TRICARE, the military’s health care program, is making policy changes that impact autism therapy. Marine Corps wife Nashota Jackson whose six-year-old son has autism said she was frustrated when she found out.
“I was angry that a therapy that works so well for our son and has really begun to draw out who our child is inside is threatening to be taken away,” said Jackson.
The changes will affect a treatment called Applied Behavioral Analysis or ABA.
“ABA is the cornerstone of autism treatment,” said Rebecca Estepp, Communications Director for Elizabeth Birt Center for Autism Law and Advocacy (EBCALA).
Estepp’s 15 -year-old son has autism. It’s estimated more than 23,000 Tricare beneficiaries have autism, with treatment averaging around $16,000 a year.
The changes take effect July 25 and require children who need more than two years of treatment to get a waiver. Children who need care after age 16 also need a waiver. The new rules also require standard testing every six months, where children must demonstrate progress. Jackson said providers already submit monthly progress reports, and she takes issue with the standardized test.
“The test isn’t going to show that without ABA he wouldn’t be partially potty trained at six years old,” said Jackson of her son. “Without ABA he wouldn’t be saying any words.”
TRICARE sent Fox 5 a statement that reads in part:
In fact, the Department of Defense is greatly expanding applied behavior analysis (ABA) services with introduction of the ABA Pilot for non-active duty family members starting July 25th…There is no change in the services available to active duty family members. – Bonnie Powell Lead Program Supervisor, Beneficiary Education & Support TRICARE Management Activity
The statement goes on to read:
“Our goal, first and always, is to support our beneficiaries and we actively work with our managed care support contractors to assure access to all types of care including applied behavior analysis.” -Bonnie Powell – Lead Program Supervisor, Beneficiary Education & Support TRICARE Management Activity
“The trick is they’re making it almost impossible to quality for these programs and I think it comes down to saving money on their bottom line,” she said.
Two senators sent a letter to TRICARE that read in part:
“The apparent lack of understanding of the needs of children with developmental disability, including autism, when drafting the recent Tricare policy changes is astounding,” Sens. Kirsten Gillibrand (D-NY) and Patty Murray (D-WA)
Estepp said she and other advocates want San Diegans to get involved as well.
“We’re asking people to please contact your senators, contact your congressional representatives, and let them know that our nation’s heroes deserve adequate care for their children who have developmental disabilities,” Estepp said.