Full Range of Services and Supports

Community Participation Support

Community Participation Support provides opportunities and support for community inclusion and building interest in and developing skills and potential for competitive integrated employment. Services should result in active, valued participation in a broad range of integrated activities that build on the participant's interests, preferences, gifts, and strengths while reflecting his or her desired outcomes related to employment, community involvement and membership.


Education Support

Education Support consists of education and related services as defined in Sections (22) and (25) of the Individuals with Disabilities Education Act (IDEA) to the extent that they are not available under a program funded by IDEA or available for funding by the Office of Vocational Rehabilitation (OVR). To receive Education Support services through the waiver, students attending eligible institutions and who are eligible for Federal Student Aid and/or PA State Grant funding must apply.


Homemaker/Chore

Homemaker services enable the participant or the family member(s) or friend(s) with whom the participant resides to maintain their primary private home. This service can only be provided when a household member is temporarily absent or unable to manage the home, or when no landlord or provider agency staff is responsible to perform the homemaker activities. Homemaker Services include cleaning and laundry, meal preparation, and other general household care.

Chore services consist of services needed to maintain the home in a clean, sanitary, and safe condition. Chore services consist of heavy household activities such as washing floors, windows, and walls; tacking down loose rugs and tiles; moving heavy items of furniture in order to provide safe access and egress; ice, snow, and/or leaf removal; and yard maintenance. In the case of rental property, the responsibility of the landlord, pursuant to the lease agreement, will be examined prior to any authorization of service. Maintenance in the form of upkeep and improvements to the participant’s home is excluded from federal financial participation.


In-Home and Community Support

In-Home and Community Support is a direct service provided in home and community settings to assist participants in acquiring, maintaining and improving the skills necessary to live in the community, to live more independently, and to participate meaningfully in community life. To the extent that In-Home and Community Support is provided in community settings, the settings must be inclusive rather than segregated.


Residential Habilitation

Residential Habilitation services are direct and indirect services provided to participants who live in licensed and unlicensed provider owned, rented or leased residential settings. This service is built on the principle that every participant has the capacity to engage in lifelong learning. As such, through the provision of this service, participants will acquire, maintain, or improve skills necessary to live in the community, to live more independently, and to participate meaningfully in community life. To the extent that Residential Habilitation is provided in community settings outside of the residence, the settings must be inclusive rather than segregated.


Respite

Respite services are direct services that are provided to supervise and support participants living in private homes on a short-term basis for planned or emergency situations, giving the person(s) normally providing care a period of relief that may be scheduled or due to an emergency. Respite services do not cover the care provided to a minor child when the primary caregiver or legally responsible individual is absent due to work.


Supported Employment

Supported Employment services are direct and indirect services that are provided in a variety of community settings for the purposes of supporting participants in obtaining and sustaining competitive integrated employment. Competitive integrated employment refers to full or part-time work at minimum wage or higher, with wages and benefits similar to workers without disabilities performing the same work, and fully integrated with coworkers without disabilities.


Supports Coordination

Supports Coordination is a critical service that involves the primary functions of locating, coordinating, and monitoring needed services and supports for participants. This includes locating, coordinating and monitoring needed services and supports when a participant is admitted to a nursing home or hospital for less than 30 days.


Specialized Supplies

Specialized Supplies consist of incontinence supplies that are medically necessary and are not a covered service through the MA State Plan, Medicare or private insurance. Supplies are limited to diapers, incontinence pads, cleansing wipes, underpads, and vinyl or latex gloves.


Therapy Services

Therapy services include the following:

  • Physical therapy based on a prescription for a specific therapy program by a physician.
  • Occupational therapy based on a prescription for a specific therapy program by a physician.
  • Speech/language therapy based on an evaluation and recommendation by an American Speech-Language-Hearing Association (ASHA) certified and state licensed speech-language pathologist or a physician.
  • Orientation, mobility and vision therapy based on an evaluation and recommendation by a trained mobility specialist/instructor or a physician.

Supports Broker Services

The Supports Broker service is a direct and indirect service available to participants who elect to self-direct their own services utilizing one of the participant directed options outlined in Appendix E-1 of this Waiver. The Supports Broker service is designed to assist participants or their designated surrogate with employer-related functions in order to be successful in self-directing some or all of the participants needed services.


Advanced Supported Employment

Advanced Supported Employment is an enhanced version of supported employment services provided by qualified providers. The service includes discovery, job development, systematic instruction to learn the key tasks and responsibilities of the position and intensive job coaching and supports that lead to job stabilization and retention.


Assistive Technology

An item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve a participant’s functioning or increase a participant’s ability to exercise choice and control.


Behavioral Support

This is a direct and indirect service that includes a comprehensive assessment; the development of strategies to support the participant based upon the assessment; and the provision of interventions and training to participants, staff, parents and caregivers. Services must be required to meet the current needs of the participant, as documented and authorized in the service plan.


Benefits Counseling

Benefits Counseling is a direct service designed to inform, and answer questions from, a participant about competitive integrated employment and how and whether it will result in increased economic self-sufficiency and/or net financial benefit through the use of various work incentives. Through an accurate individualized assessment, this service provides information to the participant regarding the full array of available work incentives for essential benefit programs including Supplemental Security Income, SSDI, Medicaid, Medicare, housing subsidies, food stamps, etc.


Communication Specialist

This is a direct and indirect service that supports participants with nontraditional communication needs by determining the participant’s communication needs, educating the participant and his or her caregivers on the participant’s communication needs and the best way to meet those needs in their daily lives.


Companion

Companion services are direct services provided to participants age 18 and older who live in private homes for the limited purposes of providing supervision or assistance that is designed to ensure the participant’s health, safety and welfare or to perform activities of daily living for the participant. This service is intended to assist the individual to participate more meaningfully in home and community life. This service may be provided in home and community settings, including the participant’s competitive employment work place.


Consultative Nutritional Services

Consultative Nutritional services are direct and indirect services that assist unpaid caregivers and/or paid support staff in carrying out participant treatment/service plan, and that are not covered by the Medicaid State Plan, and are necessary to improve or sustain the participant’s health status and improve the participant’s independence and inclusion in their community. The service may include assessment, the development of a home treatment/service plan, training and technical assistance to carry out the plan and monitoring of the participant and the provider in the implementation of the plan. This service may be delivered in the participant’s home or in the community as described in the service plan. This service requires a recommendation by a physician.


Family/Caregiver Training and Support

This service provides training and counseling services for unpaid family members or caregivers who provide support to a participant. For purposes of this service an unpaid family member or caregiver is defined as any person, such as a family member, spouse, neighbor, friend, partner, companion, or coworker, who provides uncompensated care, training, guidance, companionship or support to the participant.


Home Accessibility Adaptations

Home accessibility adaptations are an outcome based vendor service that consists of certain modifications to the private home of the participant (including homes owned or leased by parents/relatives with whom the participant resides and Life Sharing homes that are privately owned, rented, or leased by the host family). The modification (s) must be necessary due to the participant’s disability, to ensure the health, security of, and accessibility for the participant, or which enable the participant to function with greater independence in the home. This service may only be used to adapt the participant's primary residence, may not be furnished to adapt homes that are owned, rented, leased, or operated by providers except when there is a needed adaptation for participants residing in a Life Sharing setting and the life sharing host home is owned, rented or leased by the host and not the Life Sharing provider agency.


Housing Transition and Tenancy Sustaining Services

This service includes pre-tenancy and housing sustaining supports to assist participants in being successful tenants in private homes owned, rented or leased by the participants.


Life Sharing

Life Sharing services are direct and indirect, provider agency managed services that occur in one of the following locations:

  • Private home of a host family where the host family is not a relative of the participant that requires licensure pursuant to 55 Pa. Code Chapter 6500 (relating to Family Living Homes). This also applies to a legal guardian who is not the participant's relative.
  • Private home of a host family where the host family is not a relative of the participant to which licensing criteria do not apply as specified in 55 Pa.Code § 6500.3(f)(5). This also applies to a legal guardian who is not the participant's relative.
  • Private home of a host family where the host family is a relative of a participant to which licensing criteria do not apply as specified in 55 Pa. Code § 6500.3(f)(1). This also applies to a legal guardian who is a relative of the participant. When Life Sharing is provided by a relative to a participant who is younger than 18 years of age, this service may only be used to provide extraordinary care. A relative is responsible to meet the needs of a participant who is younger than 18 years of age, including the need for assistance and supervision typically required for children at various stages of growth and development. A relative can, however, receive payment for Life Sharing services when this support goes beyond what would be expected to be performed in the usual course of parenting, and when needed support exceeds what is typically required for a child of the same age. Further, the provider agency must develop a preservice agreement with relatives that states the Life Sharing program requirements that the relative(s) must comply with to be a host family and the conditions that will result in termination of the relative(s) as a host family from the Life Sharing program.
  • Private home of the participant where a host family who is not related to the participant moves into the participant's home and shares the participant's home as their primary residence. This also applies to a legal guardian who is not the participant's relative.

Music Therapy, Art Therapy and Equine Assisted Therapy

Direct therapy services provided to a participant who may or may not have a primary diagnosis of mental illness, but who could benefit by the provision of therapy to maintain, improve or prevent regression of the participant’s condition and assist in the acquisition, retention or improvement of skills necessary for the participant to live and work in the community. Services and intended benefit must be documented in the service plan. Therapy services consist of the following individual and group therapies that are not primarily recreational or diversionary.


Shift Nursing

Shift Nursing is a direct service that can be provided either part-time or full-time in accordance with 49 Pa. Code Chapter 21 (State Board of Nursing) which provides the following service definition for the practice of professional nursing: "Diagnosing and treating human responses to actual or potential health problems through such services as case finding, health teaching, health counseling, provision of care supportive to or restorative of life and well-being, and executing medical regimens as prescribed by a licensed physician or dentist. The term does not include acts of medical diagnosis or prescription of medical, therapeutic or corrective measures, except as may be authorized by rules and regulations jointly promulgated by the State Board of Medicine and the Board, which rules and regulations will be implemented by the Board."


Small Group Employment

Small Group Employment services consist of supporting participants in transitioning to competitive integrated employment through work that occurs in a location other than a facility subject to 55 Pa. Code Chapter 2380 or Chapter 2390 regulations. The goal of Small Group Employment services is competitive integrated employment. Participants receiving this service must have a competitive integrated employment outcome included in their service plan, and it must be documented in the service plan how and when the provision of this service is expected to lead to competitive integrated employment. Work that participants perform during the provision of Small Group Employment services must be paid at least minimum wage and the compensation must be similar to compensation earned by workers without disabilities performing the same work.


Supported Living

These are direct and indirect services provided to participants who live in a private home that is owned, leased or rented by the participant or provided for the participant’s use via a Special or Supplemental Needs trust and located in Pennsylvania. Supported Living services are provided to protect the health and welfare of participants by assisting them in the general areas of self-care, health maintenance, wellness activities, meal preparation, decision making, home management, managing personal resources, communication, mobility and transportation, relationship development and socialization, personal adjustment, participating in community functions and activities and use of community resources. Through the provision of this service participants will be supported to live in their own home in the community and to acquire, maintain or improve skills necessary to live more independently and be more productive and participatory in community life.


Transportation

Transportation is a direct service that enables participants to access services and activities specified in their approved service plan. This service does not include transportation that is an integral part of the provision of another discrete Waiver service.


Vehicle Accessibility Adaptations

Vehicle accessibility adaptations consist of certain modifications to the vehicle that the participant uses as his or her primary means of transportation to meet his or her needs. The modifications must be necessary due to the participant’s disability. The vehicle that is adapted may be owned by the participant, a family member with whom the participant lives, or a non-relative who provides primary support to the participant and is not a paid provider agency of services. This service may also be used to adapt a privately owned vehicle of a life sharing host when the vehicle is not owned by the Life Sharing provider agency.