I/DD Waivers in Pennsylvania

All states: Medicaid disability services map

Pennsylvania I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Pennsylvania?

The Office of Developmental Programs (ODP) runs I/DD home and community services in Pennsylvania. ODP is part of the Department of Human Services (DHS), which is also the state Medicaid agency, so one department both funds and runs the waivers. County Mental Health/Intellectual Disabilities (MH/ID) programs act as the local front door and handle much of the day to day work for ODP.

• Office of Developmental Programs (ODP): operates the four I/DD and autism waivers, sets provider rules and fee schedules, and runs state centers for people who need institutional care. The Adult Autism Waiver is run by ODP's Bureau of Supports for Autism and Special Populations. DHS keeps a main page for intellectual disabilities and autism services.
• Administrative Entities (AEs): county MH/ID programs, or in some places a non-governmental entity, that sign an operating agreement with ODP. According to the Consolidated Waiver text, AEs handle enrollment, make the level of care decision, approve service plans, authorize most services and qualify providers.
• Front door: for the Consolidated, Community Living and P/FDS waivers, people register with their county MH/ID program office. For the Adult Autism Waiver, people request services through an ODP toll-free number.
• Case management: called Supports Coordination. It is provided by conflict-free Supports Coordination Organizations (SCOs), which are agencies the participant chooses and which do not also provide the person's other waiver services. People who are not in a waiver can get Targeted Support Management, a Medicaid state plan case management service.

What Medicaid waivers and programs serve people with I/DD in Pennsylvania?

Pennsylvania has four 1915(c) waivers for people with intellectual disabilities or autism, all run by ODP. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Three of them, often called the ID/A waivers, share one service design and differ mainly in their cost limits. The fourth serves adults with autism.

• Consolidated Waiver (1915(c), control number PA.0147): serves people of any age with an intellectual disability or autism, children under 9 with a developmental disability likely to lead to an intellectual disability or autism diagnosis, and children under 22 with a developmental disability due to a medically complex condition, who meet intermediate care facility (ICF) level of care. It has no individual cost limit and is the only ID/A waiver that covers Residential Habilitation in community homes. Services include Residential Habilitation, Life Sharing, Supported Living, Community Participation Support, In-Home and Community Support, Companion, Supported Employment, Small Group Employment, Respite, Shift Nursing, Behavioral Support and Supports Coordination. About 19,989 people were enrolled in fiscal year 2024-25.
• Community Living Waiver (1915(c), control number PA.1486): serves the same groups with a cost limit of $97,000 per person per fiscal year (Supports Coordination does not count toward it). It does not cover Residential Habilitation in community homes. Services include Life Sharing, Supported Living (Needs Groups 1 and 2), Community Participation Support, In-Home and Community Support, Companion, employment services, Respite and Participant-Directed Goods and Services. About 8,973 people were enrolled in fiscal year 2024-25.
• Person/Family Directed Support (P/FDS) Waiver (1915(c), control number PA.0354): serves the same groups with a cost limit of $47,000 per person per fiscal year. Supports Coordination and Supports Broker do not count toward the limit, and it can be exceeded by up to $15,000 for employment services. Services include In-Home and Community Support, Companion, Community Participation Support, Supported Employment, Respite and Supports Broker. About 12,311 people were enrolled in fiscal year 2024-25.
• Adult Autism Waiver (AAW) (1915(c), control number PA.0593): serves adults 21 and older with autism spectrum disorder diagnosed before age 22 and substantial functional limitations. CMS approved its renewal on June 11, 2026, effective July 1, 2026. Services include Specialized Skill Development, Day Habilitation, Residential Habilitation, Life Sharing, Career Planning, employment services, Respite, Behavioral Support and Assistive Technology. Services are agency-managed only. About 722 people were enrolled in fiscal year 2024-25.

Two related programs sit alongside the waivers. The Adult Community Autism Program (ACAP) is a managed care program for close to 200 adults with autism in four counties, described in the next section. The Infants, Toddlers and Families Waiver is an early intervention waiver and is not one of ODP's I/D and autism waivers. Pennsylvania also has Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID), including state centers run by ODP, as the institutional option the waivers are an alternative to.

Does Pennsylvania pay for I/DD services through managed care?

No, with one small exception. Waiver services are paid fee-for-service, which means DHS pays enrolled providers directly for each authorized service at rates on statewide ODP fee schedules. County Administrative Entities authorize the services and Supports Coordinators coordinate them, but neither pays claims.

• The four waivers: paid fee-for-service by DHS. Residential providers can earn rate add-ons under a separate 1915(b)(4) Performance-Based Contracting waiver, described in the rates section below.
• Adult Community Autism Program (ACAP): a fully integrated managed care program that becomes the participant's health plan, covering physical and behavioral health care along with skill development, employment supports, in-home support, crisis services, residential habilitation and respite. It serves close to 200 adults in Cumberland, Dauphin, Lancaster and Chester counties. Keystone Autism Services and its provider network deliver most services under an agreement with DHS.

Is there a waiting list for I/DD services in Pennsylvania?

Yes. ODP keeps a statewide waiting list and sorts people into Emergency, Critical and Planning categories using a tool called the Prioritization of Urgency of Need for Services (PUNS). ODP's 2025 Multi-Year Program Growth Strategy report counts 7,230 adults age 21 and older waiting as of February 26, 2026.

• By category (adults 21 and older, February 26, 2026): 3,044 Emergency, 978 Critical and 3,208 Planning.
• All ages: the same report charts 4,320 people of all ages in the Emergency category and 4,951 in the Critical category as of July 2025.
• Growth plan: under its Multi-Year Program Growth Strategy, announced in February 2024, ODP reports a 31% drop in the adult emergency waiting list and total program capacity of 41,916. ID/A waiver enrollment reached 39,714 for fiscal year 2025-26 as of March 20, 2026.
• PUNS changes: ODP released an updated PUNS manual with a new supplemental form in February 2026.

For a person's place on the list, families can ask their Supports Coordinator or county MH/ID program office.

How do people apply for I/DD services in Pennsylvania, and how are budgets set?

For the Consolidated, Community Living and P/FDS waivers, a person registers with their county MH/ID program office. Adults with autism can request the Adult Autism Waiver through ODP's toll-free number. ODP measures support needs with the Supports Intensity Scale (SIS), and each waiver's cost limit sets the outer edge of a person's plan.

• Eligibility: a diagnosis of intellectual disability, autism or (for young or medically complex children) a developmental disability, an ICF level of care recommendation based on a medical evaluation, and Medicaid eligibility. The County Assistance Office decides financial eligibility. The county Administrative Entity gathers the documents and makes the level of care decision. For the Adult Autism Waiver, ODP regional staff and contractors assess functional eligibility.
• Assessment: the SIS is ODP's statewide needs assessment. An independent contractor gives it at least once every five years. ODP uses other tools for groups the SIS is not designed for.
• Cost limits: none in the Consolidated Waiver, $97,000 per year in the Community Living Waiver and $47,000 per year in the P/FDS Waiver (plus up to $15,000 more for employment services). Supports Coordination does not count toward these limits.
• Needs Groups: Supported Living is offered at Needs Groups 1 to 4 in the Consolidated Waiver and Needs Groups 1 and 2 in the Community Living Waiver.
• Service plans: the Supports Coordinator builds the plan with the person, and the county Administrative Entity approves it and authorizes services.
• Self-direction: the Consolidated, Community Living and P/FDS waivers let participants direct some services through Vendor Fiscal/Employer Agent (VF/EA), where the participant or family is the employer of record, or Agency With Choice (AWC), where an agency shares employer duties with them. A Supports Broker can help. The Adult Autism Waiver does not offer self-direction.

What day and residential services can I/DD providers offer in Pennsylvania?

In the ID/A waivers, the main day service is Community Participation Support (CPS), backed by Supported Employment and Small Group Employment, all billed in 15-minute units. The main residential options are Residential Habilitation in community homes, Life Sharing (host homes) and Supported Living. DHS licenses community homes and family living homes under Title 55 of the Pennsylvania Code.

Day and employment services (Consolidated, Community Living and P/FDS waivers)

• Community Participation Support (CPS): combines prevocational and day habilitation services to support community inclusion and progress toward competitive integrated employment. It can be delivered in community locations, in community hubs (no more than 6 participants per provider at one time) or in licensed facilities. Facility-based CPS needs an Adult Training Facility license (55 Pa. Code Chapter 2380), a Vocational Facility license (Chapter 2390) or an Older Adult Daily Living Center license (6 Pa. Code Chapter 11). Since January 1, 2023, CPS cannot be provided in a 2380 or 2390 facility serving more than 150 people at once. Staff ratios in licensed facilities run from Basic (1 staff to 11 to 15 people) through Level 1 (1:7 to 1:10), Level 2 (1:4 to 1:6), Level 3 (1:2 to 1:3), Level 4 (1:1) and Level 5 (2:1), and enhanced levels need credentialed staff. CPS is capped at 40 hours a week when not combined with employment services.
• Small Group Employment: support for small groups working in integrated business settings, such as mobile work crews or enclaves, including transportation to the work site. Ratios run from Basic (1 staff to 6 to 10 people) down to Level 3 (1:1). Billed in 15-minute units.
• Supported Employment and Advanced Supported Employment: individual job finding, job development, coaching and job retention support for competitive integrated employment, billed in 15-minute units. The research did not find a published ratio. For a person with a competitive job, CPS, Supported Employment and Small Group Employment together cannot exceed 50 hours a week.

The Adult Autism Waiver has its own day services, including Day Habilitation and Specialized Skill Development. We did not confirm their licensing or ratio rules; check the waiver's Appendix C.

Residential services

• Residential Habilitation (Consolidated Waiver; Community Homes in the Adult Autism Waiver): provider-run support in community homes, paid as a day unit. Homes enrolled on or after July 1, 2017 are limited to 4 people, and older homes may serve up to 8. Licensed homes are Community Homes for Individuals with an Intellectual Disability or Autism under 55 Pa. Code Chapter 6400 (some settings fall under Chapters 3800 or 5310). Unlicensed Residential Habilitation serves 3 or fewer adults who need an average of 30 hours or less of staff contact a week.
• Life Sharing (Consolidated and Community Living waivers; Adult Autism Waiver): a host home model where the participant lives with a host family, related or not, in the family's home or the participant's own home. No more than 4 people unrelated to the host family may live in the home. Family Living Homes are licensed under 55 Pa. Code Chapter 6500, but homes owned or rented by close relatives listed in section 6500.4 do not need a license. Since July 1, 2026, Life Sharing is a separate service from Residential Habilitation in the Adult Autism Waiver.
• Supported Living (Consolidated Waiver, Needs Groups 1 to 4; Community Living Waiver, Needs Groups 1 and 2): direct and indirect support for people living in a home they own, rent or lease, overseen by a supported living specialist and billed as a day unit. The research did not find a separate license for this service.
• ICF/IID: intermediate care facilities licensed under 55 Pa. Code Chapter 6600, including ODP's state centers, remain the institutional option. ICFs with 5 to 8 beds may convert to Residential Habilitation with ODP approval.

How are I/DD provider rates set and how do agencies enroll in Pennsylvania?

Most ODP services are paid on a statewide Medical Assistance fee schedule set with a market-based approach that uses a Pennsylvania compensation study and provider cost reports. Some services use cost-based rates. Rate changes are published in the Pennsylvania Bulletin and on ODP's rates page. Agencies become providers by completing ODP's qualification process with their county Administrative Entity.

• Rate studies: a 2023 rate study changed most rates effective July 1, 2024, and the next study is due no later than 2027. ODP's rates page lists residential rates effective July 1, 2024 through June 30, 2027.
• Performance-Based Contracting: since January 1, 2025, under a 1915(b)(4) waiver, residential providers that meet Select standards get a 3% add-on and those that meet Clinically Enhanced standards get a 5% add-on for Residential Habilitation, Life Sharing and Supported Living.
• Supports Coordination rates: a March 7, 2026 Pennsylvania Bulletin notice replaced the 15-minute Supports Coordination rate with monthly case rates of $334.01 per person (Consolidated and Community Living) and $295 (P/FDS), with a July 1, 2026 effective date. Supports Coordination Organizations should confirm with ODP when the case rates are in use for billing.
• Becoming a provider: new providers complete ODP's required orientation and training, then show they meet the waiver's provider standards through a self-assessment and required documents. The Administrative Entity reviews the application for ODP and qualifies each service specialty. Details are on ODP's provider qualifications page.
• EVV: Companion, In-Home and Community Support, Homemaker and Respite in unlicensed settings, in the Consolidated, Community Living and P/FDS waivers, ACAP and county-funded ID/A base services, count as personal care services and require electronic visit verification (EVV). DHS built its EVV system with Sandata and Gainwell Technologies to connect with PROMISe, the state's Medicaid claims system, and agencies may use an approved alternate EVV system instead. Claims without a matching EVV visit are denied, according to DHS's EVV page for personal care services.

What is changing next for I/DD services in Pennsylvania?

ODP's rates page lists new fee schedule rates for select community-based services effective January 1, 2027. ODP is also drafting amendments to the Chapter 6100 regulations, the main rules for ODP providers. The rule changes are still in draft, so their content and timing could change.

• New community-based rates (January 1, 2027): listed on ODP's rates page. We could not confirm which services the new rates cover or the amounts, so providers should read the posted fee schedule or ask ODP.
• Chapter 6100 amendments (proposed, not final): ODP told its Information Sharing and Advisory Committee in October 2026 that it is drafting changes to 55 Pa. Code Chapter 6100 after Commonwealth Court rulings in February 2026. The draft adds sections on performance-based contracting, service limits, program integrity and services provided by relatives. ODP has said it aims to publish proposed rules in 2027, but no date is set and the draft could change.
• Next rate study: the waiver text says ODP's next rate study is due no later than 2027.

Several changes already took effect in 2026: amendments to the Consolidated, Community Living and P/FDS waivers on January 1, 2026, and the Adult Autism Waiver renewal on July 1, 2026, which replaced the lifetime Assistive Technology limit with a $3,000 annual limit and made Life Sharing its own service. Proposed waiver changes are posted on DHS's waiver amendments page.

Pennsylvania I/DD sources

• Pennsylvania DHS: Consolidated Waiver
• Pennsylvania DHS: Community Living Waiver
• Pennsylvania DHS: Person/Family Directed Support Waiver
• Pennsylvania DHS: Consolidated Waiver text (amendment effective January 1, 2025)
• Pennsylvania DHS: Adult Autism Waiver 2026 renewal application
• ODP: 2025 Multi-Year Program Growth Strategy report (waiting list)
• Pennsylvania DHS: ODP rates
• Pennsylvania Bulletin, March 7, 2026: Supports Coordination fee schedule rates
• Pennsylvania DHS: ODP provider qualifications
• Pennsylvania DHS: EVV for personal care services

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Goal Tracking and Strategy Management in Disability Services
• I/DD services in every state (map)
• Pennsylvania EVV requirements

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.