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Pennsylvania State Medicaid Waiver Program Application Guide

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  • Pennsylvania State Medicaid Waiver Program Application Guide




    Waiver Overview: Pennsylvania has a bunch of different waiver programs. We are going to focus on the two we think are the best fits for children with autism. Note that there is a long waiting list for these services. The state prioritizes who gets these services first with the categories emergency (0-6 month wait), critical (6 - 24 month wait), and planning (2-5 year wait). You can find more information on the waitlist HERE.

    Waivers: Consolidated Waiver and Personal/Family Directed Support Waiver (PFDS)

    Who can apply?

    Circumstance/Diagnosis: Any child or adult who is diagnosed with either an intellectual and/or developmental disability (this includes autism). The state requires that individuals need an intermediate care facility level of care to qualify. There is a technical definition for this, but it really just means that the individual is unable to get through their day without a lot of supervision.

    Income:These waivers only account for your child’s income, so unless they are making any money they will qualify for these programs.

    What do I get?

    You can view a full list and comparison of services between waivers on page 5 of this document. A key thing to note is that the Consolidated Waiver has no cap on the amount of money that can be spent on services while PFDS has a $33,000 cap.

    How do I apply?

    Call your county's Mental Health/ Intellectual Disabilities Office to get more information on these waivers and other resources that may be available to you.

    What does the Goally Team Think?

    No parent should have to wait 5 years to get the services they need. Once you are on one of these waivers though, you will have enough funds to cover just about every service you can possibly think of. Additionally, since the waiver is all ages, your child will receive support until they have good enough employment that makes them ineligible. What's missing in Pennsylvania is an option for a smaller amount of funds for less pressing needs. Many states have county resources that fulfill this purpose, but we could not find anything definitive on the web. If you have any information on how to do this please comment below.

    Goally Waiver Scorecard

    Website clarity and ease of navigation: 3/5
    Access and requirements of qualification: 0/5
    Healthcare coverage: 5/5

    Other online resources for Pennsylvania:

    Overview of Pennsylvania waivers
    The Autism Services, Education, Resources, and Training Collaborative (ASERT) has great information for Pennsylvanian residents and resource specialists you can contact.
    Special Kids Network (SKIN) can help you access local services and supports
    PA Families inc connect parents and families in Pennsylvania

    Telephone Resources

    ASERT resource specialists: 877-231-4244
    Last edited by Nate; 07-07-2020, 10:41 PM.
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