Nebraska Medicaid is currently reviewing and considering changes to who qualifies for a specific type of autism therapy, which has raised concerns among parents and providers alike. As changes loom, many families are uncertain about what these modifications might mean for their children. To ensure that the voices of those directly impacted are heard, the state is inviting input from families and providers by January 8. Those interested in sharing their thoughts or suggestions can email the Department of Health and Human Services (DHHS) at DHHS.MedicaidMHSU@nebraska.gov.
The therapy under review is Applied Behavior Analysis (ABA), a widely recognized and effective treatment for autism spectrum disorder (ASD). ABA is known for its structured approach to improving social, communication, and learning skills through reinforcement and other behavioral strategies. However, the potential changes in Medicaid coverage for ABA therapy are causing some uncertainty among those who rely on these services, especially regarding the autism therapy guidelines that may be impacted.
Taylor Martinez, a mother of 5-year-old Brielle, is among those concerned about the changes. Martinez describes her daughter as a bright, energetic child who has made remarkable strides with the help of ABA therapy.
“She makes the room just light up with her personality,” Martinez said.
In addition to being a mother, Martinez is also a registered behavioral technician (RBT) who works with children diagnosed with autism. Her unique perspective as both a parent and a professional in the field helped her recognize the signs of autism in her own daughter. Through her experiences, Martinez learned about ABA therapy and how it benefits children like Brielle.
“I was able to actually discover myself. ‘Hey, she has the signs that I’m learning about that I’m helping other children with,” Martinez told KETV Tuesday.
ABA therapy has played a significant role in her family’s daily life, helping them navigate important behavioral milestones at home. For example, through the application of ABA principles, Martinez has been able to teach Brielle how to respond to certain situations, such as when a limit is set by her mother.
“By doing it at home, we’re able to help her realize, ‘OK, so if mom says no, this is how we have to handle that,'” Martinez said.
However, recently, Martinez received a bulletin from her employer, who works with children with autism, that Nebraska Medicaid is reviewing its ABA service definitions. This announcement included a link to the drafts of the new service definitions, one of which includes a requirement that a registered behavioral technician must hold a bachelor’s degree in psychology, social work, child development, or a related field.
“We are already struggling, living in such a rural area and having an RBT come in, now having to require a bachelor’s degree,” Martinez said.
This requirement raises further challenges for families living in rural areas, where access to specialized care is already limited. Martinez fears that the new guidelines could make it even harder to access services, as fewer qualified professionals may be available to meet the increasing demands of ABA therapy.
The DHHS, in response to these concerns, emphasized that the revisions to ABA service definitions are part of an ongoing effort to improve the quality of care and ensure that services are medically necessary. The DHHS reassured families that the changes will not limit access to essential services but are aimed at clarifying the expectations and standards for ABA therapy.
In an email to KETV, the DHHS stated:
“DHHS is committed to providing the best services possible to Nebraska children and families. Applied Behavioral Analysis is beneficial for children with autism spectrum disorder (ASD) and their families. The Department is committed to continuing to provide ABA to Medicaid recipients and improving services.
“DHHS is seeking to ensure the quality of care by clarifying the expectations and standards of ABA services. Any changes will not limit access to services that are medically necessary. DHHS is also seeking feedback from providers and Nebraska families on these documents and have already received many responses. Once all submitted responses are reviewed, DHHS will then consider potential changes to improve the ABA service standards. Nebraska residents who would like to submit a comment, please email feedback to DHHS.MedicaidMHSU@nebraska.gov.”
Despite the reassurances from DHHS, Martinez remains cautiously optimistic but expresses concern about the impact these changes might have on families in need of intensive ABA services. While some children may thrive with 20-30 hours of ABA per week, others may require up to 40 hours to reach their full potential. Martinez hopes the state’s decision-makers will carefully consider these challenges and the real-world impact on families who rely on these services.
“That makes me feel a little better. But I really hope that they hold up their end while they’re saying that because there’s so many kids that would end up going without. Even being limited to 20-30 hours a week sometimes isn’t enough. Sometimes I’ve seen clients need 40 hours a week to get the help that they need.”
As Nebraska Medicaid continues to review its autism therapy guidelines and gather feedback from families, parents like Martinez are urging the state to carefully consider the long-term effects of these changes. For many families, ABA therapy is not just a treatment; it is a vital resource that can make a lasting impact on their children’s lives. The hope is that Nebraska will continue to prioritize access to these essential services while striving to improve and maintain the highest standards of care for children with autism. Families who wish to share their thoughts on these proposed changes should not hesitate to voice their concerns by emailing DHHS at DHHS.MedicaidMHSU@nebraska.gov.
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