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PFA Tips: Staff Involved in Your Autism Waiver Services


Download a printable version of “Staff Involved in Your Autism Waiver Services”

You waited years on the Autism Waiver registry and you’ve just been told your child is approved to receive the Autism Waiver! Who are the people that will be involved in providing Waiver services to your child?

Who will be providing the services?
Autism Waiver providers are organizations that complete an application process to implement Autism Waiver services, and both MSDE and MDH review the applications to ensure that they meet the designated criteria. There are 50+ providers serving Autism Waiver children, youth, and families. Code of Maryland Regulations (COMAR) provide guidelines regarding the qualifications for who can provide each Autism Waiver service. In addition, providers are required to have professional on-call staff available at all times and must also ensure the supervision of direct care workers.

What is Supervision?
COMAR requires that the program supervisor:
• Train and provide ongoing supervision to direct care workers
• Supervise the direct care workers when crisis intervention services are necessary—evaluate the nature of the crisis and intervene as necessary
• Plan and regularly review the participant’s therapeutic activities and behavior plan
• Meet regularly with participant and family
• Observe participant in the home or community setting
• Develop individualized interventions and identify them on the Treatment Plan
• Identify the tasks that the direct care workers are to implement on the Treatment Plan

Program supervision must be provided by one of the following:
• Licensed psychologist;
• Certified school psychologist;
• Certified special educator;
• Licensed certified social worker;
• Licensed professional counselor;
• Board-certified behavior analyst; or
• Individual with a masters or doctorate degree in special education or a related field and at least 5 years of experience in providing training or consultation in the area of Autism Spectrum Disorder (ASD) or Developmental Disabilities (DD).

What is Family Consultation?
Family consultation is a separate service from supervision, although in some cases the family consultant may also function as the supervisor. Family consultation can only be billed to the Autism Waiver if the consultant is meeting face-to-face with the caregiver/family. Families should expect a strong consultant to:
• Return calls/emails within 24 hours;
• Address parents’ concerns; and
• Regularly update parents on the plan’s progress.

The family consultant’s role is to provide caregivers with training related to the participants’ needs in the following areas:
• Daily life skills
• Behavior management
• Self-direction
• Socialization
• Mobility
• Money management
• Habilitation (e.g., communication, sensory integration).

Who will be working directly with my child?
Direct care workers (a.k.a. IISS workers, respite workers, instructors, therapists, caregivers, support staff) provide direct support to the participant. The qualifications for this entry-level position are:
• High School Diploma or GED
• Adequate and appropriate training within 60 days of employment pertaining to care for children with Autism Spectrum Disorder (ASD)
• Supervised by a qualified professional employee
• Approved by parents;
• Experience as a volunteer or employee with individuals with ASD or DD as a service provider or family member for a minimum of 100 hours

Who will help me manage our Autism Waiver services?
A service coordinator provides the following case management services for Autism Waiver participants:
• Completes Risk Assessment with caregiver within 45 days of enrollment in the Autism Waiver
• Completes at least 4 quarterly visits, one of which must be in the participant’s home. Other visits may take place outside of the home, including school, Therapeutic Integration (TI) program, or another afterschool program.
• Contacts the caregiver on a monthly basis
• Conducts annual reassessment meetings to determine continued Autism Waiver eligibility
• Prepares updates to the participant’s Plan of Care – adding and/or deleting services, increasing/decreasing service hours, adding/deleting providers
• Reviews monthly tracking logs from your child’s provider(s) for each Autism Waiver participant
• Collaborates with other involved agencies
• Facilitates residential habilitation application process;
• Connects families to available resources outside of the Autism Waiver
• Facilitates a Reportable Event process for behavioral outbursts, hospitalizations, elopements, etc.
• Facilitates the preauthorization process for EAA, and ITI
• Requests MSDE review children who do not utilize waiver services each calendar month
• Assists the family with the financial application for the Autism Waiver.

Thank you to the Members of the Autism Waiver Advisory Board Committee for their contributions to this article.

Additional Resources

PFA Tips: You Finally Received the Autism Waiver – What Should You Expect?

PFA Tips: You Finally Received the Autism Waiver – Tips for Choosing a Provider

For more information regarding the Autism Waiver, contact the Maryland State Department of Education at 410-767-1446.

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