Get a Medicaid Waiver for Kids with Special Needs

Updated on October 21, 2020

A guest post by Natasha Cornin

It has been a little more than a year since the start of my journey to obtain a Medicaid waiver for my six-year-old son with autism, but I am relieved to say I finally walked through the “Front Door” and obtained a Medicaid Service Coordinator for my son – another step toward accessing additional therapy, family reimbursement and more.

 

 

Access to the services offered through a Medicaid Waiver is managed by the state department of the Office for People with Developmental Disabilities (OPWDD). Once your child is deemed eligible for the Waiver, you’ll enter the second phase to obtain services through OPWDD. As an ASD mom who felt overwhelmed and frustrated through the lengthy process to access Waiver services, it is my sincere hope that this post provides some valuable guidance on the process and what to expect in order to make the next parents’ journey easier and less stressful. Just be aware, there may be some variations in your city/state. This is my experience with my state’s procedures.

Step 1

Contact an information and referral service to schedule a neuropsychological, psychosocial and family history evaluation. I went with YAI/LINK since we’ve always received services through YAI and they have been professional and compassionate.

 

Step 2

Go through the evaluation process to determine whether your child meets the eligibility requirement to access additional services and support through the Waiver/OPWDD.

Step 3

If your child is found eligible, your next step will be to attend a session called “The Front Door” orientation.

Step 4

Once you attend the orientation, you will select an agency through which to obtain a Medicaid Service Coordinator (MSC). The MSC will contact you to conduct an intake interview in person or via phone.

Step 5

At this stage you can collaborate with your child’s coordinator to access therapy, social groups, respite care, camps and family reimbursement, among other support for items related to your child’s care. The services and amount of family reimbursement will vary by city and state. However, regardless of what your local area provides, it will be support toward the development and enrichment of your little one in excess of what’s noted in their IEP. The services are solely based on the child’s disability and determined required level of care, regardless of the family’s income.

This is a process that requires perseverance and patience but as autism parents those characteristics are our middle names. I hope this information is helpful and we would love to hear from you as you go through this process, or if you have insights as a parent who has successfully navigated the process to acquire a Medicaid Waiver for your child.

Visit the Medicaid waiver site to view information specifically related to your home state, eligibility requirements and a full listing of services and support one can access via the Medicaid Waiver. For more on The Office for People with Developmental Disabilities (OPWDD) and how they provide a wide range of services to children and adults with developmental disabilities, visit this site.

Natasha is the mom of Jaeden, a six-year-old son with Autism and speech apraxia. She became an AngelSense user following the increasing cases of kids with autism going missing, especially the story of Avonte Oquendo, whose disappearance in 2013 sparked a renewed conversation about elopement and safety for children with special needs. The use of the AngelSense system has empowered her to join the customer care team so she can  pay it forward to other parents of children with autism looking for an additional way to watch over and engage their little ones. She is also the founder of Full Spectrum Essentials – a resource site for mothers of children with autism. 

This is Natasha’s experience in New York State. Other states will vary on procedures and allowances. Please share your experience in other states in the comments!