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Services in the Developmental Disabilities (DD) System

Non-Waiver and Waiver Services. Services in the Developmental Disabilities (DD) System. Four Categories of Individuals in the DD System. SC Only Base PFDSW (Person/Family Direct Support Waiver) Consolidated Waiver. SC Only and Base.

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Services in the Developmental Disabilities (DD) System

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  1. Non-Waiver and Waiver Services Services in the Developmental Disabilities (DD) System

  2. Four Categories of Individuals in the DD System • SC Only • Base • PFDSW (Person/Family Direct Support Waiver) • Consolidated Waiver

  3. SC Only and Base • Supports Coordinator (SC) will locate, coordinate and monitorneeded services. • Locating – helping finding community programs, medical professionals, etc. • Coordination - helping the family navigate other service systems, such as the Medical Assistance system. • Monitor – monitor health and safety.

  4. Sources of Funding The Federal Government CMS – Centers for Medicare and Medicaid Services The Commonwealth of PA Both independently and in conjunction with CMS

  5. Person/Family Direct Support Waiver (PFDS/PFDSW) Consolidated Waiver Waiver Funding

  6. Waiver Eligibility Person/Family Direct Support Waiver • Be age three and older • Have a diagnosis of mental retardation • Require active treatment • Be recommended for an intermediate care facility level of care based on a medical evaluation • Determined eligible for Medical Assistance (MA) • $2,000 resource limit (does not apply to dependent children under age 21) • Income limit 300% of the Federal Benefit Rate • Individual cost limit of $30,000 per person per fiscal year (excluding supports coordination) • Does not require Office of Developmental Programs licensed community residential services Consolidated Waiver • Be age three and older • Have a diagnosis of mental retardation • Require active treatment • Be recommended for an Intermediate Care Facility level of care based on a medical evaluation • Determined eligible for Medical Assistance (MA) • $2,000 resource limit (does not apply to dependent children under age 21) • Income limit 300% of the Federal Benefit Rate

  7. Waiver Funding • Services provided by waiver are based on Need. • Need is determined through the PUNS (Prioritization of Urgency of Needs for Services) • PFDSW - all needs must be met under the $30,000 cap (not including Supports Coordination) *no residential services* • Consolidated Waiver – no cap for services

  8. What Services can Waiver Funds Buy? • Assistive Technology • transportation • home adaptations • housing • nursing respite • vehicle adaptations • day programs • Habilitation/ Companion • job coaching

  9. Housing/Residential • Supported Living • LifeSharing • Residential • CLA *Waiver funded • ICF/DD *State funded (Oversight by DOH)

  10. Day Programs/Employment Opportunities to earn money Opportunities to develop skills • Community Base • Work Activity Center (WAC) pre-vocation • Transitional Employment Programs (TEP)/Enclave • Competitive Employment • Adult Training Facilities (ATF)* • Senior Centers • Adult daycare • Volunteering

  11. Questions

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