New State Policy, Resulting From Lawsuit, May Adversely Affect Autistic Kids (January 9, 2021)

According to WITF, a state policy change may leave thousands of children with autism without the regular therapy that helps them learn crucial skills. Children with autism often participate in therapy called applied behavior analysis (ABA). Proponents say it helps those children reach milestones such as communicating and interacting with others.

The new policy program, known as “intensive behavioral health services,” was developed in response to a 2016 class action lawsuit against the Pennsylvania Department of Human Services. Advocacy group Disability Rights Network settled with the state after asserting that it was failing to provide proper treatments for children. Under the policy change, set to take effect January 17, 2021, children who attend regular therapy at clinics will no longer be able to have those services paid for by federal Medical Assistance (MA). Such services would cost about $6,000 a month without health insurance, and even with health insurance are likely to cost more than $1,500.

As a result of the settlement, the PA Department of Human Services (DHS) agreed to develop a new behavioral services model to help children with autism. The new model was made public in late 2019. It was intended to add access to services. However, according to advocates, in this case the change has had the opposite effect.

For example, although MA will continue to pay for sessions conducted in the home, some parents claim that a clinical setting can be a better environment since it offers a predictable space where communication can be better and problem behaviors can be worked on in a safe and secure manner. Another benefit of center-based services is the opportunity for more interaction between the “behavior technicians” and the behavior analysts who develop programs tailored to each child. Thus, many contend that the decision to conduct therapy at home or at a clinic should be up to the parent and the care provider.

Another consideration is that, in light of the pandemic, clinics are considered safer in many ways than in-home visits.

It is feared that the policy change will result in  thousands of children losing their center-based services. due to an “unintended consequence” of the state’s response to the lawsuit settlement whereby one-on-one therapy at clinics was incorrectly categorized as “group” treatment. According to a spokesperson, PDH is aware of parents’ concerns and is committed to ensuring children, youth and young adults receive appropriate clinical services to meet their individual needs, and to do so in settings best able to provide a therapeutic environment to meet those needs.

For more information from WITF, click here.