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AUTISM SERVICES

What is Autism Spectrum Disorder?

Autism spectrum disorder (ASD) is a developmental disability that affects how individuals socialize, communicate, and behave. It typically begins in early childhood and lasts throughout a person’s life. While the exact causes of ASD are not fully understood, individuals on the spectrum often have unique ways of learning, paying attention, and processing sensory information.

What is Applied Behavior Analysis (ABA)? 

Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior, offering valuable support for children with ASD. ABA involves a variety of techniques to understand why behaviors happen and how to support positive changes.  

This evidence-based, intensive treatment focuses on achieving meaningful improvements in: 

  • Communication 
  • Social interaction 
  • Repetitive/restrictive behaviors 

Each child will receive a personalized intervention plan, where skills are broken down into achievable steps. ABA services can be provided in various settings, such as at home, in a clinic, or within the community. Active participation and training for parents or guardians are essential for successful ABA interventions. 

ABA reduces challenging behaviors while helping children develop and improve in areas like: 

  • Academic and cognitive skills 
  • Language and communication skills 
  • Attention and focus 
  • Routine following 
  • Social skills 

ABA can involve teaching one-on-one or in group settings. The goal of ABA is to empower each individual with the skills that lead to greater independence and success in their present and future lives. 

Accessing the Autism Spectrum Disorder (ASD) Benefit

Accessing the ASD Benefit 

Step 1: Contact MCCMH 

  • To begin the process, please call our Customer Service Department at 855-99-MCCMH (855-996-2264) to register in our system, verify eligibility for Medicaid services, and be transferred to a clinician for a telephone screening. You can also walk in at one of our locations to initiate this process. After this, you will be scheduled for an intake appointment with an Autism Case Management Provider. 
  • Once ASD screening is verified, the clinician will schedule an intake appointment with one of the following Autism Case Management Programs: 
    • Easterseals MORC  
    • Specialized Children & Family Services 
    • Hope Network  
  • If the child previously received ABA services in another region of Michigan, please share this information with the clinical so prior enrollment can be documented. Additionally, please share a copy of any previous ASD diagnostic evaluations to prepare for the intake appointment.  
  • If Medicaid insurance cannot be verified, we will refer the family to their private insurance career or the Michigan Department of Health and Human Services (MDHHS) to apply for Medicaid (if applicable). Enrollment in the ABA Program depends on eligibility for Medicaid insurance. 

 

Step 2: Autism Case Management Intake Appointment  

  • Attend the intake appointment to complete the Person-Centered Planning (PCP) process to develop the Individualized Plan of Service (IPOS). This process will confirm the presentation of ASD, gather support documents of past treatments, and establish goals for the child during service delivery. 
  • A full medical and physical examination must be completed by a medical doctor (such as a child pediatrician or family primary care physician) within the past year, indicating that further evaluation of ASD is recommended. The medical evaluation must confirm that hearing and vision have been assessed and determined not to be contributing factors to the child’s ASD presentation. You must bring documentation of this full medical and physical examination to your intake appointment. If you do not have this information, it must be provided before your child can be scheduled for an ASD diagnostic evaluation. 
  • Please be sure to bring all documentation to your intake appointment, including the following:  
    • Medical exams 
    • Neurological and diagnostic reports 
    • Mental health treatment recommendations 
    •  School/academic reports 
    •  Individualized Education Plans (IEPs) 
    • 504 plans 
  • Once the intake process is completed, the child seeking services will be assigned a case manager who will assist the family in securing an ASD diagnostic evaluation. 
  • If the family has both private insurance and Medicaid, the case manager will help the family obtain an Explanation of Benefits (EOB) and determine the guidelines for securing diagnostic testing and ABA services through the private insurance provider. Please note that Medicaid is considered the payer of last resort, while private insurance is the primary payer. 

 

Questions about Medicaid Autism Benefit?

Contact Janet Marra, Autism Clinical Coordinator

[email protected]

 

Additional Resources

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