Getting an Autism Waiver in New Jersey Simplified

Autism

Navigate 'how to get an autism waiver in New Jersey' with our simplified guide - eligibility to application steps.

Steven Zauderer

June 29, 2024

9 min read

min read

Understanding Autism Waiver Programs

Autism Waiver Programs are essential services designed to support individuals diagnosed with Autism Spectrum Disorder (ASD) and their families. These programs provide a range of home and community-based services, which are tailored to meet the assessed needs of each individual. They play a crucial role in helping individuals with ASD to improve their communication skills, social interactions, adaptive behaviors, and overall quality of life.

Autism Waiver Programs in New Jersey

In New Jersey, the Autism Waiver Program is administered by the Division of Developmental Disabilities (DDD). The program, as explained by DiscoveryABA, offers a variety of services and supports to individuals with ASD and their families.

Eligible individuals in New Jersey receive services from the Division of Developmental Disabilities (DDD) via two programs: The Supports Program and the Community Care Program (CCP). Both of these programs fall under the Comprehensive Medicaid Waiver, also known as the New Jersey FamilyCare Demonstration.

The Supports Program provides a basic level of support to individuals who live with family members or in their own homes. This program allows individuals to select services based on their assessed needs from a menu of options.

The Community Care Program (CCP) covers Home and Community-Based Services (HCBS) for Medicaid-eligible individuals with developmental disabilities. This program helps these individuals live in the community. To be eligible for the CCP, individuals must meet DDD eligibility criteria and the specified level of care for Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities (ICF/IDD) as determined through the NJCAT assessment [1].

Benefits of Autism Waiver Programs

The primary benefit of Autism Waiver Programs is the individualized plan of care and support they provide. These programs aim to enhance communication skills, promote social interaction, develop adaptive behaviors, and improve the overall quality of life for individuals with ASD.

Support coordinators are assigned to ensure that the necessary interventions and therapies are received. These services are tailored according to the specific needs of each individual, ensuring that they receive the most suitable and effective care.

In New Jersey, the Autism Waiver Programs play a crucial role in supporting individuals with ASD and their families. By understanding these programs and the eligibility criteria, families can take the necessary steps to receive the services and support they need.

Eligibility for Autism Waiver Programs

In New Jersey, individuals who are eligible receive services from two programs: The Supports Program and the Community Care Program (CCP). Both programs fall under the Comprehensive Medicaid Waiver, also known as the New Jersey FamilyCare Demonstration. To enroll in either program, individuals must meet certain eligibility criteria.

Basic Eligibility Rules

The basic eligibility rules apply to both the Supports Program and the Community Care Program. These rules are outlined on the official website of the State of New Jersey.

The core eligibility requirements include, but are not limited to:

The individual must be a resident of New Jersey.
The individual must have a documented diagnosis of a developmental disability.
The disability must have occurred before the individual turned 22.
The individual must require ongoing services that are typically provided through the Division of Developmental Disabilities (DDD).

The DDD offers a comprehensive policy manual detailing the procedures and guidelines for the Supports Program and the Community Care Program. This manual can be accessed on DDD's website and serves as the definitive source of information governing these programs.

Additional Criteria for Community Care Program

Beyond the basic eligibility rules, the Community Care Program (CCP) in New Jersey has additional eligibility criteria. These additional conditions are required to ensure that the individuals who are most in need of intensive services can access the CCP.

The additional criteria for CCP include, but are not limited to:

The individual must have a level of need that requires the provision of services in a Developmental Center, group home, or supervised apartment.
The individual must not be enrolled in another Medicaid waiver program.

For the most accurate and up-to-date information regarding the eligibility criteria for the Supports Program and the Community Care Program, individuals are advised to refer to the official website of the State of New Jersey or contact the Helpline at 800.4.AUTISM [1].

Applying for Autism Waiver in New Jersey

Applying for an Autism Waiver in New Jersey is a process that involves several steps. It is a program that aims to enhance communication skills, promote social interaction, develop adaptive behaviors, and improve overall quality of life for individuals with Autism Spectrum Disorder (ASD).

Steps for Application

Reach out for an Application: Families seeking an Autism Waiver in New Jersey may request an application via email at autismwaiver@dhs.state.nj.us or by phone at 1-800-654-4839. (NJ Department of Human Services)
Complete the Medicaid Application: The first step in the application process is to complete the Medicaid application. This is necessary to determine eligibility for Medicaid, which is a requirement for the Autism Waiver program.
Submit the Community Care Waiver Application: After the Medicaid application, the next step is to submit the Community Care Waiver application. This application is specific to the Autism Waiver program and must be completed by the parent or guardian of the child.
Contact NJEIS for a Needs Assessment: Eligibility for the Autism Waiver Program requires contacting the New Jersey Early Intervention System (NJEIS) at 1-888-653-4463 for a Needs Assessment. This assessment evaluates the individual's needs to qualify for the Autism Waiver.
Participate in an Eligibility Review: After the needs assessment, the final step is to participate in an eligibility review. This review determines if the individual qualifies for services under the Autism Waiver program.

Documents Required for Application

For the application process, certain documents are required. These include:

Proof of diagnosis: This must be provided by a qualified professional and should clearly state that the individual has been diagnosed with Autism Spectrum Disorder.
Proof of age: The Autism Waiver program is for children and adults up to the age of 21, so proof of age is required.
Proof of income: Since the Autism Waiver program is a Medicaid program, proof of income is required to determine eligibility.
Proof of residence: The individual must be a resident of New Jersey, so proof of residence is required.

Remember, the Autism Waiver application must be completed by the parent or guardian of the child, and all relevant documentation should be provided. It's always best to reach out to the relevant agencies or seek professional help if you have any doubts while applying for the Autism Waiver in New Jersey.

Services Provided Under Autism Waiver

The Autism Waiver in New Jersey offers an array of services and supports aimed at enhancing the quality of life for individuals diagnosed with Autism Spectrum Disorder (ASD). These services, tailored to assessed needs and budget, include interventions and therapies designed to enhance communication skills, promote social interaction, and develop adaptive behaviors.

Enhancing Communication Skills

Communication is a foundational skill that significantly impacts an individual's ability to interact and connect with others. For those with ASD, communication challenges can often be a significant hurdle. The Autism Waiver in New Jersey provides services targeted at enhancing communication skills. This includes specific interventions and therapies aimed at improving both verbal and non-verbal communication abilities.

These services are designed to help individuals with ASD express their thoughts and feelings more effectively, understand and interpret the communication of others, and navigate social situations with greater ease. The goal is to empower individuals with ASD to build meaningful relationships and participate more fully in their communities.

Improving Quality of Life

The Autism Waiver in New Jersey is not solely focused on improving specific skills but also aims to enhance the overall quality of life for individuals with ASD. This includes services such as behavior assistance, respite, and individual and family support services [4].

The waiver also provides an individualized plan of care and support coordinators. These coordinators ensure necessary interventions and therapies are received, promoting social interaction, and developing adaptive behaviors that can help individuals with ASD lead more independent and fulfilling lives.

In essence, the Autism Waiver in New Jersey provides an array of home and community-based services that are essential for improving the lives of individuals with ASD. From communication skills to overall life quality, the waiver aids in providing support and assistance where it's needed most.

Navigating Waiting Lists for Waivers

When applying for autism waiver programs in New Jersey, it's crucial to understand the role of waiting lists and anticipate possible waiting times.

Understanding Waiting Lists

Waiting lists crop up when the demand for Home-and Community-Based Services (HCBS) waivers surpasses the available slots. These lists reflect the state's priorities in terms of services, populations served, resource allocation, and workforce availability [5].

Waiting lists have been utilized as a response to the Olmstead decision, a court ruling that deemed the unjustified institutionalization of people with disabilities as illegal discrimination. Policymakers across political parties have proposed measures to address these lists, which are sometimes viewed as contributing to the risk of unnecessary institutionalization for individuals with disabilities [5].

States, including New Jersey, have been requested to report the number of people on waiting lists for HCBS, but the methods of reporting and definitions of these waiting lists can vary. Consequently, the reported numbers might not consistently reflect the actual demand.

Anticipating Waiting Time

On average, individuals in need of waiver services might wait up to 36 months to receive them. However, during this wait period, most people are eligible for other types of HCBS.

In New Jersey, like in many other states, HCBS waivers offer a variety of benefits beyond the required home health services. These include personal care, private duty nursing, adult day care, supported employment, and non-medical transportation through the Medicaid state plan. While waiting for the autism waiver, individuals may benefit from these services.

Understanding the waiting lists and anticipating the waiting time is key to navigating the process of getting an autism waiver in New Jersey. It's advisable to explore other available resources during the wait period and keep abreast of the state's priorities and measures to address the demand for HCBS waivers.

Exploring Additional Support Programs

In New Jersey, the Division of Developmental Disabilities (DDD) offers two additional support programs for individuals with autism: The Supports Program and the Community Care Program (CCP). Both programs fall under the Comprehensive Medicaid Waiver, also known as the New Jersey FamilyCare Demonstration.

Introduction to Supports Program

The Supports Program, administered by the DDD, provides a basic level of support to individuals who live with family members or in their own homes. This program allows individuals to select services based on their assessed needs from a menu of options.

The Supports Program is designed to provide assistance in areas such as daily living skills, employment, community participation, and health and wellness. By offering a range of services tailored to the unique needs of each individual, the Supports Program aims to enhance the quality of life and promote independence for individuals with autism.

The Division of Developmental Disabilities provides policy manuals as the definitive source of information governing the Supports Program. These manuals contain procedures and guidelines for the program, and stakeholders can access the full policies and procedures manual on DDD's website, last updated in March 2019.

Introduction to Community Care Program (CCP)

The Community Care Program (CCP) is another support program administered by the DDD. The CCP covers Home and Community-Based Services (HCBS) for Medicaid-eligible individuals with developmental disabilities, helping them live in the community [1].

To qualify for the CCP, individuals must meet DDD eligibility criteria and the specified level of care for Intermediate Care Facility for Individuals with Intellectual and Developmental Disabilities (ICF/IDD) as determined through the NJCAT assessment.

The CCP provides a range of services designed to support individuals in their homes and communities. These services can include personal care, respite, behavior supports, and assistive technology, among others. By offering these services, the CCP aims to enable individuals with autism to live as independently as possible in their own communities.

For more information on the CCP, individuals can refer to the policy manuals provided by the Division of Developmental Disabilities. These manuals provide comprehensive information on the program's procedures and guidelines, and are available on the DDD website.

In conclusion, both the Supports Program and the Community Care Program offer valuable resources for individuals with autism in New Jersey. By understanding these programs and their offerings, families and individuals can make informed decisions about the services that best meet their needs.