Adult Services: What Comes After the IEP
The cliff — and how to prepare for it
When a young person turns 21 or ages out of the school system, the services and structure they relied on suddenly end. School provided a schedule, supports, and a team. Adult life does not automatically come with any of that. Knowing what is available — and starting to navigate that system before the cliff arrives — makes a significant difference.
Medicaid waiver programs in Pennsylvania
In Pennsylvania, the primary funding source for adult disability services is through Medicaid waiver programs. The Consolidated Waiver and the Community Living Waiver are the two main options for people with intellectual disabilities or autism. These waivers fund services like residential support, day programs, job coaching, behavioral support, and respite for families. Waitlists exist and can be long — apply early while a child is still in school.
Self-advocacy and supported decision-making
One of the most important goals for neurodivergent adults is having real say in their own lives. Self-advocacy means speaking up for your own needs and rights. Supported decision-making is an alternative to guardianship that allows adults to make their own decisions with the help of trusted people, rather than having those decisions made for them.
Key terms
- Medicaid waiver
- Funding program for home and community-based services.
- Consolidated Waiver
- Pennsylvania’s primary waiver for adults with intellectual disabilities and autism.
- Respite
- Temporary relief for family caregivers.
- Supported decision-making
- Making your own decisions with support from trusted helpers.
- Guardianship
- A legal arrangement giving one person authority over another; should be considered carefully.
Our perspective
Neurodivergent adults deserve lives of their own choosing — not lives managed by others. Presuming intelligence and supporting autonomy are foundational to good adult services, and to everything ND Collab stands for.