Waiver Information

Pennsylvania Waiver Summary  

 

Pennsylvania currently provides home and community based services and supports  through eleven Medicaid waivers and numerous other state-funded programs. The  Pennsylvania waivers serve over 40,000 participants with physical and developmental  disabilities, with AIDS, who are technology dependent, the elderly and those with mental  retardation. HCBS Waiver programs are administered by DPW.  

 

History of the Attendant Care Program  

 

The Department of Public Welfare initiated a three-year Attendant Care Demonstration  Program in October 1984. Deinstitutionalization and preventing institutionalization were  major goals of the Attendant Care Program. A major innovation of the program is that  participants have the right to direct their own services i.e., screening, interviewing,  hiring, training, managing, paying, and firing attendants. The three-year demonstration  program enabled the Department to define the Pennsylvania Model of Attendant Care  Service based on policies that provide for a continuum of care. This service delivery  model has received national recognition. These policies support the concept that, to the  maximum extent possible, the assistance provided be directed by the person receiving  the services and that the services be provided in a manner consistent with that  participant's capacity to manage it. The Attendant Care Program exists pursuant to the  Attendant Care Services Act (Act 1986-1 50, 62 P.S. 9 3051 et seq.), also known as Act  150. Act 150 provides for basic and ancillary services that enable an eligible person to  remain in his home and community rather than an institution and to carry out functions  of daily living, self-care and mobility.  

 

Act 150 requires that attendant care services be provided statewide. Attendant care  service shall be available only to the extent that it is funded through annual  appropriation of state and federal funds. The Act took effect July 1, 1987. By December  1987, attendant care services were available in all 67 counties.  

 

Since the inception of the Attendant Care Program, the program has been funded through  state appropriations and through the Social Services Block Grant (SSBG under Title XX  of the Social Security Act). On August 7, 1995, the Commonwealth implemented the  Medicaid Waiver for attendant care services, which accesses federal funds under Title  XIX of the Social Security Act, to provide attendant care services to Medicaid eligible  participants who meet other eligibility requirements. 

 

Effective September 17, 1996, the Commonwealth limited participation in the Act 150  Program to persons who do not meet the eligibility requirements for the Medicaid  Waiver. Attendant care services under the Medicaid Waiver are identical to the services  provided under the Act 150 Program. There are administrative differences between the  programs to allow compliance with Title XIX requirements. Primary differences include  financial and level of function requirements under Title XIX, and the Title XIX  requirement to enroll all eligible and willing providers.