South Carolina’s autism care waiver program that has been a godsend for many families for the past seven years will be ending, or fundamentally changing, in the coming years because Medicaid will begin covering those needs.
South Carolina was out front when the Pervasive Developmental Disorder program began in 2007 under legislation dubbed Ryan’s Law. Many advocates for those with autism had hoped the waiver program, which paid for three years of up to $50,000 in care, could be continued to supplement new Medicaid coverage.
But Peter Liggett, the deputy director for long term care and behavioral health services at the state Medicaid agency, said the Center for Medicare & Medicaid Services won’t allow duplicate programs. The current state program has been given an extension, but only until Medicaid services are completely ramped up in a year or two.
Liggett dropped that bit of bad news at the start of an autism summit Wednesday designed to bring advocates together to guide the state’s new Medicaid autism care regulations. Lorri Unumb, the vice president for state government relations for the national organization Autism Speaks and a Lexington resident, suggested another option.
“Why don’t we do something different with the PDD waiver rather than completely dismantle it at the sunset stage,” Unumb said. For instance, it could be pay for things Medicaid won’t cover, such as respite programs to help autism caregivers.
That’s the kind of proactive thinking Liggett wanted to hear at the summit. What he didn’t want to belabor was the need for higher rates for the professionals who work with children with autism. “We’ve heard that loud and clear,” Liggett said, pledging that the new rates will be higher than those in the current waiver program.
Higher pay rates are important to ensure quality care and to recruit the hundreds of new line therapists needed to provide services. Currently, front line therapists working with children with autism can make $12-$14 an hour. Many college graduates leave the field for better-paying jobs after a year or two. Also, the state, like all states hustling to meet the new Medicaid regulations, doesn’t have enough of the higher paying therapy supervisors who must have post-graduate training.
The S.C. Department of Health and Human Services, which handles Medicaid in the state, estimates the new Medicaid guidelines will cover 5,600 children with autism. The coverage is estimated to cost $30 million in the first year and expenses will grow quickly.
The summit participants indicated some of the important issues are raising pay rates, ensuring appropriate training for therapists and cutting some of the procedural barriers for gaining Medicaid coverage. Plenty of other issues came up, and Liggett pledged to take all of the recommendations into consideration in creating state-specific regulations for autism care.