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

Sheri Weissman, LCSW, C-ASWCM, Director Autism Services, The Coordinating Center

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You waited years on the Autism Waiver registry and now you are going to start receiving services! So how do you choose who will be working with your child? What questions should you be asking during your selection process?

Questions for the provider agencies

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?
o What are their qualifications/backgrounds?
• How many direct care workers (IISS and respite) do you employ?
o What are their qualifications/backgrounds?
• How do you recruit direct care workers?
• What trainings do you provide?
• Are trainings virtual, in-person, or a combination of both?
• How often do you expect/require the family consultant to meet with families and the supervisor to observe direct care workers?

Ask about the 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?
• How are time cards handled?
• What is required of the parent in overseeing the program?
• How much do you pay a direct care worker—is there a minimum and maximum?
• Do you offer raises to direct care workers after a certain period of time?
• Is there a difference in pay rate for IISS and respite hours?
• 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?
o How long does it take to get them hired? What is required?
• Do you provide ongoing training?
• Who is responsible for training direct care workers on a participant’s specific needs? (e.g. communication system, behavior plan)
• Who is responsible for creating 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 Expectations

How would providers describe the “ideal family”?
Providers were asked to list some of the qualities/characteristics that make a family easy to work with:
• open communication; responsive
• informed about autism
• informed about the Autism Waiver
• have realistic expectations
• provides a safe and clean environment
• meets with the provider/family consultant
• allows and supports home visits
• treats individuals with respect

What would providers consider to be “unreasonable expectations”?
Providers were also asked to list some of the unreasonable expectations from parents:
• approves only one staff person to work with the child
• expects backup/substitute staff for last-minute cancellations• does not inform provider of schedule changes
• includes siblings in the program
• assigns household chores that are not related to the treatment plan
• accepts non-approved staff as part of the program
• involves service coordinator before talking about concerns with provider

Recruiting, Interviewing, Onboarding Instructors

Recruiting
• Talk to friends, fellow school parents, support group members
• Talk to paraeducators in your child’s school or previous schools
• Talk to former Best Buddies members
• Talk to your previous caregivers
• Talk to camp counselors
• Advertise
o community colleges, local colleges
o Care.com, Indeed.com, Craigslist, Next Door
o faith-based communities

Interviewing
• 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 candidate’s perspective on autism and disability
• Ask questions about the candidate’s relevant experience
• Ask them to describe the children they previously supported
• Confirm that they meet Waiver requirements: they have had at least 100 hours of paid or volunteer experience with individuals with autism or developmental disabilities and they have at least a HS diploma or GED

Onboarding
“Onboarding” is the process by which the new direct care worker is socialized into your family in addition to being oriented to their specific job tasks and associated work expectations.
• Do not rush pairing! It takes time for most of our kids to feel comfortable with a new person in the house.
• Keep things very casual and without demands at first
• Consider inviting the direct care worker to shadow you or another staff member several times before providing 1:1 support
• Accompany your child and the worker into the community—show them routines, familiar places, activities your child enjoys
• Create a narrative about your child—update it over the course of time and be sure to include most effective strategies to build rapport with your child and to handle behaviors
• Create “cheat sheets” to place strategically around the house so that everyone is on the same page in getting to know your child

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?

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