Medicaid rule shift

State to combine 2 developmental programs for preschool kids.

Rules tightening the eligibility requirements for state Medicaid programs serving children with developmental delays cleared a legislative committee on Tuesday despite complaints from some providers that it will cause fewer children to be served.

Starting July 1, the rules approved Tuesday will combine two preschool programs, known as Child Health Management Services and Developmental Day Treatment Clinic Services.

Combined, the two programs serve about 18,000 children.

After discussion, Rep. Kim Hammer, R-Benton and a co-chairman of the Legislative Council’s Administrative Rules and Regulations subcommittee, declared the rules reviewed and approved. Two members, Sens. Larry Teague, D-Nashville, and Terry Rice, R-Waldron, objected.

The rules will go to the Legislative Council for final approval on Friday.

To qualify for the new program, known as Early Intervention Day Treatment, children will have to have an assessed developmental disability or delay and a need for speech, occupational or physical therapy or nursing services, such as assistance with using a feeding tube or ventilator.

Children already must meet those criteria to qualify for

Child Health Management Services, but they can qualify for Developmental Day Treatment Clinic Services even if they don’t require therapy or nursing services.

Of the 9,200 children receiving assistance from Developmental Day Treatment Clinic Services, 3,351 are not receiving therapy, said Melissa Stone, director of the Department of Human Services’ Developmental Disabilities Services Division.

But she said some of those children may end up qualifying for the new program based on needs that have not yet been assessed.

“We don’t think it will be anywhere near 3,351” that end up not qualifying for the new program, Stone said.

All children currently enrolled will be grandfathered into the new program, through June 30, 2019, she said.

Most children who don’t meet the new criteria should qualify for subsidized pre-

school programs, she said.

She and other Human Services Department officials believe that “if children can attend an integrated day care setting, that they will do better,” she said.

“This is the right thing to do for kids,” she said.

The change will reduce Medicaid spending by about $14 million a year through efficiencies in billing.

That figure does not include money that would be saved by serving fewer children, she said.

The proposal stemmed from a 2013 state law that directed the department to explore combining the two programs.

The department worked with providers on crafting the changes, which were ultimately supported by Child Health Management Services

providers, but not Developmental Day Treatment Clinic Services providers.

Janie Sexton, director of Building Bridges Developmental and Community Services, which operates Developmental Day Treatment Clinic Services centers in Cabot and Lonoke, said the new program will exclude children with cognitive delays who don’t need therapy or nursing care.

She and other providers are concerned about the availability of preschool and child care options for those children, especially in rural areas, she said.

“The child’s needs for intervention do not change just because you put them in another setting,” Sexton said.