Understanding Pennsylvania waiver programs can be challenging, especially when determining eligibility, available services, and how to begin receiving support. Admire Care Company works with individuals and families exploring home and community-based services and provides support through participating programs. The answers below address common questions about waiver programs, eligibility, services, and getting started with care.
What is a Pennsylvania home and community-based waiver program?
Pennsylvania waiver programs provide eligible individuals with services and supports that can help them live safely and maintain greater independence in their homes and communities. Depending on the program, approved supports may include personal care, homemaking, transportation, respite care, and other services based on individual needs.
What waiver programs does Admire Care Company participate in?
Admire Care Company participates in several Pennsylvania programs, including the Community HealthChoices Waiver, Act 150 Program, and OBRA Waiver. Eligibility requirements and available services vary by program and individual circumstances.
What is the Community HealthChoices Waiver?
Community HealthChoices (CHC) provides managed long-term services and supports to eligible Pennsylvania residents. The program helps qualifying individuals access care and support in their homes and communities. Services are based on eligibility, assessed needs, and an approved service plan.
What is the Act 150 Program?
The Act 150 Program provides home and community-based services to eligible individuals with physical disabilities who meet program requirements. The program is intended to support individuals in maintaining independence and remaining in their homes and communities.
What is the OBRA Waiver?
The OBRA Waiver provides home and community-based services to certain Pennsylvania residents with physical disabilities who meet the program’s eligibility requirements. Approved supports are intended to help eligible individuals receive necessary assistance while living in a community setting.
Who may qualify for a waiver program?
Each Pennsylvania waiver or program has specific eligibility requirements. Depending on the program, eligibility may involve factors such as disability, functional needs, level of assistance required, financial eligibility, and other program criteria.
Does being eligible for a waiver mean all services are automatically covered?
Not necessarily. Eligibility for a waiver does not mean every available service is automatically approved. Services are generally determined according to the individual’s assessed needs and authorized service plan. The type, amount, and frequency of support can vary between individuals.
What services can be provided through a waiver?
Depending on the program and the individual’s approved service plan, available supports may include Personal Care Assistance, Companion Care Services, Homemaking Services, Medication Reminders, Transportation Assistance, and Respite Care Services. Services are provided according to applicable program requirements and authorization.
How do I get started with waiver services?
Getting started generally involves determining whether the individual meets the requirements for an applicable program, completing the necessary eligibility process, and having their needs assessed. Once services are approved, the individual can work with the appropriate program representatives and an authorized provider to arrange care.
What happens after an individual’s needs are assessed?
The assessment helps determine the individual’s level of need and the types of supports that may be appropriate. If the individual is eligible and services are authorized, an approved service plan will identify the services, amount, and frequency of support available.
Can I request a specific type of service?
Individuals can discuss their support needs and preferences during the assessment and care-planning process. Whether a particular service is available depends on the applicable program, eligibility requirements, assessed needs, and authorization.
Can waiver services be changed if someone’s needs change?
An individual’s needs may change over time. When this happens, the appropriate care coordinator, managed care organization, or program representative can review the individual’s circumstances and determine whether changes to the approved service plan are appropriate.
Can waiver services be provided in the individual’s home?
Yes. Home and community-based waiver programs are designed to help eligible individuals receive appropriate support while living in community settings, including their own homes, when services are authorized and suitable for their needs.
Can a family member help with the waiver process?
Family members or other appropriate representatives may be involved in discussions about an individual’s care and available services, consistent with the individual’s preferences and applicable program requirements. Having someone assist with communication can be helpful when navigating the process.
Is private pay an option if someone does not use a waiver?
Private pay may be an option for individuals who choose to arrange and pay directly for home care services. Private-pay arrangements are separate from waiver-funded services and may have different requirements and payment arrangements.
How can Admire Care Company help?
Admire Care Company can provide information about our participating programs and the in-home support services we offer. Our team can help individuals and families better understand the services available through our company and discuss the next steps for arranging care.