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Almost nobody knows that, regardless of family
income, children in Pennsylvania who do not yet have
Medical Assistance (Medicaid) benefits but do have a mental disability (autism,
ADHD, etc) can get an expert psychological evaluation at no cost
whatsoever, in about 30 days, and that treatment (Behavior Specialist consultations and
Mobile Therapy services) can often be started almost immediately
following the evaluation if these services may be of help to the child.
Moreover, these services may be available to disabled children at no
cost whatsoever, in 35 (or more) other states as well.
Some people in Pennsylvania mistakenly refer to these federally
mandated EPSDT "Behavioral Health Rehabilitation" (BHR) services delivered under Medicaid as "wraparound"
services, but there are at least two significant differences: 1)
There is simply no need to wait for any insurance company to give
its "permission" for a child to begin receiving these EPSDT
BHR services
if he/she lives in Pennsylvania where they are routinely prescribed,
has a diagnosed mental illness, is under the age of 21, and does not
yet have Medical Assistance benefits, and 2) EPSDT services are federally mandated treatment
opportunities that are available to disabled children in all
50 states (although not all states have implemented BHR services as
conscientiously as Pennsylvania); "Wraparound" is a treatment philosophy.
Tremendous opportunities for licensed
psychologists and other "licensed practitioners of the
healing arts" to direct and supervise the delivery of these
services exist, throughout out the USA and its territories. As
a licensed psychologist since 1981, I have been providing
these services to Pennsylvania children very successfully,
and currently direct the largest private practice of
psychology in Pennsylvania dedicated exclusively to
improving children's mental and behavioral health, called
The Network for Behavior Change.
The staff who provide
these services under the supervision of the
Network
psychologists are recruited, trained, and monitored by The
Institute for Behavior Change which has been recognized by the
Pennsylvania Psychological Association (PPA)
Psychologically Healthy Workplace Award program for its
exceptional Employee Career Development
activities. I look
forward to speaking with interested colleagues and concerned
parents about the
evolution of psychology as a profession and all of the
wonderful opportunities that EPSDT BHR service delivery can
create for children, adolescents, their families and the professionals who
help them.
Steve Kossor
Executive Director
The Institute for Behavior Change
www.ibc-pa.org
The following Power Point presentation
has been converted into an extensively notated PDF file. You are free to copy this presentation file and distribute it to others, as
long as you do not change the content in any way.
Click here to download the "Medicaid, EPSDT & Wraparound"
presentation program
The thread of MA eligibility
has just been completed, tracing
EPSDT "Behavioral Health Rehabilitation" (BHR) services through U.S.
Medicaid Law and the
Code of Federal Regulations. Like an enormous bowl of
spaghetti, the Medicaid statutes are witheringly complex and
cross-referenced from here to Kingdom Come, defying anyone to "figure it all
out." In this 33 page document, I started with the first noodle in the bowl
(the Social Security Act section 1902a) and followed it
step-by-step, finding where it connects with other noodles relevant to BHR
services. I finally emerged from the bowl with a map
showing how "Behavioral Health Rehabilitation" (BHR) services are part of
the EPSDT mandate and how they can be implemented in other states in
accordance with Medicaid regulations, just as they have been in
Pennsylvania, where I have been implementing the equivalent of BHR services
successfully since 1981 — more than 10 years before EPSDT
officially came to Pennsylvania.
Contact me
if you would like information about this work.
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