Medicaid Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder (“The Autism Waiver”)
Maryland’s Autism Medicaid Waiver is administered by the Maryland State Department of Education, under the auspices of The Department of Health and Mental Hygiene (DHMH). DHMH is Maryland’s single state Medicaid agency, providing oversight to all waivers in Maryland, including the Autism Waiver.
The Autism Waiver allows eligible children with autism spectrum disorder to receive necessary waiver services to maintain them in their home and community.
The Autism Waiver is approved to serve 900 children and is currently at capacity. However, interested individuals may request that a child be put on the Autism Waiver Registry, maintained by Spherix, by calling 1-866-417-3480. Upon registering the child, Spherix will send the parent/caregiver a letter of confirmation indicating the date that the child was placed on the Autism Waiver registry. Children who apply to the waiver are referred from the registry to MSDE in chronological order when there are waiver vacancies. It is for that reason that it is of the utmost importance for parents/caregivers to keep the confirmation letter from Spherix as documentation of the date their child was placed on the registry. Upon referral from the registry, each child must then meet all of the eligibility requirements (stated below) in order to receive Autism Waiver services.
To access waiver services, a child must meet all of the following criteria:
- The child has a diagnosis of Autism Spectrum Disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR) as 299.00 Autistic Disorder or 299.80 Pervasive Developmental Disorder Not Otherwise Specified (Including Atypical Autism).
- The child is between the ages of 1-year-old through the end of the school year that the child turns 21 years old.
- The child has an Individualized Education Program and is receiving more than 12 hours per week of special education and related services and requires a more intensive therapeutic program than other students, or the child has an Individualized Family Service Plan.
- The child is able to be served in the community with the assistance of waiver services.
The child's parent or legal representative chooses autism waiver services as opposed to ICF- MR services.
- The child has less than $2,000 in assets (savings, trust, stock, etc.).
- The child's monthly income is less than 300% of Supplemental Security Income.
- The child must meet the minimum requirements in two of three domains on the
"Determination of Eligibility for Level of Care in an Intermediate Care Facility for the
Mentally Retarded and Persons with Related Conditions (ICF-MR)" form which is completed by a licensed psychologist or certified school psychologist.
Services Covered by the Autism Waiver
- Therapeutic integration services
- Residential habilitation
- Respite care, provided on a short-term basis in the individual's home or place of residence
- Supported employment
- Environmental accessibility adaptations, including physical adaptations to the home
- Family training
- Service coordination
Autism Waiver Service Providers
Waiver service providers must be Medicaid approved and appropriately licensed or certified.
- Families of waiver participants will be eligible for waiver services that are not currently provided through local school systems, early intervention programs, or the regular state plan Medicaid.
- Health coverage for the eligible child will be provided through Medical Assistance at no cost to the family.
- Local school systems, specialized programs, and early intervention programs that become Medicaid providers will be able to seek reimbursement for some of the specialized services for which they are currently unable to bill.
- Additional children will be Medicaid eligible and receive Medicaid-covered IFSP/IEP
The Maryland State Department of Education, the local early intervention programs, and the local school systems are responsible for administering the waiver.
- The Medicaid Home and Community Based Autism Waiver Program(pdf)
- Fact Sheet: Medicaid Home and Community-Based Services Waiver for Children with Autism Spectrum Disorder (pdf)
Support Groups and Resources
Autism Society of America (ASA)
Autism Society of America – Maryland Chapters
Anne Arundel County ASA
Frederick County ASA
Harford County ASA
Howard County ASA
Montgomery County ASA
Prince George’s County ASA
The Resource Finder - A Project of Kennedy Krieger Institute
707 N. Broadway | Baltimore, MD 21205
Phone: 800-390-3372 Fax: 443-923-9317
Washington County ASA
FIAT (Families for Intensive Autism Treatment)
P.O. Box 341643
Bethesda, MD 20827-1643
Families of Children with Autism Support group (FOCAS) of Carroll County
Garrett Special Needs Children
Maryland Asperger Advocacy and Support Group
(includes support groups in Southern Maryland, Baltimore County, and Montgomery County)
Howard County Asperger’s Syndrome Parent Support Group
Additional Family Resources
Pathfinders Autism Resource Center
120 Allegheny Avenue
Towson, MD 21204
Maryland Family NET Works
The Parents’ Place of Maryland
801 Cromwell Park Drive, Suite 103
Hanover, MD 21061
Maryland Disability Law Center
1800 N. Charles St., 4th floor
Baltimore, Maryland 21201
(410) 727-6352 phone