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The state budget season has finally come to a close, with Governor Snyder signing the budget last week. AAoM would like to thank Lt. Governor Brian Calley and key members of the Michigan legislature (Senators Hildebrand​, McGregor, and ​Gregory, and ​Representatives Cox, Canfield and Farris​), all of our families, partner advocacy groups, and other stakeholders who worked closely with us to achieve the most favorable outcome; Medicaid autism services will continue without significant changes going forward.

Sec. 111 – Behavioral Health Services

  • Autism Services: $192,890,700 (FY18 $187,040,400)

Sec. 124 – One-Time Appropriations

  • Autism Navigator: $1,025,000 (FY18 $565,000)
  • Autism Train the Trainer Grant: $55,000 (New)
  • University Autism: Eliminated (FY18 $500,000)

Sec. 924 – Autism Services

  • From the funds appropriated in part 1 for autism services, for the purposes of actuarially sound rate certification and approval for Medicaid behavioral health managed care programs, the department shall establish and implement a fee schedule for autism services reimbursement rates for direct services by October 1 of the current fiscal year. Expenditures used for rate setting shall not exceed those identified in the fee schedule. The rates for behavioral technicians shall be reduced by 10% of the 2017 autism fee schedule, but shall not be less than $50.00 per hour.
Code Service Description Reporting Units Reimbursement Rate
BCBA BCaBA BT
0359T Behavior identification assessment includes interpretation of results and development of the behavioral plan of care. Untimed and typically 4 hours and no more than twice a year. Encounter $480.00 $340.00 N/A
0362T/0363T Exposure behavioral follow-up assessment (Functional Behavior Analysis/FBA). 30 minutes $60.00 $42.50 N/A
0364T/0365T Adaptive behavior treatment by protocol administered by technician. 30 minutes $30.00 $30.00 $25.00
0366T/0367T Group adaptive treatment by protocol administered by technician 30 minutes $8.57 $8.57 $7.86
0368T/0369T Adaptive behavior treatment with protocol modification and clinical observation & direction administered by qualified professional 30 minutes $60.00 $42.50 N/A
0370T Family behavior treatment guidance administered by qualified professional. Untimed typically 60-75 minutes. Encounter $120.00 $85.00 N/A
0371T Multiple family behavior treatment guidance administered by qualified professional. Untimed typically 90-105 minutes. Encounter $72.00 $51.00 N/A
0372T Adaptive behavior treatment social skills group. Untimed typically 90-105 minutes. Encounter $51.43 $36.43 N/A
0373T/0374T Exposure adaptive behavior treatment with protocol modification requiring two or more technicians for severe maladaptive behavior(s) First 60 minutes

Each additional 30 minutes

$120.00

$60.00

$120.00

$60.00

$100.00

$50.00

Sec. 959 – Autism Services

  • The department shall establish a workgroup in collaboration with the chairs of the house and senate appropriations subcommittees on the department budget or their designees, CMHSP members, autism services provider clinical and administrative staff, community members, Medical autism services clients, and family members of Medicaid autism services clients to make recommendations to ensure appropriate cost and service provision, including, but not limited to, the following:
    1. Ways to prevent fraud and overdiagnosis.
    2. Comparison of Medicaid rates for autism services to commercial insurance rates.
    3. Comparison of diagnosis process between Medicaid, Tricare, and commercial insurance.
  • By March 1 of the current fiscal year, the department shall provide the workgroup’s recommendations to the senate and house appropriations subcommittees on the department budget, the senate and house fiscal agencies, and the state budget office.

Sec. 1917 – Autism Train the Trainer Grant

  • From the funds appropriated in part 1 for autism train the trainer grant, the department shall appropriate $55,000.00 to implement a pilot project to train school employees on the principles and practices of applied behavior analysis and research-based intervention strategies. The pilot project must do both of the following:
    1. Train paraprofessionals and teachers in a school district with a headquarters located in a city with a population between 6,900 and 7,000 according to the most recent federal decennial census in applied behavior analysis skills that match the national standard for behavior technician-level work and research-based intervention strategies.
    2. Train teacher consultants, school social workers, school psychologists, and other school personnel responsible for conducting functional behavioral assessments and the development of behavior support plans in a school district with a headquarters located in a city with a population between 6,900 and 7,000 according to the most recent federal decennial census methods for assuring implementation of a behavior plan with fidelity and strategies for sharing understanding of evidence-based behavioral health approaches with other school-based personnel.
  • Outcomes and performance measures for the pilot project funded under this section shall include, but not be limited to, the following:
    1. A decrease in the number of center-program and self-contained-classroom referrals.
    2. A decrease in the number of suspensions, removals, and expulsions.
    3. A decrease in paraprofessional absences.
    4. An increase in teacher retention.
    5. An increase in safety.
  • By September 1 of the current fiscal year, the department shall report to the senate and house appropriations subcommittees on the department budget, the senate and house fiscal agencies, the senate and house policy offices, and the state budget office on the information required in subsection (2).

Sec. 1920 – Autism Navigator

  • From the funds appropriated in part 1 for autism navigator, the department shall require any contractor receiving funds from this line item to comply with performance-related metrics to maintain eligibility for funding. The organizational metrics shall include, but not be limited to, all of the following:
    1. Each contractor shall have accreditations that attest to their competency and effectiveness in providing services.
    2. Each contractor shall demonstrate cost-effectiveness.
    3. Each contractor shall ensure their ability to leverage private dollars to strengthen and maximize service provision.
    4. Each contractor shall provide quarterly reports to the department regarding the number of clients served, units of service provision, and ability to meet their stated goals.
  • The department shall require an annual report from any contractor receiving funding from the autism navigator line item. The annual report, due to the department 60 days following the end of the contract period, shall include specific information on services and programs provided, the client base to which the services and programs were provided, and the expenditures for those services. The department shall provide the annual reports to the senate and house appropriations subcommittees on the department budget, the senate and house fiscal agencies, and the state budget office.
  • From the funds appropriated in part 1 for autism navigator, the department shall fund an independent evaluation of the services provided by contractors paid from the autism navigator line item in fiscal year 2017-2018. This evaluation, which shall examine cost effectiveness of services, avoidance of duplication of services, and outcomes, shall be completed by June 1 of the current fiscal year and shall be provided to the senate and house appropriations subcommittees on the department budget, the senate and house fiscal agencies, and the state budget office.

 

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