ODP Waivers in Pennsylvania: Home Care for Adults with Intellectual Disabilities and Autism

If your loved one is an adult with an intellectual disability or autism, Pennsylvania has a set of Medicaid waiver programs specifically designed for them — separate from the Community HealthChoices system that serves most other home care populations. These programs are administered by the Office of Developmental Programs (ODP), a division of the Department of Human Services, and they fund a range of home and community-based services including the option for family members to serve as paid caregivers.

Most families we work with at CareChoice come to us knowing about CHC but not about ODP. If your family member has an intellectual disability or autism diagnosis, the ODP system is likely the right pathway — and it works differently from CHC in important ways.

The Four ODP Waivers

Consolidated Waiver

The Consolidated Waiver is ODP’s most comprehensive program. It provides the broadest range of services and the highest funding levels, designed for individuals with the most intensive support needs. Services include residential habilitation (in-home support for daily living skills),day habilitation and community participation, behavioral support, nursing services, respite care, assistive technology, home modifications, employment support, and personal care.

The Consolidated Waiver has historically had a significant waitlist— the Emergency and Planning Waiting Lists can stretch for years. In our experience, families should apply as early as possible to establish their loved one’s position, even if the immediate need isn’t urgent.

Community Living Waiver

The Community Living Waiver serves individuals who need support to live in the community but whose needs are less intensive than those served by the Consolidated Waiver. The service package is similar but with lower annual funding caps. Services include residential habilitation, community participation, behavioral support, respite, nursing, and personal care.

The Community Living Waiver also has a waitlist, though it’s typically shorter than the Consolidated Waiver’s. It’s the right fit for individuals who need meaningful daily support but don’t require the level of intensive services the Consolidated Waiver provides.

Person/Family Directed Support (P/FDS) Waiver

The P/FDS Waiver is built around the principle of self-direction — the individual and their family control how the waiver budget is spent. Rather than receiving a fixed menu of services, the participant receives a budget allocation and directs how those dollars are used across approved service categories.

This is the ODP waiver that most closely resembles the Participant-Directed Services model in CHC. Families choose their own providers, set schedules, and manage the care relationship. A family member can serve as a paid provider under P/FDS, making it a natural fit for families where a relative already provides daily support.

In our experience, P/FDS works best for families who are organized, engaged, and want maximum control over the care arrangement. The budget management component requires attention — the family tracks spending against the authorized amount — but the flexibility it provides is unmatched among ODP waivers.

Adult Autism Waiver

The Adult Autism Waiver is the newest ODP waiver, serving adults age 21 and older with an autism spectrum disorder diagnosis. It was created to address the significant gap in services that many individuals with autism face after aging out of the children’s system at 21.

Services include community integration, behavioral support, day habilitation, respite, supported employment, assistive technology, and family-directed support. The Adult Autism Waiver specifically recognizes that many adults with autism are capable of significant independence with the right support structure — and that family members are often the most effective providers of that support.
The Adult Autism Waiver has its own waitlist, and eligibility is specific to adults with an ASD diagnosis.

How ODP Differs from CHC

Families familiar with Community HealthChoices often assume ODP works the same way. Itdoesn’t, and the differences are important.

Different administrative structure.  CHC runs through MCOs (AmeriHealth Caritas, KeystoneFirst, PA Health & Wellness). ODP runs through
Supports Coordination Organizations (SCOs)—agencies that assign supports coordinators to manage individual service plans. There are noMCOs in the ODP system.

Different assessment process.  CHC uses a nursing-facility level of care assessment. ODP uses the Prioritization of Urgency of Need for Services (PUNS) assessment, which evaluates the individual’s current living situation, the urgency of their service needs, and the supports currently available.

Different waitlists.  CHC generally doesn’t have waitlists. ODP waivers — particularlyConsolidated — can have multi-year waitlists. Planning horizons in ODP are measured in years,not weeks.

Different service types.  ODP services are tailored to intellectual disability and autism —habilitation, behavioral support, employment services, community participation. CHC servicesfocus on personal care and homemaker support for aging and physical disability populations.

The Supports Coordinator: Your Family’s Navigator

Every individual in the ODP system is assigned a supports coordinator through a Supports Coordination Organization. The supports coordinator is the equivalent of CHC’s service coordinator — they manage the service plan, coordinate assessments, connect families with providers, and help navigate the waiver enrollment and waitlist process.

In our experience, the quality of the supports coordinator relationship matters enormously inODP. A good supports coordinator proactively identifies services your loved one is entitled to,helps manage the waitlist process, and connects your family with resources between waiverenrollment and service delivery. If your current supports coordinator isn’t responsive, you havethe right to request a change.

Getting Started with ODP

Step 1:  Contact your county’s ODP program office or the statewide ODP information line at 1-888-565-9435.
Step 2:  Register with ODP and get connected to a Supports Coordination Organization.
Step 3:  Complete the PUNS assessment with your supports coordinator.
Step 4:  Apply for the appropriate waiver(s). Your supports coordinator will help determine whichwaiver fits your loved one’s needs.
Step 5:  If a waitlist exists, your supports coordinator helps manage interim services (base-fundedsupports) while you wait.

CareChoice helps Pennsylvania families navigate both the CHC and ODP systems. If your family member has an intellectual disability or autism and you’re not sure which pathway applies, we can help sort it out.

Contact CareChoice →Pennsylvania team

Written by Sophia Aloia, Content & SEO Manager | CareChoice