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Thursday, June 11, 2015

Medi-Cal Lags in ABA

David Gorn reports at California Healthline:
Children with autism spectrum disorder who are in Medi-Cal managed care plans are not getting the care they need, according to children's health advocates.
A specific autism therapy -- applied behavior analysis, known as ABA therapy -- became a Medi-Cal benefit in September 2014. But according to figures released last month by the Department of Health Care Services, as of May 5, fewer than 1,123 children have received behavioral health treatment services, which include ABA therapy.
An estimated 76,000 children under age two in the Medi-Cal program have autism spectrum disorder.
"That's well under 2%," said Karen Fessel, executive director of the Autism Health Insurance Project. "It's frustrating that it's taking so long. Many [managed care plans] are not building a good faith network. Some have but most have not."
According to state statistics:
  • 24 of California's 58 counties have provided no behavioral health treatment under Medi-Cal managed care plans;
  • 18 counties have fewer than 11 cases per county (an exact number can't be released due to privacy issues); and
  • The remaining 16 counties provide BHT services to 943 Medi-Cal managed care children, an average of roughly 59 children per county.