Too Many Fingers in a Pie make it Rotten

Well, I think the same-thing is happening to DHS and their autism benefit. They have asked and asked and are still asking MN autism community – what do we think? I am sorry, but by now if DHS does not know what the heck we think, then they will never ever know.

At some point, MN DHS has to take a leap and apply for this benefit that passed in the House, Senate and signed by the Governor. Not to mention, the lengthy discussions and what do you think sessions at HSAC. And, if that was not enough, we had more DHS discussions almost a year before with Autism community as far back as 2011 whereby Regina and previous DHS Mental Health Commissioner came to many autism community meetings in churches, halls and more halls. Then there was that DHS ASD advisory council led by UMN ICI dept that again asked everyone & their mamas what they thought and gave all of this data and information to DHS. I have never seen or heard of another state that did this much asking, I mean I appreciate their thoughtful process of wanting to hear from everyone, but they can’t procrastinate forever. They are the state Medicaid agency & they have qualified staff and leadership. I know they can do this, if they just did it and trusted their abilities. 

I for one am getting tired of DHS asking what the heck do I think. DHS knows what I think, what all of the providers think, what all of the mainstream parents think and everyone in between. It is time for them to have faith in their abilities and apply this benefit with CMS. Otherwise, this benefit will become a buyers remorse if it is over explained needlessly. 

MN DHS must have common sense as a state agency, take lead and responsibility without constantly asking what we think. For example, asking if BCBA can diagnose or be the ABA provider clinic leader is both stupid and negligent. The fact that there is NO BCBA certification board in MN should be a red flag. BCBA basically means that person can do functional behavior analysis and knows ABA. It does not mean they are licensed to diagnose and they are not a mental health professional. Therefore, asking us that question = stupid, Come on. Autism is a medical condition with a neurobiological and mental health symptoms. Therefore, someone with a license – such as a licensed psychologist, psychiatrist or a LMFT and has been trained in diagnosing mental health disorders should diagnose autism and head any ASD clinic. A certification of behavior analysis does not qualify, neither does someone that has worked in ASD field for years or even decades. For example, if you were sick – do you see a licensed medical doctor or someone who watched a doctor for years? Come on and give me a break. If DHS allows un-licensed people to open and provide therapy to children, they will be sued for negligence and stupidity. 

What parent says I am going to take my child to a provider headed by un-licensed medical person. It is like saying – well your child’s special ed teacher will be the para because she has worked in the school district for years. That does not make that person a licensed special education teacher. I am even baffled that DHS is asking such questions. 

Common sense has to prevail here. It has been almost a year since this law passed and for DHS to still ask stupid questions while they are still providing ABA to fee for services kids while it denies low income managed care kids and calling ABA skills training is both irresponsible and waste of time. MN DHS needs to use common sense, fill the darn 1915i application, send it to CMS and let the process work itself out. 

Furthermore, CMS will not deny this application given how few states are covering autism therapy under 1915i which is what Sec Sebelius stated herself as a potential ASD benefit. And, yes Florida ASD parents sued Medicaid agency and won. Washington State Medicaid Autism families also sued WA Medicaid agency for refusing to cover behavior health services. Good for both of these states and I hope more low income Medicaid autism families sue their Medicaid agencies, especially if they are paying for wealthier families and/or for private insurance families. I think it is cruel for any state to deny low income children the same services and treatments wealthier children get which is exactly what MN Medicaid agency is doing now. The new ASD benefit was suppose to address and fix this, but at the rate – they are crawling, children keep suffering. 

I don’t think CMS is going to appeal Florida ruling because denying medically necessary autism treatment will not go far by any judge in their right mind. Common sense is ABA provider must be led by a licensed mental health professional, be trained in the CLAS guidelines and certified. There must be service coordinator that is objective that parents can ask to help them navigate the system. Evaluation and assessment must be independent at least once a year and parents must have the ability to get second opinion if the first one is done by the provider. There must be a fair and due process policy for parents and providers to assure equal access to care and therapy. All common sense – come on DHS. Stop crawling and start walking – more like running since you have wasted months and years of asking what the heck we think.

You know what we think – just apply this benefit so that kids can start getting the services they need now.

Above words are my opinion and do not reflect any committee or agency.

Thanks!

Idil – Somali Autism Mom & Minority Advocate