Overwhelming, intimidating, and confusing are just some of the words parents of autistic children use to describe researching state-funded autism programs in places such as North Carolina. From understanding eligibility requirements to fulfilling application demands, often parents must wade through a plethora of information to request the help they need for their child.
Yet that doesn’t have to be the case. The following is a summary of the different state-funded autism programs in North Carolina. Regardless of what stage you’re at, from struggling to accept your child’s most recent autism diagnosis, or looking for fun summer activities for them, Heartlinks ABA can help. We’ve listed the different kinds of autism programs available in the state, who is eligible, and how to apply.
We hope this guide simplifies the process and empowers you with the knowledge and confidence to take the next step. Navigating support systems doesn’t have to feel like a full-time job. With the correct information and resources, accessing the services your child deserves becomes less of a struggle and more of a bridge to their growth and well-being.
Why are state-funded programs for autism in North Carolina important?
Accessing state-funded autism programs in North Carolina offers a tremendous range of benefits for children and teens on the spectrum as well as their families. These programs are most often low-cost or free, making them a vital source of autism financial assistance in North Carolina for families that might be dealing with economic barriers to private services. Early intervention is vital in treating autism, starting with toddlers and infants, to help them develop critical skills, including communication, social interaction, and independent living skills.
State-funded autism programs in North Carolina also offer a full range of support, including a variety of therapies, such as occupational, speech, and behavioral therapies, such as ABA (applied behavior analysis) therapy, which has an extensive history of treatment success. Therapies designed for an autistic child’s family, including ABA parent training or tactics to improve sibling relationships, are also available.
Additionally, state-funded services help connect families to broader community resources, reducing isolation and strengthening support networks.
What are the types of state-funded autism programs?
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Though EPSDT is a federal Medicaid requirement, it is known as the Health Check program in North Carolina, making certain that individuals under 21 receive comprehensive and preventive health services. For autistic children, this includes the following:
- Screening & Diagnosis: Regular developmental and behavioral assessments should be conducted to detect autism early.
- Medically Necessary Treatments: Coverage for interventions such as Applied Behavior Analysis (ABA), speech and occupational therapy, which have been deemed essential to address ASD.
If and when a health issue such as autism is identified, the Health Check program will ensure that necessary diagnostic and treatment services are provided. This includes referrals to specialists and access to treatments that may not be usually covered under the standard Medicaid plan but are nevertheless deemed medically necessary to correct or improve the child’s health condition.
North Carolina Innovations Waiver
The North Carolina Innovations Waiver is a Medicaid and Home and Community-Based (HCBS) waiver offering services to individuals with intellectual and developmental disabilities, such as autism. These services aim to enable them to live more independently within their communities. They provide various services, including respite care, personal care assistance, and supported employment. Unfortunately, due to tremendously high demand and limited space, eligible individuals might be placed on the Registry of Unmet Needs, the state’s waitlist, until a slot becomes available.
Research-Based Behavioral Treatment (RB-BHT)
Medicaid also covers RB-BHT services for beneficiaries diagnosed with ASD. These services promote adaptive functioning to prevent or minimize disabilities and behavioral challenges linked with autism, including aggressive behavior, repetitive body movements, or harmful behavior. Eligibility is available to individuals under the age of 21, and as of July 2021, coverage has been extended to those over 21 when interventions are supported by credible scientific evidence.
TEACCH Autism Program
The TEACCH Autism Program is based at the University of North Carolina at Chapel Hill and offers clinical services to individuals with autism spectrum disorder (ASD) of all ages. Services include diagnostic evaluations, parent training and support, and professional training for educators and service providers.
Eligibility requirements for North Carolina autism services
In North Carolina, families trying to find state funding for autism treatment have several different programs to explore, including Medicaid, Home and Community Based Services, waivers, and the Supplemental Security Income (SSI) program. Eligibility requirements differ across programs, but they generally consider factors such as diagnosis, age, residency, income, and level of need. The following is an overview of key programs and their eligibility requirements.
EPSDT
Children on Medicaid are automatically eligible for EPSDT services without the need for separate enrollment. In addition, as of December 1, 2023, North Carolina expanded its Medicaid program, broadening eligibility to cover more state residents. So, if you’re a parent looking to enroll your child in EPSDT, you must apply for Medicaid for your entire family. Once deemed eligible for the Medicaid program, your children become eligible for EPSDT services.
North Carolina Innovations Waiver
To qualify, children and teens must require the level of care typically provided in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-ID). They must also have proof of a diagnosis, such as autism or a related condition, such as Down Syndrome or Pervasive Developmental Disorder, and have shown signs of the condition before age 22. The child or teen must demonstrate substantial functional limitations in at least three areas, including self-care, communication, or independent living skills. Additionally, they must live or be at risk of being placed in an institutional facility.
Research-Based Behavioral Treatment (RB-BHT)
In North Carolina, Research-Based Behavioral Health Treatment (RB-BHT) services are available to Medicaid beneficiaries who’ve been diagnosed with autism. Generally, children under 21 are eligible, and those under age three may qualify with a provisional diagnosis. The child or teen’s family must be enrolled in NC Medicaid.
TEACCH
Eligibility for these services typically requires a formal diagnosis of autism and proof of residency in North Carolina.
It’s important to note that specific programs within TEACCH may require additional criteria, including different age ranges or particular needs. For example, the TEACCH School Transition to Employment and Postsecondary Education Program (T-step) serves individuals aged 16-21 who have received or are pursuing a Future-Ready Core high school diploma. To determine your child or teen’s eligibility and access appropriate services, individuals or caregivers should contact the nearest TEACCH regional center.
How can you apply for state-funded autism programs in North Carolina?
In North Carolina, applying for state-funded autism programs begins with confirming your child or teen’s basic eligibility. As mentioned above, verifying an autism diagnosis, proving state residency, and meeting income guidelines are all a part of it. However, in some cases, like with the NC Innovations Waiver, only the income and available resources of autistic individuals are considered.
Since many autism services are funded through Medicaid, applying for Medicaid is a key step. Families can apply through their local Department of Social Services or online using North Carolina’s ePass system.
Families should also contact their Local Management Entity/Managed Care Organization (LME/MCO), which coordinates services for people with developmental disabilities in their region. Your region’s LME/LCO will also help determine eligibility for the NC Innovations Waiver.
If your autistic child is waitlisted, the LMO/MCO may offer other state-funded services to bridge gaps in their care. Families can also seek support and guidance through organizations like the Autism Society of North Carolina or local family networks, which can assist in the application process.
Navigating North Carolina autism services
Finding your way through the world of state-funded autism programs in North Carolina can feel overwhelming for parents and families, but remember you’re not alone. With the proper guidance and a clear understanding of available options, you can confidently secure the support your autistic child or teen needs and deserves.
The state offers valuable resources for children and teens on the spectrum and their families, from early intervention through EPSDT to long-term support with the NC Innovations Waiver. Accessing support is key to applying for Medicaid, connecting with your local LME/MCO, and exploring programs like TEACCH and RB-BHT.
At Heartlinks, we’re here to simplify the process and connect you to the services that can make a lasting difference. You’re not alone; help is available, and your child deserves it. Contact Heartlinks ABA Therapy today.