From Autism Transition Handbook

Support Services Overview

State and Federal Agency Services

In the Commonwealth of Pennsylvania, the Department of Education, Bureau of Special Education oversees all special education and IEP management. The Department of Public Welfare (DPW)  manages Income Maintenance (e.g., LIHEAP); Medical Assistance Programs; Long Term Living; Mental Health and Substance Abuse Services (BHRS (Wrap Around) services) and Developmental Programs (e.g., Autism Support Services, etc.). The U.S. Social Security Administration oversees SSI but the eligibility decisions are made by the Pennsylvania Bureau of Disability Determination within its Department of Labor and Industry. 

Home and Community Based Services (aka "Waivers")

The Medicaid Home and Community Based Services (HCBS) Program (aka "Waivers") is Pennsylvania's primary funding source for supports and services to help individuals with disabilities live in their homes and communities.  Services offered go beyond those provided by Medical Assistance in order to help the individual remain in the community rather than being admitted to a Long Term Care Facilty. Eligibility for these waivers is generally based on the income of your son or daughter, not that of the parent. The Pennsylvania Department of Public Welfare administers 13 waiver programs of which four apply to individuals with Developmental and/or Intellectual Disabilities including Autism (Consolidated, Person/Family Directed, Autism and OBRA), and another three (Independence, Michael Dallas and COMMCARE) which may be applicable depending upon the primary diagnosis of your son or daughter. Each waiver has its own set of eligibility requirements, they are limited in availability (they are not an entitlement program like Medicaid) and may have long waiting lists. The Bureau of Autism Services oversees the Adult Autism and ACAP programs; ODP through the county MH/MR offices oversee the Consolidated and Person/Family Directed Waivers. For waiver service definitions click here

See Also

Pennyslvania Health Law Project's excellent summary on waivers, Home and Community Based Services Waiver Programs

For waiver service definitions see the DPW's What Type of Services are Available

Waiver Funded Services to Support Living in the Community

DPW, Office of Developmental Programs

The Pennsylvania Department of Public Welfare's Office of Developmental Programs (formerly the Office of Mental Retardation) goal is to "provide individuals with mental retardation, autism, and their families the services and supports they need and the opportunity to make real choices about living, working and options for social activities, to enable them to live in and participate fully in the life of their communities." The Pennsylvania Office of Developmental Programs oversees the Bureau of Autism Services (BAS) and Bureau of Supports for People with Intellectual Disabilities(ODP). The Bureau of Autism Services was created in 2007 to "develop and manage services to enhance the quality of life and independence of Pennsylvanians living with Autism Spectrum Disorders and to support their families and caregivers. For an excellent comparison of waivers offered by the Office of Developmental Programs, their eligibility requirements and services, please refer to the following chart from the Department of Public Welfare: Autism Adult Autism Support Services Comparison Chart.

Bureau of Autism Services

The Bureau of Autism Services is currently administering two programs designed for adults with ASD. To find out more about the Bureau of Autism Services programs or to apply for its programs, contact them directly by phone toll free at 866-539-7689.

For an excellent comparison of the Adult Autism Waiver and Adult Community Autism Program (ACAP) with other Pennsylvania programs serving adults with ASD, including their eligibility requirements and services, please refer to the following chart from the Department of Public Welfare: Adult Autism Support Services Comparison Chart.

Adult Autism Waiver

The Adult Autism Waiver received approval from CMS and has a capacity to serve 200 individuals. It is managed by the Bureau of Autism Services and adminstered at the state level. It is a Medicaid program (Home and Community Based Services (HCBS) Waiver) that provides home and community-based services specifically designed to help adults with ASD participate in their communities in the way they want to. Priority is given to people not already receiving ongoing state-funded or state and federally-funded long-term care services. Service plans provided through the Adult Autism Waiver are designed on an individualized basis to meet the specific needs of each participant.

The Adult Autism Waiver is not a temporary or pilot program. the Adult Autism Waiver has been approved by the Federal Government (the Centers for Medicare and Medicaid Services) as a part of Pennsylvania’s Medicaid program. Once an individual is enrolled in the Adult Autism Waiver he/she will receive services as long as all eligibility requirements continue to be met.

Eligibility:

• Be a PA resident
• Have a diagnosis of Autism Spectrum Disorder(ASD)
• Meet MA qualifications
• Meet federal Level of Care
• Be 21 or older

See Also:

List of Services Provided in the Adult Autism Waiver

Program details can be found on the Pennsylvania Department of Public Welfare, Bureau of Autism Services website. To apply for the Adult Autism Waiver you need to call the Bureau of Autism Services at 1-866-539-7689. They will not accept e-mail requests for applications, although they will take questions by email at RA-odpautismwaiver@state.pa.us

A list of services and providers for the Adult Autism Waiver from the Bureau of Autism Services

Adult Community Autism Program (ACAP)

ACAP is a managed care program that includes some innovative approaches to services. It provides physician, behavioral, and community services through an integrated approach to create a coordinated system of supports. In this way it is not a traditional waiver program. All ACAP services are monitored and coordinated by trained supports coordinators. Services can be adjusted as participants’ goals change or in times of crisis. ACAP participants receive support to achieve their employment, independent living or social goals. Skill development is provided along with any necessary behavior support and medication management

Other unique aspects include:

• Currently available in 4 counties (Lancaster, Cumberland, Dauphin, Chester)
• ACAP becomes the participant’s health plan
• Most services are provided by Keystone Autism Services and their network of providers (e.g. primary care physicians)
• Participants cannot require 16 or more hours of awake support, at intake

The Adult Community Autism Program is not a temporary or pilot program. ACAP has been approved by the Federal Government (the Centers for Medicare and Medicaid Services) as a part of Pennsylvania’s Medicaid program. Once an individual is enrolled in ACAP he/she will receive services as long as all eligibility requirements continue to be met.

Eligibility:

• Live in one of the counties being served by ACAP
• Have a diagnosis of Autism Spectrum Disorder(ASD)
• Meet MA qualifications
• Meet federal Level of Care
• Be 21 or older

Program details can be found on the Pennsylvania Department of Public Welfare, Bureau of Autism Services website. To apply for ACAP you need to call the Bureau of Autism Services at 1-866-539-7689. They will not accept e-mail requests for applications, although they will take questions by email at RA-acap@state.pa.us.

Keystone Autism Services was selected by BAS as the first service provider for ACAP. You may contact them for program information at 717-412-7400 or 1-877-501-4715, Monday through Friday, 9 a.m. to 5 p.m. or visit their website at Keystone Autism Services - Adult Community Autism program.

How are the Bureau of Autism Services (BAS) Adult Autism Waiver and Adult Community Autism Program (ACAP) DIFFERENT from other adult programs in PA?

• Specifically designed to meet the needs of people with Autism Spectrum Disorder
• Administered at the state level directly by BAS
• Does not use IQ as an eligibility factor
• Providers required to complete autism-specific training & demonstrate competence
• Clinical and technical assistance available to enrolled providers
• Service planning and measures of success based on individual goals
• Services based on proven approaches to help individuals realize their goals

Key Differences between the Adult Autism Waiver and the Adult Community Autism Program

How are the Adult Autism Waiver and ACAP similar to each other?

The features that make the Adult Autism Waiver and ACAP different from other adult programs in Pennsylvania are the characteristics they share. Eligibility requirements are also consistent between the two programs. To be eligible for either program, the individual served must:

• Be a PA resident
• Have a diagnosis of Autism Spectrum Disorder (ASD)
• Meet MA qualifications
• Meet federal Level of Care
• Be 21 or older

List of Services Provided in Adult Community Autism Program

See Also

Parent and Professional Training

ODP Support Services

Services for individuals with Intellectual and Developmental Disabilities (the term "I/DD" has recently replaced the term "Mental Retardation") are administered through the county MH/MR offices within ODP. The MH/MR offices serve as a referral source. Most services are provided by local agencies under contract with the county MH/MR office. The county MH/MR office determines an applicant’s eligibility for service funding, and if found eligible, will receive a Supports Coordinator. The Office of Developmental Programs offers a Customer Service Numberthat you can call for Waiver information or if you have concerns.

Registering for MH/MR Services

To register for I/DD Services in your county, contact the county intake officer at one of the County MR/MH offices. The first step is to provide a record of Intellectual/Developmental Disability diagnosis to the Intake Officer. The documentation must include:

• completed IQ test by a licensed clinician or certified school psychologist with an IQ score of 70 or lower (clinical judgment may apply),
• completed Adaptive Behavior Scale (ABS) showing deficits in two or more areas of adaptive functioning, and
• a record of MR diagnosis, signed by a licensed clinician or certified school psychologist, prior to age 22.

The intake officer reviews the documentation submitted by the family, and determines eligibility for MR services. The family is provided with a written notice of eligibility. If the family is eligible, the family will be contacted for a meeting, and assigned a Supports Coordinator to begin service planning. If your child is found not to be eligible, a written report of the decision will be sent to the family. Families will be provided with information regarding the appeals process. You can also contact the website at https://www.humanservices.state.pa.us/compass/CMHOM.aspx.  Compass is Pennsylvania’s fast and easy way to apply online for Health and Social Services. Screening helps you find services for which your family qualifies. You can submit an online application for services. You can apply for the following services through COMPASS: Medicaid, CHIP/AdultBasic, Cash Assistance, Child Care Works Program, Food Stamps, Energy Assistance, School Meals, Home and Community Based Services, Long Term Care, and SelectPlan for Women. For additional information on the county mental health system, click here.

See Also:

ODP Waiver Registration Process Checklist

Accessing I/DD Waivers

To apply for an I/DD waiver (Person/Family Directed, Consolidated and OBRA) you will need to fill out the appropriate Waiver Application Form. You may also register online through PA's COMPASS system for the Consolidated Waiver and the Person/Family Directed Waiver. You will need Documentation to complete the registration process.

Many families chose to apply directly to the local MR/MH office for waiver supports. Once an application has been made, MH/MR meets with the participant and/or a family member to complete a Priority of Urgency of Need for Services for Persons with Mental Retardation (PUNS) form which results in a ranking for need for supports: emergency (immediate), critical (within one year) and planning (more than a year away). Final determination is made by the County MR office regarding eligibility for waiver services and letter is mailed to you. You will need to coordinate these services with your Supports Coordinator, and complete an Individual Supports Plan. Please note that the OBRA waiver is closed.

• Person/Family Directed and Consolidated Waivers

Other Adult Waiver Programs

COMMCARE, OBRA and Independence Waivers

The Community Services Programs for Persons with Physical Disabilities (CSPPPD) manages applications for the OBRA Waiver (closed), Independence Waiver, COMMCARE Waiver, and Specialized Services. The Independence Waiver is intended for individuals aged 18 and older, with a physical disability, that do not have mental retardation as a primary diagnosis, and must be clinically eligible for a nursing facility.  The COMMCARE Waiver is available to individuals ages 21 and older with a traumatic brain injury and require a special rehabilitation level of care.  To apply, contact your local intake officer for CSPPPD.

Michael Dallas Waiver

The Office of Long Term Living, Bureau of Individual Supports oversees the Michael Dallas Waiver, which provides Home and Community Based services to eligible persons of any age who are technology-dependent. Technology dependence is defined as requiring technology to sustain life or replace vital bodily function and avert immediate threat to life.The is for individuals who are technology-dependent, ages 21 and older. For more information, contact the Office of Long Term Living, Bureau of Individual Supports at 717-787-8091.

See Also:

The HCSIS Services and Supports Directory is a tool for individuals with intellectual and developmental disabilities, their families, and circle of support to locate services and service providers in the Commonwealth of PA.  It can be found at https://www.hcsis.state.pa.us/hcsis-ssd/pgm/asp/prhom.asp

Resources

Pennsylvania Support Services Resources

Mental Retardation and Autism Services: Understanding the Office of Developmental Programs in PA (2010). Vision for Equality.