I recently PCSed to a new location and setting up internet took longer than normal. In the midst of unpacking on July 4th, I saw a blog by Military Special Needs Network about changes to Tricare’s Applied Behavioral Analysis (ABA) program. With no internet and surrounded by boxes, packing paper, and things to be put in closets and cabinets, I decided to follow up on the changes later. When I did, I was shocked.
The ABA changes would be implemented by July 25th, which does not give any families much time to comply. For those, like my family, that have just PCSed, the impact is even worse. I find it interesting that the changes were announced in the middle of PCS season, rather than the start of the fiscal year in October.
Maybe you think this does not matter to your family, if you do not have a child with autism; but you would be wrong. ABA is the only medical/behavioral intervention recommended by the AAP for children with autism.
A total of 37 states and the District of Columbia have enacted laws related to autism and insurance coverage. Not one of these states has placed the same restrictions on coverage that Tricare enacted a couple weeks ago.
One of the changes requires two expensive psychometric tests to be administered before ABA is started and then every 6 months. The Board Certified Behavioral Analysts (BCBAs) who generally provide ABA do not own these tests and do not use them to track progress. After that initial evaluation, the same two tests need to be given every 6 months; and then children who do not progress will no longer be able to receive ABA (this will affect children with more severe forms of autism).
On the other hand, children who perform well will be “graduated.” This will effect high functioning children who still have difficulties though they might test well. In addition, children will only receive ABA for 2 years unless a waiver is approved. Science Kid (one of my sons) has received and thrived under ABA since January 2010. If it had been stopped at 2 years, he would have missed making progress in several areas.
The American Military Family Autism Support (AMFAS) and Jeremy Hilton, 2012 Military Spouse of the Year and military family special needs advocate extraordinaire, have set up a Facebook event: Taking Tricare To Task. AMFAS has provided a sample letter to send to your Congressional Representative. Some people have contacted new stations and news coverage on this issue has started.
Your child might not have autism, but how would you feel if Tricare suddenly decided not to provide chemotherapy because your child with leukemia might die anyway? Or decided to not cover ADHD medication as there are other ways of managing ADHD. Those of us in the military autism community feel this is a stepping stone to reduce medical coverage in broader areas. The time to act is now.Join “Taking Tricare to Task” Now! Write Your Congressional Officer – Get The Sample Letter