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Thursday, April 7, 2016

Waiting in West Virginia

In The Politics of Autism, I discuss state Medicaid services for people with intellectual and developmental disabilities.

Kara Leigh Lofton writes at West Virginia Public Broadcasting that the state has no mechanism to track prevalence and that its services are poor.
“Less than 2 percent of any children with autism receive any evidenced-based treatment. So we know that the ability to give these kids the best outcome is really limited by the lack of services,” says Susannah Poe, director of the intensive Autism Delivery Clinic at West Virginia University.

Poe says that 2 percent is an estimate the non-profit Mountaineer Autism Project came up with after a 2010 survey of West Virginia Applied Behavior Analysis practitioners like herself about 5 years ago. To be clear, many practitioners think that Applied Behavior Analysis - ABA for short - is the best method for treating autism, if not the only one. So the 2 percent is only referring to kids receiving ABA therapy.
No ABA therapists in the state are currently taking Medicaid or have been able to successfully bill Medicaid. So when [autism dad] Tom [Riser] changed jobs and the family lost private insurance, they also lost the ABA therapy.

Jill McLaury is founder of the ABA facility Bright Futures in Hurricane. Though the number of board certified ABA practitioners has more than doubled in West Virginia in the last five years, McLaury says there are still not nearly enough to cover the need. Also, while federal legislation requires Medicaid to cover ABA services, there is enough red tape that most clinics like hers don’t bother trying.

“To do Medicaid I would have to be a licensed behavioral health facility and right now I’ve got a waiting list of over 50 families who are private insurance that I’m not able to serve,” she says. “So from a business perspective for me to then have to do a $1,500 application fee, to have a lot more scrutiny over the services – it doesn’t make sense when I’m not even able to provide services to the clients who already have funding.”