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 Article of Interest - Medicaid Waivers

The Medicaid HCB Waiver: The Alternative to Institutionalization
with Adelle Jameson Tilton from
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In the not too distant past, an adult with a severe Autism Spectrum Disorder faced a future that almost certainly included institutionalization. Because of the unique care needs, the expense involved, the lack of insurance coverage and more, it was impossible for the Autistic adult to live within his/her community, in most cases. Federal and State funds went to institutions and the prevailing thought was that Autistic individuals should be placed in them, "for their own good."


Thankfully, that thinking has changed. It is now recognized that many Autistic adults are able to remain within their own communities, with a minimum of actual medical care. One of the major factors in this shift of focus was the Medicaid HCB Waiver Program, which allows states to take Medicaid funds that were previously only available to institutions, and apply them to community and home based programs. According to the U.S. Department of Health and Human Services, "Medicaid's home and community-based services waiver program affords States the flexibility to develop and implement creative alternatives to institutionalizing Medicaid-eligible individuals. States may request waivers of certain Federal rules which impede the development of Medicaid-financed community-based treatment alternatives. The program recognizes that many individuals at risk of institutionalization can be cared for in their homes and communities, preserving their independence and ties to family and friends, at a cost no higher than that of institutional care."


The services that may be provided without prior approval of the Federal Government through this program include:

Case Management Services
Homemaker Services
Home Health Aide Services
Personal Care Services

Adult Day Health, Habilitation and Respite Care Services Other services which may be provided with approval include:

Transportation Services
In-Home Support Services
Meal Services
Special Communication Services
Minor Home Modifications
Adult Day Care Services

A quick review of these services clearly shows that most, if not all of them could be of great benefit to an individual on the Autism Spectrum. They could be the thing that allows the Autistic citizen the opportunity to have a life within the familiar confines of his/her own community or home. There is only one drawback.


States can implement these services as they wish, choosing which to offer and which to ignore. It is important for the parents and care givers of Autistic individuals to find out what services are available within their state, and compare those with what is allowed by law. If there are services that would benefit the Autism community that are not being offered, action should be taken to get your state's Health and Human Services Department acting to provide those which are lacking. By our awareness of what is available and what could be available, we can help to make life a little better for all developmentally disabled citizens within our borders. After all, "Awareness is the Key."


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