Autism spectrum disorder (ASD) is a developmental disability affecting how a person communicates, interacts, and behaves. According to the Centers for Disease Control and Prevention (CDC), about one in 54 children in the United States has ASD. ASD can significantly impact the lives of children and their families, requiring specialized services and supports to meet their needs.
One of the ways that families can access these services and supports is through Medicaid waivers. Medicaid waivers allow states to provide home and community-based services (HCBS) to people who would otherwise qualify for institutional care, such as nursing homes or hospitals. HCBS is designed to help people live as independently as possible in their homes and communities while saving costs for the state and federal governments.
In this article, we will discuss one of the Medicaid waivers available in Kansas: the Autism Waiver, which provides support and training to parents of children with ASD, ages 0-5 years, who meet a hospital level of care. This waiver aims to help children with ASD remain in their family homes and avoid institutionalization.
The Autism Waiver is a program approved by the Centers for Medicare & Medicaid Services (CMS) in 2022 and administered by the Kansas Department for Aging and Disability Services (KDADS). The waiver operates with a concurrent 1115 authority, meaning it is part of a broader demonstration project that tests innovative approaches to delivering healthcare services.
This waiver aims to provide early intervention services to children with ASD, ages 0-5 years, who meet a hospital level of care. Early intervention services are intended to improve the developmental outcomes of children with ASD and reduce the need for more intensive services later in life. The waiver also aims to provide support and training to parents of children with ASD, to help them cope with the challenges and stressors of raising a child with ASD.
The target population of this waiver is children with ASD who are at risk of being placed in an institution due to their behavioral or medical needs. The waiver serves up to 500 children at any time, with a waiting list for those interested in receiving services. The waiver is limited to three years per child, but an additional year may be granted in some cases based on a review process.
To be eligible for the Autism Waiver, a child must meet the following criteria:
Parents or guardians must complete an application form and submit it to KDADS to apply for the waiver. Once the application is received and the child meets the criteria, the parent or guardian will receive a letter about whether their child has been put on the Proposed Recipient List and where they are on the list. When a space on the waiver becomes available, KDADS will contact the family and refer them to a Managed Care Organization (MCO) for enrollment.
The Autism Waiver provides four types of services and supports:
One of the questions many caregivers have is whether they can get paid for caring for their loved ones. Unfortunately, the Autism Waiver does not offer a self-direction option that allows parents or guardians to hire and pay themselves or other family members as caregivers.
There was an announcement in June 2022 that the Autism Waiver would have a self-directed option for respite services, effective from July 1, 2022. However, this option was suspended later that month, pending the Centers for Medicare and Medicaid Services (CMS) approval.
Currently, there is no self-directed option for respite services under the Autism Waiver. The only self-directed service available under the Autism Waiver is financial management services.
If you are interested in determining eligibility for caregiver compensation under another Medicaid waiver, please fill out this form, and we will get back to you as soon as possible. We are here to help you navigate Medicaid and caregiving's complex and confusing world.
