Home and Community-Based Services

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Home and Community-Based Services

General Information

Long Term Care (LTC) services include both Home and Community Based Services (HCBS) and LTC Facility Services. A person who has a medical need for LTC services may choose which program to participate in. If a person applies for medical assistance and payment of LTC services, they must also meet the non-financial and financial medical assistance eligibility requirements.

Long-Term Care Facility Services

Long term care facilities, also known as nursing homes, provide both short and long term nursing and rehabilitation services for persons that require 24-hour care. A list of LTC facilities in Pennsylvania may be found via the PA Department of Health web site.

A person may also compare long term care facilities at Medicare.gov.

Home and Community-Based Services

Home and community-based services are also known as waiver-funded services or waiver programs. The name waiver comes from the fact that the federal government "waives" medical assistance rules for institutional care in order for Pennsylvania to use the funds for HCBS. HCBS provides for supports and services beyond those covered by the Medical Assistance (also referred to as Medicaid) program that enables a person to remain in a community setting rather than being admitted to a Long Term Care Facility. Currently, the Department of Human Services administers 12 HCBS programs. Each HCBS program has its own eligibility requirements and services.

If a person is determined eligible for more than one HCBS program, the person cannot receive services under two or more such programs at the same time. The person must choose one HCBS program and receive the services provided by it.

A list of the available home and community-based programs and their associated eligibility requirements follows:

Waiver	Functional Eligibility Requirements	Services Provided
Community Living Waiver	No age limit for intellectual disability or autism. Developmental disability with a high probability of resulting in an intellectual disability or autism are eligible from age 0 through 8 Require an ICF/ID or ICF/ORC level of care Individual cost limit of $70,000 per person per fiscal year (Supports Coordination is excluded from this limit)	Employment Services (job finding and job coaching) In-Home and Community Support Companion Community Participation Support Respite Shift Nursing Therapies Behavioral Support Assistive Technology Home and Vehicle Accessibility Adaptations Transportation Life Sharing *Supported Living
Community HealthChoices (CHC) Waiver	Age 21 or older with a physical disability Meet nursing facility level of care criteria *Wish to receive long-term services and supports in own home or another community setting	Daily Living Services Assistive Technology Environmental Adaptations Cognitive Rehabilitation Therapy Services Employment Services Home Delivered Meals Transportation Services Personal Assistance Services Pest Eradication Respite CHC offers many other services. The CHC Long-Term Services and Supports Benefits Package provides more information about the services offered in CHC.
Act 150 (State-Funded Program)	Age 18 through 59 (over age 59 conditional) Meet the level of care needs for a Skilled Nursing Facility Not financially eligible for Medicaid Have a medically determinable physical impairment that is expected to last of a continuous period of not less than twelve (12) calendar months or that may result in death	Personal Assistance Services Personal Emergency Response System (PERS) *Service Coordination
Adult Community Autism Program (ACAP)	21 years or older Diagnosis of Autism Spectrum Disorder (Autistic Disorder, Childhood Disintegrative Disorder, PDD-NOS, Asperger Syndrome or Rett Disorder) Require Intermediate Care Facility (ICF) level of care Be able to live in a home or community setting without 16 hours or more per day of awake staffing and supervision *Not have behaviors that are dangerous to yourself or others or that could cause harm to property	Physician, ICF, psychiatric, nursing facility, hospice services Dental, vision, speech, podiatry, chiropractic services Medical supplies and equipment Health promotion and disease prevention services Targeted case management Mental health crisis intervention services Adult day habilitation services Homemaker services Residential & behavioral support Respite care Supported employment Community transition services Environmental modifications Assistive technology *Family counseling
Adult Autism Waiver (AAW)	Age 21 or older Diagnosed with Autism Spectrum Disorder (Autistic Disorder, Childhood Disintegrative Disorder, PDD-NOS, Asperger Syndrome or Rett Disorder) *Meet Intermediate Care Facility level of care	Assistive technology Behavioral health services Community inclusion Community Transition Services Counseling Day & residential habilitation Environmental modifications Family counseling & training Job assessment and finding Nutritional consultation Occupational therapy Respite Speech/ language therapy Supported employment Supports coordination Temporary crisis services *Transitional work services
Infants, Toddlers and Families Waiver	Between birth and age 3 In need of early intervention services *Meet Intermediate Care Facility for Persons with Mental Retardation (ICF/MR) or Intermediate Care Facility for Persons with Other Related Conditions (ICF/ORC) level of care	*Habilitation, which is a service provided in-home and community settings to assist a child in acquiring, maintaining and improving self-help, domestic, socialization, and adaptive skills
Person/Family-Directed Support (P/FDS) Waiver	No age limit for intellectual disability or autism. Developmental disability with a high probability of resulting in an intellectual disability or autism are eligible from age 0 through 8 Require an ICF/ID or ICF/ORC level of care Individual cost limit of $33,000 per person per fiscal year (Supports Coordination and Supports Broker are excluded from this limit. There are also some exceptions for employment service.)	Employment Services (job finding and job coaching) In-Home and Community Support Companion Community Participation Support Respite Shift Nursing Therapies Behavioral Support Assistive Technology Home and Vehicle Accessibility Adaptations *Transportation
Consolidated Waiver	No age limit for intellectual disability or autism. Developmental disability with a high probability of resulting in an intellectual disability or autism are eligible from age 0 through 8 Require an ICF/ID or ICF/ORC level of care No individual cost limit per year on services	Residential Habilitation Employment Services (job finding and job coaching) In-Home and Community Support Companion Community Participation Support Respite Shift Nursing Therapies Behavioral Support Assistive Technology Home and Vehicle Accessibility Adaptations Transportation Life Sharing Supported Living
OBRA Waiver	Persons with developmental physical disabilities Disability results in at least 3 substantial functional limitations Disability manifested prior to age 22 Age 18 or older Disability is expected to continue indefinitely Requires ICF/ORC level of care	Daily living services Environmental adaptations Assistive technology Community integration services Respite services Transportation Supported employment services Prevocational and educational services
LIFE (Living Independence for the Elderly Program also known as LTCCAP)	Age 55 older Meet eligibility requirements for nursing facility level of care Able to safely live in the community with services available through the provider Reside in locations where services are available	Adult day health services Transportation/ escort services Primary medical specialist care Nursing care/skilled nursing Dental, vision, podiatry, audiology care Social services/ case management Physical, occupational, speech therapies Recreational therapy Nutritional counseling/ education Laboratory/ diagnostic test, x-rays Pharmaceuticals Prosthetics, orthotics, durable medical equipment and supplies Psychiatric services Personal care Homemaker chore services Home delivered meals Hospital care/ hospice services Nursing facility services Services for hearing/speech impairments Translation services

Waiver	Functional Eligibility Requirements	Services Provided
Community Living Waiver	No age limit for intellectual disability or autism. Developmental disability with a high probability of resulting in an intellectual disability or autism are eligible from age 0 through 8 Require an ICF/ID or ICF/ORC level of care Individual cost limit of $70,000 per person per fiscal year (Supports Coordination is excluded from this limit)	Employment Services (job finding and job coaching) In-Home and Community Support Companion Community Participation Support Respite Shift Nursing Therapies Behavioral Support Assistive Technology Home and Vehicle Accessibility Adaptations Transportation Life Sharing *Supported Living
Community HealthChoices (CHC) Waiver	Age 21 or older with a physical disability Meet nursing facility level of care criteria *Wish to receive long-term services and supports in own home or another community setting	Daily Living Services Assistive Technology Environmental Adaptations Cognitive Rehabilitation Therapy Services Employment Services Home Delivered Meals Transportation Services Personal Assistance Services Pest Eradication Respite CHC offers many other services. The CHC Long-Term Services and Supports Benefits Package provides more information about the services offered in CHC.
Act 150 (State-Funded Program)	Age 18 through 59 (over age 59 conditional) Meet the level of care needs for a Skilled Nursing Facility Not financially eligible for Medicaid Have a medically determinable physical impairment that is expected to last of a continuous period of not less than twelve (12) calendar months or that may result in death	Personal Assistance Services Personal Emergency Response System (PERS) *Service Coordination
Adult Community Autism Program (ACAP)	21 years or older Diagnosis of Autism Spectrum Disorder (Autistic Disorder, Childhood Disintegrative Disorder, PDD-NOS, Asperger Syndrome or Rett Disorder) Require Intermediate Care Facility (ICF) level of care Be able to live in a home or community setting without 16 hours or more per day of awake staffing and supervision *Not have behaviors that are dangerous to yourself or others or that could cause harm to property	Physician, ICF, psychiatric, nursing facility, hospice services Dental, vision, speech, podiatry, chiropractic services Medical supplies and equipment Health promotion and disease prevention services Targeted case management Mental health crisis intervention services Adult day habilitation services Homemaker services Residential & behavioral support Respite care Supported employment Community transition services Environmental modifications Assistive technology *Family counseling
Adult Autism Waiver (AAW)	Age 21 or older Diagnosed with Autism Spectrum Disorder (Autistic Disorder, Childhood Disintegrative Disorder, PDD-NOS, Asperger Syndrome or Rett Disorder) *Meet Intermediate Care Facility level of care	Assistive technology Behavioral health services Community inclusion Community Transition Services Counseling Day & residential habilitation Environmental modifications Family counseling & training Job assessment and finding Nutritional consultation Occupational therapy Respite Speech/ language therapy Supported employment Supports coordination Temporary crisis services *Transitional work services
Infants, Toddlers and Families Waiver	Between birth and age 3 In need of early intervention services *Meet Intermediate Care Facility for Persons with Mental Retardation (ICF/MR) or Intermediate Care Facility for Persons with Other Related Conditions (ICF/ORC) level of care	*Habilitation, which is a service provided in-home and community settings to assist a child in acquiring, maintaining and improving self-help, domestic, socialization, and adaptive skills
Person/Family-Directed Support (P/FDS) Waiver	No age limit for intellectual disability or autism. Developmental disability with a high probability of resulting in an intellectual disability or autism are eligible from age 0 through 8 Require an ICF/ID or ICF/ORC level of care Individual cost limit of $33,000 per person per fiscal year (Supports Coordination and Supports Broker are excluded from this limit. There are also some exceptions for employment service.)	Employment Services (job finding and job coaching) In-Home and Community Support Companion Community Participation Support Respite Shift Nursing Therapies Behavioral Support Assistive Technology Home and Vehicle Accessibility Adaptations *Transportation
Consolidated Waiver	No age limit for intellectual disability or autism. Developmental disability with a high probability of resulting in an intellectual disability or autism are eligible from age 0 through 8 Require an ICF/ID or ICF/ORC level of care No individual cost limit per year on services	Residential Habilitation Employment Services (job finding and job coaching) In-Home and Community Support Companion Community Participation Support Respite Shift Nursing Therapies Behavioral Support Assistive Technology Home and Vehicle Accessibility Adaptations Transportation Life Sharing Supported Living
OBRA Waiver	Persons with developmental physical disabilities Disability results in at least 3 substantial functional limitations Disability manifested prior to age 22 Age 18 or older Disability is expected to continue indefinitely Requires ICF/ORC level of care	Daily living services Environmental adaptations Assistive technology Community integration services Respite services Transportation Supported employment services Prevocational and educational services
LIFE (Living Independence for the Elderly Program also known as LTCCAP)	Age 55 older Meet eligibility requirements for nursing facility level of care Able to safely live in the community with services available through the provider Reside in locations where services are available	Adult day health services Transportation/ escort services Primary medical specialist care Nursing care/skilled nursing Dental, vision, podiatry, audiology care Social services/ case management Physical, occupational, speech therapies Recreational therapy Nutritional counseling/ education Laboratory/ diagnostic test, x-rays Pharmaceuticals Prosthetics, orthotics, durable medical equipment and supplies Psychiatric services Personal care Homemaker chore services Home delivered meals Hospital care/ hospice services Nursing facility services Services for hearing/speech impairments Translation services

​Home and Community-Based Services

General Information

Long-Term Care Facility Services

Home and Community-Based Services

Home and Community-Based Services