Paid Caregiving for Adults with Intellectual Disabilities in PA: What Families Should Know

If your family has been providing care for an adult relative with an intellectual disability —helping them with daily routines, managing their medication, supporting their participation in community life — Pennsylvania’s ODP waiver system may offer compensation for that care. The programs exist. What’s often missing is the awareness that they apply to your family.

Which ODP Programs Pay Family Caregivers

Three ODP waivers support paid family caregiving in different ways.

Person/Family Directed Support (P/FDS) Waiver: This is the most explicitly family-directed option. Under P/FDS, the individual receives a budget allocation and the family directs how it’s spent — including hiring a family member as a paid caregiver for approved services. The family manages the budget with support from a fiscal management service that handles payroll and compliance.

Consolidated Waiver: The most comprehensive ODP waiver. Family members can serve as paid providers for certain services within the Consolidated Waiver’s extensive service package. The service plan developed with the supports coordinator determines which services are eligible for family provision.

Community Living Waiver: Similar to Consolidated but with lower funding caps. Family-directed care options exist within the Community Living service structure.

The Adult Autism Waiver also supports family-directed services for adults with ASD specifically.

How Paid Family Caregiving Works in ODP

The ODP paid family caregiver model shares the core principle of CHC’s Participant-Directed Services: the individual (or their family representative) chooses who provides the care, and that person is compensated through a payroll structure that handles taxes, withholdings, and compliance.

The mechanics differ slightly from CHC’s Agency with Choice model. In ODP, the fiscal management is handled through ODP-specific financial management services, and the supports coordinator (rather than an MCO service coordinator) manages the care plan.

In our experience, the families who navigate ODP paid caregiving most successfully are the ones who maintain a strong relationship with their supports coordinator and stay organized with the budget management component of P/FDS. The supports coordinator is your advocate within the system — a good one makes the difference between a smooth experience and a frustrating one.

The Waitlist Reality

Consolidated and Community Living Waivers often have multi-year waitlists. P/FDS waitlists are typically shorter but not instantaneous. The Adult Autism Waiver has its own waitlist.
While waiting, individuals may access base-funded services— a more limited set of ODP supports available without a waiver slot. Base-funded services won’t provide the full waiver package, but they can include some caregiver support and community services.

Our consistent recommendation: apply for the waiver now, even if the need feels manageable today. Intellectual disabilities don’t resolve, and the caregiving demands typically increase as the individual ages and as family caregivers age alongside them. Getting on the waitlist today positions your family for services when you need them most.

CareChoice Helps Navigate Both Systems

Many families we serve have loved ones who interact with both the CHC and ODP systems — an aging parent receiving CHC home care AND an adult child with IDD receiving ODP services, all within the same household. CareChoice understands how both systems work and can help families coordinate across them.

Contact CareChoice →Pennsylvania team

Written by Gary Murray, Chief Marketing Officer | CareChoice