I’ve been invited to The Institute for Pure and Applied Knowledge (IPAK) conference in June

The Institute for Pure and Applied Knowledge (IPAK) has invited me to participate in their conference in Pittsburgh, PA from June 15-17.  I participated in a conference call with the founder of the organization, Dr. James Lyons-Weiler on March 30th.  The Pittsburgh conference in June will bring medical doctors and other scientists together for what promises to be a groundbreaking event that will lead to new research and treatment modalities for children with Autism Spectrum Disorders and other disabilities.

Hope you can join us there!  Listen to the conference call here.

Steve

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Supreme Court rules in landmark case with implications for in-school treatment providers

The February, 2017 Fry v. Napoleon Community Schools Supreme Court ruling appears to indicate that if a child is prescribed a Behavioral Health Rehabilitation Service (TSS, MT or BSC in Pennsylvania) by a licensed practitioner of the healing arts in any State which is funded by the EPSDT mandate of the Medicaid Act, then the parents of that child can bring a suit in Federal court, bypassing the “FAPE” court (pun intended) that schools offer and get a ruling as to whether or not the school can bar the entry of a trained mental health professional on their premises (whether or not they claim to already employ comparably skilled, trained or supervised people on-site to do the same tasks).  If the parents win, their lawyer can collect “attorney’s fees.”  This balancing of the scales in the education of children with disabilities is long overdue.  Parents no longer have to ask permission from education authorities to bring their complaints about the denial of their child’s access to mental health treatment services to Federal court authorities!

This ruling, described in the SCOTUS blog by Amy Howe (http://www.scotusblog.com/author/amy-howe) has terrific implications for all of the children who need honest mental health treatment professionals beside them in school in order to address their mental illness symptoms – NOT to get a “free, appropriate public education.”  It is now possible for parents to go to the Court Room without having to ask permission to leave the Class Room.

Amy’s analysis is here: http://www.scotusblog.com/2017/02/opinion-analysis-court-outlines-boundaries-disabilities-education-cases

Making information about EPDST funded mental health treatment for children more widely available to children is the focus of The Issachar Project   This short video explains the essentials of EPSDT funding for the treatment of mental illness symptoms in children:  https://www.youtube.com/watch?v=kwsdiQ0JKo8

Steve

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Understand how EPSDT funds mental health treatment for children — in 5 minutes

Understand EPSDT funding to help children with behavior challenges – in less than 5 minutes.

https://youtu.be/kwsdiQ0JKo8

Pass it on!

Steve

My apologies when WordPress inserts advertising in my posts.  I am not endorsing, selling or promoting any of the products in the ads that WordPress inserts in my posts.

A Necessary Addition to the New BHRS – IBHS Regulations

The National Academy of Sciences (NAS), chartered by the US Congress more than 150 years ago to advise Congress on matters of science, published the results of an exhaustive study of the behavioral treatment needs of children with Autism Spectrum Disorder symptoms in 2001. In that study, they revealed that children who didn’t receive at least 25 hours of year-round “intensive, individualized treatment” did not have a reasonable probability of symptom reduction. The American Academy of Pediatrics (AAP) published the results of their own studies in 2007 and 2012 that came to the exact, same conclusions: Children with Autism Spectrum Disorders require a MINIMUM of 25 hours of “intensive, individualized treatment” in order to have a reasonable probability of symptom reduction.

Because insurance companies exist to spread the funds they control as widely as possible (giving as little as possible to as many of their members as possible), there is an unavoidable conflict between their mission and achieving the NAS and AAP standards for prescribing “intensive, individualized treatment” to children with Autism symptoms. Insurance companies routinely authorize just 10 or fewer hours of intensive, individualized treatment (TSS service), and they routinely cut off treatment authorizations after 3 years or less. The fact that the State has encouraged and supported these under-prescribing practices for decades is widely known; it is the biggest reason for the passage of Act 62 which was intended to make more funding for the treatment of Autism available.

For these reasons, it is essential that a reference to the NAS and AAP national standards for the prescription of “intensive, individualized treatment (TSS service)” has to be included in the IBHS regulations currently being drafted to replace Behavioral Health Rehabilitation Services (BHRS) that have been called “wraparound services” in Pennsylvania. With a reference to national standards in the new IBHS regulations, prescribers who recognize a child’s true need for “intensive, individualized treatment (TSS service)” can confidently write prescriptions that will deliver the minimum amount of treatment necessary to reasonably have an impact on the child’s Autism symptoms.

Without that explicit reference in the regulations to an unequivocal national standard, insurance companies and their supporters will continue to water-down and dilute the prescribing practices of honest, ethical and knowledgeable practitioners and force them to accept lower standards of care for the children they are trying to treat. This is the “state of the art” now. This sad status quo will continue unless the regulations include national standards of care for children with Autism Spectrum Disorder symptoms. It won’t matter if the treatment providers have become better trained and more skilled. If they can’t deliver the amount of treatment that the child actually requires because an insurance company can maintain pressure to lower levels of treatment, it won’t matter how good the treatment providers are.

The IBHS workgroup meets on January 20th.  Its work is nearly finished.  It has to insist that the NAS and AAP national standards are included in the IBHS regulations in order to give prescribing practitioners the support that they desperately need in order to deliver and defend the honest, helpful treatment prescriptions that children with ASD symptoms need. Without the addition of those national standards, it will be “business as usual” despite having better qualified providers.

Learn more at www.ibc-pa.org

Steve

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A saying attributed to Buddha now circulating on the internet calls for a response

I recently saw something on the internet that begs a response.  Buddha is reported to have said:  “Believe nothing.  No matter where you read it, or who said it, no matter if I have said it, unless it agrees with your own reason and your own common sense.”  Whether or not Buddha said it many, many years ago, it’s bad advice now, especially for people living in America.  Here’s why:

If your ability to reason has been stunted by years of schooling that reveal only one route to truth (deductive reasoning), instead of its alternative (inductive reasoning, where truth is measured in probability, not the “certainty” offered by deductive reasoning based on the “acknowledged truthful facts” generously provided by the various authorities for your peace of mind), you can’t rely on your own “common sense” because it doesn’t EXIST anymore.  That’s the true legacy of schooling in America for the past 100 years, and especially so in the last 50.  We keep electing the leaders that our leaders want us to elect, by offering us their choices.  It’s a downward spiral.  See?  The only way out to recover from this situation is to “unflush the toilet” and that’s impossible, since there are too many people riding the spiraling stream downward.  The best we can hope for is to find a way to climb out of the bowl.  That’s what being an entrepreneur is all about – climbing out of the bowl.

Best wishes for 2017 to all of the other entrepreneurs out there.

Steve

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Has a New Era of openness & responsiveness dawned at Pennsylvania DHS?

I had a very productive meeting today with several members of the PA Department of Human Services regarding plans to transition from BHRS (wraparound) services to “Intensive Behavioral Health Services” (IBHS) over the next year or so. I was reassured that the new license that will be required for BHRS providers to become eligible providers of IBHS will be accessible to BHRS providers that currently deliver services in compliance with all existing standards, so my organizations should be able to become licensed as IBHS providers without any doubt. Continued affiliation with existing Behavioral Health Managed Care Organizations should also not be a problem, but that remains to be seen (although I’m optimistic).
 
It appears that DHS may be in the process of becoming more accessible and responsive, following several decades of maintaining a decidedly “different” attitude. Hopefully, the shape of things to come will continue to be positive. At least I’ve finally been allowed to receive and review the draft IBHS regulations, and have been invited to submit comments and recommendations directly to DHS authorities.

Welcome to The Issachar Project!

I created The Issachar Project in 2009 to provide parents, advocates, attorneys and practitioners with a source of information about Medicaid, the EPSDT benefit and successful behavioral intervention strategies for treating children in their homes, schools and communities.  Now, the Issachar Project is moving into high gear with the publication of my book THE ISSACHAR PROJECT set for May 25th in conjunction with my presentation at AutismOne in Chicago the following day. The Issachar Project will present questions to State Medicaid Agency personnel regarding the availability of EPSDT funding for behavioral treatment programs in all fifty US States. With the answers to these questions, it will be possible for a parent to strategically navigate the dark waters of the EPSDT system in any State in a search for honest and compassionate government employees. They do exist, but it’s really disheartening to wade through the system until you find one, especially without a map.

The mission of The Issachar Project is to provide that map, individualized for every state. It will be updated no less than once yearly and maintained in an on-line database, supported by philanthropy. With this map, parents will be able to quickly identify

•  The correct forms to fill out, how to fill them out and where to send them to enroll a child with a disability in the Medicaid system in that State.

•  If the State has implemented the “Medically Needy” category of Medicaid eligibility as a matter of State law, then virtually any child under the age of 21 who has a disability can enroll in Medicaid in that State, but the enrollment form has to be specially marked for this category.

•  The key people in the State who “know the truth” about EPSDT funding and how it is administered in that State to provide funding for Behavioral Health Rehabilitation Services (in addition to dental & lead level screenings and the other better-known portions of the EPSDT mandate).

•  The names and contact numbers for the Medicaid Managed Care Organization(s) in the family’s catchment area that will be involved in the overseeing of the child’s EPSDT funding, and the “best practice standards” that they espouse.

•  The names and contact numbers for the Medicaid Enrolled Practitioners within the family’s catchment area that are now, or could be, involved in delivering EPSDT funded Behavioral Health Rehabilitation Services to the child. We will assess their “track record” based on national standards of practice and a review of training and treatment documents, State performance assessments, audit and criminal investigation records and other material that may be submitted by parents.

•  The names and contact numbers for “licensed practitioners of the healing arts” who are not yet enrolled in Medicaid within the State who may be interested in working with The Institute for Behavior Change to create a “Medical Home” within a pediatric or family medical practice that will have a strong Behavioral Health component. With help from the Institute for Behavior Change in regard to staff recruitment, training and monitoring, it is possible for any medical practice in any State to implement Effective Treatment in a Wraparound Cup® as efficiently and successfully as The Institute for Behavior Change has done for the past 20 years.

Steve