Pennsylvania's Department of Public Welfare, Office of Mental Retardation ran pilot projects in urban, rural and suburban counties —Allegheny, Blair and Lehigh—to develop and implement the first steps of county plans to give people with developmental disabilities greater choice in determining the services they receive.
The project was part of the Robert Wood Johnson Foundation's (RWJF) national program, Self-Determination for People with Developmental Disabilities.
By February 1998, the Department of Public Welfare, Office of Mental Retardation reported that 15 counties participated in self-determination initiatives of their own design. State officials attributed this outcome to the combination of RWJF funding and Pennsylvania's commitment to the Multi-Year Plan for Pennsylvania's Mental Retardation Service System, which accelerated change by prompting an examination of county policies regarding services for people with developmental disabilities.
Pennsylvania used information gained from the three pilot projects to develop its Home and Community Based Services waiver to the federal Centers for Medicare & Medicaid that became effective July 1, 1999. It allowed Pennsylvania to provide greater flexibility in living arrangements and service delivery.
Pennsylvania reported the following county results:
- Allegheny County: Independent support coordination agencies designed an assessment tool to determine provider rates according to levels of need (using such factors as living arrangements and medical needs), which 33 agencies tested with 69 individuals.
- Blair County: The county designed and implemented a process to transfer funds from the county or from its contracted providers to create individual budgets for 21 individuals, who also utilized person-centered planning to develop support plans.
- Lehigh County: Through the creation of an individual purchasing process that uses vouchers, 95 individuals selected and purchased employment-related and/or day services.