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Navigating the Systems of Care

Navigating the Systems of Care

 

Written by Arizona Autism United with help from the Arizona Health Care Cost Containment System (AHCCCS)

 

When you suspect your child may have a developmental delay, it can be difficult to know where to begin. This is where AZA United’s Outreach Team can help. As parents of children with autism, the Outreach Team empathetically understands your journey. We can assist you in finding a diagnostician and navigating the systems of care. When seeking services, it is important to take your funding source into consideration.

If you have private insurance, start by contacting your plan’s benefit department. Many plans cover Speech Therapy, Occupational Therapy, and Physical Therapy.  Some plans also cover Applied Behavior Analysis (ABA). For step-by-step help, see this guide from the Arizona Autism Coalition.

Applying for government-funded services is another important step for families to ensure your child is eligible for the many services provided through Arizona’s Medicaid program for individuals with disabilities.  The Outreach Team at AZA United talks to families every day to help them understand the details of the application and approval process. Visit the How to Access Funding for Services page on our website for important phone numbers and websites.

For families with children under the age of three, call the Arizona Early Intervention Program (AZEIP, pronounced "A-Zip").  Anyone, not just a doctor, can make a referral to the program.   If a child is eligible, AZEIP provides service coordination and therapy supports until the age of three years.  AzEIP will also work with DDD (see below) to determine if your child is eligible for additional services and supports.

The educational system can also be confusing to parents. It is important to know your student’s rights to ensure that your child receives the best education and in-school services possible. Many families are unaware of the benefits of having an Individualized Education Plan or 504 Plan. Raising Special Kids is Arizona’s Parent Training and Information (PTI) Center. Raising Special Kids assists families, at no cost, in understanding and navigating education and services for children with disabilities. They provide information, training, and individual consultations to help parents along their child’s educational journey.

For children over the age of three, call the Arizona Department of Economic Security’s Division of Developmental Disabilities (DDD), a government agency that provides services to eligible Arizona residents who have a developmental disability or other qualifying conditions.  The steps to get approved can be complicated, but the Outreach Team at AZA United is available to help.  

DDD provides a wide range of medically necessary services.  The first step is to contact DDD, who will then review records and other information to determine if your child is eligible.   If so, your child becomes a DDD member and your family will be assigned a DDD Support Coordinator whose role is to identify needs, direct your family to other services, and monitor the progress of your child towards reaching individual goals.

In order to access a wide range of other important services for your child, you must also be approved for the Arizona Long Term Care System (ALTCS, prounounced "All Tex").   A special application is necessary for ALTCS since DDD receives federal funds to provide services to people who may be eligible.  Once a child is over the age of 3, ALTCS is necessary to receive services such as Habilitation, Respite, Speech Therapy, or ABA.

When applying for ALTCS, your family must complete both a financial and medical application to determine eligibility for Medicaid funding, also known as Title 19.  Our state's Medicaid agency is the Arizona Health Care Cost Containment System (AHCCCS, pronounced "Access").  Once approved for ALTCS, a separate evaluation is required to determine your child’s need for therapies and services, including how long and how often the service should be provided.  Your assigned Support Coordinator will assist you in developing this plan, known as an Individual Service Plan (ISP).  AZA United’s Outreach Team is available to help you prepare for this process.

Once you have completed the ISP, your child will become eligible to receive medically necessary services through AZA United or other contracted DDD provider agencies.  Many other services are also available including communication devices and personal medical supplies, such as diapers or pull-ups.

Your child may also be eligible for behavioral health services.  Each county has a separate entity that manages the behavioral health system for that area, which is called a regional behavioral health authority (RBHA, pronounced “Ree-Ba”).  In Maricopa County, the RBHA is Mercy Maricopa Integrated Care (MMIC). All children who are ALTCS approved are eligible for services through the RBHA, as well as individuals enrolled in AHCCCS without ALTCS.  Behavioral health services include a wide range of services and supports, which MMIC or the Outreach Team can help you understand.

To get started, you should call MMIC and ask to become connected to an agency in your area to schedule what is known as an intake assessment.  You will then be assigned a Case Manager, who is very similar to the DDD Support Coordinator but has special knowledge to help with the systems of care for behavioral health.   AZA United offers some services through the behavioral health system, including Behavior Coaching.  A referral to AZA United from the Case Manager is required, which the Outreach Team can help you request.

One other source of funding for therapeutic services is the Empowerment Scholarship Account (ESA) program through the Arizona Department of Education.  This program is funded by state tax dollars to provide educational options for qualified Arizona students who choose to opt out of the public school system. Once approved, parents can seek a range of alternative educational services, such as private school or home-based education, to tailor an individualized educational plan that is best for their child. At AZA United, some families choose to utilize their ESA funds to access services such as Speech Therapy and Applied Behavior Analysis (ABA).

With all these service systems and acronyms, navigating the system can be a daunting task.  Initially it may be difficult to understand which source equates to which type of service, but with some time and experience you will understand them like a pro. And if not, the Outreach Team at AZA United is always here to help!

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