Pennsylvania
Pennsylvania Waiver Programs: Find the Right Path and Get Help Applying
A PA waiver program is a Medicaid Home and Community-Based Services arrangement that helps eligible older adults, people with disabilities, and children remain at home and in their community. Pennsylvania runs several waiver programs through different state offices, and the right pathway depends on the person's age, diagnosis, and needs. This page is a starting point — not a determination of eligibility — to help you find the pathway that fits and the next practical step.
Find your pathway
Select the description that sounds most like your situation. Each option links to an explanatory section further down this page — it does not determine or claim eligibility.
What a Medicaid waiver is
A Medicaid waiver, formally a Section 1915(c) Home and Community-Based Services waiver, lets a state "waive" certain Medicaid institutional-care rules so eligible people can receive long-term services and supports at home or in the community instead of a nursing facility or institution. States design their own waivers within federal guidelines, which is why the services, eligibility rules, and administering agency differ from state to state — and from program to program within Pennsylvania.
Why programs differ
Pennsylvania does not run one single "PA waiver program." It runs several, grouped mainly under two state offices: the Office of Long-Term Living (OLTL), which serves older adults and adults with physical disabilities, and the Office of Developmental Programs (ODP), which serves people with intellectual disabilities, developmental disabilities, and autism. Each program has its own eligibility rules, application process, and service menu, which is why finding the right pathway matters before you apply.
Who may qualify
Eligibility for any Pennsylvania waiver program generally depends on several factors together, not any single one. A person's actual eligibility is always determined by the relevant Pennsylvania agency, never by Alenta.
- Medical and functional considerations: the level of help a person needs with daily activities, health conditions, and safety at home.
- Financial considerations: most waivers use Medicaid financial rules, which examine income and resources against program limits.
- Age: some programs serve older adults only; others serve children, working-age adults, or all ages.
- Diagnosis: programs for autism, intellectual disability, or traumatic brain injury generally require a qualifying diagnosis.
- Residency: the applicant must generally live in Pennsylvania and, for county-administered programs, in the county where services are requested.
Services that may be available
Depending on the specific waiver and an approved service plan, participants may access services such as personal assistance, home-delivered meals, respite for family caregivers, home accessibility adaptations, assistive technology, community integration, supported employment, residential habilitation, and service or supports coordination itself. Not every service is available under every waiver, and availability always depends on the participant's approved plan.
OLTL-related pathways
The Office of Long-Term Living oversees Pennsylvania's waivers for older adults and adults with physical disabilities.
- Community HealthChoices (CHC): the current managed-care program combining physical health, behavioral health, and long-term services and supports for most adults 21 and older who need nursing-facility level of care or receive both Medicare and Medicaid. See Community HealthChoices service coordination.
- OBRA Waiver: serves people with severe developmental physical disabilities, such as cerebral palsy or epilepsy, who need an intermediate care facility level of care.
- Act 150: a state-funded (not Medicaid-funded) attendant care program for people who need hands-on personal assistance but do not qualify financially for a Medicaid waiver.
Historically, Pennsylvania also operated waivers known as Aging, Attendant Care, Independence, and CommCare. Those names are no longer current program names; most of what they covered is now part of Community HealthChoices.
ODP-related pathways
The Office of Developmental Programs oversees Pennsylvania's waivers for people with intellectual disabilities, developmental disabilities, and autism. See our detailed guide, PA autism and IDD waiver programs, for more on each pathway below.
- Adult Autism Waiver: serves adults 21 and older with an autism spectrum disorder diagnosis.
- Consolidated Waiver: serves people with intellectual disabilities or autism who need a more comprehensive, often residential, level of support.
- Community Living Waiver: serves people with intellectual disabilities or autism whose support needs fit a community-based, non-residential model.
- PFDS (Person/Family Directed Support) Waiver: a family-directed, lower-cost-cap option for people with intellectual disabilities or autism who want more flexibility over how services are arranged.
Children and family pathways
Families of children with disabilities or complex developmental needs generally start with their county MH/ID program office, which screens for intellectual disability and autism services, or with an early intervention program for younger children. Some children's medical needs are addressed through other Medicaid pathways rather than a waiver. Because children's eligibility pathways vary widely, a conversation with the county office — or with Alenta for complimentary initial navigation — is the fastest way to sort out where to begin.
Where applications generally begin
Where applications generally begin
Most adults age 60 and older, and most adults with a physical disability, begin with the Pennsylvania Independent Enrollment Broker or their county Area Agency on Aging. Most people with an intellectual disability, developmental disability, or autism begin with their county MH/ID program office. If you are unsure which applies to your situation, Alenta can offer complimentary initial navigation to help identify the right starting point, or you can contact us with questions.
What the IEB does
The Independent Enrollment Broker (IEB) is the Pennsylvania DHS contractor responsible for initial screening and enrollment counseling for OLTL programs like Community HealthChoices and OBRA. The IEB conducts the initial eligibility screening, explains program options, and helps route an applicant toward enrollment — but it does not provide ongoing service coordination. Learn more on our PA Independent Enrollment Broker guide.
What county MH/ID offices do
Each Pennsylvania county has a Mental Health/Intellectual Disability (MH/ID) program office that manages intake, eligibility determination, and waiting-list functions for ODP waivers serving people with intellectual disabilities, developmental disabilities, and autism. The county office — not Alenta — makes these determinations and manages enrollment into a supports coordination organization once a person is approved.
Documents and assessments
Applications typically require proof of Pennsylvania residency, income and asset documentation, medical records supporting a qualifying diagnosis or functional need, and participation in a functional or level-of-care assessment conducted by the state or its contractor. Programs may also require a psychological evaluation for intellectual disability or autism pathways. Requirements vary by program, so confirm the exact list with the agency handling your application.
What happens after approval
Once a person is approved for a waiver, they are generally assigned a service coordinator (OLTL programs) or supports coordinator (ODP programs) who helps develop an individualized service plan, connects the participant with approved providers, and monitors the plan over time. Participants may often choose their own service or supports coordination entity — including Alenta, where Alenta is an approved provider.
Service coordination versus supports coordination
"Service coordination" is the term generally used for OLTL programs such as Community HealthChoices and OBRA, while "supports coordination" is the term generally used for ODP programs serving people with intellectual disabilities, developmental disabilities, and autism. Both roles perform similar functions — planning, connecting, monitoring, and advocating — but the administering office, terminology, and specific rules differ.
How Alenta may help
Before a participant has an assigned coordinator, Alenta offers complimentary initial navigation: helping a family understand which pathway may fit, what documents to gather, and who to contact next. After enrollment, in counties where Alenta is an approved service-coordination or supports-coordination provider, Alenta may formally coordinate a participant's waiver services going forward. Families who are not pursuing a waiver, or who want additional private support alongside one, can also explore private geriatric care management.
County and service-area distinction
Alenta's formal waiver service-coordination area currently includes 14 Pennsylvania counties: Berks, Bucks, Carbon, Chester, Delaware, Lancaster, Lebanon, Lehigh, Luzerne, Montgomery, Northampton, Philadelphia, Schuylkill, and York. Alenta supports eligible participants in Pennsylvania programs and managed-care arrangements in which Alenta is an approved service-coordination provider; availability depends on program, location, authorization, and participant choice. See our Pennsylvania waiver service coordination page for details.
Frequently asked questions
- What is a PA waiver program?
- A Pennsylvania waiver program is a Medicaid-funded Home and Community-Based Services arrangement that lets an eligible participant receive long-term supports and services in their home or community instead of an institution. Pennsylvania administers several waivers through different state offices depending on the population served.
- Who decides if I qualify for a PA waiver program?
- Eligibility is determined by the Pennsylvania Department of Human Services, the Independent Enrollment Broker, or the applicable county office — never by Alenta. Determinations generally weigh medical, functional, financial, age, diagnosis, and residency factors that vary by program.
- How do I start a PA waiver program application?
- Most adults age 60 and older, or adults with a physical disability, start with the Independent Enrollment Broker or their county Area Agency on Aging. Most people with an intellectual disability, developmental disability, or autism start with their county MH/ID program office. A call to Alenta for complimentary initial navigation can help you find the right door.
- Does Alenta approve waiver applications?
- No. Alenta is not the Pennsylvania Department of Human Services or the Independent Enrollment Broker and does not determine eligibility, approve applications, or control waiting lists. Alenta offers complimentary initial navigation and, where approved, formal service or supports coordination after enrollment.
- What is the difference between service coordination and supports coordination?
- Service coordination generally refers to OLTL programs such as Community HealthChoices and OBRA, while supports coordination generally refers to ODP intellectual disability, autism, and family-directed programs. Both roles help a participant plan, connect to providers, and monitor services, though the administering office and terminology differ.
Not sure this is a fit? Talk to us.
Whether you are exploring a Community HealthChoices application, looking into ODP pathways for a family member, or considering private geriatric care management instead, the fastest way to find your next step is to submit a waiver referral or contact Alenta directly.
Official sources and further reading
Ready to hand this to someone who does it for a living?
One free, no-obligation 20-minute phone consultation with a care manager — not a salesperson. We return every call within one business day.