SWFL mom calling on medicaid for better therapy option

Posted at 9:47 PM, Apr 10, 2020
and last updated 2020-04-10 22:23:47-04

CAPE CORAL, FLA — "He has the biggest funniest personality."

Alisanne Colkitt says her 2-year-old, Jozsef, is in a really good place.

Especially, when she considers that just one year ago, things looks a lot different.

"He was completely non-verbal and he would get upset so he would start banging his head and as a parent I didn't know how to handle that," said Colkitt.

She credits his transformation into the talkative, active toddler she has today, to something called "ABA" therapy.

"It's called applied behavioral analysis and basically what that does it helps him with is behaviors," said Colkitt.

Before the COVID-19 pandemic, Jozsef was getting about 20 hours a week at a center in Naples.

His therapists have switched home-based therapy for now, but things are still uncertain.

And she says medicaid isn't making things any easier.

"It feels like it's a constant battle some days," said Colkitt.

The insurance, which is handled by Florida's Agency for Healthcare Administration, or AHCA, hasn't given any clear guidelines as to if or when they should switch to teletherapy.

But they have made it clear that if children receiving ABA therapy have to switch to an online version because of COVID-19 concerns, they won't cover any interactions between the therapist and child, what they will pay for is for parents to learn how give the therapy to their kids.

"I wouldn't be able to do the therapy justice that's why these people are trained to be able to this therapy. They know how to do it, they're the expert," said Colkitt.

When Fox 4 reached out for comment, AHCA released the following statement:

The Agency for Health Care Administration is committed to ensuring children continue to receive services during this state of emergency. The delivery of behavior analysis services both in person or via telemedicine requires constant direct observation of a child’s behaviors and redirecting inappropriate behaviors, especially those that are self-injurious or harmful. Since these services are hands-on and designed to be delivered in person, a caregiver must directly participate when the provider is not physically present during telemedicine.

During caregiver training services, the board-certified behavior analyst or assistant analyst is available for a couple of hours each day via phone and video to observe and guide the parent. If a parent is feeling overwhelmed because their child’s provider is not able to deliver in-person services and telemedicine services are not ideal, the Agency can assist a parent in getting assigned a new technician temporarily who is able to continue rendering services in the home.

"The problem with that is when you throw someone new in with my son they have to spend days of what they call 'pairing,'" said Colkitt.

It's basically building a connection, from scratch.

Colkitt says she's already had the training and while she's happy to help out, she's also calling on AHCA to provide better guidance and flexibility, so that her son's therapists can make the final call on what's best for her child.

"One thing that works for one kid, is not going to work for another kid," said Colkitt.