Katie Beckett Medicaid waiver DC - ASD

[Anonymous]

Can anyone tell me about your experience with applying for/success with this process for an ASD child in DC?

TIA.

[Anonymous]

I have it for my kid. Not for ASD though. Do you want to know if kids with ASD qualify or just how to apply?

[Anonymous]

Not the OP, but I'd be interested in your (or someone else's) thoughts on both -- (I have a recently diagnosed 3 year-old with high-functioning autism).

[Anonymous]

NP here. Could someone lease explain what this is?

[Anonymous]

Anonymous wrote:I have it for my kid. Not for ASD though. Do you want to know if kids with ASD qualify or just how to apply?

OP here. Both preferably. The criteria related to showing the child would normally need institutionalized care seems daunting.

[Anonymous]

I'm not sure what it takes to qualify for ASD. My kid has an automatic qualifying condition.

[Anonymous]

Me again. When I applied, I had to give the doctor a two page questionnaire about medical needs and equipment or therapy needs or accommodations. I wouldn't be intimidated if you think your child has a need for it.

I would contact Family Voices for help with the application. Here's a link that helps explain it.

http://downinthedistrict.wordpress.com/the-katie-beckett-waiver/

[Anonymous]

Anonymous wrote:Me again. When I applied, I had to give the doctor a two page questionnaire about medical needs and equipment or therapy needs or accommodations. I wouldn't be intimidated if you think your child has a need for it.

I would contact Family Voices for help with the application. Here's a link that helps explain it.

http://downinthedistrict.wordpress.com/the-katie-beckett-waiver/

That's very helpful, thank you -- but it only mentions applicability for Down Syndrome, not for ASD. Does the same process and applicability apply for an ASD diagnosis (or something else, eg POD-NNS, ADHD, etc.)?

[Anonymous]

It is just a site for Ds. The process is the same for everyone.

[Anonymous]

I can't help with specifics in Autism. I would contact Family Voices for those questions

[Anonymous]

Anonymous wrote:

Anonymous wrote:Me again. When I applied, I had to give the doctor a two page questionnaire about medical needs and equipment or therapy needs or accommodations. I wouldn't be intimidated if you think your child has a need for it.

I would contact Family Voices for help with the application. Here's a link that helps explain it.

http://downinthedistrict.wordpress.com/the-katie-beckett-waiver/

That's very helpful, thank you -- but it only mentions applicability for Down Syndrome, not for ASD. Does the same process and applicability apply for an ASD diagnosis (or something else, eg POD-NNS, ADHD, etc.)?

The application says that children need to be candidates for nursing home, or ICF (Intermediate Care Facility, a Medicaid facility that is half way between an institution and a group home). I don't think that ADHD kids would be considered candidates for either of those. My understanding of Katie Beckett, is that the child either needs to have substantial medical needs, or an Intellectual Disability, although significant ASD might well qualify too.

[Anonymous]

Anonymous wrote:
The application says that children need to be candidates for nursing home, or ICF (Intermediate Care Facility, a Medicaid facility that is half way between an institution and a group home). I don't think that ADHD kids would be considered candidates for either of those. My understanding of Katie Beckett, is that the child either needs to have substantial medical needs, or an Intellectual Disability, although significant ASD might well qualify too.

So then, unless your child falls under the category of needing a nursing home or ICF, one cannot get a Medicaid waiver?

[Anonymous]

Anonymous wrote:

Anonymous wrote:
The application says that children need to be candidates for nursing home, or ICF (Intermediate Care Facility, a Medicaid facility that is half way between an institution and a group home). I don't think that ADHD kids would be considered candidates for either of those. My understanding of Katie Beckett, is that the child either needs to have substantial medical needs, or an Intellectual Disability, although significant ASD might well qualify too.

So then, unless your child falls under the category of needing a nursing home or ICF, one cannot get a Medicaid waiver?

That is what the application and the law seem to say for this particular waiver. Katie Beckett is designed as a cost cutting measure to keep kids out of hospitals, nursing homes and ICF's. To be clear, it's for children who would be candidates, not children whose parents are going to place them. You can have no intention of sending your child to an ICF, but if your child would meet the guidelines to be admitted then it seems they qualify.

Having said all that, I have no idea how they qualify a kid as in need of an ICF. They may feel that it's justified for kids that I would not feel it's justified. However, I think that ADHD is unlikely to qualify a child.

[Anonymous]

There is a definition somewhere of institutional level of care, and it has something to do with how many hours per week the person needs therapy or special services, and so if your child requires X number of therapy hours or nursing attention or other special services per week, your kid could qualify even with an ASD diagnosis. The best thing to do would be to call DC Health Care Finance to ask.

[Anonymous]

Anonymous wrote:There is a definition somewhere of institutional level of care, and it has something to do with how many hours per week the person needs therapy or special services, and so if your child requires X number of therapy hours or nursing attention or other special services per week, your kid could qualify even with an ASD diagnosis. The best thing to do would be to call DC Health Care Finance to ask.

I held off applying for the Katie Beckett waiver for my son for over a year even after our Early Intervention service coordinator suggested it, because I felt like the "institutional level of care" standard meant it was not for him--he doesn't need to be institutionalized. But as the PP says, this term is misleading; in fact the criteria they apply just says if the child needs a certain number of hours per week of services, they qualify. (I don't know the # of hours.) We applied and received the waiver for our son who has global developmental delays.

I second the recommendation to call Family Voices of DC, specifically their Executive Director, Doreen Hodges. She is very committed to helping families through the (somewhat confusing) Katie Beckett application process. Here is her