Hello to providers, families, and various other related/concerned individuals, Turning Point Educations Services, Inc. provides applied behavior analysis services to children with autism and related developmental disorders. Many of our clients are children of military members and rely on their benefits from Tricare for these services for their kiddos. This past Friday, Tricare quietly released new policy and operations manual updates. You can view the changes here: http://www.autismspeaks.org/sites/default/files/docs/gr/tricare_newpilot_9.2014.pdf Here is a summary of concerns we at Turning Point Education Services, Inc. agree with (as summarized by Megan Marie Miller, Navigation Behavioral Consulting): 1. Rates for BCBA direct services are HALF of what they were prior to this policy change. This will result in families losing services because BCBAs will not be able to provide services at this rate. BCBAs are only paid for the time they spend with a client so current rates help to offset costs related to travel, developing programs, writing treatment plans, etc. 2. Rates for BCaBAs are almost 1/3 of what they were prior to this policy change and the role of BCaBAs is unclear but appears to be further limited to solely providing direct services as there is no billing code for BCaBAs to provide supervision. 3. Increased cost to military families. The new cost share and co-pay policy is not clear but appears to result in increased costs for families. Many military families struggle to meet the current monthly copay ranging from 25-75/month. The new cost share could result in up to $800/month (or more) of cost shares based on the explanation given on p22 of the manual and the expected costs. 4. Reduced access to services by imposing a 2 year limit. The new policy states that services will only be authorized for 2 continuous years and then approval will need to be sought from the contractor. There are no guidelines provided for this and there is no explanation given for what qualifications the contractor will have in making this decision. Many children with autism do not make all of the progress necessary in 2 years. 5. Reduced access to effective services by limiting the authorizations to 1 BCBA. Currently, a company can obtain an authorization for services and assign BCBAs to a child's case as needed. Many companies employ a collaborative model where more experienced BCBAs will help consult and troubleshoot to provide the most effective services possible. It takes at least 1 month to obtain an authorization and is not best practice to limit beneficiaries to only 1 BCBA from a company. There are many things we as providers, beneficiaries, and advocates can do to let Tricare know we are unhappy about these changes. The can include, but are not limited to the following: 1. Write letters to your legislators. You can look them up here: http://www.house.gov/representatives/find/ or http://www.senate.gov/.../contact.../senators_cfm.cfm 2. Organize or Join a current meet up to show Tricare these changes are not acceptable. Many providers are in the process of organizing events for October 4th. 3. Post on social media. BE LOUD. Let Tricare know this is NOT ok. Here is the information for the organized “meet ups”: This will be a virtual and real life event. People are encouraged to organize meet ups in their area on the date of the event and to take pictures of everyone affected by the newly proposed Tricare changes. More information about the event will be added later today. (SEE LINK TO THIS PAGE BELOW.) A pinned post with the addresses for participating locations will be added as we get more information about settings for the event. WHAT: *Wear a BLACK shirt and make a puzzle piece (nothing fancy colored paper will do) to represent your branch of the military: ARMY = GOLD/YELLOW NAVY = NAVY AIR FORCE = WHITE MARINES = RED COAST GUARD = ORANGE RETIRED MILITARY = GREEN PROVIDER OF SERVICES = PURPLE ADVOCATE = PINK If you want to, write your child's name and age on the puzzle piece. Hold up the puzzle piece or pin it to your shirts. *Make picket signs or posters to represent your frustration with these changes. Ideas include signs that play off Tricare's own written policy such as "How can this policy increase military readiness when Tricare isn't ready?" or "My child doesn't stop learning after 2 years" or "Cutting rates means cutting services" *Send letters to your congressman. Include a LETTER WRITING STATION AT the meet up. THE STATIONS WILL INCLUDE TEMPLATES AND CONTACT INFO FOR CONGRESSMEN. *Contact media to let them know about the event and encourage them to cover it *Send this information to other providers and families so that they can participate *Organize a location to rally in your own community, take pictures and put them on social media (especially Tricare's Facebook Page). If you don't have an event in your community take a picture and post it to social media. *Prepare what you might say to media if interviewed on the day of the event. WHEN: October 4th, 2014 Time to be determined by each location WHERE: Everywhere! Details on specific participating locations will be provided on this page: https://www.facebook.com/events/292297410958916/?ref_dashboard_filter=upcoming WHO: Providers, families, and anyone else who wants to voice their concerns about these policies WHY: Because our children deserve better! Tricare's policies have been working well for the past 5 years for active duty families but these changes will result in a decrease in access to services and increase costs for families. Megan Marie Miller with Navigation Behavioral Consulting organized a similar event last year after Tricare proposed sweeping changes. You can view the OLD page here for an idea of the event: https://www.facebook.com/events/275532545921770/ A similar event was held last year related to the Tricare changes proposed for July 25, 2013. We encourage those who are interested to visit the old event page for that event to see what we did. Here is the link to the OLD page for that event: https://www.facebook.com/events/275532545921770/ I will be working to organize one or help with other providers. I will send out an email to update once time and place of events are determined. Feel free to forward this email on. If you would prefer I remove you from this list please respond and let me know you’d like to be removed and I will not send you updates regarding the events and Tricare’s changes. Thank you all! Erica Erica Kinnebrew, M.S., BCBA Turning Point Education Services, Inc. www.turningpointinbehavior.com​ www.facebook.com/turningpointeducationservicesinc C: 850-264-1507 F: 888-958-5753