Do your research, ask questions, familiarize yourself with educational laws and policies and fight for a Free and Appropriate Public Education (FAPE) in the Least Restrictive Environment (LRE) for your child(ren). Please contact me if you need any assistance. If I cannot answer your questions, I will help you find someone who can.
Briar has had an Individualized Education Program (IEP) in place since his first year in school in 2009, when he was 5 years old [in the state of New York.]
In Texas, IEP's are known as ARD's. Briar receives home-bound services through Spring Branch Middle School in Comal ISD. PT, OT, Vision and Speech are not provided by the school district due to medical necessity, but rather due to academic necessity. PT, OT, Vision and Speech therapists communicate and work with the special education teacher and "indirectly" assist with Briar's needs. I have tried on numerous occasions to explain Briar's situation and how it would be beneficial to him to receive these therapies, but the school refuses to understand. I have explained that setting a goal for Briar to gradually tolerate sitting in his wheelchair for any amount of time is a great example of an "academic necessity" but they do not agree. A special education teacher can not provide what a trained therapist can provide.
School districts refuse to provide home therapy services. Our private insurance only approves 50 visits a year and Superior Health Star Kids continually asks for additional information and refuses to approve therapy. In the meantime, Briar goes without therapy services and suffers the consequences. Lack of therapy services affect Briar's health and well-being. He has an increase in spasms, contractures and seizures, and requires more narcotic pain medication. This is all preventable with continuity of care.
DO NOT allow MCO's to deem your child a "maintenance" patient. Please explain that therapy is for preventative purposes. If your child is denied therapy services, please file a complaint with HHS and file an appeal with your child's MCO. In addition, request Medicaid Fair Hearing and contact Disability Rights Texas for legal assistance.
If death were to claim your life before it claims mine, my only regret would be, I couldn't birth you a second time.
~Flesh Of My Flesh
~Flesh Of My Flesh