Pennsylvania Medicaid Waiver Programs Guide

Who it serves: Pennsylvanians with an intellectual disability, autism, or developmental disability who need home- and community-based supports and meet ODP level-of-care requirements. The Consolidated Waiver is generally the broadest ODP waiver for people who need more intensive or residential supports. Diagnosis, level of care, and current waiver criteria are determined through ODP and the county MH/ID process — confirm requirements with your county office.

How to apply: Start with your local county MH/ID office. PA.gov's service page for the Consolidated Waiver directs families to apply at the county Mental Health/Intellectual Disabilities office, not by sending a direct family application to DHS. Ask the county office how to register for supports, what records they need, and how they document your priority or waiting-list status.

Note: Keep a dated call log for every county MH/ID contact. Ask for written confirmation of the intake date, eligibility documents received, assigned supports coordinator if applicable, and any waiting-list or priority category the county records.

Who it serves: People with intellectual disability, autism, or developmental disability who meet ODP eligibility rules and need HCBS supports, often at a less intensive level than the Consolidated Waiver. Exact service limits, eligibility criteria, and availability can change — confirm current Community Living Waiver requirements with your county MH/ID office.

How to apply: Use the same county MH/ID entry point as the Consolidated Waiver. Contact the county office, register for services if you are not already registered, and ask whether the Community Living Waiver or Consolidated Waiver is the more appropriate track based on the person's documented support needs.

Note: Families can lose time when they treat the ODP waivers as separate online applications. The practical first step is county registration and documentation. Keep copies of evaluations, county forms, and any notice describing next steps.

Who it serves: People with intellectual disability, autism, or developmental disability who qualify for ODP services and need capped home- and community-based supports, including traditional provider models and self-directed options. PA.gov describes diagnosis and age categories for P/FDS, but official eligibility is determined through the county and ODP process — confirm the current criteria before relying on any checklist.

How to apply: Contact the local county MH/ID office and ask to register for ODP supports or services. Bring diagnosis records, medical evaluations, school or adult-service records, proof of Pennsylvania residency, and Medical Assistance information. Ask the county how P/FDS differs from Consolidated and Community Living for your family member's needs.

Note: P/FDS can be useful for families looking for support that is smaller in scope than a residential or high-intensity waiver package. Service caps and covered supports are policy details, not promises — confirm current limits with the county office or support coordinator.

Who it serves: Adults age 21 or older with autism spectrum disorder who need long-term services and supports for community living. PA.gov describes the Adult Autism Waiver as a 1915(c) HCBS waiver tailored to adults with ASD. Confirm current eligibility, diagnostic documentation, and availability through DHS or your county office.

How to apply: PA.gov's Adult Autism Waiver application page directs applicants to call the local county MH/ID office to apply. Ask the county office what autism diagnostic documentation is required, whether Medical Assistance must be active before the next step, and how they communicate eligibility or waiting status.

Note: Do not assume an autism diagnosis alone completes eligibility. Keep the diagnostic report, functional-support records, Medical Assistance details, and every county contact note together.

Who it serves: Adults age 21 or older who meet CHC enrollment categories, including people receiving both Medicare and Medicaid, people needing Medicaid long-term services and supports, certain OBRA waiver participants who are nursing-facility clinically eligible, people in Medicaid-paid nursing facilities, and certain Act 150 participants who are dually eligible. PA.gov lists exclusions, including people receiving ODP services — confirm current CHC eligibility with DHS, OLTL, or the enrollment channel.

How to apply: Start with Pennsylvania's CHC enrollment resources, your county Assistance Office, Area Agency on Aging, or current managed care plan. Ask how to request the level-of-care assessment, how the MCO assignment works, and which notices or deadlines you should track.

Note: CHC is managed care. Record plan names, care coordinator contacts, assessment dates, and any service-plan meeting dates separately from Medical Assistance renewal dates.

Who it serves: People with developmental physical disabilities who may need home- and community-based supports to live in the community. PA.gov describes OBRA as an HCBS waiver for developmental physical disability. OBRA interacts with CHC rules for some adults, so eligibility and enrollment should be confirmed directly with OLTL or the appropriate local intake channel.

How to apply: Contact OLTL, your county Assistance Office, or the local long-term services intake channel and ask whether OBRA or CHC is the correct path. Be ready to document the physical disability, level-of-care need, Medical Assistance status, and current services.

Note: Because OBRA and CHC rules can intersect, avoid relying on old program names alone. Ask the intake worker to confirm the current waiver or managed-care pathway in writing.