DDP Children's Autism Waiver (CAW) Overview
In January 2009, the Montana Developmental Disabilities Program (DDP) received approval from the Centers for Medicare and Medicaid Services for a Medicaid waiver (or funding source) specifically designed to serve young children aged 15 months through seven years who are diagnosed with Autism Spectrum Disorder and who have deficits in adaptive behaviors. The waiver provides a means to reimburse for services to eligible children that are based on Applied Behavioral Analysis (ABA).
The children’s autism services funded under this waiver are designed to provide intensive early intervention training using applied behavioral analysis training techniques which focus on improving skills in receptive and expressive communication, social interaction and activities of daily living and those which focus on reducing inappropriate or problematic behaviors often associated with autism. The services will be provided to eligible selected children within the following parameters:
- Program Design and Monitoring Specialists will design, monitor and modify the formal training plan. The training plan will govern the activities of the autism trainer and will be based on the specific assessed needs of the individual child.
- Services to children in this waiver will not exceed three years in duration, so that the Developmental Disabilities Program can use this service model to serve as many qualifying children as possible.
- Eligible children aging out of the waiver after 3 years will be enrolled in the 0208 Comprehensive Services DD Waiver.
- A child’s continued eligibility for placement in the waiver is subject to annual re-determinations of waiver eligibility, based on the child meeting the waiver-specific Level of Care criteria.
Eligibility for waiver services
- Eligible children must be diagnosed with Autism Spectrum Disorder (ASD) and have training needs based on meeting the required criteria for Vineland II adaptive behavior assessment scores.
- Eligible children are those diagnosed sometime between the ages of 15 months through their fourth birthday.
- Eligible children will be placed on a waiting list for services under this waiver and selected by computer generated random drawing as openings become available.
- Children will transition out of this waiver prior to their eighth birthday.
- A child eligible for services under this waiver may or may not also have a diagnosis of mental retardation.
- The parents of any child receiving services under this waiver must agree to follow through with assigned objectives as outlined in the plan of care as a precondition of enrollment and continued participation in the waiver.
Children’s Autism Waiver services
Services funded under this waiver include case management, program design and monitoring, children's autism training, and limited ancillary services. Ancillary supports are limited to a cumulative maximum of $4,000 annually and may include one or more of the following services: adaptive equipment/environmental modifications, respite, transportation, individual goods and services (limited to $2,000) and speech therapy, occupational therapy or physical therapy not otherwise covered under the Montana State Medicaid Plan.
Service costs are expected to average approximately $45,000 per child per year (2008 dollars), for a maximum of three years per child. Funding currently available is projected to serve an estimated 55 children per year in the first three years of the waiver
DDP child and family service providers have provided services to children with autism for many years. Until now, however, the State of Montana has not offered a systematic, comprehensive treatment approach designed to maximize the developmental potential of very young children with autism, or ASD. This waiver will give Montana children diagnosed with ASD an optimal opportunity to enjoy a higher quality of life.