EI reducing services

[Guest guest]

I just got word that our state's early intervention program is switching to a

primary provider type model, and children will be limited to 24 hours of

services per six months. That would mean only one hour per week.

Has anyone ever heard of this happening? Can they really do this?

My son is currently receiving 2 hrs of speech, 2 hrs of OT and 1 hr of special

instruction per week, and I was considering asking for one more session of

speech. Obviously we would choose speech if we had to, but this just does not

seem right at all. I cannot imagine how much this is going to affect my son. We

were finally beginning to make some progress.

a

[Guest guest]

What state are you in? What do they mean by primary provider? Thanks Beth Ann

Shanks MSCCC/SLP www.speechacademyllc.com

________________________________

From: aFirst Name <alexsmommee@...>

Sent: Tue, February 2, 2010 12:22:34 PM

Subject: [ ] EI reducing services

 

I just got word that our state's early intervention program is switching to a

primary provider type model, and children will be limited to 24 hours of

services per six months. That would mean only one hour per week.

Has anyone ever heard of this happening? Can they really do this?

My son is currently receiving 2 hrs of speech, 2 hrs of OT and 1 hr of special

instruction per week, and I was considering asking for one more session of

speech. Obviously we would choose speech if we had to, but this just does not

seem right at all. I cannot imagine how much this is going to affect my son. We

were finally beginning to make some progress.

a

[Guest guest]

Early Intervention services are being cut nationwide due to our current economy

and how deep the cuts are going is based upon the state you live in. Parents in

North Carolina are going to see cuts (or the elimination) of services that they

are currently receiving. I think the case managers for the 0-3 EI services are

your best bet to find out exactly what is going on in your individual state and

how they see things from the front lines.

In NC a few months ago there were groups organizing parents to get them to write

to their senators and reps to not follow through with these cuts. They were

holding forums state wide. The cuts came down regardless and are affecting all

of our kids. Even our school age children that are receiving Medicaid services

(and CAP in North Carolina) are feeling the pinch. Things that were once paid

for are being scruitinized and denied.

Therapy providers who once just had to submit to Medicaid a request for services

for a child were notified in October that all children had to be entered into a

database by 12/31/09 with very detailed plans and justification for continuation

of services -- this from a Federal level. If they did not make it into this

database then providers could not provide services.

I've even seen private insurance bite back. My daughter was basically kicked

out of PT by my private insurance because they determined her gait would never

improve (even though still low tone)and she was how she was going to be for the

rest of her life so they denied her based upon the services were becoming

" maintenance " . When a health insurance company denies you because of

" maintenance " then Medicaid will not cover additional services. We attempted to

get them to change the denial reason and they refused. Now I have to rely on

the school and myself for PT.

Another example -- I have had an augmentative communication eval scheduled for 2

months. 2 weeks ago the evaluator called and said all of a sudden Medicaid had

changed the rules and all aug comm evals had to had to go through a pre-cert

process with private insurance and Medicaid. While we know in NC our Medicaid

services cover aug comm -- it didn't matter. So we had to rush around and fill

out paperwork and provide copies of insurance cards in advance, get the pre-cert

done and doctor's order so I could just go to the initial eval. Personally I

think we have not seen the end of this or the cuts yet unfortunately.

Huggins

Mom to Hailey (12) and Jillyan (8 - CHARGE Syndrome)

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> What state are you in? What do they mean by primary provider? Thanks Beth Ann

Shanks MSCCC/SLP www.speechacademyllc.com

>

>

>

>

> ________________________________

> From: aFirst Name <alexsmommee@...>

>

> Sent: Tue, February 2, 2010 12:22:34 PM

> Subject: [ ] EI reducing services

>

>  

> I just got word that our state's early intervention program is switching to a

primary provider type model, and children will be limited to 24 hours of

services per six months. That would mean only one hour per week.

>

> Has anyone ever heard of this happening? Can they really do this?

>

> My son is currently receiving 2 hrs of speech, 2 hrs of OT and 1 hr of special

instruction per week, and I was considering asking for one more session of

speech. Obviously we would choose speech if we had to, but this just does not

seem right at all. I cannot imagine how much this is going to affect my son. We

were finally beginning to make some progress.

>

> a

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