PFA Tips: Maryland Waiver Programs

What is a waiver program?
A special Medical Assistance (also known as Medicaid) program in which the federal Centers on Medicare and Medicaid (CMS) allows states to waive or bend the usual rules to allow Medicaid and other services to be delivered to people with different needs, in the community, or different income levels. Maryland administers several different waiver programs to fund community supports. States apply for a waiver and put in matching dollars according to a formula based on each state’s population and income. These waivers provide services in the community as an alternative to receiving them in an institution.

What are the eight waiver programs in Maryland?

Autism Waiver (AW)
The Autism Waiver allows a specific number of children with Autism Spectrum Disorder to receive services to support them in their homes and communities. A child may remain in the Autism Waiver until the end of the school year in which they turn 21 as long as they meet the medical, technical, and financial eligibility requirements annually. Waiver participants are eligible for a variety of services, such as respite care; intensive individual support services; therapeutic integration; environmental accessibility adaptations to their home; and family consultation. The Autism Waiver is administered through the Maryland State Department of Education (MSDE).  If you apply for the Autism Waiver, you will be placed on a registry and contacted on a first-come first serve basis when a vacancy is available. Only after your number comes up will you be evaluated to determine if you qualify for the waiver.

Brain Injury Waiver (BIW)
The Brain Injury Waiver provides services to individuals who are currently residing in state psychiatric hospitals, state-owned and operated facilities, chronic hospitals that are accredited for brain injury rehabilitation, or for whom Maryland is paying for services in an out-of-state facility. The Brain Injury Waiver is administered through the Behavioral Health Administration. The waiver provides services such as case management; day habilitation; individual support services; residential habilitation; supported employment; and medical day care.

Family Supports Waiver (FSW)
The Family Supports Waiver provides individual and family supports for children birth to 21 with developmental disabilities on the Developmental Disabilities Administration (DDA) Waiting List. The waiver provides services such as assistive technology services; behavioral support services; environmental assessments; environmental modifications; family caregiver training and empowerment services; family and peer monitoring supports; housing supports; individual and family-directed good and services; participant education, training and advocacy supports; personal supports; respite care services; transportation; and vehicle modifications.

Community Supports Waiver (CSW)
The Community Supports Waiver provides individual and family supports for children and adults with developmental disabilities on the DDA Waiting List. The waiver provides services support services such as assistive technology services; behavioral support services; environmental assessments; environmental modifications; family caregiver training and empowerment services; family and peer monitoring supports; housing supports; individual and family-directed good and services; participant education, training and advocacy supports; personal supports; respite care services; nurse case management and delegation services; transportation; and vehicle modifications.  The waiver also provides a variety of meaningful day services such as supported employment; employment discovery & customization; community development services; day habilitation; and medical day care.

Community Pathways Waiver (CPW)
The Community Pathways Waiver provides individual and family support for children and adults with developmental disabilities on the DDA Waiting List. The waiver provides services varies meaningful day, support, and residential services. Support services include assistive technology services; behavioral support services; environmental assessments; environmental modifications; family caregiver training and empowerment services; family and peer monitoring supports; housing supports; individual and family-directed good and services; participant education, training and advocacy supports; personal supports; respite care services; nurse case management and delegation services; transportation; and vehicle modifications.  Meaningful day services include supported employment; employment discovery & customization; community development services; day habilitation; and medical day care.  Residential services include supported living; shared living; and community living – group home.

Community Options Waiver (COW)
The Home and Community-Based Options Waiver provides services for older adults and individuals with disabilities in order for them to live at home or in an assisted living facility instead of a nursing facility. The waiver provides services such as assisted living services; behavior consultation services; case management; dietitian and nutritionist services; medical day care; Senior Center Plus and all other standard Medicaid Services, including Community First Choice, if living at home.

Medical Day Care Waiver (MDCW)
The Medical Day Care Services Waiver offers services in a community-based day care center. Day care centers operate five to seven days a week providing services four to twelve hours per day. The waiver provides services such as skilled nursing and nursing assessments; medication monitoring; meals; social work services; activity programs; daily living skills training; daily living skills enhancement; transportation; therapy; personal care; and nutrition services.

Model Waiver (MW)
The Model Waiver for Medically Fragile Children allows children with complex medical needs to receive medical care in their homes instead of in a hospital, nursing facility or other long-term care facility.

Are there waiting lists for the waivers?
Yes, there is a waiting list/Registry for each waiver program, therefore we recommend you apply even if you are not in current immediate need of service.

Can an individual receive services from more than one waiver?
No.  While you may be on several registries or waiver waiting lists, individuals may only be enrolled in one waiver at a time.

How do I know which waiver is right for my family?
The needs of each child, family, and individual are unique and may change over time. Sometimes your waiver choices will be limited based on participant qualifications (ex, if the person no longer meets the age requirements, if your child needs more specific services, treatment, etc.). Base your decision on the person’s trajectory toward their self-defined “good life” and then matching the services offered through each waiver program to reach those goals.

How do I get on a  waiver programs registry or waiting list?

• Autism Waiver,  call 1-866-417-3480.
• Family Supports Waiver, Community Supports Waiver, Community Pathways Waiver, and the Medical Day Care Waiver, visit https://dda.health.maryland.gov/Pages/eligibility.aspx to fill out an application for eligibility or contact a DDA Regional Office.
• Community Options Waiver and Model Waiver, call Maryland Access Point at 1-844-627-5465.
• Brain Injury Waiver, call the Maryland Department of Health at 410-767-1444; TTY 800-735-2258

Additional Resources

Blue Book Guide to Home and Community Base Services

Home and Community Based Services (HCBS)

The Autism Waiver

Family Supports Waiver

Community Supports Waiver

Community Pathways Waiver

Understanding DDA Waiver Programs – recorded webinar

© 2018 Pathfinders for Autism