Adult Community Autism Program (ACAP)

The Adult Community Autism Program, 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.

Below are responses to some frequently asked questions regarding general information about the Adult Community Autism Program. 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.

General Program Questions

What is the Adult Community Autism Program (ACAP)?

The Adult Community Autism Program, ACAP, is a managed care program in Pennsylvania. It is a fully integrated, comprehensive system of care that includes physical health, behavioral health, social, recreational, transportation, employment, therapeutic, educational, crisis, in-home support, and independent living services.
Benefits of the ACAP model include:
  • Person-Centered ISP – assessment based, outcome driven
  • Behavior Support Plan (if needed)
  • Crisis Intervention Plan (if needed)
  • One-stop shop – continuity, flexibility, integration and coordination of services
  • Team approach – with the center being the participant and the family/caregiver
  • Based on the wants and needs of the participant
  • Fully integrated – continuity of care
  • More efficient provider communication and coordination of care.
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 autism spectrum disorder based on need
  • Help adults with 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 other important features of ACAP?

  • Providers a holistic approach and integration of physical health, behavioral health as well as home and community based supports.
  • Becomes participant's health plan
  • 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

Where is ACAP offered?

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

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.

How many adults can be served through ACAP?

ACAP can serve 158 adults (including reserved capacity). 

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, before you enroll in ACAP, you will have to dis-enroll 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.

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?

At the participant’s request, 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. However, the participant is at the center of his or her planning and can determine who is part of his or her team.
 

ELIGIBILITY REQUIREMENTS

Who is eligible for the Adult Community Autism Program?

In order to be eligible for ACAP, a person must be age 21 or older, a U.S. citizen or qualified alien, reside in the service area at the time of enrollment, and meet certain diagnostic, functional and financial eligibility criteria (listed below).

Diagnostic Criteria:

Have a diagnosis of Autism Spectrum Disorder (ASD) using the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) applicable at the time of the diagnosis.
 
Functional Eligibility:
Must have substantial functional limitations in three or more of the major life activities listed below:
  • self-care
  • understanding and use of receptive and expressive language
  • learning
  • mobility
  • self-direction
  • capacity for independent living

Additional eligibility criteria:

  • Be eligible for Medical Assistance
  • 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
  • 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 eligibility starts at age 21, how far in advance should I apply for the Adult Community Autism Program?

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.

Can I apply for more than one Pennsylvania waiver or the Adult Community Autism Program (ACAP) at the same time, or will applying for one make me ineligible for the other ones?

You may apply for more than one waiver or the Adult Community Autism Program at a time, including the Adult Autism Waiver. However, individuals may not enroll in more than one.

What happens to my waiting list status for the Person/Family Directed Support waiver or the Consolidated waiver if I enroll in ACAP?

An individual can be on a waiting list for another program while receiving services from ACAP. Applicants should discuss their individual situation with program staff from the Bureau of Autism Services and their county office.
 

APPLICATION PROCESS

How do I request an application?

There are two ways to request an application for Pennsylvania’s adult autism programs: by phone, or online. Applications may not be requested via email or through this website.

To request an application by phone:

Call 1-866-539-7689 (toll free number) and follow the prompts to select the Adult Autism Waiver or the Adult Community Autism Program. Leave a message with the following information:
  • Name of person who wishes to apply
  • Telephone number
  • Address
  • County of Residence
  • If you are calling on the behalf of the person who wishes to apply also leave your name and daytime phone number.

To request an application online:

Visit the Information Referral Tool (IRT): http://www.dhs.pa.gov/irt
  • The IRT asks a few basic questions and will link individuals who indicate an interest in Autism Services to the COMPASS website.
  • Once connected to COMPASS, select “Submit a Referral.”
  • After answering some additional questions, the referral is submitted electronically to the Bureau of Autism Services

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 is 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 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 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.

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

Functional Eligibility is determined by BAS staff. The location of the assessment 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. You must meet the financial eligibility criteria for Medical Assistance to enroll in ACAP. If you are employed, you may still be eligible for Medical Assistance under the Medical Assistance for Workers with Disabilities (MAWD) program. The County Assistance Office will be able to assist you in this area.

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.

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 dis-enroll 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.

Can a participant be dis-enrolled from the Adult Community Autism Program for any reason?

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

Available 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
  • Assistive technology
  • Family Support
  • Homemaker/chore services
  • Career Planning 
  • 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
  • Home and/or Vehicle modifications
  • Community Support 
  • Non-medical transportation
  • Personal assistance services
  • Residential Habilitation
  • Supported employment
  • Visiting nurse
  • Additional services determined necessary
  • Specialized Skill Building (1/1/18)
  • 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.

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?

While the Residential Habilitation service in the Adult Autism Waiver does include a housing component, it is not designed as a housing alternative for waiver participants who do not need round-the-clock supervision. In order to receive Residential Habilitation services, a waiver participant must show this need during an annual assessment when the service plan is developed. Residential Habilitation is designed for participants who are unable to live at home, either alone, with family or with others, because they require awake support staff 24 hours a day, seven days a week. The intent of this service is to ultimately reduce the participant’s need for this degree of support by improving the participant’s capacity to perform activities of daily living (e.g., bathing, dressing, eating) and instrumental activities of daily living (e.g., communication, shopping, housework). The goal is for the participant to eventually move to a natural setting in the community. The Adult Autism Waiver does not pay for housing outside of the Residential Habilitation service.
 
A participant receiving Residential Habilitation services must contribute 72 percent of his or her monthly Supplemental Security Income (SSI) payment to the provider for room and board. Residential Habilitation providers in the Adult Autism Waiver must be licensed by the Department of Human Services, Office of Developmental Programs as either a Family Living Provider (Title 55 PA Code Chapter 6500) or a Community Home (Title 55 PA Code Chapter 6400).
 
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.

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.