Military Autism Families Fear Loss of Services Amidst New TRICARE Policies
|An ABA therapist working on fine motor skills |
with a military child on the spectrum.
Many autism families will attest that ABA therapy is value added. Bonnie K. (autism parent) describes what a game changer ABA has been for her family: "ABA was a huge help for our family. My son went from combativeness and aggression to cooperative and able to attend school." Because of similar testimonies and clinical findings most healthcare and state services are moving in a direction that will get more families covered (thanks to the tireless lobbying efforts of Autism Speaks and other organizations 45 states have now signed on to autism insurance reform). While most state and private insurers are moving towards more coverage for autism families, TRICARE is making it more difficult to access the autism services it already covers. TRICARE requires more ABA provider credentialing than any other insurance, which is costly and time consuming for providers making TRICARE patients harder to serve. Their new policy (which was released at the end of November and started implementation on January 1st of this year) mandates providers administer and submit a behavior inventory every year for services to continue. This is in addition to the re-authorizations that need a specialist referral and severity level to be submitted every six months that families are already burdened with acquiring. Many families have already had reauthorizations rejected in the new year due to the short notice for the required behavior inventory. Thus military kids are already losing services due to the new ill-planned policy changes.
|A military child with autism works on gross |
motor and transitions with his therapist.
And that's not the worst of it. The policy that most worries providers and families alike is the new requirement that already diagnosed kids will need to have diagnosing evaluations re-administered every two years to continue services. The evaluations must be administered by an autism diagnosing specialist, many of whom have waitlists 12-24 months long for an initial evaluation. And many of whom will not entertain the idea of taking up a valuable 2 hour evaluation slot for a child who already has a diagnosis when so many kids are awaiting initial diagnosis so they can start receiving services. The new requirement that seems to be seeking a new diagnosis for a lifelong disorder has everyone pretty confused. Military spouse Cassie J. voiced her frustration with the changes: "I'm just dumbfounded at re-diagnosing every two years. Are they supposed to outgrow autism?! The need for ABA may change, but the diagnosis itself will never change if they were initially correctly diagnosed by a qualified provider."
|An ABA therapist practices walking in the "wrong" direction|
with her client. He has struggled for months with rigidity
as to which way they can walk from his home.
|An ABA therapist practices nice play with |
a military autistic child who has had severe aggression
towards his siblings.
Families and providers are hoping these newest ill-conceived policies will be re-evaluated as well. They are calling their Senators and reaching out to the powers-at-be in hopes that their voices will be heard. But how long will it take the DoD to realize how detrimental these changes will be for families? And how many military autistic children (who already face a great deal of challenges) will go without critical services in the meantime?