Ohio Level 1 Autism Waiver and ABA Therapy: What Families Need to Know

What Is the Ohio Level 1 Autism Waiver?

The Ohio Level 1 autism waiver is a home- and community-based services (HCBS) waiver administered by the Ohio Department of Developmental Disabilities (DODD). It is designed specifically for children with autism spectrum disorder (ASD) who do not require an institutional level of care but still need significant support. The waiver covers a range of services, with applied behavior analysis (ABA) therapy being one of the most commonly accessed.

Unlike traditional Medicaid, the waiver allows children to receive services in their natural environment-home, school, or community-rather than in a facility. This approach aligns with best practices in ABA, which emphasize generalization of skills across settings.

How It Differs From Other Ohio Waivers

Ohio offers several HCBS waivers, but the Level 1 autism waiver is unique because it is targeted only to children with autism who have moderate needs. The Level 2 autism waiver is for children with more intensive needs and is more costly. The SELF (Self-Empowered Life Funding) waiver is for adults. Knowing which waiver fits your child is critical because eligibility criteria and available services differ.

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Who Qualifies for the Ohio Level 1 Autism Waiver?

Eligibility for the waiver depends on several factors set by DODD. You must:

• Have a child under age 7 (the waiver can be renewed up to age 9 after a redetermination).
• Provide a formal autism diagnosis from a qualified professional (e.g., developmental pediatrician, psychologist).
• Demonstrate a functional need that requires at least one hour per week of waiver services.
• Meet Ohio Medicaid income limits for children (usually through the Medicaid Buy-In for Children program or Medicaid for infants and children).
• Be enrolled in Ohio Medicaid before waiver enrollment.

Note that the waiver has a legally capped number of slots (currently around 2,000), and there is often a waiting list. Applying when your child is as young as possible-ideally soon after diagnosis-improves your chances.

Does the Ohio Level 1 Autism Waiver Cover ABA Therapy?

Yes. ABA therapy is a covered service under the Level 1 waiver. It must be provided or supervised by a Board Certified Behavior Analyst (BCBA) and can include: behavior assessment, developing and implementing a treatment plan, direct one-on-one therapy, parent training, and ongoing monitoring and updates.

The waiver covers both center-based and in-home ABA, though in-home is often the default to reduce travel barriers. Many providers also offer community-based ABA, such as at a playground or grocery store, to work on social and adaptive skills.

What Other Services Are Covered?

Besides ABA, the Level 1 waiver can pay for: respite care (up to 8 hours per month), personal care assistance, specialized equipment, transportation to medical appointments, and minor home modifications (e.g., safety locks). Some families also use waiver funds for social skills groups or parent counseling, but these must be approved in your child's plan.

Importantly, you cannot double-dip with private insurance for the same service. If your child has private insurance that covers ABA, the waiver may become a secondary payer. But many families use the waiver as primary since it usually has no co-pays or deductibles.

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How to Apply for the Ohio Level 1 Autism Waiver

Step 1: Get Your Child on Ohio Medicaid

Your child must be enrolled in Ohio Medicaid before applying for the waiver. If you are not already receiving Medicaid, apply through the Ohio Department of Medicaid or your county Job and Family Services office. For children in families with higher incomes, the Medicaid Buy-In for Children program offers coverage with an income-based premium, making the waiver accessible to many middle-income families.

Step 2: Request a DODD Eligibility Evaluation

Contact your county Board of Developmental Disabilities (county DD board). They will assess if your child has a developmental disability (autism qualifies) and if the child needs waiver-level support. This evaluation typically includes a review of medical records, a functional assessment, and an interview with you.

Step 3: Complete the Waiver Application

Once your child is found eligible for DODD services, you can request a Level 1 waiver slot. The county DD board will help you complete the application. Because slots are limited, you may be placed on a "waiting priority list." It is not based on first-come, first-served but on a combination of age, need, and risk of institutionalization. You can reapply each year; do not assume a previous denial is permanent.

Step 4: Choose a Provider and Develop a Plan

Once a waiver slot opens, you will work with a service and support administrator (SSA) from your county DD board to craft an individualized service plan. You can select any Medicaid-enrolled ABA provider that offers waiver services. This is where a free matching service like ABA For My Child can help-they connect you with vetted, BCBA-led providers who are experienced with the Level 1 waiver and have openings.

Costs: Is ABA Therapy Free With the Level 1 Waiver?

For eligible families, the Level 1 waiver covers 100% of approved ABA therapy costs. There are no co-pays, deductibles, or premiums associated with waiver services themselves. However, if your child is on the Medicaid Buy-In program, you may pay a monthly premium-but that covers all of Medicaid, not just the waiver. For families who qualify for full Medicaid, there is usually no cost.

Out-of-pocket costs might arise if you choose ABA provider services that are not on the waiver-approved list or if you exceed the cap on certain services like respite. But typical ABA therapy-a BCBA assessment, ongoing direct therapy, and parent training-is fully covered.

Common Mistakes Families Make When Applying

1. Waiting too long. The earlier you start the process, the more likely you are to get a slot by age 3-5 when early intervention is most effective.
2. Not applying for Medicaid early. Many families assume they make too much money, but the Medicaid Buy-In for Children program allows higher thresholds. Check eligibility anyway.
3. Only applying to one county. If you are willing to travel, consider applying in a county with fewer applicants. Your county DD board can advise.
4. Giving up after one denial. The waiting list rotates; reapplying annually is essential. Also, check if slots open mid-year as families move or age out.
5. Not having a provider ready. Once a slot opens, you must act quickly to begin services. Pre-select a provider through a matching service like ABA For My Child so you can start immediately.

How a Free Matching Service Can Simplify the Process

Navigating waivers, Medicaid, and provider lists can be overwhelming, especially while caring for a child with autism. ABA For My Child is completely free for families. We do not charge you-we are funded by the participating providers. Our team can help you find local BCBA-led ABA therapy providers who accept the Ohio Level 1 autism waiver and other forms of insurance. We vet each provider for credentials, experience with waiver billing, and capacity to start services soon. Simply call or fill out our online form, and we will match you with providers that fit your child's needs and location in Ohio.

Using a matching service does not affect your place on the waiver waitlist. It simply saves you hours of research and calls, and ensures you are connecting with providers who are ready to serve families on the Level 1 waiver.

Frequently Asked Questions About Ohio Level 1 Autism Waiver and ABA