Medicaid Waivers For Individuals
With Autism

Medicaid waivers are actually Home and Community-Based Services (HCBS) waivers provided by most states to persons with developmental disabilities or long-term illnesses to receive certain medical and non-medical services.

These services may help an individual at any age remain living at home or within their community instead of an institution or residential placement.

Medicaid will count family income and resources in determining eligibility. However, a person with a disability under age 21 may qualify regardless of parental income and resouces for what is known as a "waiver."

The name refers to the fact that Medicaid requirements regarding parental income are "waived" when the local Department of Social Services district is determining a disabled person's eligibility.

Two waivers used by people with developmental disabilities in New York State are the Home and Community-Based Services and Care at Home (CAH) Waivers.

Medicaid Waiver Services include:

  • Adaptive Technology
  • Environmental Modifications
  • Respite Care
  • Day and Residential Habilitation and Prevocational Services
  • Supported Employment
  • Family Education
  • Plan of care of support services
  • Consolidated Support Services
  • Live-in Companion

Family members and friends may be providers of waiver services if they meet the necessary provider qualifications. Generally, spouses and parents of minor children cannot become paid providers of waiver services.

Olmstead & HCBS Waivers

In the 1999 Olmstead v. L.C. decision, the Supreme Court declared the right of individuals with disabilities to receive public benefits and services in the most integrated setting appropriate to their needs. The Olmstead v. L.C. decision explains Title II of the American with Disabilities Act (ADA) and its regulations.

Medicaid can be an important resource to help states fulfill their obligations under ADA. The HCBS waiver program is a workable option for states to use to provide community-based long-term care, services and supports to qualified Medicaid eligible recipients.

Current Status

Forty-nine states and the District of Columbia offer services through HCBS waivers, and Arizona operates a similar program under section 1115 research and demonstration authority. There is no federal requirement limiting the number of HCBS waiver programs a state may operate at any given time. There are now approximately 290 active HCBS waiver programs in operation throughout the country.



Medicaid Waiver or HCBS Waiver Resources

The Medicaid Waivers and Demonstrations List contains information about state-specific Medicaid waiver and demonstration programs. Users can access fact sheets, copies of proposals, approval letters, and other documents related to specific programs.

HCBS.org is the site of the Community Living Exchange Collaborative Clearinghouse which shares information, tools, and resources across the many states and local entities providing services and supports reflecting the needs and preferences of persons of all ages with disabilities.

The National Association of State Medicaid Directors provides a listing of all Medicaid waivers by State on their website. Learn what services are available for your child or loved one in your state.

Home and Community-Based Medicaid Waiver Information offers the latest summary report of all HCSB waivers and a broad overview of programs organized by target groups.

The Kaiser Commission provides an online database you can use to review or compare services and benefits in other states.

Medicaid Benefits by Service

Medicaid Benefits By State

Home and Community Based Services
The Kaiser Commission on Medicaid and the Uninsured (KCMU) and The University of California at San Francisco (UCSF) provides updated data on Home and Community Based Waivers based on The Centers for Medicare & Medicaid Services (CMS) Form 372, December 2006, Table 4. "Medicaid 1915(c) Home and Community-Based Service Programs: Data Update" available at http://www.kff.org/medicaid/7575.cfm.

These 2003 data include HCBS participants, expenditures, and waiting lists (data as of 2005).

Information is also available for Home Health participants and expenditures, and Personal Care Services participants and expenditures.



Develop An Autism Action Plan

Our autistic loved one will need help to plan for his lifetime of care, supervision, protection and financial security. However, there are some necessary steps to take in order to access local, state or federal funds where available to help us create what our family calls an Autism Action Plan. The plan for our family member is flexible and very similar to daily life planning and future planning.

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