New York State cuts white card rates three times, halving income for autism institutions

new York State Effective October 1, the federal Medicaid program (Medicaid, also known as Medicaid).white card ) payment rates, and interviewed operators described the rates as “cut straight in half”. to passautism Families received notices from their parent agencies that services would be eliminated in October and were forced to find replacements. Agencies that were still accepting white cards also found it difficult to acquire due to the sharp decline in income and some even suffered losses.

•The family is urgently looking for a replacement agency to meet the losses.

Applied Behavior Analysis (ABA) is a training method primarily for autistic children. Through encouragement and repeated practice, children are taught how to communicate with others, how to get along with each other, and how to take care of themselves.

Dai Ni, head of Flowmind ABA, and Wang Huijuan, chief operating officer of NY Special Care, said this is the third time in recent years that the white card rate has been reduced. The first cut was 12.5% ​​in October last year, followed by a 12.5% ​​cut in April this year and a 25% cut in October this year. “The current level is 50% of last year, which has been halved.”

Both said the proportion of Chinese families with children using white cards is very high. Since October, he has received calls almost every day from new Chinese families requesting referrals, mainly from white card holders, but the institution’s reception capacity is limited. First, cases with too few service hours will lose money, so cases with more service hours will be prioritized; If some of the new families brought their native behavior technicians (BTs, front-line teachers who go directly to the training with their children), the situation would be better.

Wang Huijuan also said that NY Special Care is a non-profit organization and has kept its costs very low, but it still needs to reduce the salaries of certified behavior analysts (BCBAs) to maintain operations. He explained that the BCBA is a professional responsible for designing and supervising ABA treatment plans; The white card provides that a licensed analyst can only supervise a maximum of six technicians, and an autistic child often requires multiple technicians to work in shifts. In practice, a certified behavior analyst can really only serve two or three families.

He said existing professionals responsible for overseeing treatment at the institute are already overwhelmed, and it is more difficult to recruit people after the rate reduction. In addition, newly qualified personnel are temporarily unable to join the White Card Service System, resulting in a shortage of manpower in the institution and the inability to accept more families. “It’s not that the agency doesn’t want to accommodate new families, but it doesn’t have enough supervisory manpower to handle cases in a compliant manner.”

•Disruption of intervention skills can lead to significant decline

Apart from manpower constraints, organizations also face ethical baseline tests. Wang Huijuan emphasized that ABA has ethical issues and cannot abandon cases suddenly. Termination of services requires long-term planning involving analysts, customers and parents.

Dai Ni said that the cost of interruption cannot be ignored, because it has been scientifically proven that the earlier autism is intervened, the better the effect. If ABA intervention is suddenly interrupted in the middle, children with autism generally do not have the ability to learn independently, and their progress will suddenly stop. In more severe cases, they will retreat. “Let alone half a year, if you wait for two-three months or even a month or two, you can clearly see negative changes in the child’s behaviour.”

Dai Ni also admitted that in some cases, after rate cuts, it was no longer enough to cover costs, but the organization did not want the salaries of serious and experienced teachers to be reduced, nor did it want children to be suddenly deprived of treatment, so it still kept some services at a loss. He said that in the short term, he and many of his colleagues will observe income and expenses for one to two months before evaluating whether they can continue; If this could not be afforded over the long term, it would be difficult to sustain.

At the institutional level, Wang Huijuan said that many parents have not yet felt the impact of the rate reduction, and the institution issued a long notice to existing families in mid-September. But he warned that if the agency were to replace underperforming behavior technicians in the future, children with fewer service hours per week would be at an even greater disadvantage: New teachers earn less and are less prepared to take on the workload, and it may be harder to find someone to take over for children.

At the policy level, Dai Nee said that cuts to the white card budget affect white card families across New York State. Family advocates initiated action for the first two cuts, but this is the third cut, “so there’s really very little we can do.”