What is ODP?
The Office of Developmental Programs (ODP) within the Department of Human Services is responsible for the oversight of intellectual and developmental disability services in Pennsylvania. Local County MH/ID Programs verify program eligibility for services through ODP.
Program Eligibility
Must have a diagnosis of one of the following:
Intellectual disability with a full-scale IQ of 70 or below that occurred prior to the age of 22.
Autism diagnosis is based on diagnostic tools that occurred prior to the age of 22.
Developmental disability between age 0 through 8 with high probability of an intellectual disability or autism.
Medically complex condition between age 0 through 21 with a current medical evaluation from a licensed medical provider.
And also have:
Substantial adaptive skills deficit in 3 or more of these major life activities: self-care, understanding and use of receptive and expressive language, learning, mobility, self-direction, capacity for independent living.
Intermediate care facility (ICF) level of care.
Medicaid eligibility (required for most services).
What ODP Waivers do No One Left Behind Accept?
Person/Family Directed Support (PFDS) Waiver
Diagnosis of an intellectual disability, autism, or developmental disability.
No age limit (except for developmental disability, which has an age limit of 0-8).
Meet financial and financial eligibility.
Individual cost limit of $41,000 per person per fiscal year effective January 1, 2022. (Supports Coordination and Supports Broker are excluded from the cost limit.
Consolidated Waiver
Diagnosis of an intellectual disability, autism, or developmental disability.
No age limit (except for developmental disability, which has an age limit of 0-8).
Meet financial and financial eligibility.
No individual cost limit.
Community Living Waiver
Diagnosis of an intellectual disability, autism, or developmental disability.
No age limit (except for developmental disability, which has an age limit of 0-8).
Individual cost limit of $85,000 per person per fiscal year effective January 1, 2022. (Supports Coordination and Supports Broker are excluded from the cost limit.
How to Apply for ODP WAIVERS?
There are 5 steps to waiver funding:
Getting an ODP Supports coordinator.
To apply for services and support, you should register with your local County/Administrative Entity (AE). You can locate your County/AE Office by calling the ODP Customer Service Hotline at 1-888-565-9435 or by clicking on the Directory of Administrative Entities.
Before contacting the MH/DS Program office, ensure you have completed the required documentation, including a Full-Scale IQ Test signed by a Licensed Psychologist and an Adaptive Behavior Scale. If you are of school age, an IEP will be required during the intake process.
When you make contact with the County/AE Office, a representative will set up an intake appointment. At this appointment, you’ll need to provide various documents, including, if available, your:
State-issued identification.
Social Security Card
Birth Certificate
Proof of Address
MA Card (also known as Medicaid, Access Card, Medical Assistance)
other insurance cards
Any assessments or psychological evaluations.
Legal guardian or custodial papers.
The County/AE representative will ask you to sign a Release of Information form, which allows them to obtain your medical records and other supporting documents. The County/AE programs can assist you in completing any needed assessments and psychological evaluations. School records may also be used. Once all the required documentation is received, the County/AE will determine your eligibility for services and must provide written notice of this within 14 days. If you do not receive notification, you should call your County/AE.
Once you have submitted all required documentation to the intake worker, they will review it and determine your eligibility for intake, which can take between two to three hours. If found eligible, the intake assessment will be completed, and you will then be given a listing of all support coordination organizations (SCOs) available. Keep in mind that participants and families have the freedom of choice to choose the SCO they would like to work with. Once you have selected the SCO, you will be assigned an ODP Supports Coordinator to help determine what services are needed and what resources are available.
Individual Support Plan Meeting & PUNS List
Once you have been assigned an ODP Supports Coordination (SC) through your SCO, the SC will schedule and complete an initial Individual Support Plan (ISP) meeting. This meeting will be used to create the ISP specific to the goals and needs of the Participant and Family.
After the initial ISP meeting, the SC/SCO will place the participant on PUNS.
The PUNS is similar to a waitlist, but it is based on need.
It is important to get on PUNS prior to turning 21 to lessen the time period the individual may go without services.
Complete the Service Preference Form
The participant/family along with their SC will complete a Service Preference Form, also known as a DP458. This document is a 2-page form that will give you the choice of services either through the Home and Community Based Waiver or services in a State facility such as a Residential Campus.
The SC will then complete a letter of need going over what the participant will need from the waiver. This may not necessarily be what the participants want, but what they truly need. For example, a day program or transportation.
When choosing individuals to give waiver slots to, they are not just looking at the needs of the individual but also the needs of the family. For instance, if the individual does not get the waiver to cover his day program and transportation, what will happen?
Waiting for a Waiver Slot
Each County meets to discuss the current PUNS list to select individuals based on the need to fill any waiver openings they may have.
Waiver slots become available if an individual on the waiver passes away,
moves out of state (if moving within the state of PA waiver services will not be lost) or choose to no longer receive waiver services.
The state can also provide counties with additional waiver slots based on waiver initiative as well as the ability to provide unanticipated emergency slots if needed.
Congratulations! A Waiver Slot is available for you.
Once a waiver slot is available for you, you will receive a letter that says funds are available for you from ODP.
Once receiving notification, you will have 45 calendar days to submit all needed paperwork, pick a Provider Agency like No One Left Behind for your support services, have your support coordinator put services into your plan, and have all paperwork approved by the county. Your assigned ODP support coordinator will assist you with this process.
What should I do if I am told I am not eligible for any services?
If you've been found ineligible for an Office of Developmental Programs (ODP) waiver in Pennsylvania and wish to appeal the decision, here's what you can do:
Contact Your Supports Coordinator: Your supports coordinator can provide you with the necessary forms and guide you through the appeal process.
Understand Your Rights: It is your right to use fair hearing and due process available through the Department of Human Services Hearings and Appeals.
Submit an Appeal: You can submit an appeal as per ODP Bulletin #00-08-05. The appeal should be filed within the specific time frame mentioned in the eligibility determination letter you received.
Prepare for the Hearing: Collect all relevant documents and evidence that support your case for eligibility. This may include medical, psychological, and school records.
Attend the Hearing: During the hearing, you will have the opportunity to present your case to an administrative law judge.
Remember, the process can vary depending on individual circumstances, so it's important to follow the guidance provided by your supports coordinator and any instructions outlined in your eligibility determination letter. If you need further assistance, you can contact the Intellectual Disabilities Services Customer Service Line at 1-888-565-9435.
*Note: For further information on appeals and what your rights are in the waiver programs, you can review Chapter 8 (Understanding Your Rights) within the Gold Book publication located under the Resources tab.
What do I do if I need more hours of services than the service definition allows?
If more hours for services are needed than what the service definition offers for a particular service, (Like In-Home and Community Supports) a request can be made to the SC to complete the variance form (DP1086). The need for this variance (difference) must be discussed with the SC, and the ISP must reflect the need for the change. The SC will submit the request to the authorizing County/AE for review of assessed need. If approved, the request for Variance will be sent by the County/AE to the appropriate ODP Regional Office for a decision.
What services does No One Left Behind Offer?
No One Left Behind offers the following services: In-Home and Community Supports (IHCS), In & Out of Home Respite, Companion Services, Homemaker/Chore Services, Community Participation Support (CPS), both Behavioral Support Services and Supported Employment COMING SOON!
Can services be provided when traveling or on vacation?
Yes, the following services can be provided while traveling and on vacation:
In-Home and Community Support
Residential Habilitation (licensed and unlicensed)
Life Sharing (licensed and unlicensed)
Supported Living
Shift Nursing
Supports Coordination
Specialized Supplies
Supports Broker
Behavioral Support
Companion
Respite
*Note- These services may be provided anywhere during temporary travel. The only exception is Respite Camp which can only be provided in Pennsylvania, Washington DC, Virginia, or a state contiguous to Pennsylvania.
For more information, please review the Resource tab where you could find No One Left Behind brochure, and the Gold Book publication which is filled with a wealth of information that can answer most of your questions.
Frequently asked questions
