Frequently Asked Questions
(Families-FAQ)

 

 

SCREENING

MEDICAID AND MICHILD AUTISM BENEFIT
  
PRIVATE INSURANCE
  
CRISIS SERVICES

 

If parents suspect their children of having Autism Spectrum Disorder (ASD), what should they do?

The parents should discuss their concerns with a health care provider.

If parents have a concern about a child's health or development, EarlyOn serves infants and toddlers from birth to 36 months with developmental delays or conditions that could lead to such delay. Parents can confidentiality discuss their concerns at 1-800-EarlyOn (1-800-327-5966).

The parents can also go to M-CHAT.org and fill out the Modified Checklist for Autism in Toddlers (M-CHAT). M-CHAT's can be used to determine if further evaluations for Autism Spectrum Disorder is neccessary. M-CHAT is a screening tool only. The M-CHAT is intended to be administereed by a trained health care professional. Parents should discuss answers and results of the M-CHAT with a doctor, regardless of the result.

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If a child is diagnosed with Autism Spectrum Disorder (ASD), what should the parents do?

The parents should organize and maintain copies of all administered screening tools, doctor’s records/prescriptions, psychological evaluations, and testing information with reports and scores.

If the child is insured under private insurance, the parents should contact their insurance company and research their coverage for Autism Spectrum Disorder. The customer service number listed on an insurance card can be utilized to find this information.

If the child is insured under Medicaid or MIChild, the parents should contact their local Community Mental Health Service Program (CMHSP) and request to speak with their Autism Program Coordinator.

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Who is eligible to receive the Autism Benefit from Medicaid or MIChild?

Children insured through Medicaid or MIChild, between the age of 18 months and 5 years, with a medical diagnosis of Autism Spectrum Disorder are eligible to receive the Autism Benefit.
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Who should parents contact if they believe a member of their family is eligible for the Medicaid/MIChild Autism Benefit?

The parent should contact their local PIHP/CMH agency. The Medicaid and MIChild map can assist parents in reaching the appropriate agency. 
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Once a child is diagnosed with Autism Spectrum Disorder (ASD), when can the family apply for the Medicaid/MIChild Autism Benefit?

While applied behavior analysis services cannot start until the child is 18 months old, the child should be enrolled in the Autism Benefit as soon as possible.
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What is applied behavior analysis (ABA)?

Applied behavior analysis  is the science of analyzing and improving socially significant behavior.
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What is applied behavior analysis (ABA) service?

Applied behavior analysis treatment can be used to address a number of issues relevant to children with Autism Spectrum Disorder, including language acquisition, peer interactions and social skills, responding to group instruction, academic/cognitive skills, following typical classroom routines, self-help and daily living skills, learning in and from the natural environment, and reducing inappropriate behavior(s).
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Can a family pick and choose what services they want for their child?

Services are determined based upon the child's needs. While the family may decide to obtain supplementary services from other networks or outside agencies, they will need to confirm that the supplementary services are addressing specific needs of the child. 
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If a child qualifies for the Medicaid/MIChild Autism Benefit and the parent does not want to pursue applied behavior analysis (ABA) services, can the child still get other needed services such as occupational or speech therapy for the child?

The child may qualify for other services. An inquery should be made with the case manager to pursue other services.
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Generally, how long will it take to get the services for a child in the Autism Benefit?

Multiple factors are involved in the application, eligibility, and determination process. Typically the PIHP/CMH has 14 days from the time of intake, to planning and start of services. When additional assessments or evaluations are needed, then the time may be exteneded. If information confirming diagnosis, cognitive abilities, and adaptive functioning are readily available, it will speed up the process.
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Are support services available for family members of a disabled individual?

There are services that family members may qualify for. The family should ask their case manager if they qualify for any other services that may assist their family. Additionally, many CMH/PIHPs provide support groups, parent trainings, and links to other resources that may be helpful in supporting the entire family.
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Who should parents contact if they have concerns with the services their child is receiving?

The parents should contact their case manager. The case manager will work with the family to resolve concerns or problems that may arise.
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What are the responsibilities of a Board Certified Behavior Analyst (BCBA)?

  • A Board Certified Behavior Analyst (BCBA) will work with the family and team to develop and implement the applied behavior analysis treatment program. They will supervise and train staff and family on specific goals the child is working on. They will focus on goals to increase skills specific to your child's need and/or reduce disruptive or challenging behaviors that may be interfering with learning opportunities of everyday functioning. Some examples may be increasing communication, play skills, toileting skills, imitation skills, and all other skills the family and team feel will help the child reach their fullest potential.
  • Priorities with applied behavior analysis may be increasing communication, play skills, toileting skills, imitation skills, and other self-care skills to help the child reach their fullest potential.
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Are parents restricted to the PIHP/CMH of their primary residence?

Yes
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If a child is determined "not qualified" or denied the Autism Benefit, what is the appeal process?

The family may file a Medicaid Fair Hearing request. A form for the Medicaid Fair Hearing hearing can be requested from the local Department of Human Services, Health Maintenance Organization, Area Agencies on Aging, Substance Abuse Agenciy, Community Mental Health Agency, MI Enrolls (1-888-367-6557), and/or online. More infromation can be found on the Department of Community Health Website.
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Are advocacy and support groups available to families and persons with developmental disabilities and Autism Spectrum Disorders?

There are numerous advocacy and support groups. Since the availability of these groups may vary from one region to another, the family should check with the case manager and/or CMHSP to find groups that would best meet their needs.
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What resources can parents utilize to reseach the Autism Spectrum Disorder coverage for private insurance and the state fund?

The parents may contact their insurance company's Mental and Behavioral Health Department and utilize the Department of Insurance and Financial Services's Insurance page.
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How can a family with private insurance get applied behavior analysis (ABA) services for their child?

The family will need to contact their insurance company and research their coverage for Autism Spectrum Disorder. The insurance company's customer service number can be utilized to reseach this information.
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If a family is in crisis, what should they do?

The families should call 911. Additionally, each county maintains crisis situations lines - the Mediciad/MIChild Map can be used to link to the PIHP/CMH crisis situation lines.
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