Tutelage Talks
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Today I want to talk about the different types of waivers. If you are looking for services or are assisting someone looking for services then you have heard of waivers. What are waivers? Waivers are one way to pay for the services that support people with intellectual developmental disabilities and autism. Waivers offer a variety of services and benefits such as choice of qualified providers, due process, and health and safety assurances. The Pennsylvania Department of Human Services (DHS) administers multiple medical assistance/ Medicaid waivers. Each waiver has its own unique set of eligibility requirements and services. The waivers are overseen and disseminated to the states by the Centers for Medicare/ Medicaid Services (CMS). In January 2014, CMS created a final rule for Home and Community Based Services (HBCS) in order to make sure individuals receive services in settings that are integrated into the community and individuals receiving services have access to community resources equal to that of those who do not receive services. The CMS final rule states that individuals receiving services should be able to do all the following: Have opportunities to seek employment and work in competitive and integrated settings.
The CMS final rule further aims to make sure that individuals receiving services have free choice of where they live and what provider to choose as long as the providers is willing and qualified. This is a big deal. Therefore, there are many regulatory requirements and reviews. This ensures compliance. The CMS Rule also ensures that an individual’s rights are not restricted and clarifies that services will not be allowed in settings that have the qualities of an institution. The rule's settings requirements apply to each of ODP's waivers.
Below is a brief description of each waiver.
I will review each of these waivers in greater detail, the differences, eligibility requirements and how they can be used as per ODP later. Thank you for checking out this blog post and video. If you or a loved one has any questions, please feel free to contact me. If you are a provider or interested in becoming a provider, please feel free to contact me for a consultation.
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I often get asked how someone applies and receives disability services. The Office of Developmental Programs (ODP) is the entity within the Pennsylvania Department of Human Services (DHS) that is responsible for the oversight of the intellectual disabilities and developmental services in Pennsylvania. It is the role of the local county offices of intellectual disabilities to verify eligibility for intellectual disability services. Each of the 67 counties has an office, some smaller counties combine service areas. They are called joinder counties these include Adams/ York, Armstrong/ India, Bedford/ Somerset etc. To be eligible for intellectual services through the Office of Developmental Programs (ODP) requires a diagnosis of an intellectual disability based on the results of standardized testing. One must also be registered with their local county of intellectual disabilities. When applying for services this can be by person who will be receiving services their family or trusted person assisting them. If someone is not registered through their county, they can contact their local office for more information. I will include the link at the bottom of this post. Once a person expresses interest in applying, they will be provided with information to gather and present with their application to establish eligibility. These documents may include medical, psychological and school records. Once eligibility is determined the next step is to obtain additional information birth certificate, social security card, income info which may include Supplemental Security Income (SSI), Social Security Disability (SSD) or any other applicable income. The eligibility process is straight forward, however, the actual process to get a waiver (depending on the waiver), can be lengthy depending on circumstances. There are additional factors to consider, such as availability of funding, urgency, and level of car to name a few. When speaking with individuals and families, I prepare them to utilize their natural supports as best they can until paid supports are possible. After application is made, if there are any concerns on outcome of the application or eligibility review, there is due process. It is advised that anyone looking for services register with the county as soon as possible. Individuals can be registered as early as age 14. This is important for school aged children who would otherwise benefit from services now and in the future. This phase is considered the planning phase and preparation for the Individual Support Plans (ISP) and/ or Individualized Education Program (IEP). Once registered, an individual is assigned a support coordinator (they are like case/ care managers). There may be one or several supports coordination units operating within a county. An individual has a choice. The supports coordinator is to assist an individual with locating, coordinating and planning services. This is a condensed, yet simple explanation to how to obtain services. If you or a loved one is seeking services and would like additional information, please feel free to contact me. OR, if you are already a provider or looking to become a licensed provider, contact me for a consultation at [email protected]. Pennsylvania County Contact Information www.hcsis.state.pa.us/hcsis-ssd/ServicesSupportDirectory/CountyContacts |
Blog AuthorFounder and CEO, Aeisha M. Carter, MAEd of Tutelage Residential Services, LLC. Is a coach, consultant, speaker, trainer and industry veteran. She has more than 25 years of education and experience in human and social services. Aeisha has worked with children and adults with intellectual disabilities and autism in both the public and private sectors. Archives
April 2025
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