Tricare Cuts to ABA Could Diminish Services for Autistic Kids

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Services for autistic military children are on the chopping block again. Tricare proposed making cuts that could potentially affect thousands of special needs children.

The new Tricare Autism Demonstration would combine Applied Behavioral Analysis (ABA) services for Reserve, Retirees and Active Duty families into a single program. The new demonstration project is scheduled to go into effect October 20, 2014.

This is not the first time Tricare has attempted to cut care for autistic children. During the summer of 2013 Tricare proposed making many of the same cuts, however it was met with resistance from families, providers and Congress. Advocacy groups say that these cuts could restrict thousands of military children from getting the care they need.

According to American Military Families Autism Support (AMFAS), the new policies would limit access to care by slashing reimbursement rates for ABA providers. Reduced rates could drastically reduce the number of providers that accept Tricare Insurance and greatly affect access and timely receipt to care. The Pentagon has pushed back the rate change until April 2015 which has some parents wondering what will happen next summer.

Other areas of change that are proposed include a two year limit on the duration of care and a new discharge criteria would be applied. In order for ABA recipients to gain any additional care past 2 years, Tricare would require a review for clinical necessity annually.

Tricare would also restrict the area of deficits that ABA providers would be authorized to treat, essentially making care less effective. Providers would no longer be able to work on motor, academic, cognitive, developmental and vocational skills. Cuts to deficit areas would stop providers from providing ABA in school and would restrain access to specialized autism schools.

For families such as my own, these changes would impact our children’s future. My family was compassionately reassigned to an area specifically with ABA services at the request of my child’s doctor. Since my children’s commencement of ABA, I’ve seen my sons grow in many ways, many which wouldn’t have been possible without goals being centered on daily living, developmental, motor and academic skills.

ABA has allowed my children to be integrated into a generalized setting and flourish in areas in which they were previously struggling. Limiting access to care could cause regression and long term loss of independence as well as hurt their chances at obtaining a high school diploma or going on to live a better life.

If families wish to contact their representatives in government, as well as tricare, to voice their disapproval they may do so by contacting their legislators, Defense Health Agency Policy and Operations, Dr. Gina Green of The Association of Professional Behavioral Analysts or the Military Family Readiness Council.

Lisa Pedraza is a long time military spouse with experience in dealing with autism and the military lifestyle. She is an advocate for autistic military children and has twin autistic boys that keep her tremendously busy. Lisa is also the founder of a small online blog called Howdy Fort Bliss and has guest written for several online news sites.

 

 

 

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  • jojo613

    One large area of concern I have regarding this new policy is the discharge criteria. They state that children can be discharged under three circumstances, one of those criteria is lack of progress towards goals. This does not seem to address the fact that even children who are typical commonly have set backs when family members deploy or when families PCS.

    There are so many things wrong with this policy… Unfortunately, in this area of cutting, it’s easier to cut health programs for kids than it is to cut weapons systems or bases.

  • OT2015

    ABA therapists should not be working on motor skills anyway. This is outside of their scope of practice and should be evaluated and treated by an occupational therapist. The purpose of ABA therapy is to try and understand the underlying cognitive process behind different behaviors so they can be altered. These individuals are in no way trained to be evaluating or treating the musculoskeletal system in any way.