Funding Autism Treatment Using Medicaid Funds In Pennsylvania

Learn about federal and state laws regarding EPSDT funding in Pennsylvania that control access to funding for Behavioral Health Rehabilitation Services (BHRS, often misleadingly called "wraparound services" in Pennsylvania). Access to EPSDT funding for BHRS is a civil right for children with disabilities, but formidable barriers to it have been created and maintained. Learn how to overcome obstacles to EPSDT funding, regardless of family income and private insurance status.

This presentation provides an in-depth understanding of the Early and Periodic, Screening, Diagnosis and Treatment (EPSDT) benefit, especially the “Rehabilitation Option” and how schools and professional mental health practitioners can use these resources to deliver “Behavioral Health Rehabilitation Services” (BHRS, often misleadingly called "wraparound" services in Pennsylvania) to children with disabilities who are enrolled in Medicaid in all 50 states. 

When BHRS is imbued with the “wraparound” philosophy of treatment, an extremely effective, efficient treatment modality is created.  “Wrap-around” is a philosophy of care in which services “wrap-around” the child to provide optimal support from adults in the child’s home, school and community. The delivery of “BHRS in a wraparound cup” is the ultimate means of delivering cost-efficient, highly effective treatment for children with mental illnesses and behavioral challenges in their homes, schools and communities.

A model like this was developed by the presenter of this program and has been implemented successfully in Pennsylvania for more than 20 years, serving more than 1,000 children and delivering over one million hours of treatment.  The presentation describes how this “BHRS in a wraparound cup” model exists within the EPSDT framework, how EPSDT funding for it was accessed and how a simple documentation system significantly increases the probability that EPSDT funds will remain accessible for children who are receiving and benefiting from this treatment modality in their homes and schools.

This model can be implemented in all 50 states and comparable success can be expected because it has been operating successfully for more than 20 years.