Disability services in Pennsylvania are delivered through a mix of Medicaid waivers, a state-funded attendant care program, vocational rehabilitation, federal cash benefits, a tax-advantaged savings account, early intervention for young children, community mental health care, housing assistance, and civil rights enforcement. Each program has its own eligibility test and its own front door, so the first task is matching your situation to the right office rather than trying to apply everywhere at once.
The Department of Human Services administers most of it. Within DHS, the Office of Developmental Programs handles intellectual disability and autism services, and the Office of Long-Term Living oversees supports for older adults and people with physical disabilities. The Department of Labor and Industry runs the Office of Vocational Rehabilitation. The Treasury Department runs PA ABLE. The Pennsylvania Human Relations Commission enforces disability discrimination law. County Mental Health/Intellectual Disabilities offices are the local entry point for a large share of these services.
Where to Start Depending on What You Need
The right phone call depends on the person and the need.
- For intellectual disability or autism waiver services, contact your county Administrative Entity (the local MH/ID office).
- For adults with autism seeking the Adult Autism Waiver, call the Bureau of Autism Services at 866-539-7689.
- For physical disability services, the OBRA Waiver, Community HealthChoices, or Act 150, call the Pennsylvania Independent Enrollment Broker at 1-877-550-4227.
- For a child from birth to age five with a possible developmental delay, call Pennsylvania Statewide CONNECT at 1-800-692-7288.
- For employment services, apply to the Office of Vocational Rehabilitation through PA CareerLink or one of 21 district offices.
- For Social Security disability benefits, apply through the Social Security Administration at ssa.gov or 1-800-772-1213.
- For legal help with discrimination, access problems, or facility concerns, call Disability Rights Pennsylvania at 1-800-692-7443.
Medicaid Home and Community-Based Waivers
Pennsylvania runs 12 Home and Community-Based Services waivers. These use federal and state Medicaid dollars to pay for support in your home or community rather than in an institution. Most require both a clinical eligibility finding (that you would otherwise need the level of care provided in an Intermediate Care Facility or nursing facility) and Medicaid financial eligibility.
Across most waivers, the income limit is 300% of the Supplemental Security Income standard. The countable resource limit is $8,000, excluding a primary home, one vehicle, and prepaid funeral expenses.
Waivers for Intellectual Disability and Autism
Three waivers run through the Office of Developmental Programs. All three require a diagnosis of intellectual disability or autism with onset before age 22, substantial limitations in at least three major life activities, ICF level of care, and Pennsylvania Medical Assistance eligibility.
- The Consolidated Waiver is the most comprehensive, with no annual spending cap, and is the only one of the three that covers residential habilitation. Its most recent amendment took effect January 1, 2026.
- The Community Living Waiver covers a broad range of community supports with an annual individual cost limit of $97,000.
- The Person/Family Directed Support Waiver is built for individuals and families who want more control over their services, with an annual cost limit of $47,000.
Adult Autism Waiver
For adults 21 and older with an autism spectrum disorder diagnosis who require an ICF level of care. Applications go through the Bureau of Autism Services.
OBRA Waiver
For adults ages 18 to 59 with severe developmental physical disabilities that manifested before age 22, who do not have a primary diagnosis of intellectual disability or major mental illness. Services include personal assistance, structured day habilitation, therapies, employment supports, home adaptations, and residential habilitation. The OBRA Waiver has no waiting list, which makes it one of the more accessible entry points into the system.
Community HealthChoices
Pennsylvania’s mandatory managed care program for adults 21 and older with physical disabilities who meet nursing facility clinical eligibility. As of mid-2024, more than 383,000 people were enrolled in CHC overall, with about 34% receiving home and community-based services. The program runs through managed care organizations across five geographic zones.
Infants, Toddlers, and Families Waiver
For children from birth to age three who need early intervention services and meet ICF level-of-care criteria. It provides home and community-based supports beyond what the general Early Intervention program covers.
LIFE Program
An alternative for adults 55 and older who meet nursing facility level of care and can live safely in the community.
The PUNS Waiting List for ID and Autism Waivers
If you apply for a Consolidated, Community Living, or Person/Family Directed Support Waiver, your supports coordinator will enter you into PUNS — the Prioritization of Urgency of Need for Services assessment. PUNS places each person in one of three categories:
- Emergency: needs services within six months.
- Critical: six months to two years.
- Planning: two to five years.
As of February 2026, the statewide adult PUNS list stood at 7,230 people: 3,044 emergency, 978 critical, and 3,208 planning. An earlier 2024 advocacy presentation cited over 13,000 people, which may reflect a different time period or population count. Since February 2024, the adult emergency list has been cut by 31%, and Forest, Lawrence, and Warren Counties have eliminated their emergency lists entirely, enrolling 134 individuals in waiver services. More than 42,000 Pennsylvanians now receive home or community-based services through the Office of Developmental Programs, which the Shapiro Administration describes as the highest number on record. The proposed 2026-27 budget includes $30 million in state funding and $36.2 million in federal funding to enroll up to 1,625 additional individuals.
Because the Consolidated, Community Living, and Person/Family Directed Support Waivers all run through PUNS, enrollment is not first-come-first-served. People in the emergency category move first.
Act 150: When You’re Over the Medicaid Income Limit
Not everyone who needs in-home care qualifies for Medicaid. Act 150, the Attendant Care Services Act, provides state-funded personal assistance to Pennsylvanians ages 18 to 59 with physical disabilities who are clinically eligible for nursing facility care but earn too much for the Community HealthChoices Medicaid waiver.
Act 150 covers personal assistance services, personal emergency response systems, and service coordination. You must be able to direct your own care, including hiring and supervising attendant care workers and managing your own financial and legal affairs. A sliding-scale co-payment may apply based on income. The application process starts with a CHC waiver application through the Independent Enrollment Broker; if you are found financially ineligible for Medicaid, you are referred to Act 150.
Working With a Disability
Office of Vocational Rehabilitation
OVR, housed within the Department of Labor and Industry, provides diagnostic evaluations, vocational assessments, career counseling, job training (academic, vocational-technical, and on-the-job), job placement, assistive technology, and medical restoration services such as physical therapy and wheelchairs. Services are built around an Individualized Plan for Employment developed with a counselor.
Social Security disability beneficiaries are exempt from the OVR financial needs test. High school students with disabilities are encouraged to connect with OVR through transition services, ideally two years before graduation. OVR must reach out to applicants within 10 days of receiving a referral. Applications can be submitted online through PA CareerLink or at one of 21 district offices. The Commonwealth Technical Institute at the Hiram G. Andrews Center in Johnstown offers barrier-free education and job-readiness training. OVR also participates in the federal Ticket to Work program, which lets Social Security beneficiaries pursue employment while keeping Medicare or Medicaid coverage.
Medical Assistance for Workers With Disabilities
MAWD lets people with disabilities work and keep Medicaid under more generous income and resource limits than standard Medicaid. Countable income must be below 250% of the federal poverty guidelines, and countable resources below $10,000. Participants pay a monthly premium of roughly 5% of income.
Act 69 of 2021 created the Workers with Job Success expansion. Individuals who have been on MAWD for at least 12 consecutive months can continue coverage even if their income rises above the standard MAWD threshold, up to 600% of the federal poverty guidelines. MAWD can also serve as a pathway into waiver services for people who meet clinical criteria but would otherwise fail the financial test.
Employment Services Inside Waivers
Several Medicaid waivers include career assessment, job coaching, employment skills development, and supported employment. ODP has pushed providers toward competitive, integrated employment rather than sheltered workshops. ODP data shows that over two-thirds of adults with autism in Pennsylvania are unemployed, and those who do work are primarily in part-time positions.
Federal Cash Benefits: SSDI and SSI
Many Pennsylvanians with disabilities rely on Social Security Disability Insurance or Supplemental Security Income. SSDI is for people who have worked and paid Social Security taxes but can no longer perform substantial gainful activity because of a medical condition expected to last at least 12 months or result in death. SSI is a need-based program for elderly, blind, or disabled individuals with limited income and resources, regardless of work history.
Apply through the Social Security Administration online at ssa.gov, by phone at 1-800-772-1213, or in person at a local office. SSA recommends using its Adult Disability Checklist to gather medical records, work history, and identification before applying. The medical eligibility decision in Pennsylvania is made by the Bureau of Disability Determination Services within the Department of Labor and Industry. If a claim is denied, you have 60 days to appeal. SSDI has a five-month waiting period before payments begin; SSI payments can start the first full month after the filing date.
PA ABLE Savings Accounts
PA ABLE, run by the Pennsylvania Treasury, lets people with qualifying disabilities save money in a tax-advantaged account without losing eligibility for means-tested benefits like SSI and Medicaid. As of January 2026, eligibility expanded to include individuals whose disability began before age 46, up from the previous threshold. Participants can contribute up to $20,000 per year, with an additional ABLE to Work provision allowing higher contributions for those who are employed. Fees were reduced in September 2025, and starting July 2026, accounts transition to a new online platform managed by Vestwell.
Early Intervention for Children Under Five
Pennsylvania’s Early Intervention program serves children from birth to age five who have developmental delays or disabilities, at no cost to families. It operates under the federal Individuals with Disabilities Education Act (Part C for infants and toddlers, Part B Section 619 for preschool children) and state Act 212 of 1990. Services are delivered in familiar settings: the child’s home, child care centers, Head Start, or early childhood classrooms.
Call Pennsylvania Statewide CONNECT at 1-800-692-7288 or submit an online referral. A referral leads to a developmental screening and, if warranted, a full evaluation. For children with more intensive needs, the Infants, Toddlers, and Families Medicaid waiver adds home and community-based supports on top of the standard program.
Mental Health Services
Community mental health services are overseen by the Office of Mental Health and Substance Abuse Services within DHS. Most care is delivered through Behavioral HealthChoices, a managed care program in which each county contracts with a managed care organization to provide mental health and substance use treatment. A fee-for-service pathway is available through county Medicaid providers for people not enrolled in managed care.
Specialized programs include Assertive Community Treatment teams, First Episode Psychosis programs, peer support services, consumer-run drop-in centers and clubhouses, and the Projects for Assistance in Transition from Homelessness grant program for individuals with serious mental illness who are homeless or at risk. The state maintains active Olmstead Plans governing service delivery in the most integrated community settings possible. Crisis services are available around the clock through the 988 Suicide and Crisis Lifeline.
Housing Supports
The Pennsylvania Housing Finance Agency operates PA Housing Search, a tool for locating accessible rental housing statewide. PHFA also administers the Section 811 Project Rental Assistance program, which provides permanent supportive rental assistance to extremely low-income individuals with disabilities ages 18 to 61 who are institutionalized, at risk of institutionalization, or living in congregate settings and want to move into the community. Units are integrated into existing affordable housing developments, with no more than 25% of units at any property set aside for supportive housing.
The Self-Determination Housing Partnership, an Inglis program, manages the statewide Section 811 waitlist and provides training on tenants’ rights, eviction prevention, home modifications, and income-based housing. Housing Choice Vouchers remain a major federal resource and are administered locally by public housing authorities through HUD. DHS maintains a five-year housing strategy covering 2024 through 2029.
Disability Rights and Legal Protections
The Pennsylvania Human Relations Act is the state’s main anti-discrimination statute. It prohibits discrimination based on handicap or disability in employment (for employers with four or more employees), housing, and public accommodations. Employers cannot ask about the existence or severity of a disability before making a job offer, and landlords must allow reasonable modifications and accommodations. The Pennsylvania Human Relations Commission investigates complaints, with a 180-day filing deadline.
Disability Rights Pennsylvania is the state’s federally designated Protection and Advocacy organization. It operates under seven federal mandates covering developmental disabilities, mental illness, assistive technology, Social Security beneficiaries, traumatic brain injury, voting accessibility, and the general disability population. DRP provides free legal advocacy, investigates facilities, pursues systemic litigation, and takes more than 6,800 intake calls per year through 1-800-692-7443, with offices in Harrisburg, Philadelphia, and Pittsburgh.