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

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

Download a printable version of “You Finally Received the Autism Waiver – Tips for Choosing a Provider”

When interviewing potential Waiver providers, here are some questions that may help you determine which providers will be a good fit for your child and family:

Begin with the Basics
• How long have you been providing Autism Waiver services?
• How many families do you serve in Maryland? In your county/city?
• How many family consultants do you employ? What are their qualifications/backgrounds?
• How many direct care workers do you employ? What are their qualifications/backgrounds?
• How do you recruit direct care workers?
• What trainings do you provide your staff?
• How often do you expect/require the family consultant to meet with families and/or the Intensive Individual Support Services (IISS) supervisor to observe direct care workers?

Ask about their business model
• What reporting (data) is required of the direct care workers on a daily basis?
• How much of your day-to-day business reporting is done electronically?
• What role does a parent play in approving time worked by the direct care worker?
• What is required of the parent to oversee the program?
• What is your school closing and snow day policy?
• What is your transportation policy?

Ask the big questions
• How do you assign direct care workers to a participant?
• Do you hire direct care workers recommended by the family?
• How long does it take to hire staff? What is required of them?
• Do you provide ongoing staff training?
• Who is responsible for training direct care workers on a participant’s specific needs? (e.g. treatment plan, communication system, behavior plan)
• Who is responsible for creating or providing materials for the program, if necessary? (e.g. visual schedule, task list, PECs, etc.)
• What is an ideal family for you to work with?

Understanding Provider Expectations

How would providers describe the “ideal family”?
Autism Waiver providers were asked to list some of the positive qualities/characteristics of families that lead to strong working relationships:
• Responsive and willing to engage in open communication
• Knowledgeable about Autism
• Informed about the Autism Waiver
• Has realistic expectations about the Autism Waiver
• Provides a safe and clean working environment for the direct care workers
• Open to meeting with the supervisor/family consultant as needed or upon request
• Actively participates in the development of treatment plan(s) with the provider
• Supports home visits
• Treats Autism Waiver provider and direct care workers with respect

What would providers consider to be “unreasonable expectations and requests”?
Autism Waiver providers were asked to list some examples of unrealistic parent expectations and requests:
• Approves only one direct care staff to work with the child
• Expects backup/substitute staff for last-minute cancellations
• Makes schedule changes without informing the provider or direct care staff (staff come and family isn’t home)
• Requests unrealistic start times and short periods of time
• Requests direct care staff to transport the child to appointments or travel beyond the local community
• Asks direct care workers to watch siblings in addition to Autism Waiver participant
• Assigns household chores that are not on the Autism Waiver treatment plan
• Accepts non-approved staff as part of the program
• Involves service coordinator regarding concerns before they’ve spoken with the Autism Waiver provider (talk with provider first)

How Can Parents Support Recruiting, Interviewing, and Onboarding of Direct Care Workers?

Recruiting direct care workers for the provider to hire
• Talk to friends, fellow parents, Autism Society members
• Talk to paraeducators in your child’s school or previous schools
• Talk to members of Best Buddies
• Talk to your previous caregivers, neighbors, friends, etc.
• Talk to camp counselors

Interviewing a direct care worker to work with your child and family
• Prepare a list of questions in advance
• Be clear about your expectations and goals
• Be honest about your child’s best day and worst day
• Listen carefully to the potential staff’s perspective on autism and disabilities
• Ask questions about the potential staff’s relevant experience
• Ask them to describe the children they previously supported
• Confirm that they have had at least 100 hours of experience with individuals with Autism Spectrum Disorder or Developmental Disabilities and that they have either a high school diploma or GED. Experience may be as a volunteer, employee, or live-in family member. Ask what they did.

Onboarding direct care workers to work with your child and family
“Onboarding” is the process by which the new direct care worker is socialized into your family home and begins building a working relationship with your child and family.
• Do not rush pairing! It takes time for most children with Autism to feel comfortable with a new person in the house.
• Keep things casual and without demands, at first
• Consider inviting the direct care worker to shadow you or another staff member several times before they provide 1:1 support
• Accompany your child and the worker into the community—show them routines, familiar places and activities your child enjoys
• Allow sufficient time to build a relationship before community outings begin
• Create a narrative about your child—update it over the course of time and be sure to include the most effective strategies to build rapport with your child engaged and to handle behaviors
• Create “cheat sheets” to be placed strategically around the house so that everyone is on the same page in getting to know your child


Additional Resources

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

PFA Tips: Staff Involved in Your Autism Waiver Services

Autism Waiver Providers Alphabetically as of August 2021

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

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