Understanding the Services of Allegheny County, PA Department of Human Services
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Understanding the Services of Allegheny County, PA Department of Human Services

March 28, 2023

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Good morning, everyone and thank you for joining us. My name is Patty Yerina and I'm the assistant director of Education and Outreach for Achieva Family Trust, and I'm really excited for this morning's presentation. We have three representatives from the Allegheny County Department of Human Services, Office of Developmental Supports here this morning to talk about the different services provided by the County.


So just a couple of housekeeping items before we get started. If you have any questions, please put them in the Q&A box. We will be monitoring that and the presenters will take questions at the end of each of their presentations. We should have plenty of time after each one to get to your questions. If not, we'll try and get to them at the end.


This webinar will be recorded and put on our website. Probably by the end of the week it should be on the website. And I will be sending out the PowerPoints today or tomorrow. So again, I'm going to go ahead now and introduce our first presenter from Allegheny County Mary Evrard and let's go ahead and get started. Thank you.


So today, we are going to talk about Allegheny County Department of Human Services and the Office of Developmental Supports. We each are going to introduce ourselves, let you know what we're going to cover. We have our own slides that we're going to review. As Patty told you, the slides will be made available to you. And we really are interested in your questions and feedback. So have built in time to listen and to try to get to all of your questions.


For my time with you, we're going to talk about who is the Department of Human Services at Allegheny County, what our office does and who we are. We're going to talk about some community resources. We're going to touch on charting the life course and review the system process and language. How you access Office of Developmental Supports and then what happens next.


There are going to be lots of links on the slides. There are QR codes. If you've not used QR codes before, you just open the camera on your smartphone, hold it up to the QR code. And on the top of your phone then will open up the site that you're trying to reach. If you have any trouble with the QR codes, again, there are also links and you can just reach out to us.


I guess I should have started with I am Mary Evrard. We also have Mary Peterson and Anne-Marie with us so though each introduce themselves and let you know what they're going to cover during their time with you. Mary, do you want to introduce yourself?


Yeah. Hi, everybody. My name is Mary Peterson. I am the resource and eligibility supervisor here at the Office of Developmental Supports. And what I am going to be discussing with you all today is how you register with the Office of Developmental Supports for supports coordination services, the eligibility requirements that we require for registration into our system.


The follow up intake process that follows the registration, application, and eligibility determination. I will also be discussing supports coordination services and what that entails, how they can help you within the system. And also the individual support plan that is completed for each individual registered with support coordination annually. And we'll go into some details about that. So I'm looking forward to talking with you all about all these topics this morning. And welcome.


I am Anne-Marie Quealy with Allegheny County. I am going to first be talking about our waivers and our e-PUNS process and waiver application. And I know a lot of what I say is going to be very confusing for parents, and individuals, and sometimes SCs. So if there's any questions, I don't expect everybody to remember everything that I say. So as Patty had said, the PowerPoint will go out. And after I go over all the interesting things about the waivers, then I want to talk a little bit about ARPA funding for individuals that have supports coordination services only. So that would be me.


OK. So we're going to-- I'm already behind on my papers. These are the offices within the Allegheny County Department of Human Services. As you can see, it includes the Office of Behavioral Health which under there is the Child and Adult mental health, substance use and justice related services.


Also within the Office of Behavioral Health are education specialists. Those education specialists are available to anybody in Allegheny County whose students have IEP plans, 504 Plans, or there are questions about their education services. And those are free services. And even though it is under the Office of Behavioral Health, your student does not have to have a mental health diagnosis.


Also, there's the Area Agency On Aging. Under the Area Agency On Aging, of course, is services for Allegheny County residents that are 60 and over. But there are also under the AAA caregiver support programs. And those caregiver support programs, the caregiver care receiver does not necessarily have to be a senior of 60 years old or older.


Some of the resources that you'll find on the website are Project Prom which is happening now. And that provides free prom attire for students. It includes the music festival fund which provides for some funding for things like computers, and passes for the zoo, or dance lessons, any number of things. So that's some reasons why you should be familiar with your department of Human Services to be connected to any of those things.


I apologize. My slides went. To be included in any of those things, to learn about any of the program offices. Or if you have a basic need, if you have a question, you don't have to know what office that falls under. You can contact the Allegheny link and they can help you connect with the right resources and people at the Department of Human Services.


The link also can help with housing concerns and any number of home visitation programs that help parents just in general with some peer support. And also the community centers that are in your neighborhoods. So the link can connect you to all of those things.


So the PA department of Human Services not to be confused with the Allegheny County Department of Human Services. Is the state office that oversees the services and supports that Office of Developmental Supports, and will now say ODS, provides.


So each County has an administrative entity that oversees the services from the Office of Developmental Supports for people in PA with disabilities. And the administrative entity, of course, in Allegheny is our office, Department of Human Services, Office of Developmental Supports.


So as you can see, we love our acronyms. And most often, our acronyms are very close to another. And there's a big difference between PA DHS and Allegheny County DHS. And of, course ODP and ODS. This document on our web page will not only give you information about the differences in those offices, but also give you links if you want to learn about how to receive regular communications.


Both the State Office of Developmental Programs and our office has email distribution lists that you can receive, again, regular communications about changes in the system and about general community resources.


So our office has many charges from office of Developmental Programs. But one of the main ones is to register eligible Allegheny County residents for supports coordination. So those residents include people with intellectual disability, autism, developmental disability prior to age 9, and medically complex condition prior to age 12.


When that target population has changed recently, so we're really interested in making sure stakeholders know about our target populations and what all of the eligibility requirements are. And Mary Peterson is going to talk to you about those during her time.


So if you don't remember who we are, if everything is a blur that we say from this point forward, if you have this slide and a couple of other ones like the link slide that we're going to share with you, if you just have those available to you, you'll be able to reach us, reach all of this information, and follow up on any questions that you have. So again, this will be included in the slides that you'll be sent and this is a really important one.


So during our time together, we're going to talk about all of these things in detail but wanted to just share some of the language and the general overview of the process towards supports and services. So there is a document on our web page that is called Why Connect with the Allegheny County DHS and ODS, and get to supports coordinator.


And that document really is so people who are not registered with us get a sense of how they can be assisted through working with the support coordinator. So everybody begins registration with ODS by calling our intake specialist at the number on the screen. And they'll guide you through the process. We're going to talk a lot about this document is needed and this information is required.


But really, just call the intake specialist and they will guide you through that process. Please don't think if you don't have the appropriate documents that you shouldn't call yet. Don't think if you don't need anything yet, you shouldn't call yet. We hear families say, "Well, our students or our loved ones aren't transition age. They're not getting ready to leave high school." It doesn't matter.


If they're younger if they're out of school and they're not being supported by supports coordinator, and they may be eligible, give us a call and we can walk through that. So for people who call our office. The first thing that happens is that they are connected with a support coordinator. So they choose the supports coordination organization. And that SCO organization assigns them a supports coordinator.


Now, for folks that are already registered and working with the supports coordinator, it's important to know how vital that relationship is to the rest of these steps. So if you don't have an open communication, regular communication with your support coordinator, we always suggest that you remedy that. Either through phone calls or emails, that you're touching base and just keeping your support coordinators up to date.


The first thing that supports coordinators do and ongoing annually is the individual support plan. So that ISP is crucial in outlining the supports and services needed by the individual and the family. And that doesn't mean I'm just paid for supports, that's all kinds of community resources and community supports that your supports coordinator can help you with.


And that includes, as Anne-Marie will talk about later, funding that may be available. We already touched on the music festival fund. And again, Anne-Marie is going to talk about FDSS. So there are ways that you can receive assistance before we get to that having a waiver.


So what if you do need some funding for your individual needs? And the next step would be to have the support coordinator complete with the individual and family. A prioritization of urgency of need form. And you'll rarely hear anyone else say all of those words. You'll hear PUNS form.


So through the PUNS form, the counties are told who needs funding and how much so that we can begin to plan for that. Anne-Marie is going to talk in detail about that. And this is when people start talking about but the County has a waiting list, and we do. There's only so many waivers of funding sources that we have to match up to folks that need it.


But we do our best to make sure that the most emergent needs are being taken care of. And until you call us, start working with the SC, have a really robust individual support plan, and you get to that PUNS step, we don't know about you and we can't plan. Hearing about a waiting list as it's called shouldn't deter you from beginning that process.


So once funding is needed and available, those are called waivers. And again, we'll go through those in detail later. But the purpose of a waiver is to fund home and community based services. And each County has-- I'm sorry, each state has their own waiver services programs that are statewide. And each of those waivers can cover certain services and they need to be provided by certain service providers.


So that's a lot. But again, I just wanted you to hear those words and then Anne-Marie and Mary is going to really touch base on each one of those. I keep saying Mary Peterson because in our office, of course, there are two Mary. So we've begun to use last names.


OK. So there are resources that we offer on our web page that are available to everyone, regardless of eligibility. Some of those are the community and service systems resource list. There's one about free clothing, furniture and basic needs, and then there's a statewide resource list as well. So you can use the QR codes, use these links once you get the slides, or call me and I can connect you.


OK. So again, not everyone that registers is going to be eligible. So we want to make sure that we can provide resources for supports and services, and case management to everyone. So these are some of the things that we share with folks. And again, that are on those resource lists.


So Charting the LifeCourse, as you see, that icon comes up all over the process because at every juncture of that process, we want to be thinking about Charting the LifeCourse and how it can help really develop a vision for good life, problem solve, and figure out how to plan for all these supports and services. And most especially what's available through natural supports for people you know and from your community.


So Charting the LifeCourse, again, it's a way to develop a vision for a good life. It helps you think about what you need to know and do to identify supports and services, and really as tools for conversation and discovery. And there are specific tools that come with the framework. And there are principles that everything is based on.


So the Charting LifeCourse presentation itself is an entire at least an hour if you're really going to dive into this and get into the weeds, which is a great thing to do. But we won't have time today. So the principles include that we're going to focus on all people that we know that people exist in the context of their family. And the family doesn't have to be a biological family, it can be chosen family.


That we need to think about the life experiences across all the life spans. And as we grow older, our needs change, our desires change. And so it's important to think about where we are now and where we're going. And often, our life experiences before where we are now influence so much.


Also, we talk about achieving life outcomes, filling our three buckets of support that you can learn about more once you learn more about Charting the LifeCourse. The supports star is a tool that's my personal favorite. And it really talks about what you need, and/or what you're hoping to accomplish, and all the different ways that is and can be supported.


The LifeCourse is holistic. We want to look across all life domains. For a very long time, the system of services and supports focused on health and safety. We heard those words a lot, health and safety. But of course, developing a vision and having a good life goes way beyond just health and safety. So we want to take into consideration all of these things.


The tools are divided into two categories. The tools are person centered and then the same tools are offered as a family perspective tool. So this is often interesting because sometimes the person doesn't have the same desires, or goals, or opinions about things that perhaps the family does.


So it's really interesting when we have individuals in service fill out the tools and families fill out the tools. And that can create really rich and sometimes difficult and hard conversations but really important. So these are three of the tools that are often used.


These documents do a great job at summarizing everything and really explaining all of the things that we just touched on. And again, they are available at the links that we're going to give you.


So some of the things I've learned along the way about Charting the LifeCourse, it's really not about filling out all of those papers. It's about creating a vision and planning for a better and a rich life. That it can help you prepare for your meeting, it does not replace the IEP at school or the ISP from our system. But it can really help enrich those and get everybody thinking about the details in a different way.


So some of the places you can go for information is, of course, our website. And you just click there and then there's a Charting the LifeCourse framework and tools bar. There's a 17-minute video that you can link to that does a really great job at introducing all of these things and some practical uses for them.


There is on Achieva's website a great training presentation. It's at least an hour long so they really dive into this. So that's really great to access. The Charting the LifeCourse website is where all of this grows from. And that the PA family network is available to everyone, not only around Charting the LifeCourse but around supporting families.


So they can be reached directly by phone and then that's their website as well. So I am going to stop sharing, address any questions that have come in, and then Mary is going to start sharing. Mary Peterson is going to start sharing and take it a little further into the details of this.


OK. I don't see any, Mary, so we can go ahead and get started with Mary Peterson.




Thanks. We'll keep watching. Thanks


OK. Good morning, everybody. I hope everybody can see my screen. I'm going to be talking with you this morning about registration with the Office of Developmental Supports. And essentially, you might be asking why register with ODS. And basically, as Mary had talked to you a little bit about in the beginning of her presentation, you do want to within the system get hooked up with the supports coordinator to assist you with supports and services for your son, daughter, whomever it is that you're supporting.


And those supports coordinators will then in turn be able to link you with different resources if you need. Like Mary said, if you're younger and your child is younger and they need assistance maybe in school with an IEP meeting, if they're transition age in high school and they're looking to transition from school to employment.


We want to be able to have a support coordinator involved to help you with those next steps in how to properly complete transition and look for planning, whether that be with services through the waiver, or for other employment services with OVR, etc, following graduation. And basically just into the future. Looking at future planning is very important and the supports coordinator will continue to basically follow you throughout the lifetime-- throughout the individual's lifetime.


So in order to begin registration with our ODS system, you would contact us by calling the 253 1250 phone number. That is the direct line to our intake specialists. We currently have four intake specialists that man those phones. So they begin the process of registration for anyone that wants to determine their eligibility for services.


And we are also, which is brand new to us, which has been in process actually for the last, I'd say over a year, been looking at completing an online portal for registration into our system for a registration application. We're looking at a possible go live date in April. We don't have an exact date yet. We're still continuing to refine the site and we're continuing to test it.


But we really wanted to have a system, an online registration system available, especially for those families who we know you're all very busy. Lives are very busy today. And we wanted to have that additional option where you could actually go into the portal.


And what you will do is you'll register an account with us. You'll set up that account. You'll be able to go in and out of the portal, including sending us the sign. We'll be able to sign a consent form for services on the portal, upload any type of documents, upload all of your demographic information.


And you can also communicate with an intake specialist on that portal as well. So everything can be done through there to register for our services and you can register on your own time. So that's really the benefit of having the online portal. You can utilize your phone or laptop and just make it easier for you to be able to do that at a time that is convenient for you.


In addition, the other huge benefit is that say you're at an IEP meeting with the transition counselor. You can actually log into the online portal at that time. And the transition counselor then would be able to upload some of the eligibility documentation that we require and make it very streamline for you.


Typically, when you're calling in, we are giving you the documentation that's required for the intakes. And people have to email it, they'll fax it, what have you. With the portal, you can just upload that yourself and get that all into our system. Obviously, if all of you have video capability and laptops and things like that.


But obviously, for the folks who aren't as comfortable with an online portal system, you can still call our main intake number and we will assist you in getting registered and any documentation eligibility paperwork that you need. So hopefully, you'll be hearing about through key communicators if you're signing up for that. You'll be hearing about the new intake portal and when it's going to go live in the next month.


So as far as when you call in or whether you're online, it's going to be the same information that we're going to gather. We're going to gather referral information. We're going to have the individual or if it's a guardian sign a consent for service and a release that will be sent-- it will be sent out to you to sign and return back to us. And then we will go over, based on your diagnosis, the eligibility documentation that's needed to be provided to us to begin the process.


So what we have to do then is determine eligibility or ineligibility for the services based on the documentation that is provided to us. If you are determined eligible for services, then what will happen is, and I will talk about this a little bit further on down, but we will schedule an intake meeting with you. Where somebody will come out to the home and they will actually talk to you about the services that are going to be offered.


You'll choose an SEO organization, a supports coordination organization. Currently, we have five different SEOs that we're working with right now that you would have the choice of working with. And that includes Mon Valley Supports Coordination, Community Center for Resources Service Coordination Unlimited. And we have Carelink, which is one of our newest SEOs, Bridge to Independence.


And we also have a couple-- we have a couple other support coordination organizations that are with us that you would be able to choose. However, they have stopped intakes at this time. And when they're more ready to accept additional individuals, then those folks will be offered as well. So you have actually a large choice of support coordination organizations to choose from.


So any of that necessary paperwork will be completed during the meeting that we have. And if you're doing it virtually, obviously, we will send the information to you and have that information signed and sent back. So that would be completely up to you. But once you do choose the support coordination organization, then all of your information is entered into our home and community service information system, which is the system that houses all of our documents, including the intake information.


It includes the ISP, anything that you would need require for services, that is the system that we use when we're doing intake, waiver, etc. So that's where we'll put all of your initial information into the system.


So just to review. We're going to go over the diagnosis eligibility requirements for an intellectual disability, autism, developmental disability, and medically complex conditions. So those are the four diagnoses that will allow you to be eligible to receive services here in Allegheny County with us.


To start off with the first one, and when we look at what is needed for the diagnosis and for the determination for eligibility, we obviously need a standardized intelligence test that to be completed. And typically, that is the Wechsler or it's the Stanford-Binet in which we'll receive an overall full scale IQ. That's full scale IQ typically is 70 or below. And it has to also include--


In addition to the full scale, you also have to include the level of the intellectual disability. So whether it is mild, moderate, severe, or profound disability. We also require adaptive testing. And the two tests that we will-- or assessments that we will accept are the ABAS and the Vineland.


When these assessments are completed, we need to see significant skill deficits in two of the following skill areas. So they are communication, self care, home living, social, and interpersonal skills, use of community resources, self direction, functional academic skills, work, leisure, and health and safety. So you only need to have the two deficits in two of those areas as a result of the adaptive testing that's completed.


So also, once we receive that testing, what also needs to be included in that testing that needs to be sent to us are both the domain. There are domain and sub-domain scores. So we need to have both of those included or we cannot move forward with the assessments. The indication that the diagnosis was prior to age of 22. So they have to be diagnosed with an intellectual disability prior to age 22 in order to be eligible.


And then we also need the signature of the professional or the psychologist that's completed the testing. So we cannot accept much else besides the handwritten. Or if it's an electronic signature, we can accept that. But no typed in fancy font or anything like that. We actually need the actual signature based on the state regulations as to who completed the test.


Moving on to developmental disability. This is one of those diagnosis that essentially within the past year was is something that we're allowed to accept based on ODP. So this again, is having a qualified professional who can certify that they do have a developmental delay, which is a condition of substantial developmental delay or specific congenital or acquired conditions.


And basically, that there's going to be a high probability that this would result in an intellectual disability or autism and is likely to continue indefinitely. And we do actually have to have it documented by a diagnostic tool. And just as similar to the ID diagnosis, again, we need the adaptive testing, the ABAS or the Vineland.


Only with the developmental disability, we need substantial limitations in at least three of the skill life activities. So ID is two and then developmental disability is three of the following major life activities. And also again, including both the domain and the subdomain scores on that evaluation.


In addition, we also need a medical evaluation. So a physical exam that's completed by the physician and recommends an intermediate. Again, we have these acronyms. Intermediate care facility really is ICF and ORC is other related condition level of care. So it's a level of care diagnosis that we have present on our physical forms.


And basically, that has to be circled because it's other related condition. It's not an intellectual disability. And that would be circled on the physician's form. The individual also must be eligible for medical assistance and the child must be eight years old or younger. So at that age, once that child turns nine, they either have to be diagnosed then with an intellectual disability, or autism, or a medically complex condition in order to continue to maintain services within our system.


As we all know, as children typically get older, sometimes things will change, etc. So we have to just make sure that they are eligible for services continuing after the age of nine. So autism spectrum disorder. Essentially, again, we need diagnostic tools, diagnostic testing that indicates the autism diagnosis.


Some of the examples included here are the ADOS, the GARS, CARS, SRS, ASRS, GADS, and ASDS. Don't ask me what all of those exactly stand for because I couldn't tell you but those were the diagnostic testing that we need to be provided for that autism diagnosis.


The adaptive testing also, excuse me, in addition would be with limitations in at least three of the following life activities which we talked about a little bit previously. This is a little bit smaller subset. So it would be communication, self care learning, motor skills, self-direction, and capacity for independent living. And again, as previously, both domain and domain scores must be included.


You also must have a medical evaluation that indicates that the individual is recommended for ICF ORC level of care, and also must be eligible for medical assistance. An indication that the diagnosis was present prior to the age of 22, along with the signature of the professional that completed the testing for autism.


Medically complex condition. This is the newest diagnosis that we began accepting this year. Actually, it was early last year-- at the end of last year, at the end of 2022. And we've just started to register people with medically complex conditions. So it's very different in that medically complex condition, it's a chronic health condition.


It needs to affect three or more organ systems and requires medically skilled nursing intervention to execute things like if they need technology for respirators, feeding tubes, nutrition medication administration. Anything like that, it requires that medically necessary interventions in order to qualify.


Basically, we have the licensed physician, the pediatrician that will basically certify that the individuals has that condition with the three or more organs that are involved with the individual. And we have to include all of that documentation on one of our medical forms that's called the DP 1090. So they can actually write in information.


The doctor will actually write in information there on the medical complications that each individual has so that we can see that there are actually three or more organ systems involved. And again, it's everything else that we talked about previously. The adaptive testing is within the substantial limitations within three of the areas. We also the medical evaluation and physical examination. So that's actually on top of the DP 1090. We need the DP 1090 completed and the medical evaluation.


And the individual must be eligible for medical assistance. And in this case, the individual must be 21 years old or younger. So when they turn 22, they're either going to have to be diagnosed with one of the other diagnoses to qualify or they will have to be-- with the exception, I'm sorry, of the developmental disability. Or they will need to have waiver at that point. And with the medically complex conditions, there is eligibility for waiver services with that.


So those were the four diagnoses that we accept to be eligible for services within our system. And once we have established the eligibility, we've determined the individual to be eligible, then we complete the intake process. The intake specialist will schedule an intake meeting. Like I said before, we could come out and do a home visit or we can do a virtual meeting. And it's all based on your individual preference and how comfortable you feel with us coming out and in meeting with you.


So the individual then in the family, once we come out to meet with you, we'll sit down and we'll complete the following forms. There's obviously, like I said, before, you're going to complete the SEO choice form. And we do have, obviously, brochures and things like that for you to review on each of the supports coordination organizations that we work with.


And we've had families that have made phone calls to the SEOs just to talk to them and get a feel for caseload size, responsiveness. Anything that you might want to ask, you can do that if you call the sports coordination agency. So you would determine who you want to choose to work with at that point.


We would also complete a service preference form. And that service preference form essentially documents the individual's choice to receive services in the home or community as opposed to an intermediate care facility.


So where we used to have folks that would be in intermediate care facilities for people with ID, we now can obviously have services come in the home and provide community services. Whatever the need is, we can work with the individual and the family to support that need.


We complete consent to release information forms. So any information that you need to share with us, we complete those. And we also will provide the HIPAA privacy notice to the families. So then we also review just a bunch of other information about our processes here at ODS.


So we'll provide information on County conference and appeal processes. We'll provide information on life sharing employments, which includes OVR services. We have a bunch of different fact sheets that you'll get. We'll have waiver service fact sheet, service definitions, and service delivery fact sheets. We obviously provide incident management services.


So we follow up with incidents as they occur. We also have an ODS frequently asked questions sheet on IM4Q. And IM4Q, it's basically-- IM4Q is a survey that ODP uses. It's basically a method to gather information in order to improve the lives of the individual with the disability that we're working with. It helps to promote safety, health, and promotes choice and control that the individual will have over his or her life.


So they will come out and ask questions just about how your life is and what you're doing and what you would like to do. So we have a fact sheet on that as well. And also a voter registration form. If you're over 18 and you would like to register to vote, we have a process to be able to assist with that as well.


So moving into supports coordination services. So once you receive a support coordinator you get, you will basically put the information into [INAUDIBLE]. The SEO will receive and will assign a support coordinator to you. You'll basically meet with that individual, they'll contact you. And they'll set up your ISP, etc.


Basically, what their role is to locate, coordinate, and monitor any services that you have. And so essentially, when they could-- they're locating, as Mary said previously before. If you need a service that's within the community, a support group, assistance with certain daily life activities, if you need a senior citizen program that you're looking at or anything like that, they locate those services for you. It's all based on what you need and what you're asking them to assist you with.


They also coordinate services and supports. So depending upon who you're working with as a team, you may be working with the school and you may be working with wraparound. Any type of services that you're working with will be put in the plan. Basically, the supports coordinator can help coordinate those supports for you and pull everything together to make sure that you're basically getting the best services you can.


Monitoring those services ensures that you're receiving the services. If you have waiver services, they're monitoring services at a different level depending upon which type of waiver you have. So you can be meeting with the supports coordinator once a year or you can be meeting with them four or five times a year. It's all just basically dependent upon what your needs are. Sorry.


So what supports coordinators are responsible for is, again, talking about the types of supports and services that the individual needs, helping to develop the ISP plan. And that basically has just a plethora of information about the individual in there so that anybody who picks up that plan will get a very good idea of what supports are needed to assist this person in basically living their best life.


They help to make referrals for anything you might need, communicate with agencies in the community that provide supports. They also complete the priority of urgency of need for services which is the PUNS, as Mary alluded to before. And they basically identify the individual based on the PUNS, whether you are in emergency for services critical or planning for services if there's waiver funding that is needed.


And then they follow state guidelines for basically, like I said, where and how often they will visit the individual or contact the individual. Typically, it's between phone calls and face to face visits. And like I said, it's based on need and funding type of and the services provided.


So how the SC can help you. The SC can basically secure services and help you to plan for the future, attend meetings with agencies you're working with and advocate on your behalf. So like I said, if you have a younger child attending IEP meetings, to make sure that-- ensure that they are receiving the services that they need within their IEP.


If it's employment, following up with the-- if it's a one to one job coach, following up with those folks to make sure that they're providing the necessary direction for the individual in his or her job, or just planning for employment and transitioning in schools, so anything like that. And assist you in completing applications for services, paperwork for waiver funding.


Obviously, they're like the linchpin of the system and that they're going to help you with the paperwork if you require a waiver for services, after high school, for residential services, etc. They will keep you informed about any changes within our ODP system and give you information about resources and supports that you need.


So what the SC will not be able to do is they will not be able to provide direct services other than the support coordination services that they do provide. So they can make a referral to help you with job supports but they cannot actually like find you a job or work with you at the job site. So they're really there for assisting with referrals for the types of services that you need.


And in addition, they cannot guarantee funding for services that you want or need or decide if funding will be provided and when. So that's basically-- that is really the job of ODS to what the SC is going to be doing is going to be putting you on the PUNS that are going to be identifying your needs, your level of need on that PUNS if you feel that you require waiver services. And then they will not provide transportation. That's the other thing they cannot provide.


So just some additional support coordination information. You can contact your SC by phone, email. I know a lot of them, they have phones now so they text, or good old US mail. You can invite them to meetings you want them to attend with you, to support you, to ask questions about services or information that you might be interested in or need to know about.


Talk to them if there's significant changes in whether it's a financial situation, if you've moved, have a change of address or phone number so that they can contact you. And if there are any significant health changes for you or your family members or needs change. So we know as family members get older, there may be more of a need for services at that time. So it's really, like I said, the SC is going to be the key to documenting the services that you need so that we on this level can assist in helping to plan for those services.


You can also request a new SC or a new support coordination organization. If you feel that they're not representing you well, you feel like there's not a connection there, you can always contact the SEO program manager and they will either provide you with a new support coordinator or like I said, you can switch supports coordination entities as well. So it's just a matter of letting them know that that's what you want to do.


And then the SCs just so you know, they receive standard orientation. They're required to meet annual training hours. Last time I checked, I think it was 24 hours of training. And that's basically to stay informed about changes within our system, within the ODP system, and just on planning topics that are of interest to them.


Just to go over like I said before, the individual support plan, is the plan that you will complete with your SC annually. And obviously, to update any changes. If you have waiver, there are services and supports attached to the ISP that we want to make sure that you're getting the services that you need, the amount of services that you're supposed to be getting. And that's why they do monitor those services.


So it's basically just a comprehensive summary of the services and supports that you have. It's also truly just from top to bottom. It really tells you who this person is, what are their likes and dislikes, financial situations. All of those types of things which I think we'll go over in the next slide.


So it's first developed with the SC once you make that choice. And then they are responsible, obviously, for coordinating the plan and updating it annually or more as needed. So if there are significant changes, there can also always be updates to the plan made outside of that annual time frame.


So to help everyone prepare and plan input, a copy of the plan can be given to you from the SC ahead of time in order to include information that you want to put into that plan. So reading over the plan and looking at it and saying, "Well, oh jeez, we need to add this change over the last year," and making those changes.


The ISP team can include anybody who is important to that person, that individual wants to involve in their meeting. So again, it can include close family, friends, providers, school staff, and basically anyone that that individual would want to invite to that ISP meeting. Like Mary said, it doesn't have to be a typical family mom and dad. And it could be who really supports that individual in completing that plan.


And then basically, it's completing the plan in order to provide the individual with the needed supports that they want to basically live their best life. And so that's why it's so critical to work with your SC throughout, not only just once a year. But throughout the year, to make sure that they're provided with all of the information that they need to assist to assist you.


It helps explore opportunities and resources that may be available and it supports everyday lives. Person centered approaches, positive approaches, and as Mary talked about, can ask about the tools for Charting the LifeCourse. That really does help you to look if it's-- we're using it even right now for some folks for future planning. Working with a trajectory as to what does that individual want to see for their best life? Or how do you continue the good life that you already have? And just planning for what if something happens.


So as far as the information that's included in the ISP, like I said before, individual preferences. So what's important to the person? What activities do they like? What do they enjoy? Medical. That includes current medical exams, any type of medical concerns, other diagnosis medications, and health evaluations. Health and safety, including like just safety practices. So they'll ask you, "Can this individual-- can they determine hot and cold water temperature? Can they use appliances? Are they safe in the community?" Those types of things.


Outcomes are more developed as to what the individual wants to accomplish. So in their life, whether it's getting a job, whether it's earning more money. The outcomes are like goals for the individuals, just to make it simple. And those can change and they're fluid as they move through life. So financial resources. Are they on SSI? Do they have medical assistance? Do they have a trust? Do they have-- how can they manage their money? Can they manage their money or do they need somebody else to manage their money?


And then finally, like services and supports which includes whatever services that they have. That could be services that are waiver services or non waiver services. It also includes, how do they communicate, which is crucial. Obviously, how they communicate with others. And how much supervision do they need, if any? So these things are all detailed in the ISP.


So now we'll look at the Q&A here and see what we have as far as questions go. OK. So Tracey, every application. I think this says, "I have sent since COVID have mandated a signature and would not accept a virtual signature." OK. So I'm not sure.


So the virtual signature, is it-- I'm just thinking if it's an e-signature, we can accept like the electronic signatures for registration and for the documentation like on a psychological if that's what you're referring to. And if that's not what you're referring to, please let me know.


OK. Let's see. Clarification. What are SC's guidelines in PA for contact with an individual? OK. So that is basically based on the waiver type. So if they don't have a waiver, then it's there is an annual contact once a year to complete the annual ISP.


But it's different based on whether you have a person family directed waiver, community living waiver, or consolidated waiver. All of those contacts vary. And I can actually-- if you wanted me to actually look that up for you all, I can look that up and get that information for you specifically to what the contacts are for each of those because I know they have changed a bit.


OK. Tracey is asking, it is but they have wanted a real signature every time. OK. So I would say if there is a specific issue and they're not accepting the electronic signature, then please, you could reach out. If it's something specific that you have, you can reach out and contact me.


And I can give you my phone number. I'll put my phone number here in the chat and then we can review the information that you have or that is on the psychological. OK.


Mary, can you take your [INAUDIBLE] down and I'll share my screen.


Yes, I can. OK. Let me just see if there's anything. OK, SC contact. So Anne-Marie, you may be able to answer the community living waiver. SC contact, you know that offhand by chance?


Theresa, near living waiver.


They were wanting the guidelines for the contact with the individual for community living waiver.


I'm not sure.


OK. We can find out that. I can find out that information. And as maybe as Anne-Marie is going through her screens, we can get that information to you. So I'm going to stop sharing my screens. And I appreciate the questions. And I'm going to turn it over to Anne-Marie.


OK. I got this. Sorry, everyone. I need to share my screen. OK. So I would like to start off by saying that the E PUNS process and the way we're application that I'm going to reviewing today is basically Allegheny County's process.


So if you're from another County and you don't have a support coordinator from Allegheny County, then this is not going to apply to everyone. So if there are specific questions about how we Allegheny County does things, I can answer those. But if we have questions from if Westmoreland does this, or the assistance office from Butler does this, I can't answer those questions.


So I'm going to do a general overview of our processes and the waiver application because we would be here for hours if you would let me to talk to you about these two processes and what I'm going to be talking about today. So just to start off, so you all know that Allegheny County has 4,210 individuals total in one of the three waivers.


The way that we have turnover in waivers to have other people come in to the waivers is either through turnover, someone gives up their slot, or we have an initiatives. We have not had initiatives in quite a few years. The only thing that's been going on is with CLW, the community living waiver. That is basically the newer waiver within the last few years.


And we will get initiatives, typically, and September, October, but there will be criteria to those initiatives. So with the CLW initiative, they will usually give us slots for individuals that are SC services only, that have no service available to them at the current time. So if an individual has PFD or already has PFD, they are not eligible for that waiver, that initiative.


So moving on. So my team's responsibilities, including all individuals that come on to emergency PUNS. And when they come on emergency PUNS, then I have three different teams, oh, consolidated team, a CLW team, and a PFD team. And they will review the situation and from beginning to end. So when they come on emergency PUNS, all the way through the review, putting on wait lists if we have available slots for a waiver, then they will follow through with that.


So what is an emergency community living waiver and consolidated waiver? The list are basically crisis oriented. Like I said before, we have a certain amount of slots that we have. And the slots when I say slots, it's capacity. So each county has a certain amount of capacity that they manage. And the only way that capacity changes is through churnover, or like I said, if there is an initiative.


With our community living waver and consolidated, waiting lists are usually crisis oriented. So we're looking at, what is the threat to the individual's health and/or safety that requires a service to address that need. With PFD, basically, it's quality of life needs because PFD, we have available capacity in PFD at this time.


So if an individual requires supports that the individual can stay in their own home or the family home, or they need supports that can enhance their life, then we're able to provide the PFD waiver to that individual. And I will explain what the necessary steps are to get any of the three waivers.


These are the different types of supports needed that are on the PUNS. So if a person needs 24 hour respite, family is going away on a vacation or something and the individual does not want to go. If they have a budget that will be able to provide for respite, then they can have respite. If an individual is support coordination only services and you're looking at the PUNS and you're saying, "These are the services that the individual needs," maybe they need respite.


They need a respite camp or something like that. So when you're with your support coordinator, you would be reviewing the PUNS and reviewing supports that are needed for the individual. And the individual should be part of that process.


So the different supports will determine what waiver would be needed. So if you need any supports that a budget total would be $41,000 or less, that would be for PFD. Community living waiver has a cap of $85,000 and consolidated waiver has no cap. So consolidated waiver is basically for a lot of individuals that are receiving residential services and that's on the second page. So residential supports. Licensed residential, unlicensed residential, life sharing.


At times, depending on people's level needs groups and you probably heard that before with this is, will determine what the budget is. So individuals can be supported in life sharing with the CLW budget. You don't always have to have a consolidated budget for residential services.


These are the activities that are to be completed prior to putting someone on emergency PUNS. And the SC is usually completing these activities. But like Mary said before, when you're developing the ISP when you're meeting with your support coordinator, you should be discussing all of this in the ISP. Making sure when you have your ISP meeting, you need to discuss everything with your support coordinator so they are fully aware of the current situation that's going on.


So you want to make sure that what is the current situation in know one do. What's going on that constitutes an emergency? What are the services? What's the frequency and the duration that would be needed for the emergency? Especially, the support coordinator needs to let us through the service notes what is going on with the individual. What do they think? Which waiver does the person need? What's the estimated budget?


And are there any special indicators? And when I say special indicators, I mean is the person graduating? Is the person going to be turning 21 and the EPSDT services will not be available for them? Will they be turning 21 and they will not have behavioral health services through EPSDT and they will need some sort of behavioral help once they pass-- when they become 22?


It's important to note if the individual is SC services only, assist is needed because assist is needed prior to enrollment. So anyone and everyone that becomes an emergency on the PUNS that is SC services only should become-- should have a request for assist at that point in time.


Mary went over the psychological and adaptive assessments, what is needed for both of those. I will do a little bit more with that in the upcoming slides. And we are also checking to make sure that they have a valid service preference. So these few things that when you're meeting with your SC, SC should be going over with you. So make sure that you have a list of what we need to go over.


This next slide is the second page of the service preference. So the service preference is the individual or the legal guardian or parent for anyone under 18, is they are choosing home and community based services. So this top part is the individual. And if they're over 18, they would be signing this. If they have a legal guardian, the legal guardian would be signing this because the individual over 18 with a legal guardian cannot sign for themselves. So they would sign here in this section.


The SC usually signs here and then we are signing here. So once we determine that the individual is choosing home or community based services, then we will be signing off on this also. You as the family member or individual will be getting a copy of this so you know that the service preference has been signed.


So when people become an emergency on PUNS, we have what we call a PUNS poll and it's done every two weeks. The first Monday of the month and then the third Monday of the month. And initially, when the PUNS poll comes on, it's a list of everyone that is new to emergency. So I have a staff person that does a basic triage to those new people coming on.


And she will look at, like I said, service notes. She will look at service notes and see that did the SC a service note that says, "John Doe is going on emergency PUNS and he will need PFD waiver. He needs these services." So she right away will be able to ascertain which grouping the individual would go in. And then once she makes-- once she goes through all of the individuals, she will assign them per team.


And as you can see, these are the teams. I currently have a vacancy on my PFD team. And those are the individuals that per team are assigned. Once the individuals-- Once my planning staff get the person's name, they will be doing the review. So they'll look at everything. They'll look at the service preference. They'll look at the no and do. They look at the ISP. They look at monitoring tools. They're looking at everything to get a clearer picture of what is the emergency. Is there crisis? And what can we do to help?


Sometimes, as Mary ever have talked in the past, and previously, sorry, with Charting the LifeCourse tools, we might call you up. And we might say, "What's going on? What's needed and how can we help at this moment in time?" Because like I said, capacity is depending on what is going on at the moment. And CLW and consolidated waver at this moment in time, we have no capacity in either one.


So a lot of people might need residential. They might need enhanced services. They might need to go to a day program. They might need community support services. They're going to run over that their PFD waiver cannot support or even the CLW waiver cannot support. So we're going to try to get to know who the individual is and see how we can help. What other resources might be out there? Because we know that the waiting lists are pretty lengthy at times.


So as I said before, we have capacity in PFD. So once it's determined that the individual needs PFD, the wait time depends on you and your family and the SC. Because if we can gather all the eligibility and final-- excuse me, all the eligibility and financial application documentation, and able to send that down to the assistance office, if there is a provider that will be able to provide the service and the service can start within 45 days, then we're ready to go with PFD.


With consolidated and CLW waiver, what are mitigating-- how can we mitigate the risk that the individual is occurring at that time? Is there a way that we can mitigate risk since we don't have capacity? So these are some of the questions we might be asking you or the support coordinator.


So basically, we need to ascertain, what is the crisis? What is the emergency? Are health and safety threats dangerous and/or imminent? Especially with consolidated and CLW waiver, we're going to be asking for updates. What's going on? We want to know what's going on. So what do we need to do right now in this very moment for individuals?


Level of care. So moving forward, so once we determine the person's on one of the three lists and they're going to be needing waiver, we might get a slot for an individual. Once we get a slot, we have to provide two different types of-- satisfied two different types of eligibility requirements, the level of care eligibility and the financial eligibility.


The level of care is something that the AE and the support coordinator-- supports coordinator and you guys as family members and individuals will be doing. Mary Peterson talked about the diagnostic tool.


This next slide is the bulletin that says how an individual, what the eligibility requirements are for a waiver if anybody was ever curious. And it's bulletin 001904. So we look at this, look at the bulletins that come out from Department of Human Services and we need to follow along with those bulletins.


So the first level of care requirement deals with an individual that is ID. If the person is ID, then we need a psychological, as Mary talked about. And these are the things that are needed on that psychological for an individual with ID. The test used, their IQ, their level of ID, and the signature of the assessor. Where I say, ensure the ICF ID level care is circled on the physical. We'll get to that in a minute.


For autism, then the level of care for autism is different because it's test used, test results. They must have a diagnosis of autism. And once again, the assessor. So if it's ID, it's ICF ID. And if it's autism, it's ICF ORC. Adaptive functioning. Mary said in the beginning--


Mary Peterson said in intake that you need-- for ID, for intake, you need two deficits in major life activities. If you look here according to the bulletin from ODP, to qualify for waiver services, an individual with ID needs three or more areas of major life activities. That is the only difference from intake for ID is the fact that three or more areas are needed. So we have to be really careful when we're getting information from intake.


Now, generally speaking, when intake comes through with an individual that has an ID diagnosis, majority of the time there are three deficits. There are three areas of deficits. If there is not and we need to have a new adaptive, I have an individual on my staff that is qualified to complete that Vineland. And he would get information from the supports coordinator as to who would be a good respondent in order to complete that Vineland. And as you can see, you would get an email from him with the link, that q global link at the bottom. And that's in order for us to be able to complete the adaptive functioning.


The level of care is once again, like I said, for ID is ICF ID and for autism it's ICF ORC. So on the medical form, it needs to have one of the two circled. Now that we have included autism along with being able to get waiver in the ID world, that our forms need to change. And as you can see, this is the physical form that is used 99% of the time.


The SC will have this physical, give it to you the family member or the individual and say, "Take this to your doctor's office." And as you can see, at the bottom it says it needs-- one of the two need to be circled. So if the individual is ID, then the ICF ID is circled.


If the individual is autism, then the ORC section is circled. We need to make sure that the data the appointment is on the physical form. And this is so very important that the physician signs it and the physician dates it. We need those two things that need to be present always.


This is the other form that people might have heard of. It's the MA 51. On the MA 51, it's down here as you can see. This is the ID box and this is the autism box. So we have to make sure that if they have ID, that this box is checked. If they have autism, this box is checked. Once again, the physician needs to sign and the individual is signing up here. That's a different. This is the only difference, well, along with all of this in the middle. The individual is signing on the MA 51.


We have to make sure that the individual has documentation prior to age 22. That is the fourth area that is needed. Typically, on IQ testing, the adaptive functioning, or the physical, they'll say the person is X age, usually under 22. And they have the testing that proves that they had a diagnosis prior to age 22.


There are several incidences where people are coming in through intake or haven't had good psychologicals. So we will have our psychologist do maybe mini review that says, "The individual, in my professional opinion, that the individual had these diagnoses prior to the age of 22."


With financial eligibility, this is now out of the actual hands of Allegheny County and the SC. And it's in the hands of the assistance office. So once we get all the documents that I'm going to be talking about, and I'm going to give you some tips on what we need to make sure that it's smooth sailing for the financial eligibility part. It's up to the assistance office.


The first thing I need to say is the County assistance office has 30 days to process it. So we like to get anybody that's SC services only because they're new to waiver and we need all this financial eligibility. We want to make sure everything that we're sending to them is correct. Signatures are there, any type of documents that are needed are there, everything is accurate. But we all know that sometimes that doesn't happen. So we're going to go over that.


So the first thing we want to make sure is that their monthly income limit is not over $2,742. Their actual resource limit is not over $8,000. So those are the first two things that we have to make sure or they will not be eligible for services, for a waiver.


The next thing is this is the PA 4. So the SC would come to you and say, "For waiver, we need to sign-- you need to sign the PA 4." And that is an authorization of release of information for the CAO to be able to look at your financial documentation that you send down and for them to be able to look at any financial documentation that they have purview to that they can see themselves.


Because let me tell you, they will find anything and everything. Whether or not you put it on the next one, which is the PA 600. Whether or not you put what you have on the PA 600, they will find it. They will find everything and they will question everything. So it's important that on the PA 600, that each of the boxes they ask.


They ask, "Is there a monthly mortgage? Would you have a checking account? Do you have a savings account? Do you have a trust? Do you have this? Do you have that?" If the answer is no, don't leave it blank because they assume if it's left blank, the answer's yes.


And they'll say, "What's this? Or what's that?" They'll come back and say application is denied because they did not complete this. So it's best to say no or none or put a cross through it and say none so they know that you don't have anything in that area. So it's important that, like I said, that you were supplying everything that you can.


Once again, this is specific to Allegheny County because I've heard that other counties don't have as far back of information that they need to provide to their assistance office. Allegheny County needs to provide five years of information, current pay stubs. Then we need to provide the ward letter. Five years of tax returns if they have any. And the other thing to remember is this is for the applicant only.


If they're living in your house, if an individual is living in their family house, whoever else is in that house does not have to. None of their information is put on the PA 600, it's just the individual's information. And like I said, if there's a life insurance policy that needs to go on there, if perchance that life insurance policy's name has changed, put the name change on there.


Your initial policy might be from XYZ but a changed to Q or Z. If you put XYZ, they're going to find the other one and they'll say, "You have two life insurance policies." So it's very important that whatever you put on the PA 600, that you provide the supporting documentation for that.


Before, I had said about the assets. So if anybody was over assets, was over the $2,742 or over the $8,000 assets, then it would be in best interest that maybe get a PA able account, spend down on your item, spend down your money.


But I must warn you that if you spend down your money, that the individual spends down their money, that the CAO is going to see that because they're going to ask for documentation. And you need to verify what the money went t0-- where did this money go? You took out $10,000. Where did that go? How was that spent? They are very particular with everything related to any type of financial documentation.


When everything is gathered, then the supports coordinator will give us all that information. We in turn will send it down to the assistance office. Majority of the time, the assistance office will let us through a form called a 162 whether the person is eligible or ineligible for waiver services.


If perchance you were applying for or the individual was applying for waiver and got a letter like the one on the screen and it says 162, you are not eligible for services. You need to let your SC know immediately because we only have X amount of days. And it says in there, you must return everything by September 14. And sometimes with this letter, if a family member gets it, it can be so overwhelming as to, "What do you mean this wasn't shown? What are you talking about?"


So it's best you let your SC know so then they can inform us that they got a pending letter. This is what we call a pending letter. Even if you get a rejection letter, you need to let us know so we can appeal it. Don't do anything. Don't send any information directly to CAO because a lot of times, unfortunately, it might get lost.


So my best advice is if you get a pending letter, a rejection letter, let your SC know so we can know and then we will work together to get it resolved. Because all we need to do sometimes is explain to the CAO in their terms what we're trying to-- we did send that information. That was part of the packet. And they might look at it and go, "Oh yeah, I do see that now." So it's important that if you get something like this from the assistance office to let us know immediately.


So that's just a second page. And like I said, we recommend the documentation be given to us so we can send it down so we have record. Unfortunately, we had a situation where a family member got this letter. They thought they were being proactive. So they sent-- there was like five things that they sent right down to the assistant office. And only later did we learn that 162 went directly to the family.


And we had said to the assistant's office, "We understand that the family sent the information via email a month ago." And the assistant's office said, "We never received anything." So we had to go back to square one with this family, "And what did you send to them?


Make copies of it and send it to us so that we can rest assured that we can get that information to the assistance office because we have direct contact at times with the assistance office and we can just make a phone call." So it's best that you let us know when anything ever happens. I know that was a lot of information and I'm running out of time.


So I just wanted, lastly, to say that we have ARPA funding, family driven support services. And ARPA funding is for people that are only SC services only. Initially, they-- the state decided that they were only going to give this money to people that had emergency PUNS. Well, unfortunately, people with emergency PUNS are dealing with a crisis more than $2,000 at times.


So they opened it up to anyone that had support coordination services that were experiencing the short term emergency, i.e. meaning that if an individual needed respite, something unforeseen came up that you needed to pay for respite for an individual, there was $2,000 that you would be able to utilize for paying for respite for a family member camp.


And things like that, respite camp, assistive technology. So basically, what we're trying to say-- I'm trying to say is if you have your son or daughter or individual, if individuals are listening and you're SC services only, talk to your supports coordinator about the ARPA funding. $2,000 for eligible people, individuals. There is a request form that comes to me.


And last but not least, here is Colton. He was emergency on PUNS. Prior to beginning getting his PFD waiver, we had a meeting with the family. And the family was saying he can communicate better with his laptop, with a computer. We have a computer at home. We all share it. We all have to take time.


So through ARPA funding, through the FDSS funding, we were able to get Colton and his brother both a laptop and an iPad. And this is a picture of Colton and mom saying, "The iPad came in one day. We got a keyboard for it. He loves it. Thanks for everything."


He's going to try the headphones on and he's really busy now. So it's a feel good story. I like sharing these stories different. Stories are out there about people being able to get FDSS funding has really helped enhance their lives. So I'm going to stop sharing right now. And I didn't see-- I can't see if there's questions so I will look at those. So I will open it up. Yes. So--


Anne-Marie, Mary and I have been answering some questions as we go but there are still a couple in there.


So the one question is, is the monthly income of $2,742 only for the initial applicant? Yes. It's for only the applicant. So like I said before, if the individual lives in a household with mom and dad and brothers and sisters, you're only filling out that PA 600 for that person. And nobody else's savings account, checking account, it's only that individual's money.


So you don't have to say mom and dad make-- have a savings account. It's just the individual. It's a financial eligibility criteria for the person going into waiver. And I see Mary Peterson is typing the answer for the other one and she did.


Anybody else have any more questions? Let's just give it another minute. It looks like there are some questions in the chat box. If one of you want to take a look at those. Oh, I'm sorry. No, there's two more in the Q&A box.


Consolidated waver has a committed capacity of 2,234. Community living waiver is our [INAUDIBLE] waiver, 563 capacity and PFD waiver has $1,413 committed capacity. And like I said, our PFD waiver has a current vacancy in it.


So if an individual needed PFD, then they could get it as long as they met those criteria that I just talked about. We need the level of care criteria, we need the financial criteria. Financial criteria, like I said, usually takes 30 days. Sometimes it's quicker, sometimes it's longer.


And with PFD, if there's a provider, you have a physical. The physical needs to be within a year. So if you had a physical six months ago, as long as that physical got signed, as long as that physical-- if you had a physical six months ago, you can take the form down to your doctor's office and hopefully they would complete it for you so you wouldn't have to get another physical.


So rest assured that if you had one six months ago, you have your physical. That level care piece for the physical is met. Typically, the psychological should be good. The adaptive should be good. It's the mere fact of is there a provider that has the service available, has the staff available. That's where we've been running into drawbacks with getting people PFD.


There's no providers, unfortunately, since COVID. But it's opening back up and more and more providers are taking on, more and more people. So it's becoming better now than it was two years ago. So that's a good plus there. And once again, need to stress about the financial. All that documentation is necessary because if we don't have it all, they will reject the application.


So it's better to be safe than sorry and submit everything that you have for the individual only. Don't submit any of anybody else's stuff. It's only the individual. And if you have questions, the supports coordinator knows that and they're able to help. And if you have any other questions that you want to just ask me or any member of my team, feel free to do so.


There's a question about an irrevocable trust. Yes, you need to put that on there because that needs to be looked at. No, parents' income assets are not counted. It's only for-- when we're applying for a waiver, we're applying for the individual. We're not applying for anyone else. So it's the individual's income assets level of care requirements, no one else's.


CLW had 563, consolidated had 2,234. Autism waiver is through the adult autism program but we serve-- any autistic individual that is registered with us is served with one of our waivers. If they're only autism and they're not eligible for us, then there is an autism only waiver that they would have to go through, if I said that correctly. That makes sense.


And like I said, each County, their capacity is different. Some counties, all they have is 2,000 people in total whereas Allegheny County has 2,000 people on consolidate-- that have consolidated. So it's interesting that when we're talking with other counties and they say, "We have 200 people," I'll say, "I have 200 people on my PFD waiting list." So it's a shocker sometimes.


Yeah. It looked like there were a couple more that came up. One at the bottom says, "Are you saying supports coordination agencies like family links are not taking any more people?"


OK. Yes. So family links right now is only taking a couple people a month. So they are not fully open to receive ongoing individuals at this time. And we have a couple others that they're basically at capacity right now.


OK. A question about the consolidated waiver, is that for the whole state of Pennsylvania, meaning not by County?


Yeah. So I was just going there. So the consolidated waiver is a statewide waiver. It's available statewide but each County has a certain number of waivers for their individuals.


Now the question is 563 on the wait list. No, 563 is how many-- what our capacity is. So there are 563 people that have or have a community living waiver. There's 2,234 that have consolidated waiver, and there is 1,413 that have PFD waiver.


As to how many people on the actual waiting list for all three waivers? It varies. At this point in time, we're probably at 120 on our waiting list for Allegheny County for consolidated. Community living waiver is around 100 people. And like I said before, PFD waiver is around 200.


And unfortunately with PFD-- and you would say, why are people waiting for PFD when I said I have capacity for PFD? And that's because one of the three things I said before, people don't have all their financial documentation in. Some families are very leery about providing that information. I don't blame them.


But without that information, we cannot have-- we cannot give someone waiver because that's part of the eligibility requirements by the state. That they need to be financially eligible to receive a waiver. There are issues with providers. And the providers are coming back in.


Because of COVID, a lot of things shut down and people didn't have-- couldn't work. They didn't have staff but that's all changing again for the better. More and more staff are coming back. And people are providers are able to provide services.


So the financial piece, the actual service piece with staff, and then even the physical piece. You'd be surprised to know that people can't get to the doctors. They couldn't get to the doctor. So we have to make sure that all those eligibility requirements are met for someone to be able to become waiver eligible. I hope that makes sense.


Thanks. There's two more questions up there. The first one is, is the monthly income of $2,742 only for initial application for the waiver or is this the amount for all months while someone is on the waiver as well?


You have to reapply every year and a re-app. So initially, and then after that it's yearly. So initially, they look at everything to make sure that you're eligible and then every year after, they'll look at everything to make sure you're eligible. So typically, that monthly income might change from year to year or things might change from year to year. If the SSI amount goes up, and that changes.


So initially, this is where we're at right now. This is what you need to be-- this is what the financial eligibility is at this moment in time. Next year when you come for a re-app, it might be different. But rest assured, they look at it every year to make sure you still maintain your financial eligibility.


OK. The next one. My son generally falls within the income limitations but surprisingly, this month he got a nice bonus. In addition to three paydays this month, he would be over the limits. Are unusual circumstances recognized?


So are we saying that the person is not waiver right now and if we send in something for that month he would only be over for one month? If that's the answer, then it's-- they look at that. They look at the last three years of-- three, four years of bank statements and then two random months for previously.


So yes, he'd only be able for one. If he's only over for one month, then that-- they look at it globally. It's like they'll average it out to make sure that he's not over all the time. If it just one month that he's over, then there's mitigating circumstances like you said, there's three pays that month. So they would look at that. But if it's a consistent over, then they're going to deny him.


But one option I believe would be for individuals who do go over excess. That's where special needs trust, [INAUDIBLE] trust come in handy as well. And that's something that we can help you with that achieve a family trust if you have any questions about that. Pooled trust are fairly simple to open. The information is online. You don't need an attorney to do that. It's just a way to put that-- a place to put that excess money and not compromise your benefits.


I don't see anything else up there. I think that's all of them. Thank you all so much for answering. Those questions and everyone for attending this morning as well.