Adult Community Autism Program (ACAP)

The Adult Community Autism Program, ACAP, is a program in Pennsylvania that provides physical, behavioral, and community services to adults with an autism spectrum disorder. ACAP is one of two programs in Pennsylvania specifically designed to help adults with Autism Spectrum Disorder participate in their communities in the way that they want to, based upon their identified needs.

Eligibility Criteria:

  • Be 21 years of age or older
  • Be eligible for Medical Assistance
  • Have a diagnosis of Autism Spectrum Disorder
  • Be certified as requiring services at the level of an Intermediate Care Facility, ICF
  • Not be enrolled in a Medical Assistance Home and Community Based Waiver program at the time of enrollment
  • At the time of enrollment, be able to live in a community without sixteen (16) or more awake paid and unpaid staff and supervision hours per day without presenting a danger to self or others or a threat to property
  • Not exhibit levels of extremely problematic behaviors that would present a danger to self or others or threat to property
  • Have three or more substantial functional limitations in the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, or capacity for independent living
  • Reside in the service area at the time of application
  • Not be enrolled in a Medical Assistance managed care organization at the time of enrollment in the plan
  • Not be enrolled in the Health Insurance Premium Payment (HIPP) Program at the time of enrollment in the Plan
ACAP is currently available in four counties - Dauphin, Cumberland, Chester, and Lancaster.

To Apply:

Call the Bureau of Autism Services at 1-866-539-7689 and select option 2.

Resources:

Comparison of Medicaid Programs that Serve Adults with Autism Spectrum Disorders (ASD) (pdf download)

Adult Autism Waiver - ACAP Comparison (pdf download)

If you can't find the information you are looking for here, please call the Bureau of Autism Services toll free at 1-866-539-7689 or email us at: RA-acap@pa.gov.

You can also contact the ACAP service provider  by calling 717-412-7400 or 1-877-501-4715, Monday through Friday, 9 a.m. to 5 p.m. to speak to someone directly about ACAP services, or visit their website at Keystone Autism Services - Adult Community Autism Program .

Frequently Asked Questions:

FAQs ACAP Application Process

How do I request an application?

All application requests must be made through the Bureau of Autism Services’ toll free number at 1-866-539-7689. Applications may not be requested by email and are not available on-line. Call the toll free number and leave a message with the following information:

  • Name of person who wishes to apply
  • Daytime telephone number
  • Address
  • County of residence
  • If you are calling on behalf of the person who wishes to apply, also leave your name and daytime telephone number.

NOTE:

Keystone Autism Services cannot accept requests for applications for ACAP.

What happens after I request an application? What are the steps and the timeline in the application process?

After the request for an application is made: Someone from the Bureau of Autism Services, BAS, will call to ask general information questions. If there are still openings in the program, an application will be mailed. If the program is full, the Bureau of Autism Services will send out applications as openings occur, in the order the calls were received.


What will the application packet include? What paperwork will I need to fill out?

The general application will initially be mailed. If basic eligibility requirements have been met, additional forms, including assessments, will be given to you or your physician to complete. Staff from the Bureau of Autism Services, BAS and Keystone Autism Services, KAS are available to answer questions and help applicants with the forms. Details about this process are below.

After you receive the application: You have 15 days to return the application to the Bureau of Autism Services. If it isn’t returned on time, we will assume you are no longer interested in applying for ACAP. If you do become interested again at a later date, you will have to call the Bureau of Autism Services and start the application process from the beginning. If you have questions about completing the application, please call 1-866-539-7689 and someone from the Bureau of Autism Services or Keystone Autism Services will return your call and assist you in completing the application.

After BAS receives your completed application: The Bureau of Autism Services will review the application to determine if basic eligibility requirements such as age and residency are met. If the requirements are met, someone from the Bureau of Autism Services’ clinical staff will schedule a time to come to your home to do the initial assessments and gather information. If you do not meet the basic eligibility requirements, a denial letter will be sent.

Functional eligibility is part of the eligibility process for ACAP. Who completes the functional eligibility assessment and where?

This assessment is completed in person by trained staff contracted through the Bureau of Autism Services. The location is determined jointly with the applicant. Generally, the individual’s home is preferred.

Medical Assistance: If you do not currently have Medical Assistance, you must also submit a Medical Assistance application to the County Assistance Office. If you are not eligible for Medical Assistance, you will receive a Medical Assistance denial letter from your County Assistance Office. If you receive a denial letter from the County Assistance Office, the ACAP application process will not continue.

After the assessments are completed: The Bureau of Autism Services will decide if the application process should continue based on the assessments, information gathered, financial eligibility and ACAP requirements.

  • If the application process is to continue, your application will be sent to Keystone Autism Services, KAS.
  • If the application process is not to continue, you will receive a denial letter from the Bureau of Autism Services.


If the individual meets functional eligibility after the assessment:

  • You will be asked to have two forms completed by your doctor: the Medication Evaluation form, sometimes called the MA 51 form; and the Confirmation of Diagnosis form.
  • You will be asked to have physical, behavioral and/or school records sent to the Bureau of Autism Services.

After Keystone Autism Services receives your application: Keystone Autism Services will call you to set up a meeting to gather additional information and complete other assessments. Keystone Autism Services will make a recommendation to the Bureau of Autism Services about your eligibility for ACAP. The Bureau of Autism Services will review Keystone Autism Services' recommendation and make the final decision about your eligibility. If you are not eligible for ACAP, you will receive a denial letter from the Bureau of Autism Services.

After you are found eligible for ACAP: Keystone Autism Services will meet with you to develop your initial Individual Service Plan, ISP. If you agree to enroll, you will start ACAP the first day of the next month. You must disenroll from any Medical Assistance Health Choices program (ACAP will provide medical services) and any home and community based waiver program that you are enrolled in, if any, at the time of enrollment in ACAP. Once you enroll, Keystone Autism Services will meet with you again to develop a new Individual Services Plan, ISP based on more detailed assessments.

How do I decide whether to apply for a waiver for people with intellectual disabilities, the Adult Community Autism Program or the Adult Autism Waiver?

For an overview of Pennsylvania programs for adults with developmental disabilities, please reference the Comparison of Medicaid Programs that Serve Adults with Autism Spectrum Disorder (ASD) (link below). This chart compares the Adult Autism Waiver and the ACAP program with other Pennsylvania programs where adults with ASD may be eligible. For a more specific side-by-side look at the Adult Autism Waiver and the ACAP program, please see the link below to review the Adult Autism Waiver/ACAP Program Comparison Chart, also available at the Bureau of Autism Services Virtual Training and Resource Center or you may call the Bureau of Autism Services at 1-866-539-7689 and we will mail the charts to you.

Comparison of Medicaid Programs that Serve Adults with Autism Spectrum Disorders (ASD)

Adult Autism Waiver - ACAP Comparison

FAQs ACAP General Information

The Adult Community Autism Program, ACAP, is one of two programs in Pennsylvania specifically designed to help adults with autism spectrum disorder, ASD, participate in their communities in the way that they want to, based on their identified needs. Below are responses to some frequently asked questions regarding general information about the Bureau of Autism Services Adult Community Autism Program; if you can’t find the information you are looking for here, please call 1-866-539-7689 or email us at: RA-acap@pa.gov.

You can also contact Keystone Autism Services (the ACAP service provider) at 717-412-7400 or toll free at 1-877-501-4715, Monday through Friday, 9 a.m. to 5 p.m. to speak to someone directly about ACAP services, or visit their website at www.keystoneautism.org or Keystone Autism Services - Adult Community Autism Program

What is the Adult Community Autism Program (ACAP)?

The Adult Community Autism Program, ACAP, is like a managed care program in Pennsylvania that provides physical, behavioral, and community services to adults with an autism spectrum disorder.

What are the goals of the Adult Community Autism Program?

  • Increase a person's ability to care for themselves
  • Decrease family/caregiver stress
  • Increase quality of life for both the person and the family
  • Provide specialized supports to adults with an autism spectrum disorder based on need
  • Help adults with an autism spectrum disorder reach their employment goals
  • Support more involvement in community activities
  • Decrease crisis episodes and psychiatric hospitalizations
  • Support development of peer and social networks

What are some of the key features of ACAP?

  • Designed to meet the needs of adults with autism spectrum disorder
  • Administered at the state level directly by the Bureau of Autism Services
  • Does not use IQ as an eligibility factor
  • Providers required to complete autism-specific training and meet standards
  • Clinical and behavioral support, as well as technical assistance, is available to enrolled providers
  • Service planning and measures of success based on individual goals
  • Services based on proven approaches to help participants realize these goals

What are some other important features of ACAP?

  • Becomes the participant's health plan
  • Includes and coordinates physical, behavioral and community support services
  • Currently available in four counties only (Cumberland, Dauphin, Chester, and Lancaster)
  • Support greater participation in community activities
  • Keystone Autism Services and their network of providers (e.g., primary care physicians, dentists), provide most of the services
  • Participants cannot require 16 or more hours of awake support, at intake

How many adults can be served in ACAP?

ACAP can serve 146 adults.

Where is ACAP offered?

ACAP is offered in Dauphin, Lancaster, Cumberland and Chester counties.

How were these counties chosen?

A Statewide Request for Information was sent out and the Bureau of Autism Services chose a provider (Keystone Autism Services) based on the response to the request. The provider's response listed the counties that they could serve, which included Dauphin, Cumberland, Lancaster, and Chester.

Does the Bureau of Autism Services plan to expand the ACAP to include other counties?

Expansion of ACAP across the state is dependent on available resources.

What role does the individual with an ASD play in the Adult Community Autism Program?

The participant is at the center of all service planning and service delivery. During the service planning process ACAP participants share their goals, likes and dislikes to help determine what services they will receive. Once enrolled in ACAP, the participant is actively involved in the services they receive and their ongoing services plan.

What role do families play in the Adult Community Autism Program?

Families have the opportunity to provide information during the service planning process and to provide feedback about the program. Decreased family stress is one goal of the program and is assessed each year.

FAQs ACAP Eligibility

Who is eligible for the Adult Community Autism Program?

In order to be eligible for ACAP, a person must meet the following criteria:

  • Be 21 years of age or older
  • Be eligible for Medical Assistance
  • Have a diagnosis of an autism spectrum disorder
  • Be certified as requiring services at the level of an Intermediate Care Facility, ICF
  • Not be enrolled in a Medical Assistance Home and Community Based Waiver program at the time or enrollment
  • At the time of enrollment, be able to live in a community without sixteen (16) or more awake paid and unpaid staff and supervision hours per day without presenting a danger to self or others or a threat to property
  • Not exhibit levels of extremely problematic behaviors that would present a danger to self or others or threat to property
  • Have three or more substantial functional limitations in the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, or capacity for independent living
  • Reside in the service are at the time of application
  • Not be enrolled in a Medical Assistance managed care organization at the time of enrollment in the plan
  • Not be enrolled in the Health Insurance Premium Payment (HIPP) Program at the time of enrollment in the Plan

Can someone with a diagnosis of an intellectual disability enroll in the Adult Community Autism Program?

Yes, as long as they meet all the eligibility criteria listed above.

If I am already receiving services, can I still apply for the Adult Community Autism Program?

Yes. You can request an application while receiving services from another waiver program, but if you enroll in ACAP you will have to disenroll from the other waiver program. Timelines are coordinated however, so that you will continue to receive services from the old program until ACAP Services start.

If someone needs or has been receiving 16 or more hours of awake supports in their home, are they still eligible for the Adult Community Autism Program?

Individuals who need 16 or more hours of awake supports right away are not eligible to enroll in ACAP. If the situation changes after a person is enrolled, however, he/she can receive more hours of awake supports if that level of support becomes medically necessary.

Can a participant be disenrolled from the Adult Community Autism Program for any reason?

There are very specific reasons as to why a person may be disenrolled from ACAP. The Bureau of Autism Services is the only authority that can disenroll a participant.

If eligibility starts at age 21, how far in advance should I apply for the Adult Community Autism Program, so that services can be in place when I turn 21?

Individuals can request an application at any time. However, applications will be denied if they are received prior to 90 days before the applicant’s 21st birthday.

If I am found eligible for the Adult Community Autism Program, how long can I remain in the program?

There is no time limit or maximum age limit. Participants are assessed each year to ensure they continue to meet all eligibility requirements.

FAQs ACAP Services

What types of services does the Adult Community Autism Program offer?

All physician services (including emergency services provided by a physician, psychiatric services, and direct access to a woman’s health specialist to provide women’s routine and preventive health care services)

  • Certified registered nurse services
  • Intermediate care facility (ICF)
  • Non-emergency medical transportation to services covered under the Medical Assistance program
  • Nursing facility services
  • Optometrists' services
  • Chiropractors' services
  • Audiologist services
  • Dentist services
  • Health promotion and disease prevention services
  • Medical supplies and durable medical equipment
  • Outpatient psychiatric clinic services
  • Respiratory Services
  • Targeted case management
  • Assistive technology
  • Family counseling
  • Homemaker/chore services
  • Pre-vocational services
  • Respite
  • Supports coordination
  • Prosthetic eyes and other eye appliances
  • Hospice services
  • Mental health crisis intervention services
  • Behavioral support (similar to Behavioral Specialist Services in the Adult Autism Waiver
  • Community transition services
  • Crisis intervention services
  • Adult day habilitation
  • Environmental modification
  • Habilitation
  • Non-medical transportation
  • Personal assistance services
  • Residential support (similar to residential habilitation)
  • Supported employment
  • Visiting nurse
  • Additional services determined necessary
  • Physical, occupational, vision and mobility, and speech therapies (group and individual)
Other services covered under Medical Assistance: Inpatient facility, ambulatory surgical center, home health care, clinic-including family planning, transportation, renal dialysis center, laboratory, x-ray clinic, pharmacy.

Are the services equivalent to, or more limited, than those provided under the Adult Autism Waiver?

The comparison chart Comparison of Medicaid Programs that Serve Adults with Autism Spectrum Disorder (ASD), (click link below) shows the differences between ACAP and the Adult Autism Waiver services, or call BAS at 1-866-539-7689 and BAS will mail the chart to you.

Comparison of Medicaid Programs that Serve Adults with Autism Spectrum Disorders (ASD)

Also look at the link below to see a comparison of just the two adult programs, the Adult Autism Waiver and the Adult Community Autism Program (ACAP).

Adult Autism Waiver - ACAP Comparison

How are individual services determined for participants in the Adult Community Autism Program?

Individual needs and interests are used by the participant and their team to develop the Individual Service Plan (ISP). The ISP team includes the Supports Coordinator, a Behavioral Health Specialist, the participant, the participant’s legal guardian (if applicable), and anyone else the individual or legal guardian chooses to have involved.

The ISP specifies the services a participant will receive, the reason(s) those services are needed, and the goals and objectives of the services.

Is there a maximum amount (cap) of ACAP-funded services a participant can receive?

No, services are based on your Individual Service Plan (ISP).

Do services change over time? How?

Services in the Individual Service Plan (ISP) will change if the needs of the individual have changed. This is determined at the annual review or at other points during the year if service changes are needed to better support the individual.

Does the Adult Community Autism Program pay for transportation?

Non-medical and non-emergency medical transportation to services covered under the Medical Assistance Program are available through ACAP, when listed on the Individual Service Plan (ISP).

Does the Adult Community Autism Program pay for housing?

No. The Social Security Act specifies that room and board cannot be paid for in ACAP or any federally-funded waiver program.

Is it true that an ACAP participant can only receive 8 hours per day of services?

No, that is not correct. A participant’s Individual Service Plan (ISP) will list the number of hours needed to meet the person’s needs.

If someone needs or has been receiving 16 or more hours of awake supports in their home, can their needs still be met under the Adult Community Autism Program?

Individuals who need 16 or more hours of awake supports right away are not eligible to enroll in ACAP. However, if the situation changes after a person is enrolled, he/she can receive more hours of awake supports if that level of support becomes medically necessary.

How does the Bureau of Autism Services monitor program quality?

Monitoring of the program is an ongoing process throughout the year and includes the following: reports, on-site reviews, interviews with participants, an annual quality review by an outside agency, quality performance outcome measures, and oversight of provider qualifications (including training). Participants are interviewed to find out if they are getting the services in their plan, if they are happy with their services, and if they are treated well by their providers. BAS also checks to make sure participants are healthy and safe. Families can also help with monitoring quality.