Parents urge Maryland education leaders to preserve autism-waiver Appendix K flexibilities

Parents and caregivers urged the Maryland State Board of Education to preserve pandemic-era Medicaid "Appendix K" flexibilities that allowed family members to be paid as autism-waiver caregivers, saying an abrupt end to the policy would create financial hardship and service gaps.

"Why would you make the waiver more difficult for us in this regard?" asked Angelique Vigliotti during the public-comment period, describing long waits and staff turnover that left many families relying on parent-provided care. Several other speakers said they had waited years to enter the waiver or had repeatedly lost aides, and that the Appendix K changes had provided stability and, in some cases, the ability to work fewer outside hours.

State Superintendent Choudhary responded that the Appendix K flexibilities had been a temporary, pandemic-era allowance and that MSDE is working with the Maryland Department of Health to pursue an amendment to the state Medicaid plan to make caregiver compensation changes permanent. "We want to make it permanent," the superintendent said, but cautioned that final approval rests with federal Medicaid administrators and could not be guaranteed.

Board members pressed staff for more detail on the long-standing autism waiver wait list and on steps to expand provider capacity. MSDE staff noted that Maryland has historically tried to expand slot capacity and that supply limits for qualified special-education providers mean added funding alone may not eliminate waits quickly. The board and agency said they would return to the topic in a later agenda item and continue outreach to families and districts.

The public comments and the superintendent's reply closed with an acknowledgement from the board that the issue affects families statewide and that MSDE would continue coordination with MDH and local systems as it seeks a longer-term solution.