The Maryland State Department of Education (MSDE), Division of Early Intervention and Special Education Services (DEI/SES), manages and administers two major Medicaid programs. The schoolBased Medicaid Program has been in operation for more than 25 years and enables school-based providers to recover a portion of the cost-of-service coordination and health related services from the federal Medicaid program. Medicaid allows local education agencies (LEAs), local lead agencies and nonpublic schools to seek payment for providing medically necessary Medicaid services to eligible Maryland Medicaid enrolled children with Individual Family Service Plans (IFSPs) and Individualized Education Programs (IEPs). The program is administered in collaboration with the Maryland Department of Health (MDH) with a focus on compliance monitoring, training, revenue maximization, and technical assistance to meet compliance requirements under both Medicaid and Individuals with Disabilities Education Act (IDEA) regulations. As approved by the Centers for Medicare and Medicaid Services (CMS), MSDE DEI/SES is the Operating State Agency (OSA) for a 1915(c) Home and Community Based Services (HCBS) Waiver for Children with Autism Spectrum Disorder (ASD), also known as the Autism Waiver (AW). The AW is designed to enable children to remain in their home and community and serves as an alternative to an institutional level of care. The AW is jointly administered by the MSDE and the MDH and is a national model for interagency collaboration. The CMS requires that Maryland has regulations and policies for implementation of the AW, a quality review system for assuring service delivery, and a process for approving and monitoring AW providers. MSDE has primary responsibility for provider compliance with regulations, conducting compliance monitoring, information tracking, and performance measurement and reporting. MSDE and LEAs are responsible for determining and tracking medical and technical eligibility for each AW participant, verifying requirements of age, special education and health related service hours, and ASD diagnosis. The MDH is the single State Medicaid Agency (SMA) responsible for the oversight of the AW, Medicaid reimbursements, and financial eligibility determination of AW participants. Both State agencies work together to sustain the AW and adhere to the approved federal application. Annually, over 1,600 children receive services through the AW and this number will be increasing due to End the Wait legislation. A prescribed set of federally approved services are delivered by over 60 community-based providers and over 50 AW service coordinators contracted by LEAs.
