Anyways, 2010 is going to be great. It seems like the insurance companies are doing a much better job now. Authorizations are not exactly flying into our hands, but they are also not the unattainable myths that they once were. We’ve developed some wonderful contacts with some of the insurers – believe it or not, there are helpful people in those offices who care if you get service. I didn’t say there were a lot of them, but we’ve been able to find a few.

We’re also gearing up our plans for summer camp. It may seem premature, but believe it or not we’ve been having families and agencies asking already. So – give the people what they want – right? I was talking with Chrystal, our new Director of School Programming, today and she thinks a large group camp 10 -12 kids with 2 staff would be really great for a high functioning and typical kids social skills group. She just may be right. This is something we will definitely be putting together. We’re also planning to DEFINITELY have a pre-school summer camp. It’s going to be kind of Montessori style – hands on, lots of play, for 2 – 4 year olds with ASD. Camp this summer is going to be geared more toward just being a socially engaging experience than trying to accomplish individual goals.We’ve found in past camps it’s just not possible to achieve the goals of one on one therapy in small group environments. We’re going to be tracking a few basic targets, like number of social initiations or time spent engaging on task as our measures. Kids who are interested in a more intensive experience will of course still be able to sign up for one on one therapy.

What else? Well, if you read the e-mail notice – you already know that Jessica’s last day is next Friday. I’m personally sad to see her go. A good worker and a good friend, she’s just extremely put together and a rare find. The truth is though, I knew several months ago that she’s be leaving soon. I told my husband I could tell she was getting that ‘BCBA itch’ I call it. Once one reaches the pinnacle of our field – BCBA certification – they want to go to big, bad things. I get that – I mean, I started a company with my BCBA itch! I always hope our staff will stay forever, but I know that we are a training ground – and we’re designed by me to be just that. I have a goal of training people to do superior ABA services and amazing programming and just to be the best behavior analysts around. Once they know how to do that, I like them to go off and share that with someone else.

One last thing – we have a preliminary program to our amazing DataTrack software. By February 1, all data, daily notes, etc. will be computer based. No, I didn’t say web-based, we’re not there yet. But, we’re one step closer. I’ll try to remember to give an update once we have it running.

Best wishes for the new year. I hope all you beautiful readers have as positive and outlook about 2010 as I do.

This event is being held in our SANFORD location at 1708 Lexington Green Lane, Sanford, FL 32771. Please call the office at 407.413.9550 for details.

We’re also all worked out with United. We’ve got a method that works to determining rather a child is eligible for service or not.

We’re throwing around a couple different ideas for expanding service at FAC. I really want to hear your feedback on these ideas, so please comment. We want to find out if there is interest in our conceptualizations.

First, I’m tossing around the idea of offering low-level service by interns. The purpose of this is threefold. 1. It gets people new to our profession experience. 2. It gives families an option to increase their level of service for cheap. 3. It gives parents a way to start service at an affordable price so that we can get the insurance ball rolling and find out if they are eligible.In this program, families could receive 5 hours of one-on-one  per week from an intern for $100. Parents would need to understand that program updates and other services needing the time of someone certified would bear and additional cost, approximately 2 hours per month at $60 per hour.

The second idea I’m kicking around is to increase access to our school program for higher functioning kids. We’ve had a lot of people asking about school for their older elementary children who are able to do the work academically, but are having social and / or behavioral difficulties. We’re considering a classroom of 8 kids with a single teacher, using the McKay, that focuses on social skills. This would allow access to our program for families with Matrix Scores of 251, 252, and 253 without extreme co-pay.

Let me know what you think! I look forward to everyone’s input.

Also, a reminder: TOMORROW is the last day to file intent to switch to a private school beginning October 1. Go to www.floridaschoolchoice.org to file. Call us with questions. If you haven’t filed by the end of day tomorrow, you won’t be able to use your McKay until January.

I also wanted to let everyone know about some upcoming open houses in Daytona. Tomorrow I have one at 11AM. Then, here’s the schedule for the next couple weeks. These will be with me E-mail me at info@FloridaAutismCenter.net if you’re planning to attend. We’re at the Easter Seals building (separate company, same location) at 1219 Dunn Avenue in Daytona Beach.

Open House 1: Friday, September 4 at 11AM

Open House 2: Tuesday, September 8 at 2:30PM

Open House 3: Friday, September 11 at 11AM

If you’re interested in an open house in Sanford, call the office. I know Martha has several set up – 407.413.9550.

SCHOOL: We made it through our first week of school. Mind you, this was school both in Daytona Beach and in Sanford. I’m pleased to report success in both locations. If I’m not mistaken, both locations have full programming in place for all their kids as of today, and also have their schedule for the entire year completely mapped out (except some TBD field trips). We’re really lucky this year. We’ve got some amazing parents and some really great kids. School is off to a good start with 11 kids. We are adding Daytona Beach kids October 1. We are adding 2 – 4 more Sanford kids in January and might consider another 1 or 2 in Daytona for January as well. Let us know if you’re interested in making the switch – we’ll take waiting list enrollment and see when it makes sense to move you from the public school to our program.

Speaking of waiting list enrollment – it’s time to get it started for January in Winter Park. We have 2 families currently in Sanford who are interested in moving to Winter Park. We need 4 more committed, contracted families before we will begin searching for a building. So, if you’d like to send your child to Florida Autism Center’s Academy program beginning in January, we need to know about it now.

EI: Wow, EI has been through some craziness lately. I’m extremely happy to say things are going along really well with United Healthcare (UBH). Our contract with them is really moving along and we have secured authorizations for kids up to 20 hours per week. Incredible.

Concerning Blue Cross, we’re resubmitting claims from some of our EI summer kids. Apparently the State of Florida has let Blue Cross know ‘in no uncertain terms’ that behavior analyst claims are to be paid. We’re hoping so, because sadly a few of our families had to drop service due to cost, and it’s really not fair when their insurance should be helping. We’ll keep you updated. Currently, we do have some EI spots open. We have one after-school slot in Daytona (3 – 5PM daily) and 3 daytime slots in Sanford (9 – 12 daily).

BIRTHDAY: We’re still working on plans for the FAC 5th Birthday Party. I’ll be posting about it soon.

MATERIALS DRIVE: We pushed our August Materials Drive back to September. If you have outgrown toys and activities, we’d be happy to get them. Jess is still working on her yard sale to create some help for private pay families, so things you have that FAC doesn’t need will go towards that. I hope she chooses the date for the yard sale soon. There is a REALLY old dresser of mine sitting around in the center, looking terrible, and waiting for the yard sale!

GRAD UPDATES: 3 of our babies started public school this week. I’m thrilled to say all 3 did great. So far so good with joining their classrooms and peers. I can’t wait to hear more from their families, which I’ll report on to all of you.

Well, there’s a lot more I could talk about – especially after a 2 week hiatus – but I don’t want this post to be too long . . .

Sanford’s Open House will be Wednesday (not today, next week!) from 6PM – 7:30PM. Come on in, meet your teacher, and see your classroom. You’re child can learn where his or her cubby is, see where his or her seat is, etc. We hope that familiarizing your child with our center early will help ease the transition for the new school year.

Daytona’s Open House is a little different – it’s open to the public and lasts ALL DAY next Thursday. We’ll be showing our school and EI kids their new home as well as meeting other interested families that aren’t yet registered for service. Our Daytona staff will be available, although Jess won’t be in for a good portion of the day as she will be busy busy busy taking her BCBA exam! Wish her luck (which she doesn’t need – she’s extremely prepared). I’ll post a few more details about the Daytona Open House soon.

Also, I wanted to let everyone know how excited we are about United HealthCare. We got our first auth for a child to receive 20 hours per week of therapy. Yea, United! If your policy falls under the new mandate and has been renewed since April 1st, we’ll be happy to help you get service for your child, too!

I’ll update everyone soon about BCBS. I haven’t been to the office since the new info from FLOIR came out – but I know Jess is starting to resubmit claims. I’ll definitely let you know when that success materializes.

OK – I’m off for the week, so I’m going to wrap up the blog for the night.

I have a couple meetings in Volusia County tomorrow with people who want to help us expand our services there. The reception in Volusia County has been wonderful. People seem truly grateful for our ABA service, and that’s very refreshing.

I’m really happy with the Sanford location, too. We ended up with a very busy summer. I can’t believe how quickly it’s flown by. We have 10 kids for school and are still growing. We’re at the point of a waiting list for October now. We have a couple EI spots open right now, but I’m guessing by the end of next week we won’t again.

The staff are busy getting the center ready for the upcoming school year. We’re reducing a lot of the clutter – thinning out the toys and moving some things to Daytona as well as packing other things away in the hopes of an Orlando location shortly materializing. We’re pretty excited about our new classroom, even though it did boot me out of my big, beautiful office. It’s going to look great and be a great space in which to learn.

We’ve scheduled our open house events for school parents and community members, but I’m not quite ready to announce the dates as there might be a change for the Daytona location upcoming. In the next few days, I’ll be sure to get the info out, though.

In sad news, we’ve lost a couple kids lately because their insurance hasn’t come through on their claims. We have a couple tricks up our sleeves that I hope will remedy this, and I’ll excitedly post info as soon as we know if our plans are going to work out.

We’re still planning for the big birthday bash in September, and Jess is still working on her yard sale – clean out those closets! August is also the materials drive, so bring us all your old kid stuff and if we can’t use it we’ll put it in the scholarship yard sale. If it’s still around after the yard sale, we’ll be taking remaining items to Children’s Home Society or Community Based Care to give to the Crisis Nursery kids.

Well, I guess that’s all for now. Like I said, there’s a lot of exciting possibilities in the next few days, and I’ll post everything that materializes, I just don’t want to jump the gun. I’ll look forward to reporting lots of good news soon!

Step 2: All hands on deck. Now, you’ve found a behavior analyst, you’re researching ABA and Verbal Behavior. You know this is what you’re child needs – here’s the big question – How do we pay for it? It’s time to solicit some help. Assemble the following:

A prescription for ABA from your doctor

A summary of relevant research about ABA’s effects

A copy of your assessment, behavior program, or other program materials from you ABA provider

Your insurance contact information

Here are some details:

Letter and Prescription from you Doctor – a primary care physician or a specialist who diagnosed your child are great people to help. You should have a prescription for behavior analysis services. Ask for specifics, like recommended number of hours per week. We’ve had kids with something like ’40+ hours per week of intensive Applied Behavior Analysis at an Early Intervention Clinic until at least the 5th birthday’
Having this documented as your physician’s recommendation is very helpful. Your ABA provider can submit this with their assessment and recommendation to your insurance company, state agencies, etc.

Now that your physician has done their part, your behavior analyst needs to do the same. A BRIEF summary of successful published research, the agencies personal results, and clarification of the services to be provided can be helpful in allowing the potential funding source to understand what is being requested. Remember, there are a whole lot of people out there who still don’t know about ABA. They want to be sure that if money is going to a treatment, it’s legitimate and warranted. Your documents should provide clear, concise information about ABA, its expected outcomes, and why it is absolutely necessary that your child receive it and receive it now. Documents should always be professional and polite, but firm.

Assessment: Your behavior analyst should have conducted an assessment, and should have a recommendation for service as well as program goals. If you’ve already been receiving service, then a progress summary is also very helpful.

Now it’s time to call your insurance company, probably with your behavior provider, and all the ammo you’d like to try.

You may get pre-authorization for service, or you may leave the call empty-handed. Don’t give up! Try sending a claim for service received, it just may get paid. Try fundraising to off-set your out of pocket costs.

Family, friends, and even strangers may be sympathetic to your struggle. Don’t let me be a pessimist, sometimes, a family has great insurance, or a pre-established program for funding, or a school system that is willing to cover their ABA expenses, or a full-scholarship. We have half a dozen clients right now who we NEVER have to say a word about money to. However, we have far more clients who funding is the overriding topic of our every interaction. If you can afford to pay out-of-pocket for service, that’s great! There is no better investment. If you can’t, though, it’s time to get creative. We have a couple moms (and dads) who are true superstars with this, and their efforts are commendable, impressive, and downright amazing. They do bake sales, movie nights, picnics, and a whole host of other undertakings to raise funds for their child’s therapy.

The overall lesson to take from Step 2 is: You’re going to be busy if funding therapy is your goal. Sit down with your behavior analyst and call your insurance company to try to get pre-authorization for service. If you are unable to get a pre-authorization, ask your behavior analyst to submit the claim as an out of network provider. They may get rejected, but you may get reimbursed by your insurer, as some of our clients have. It never hurts to try.