Autism Waiver Program
The Children’s Autism Spectrum Disorders Home and Community-Based Services Waiver Program
The Office of Medicaid and the Department of Developmental Service’s Autism Division received approval from the Federal Centers for Medicare and Medicaid Services (CMS) to implement an autism services program. It receives federal matching funds for Medicaid eligible children diagnosed with an autism spectrum disorder.
This three-year model program is called the Children’s Autism Spectrum Disorders Home and Community-Based Services Waiver Program. Waiver services supplement special education services provided under IDEA (Individuals with Disabilities Education Act).
The Waiver Program is managed by the Autism Division at the Department of Developmental Service (DDS). Autism Targeted Case Managers provide oversight, technical assistance and monitoring. The Waiver Program uses a service delivery model called Participant Direction in which the parent takes the lead in designing the program and selecting service providers based on the child’s assessed level of need.
Each family develops and directs a plan of supports and services within the limits of an individual budget, up to $25,000 based on the child’s assessed needs. Families receive support in identifying, hiring and training providers who are qualified to deliver these services.
Each family receives support from a designated staff person, an Autism Support Broker, at one of the seven DDS-funded Autism Support Centers and from a Targeted Case Manager at the Autism Division of DDS. They assist families to develop and direct a plan of supports and services within the limits of an individual budget, up to $25,000 based on the child’s assessed needs.
Autism Connections is one of the seven DDS-funded Autism Support Centers.
The Waiver Program is a Medicaid program designed to provide services that help children with autism remain in their homes and actively participate in their families and in their communities, based on a service called Expanded Habilitation, Education.
The goal of Expanded Habilitation, Education is to support children who demonstrate significant deficits in the areas of behavioral, social and communication skills as a result of their autism. The service consists of one-to-one behavioral, social and communication based interventions developed and monitored by a trained clinician. These services are carried out in the child’s home and community. Expanded Habilitation includes, but is not limited to, behavioral approaches such as Applied Behavioral Analysis (ABA), Developmental and Relational Models such as Floor Time and Communication Models. Expanded Habilitation Services, Education should help children develop basic adaptive skills, elementary verbal skills and appropriate interactive and play skills.
The waiver also provides related support services such as community integration activities and respite.
The Waiver Program uses a service delivery model called Participant Direction in which the parent takes the lead in designing the program and selecting service providers based on the child’s assessed level of need. Each family receives support from a designated staff person, an Autism Support Broker, at one of the seven Department of Developmental Services-funded Autism Support Centers and from a Targeted Case Manager at the Autism Division.
In order to participate in this program, the following requirements must be met. The child:
- must have a confirmed diagnosis of an Autism Spectrum Disorder, which includes Autistic Disorder, PDD-NOS, Rhett’s Syndrome, Childhood Disintegrative Disorder and Asperger Syndrome subject to verification by the Department of Developmental Services
- has not yet reached his/her 9th birthday
- is a resident of Massachusetts
- must be found by the MassHealth agency to be eligible for MassHealth Standard coverage, based on family income. For families who have not yet applied for MassHealth, this must be done at the time of the filing of the Waiver Program Eligibility Request Form
- meets the level of care required for services in an Intermediate Care Facility for the Mentally Retarded (ICF/MR) as assessed by DDS
- must be able to be safely served in the community
An individualized planning process that results in an Autism Support Plan of Care, is used to assist each family in identifying the assessed needs of their child and the specific waiver services available to address those needs. All services have limits on their frequency and scope.
The primary service of the autism waiver program is:
- Expanded Habilitation, Education
Additional services that address other functional needs include:
- Habilitation- This service is designed to assist children in acquiring, improving, and retaining the self-help, socialization, and adaptive skills necessary to live successfully in their family home and community settings, including
- Community Integration Activities
- Activities of Daily Living/Independent Living Skill Development Services
- Family Training
- Individual Goods and Services
- Adaptive Aids
- Home Adaptation
- Vehicle Modification