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How To Become An Autism Waiver Provider In Maryland

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Become a Medicaid Waiver Provider of RN, LPN, NP or Licensed Professional Services

Anne Arundel County Board of Education

2644 Riva Road

Annapolis, MD 21401

Preregistration is required. To register, please contact Ms. Lillan Cox at 767-0046 or at . Ms. Cox is also available to answer questions regarding the workshop. We look forward to your attendance.

For more information on the autism waiver, go here:

The Goals For The Autism Waiver Are:

  • Keeping children with autism safe in their home and community
  • Improving the quality of life for families of children with autism
  • Providing quality services to maximize a childâs capacity for independence
  • Providing quality services to support and develop functional and adaptive skills and
  • Providing quality services to reduce maladaptive behaviors in children with autism spectrum disorder.

  • The phone number for the Autism Waiver Registry is 866-417-3480.
  • Parents will receive a registry confirmation, but because roughly 10% of the 1,000 slots become available each year, it could take several years before an opening occurs.
  • Once a slot does open, parents are notified in numerical order. At which time, parents are directed to complete an Autism Waiver application.
  • Parents tell us that they are pleased to know that we are one of the larger Autism Waiver agencies â serving 10% of all the waiver participants in the state.
  • Parents are aware the we have a proven track record of doing all we can to find the right staff for their family and that we do all we can to support the staff to stay and learn with their child.
  • Though we encourage families to interview other providers before they make their final decision, we are happy to discuss possibilities of how we might work to be the best fit for their family

Autism Spectrum Disorder And Medicaid

In response to the increased interest and activity related to ASD, CMS has provided a series of information and guidance intended to increase awareness and understanding of ASD and the role that Medicaid can play in supporting beneficiaries with this diagnosis.

On July 7, 2014, CMS released an Informational Bulletin to provide information on the options available under the federal Medicaid program for furnishing services to eligible individuals with ASD. The Informational Bulletin outlines the Medicaid coverage categories that are available to cover services to treat ASD. The Bulletin also discusses requirements related to services for individuals eligible for the Medicaid benefit for children ) and how states currently furnishing services to treat ASD under a section 1915 waiver or section 1915 Medicaid state plan amendment may have to transition those individuals to EPSDT coverage.

In addition, on September 24, 2014, CMS released a set of Frequently Asked Questions to respond to questions raised by states and stakeholders regarding autism services. Additional questions may be directed to the autism services mailbox at .

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Hcbs Waivers For Adults With Intellectual Disabilities

DDS operates three HCBS waiver programs specifically for adults with intellectual disabilities.

Adult Supports Waiver The Adult Supports Waiver provides services to individuals who meet the eligibility criteria and require at least one home- and community-based waiver service per month. Participants do not require the levels of support provided under either the Community Living Waiver or the Intensive Supports Waiver. Participants live in family homes, adult foster care, or independently and do not require 24 hour care. Their health and welfare needs can be met in these community settings. Waiver services may vary depending on the living arrangement of the participant. Participants will only receive services through the waiver that are needed in order to remain safely in the community. Participants in the Adult Supports Waiver can choose to direct their services if they are interested. The Adult Supports waiver offers both budget authority and employer authority as options for participant direction.

Eprep For Provider Medicaid Enrollment And Registration With Optum

Apr 24

The state of Maryland has implemented the electronic Provider Revalidation and Enrollment Portal . This resource enables online provider enrollment, re-enrollment, revalidation, information updates, and demographic changes. For resources to assist you with ePREP, visit the .To create a user profile or log into and existing account for Maryland Medicaids ePREP portal, visit After enrollment at Maryland Medicaid, register with Optum using Provider Connect.

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Level Of Care Eligibility Criteria: Bureau Of Developmental Disabilities Services

To be eligible for BDDS programs, an individual must be found to have substantial functional limitations in three or more of six major life activities AND meet all of the following four basic conditions. They include:1. physical or intellectual disability, cerebral palsy, epilepsy, autism, or condition similar to an intellectual disability 2. the condition is expected to continue indefinitely 3. the condition had an age of onset prior to age 22 and4. the individual needs a combination services.The six major life activity categories are:1. self-care 4. capacity for independent living 5. receptive and expressive language and6. mobility.

Community Integration And Habilitation Medicaid Waiver

The Community Integration and Habilitation waiver is to be used as a “needs based” waiver ONLY for people who meet specific criteria. To move from the Family Supports waiver onto the CIH waiver, an individual must meet specific eligibility/priority criteria which may include:

Death of primary caregiver and no other caregiver available Caregiver over 80 years of age and no other caregiver available Evidence of abuse or neglect in the current placement Extraordinary health and safety risk Eligible individuals transitioning to the community from a nursing facility, extensive support needs homes or state operated facilities Eligible individuals determined to no longer need active treatment in a group home Eligible individuals transitioning from 100% state funded services Eligible individuals aging out of Department of Education, Department of Child Services or supported group living and Eligible individuals requesting to leave a Large Private Intermediate Care Facility for Individuals with Intellectual Disabilities .

In addition to the same services approved for the FS waiver , the CIH waiver allows for a larger budget for eligible services and may provide the following additional approved services :Community Transition Rent and Food for Unrelated Live-In Caregiver Residential Habilitation and Support

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How To Become A Medicaid Provider

Providers delivering autism spectrum disorder services must be enrolled with SCDHHS as a Medicaid provider to deliver and bill for Medicaid state plan benefit ASD services.

To enroll with SCDHHS as a Medicaid provider:

  • Prep for Enrollment: Providers will need a national provider identification and taxonomy number. Apply for individual National Provider Identifier number. Use the correct taxonomy code as listed in the provider manual.
  • Complete and submit the Medicaid provider enrollment application.
  • SCDHHS will notify providers of successful enrollment.
  • *Note, BCBA and BCaBA providers must enroll individually. If there is a group practice, a group enrollment must also be completed.

    To enroll with one of the managed care organizations , a provider must be an approved Medicaid provider. Providers need to contact the MCO directly to complete the network enrollment process. Providers are not required to enroll with a MCO, but they may not be reimbursed by the MCO for services provided to beneficiaries enrolled in managed care.

    To enroll with a MCO:

    • Contact each MCO to begin the process of contracting, credentialing and enrolling.
    • MCO contact information:

      Healthy Blue 757-8286

      First Choice by Select Health 741-6605

      Molina Health Care of South Carolina 237-6178

    P. O. Box 8206 Columbia, SC 29202-8206 | Email: | phone: 549-0820

    Language Services

    If your primary language is not English, language assistance services are available to you, free of charge. Call: 1-888-549-0820 .

    Medical And Financial Eligibility Criteria Includes:

    Become a Medicaid Waiver Provider of RN, LPN, NP or Licensed Professional Services
    • Individuals must require a nursing facility level of care based on a uniform medical assessment.
    • An individual’s income and assets are reviewed to determine financial eligibility for Medical Assistance.
    • The monthly income of an individual may not exceed 300 percent of SSI benefits.
    • The individual’s countable assets may not exceed $2,000 or $2,500 depending on eligibility category.
    • Only the income and assets of the individual and assets of any spouse are considered in determining financial eligibility.

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    Section 1135 Waiver Flexibilities

    Department of Health & Human ServicesCenters for Medicare & Medicaid Services7500 Security Boulevard, Mail Stop S2-26-12Baltimore, Maryland 21244-1850

    Office of Innovation, Research and DevelopmentMaryland Department of Health

    Re: Section 1135 Flexibilities Requested in March 20, 2020 Communication

    Dear Ms. Roddy:

    Your communication to CMS on March 20, 2020, detai1ed a number of federal Medicaid, the Childrens Health Insurance Program , and Medicare requirements that pose issues or challenges for the health care delivery system in all counties in Maryland and requested a waiver or modification of those requirements. Attached, please find a response to your requests for waivers or modifications, pursuant to section 1135 of the Social Security Act, to address the challenges posed by COVID-19. This approval addresses those requests related to Medicaid, Medicare, and CHIP, as applicable.

    To streamline the section 1135 waiver request and approval process, CMS has issued a number of blanket waivers for many Medicare provisions, which primarily affect requirements for individual facilities, such as hospitals, long term care facilities, home health agencies, and so on. Waiver or modification of these provisions does not require individualized approval, and, therefore, these authorities are not addressed in this letter. Please refer to the current blanket waiver issued by CMS.



    CMS Response: March 26, 2020

    Great Opportunities Await With Trellis Services

    Students will be touring the facility and what it has to offer

    Trellis Services strives to improve the lives of children with autism and related communication disorders. With the help of the Career Center, a group of students will tour their facility.

    On April 17, students with the Career Center: On the Road will be taking a trip to the Trellis Services facility in Sparks, Md. Founded in 2001, Trellis is an agency that works towards providing comprehensive services for children with autism and other related disorders. Their goal is to instill in children that learning can be an enjoyable and rewarding experience.

    This particular On the Road visit is part of UMBCs Career Crush, which allows students to become better acquainted with their career options through presentations, workshops, one-on-one mentoring and, in this case, a tour of a facility. Trellis is currently looking to hire students who are studying education, social work, psychology, applied developmental and human services.

    Career Center Director Christine Routzahn said, The Career Center regularly takes groups of students by bus to visit organizations in order to provide undergraduate and graduate students with an inside look into various career and intern options. Our On the Road program serves as a great networking opportunity and learning experience.

    Photo Credit: Heather Capezio with Learn It

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    The Whole Self Center Is A Maryland Medical Assistance Autism Waiver Provider

    • There is no cost to parents whose children and adolescents are receiving services while enrolled on Autism Waiver.
    • âThe Waiver,â as itâs commonly called, must be reviewed for quality and compliance by the federal government every 3 to 5 years.
    • Continued funding is dependent upon the result of the renewal process as well as the availability of federal funding and those funds matched by the state.
    • As of 2013, The Waiver is funded to provide services to 1,000 individuals, referred to as âWaiver participantsâ.
    • Each participant is reviewed on an annual basis to assure that they still meet the eligibility standards or requirements.
    • Each autism waiver participant is then also eligible to receive Medical Assistance as well.
    • There are approximately 4,000 individuals on the waiting list beyond the 1,000 individuals being served.

    Home And Community Based Options Waiver

    Maryland Autism Waiver Providers

    Formerly known as the Medicaid Waiver for Older Adults, the Home and Community-Based Options Waiver is run by the State of Maryland Department of Health .

    This waiver provides community services and supports to enable older adults and people with disabilities to live in their own homes. Maryland residents age 18 and over who need assistance with activities of daily living, such as bathing, grooming, dressing and mobility, can apply.

    If you currently live within a nursing facility, contact Medicaid’s Long Term Care and Waiver Services by calling 410-767-1739 or 1-877-463-3464.

    If you live in the community, to put your name on the Waiver Interest List you should contact Maryland Access Point of Baltimore County by calling 410-887-2594.

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    Services Available In The Hcbs Waivers For Adults With Intellectual Disabilities

    Participants in the HCBS waivers for Adults with intellectual disabilities work with a DDS Service Coordinator to develop their individual service plan and plan of care, which include the participants goals as well as the waiver and non-waiver services and supports the participant needs in the community.Waiver services include the following: Adult Companion

    Hcbs Waiver Provider Application Process

    For first time applicants requesting provider enrollment into the DDA Home and Community Based Services Medicaid Waiver Program, the instructions to complete a Waiver Provider Application and other pertinent information is outlined in the General Provisions. Interested organizations and licensed clinicians must refer to the waiver service descriptions and rules for detailed requirements to become enrolled as a Home and Community Based Services Medicaid Waiver Provider. Please read the materials carefully to determine what services you or your organization may be eligible to provide.Prior to submitting an application, as a Microsoft Word attachment, potential providers must submit a letter of intent to . In the subject line of the email, please include the name of your company and Letter of Intent .

    Acme Agency Letter of Intent

    An introduction of your company the name of the company, contact information including phone and email address.

    What services that are currently being provided in the community and in what state, What services your company would like to provide as a DDA Home and Community Based Services Medicaid Waiver provider, how many years of experience you have providing services and supports for persons with I/DD.

    What services your company would like to work toward providing in the future as a DDA Home and Community Based Services Medicaid Waiver provider.

    Existing HCBS Medicaid Waiver Providers

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    Msde Announcement: The Medicaid Home And Community

    The Maryland State Department of Education and Maryland Department of Health is hosting an informational workshop for individuals/agencies interested in becoming an Autism Waiver provider. If you are interested in learning more about the Autism Waiver and the application process to become a provider, please join us at our upcoming Prospective Provider Workshop:

    What Services Are Available Through The Autism Waiver

    Georgia Medicaid Waiver Program Application Guide – Children With ADHD, Autism, Down Syndrome
    • Therapeutic integration services
    • Intensive Individual Support Services
    • Adult life planning

    What is the Autism Waiver? The Autism Waiver, through Medical Assistance, allows eligible children with Autism Spectrum Disorder to receive specific services to support them in their homes and communities. A child may remain in the Waiver until the end of the school year in which he turns 21 as long as the child meets ALL eligibility requirements annually. Waiver participants are eligible for a variety of services, such as respite care, environmental modifications to their home, and family training. The Autism Waiver is currently full and the wait is approximately eight years. To be eligible your child cannot have more than $2,000 in resources and assets. A review of the childs assets looks back five years. Be sure to alert other family members not to give large gifts of money or stocks to your child directly or in their wills. Autism Waiver Fact Sheet Who can apply? Parents or legal guardians of children with an autism spectrum diagnosis. The waiver only applies to families residing in Maryland. How do I apply? To be placed on the Autism Waiver Registry, contact 1-866-417-3480. For more information on the Autism Waiver, please call the Maryland State Department of Education at 410-767-1446 or the Department of Health and Mental Hygiene at 410-767-5220.

    Additional Resources

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    What Is The Autism Waiver

    The Autism Waiver, through Medical Assistance, allows eligible children with Autism Spectrum Disorder to receive specific services to support them in their homes and communities. A child may remain in the Waiver until the end of the school year in which he turns 21 as long as the child meets ALL eligibility requirements annually. Waiver participants are eligible for a variety of services, such as respite care, environmental modifications to their home, and family training. The Autism Waiver is currently full and the wait is approximately eight years. To be eligible your child cannot have more than $2,000 in resources and assets. A review of the childs assets looks back five years. Be sure to alert other family members not to give large gifts of money or stocks to your child directly or in their wills.

    Autism Waiver Fact Sheet

    Shes Desperate To Get Home Care For Her Mom In Maryland 21000 Are On The Wait List

    Tiffanie Rivers was running out of time.

    Over the past year, as the coronavirus swept through nursing homes across the country and as dementia deepened its hold on her mother, she had promised herself that she would do everything possible to keep Gayle Love, 75, at home with her in Hyattsville, Md.

    She had pestered state employees about her paperwork for a Medicaid waiver, filed two years ago, that would help her afford home-based care. She had hired a consultant, who told her that the waiver that she was applying for in Maryland has a wait list of 21,000 names one of the longest in the country and that the vast majority of families see their loved ones check into nursing homes or die before they hear back.

    In the caregiver Facebook groups that Rivers was in, people talked about a bill in Congress recently absorbed into the $3.5 trillion spending plan mired in debate on Capitol Hill that would permanently bump up the federal match for home-based care and designate $400 billion for states to expand access to such services.

    Rivers, 46, stayed updated on these efforts. But now she couldnt afford to wait.

    I dont know what happens if doesnt kick in, Rivers said one recent afternoon, sitting outside her house. I have to work. Theres no other choice. My moms care … itll literally suffer.

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