Independence Waiver in PA: Paid Caregiving for Individuals with Intellectual Disabilities

Pennsylvania’s Independence Waiver serves a population that most home care content
overlooks: individuals with intellectual disabilities who want to live in the community
with family-directed support. If your loved one has an intellectual disability and your
family provides daily care, this waiver may allow a family member to be hired and paid
for that care.

The Independence Waiver is administered by the Office of Developmental Programs
(ODP) — a different branch of DHS than the Office of Long-Term Living that manages
CHC and OBRA. That distinction matters because the enrollment pathway, the service
coordinators, and the support infrastructure are different from what families encounter
in the CHC system.

How the Independence Waiver Works

The Independence Waiver funds home and community-based services for individuals
with intellectual disabilities who would otherwise require care in an Intermediate Care
Facility (ICF). Like other Medicaid waivers, it “waives” the institutional care requirement
and funds services at home instead.

Services covered include residential habilitation, which supports the individual in
developing and maintaining daily living skills. Companion services provide supervision
and engagement. Respite care gives family caregivers periodic breaks. Home and
community habilitation supports participation in community activities, employment, and
social engagement. Behavioral support services help manage challenging behaviors.
And nursing services provide periodic clinical support.

The critical piece for families: the Independence Waiver supports participant-directed
services, allowing the individual (or their family representative) to choose their own
caregiver — including a qualifying family member who can be hired and paid through a
similar employment structure to the Agency with Choice model used in CHC.

Who Qualifies

The individual must have a diagnosed intellectual disability, be a Pennsylvania resident
enrolled in Medicaid, and meet the level of care required for ICF placement. Eligibility is
determined through the ODP system, not through the OLTL or CHC pathways.
In our experience, the most important step for families exploring the Independence
Waiver is connecting with their local Supports Coordination Organization (SCO). The
SCO assigns a supports coordinator who manages the individual’s service plan,
coordinates assessments, and facilitates enrollment in waiver services. In the
Philadelphia area, multiple SCOs operate — your county’s ODP office can identify which
ones serve your area.

What Makes This Different from CHC

Families who are familiar with Community HealthChoices sometimes assume the
Independence Waiver works the same way. It doesn’t — and the differences matter.

The administrative structure runs through ODP, not OLTL. There are no MCOs in the
Independence Waiver system — instead, supports coordinators manage the care plan
directly. The service types are tailored to intellectual disability needs (habilitation,
behavioral support) rather than the personal care and homemaker services that
dominate CHC. And the enrollment process involves ODP-specific assessments and
waitlists.

However, the family caregiver pathway shares the same core principle: the participant
directs their care, a family member provides it, and a financial management structure
handles payroll and compliance. The mechanism is similar even though the
administrative home is different.

Waitlists and Planning

The Independence Waiver, like many ODP-administered waivers, may have a waitlist.
Planning horizons can be measured in months or years, not weeks. Families who
anticipate needing these services should begin the ODP intake process as early as
possible — even if the immediate need isn’t urgent. Getting on the waitlist sooner means
accessing services sooner.

In the interim, some individuals may be able to access services through other ODP
waivers (Community Living Waiver, P/FDS Waiver) or through base-funded services
while waiting for a waiver slot. The supports coordinator can advise on the best
approach for your family’s timeline.

What We See Working with Families

The families we serve through the Independence Waiver pathway often share a common
story: they’ve been providing care for a son or daughter with an intellectual disability for
decades — often since childhood — without any compensation or formal support
structure. When they learn that a waiver program can pay a family member for that care,
the most frequent reaction is disbelief followed by urgency.

These families aren’t new to caregiving. They’re experts. What they need is navigation
through a system that’s parallel to but separate from the one most home care content
describes. CareChoice helps bridge that gap.

Contact CareChoice → Philadelphia team

Written by Shamere Dunswell, Community Relations Manager | CareChoice Shamere
works directly with families across CareChoice’s service areas to connect them with
programs they may not know exist.

Related: Get Paid to Care for Family in PA → | OBRA Waiver in PA → | Attendant Care
Waiver in PA →