PA Person/Family Directed Support Waiver Explained

Suppose you are a family caregiver for a loved one with an intellectual, developmental, or autism disability in Pennsylvania. In that case, you may be wondering if there is a way to get paid for the care you provide. The answer is yes; there is a Medicaid waiver program that can help you get compensated for your caregiving work. In this blog post, we will explain the Person/Family Directed Support Waiver (P/FDS), how it works, and how you can apply for it.

Overview of Person/Family Directed Support Waiver

The P/FDS waiver is a home and community-based waiver program that helps individuals with an intellectual, developmental, or autism disability to live more independently in their homes and communities. The P/FDS waiver provides various services that promote community living, including self-directed and agency-based service models1. The P/FDS waiver is designed to supplement, not replace, the supports and services available to individuals and their families through other sources, such as the base-funding system.

The P/FDS waiver is administered by the Department of Human Services (DHS), Office of Developmental Programs (ODP) in collaboration with the county's intellectual disability/autism programs. The P/FDS waiver operates under a federal-state partnership, where the federal government pays for 52% of the costs, and the state pays for 48% of the cost.

The P/FDS waiver has an individual cost limit of $41,000 per person per fiscal year, excluding supports broker services and support coordination. The limit can be exceeded by $15,000 for advanced supported employment services.

Eligibility requirements

To be eligible for the P/FDS waiver, individuals must meet the following criteria:

• Have an intellectual disability, autism, or developmental disability diagnosis.
• Require an intermediate care facility (ICF) level of care based on a medical evaluation.
• Be determined eligible for Medical Assistance (MA) in Pennsylvania
• Meet the financial requirements as determined by the local County Assistance Office
• Be registered on the statewide waiting list for intellectual disability/autism services.
• Have an individual support plan (ISP) that identifies the need for P/FDS waiver services
• Agree to receive P/FDS waiver services per the ISP.
• Choose to receive P/FDS waiver services instead of institutional care.

Services and supports

The P/FDS waiver offers a range of services and supports that can help individuals with an intellectual, developmental, or autism disability to achieve their goals and preferences. Some of the services and supports available under the P/FDS waiver are:

• Advanced supported employment: Provides intensive, ongoing support to help individuals find and maintain competitive integrated employment.
• Assistive technology: Provides devices, equipment, or software that enhance independence, communication, mobility, or safety.
• Behavioral support: Provides assessment, intervention, training, and monitoring to address challenging behaviors.
• Benefits counseling: Provides information and guidance on work incentives and benefits programs.
• Communication specialist: Provides assessment, training, and consultation to improve communication skills.
• Community participation support: Provides opportunities for community integration, socialization, leisure activities, and skill development.
• Companion: Provides supervision and assistance with daily living activities.
• Consultative nutritional services: Provides assessment, education, and counseling on nutritional needs.
• Education support: Assists with accessing post-secondary education or training programs.
• Family/caregiver training and support: Provides education, resources, and guidance to family members or caregivers.
• Family medical support assistant: Provides personal care assistance to family members with medical needs.
• Home accessibility adaptations: Provides modifications or improvements to the home environment to increase accessibility and safety.
• Homemaker/chore: Assists with household tasks such as cleaning, laundry, shopping, or meal preparation.
• Housing transition and tenancy sustaining services: Assists with finding and maintaining housing in the community.
• In-home and community support: Provides direct support with daily living activities in the home or community setting.
• Music, art, and equine-assisted therapy: Provides therapeutic interventions using music, art, or horses to improve physical, mental, or emotional well-being.
• Participant-directed goods and services: Provides goods or services that are not otherwise available under the P/FDS waiver but are necessary to meet an individual's needs.
• Remote supports: Provides monitoring and communication through technology devices such as cameras or sensors.
• Respite: Provides temporary relief for family members or caregivers from their caregiving responsibilities.
• Shift nursing: Provides skilled nursing care in the home or community setting.
• Small group employment: Provides support to help individuals work in small groups in competitive integrated settings.
• Specialized supplies: Provides essential items for daily living, such as diapers, wipes, gloves, or catheters.
• Supported employment: Provides support to help individuals find and maintain competitive integrated employment.
• Supports broker: Provides assistance with managing self-directed services, such as hiring, training, and supervising workers.
• Supports coordination: Provides case management and service coordination to help individuals access and receive P/FDS waiver services.
• Therapy: Provides physical, occupational, speech, language, orientation, mobility, and vision therapy to improve or maintain functional abilities.
• Transportation: Provides access to transportation services to enable community participation.
• Vehicle accessibility adaptations: Provides modifications or improvements to the vehicle to increase accessibility and safety.

Compensation for caregivers

One of the benefits of the P/FDS waiver is that it offers a self-directed option that allows eligible participants to have more control over their care and choose their care providers, including family members. This means family caregivers can get paid for personal assistance, respite, companion, in-home and community support, or other services to their loved ones under the P/FDS waiver.

To self-direct services under the P/FDS waiver, participants must:

• Choose a financial management service (FMS) provider that will handle the workers' payroll, taxes, and insurance.
• Choose a supports broker that will help with managing the self-directed services.
• Develop an individual service budget (ISB) that allocates the funds for self-directed services.
• Hire, train, supervise, and dismiss the workers who will provide the self-directed services.
• Follow the rules and regulations of the P/FDS waiver and the FMS provider.

The amount of compensation that family caregivers can receive depends on several factors, such as:

• The type and amount of services that are authorized in the ISP and ISB
• The hourly rate that is negotiated with the FMS provider and the worker
• The individual cost limit of $41,000 per person per fiscal year for the P/FDS waiver.

Learn more about Medicaid self-directed care >>

A note from Givers

If you are interested in applying for this program or finding out if you are eligible for compensation, please fill out this form, and we will get back to you as soon as possible.