This study examines state variations in health care services for children with Autism and other developmental disabilities across the fifty states through the Autism and Developmental Disabilities Monitoring Network (ADDM). The ADDM network monitors and tracks the number of children with Autism and other developmental disabilities. The purpose of this study is, first, to understand the differences between the states in the implementation of the ADDM network and, second, to determine what state factors (political variable, i.e., party identification; structural administrative variables, i.e., Medicaid Home and Community Based Service Waiver, HCBS (Section1915C) and the number of pediatricians per 10,000 children; Autism prevalence variable, i.e., Autism among children in special education per 10,000 children; and state economic variables, i.e., spending per pupil for children with Autism in special education, children in poverty, and state financial health) influence the likelihood of a state applying for the ADDM network. Furthermore, the purpose of this study is to consider the potential impact of these various state characteristics in order to understand what state factors might contribute to such differences. The results reveal that structural administrative and economic factors influence a state’s decision to apply for the ADDM network. Furthermore, political factors (e.g., Democratic party control of governorship and legislature) did not influence a state’s decision to apply for the ADDM network. However, when controlling for Republican political party identification, the structural administrative, economic, and political (Republican-controlled legislature) state characteristics influence whether a state applying for the ADDM network. The results indicate that political party control does not play a significant role in determining whether a state will apply for the ADDM network. In expanding the research, to include another structural administrative factor (prior application), political party control (i.e., Republican-controlled legislature) was no longer significant. Thus, the bureaucratic environment is not influencing the actions of state administrators. Instead the individual characteristics of the state is influencing whether a state will apply for the ADDM network. Understanding the differences between the states in the implementation of the ADDM network provides a comprehensive model for establishing the ADDM network or similar programs in other states.