Comparing Waivers | Lehigh Valley Autism

What is the Community (Adult Autism) Waiver vs. Other Waivers in PA?

Adult Autism Waiver (AAW) (Eligibility/Services)
- For adults 21+ with ASD, Medicaid-eligible, needing intermediate care facility (ICF) level of care
- Current cap on spending per participant is $10,000.
- Focused on community living: employment, in‐home supports, behavioral services, respite, etc. (for more info)
- No IQ requirement; eligibility determined by functional needs
Community Living Waiver (CLW) (Eligibility/Services)
- Covers all ages with intellectual/developmental disability or autism
- Broad services: employment, therapies, home adaptations, vehicle mods.
- Annual spending cap: approx. $97K/year, excluding supports coordination
Person/Family‑Directed Support Waiver (PFDS) (Eligibility/Services) Administed by the Office of Developmental Programs (ODP)
- Similar population/eligibility as CLW, but with $47K/year cap, extendable by $15K for employment-related services
- Children under 18 who have extensive needs because of their disability
- Autism, developmental disabilities, and complex medical needs
- The parents’ assets or income are not considered/supplemental to parents work plan.
Consolidated Waiver
- For severe intellectual/developmental needs including autism.
- No spending cap—most flexible and comprehensive Disability Rights Pennsylvania.

Click here to see the whole list and the restrictions of each waiver.

What is "Agency of Choice"?

Agency of Choice is a self-directed care model that allows the person receiving care (or their representative) to select a caregiving agency to handle employment responsibilities for the caregivers they choose. It offers a middle ground between traditional agency care and full consumer-direction.

Which waivers can use Agency of Choice?

The Consolidated Waiver and Community Living Waiver allow for agency of choice or participant direction, meaning individuals can choose their service providers, including family members, or have more control over their care.

What Caregivers Need to Know

1. Who is the Employer?

The agency is technically the legal employer of record.
However, the individual receiving services (or their representative) often recruits, selects, schedules, and trains the caregiver.
The caregiver works under the direction of the client, not just the agency.

2. Hiring & Relationship with the Client

Caregivers are often personally known to the client (family or friends).
The client has a say in hiring, firing, and training.
This allows for more personalized care and stronger caregiver-client relationships.

3. Pay and Benefits

The agency handles payroll, taxes, and often benefits.
Pay rates may be set by Medicaid or state programs, but vary depending on the agency and location.
Some agencies offer health insurance, workers’ comp, or training.

4. Training and Support

While caregivers may receive basic training through the agency, the client often customizes training to meet their needs.
Agencies may also offer support, supervision, or backup staffing when needed.

5. Documentation & Compliance

Caregivers must follow the agency’s policies on timesheets, reporting, background checks, and HIPAA compliance.
Some states require electronic visit verification (EVV).

6. Job Stability and Scheduling

Shifts are often flexible, negotiated between caregiver and client.
Because the relationship is close, job satisfaction can be high, but if the client leaves the program or passes away, the caregiver may lose employment.