Pennsylvania Parents and Caregivers Resource Network

 
The Waiver Wizard 
Frequently asked questions about the Person/Family Directed Support Waiver (P/FDS) for Community Supports

Why should I be waiverized?  The day is fast approaching when Pennsylvania will support most, if not all, services through the “waiver.” This will include the day services your family member currently receives. If you sign up now, you will be (1) helping to bring federal dollars into your county that can be used to assist other families in need; (2) you may get a little bit of additional service, and; (3) you will get more case management. Case Management can advocate for more services for your family member if your needs should change and, since your family member will already be enrolled in the waiver, it will be easier for those needs to be met.

What are the current Waivers used by Mental Retardation Services and how are they the same/different? There are two waivers currently in use by Mental Retardation Services. The Consolidated Waiver (2176) is used for residential, family living, and some in-home supports for those requiring high levels of support and monitoring. The Person/Family Directed Support Waiver provides in home supports for those needing lesser amounts of services and monitoring (up to a $20,000 cap). Both waivers have the same financial eligibility requirements. They require that the person have mental retardation, that the person qualify for an ICF/MR level of care and that the person can be served in a cost effective manner. A person can only be in one Waiver at a time be it the Consolidated Waiver, P/FDS waiver, PCA or any other federal waiver.

How do I know which waiver is better for me/my family member? Your case Manager is the first person to talk with regarding a choice of Waivers. You must also educate yourself, attend training sessions, and be aware of the availability of funds for the Waivers. Your family’s priority for Waiver services is based on the information gathered on the Prioritization of Urgency of Need for Services (PUNS) form.

What is the role of case management in the Waiver? The Waiver case Manager completes eligibility forms, calls the team together and produces person-centered plan. He or she monitors supports and services and has an ongoing relationship with the person and his/her family. The case Manager functions as an advocate for the consumer and arranges for the services to be provided.

Under What circumstances would I be rejected for the Waiver? What are my rights? All persons registered in the Mental Retardation system have a right to apply for the Waiver. If they are rejected, they must be informed in writing and have a right to a Fair Hearing. People will be rejected for the following reasons; (1) the person does not have mental retardation; (2) the person does not meet the level of care requirements for ICF/MR; (3) the person does not meet the financial criteria (for example, has too much money in the bank); (4) the person can not be served in a cost effective manner; (5) the person does not express a preference for the Waiver. If the funds are not available for the Waiver, or they are not a high priority, they will not be rejected, but will have to wait for services. Can I still get FDFSS if I receive P/FDS Waiver Services? Please check with your local county regarding this decision.

Is there a cap on the number of people served by the waiver? Yes. The state imposes a statewide and countywide cap for numbers of people to be served. Therefore, there may be a waiting period before services can be provided.

What happens if my day program costs exceed the cap? Each plan will be reviewed on an individual basis. There are a few options in this case: (1) negotiating with the provider; (2) finding a new provider; (3) paying for some services outside the Waiver; (4) or changing into another Waiver if funds are available.

Do respite (family aide, habilitation) providers need training? Yes. These providers all must have person-specific training. This training is done on an individual basis, and the provider is certified.


This article was prepared by Elayne Blender, Elaine Thilo and Fran Rementer for the Philadelphia Family Forum – Permission to reprint 11/18/2000


717-561-0098 PPCRN 1-888-5-PARENT



Return to the PPCRN Home Page