elwyn Waiver, please call the Office of Long-Term Living Hotline at 1-866-286-3636.
Infants, Toddlers, and Families Waiver : This Waiver program provides services to children in need of Early Intervention services who meet certain level of care requirements.
To qualify for the Infants, Toddlers, and Families Waiver, a child must:
• Be age 0-3 (from birth until their 3 rd birthday)
• Require early intervention services due to mental retardation or other related conditions (such as cerebral palsy or seizure disorder)
• Meet level of care requirements ( Intermediate Care Facility for Persons with Mental Retardation or Other Related Conditions ICF/MR-ORC)
• Have income less than $2,022/month
Services available:
- Habilitation services by qualified professionals with family/caregiver participation
To learn more about the Infant, Toddlers, and Families Waiver, contact the Special Kids Network Helpline at 1-800-986-4550.
State-Funded HCBS Programs
Individuals who are not eligible for an HCBS Waiver Program may be able to get non-medical support services in their home through one of the following programs. The state-funded programs do not include Medical Assistance coverage as part of their benefit package.
State Programs for Older Adults
Options Program (see page 40 of the HCBS Waiver Manual)
State Programs for Persons with Physical Disabilities
Act 150 Attendant Care program (see page 39 of the HCBS Waiver Manual)
Other resources: Head Injury Program : This is a program for adults with a Traumatic Brain Injury offered through the PA Department of Health. Contact the Dept of Health at 1-866-412-4755 to find out more about the program or visit their website: http://www.dsf.health.state.pa.us/health/cwp/view.asp?a=179&q=232536
Base Service Funding : Individuals with MR can contact their local MH/MR Office in their Counties to find out if there are funds available and what services might be available. For information about what other services are available to individuals with Mental Retardation, contact the Office of Developmental Programs at 1-888-565-9435 or go online to DPW 's website: http://www.dpw.state.pa.us/ServicesPrograms/MentalRetardation/
If you have questions about Home and Community Based Services programs or need assistance in enrolling in or obtaining services from these programs, please contact the Pennsylvania Health Law Project HELPLINE at (800)274-3258.
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