142nd APHA Annual Meeting and Exposition

Home Events & Meetings Annual Meeting Schedule & Program

Online Program

Annual Meeting Recordings are now available for purchase

305934
State Medicaid Waivers and Insurance Mandated Services for Children with Autism

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Wednesday, November 19, 2014 : 10:50 AM - 11:02 AM

Diana Velott, MPA, MS , Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, PA
Edeanya Agbese, MPH , Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, PA
Doug Leslie, PhD , Department of Public Health Sciences, Penn State Hershey College of Medicine, Hershey, PA
Background. While there is a growing need to provide services to children with ASD, it is unclear what options are currently available in individual states. As changes are implemented under the Affordable Care Act, it is imperative to characterize existing state services in order to monitor changes and improvements. The purpose of this study is to identify states that (1) offer TEFRA or Medicaid HCBS waivers to children with autism and (2) mandate insurance coverage for autism services or have mental health parity laws.

Methods.  Researchers reviewed waivers on the Medicaid website, reviewed state websites and spoke with state administrators for waiver information and reviewed the National Conference of State Legislatures website for insurance mandates and parity laws.

Results.  Currently, 23 states have mental health parity laws in place and 34 states have laws that mandate insurance companies cover services for children with ASD.  Forty-one states offer TEFRA waivers (26) or HCBS(c) waivers (31) that include some services for children with ASD and ID/DD, while 12 states have waivers explicitly designed for children with ASD.  There is considerable variation across states; researchers found wide ranges in ages covered (no age restriction, 0-2, 3-6, 0-21, etc.), services covered (ABA to respite only), expected cost of services ($6,295-$161,040), and number of children served (30 to 4,710).

Conclusions.  There is currently no standard set of practices employed by states to help children with ASD. State efforts need to be compared for efficacy and to serve as a baseline for ACA changes.

Learning Areas:

Provision of health care to the public
Public health or related public policy
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the efforts being made by each state to provide services to children with ASD. List the states that have passed mandates requiring insurance companies cover autism services. Compare the number of children with ASD served by Medicaid waivers across states Describe the different services provided by each waiver and their associated expected costs.

Keyword(s): Child Health, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in women's health research for the past nine years and autism research for the past year. I have done extensive research on the subject of this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5125.0: Disparities and Access to Services for Autism and Other Developmental Conditions