Can someone explain to me HCBS?

amother

Wed, Jul 20 2022, 11:33 am

I'm in NY. I have a child with an ASD diagnosis and am trying to understand services/options/resources.

- Can someone explain to me HCBS and what it offers? lots of fancy words online but how does it practically translate?

- Most importantly, I was told to go this route for assistance paying insurance premiums to receive ABA. Anything they're not telling me?

- What is the process to being approved / receiving help

- I saw it being mentioned that it isn't only for ASD. I have an older child who has anger/emotional issues, is receiving counseling through the BoE and has an IEP. Would they also qualify for anything?

amother

Lightgreen

Wed, Jul 20 2022, 11:52 am

Please be advised that any sort of assistance in paying aba insurance premiums doesn't happen for at least a year. It takes a very long time for medicaid to approve financial help for private insurance premiums.
Regarding HCBS I don't know what that is. But if ur child is autistic they can qualify for opwdd services, witch is actually probably a little better.

Sudy

Wed, Jul 20 2022, 12:28 pm

amother [ OP ] wrote:

HCBS is a government sponsered program offering services for children and teens. The child must have either a chronic condition or an emotional disorder such as anger management, difficulty getting along with peers.

HCBC does not pay for any insurance premium. They pay providers to work with your child towards goals previously established.

ABA services are for children with an ASD diagnosis. Medicaid does not pay for this. Private insurance such as Oxford does pay. Whoever told you to get HCBS to pay for the insurance premium was suggesting fraud. Some ABA agencies will reimburse you for the premium but that should not be thru billing HCBS it should come off their profit.

amother

Thu, Jul 21 2022, 9:55 am

thanks for your replies

to be honest, I'm even more confused. I'm trying to figure out services and resources. Can you clarify from the ground up? I'm not looking for fraud. I'm looking to get my child the help they need. And aba therapy was recommended. Maybe it's not HCBS. Lots of initials getting thrown around like alphabet soup and I left my decoder ring elsewhere...

amother

Mayflower

Thu, Jul 21 2022, 11:09 am

I work with an agency "go forward" for hcbs ser ices. They work with hamaspik. They have been super helpful for us. My child also gets services from boe thtough an IEP. My child does not get aba services , only because if all the red tape involved.

Sudy

Thu, Jul 21 2022, 12:53 pm

amother [ OP ] wrote:

If your child has an asd diagnosis it makes sense to pursue ABA. Does your child have Opwdd?

amother

Lightpink

Thu, Jul 21 2022, 6:23 pm

amother [ OP ] wrote:

There is a way to use HCBS to pay for ABA insurance premiums, there is a company called proassistance that takes care of the paperwork to get the reimbursement (they do charge a fee)

In order to get HCBS you need to enroll in a health homes program and are assigned a care manager, if care manager feels child needs more support than they can enroll them in HCBS which gives respite hours, parent support...

Older child can definitely be eligible, actually ASD is not a qualifier for this program, a mental health diagnosis or medically fragile are the way child is eligible (ASD is not considered enough of a mental health diagnosis)