An advocacy group for autistic children blasted Florida’s Agency for Health Care Administration (AHCA) this week, saying approvals and enrollments for behavior analysis services have been very slow.
According to a press release from the Florida Association for Behavior Analysis (FABA), the group called on state officials to “immediately address significant issues in how behavior throughout Florida are approved and authorized to provide treatment for children.”
According to FABA, many children with autism or other developmental disorders are being denied medically necessary behavior analysis services as a result of harmful delays, routinely lasting a month or longer, by a state contractor hired by AHCA.
“These delays are inexcusable and are causing heartache for so many children and families who desperately need the services provided by qualified behavior analysts,” said Nikki Dickens, president of FABA. “Our state government simply cannot sit back while these vulnerable children suffer as a result of an ineffective and inefficient bureaucratic system.”
Behavior analysts represented by FABA are the people who help children with autism and other developmental disorders. AHCA recently switched the contractor who was doing this work from Beacon to eQHealth and the results have impacted families with special needs, including Jennifer Quinn. She is a mother of eight children, including five who were adopted with special needs.
Quinn told Bay News 9 earlier this month that AHCA’s delays are causing setbacks for her children, who aren’t getting the therapy they need. From the Bay News 9 story:
Four of (her children) were getting the therapy until it stopped recently.
“Their communication started to improve and improve. And as these kids improved their communication, their bad behaviors decreased,” said Quinn.
She says for weeks her children have been without their FABA therapy while their therapist is audited. Four of her children have down syndrome and one has cerebral palsy. She says she’s already noticed regression.
“This therapy is the therapy that keeps families intact, that keeps children and parents healthy and happy and growing and learning,” said Quinn.
Quinn now fears without the therapy, her children will continue to regress. She says FABA is an effective therapy for children with autism or other special needs like down syndrome.
“That’s my fear is that our family will go back to where we were a year ago and that was a dark place and a scary place for us as parents and for them,” said Quinn. “I just don’t want to go backwards. It’s very scary. These kids deserve better than that. We can do better than that for these kids,” said Quinn.
In May, AHCA issued a moratorium on new behavior analysts in Miami and Broward counties in order to weed out fraud that was occurring there. While this was an important step that state officials were right to take, FABA says the state needs to do a better job to find a solution that doesn’t involve preventing kids from getting care.
The delays have been going on for months but the problem was exacerbated in June, when the contractor hired by AHCA to process Medicaid assessments, authorizations, and claims for behavior analysis services, terminated all authorization approvals from the previous contract administrator. This caused a chain reaction requiring all providers to seek reauthorizations. The transition from one provider to the other has created signficant problems affecting both behavior analysis professionals and the people they care for every day, says FABA.
A spokesperson for AHCA told Bay News 9 that the agency stands by its original plan and says that no children who need therapy have been affected:
“There is absolutely zero loss of services for children that need BA therapy. Saying otherwise is untrue and misleading. To crack down on widespread fraud and abuse and to protect taxpayers, AHCA recently put a moratorium on new providers in Miami- Dade and Broward counties. This does not apply to Tampa.”
But FABA says AHCA’s claims are simply not true.
Providers say the delays threaten their ability to provide services to vulnerable children. Many are still providing services to children even without any assurances from the state about when, or even if, they will be reimbursed.
Some providers have already gone months without reimbursements, which forces them to pay out of pocket.
“AHCA has repeatedly said there will be no loss of service for children who need behavior analysis services, but we are hearing from countless providers and families across the state who say that is simply not true,” Dickens said. “This problem must be addressed immediately, and it must be addressed with the top priority on helping those Floridians who need the services that skilled professionals can provide.”
FABA says parents and caregivers held rallies in Jacksonville and Tampa this week and have another planned for Melbourne next week to highlight the challenges. While the issues facing AHCA are apolitical, the rallies come during the peak of the political campaign season. AHCA’s top executive, Secretary Justin Senior, reports directly to Governor Rick Scott, who is currently engaged in a competitive election battle for the U.S. Senate.