1. What is the Waiver ?

The Waiver is a federal program based on an amendment to the Social Security Act. This amendment allows any state that meets the federal requirements to use federal dollars to fund programs and services for people who have mental retardation and who live in the community. Prior to the amendment, these federal dollars could only be used for institutional care -- in nursing homes or state MR facilities or Intermediate Care Facilities (ICFs/MR).

In Pennsylvania, the waiver is a funding source that enables us to provide services to people in the community. To receive federal dollars, the state must comply with federal requirements.

The Person and Family Directed Support Waiver (P/FDSW) was approved for three years starting January 2000. This waiver has a $21,125 cap for services.

2. Why is waiver funding important ?

The P/FDS Waiver affords the state an opportunity to bring more federal dollars into Pennsylvania.

There are two types of funding for services and supports:

• Base funding: this is 100% state dollars:

• Waiver funding: this is approximately 54% federal dollars and 46% state dollars

As of April 2, 2002, Philadelphia has enrolled approximately 520 individuals in the P/FDS Waiver. New enrollees includes: 1) individuals who receive services and are "converting" to the waiver and 2) individuals who are new to service.

Converting base funded services "frees up" state dollars, which allows the city to obtain more federal dollars. The state Department of Public Welfare has agreed that Philadelphia can keep all savings from the conversion of services from state dollars to waiver funding. This money is available on an individual basis, up to the ceiling, to assist individuals in the waiver if their circumstances change. Money is also available to support a limited number of new people in emergency or critical need, according to their Priority of Urgency of Need Survey (PUNS).

3. Who is eligible for waiver funded services ?

To be eligible, you must be a resident of Philadelphia, have a documented diagnosis of mental retardation and meet the financial eligibility requirements. The new waiver is only available to people who live with their families or on their own.

4. What services are eligible under the new Person and Family Directed Support Waiver?

The following is a list of the services that are waiver eligible.

• Habilitation: any support or service that helps the individual acquire, retain or improve their skills related to activities of daily living; including transportation to and from work as an individual is learning to travel.
• Home/Vehicle Adaptations: adaptations to make the house accessible, modifications to a vehicle to accommodate an individual’s disability. The per household limit is $20,000.
• Adaptive Appliances and Equipment: clinically prescribed equipment that is not paid for by Medical Assistance (MA) such as durable medical equipment.
• Therapies: Evaluations and clinically indicated therapies, including OT, PT, Speech, Behavior, Vision/Mobility, Visiting Nurse, which are not covered by your HMO including EPSDT, or private insurance,
• Respite: relief for the caregiver, maximum of 30 (24 continuous hours) days per year; unlimited amounts of time in less than 24 hour blocks of time.
  Daytime Services: Adult Day Programs, Vocational Workshops, and Supported Employment
• Homemaker/Chore Services: General household activities provided by a trained homemaker as well as chore services needed to maintain a clean and safe home, including heavy household chores and lawn care.
  Personal Support: Assistance needed by the person to plan, organize and manage community resources.