"Many Arkansans with special needs benefit from specialized therapy, like speech therapy, physical therapy, and occupational therapy. The Department of Human Services is proposing to put a cap on how much of that therapy people with special needs can get each week." - Bob Clausen, Arkansas Matters
"The rules for specialized therapy could soon change. DHS proposes allowing only 90 minutes of occupational, physical and speech therapy a week that would be reimbursed by Medicaid. If more therapy is needed, families would have to go through a different process." - Arkansas Matters
Kimberly Hines, an Arkansas mother of a child with Downs Syndrome, has begun a petition on change.org to help explain why this proposal shouldn't be approved. She posted this on her page for her petition:
"Primary insurance does not pay for therapy services, which means that in addition to a primary insurance, we must pay out of pocket for a type of Arkansas Medicaid insurance called TEFRA that does cover therapy services. To qualify for therapy services each child must be evaluated biannually to determine (per Medicaid standards) whether or not they "qualify" for these services. Just last year, [her son] did not qualify for any physical therapy, even though he continuously scores extremely low on these evaluations. The 'qualifications' remain so high, that even if a child is considered on a less than 'profoundly delayed' level, therapy services may be reduced or denied."
The DHS director of communications, Amy Webb, said, "Setting these thresholds will help ensure that people who need the services will have access to the services, but also that the services, but also that the services go to the appropriate individuals. This is really about us making sure those services are available to those who need them."
"DHS says this is a way to sustain the Medicaid program in the state." - Arkansas Matters
I asked two individuals that have connections with children with special needs what their opinions were on this proposal to decrease therapy. I asked both of them: "Do you have any thoughts or opinions on Arkansas voting to decrease therapy to 90 minutes per therapy (speech, occupational, physical) that is reimbursed by Medicaid?"
Take a look at their responses.
Lindsey Marshall, an elementary education teacher at Westside School District In Jonesboro, stated, "Part of me says that four and a half hours a week is enough for some kids, but there are other types of therapy too. Some kids really need therapy working with their social skills, recreational therapy, warm water therapy, ABA therapy, etc. If these common therapies aren't covered by Medicaid to the extent that they are needed, being that it is more than the limit set by DHS, and children still need additional therapies on top of that, how will parents pay for that? The least Medicaid could do is support the funds for recommended amounts. It is also important that providers are following a strict guideline that appropriately shows why they recommended a certain amount of minutes and limited it to that amount."
Holli Crowe, an LPN and mother of a daughter with Down Syndrome, responded with, "Therapy and early intervention is the key to kids with special needs and developmental delays becoming successful. Therapists work to get these kids ready for school, help teach them activities of daily living and work closely with their primary care physicians with concerns to help ensure these kids are getting what they need. Medicaid should not be able to dictate how much therapy a child can receive. That should be left up to the primary care physician and licensed therapist."
It is apparent that limiting therapy for children with special needs is a disapproved approach. In my opinion, there are many other programs within Medicaid's funding that could be reconstructed, and therapy for special needs children is not one of those.
If you would like to sign the petition fighting this proposal to decrease therapy for special needs children, follow this link and help get the word out .