Wednesday, November 25, 2015

Medicaid

The Waiting List is no longer...

We waited 2 1/2 years for the therapy we knew Aiden needed--the same therapy I read over and over again that changed the lives of so many young children diagnosed with autism.  The science says the "sooner the better," but we had to wait.  Without insurance to pay for the therapy, we had to wait for the Waiver Program.  They said the wait was a year long--it was more than double that time.  Imagine our joy when we were finally done waiting--only to have our dreams crushed when Aiden was denied therapy after his assessment.  What a roller coaster of emotions!

Things are changing in January 2016.  Medicaid will now pay for all autism services.  No more waiting list.  The family chooses the provider, and the provider gets the authorization from Medicaid for reimbursement. 

There is a positive and negative to almost everything, so here it is:

Positives--
1. Even though this was Aiden's last year on the Waiver Program, he may be able to continue with therapy after June 2016 given the new funding.  Let's see how Medicaid feels about Aiden's progress!      
2. No more forced hours of therapy.  At this point, we HAVE to get 40 hours a month, otherwise we are kicked out of the program.  

Negatives--

1. Providers will no longer be reimbursed for travel, which means they will no longer serve certain areas that are too far from "home base".  Some families may be forced to move.

2.  At Aiden's level of functioning, he will require a person with a Bachelor's degree in a communication field to work with him.  Hiring employees in that field for after school hours is going to be very difficult for the providers.  Will they be able to hire enough qualified people?  At this point, Aiden's "behavior coaches" are not required to have a degree.  

I know everything will work out for the best in 2016!