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Algorithms for Navigating Intervention and Funding Systems

Algorithms for Navigating Intervention and Funding Systems

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Published by: sdschuyler on Nov 06, 2009
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Algorithms for Navigating Intervention and Funding SystemsThe Military Family and AutismIntroduction: The algorithm is built as a flowchart that helps you organize the stepsinvolved in acquiring funding and services as soon as possible. All 3 algorithms assumethat a diagnosis has been made. For more information about obtaining a diagnosis,please contact your Primary Care Physician immediately; the resources listed in thebook will also be helpful to you.
You will move through all 3 algorithms at the same time.
By doing this, you staycontinuously engaged in activity though you may be waiting for one step to becomplete (e.g. waiting for someone to phone back or to hear back from TRICARE).This continuous engagement manages 2 very important elements: anxiety (it’s saidthat doing something about a problem helps allay the anxiety associated with thatproblem) and eliminate as much time as possible between diagnosis and the beginningof services. It’s a little like building a railroad that no train is yet able to travel. Onebuilds the railroad because it is necessary, and there will be a train. If one waited fordevelopment of the train to create the tracks, all the more time would be required.Algorithm Key:StartAction/ ProcessDecisionStopAlternatives
Navigating the Military Funding System
Did your Primary CarePhysician (PCP) assignthe diagnosis?YesSee your child’s PCP toensure that thediagnosis of an ASD isaccurately and fullydocumented in theTRICARE system. Also,request a consult toCase Management.NoAsk your PCP for a consult to
Case Management
. Youcan also seek on your own- see notes (FS1) on nextpage.
Enroll in
Exceptional Family MembersProgram (EFMP)
. See notes (FS2) onnext page.
Register your child in the
Extended Care HealthOption (ECHO)
. Your child must be 18 months old orolder. See notes (FS3) on next page.
Do you plan to seekABA intervention?Complete:Remember tokeepdocumentationBegin Process to enroll your child in the
TRICAREAutism Demonstration Project
. There are severalsteps to this process- see notes (FS4) on next page.1.
Enrollment in EFMP and registration withECHO are required to enrollment with theAutism Demonstration Project.2.
Submit your child’s IEP or IFSP documentationto the Managed Care Support Contractor(MCSC) OR if unavailable, see notes (FS4).3.
Make sure that your child’s behavioral plan,developed by the Educational Interventions forAutism Spectrum Disorders (EIA) supervisor,has been sent to the medical provider who willoversee your child’s autism care.4.
Your PCP should submit verification and dateof a diagnosis of autism or ASD to the MCSC.
Either during or afterthe completion of thesteps listed here, youcould also seekalternative andsupplemental means of funding. Please seenotes (FS5)
i  m e a  s  s i  n g 
 (   l   e a  s  e em em b  e t  o s  t  a  t  t  e o t  e a  l   g  oi   t m s  w en y  o u b  e g i  n t i   s  . )  

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