8217 Waiver for Children with Autism (HCBS/AU) - This waiver serves children under the age of 6 years old who are determined to meet functional eligibility criteria of an Autism Spectrum Disorder (ASD) and would otherwise be at risk of placement in a state mental health hospital. Participation under this waiver shall be limited to a maximum of three years. A one year extension may be approved by the Autism Review team if the child has demonstrated continued improvement.
Individuals seeking coverage under this waiver will file a preliminary functional eligibility application with the waiver program manager. A limited number of children will be served under this waiver. Those children qualifying for an opening will be referred by the program manager for a screening assessment. A wait list will be maintained for those requesting services when no openings exist.
Functional Eligibility Specialists contracted across the state will complete the screening assessments for the waiver. The families of children who meet the clinical autism eligibility criteria will be offered a choice between state mental health hospitalization or HCBS services. If HCBS services are chosen, Autism Specialists will be responsible for developing and maintaining an Individual Behavioral Program (Plan of Care) including the cost of services to meet the child's and family's needs.
A level of care code of AU must be placed on the LOTC screen along with an HC living arrangement code and the appropriate effective dates.
NOTE: Children who are eligible under the waiver and have received SSI benefits in an institutional setting are potentially eligible for a $30/month SSI benefit as though they were institutionalized. The family is to be referred to Social Security if the child meets all waiver criteria and will be Medicaid eligible.