What Does OPWDD Pay For in New York?

If someone in your family has a developmental disability, you may have heard that OPWDD can help pay for services. The next question is usually: What does OPWDD actually cover?

The answer goes far beyond basic Home Care. New York’s Office for People With Developmental Disabilities supports a broad range of services designed to help eligible children and adults live more independently, participate in their communities, work, develop daily living skills, and remain safely at home when possible.

Most OPWDD services are funded through Medicaid, although New York also funds certain services separately. The exact services available to one person depend on OPWDD eligibility, Medicaid and waiver enrollment when required, assessed needs, the person’s Life Plan, and service authorization.

Quick Answer: What Does OPWDD Pay For?

Depending on eligibility and the individual’s approved service plan, OPWDD-funded supports can include:

• Community Habilitation
• Respite services
• Day Habilitation
• Supported Employment and employment training
• Prevocational services
• Residential supports
• Assistive technology
• Home and vehicle modifications
• Behavioral supports
• Family education and training
• Support Brokerage
• Fiscal Intermediary services
• Individual Directed Goods and Services for qualifying Self-Direction participants
• Community Transition Services
• Certain housing and independent-living supports

New York’s official HCBS Waiver guidance lists many of these services as part of the OPWDD Comprehensive Home and Community-Based Services Waiver. You can review the official OPWDD HCBS service list.

How Much Does New York Spend on OPWDD Services?

OPWDD is a major statewide disability services system. According to OPWDD’s 2025 Strategic Plan Annual Report, more than 135,000 New Yorkers received OPWDD support in 2024.

OPWDD reported approximately $10 billion in Medicaid spending for services during 2024, including:

Service Category	2024 Medicaid Spending
Certified Residential Services	About $5.9 billion
Day Programs and Employment Supports	About $1.8 billion
Community Habilitation	About $823 million
Care Coordination	About $517 million
Respite	About $372 million
Other Supports and Services	About $509 million

Those figures show the size of the overall system. They do not represent an individual person’s budget or guarantee that one participant will receive any particular service or dollar amount.

Community Habilitation: Support at Home and in the Community

For many families, Community Habilitation is one of the most relevant OPWDD services.

Community Habilitation provides individualized support designed to help a person develop or maintain skills needed to live more independently. Services are connected to goals in the person’s Life Plan and can take place at home or in community settings.

Community Habilitation can include support with areas such as:

• Daily living and adaptive skills
• Community participation
• Building relationships and social skills
• Travel and transportation skills
• Money management
• Personal care when included as part of the habilitation service
• Self-advocacy and decision-making
• Developing greater independence

Unlike ordinary custodial care, Community Habilitation is built around specific person-centered goals rather than simply having someone present in the home.

Families looking specifically for this type of developmental disability support can learn more on our OPWDD Home Care page.

Does OPWDD Pay for Respite Care?

Yes. Respite is an important OPWDD service designed to provide temporary relief for the people who normally provide care.

Respite may be provided in or outside the home and may be available during the day, evenings, or overnight, depending on the approved service and provider.

The purpose is not simply convenience. Respite can reduce caregiver stress and help families continue supporting a person with a developmental disability at home.

Official information is available on the OPWDD Respite Services page.

Day Habilitation and Community Programs

OPWDD also funds Day Habilitation for eligible individuals who benefit from structured activities and support outside the home.

Day Habilitation can focus on communication, socialization, adaptive skills, travel, community involvement, self-advocacy, and developing greater independence.

Some programs operate from a certified site, while others provide activities directly in community settings.

Employment and Job Support

For people who want to work, OPWDD can fund several types of employment support.

• Prevocational Services: Help develop workplace skills and prepare for employment.
• Supported Employment: Provides ongoing assistance for people who need support obtaining or maintaining competitive employment.
• Employment Training Program: Can provide paid internship opportunities while an individual builds the skills needed for employment.
• Pathway to Employment: Helps individuals explore their employment goals and determine what support they may need.

These programs can be especially important for teenagers transitioning into adulthood and for adults seeking greater independence through employment.

Does OPWDD Pay for Home Modifications and Assistive Technology?

Potentially. The OPWDD Comprehensive HCBS Waiver includes Assistive Technology, Environmental Modifications, and Vehicle Modifications for qualifying individuals when the support is authorized and connected to the person’s assessed needs.

Examples of Environmental Modifications may include physical changes that help someone safely enter, leave, or function within their home, such as accessibility modifications.

Assistive Technology can include approved devices or technology that help a person maintain independence or perform tasks they otherwise could not perform as safely or independently.

Vehicle Modifications may be considered when approved modifications are necessary to help the person access the community.

These are not automatic benefits or unrestricted cash allowances. The support must go through the applicable assessment, authorization, and approval process.

Can OPWDD Help With Housing?

OPWDD supports several living arrangements based on an individual’s needs and goals.

• Living with family while receiving community supports
• Independent apartments or homes with appropriate services
• Housing subsidies for certain eligible individuals
• Live-in caregiver arrangements
• Paid Neighbor supports
• Family Care homes
• Certified residential settings such as group homes when a higher level of support is needed

The appropriate housing option depends heavily on the person’s age, needs, independence goals, living situation, and approved services.

What Does OPWDD Self-Direction Pay For?

Self-Direction is not a separate disability benefit or a check issued directly to a family. It is a way for an eligible OPWDD participant to have greater control over how certain authorized services are arranged.

OPWDD describes Self-Direction as giving participants greater flexibility over their supports, including choosing staff, schedules, and how certain authorized services are delivered.

Depending on the type of Self-Direction selected, a person may have Employer Authority, Budget Authority, or both.

Certain services such as Community Habilitation, Respite, and Supported Employment can be self-directed under applicable OPWDD rules. Budget Authority can also involve services and supports such as Individual Directed Goods and Services, Support Brokerage, and Fiscal Intermediary services.

Can a Family Member Be Paid Through OPWDD?

Possibly, but Self-Direction does not automatically mean that any relative can become a paid worker.

Whether a particular relative can be hired depends on the authorized service, Self-Direction arrangement, provider or Fiscal Intermediary requirements, employment rules, and the relationship between the worker and the person receiving services.

Through the OPWDD provider pathway we currently support, certain extended relatives such as siblings, cousins, and other qualifying family members may be considered. Parents of adult children and legal guardians are not eligible to be paid caregivers through this pathway.

That is why we screen the caregiver relationship before sending a family through the full application process.

What Are Individually Directed Goods and Services?

Individual Directed Goods and Services, commonly called IDGS, are available to eligible HCBS Waiver participants who use Self-Direction with an approved budget.

IDGS can provide flexibility for certain approved goods and services that address an individual’s needs and Life Plan goals when the expense meets OPWDD and Medicaid requirements.

It is not a general spending account. Individual purchases and services must meet program rules, and the Fiscal Intermediary plays an important role in administration and payment.

Does Everyone With OPWDD Eligibility Receive All These Services?

No. Being found eligible for OPWDD does not automatically authorize every available service.

The individual service package is based on the person’s needs, goals, living situation and applicable assessments. Services are incorporated into the person’s Life Plan and must go through the appropriate authorization process.

For many Medicaid-funded OPWDD services, the individual must also be eligible for Medicaid and enrolled in the OPWDD HCBS Waiver.

You can learn more about the general steps in our Home Care and program application process page.

Frequently Asked Questions About What OPWDD Covers

Does OPWDD pay cash directly to families?

Generally, OPWDD does not simply issue unrestricted cash payments to a family. Most OPWDD services are funded through Medicaid and provided or administered through authorized providers, Fiscal Intermediaries, and other approved service arrangements.

Does OPWDD pay for someone to help at home?

Yes, qualifying services can provide support in the home. Community Habilitation is one major example and can include skill development, community integration, supervision, and certain personal care supports when those activities are part of the authorized habilitation service.

Does OPWDD cover respite for parents and caregivers?

OPWDD offers respite services designed to give unpaid caregivers temporary relief. The type, location, and amount of respite depend on the person’s authorized services and provider availability.

Does OPWDD pay for autism services?

Autism spectrum disorder can be a qualifying developmental disability, but diagnosis alone does not automatically establish OPWDD eligibility or authorization for a particular service. OPWDD separately determines eligibility and service needs.

Does OPWDD pay for Home Care?

OPWDD funds several services that can be delivered in a person’s home or community, including Community Habilitation and Respite. These services differ from standard Medicaid PCA Home Care and are designed specifically to meet developmental disability needs and person-centered goals.

Does someone need Medicaid for OPWDD services?

Most OPWDD services are funded through Medicaid. Enrollment in Medicaid is required for the OPWDD HCBS Waiver and many other major OPWDD services, although OPWDD also has some state-funded supports.

Can a child receive OPWDD services?

Yes. OPWDD serves eligible children and adults. The services available to a child may differ from those available to an adult and must be based on the child’s individual needs and authorized plan.