Autism Resources
Subject: Adult Autism Waiver Update for October 2008 from the Bureau of Autism Services, Pennsylvania Department of Public Welfare
PUBLIC ANNOUNCEMENT
Adult Autism Waiver update October 2008
While the Adult Autism Waiver is taking longer to roll out than the Bureau of Autism Services (BAS) expected, it is still very much alive and active. The Adult Autism waiver is a new program. All the procedures, processes and materials required to implement the program are being created and revised on a daily basis. As one can expect from any new program, there will be setbacks and unforeseen circumstances that need to be resolved before proceeding to the next phase of the program. BAS's current goal is to ensure that well trained and qualified providers are enrolled to serve the needs of waiver participants. Without providers, consumers cannot begin receiving services. It is for this reason that BAS must first enroll its providers before sending out applications to consumers.
BAS expects to begin mailing out applications to consumers around late October. The initial plan was for the Adult Autism Waiver to serve 200 individuals. That number has remained unchanged. Applications will be mailed out over the course of the next 8 months until 200 people are enrolled in the Adult Autism Waiver program.
The eligibility requirements for the waiver program are as follows:
- Individual must have a diagnosis of Autism Spectrum Disorder (ASD)
- Must be age 21 or older at the time of application
- Must be a resident of PA
- Must meet financial and functional eligibility
In order for a person to be eligible, he or she must qualify for Medical Assistance, therefore financial eligibility is determined by the County Assistance Offices (CAO).
Functional eligibility is determined by BAS. An in-person assessment will be made by individuals specifically trained to determine functional eligibility through a Level of Care evaluation. The level of care evaluation determines if the applicant has extensive limitations in daily living skills such as communication, learning, mobility or capacity for independent living.
BAS receives application requests on a daily basis and continues to see a positive response to the Adult Autism Waiver program both from providers and consumers. We will continue our efforts in implementing our waiver program in a way that is most beneficial to the population we wish to serve-adults living with autism in Pennsylvania.
FREQUENTLY ASKED QUESTIONS
Q: Has the capacity of the Adult Autism Waiver been reduced?
A: No, the Adult Autism Waiver still expects to enroll 200 participants by June 30, 2009 (the end of the current state fiscal year).
Q: Is the Adult Autism Waiver "falling apart" or at risk of disappearing?
A: No; because this is a brand new program, there have been unavoidable delays in enrolling providers and participants, but the waiver is funded and is progressing towards implementation as planned (just more slowly than we had hoped).
Q: The application form on the web site is impossible to understand!
A: The application for individuals to enroll in the waiver is not posted on the DPW web site (at autisminpa.org). The document which was labeled, "Application for 1915© waiver…" was the application which DPW submitted to the federal Centers for Medicare and Medicaid Services (CMS) to allow Pennsylvania to offer the Adult Autism Waiver. That application was approved, and the reference to that document has now been updated on the web site. All requests for consumer applications MUST be made through the Bureau of Autism Services toll-free phone number, 866-539-7689. BAS will contact callers within 2 weeks.
Q: Applications were only accepted from July 1 through August 11, and now it's too late to apply.
A: BAS did have a "lottery" period for applications for a 6-week period in July and August. All individuals who requested an application during that time will be given a randomly assigned number and applications will be sent out in the order of those numbers. However, BAS continues to accept requests for applications, and will do so indefinitely. Anyone calling after August 11 will be listed in the order of the day and time of their call to the BAS toll-free number, 866-539-7689.
Q: What are the eligibility criteria?
A: To be accepted into the Adult Autism Waiver, a person must 1) be 21 years old or older at the time they apply; 2) have a diagnosis of Autism Spectrum Disorder (Autistic Disorder, Childhood Disintegrative Disorder, PDD-NOS, Asperger Syndrome or Rett Disorder); 3) be eligible for Medical Assistance; 4) live in Pennsylvania; 5) meet Intermediate Care Facility level of care (functional) criteria.
Q: How severely affected does someone have to be to be eligible? What does "ICF level of care" mean?
A: Home and Community Based Services (HCBS) waivers, like the Adult Autism Waiver, are intended to help people live and work in their communities, who would probably have to live in an institution if they didn't get waiver services. ICF stands for "Intermediate Care Facility" which is the kind of institution that people who qualify for these waivers would otherwise use. Everyone who applies for this waiver will be evaluated to determine whether or not they need a level of support which they would get from an ICF if community-based services were not available. That level of need is defined by federal regulation as "substantial functional limitations" in three or more of the following areas of major life activity: self-care; receptive and expressive language; learning; mobility; self-direction; and capacity for independent living.
Q: Can someone with MR enroll?
A: Yes, as long as they meet all the eligibility criteria. IQ is NOT a factor for this waiver.
Q: Do I have to disenroll from my current waiver program before I can apply? What will happen to my services while I'm waiting?
A: You do not need to disenroll from your current waiver program. Federal regulation guarantees a person's right to apply for any and all programs for which they feel they may be eligible, whether already enrolled in one or not. If a current HCBS waiver participant receives an application for the Adult Autism Waiver, they can continue to receive services through their current waiver up to the date the services under the Adult Autism Waiver are in place. Federal regulation does not allow a person to receive services from more than one waiver at the same time, so at that time the person will have to disenroll from their previous waiver. There should be no gap in services.
Q: What are the Priority categories? How does that work?
A: This waiver is designed to give preference to people who do not now get any ongoing services, so there are two priority categories: people who are now enrolled in a HCBS waiver or live in a State MR Center, an Intermediate Care Facility, a State Mental Hospital or a Nursing Home are in Priority 2; everyone else is in Priority 1. There is a separate list for each Priority category. No applications will be sent out to people on the Priority 2 list until everyone on the Priority 1 list has had their application processed. This means that it may be a while before people who are already on a waiver receive an application for the Adult Autism Waiver.
Q: I've heard that people on a waiting list for other waivers can't apply. Is that true?
A: That is not true. Anyone on a waiting list who does not have access to services under a waiver would be in the Priority 1 category. (See answer to previous question.)
Q: If I only get Base Service Unit funds, am I considered in the Priority 2 category?
A: BSU funding is not guaranteed from year to year, so it is not considered ongoing funding. A person only receiving BSU funding would be classified as Priority 1.
Q: Can't I just send BAS an email to get on the list for an application?
A: No, the only way to request an application is by calling the BAS toll-free number, 866-539-7689. For English, press 1 and follow the prompts to the mailbox for application requests and leave the contact information requested. For all other languages, press 2 and leave a message. In all cases, a BAS staff member will return your call within 2 weeks.
Q: I called the toll-free number, got a call back, got a letter confirming my Priority status. Now what? Why haven't I heard anything more?
A: Once you receive your Priority Status Letter, you will not hear from the Bureau of Autism Services again until it is your turn to receive an application. You will not receive an application unless there is capacity to serve you in the Adult Autism Waiver. You will not go through the process of determining whether you are eligible for the Adult Autism Waiver until that time. As it says in the Priority Status Letter, it is very important that you notify the Bureau of Autism Services if your contact information changes before you receive an application. If it is your turn, but we can't locate you, you will lose your chance to apply at that time and you will have to start the process all over again.
How to request an application for the Adult Autism Waiver
All requests for applications for the Adult Autism Waiver must be made through the Bureau of Autism Services' toll free number. Please speak slowly and clearly, spelling n 1-866-539-7689
For instructions in English. press 1. You will then be asked to press 1 again to leave a request for an application. Please leave a voice-mail message with the following information:
- The first and last name of the person who is applying;
- Your first and last name if you are calling for someone else;
- Your daytime phone number (between 8:30 a.m. and 4:30 p.m.). We must be able to reach you during the day; and
- The applicant's mailing address, including county in which you live.
You will be contacted by a member of the Bureau of Autism Services staff within two weeks following your call.
For instructions in Spanish or another languagel press 2. Please leave your name, phone number and language spoken, and a Bureau of Autism Services staff member will contact you with a translator.
Each person who asks for an application for the Adult Autism Waiver is put into a Priority 1 group or a Priority 2 group. The Priority 1 group is for people who are not in any of the service programs listed below:
- Home- and community- based services waiver program
- Intermediate Care Facility (ICF), either for Mental Retardation (ICF/MR) or for Other Related Conditions (ICF/ORC)
- State Mental Retardation Center
- State Mental Health Hospital
- Nursing Home
The Bureau of Autism Services will be sending out applications for the Adult Autism Waiver in the following order:
- People in the Priority 1 group who called and asked for an application between July 1 and August 11, 2008, will be sent an application in the order of their random number;
- People in the Priority 1 group who called and asked for an application after August 11, 2008, will be sent an application in the order they called;
- People in the Priority 2 group who called and asked for an application between July 1 and August 11, 2008, will be sent an application in the order of their random number;
- People in the Priority 2 group who called and asked for an application after August 11, 2008, will be sent an application in the order they called.
No applications will be sent to people in the Priority 2 group applicants until all people in the Priority 1 group who have asked for an application have been sent an application.
Contact the Bureau of Autism Services toll free 1-866-539-7689
[from How to Request an Application 09108 available on the Bureau site]
Bureau of Autism Services, Office of Developmental Programs
Department of Public Welfare
Room 501 Health & Welfare Building | Hbg PA 17120
www.autisminpa.org
www.dpw.state.pa.us
