Supports for Adults with Autism Spectrum Disorder

Background

The Department of Developmental Services (DDS) has provided supports to children with autism and adults with autism who met the department’s eligibility criteria for intellectual disability. In 2010, the legislature established an Autism Commission to investigate the needs of individuals with autism spectrum disorders (ASD), including those who did not meet the criteria for DDS as related to intellectual disability. After extensive study, the Autism Commission developed a comprehensive report that identified a number of priorities, findings and recommendations.

The Massachusetts Autism Commission Report, issued in March 2013, identified a number of priorities, including:

» Expand the eligibility for DDS so that individuals with autism who have higher IQ scores and substantial functional limitations have access to services.

» Ensure that individuals with autism with co-occurring mental health conditions have access to services from the Department of Mental Health.

» Expand insurance coverage for treatment for individuals with autism.

» Increase employment, housing, educational, and health care options for individuals with autism.

» Determine the number of people with autism in Massachusetts and their needs by consistent data collection.

Autism Omnibus Act

In 2014, the governor signed the Autism Omnibus Act into law in order to expand supports and services to individuals with autism living in Massachusetts. This legislation establishes a permanent Autism Commission to oversee the implementation of autism services. It also creates the opportunity for families to establish tax-advantaged accounts to use for their family member with a disability. It requires the Board of Elementary and Secondary Education to revise educator licensure to provide a mechanism for special education teachers to achieve Autism Endorsement through mastery of specialty training and skills. Insurance coverage to cover services for individuals with autism is expanded as a result of this legislation.

What does this mean for DDS?

Eligibility for supports through DDS has expanded. The criteria for children and for adults with intellectual disability have not changed. Eligibility for adults with ASD, Prader-Willi Syndrome, and Smith–Magenis Syndrome has been added. Provision of adult services begins at age 22.

IQ (Intelligent Quotient) is not a criteria for individuals with ASD and Prader-Willi Syndrome. Individuals with these diagnoses can be eligible without having an intellectual disability. In order to be determined eligible for ASD services, an individual will need a verified diagnosis by a qualified professional, and

for Prader-Willi a genetic testing result. The qualifying disability must manifest prior to age 22 and be determined to continue indefinitely.

In addition to the diagnosis, the individual must have substantial functional impairments in three or more areas of seven major life areas. The major life areas are self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency.

What will happen after eligibility?

After an individual has been determined eligible, he or she will be contacted by a DDS assessor who specializes in conducting the Supports Intensity Scale® (SIS). The SIS is a standardized assessment tool that will help in service planning. The individual will also be referred to the DDS Area Office closest to that person’s home for assistance with planning and services.

In the event that the individual has a 688 referral and is under 22, the planning requirements of Chapter 688 will be met. Using a person-centered planning process, the individual will receive assistance from a DDS Service Coordinator to determine service needs, preferences and options. The Service Coordinator will help the individual locate and arrange supports.

Services provided by DDS are dependent on availability and funding. It is anticipated that some individuals can be supported on existing service models, while other individuals will need and benefit from new services and or/individualized options. The Autism and Family Support Centers funded by DDS are also available to provide information, support, and resources to individuals and families.

What services will be available?

Community Developmental Disability Services will be made available and include the following types of services: employment/day services; individual supports to assist individuals who may be living more independently; support services for assistance both in-home and in the community, such as adult companion, individualized home supports, behavioral supports and consultation, and peer support; and family support services for individuals living with their families, including respite, family training, and flexible funding. Individuals have the option to receive services from traditional providers or can choose one of the self-directed service options, the Participant-Directed Program or Agency With Choice Program.

Ongoing Development

With experience it is expected that our understanding of the support needs of this new, diverse population of adults with ASD will continue to evolve. DDS is committed to the ongoing development of services to be able to provide quality supports and assistance relevant and responsive to the needs of this group of individuals. This will involve additional education and training and strong partnerships with providers, individuals and families, and other stakeholders.