I can’t believe where time has gone, but in June of 2017, I will be graduating from high school and starting the next phase of my life. Over the next couple of months, I will be taking you along with me as I prepare to graduate from high school. My blogs will explain to you the different processes that I must complete and decisions that I must make before I graduate. These include guaranteeing that my current services continue, decisions about where I can live, and whether I will continue my education or if I’ll get a job.
Curiosities about waivers after high school? Don’t kill the cat, read this instead!
Today’s blog will be about the waiver application process. At the conclusion of reading my blog, you will have a better grasp of what a waiver is and how to apply for one and hopefully waivers will be less intimidating for you.
Q. What is a waiver?
A. A waiver is money that is allocated by the state government to assist individuals in paying for necessary services.
Q. Why do you need waivers?
A. The reason why you need a waiver is because medical assistance stops paying for some services after exiting from high school at 21. So, if your child receives speech therapy, occupational therapy, or physical therapy provided by school, these services will cease when they turn 21 and exit from high school. Services such as home health aides will stop upon the child’s 21st birthday. Note, this will occur even if the child had not graduated from high school.
Types of Waivers
There are different types of waivers that are available. They include Consolidated waivers, Autism waivers, Independence waivers, Person/Family Directed Support (PFDS) waivers, and OBRA waivers. Each waiver is curtailed to the different types of disabilities and the services they provide. For a complete list of waivers that are available and the services they provide, please refer to the following website.
The Consolidated waiver is designed to help individuals with an intellectual disability and provide services such as supported employment, nursing, and educational support. For a complete list of services, please visit the following website:
The Adult Autism Waiver (AAW) is tailored to the specific needs of adults age 21 or older with Autism Spectrum Disorder (ASD). Please refer to the link below for a complete list of services and additional information. http://dhs.pa.gov/learnaboutdhs/waiverinformation/adultautismwaiver/index.htm
The Independence waiver is for people with a severe physical disability. The Independence Waiver may be able to help you or your child live or remain in the community and remain as independent as possible. The independence waiver provides services such as financial management, home health, and nonmedical transportation. For a complete list of services, please visit the following link below.
The Person/Family Directed Support waiver (PFDS) is a waiver for individuals with intellectual disabilities. It helps them stay in their homes and communities and remain as independent as possible. The PFDS waiver is the most commonly applied for waiver in the intellectual disability community. Please note this waiver has an individual cap of $30,000 a year. Some of the services that this waiver can provide include respite care, behavioral supports, and transportation. For a complete list of the services that this waiver provides, please visit the following link.
The OBRA Waiver assists individuals with a developmental physical disability and provides services such as nonmedical transportation, home health care, and receiving medical equipment. For a complete list of services that this waiver provides, please visit the link below
How do I apply for a waiver?
The application process for a waiver is dependent on the waiver. Each waiver has its own set of requirements. You can contact The Arc Alliance to help guide you through this process. For my disability, the OBRA waiver is what I needed. The following information is the process that I am going through. Remember, your steps may be different.
The OBRA waiver requires a couple of assessments and a lot of paper work. You are instructed to start applying for the waiver the year that your child graduates.
The first step in the waiver application process is to ensure that your child has medical assistance. Without medical assistance, your child cannot receive a waiver. This can be completed by contacting the Pennsylvania Department of Public Welfare or by clicking on the following link:
Once you have medical assistance, the waiver application can commence. The process starts by calling a company called Maximus. Maximus will work with you to determine which waiver is appropriate and will guide you through the proper steps. Make sure you call them at least six months before your child turns 21 as this process is lengthy. Maximus will call you to coordinate the Level of Care Assessment, or LOCA for short, with The Department of Aging from your county of residence. Once The Level of Care Assessment is completed, the report may take up to two weeks to reach Maximus, depending on how fast your State Department gets it into their system. After the LOCA is completed Maximus will send you and your doctor a copy of the physician certification form. Your doctor must fill out this form completely and correctly.
After Maximus receives both the LOCA and the correctly completed physician’s referral, they will then send a representative from the independent enrollment broker (IEB) out to your house. This representative will conduct one final in-home assessment. Once this is completed, Maximus and you will determine which waiver is appropriate based upon your child’s disability. Once Maximus has determined the waiver you require, they will submit the information packet to the county assistance office for processing. The county assistance office has up to 30 days to make the financial approval. Once you receive the financial approval, you can get a supports coordinator. The supports coordinator will help you hire the companies with which you can get the services. Maximus requires you to choose three. The Support coordination agency will tell you which agencies have spots open.
For the intellectual disability community, there is sometimes a waiting list for waivers, which means you might not receive the waiver right away. Issues get what is called a PUNS. Your supports coordinator can help you receive this. There are three levels of PUNS. The three levels are planning, critical and emergency. For more information, please contact your supports coordinator or The Arc Alliance. While we are on the topic of waiting lists and supports coordination, you are able to change your supports coordinator for any reason. You are not locked in forever.
All of this information might be a little overwhelming, but I wanted to let you know that I am with you every step of the way. As Paul Ryan has said, “Every successful individual knows that his or her achievement depends on a community of persons working together”. Think of the blog as a community. Together, we will work to achieve your goals of giving your child a successful life after high school. Through my blogs, we will be able to bounce ideas off of one another and hopefully this transition process will be an easier process for everyone. Remember, if you have any questions regarding waivers, contacting DHS or The Arc Alliance is always a great resource. You can also contact me if you have questions or are stuck on how to apply for a physical disability waiver. Don’t be afraid to contact me by commenting on the blog or on the Facebook page.
Since we have been talking about waivers this whole time, you might be wondering where I am in the process. I am at the point where we are waiting on the final approval from the county assistance office. They have until December 20th to make a decision. If my request for OBRA waiver is denied, I will have to start the process all over again. So let’s keep our fingers crossed for an approval. That’s about all for now. Talk to you guys soon. Remember, it only takes one person to change the world. 🙂
Coming soon –
Wondering how to help your child succeed in competitive employment, read my next blog on how to apply for OVR. If you want answers NOW check out OVR’s website.