Ways in which the Center for Medicaid and CHIP can best improve Dental benefits and coverage for Children under the age of 18 (Research Paper Sample)

How can the Center for Medicaid and CHIP, best improve Dental benefits and coverage for Children under the age of 18, who have Autism Spectrum Disorder?
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Institution Affiliation
Public Policy Brief
Introduction
According to Chi et al., (2015), Autism Scale Disorder (ASD), is defined as a series of conditions that are referred to as neurodevelopmental disorder. The signs of autism in children include sensory issues, cerebral delays, social deficits, stereotyped or repetitive behavior, and difficulties in communication. In early stages, children with ASD don’t prattle or use other verbal sounds. For older children, they may experience hiccups in using von-verbal behaviors to interrelate with others. They have challenges with facial expression, gestures, eye contact, and body language.
Problem Statement
The paper seeks to explore on the policy that the Center for CHIP and Medicaid can use to advance Dental benefits and coverage for children under the age of 18, who are affected by Autism Spectrum Disorder.
Significance of the Study
The study will assist in early identification of autism cases. The early identification and intervention will have a great impact in the child life as they will impact on the ability of the child to learn new skills. It will also come up with a policy that will increase dental coverage for children under the age of 18, who are affected by ASD. The research has great significance in rural areas where there is less coverage (Parish, S. L. 2014, January).
Coverage for Autism – Related Health Cases
A lot of autistic children health issues are covered by Medicaid. The eligibility for Medicaid include: children whose parents earn an income that is below a prescribed amount that varies in different states, children who have disabilities and are eligible for Supplementary Security Income (SSI), if their families earn above the threshold of benefiting with the SSI but they pay for Medicaid through a Buy-in program. There are those children who are not eligible for Medicaid but can benefit through the CHIP.
The Responsibility of State and Federal Laws on Children who have Autism
The Medicaid is financed through the federal government. The Medicaid program varies depending on individual states. Thus, the benefits of Medicaid are shielded by both the state and federal laws. The law stipulates the kind of benefit that needs to be provided by the Medicaid program. The laws that have been formulated to assist kids include: the federal medical law, the mental health parity, the affordable care act, the individual with disabilities education act and the state autism coverage mandates (Chi et al., 2015).
There has been a rapid increasing demand for the ASD services in the states amidst decline in state revenues. The study shows that there is projected decline in the revenues from the states that are necessary in supporting the Medicaid program. There is also a difference or disparity between financing the projects and the ASD children getting the necessary services. However, there are multiple sources that assist to finance the ASD program. Individual states are required to formulate better policies that can assist in the sustainability of the project so that the children can get timely services.
Challenges Encountered in Formulating an Effective Autism Benefit Plan
There are numerous challenges that are faced by Medicaid plan administrators and CHIP when formulating a benefit structure for ASD. First, there is the issue of determining the type of interventions such as applied behavior analysis and floor time. Second, challenges in the formulating a suitable licensing and administration requirements. Third, hiccups in the execution of significant quality control. Lastly, the plan may have difficulties in prevention of replication of services that are provided to cater for ASD.
Care Scheme Development Concerns
Access to dental care and other services that is eligible to autism kids who are 18 years and below can be impaired by several factors. The factors are geographical and cultural issues, disparity gaps in provision of health care, and problems in the capacity of services (McKinney et al., 2014).
Geographical Space – Admittance to healthcare is a vital phase towards conveyance of services that are evidence-based. Those children incarnate in the countryside areas have a lot of challenges and obstacles as compared to those who lives in the city. The geographical distance is principally challenging for access to dental and other specialty services.
Screening and diagnosis issues – The issues have been addressed in states such as Arizona that are primarily rural. The specialty treatment such as dental care has been sorted through mobile clinics. The study shows that an autism child in the state of Maine which is primarily rural faces challenges in accessing dental healthcare. The nearest center where the children can obtain the medical services is more than six hours on a car before you reach to the nearby hubs where children can get dental amenities.
Admittance to dental amenities – In the countryside like in Dunklin in Missouri State, Maine in the Washington, or Apache in the state of Arizona such services are not available. An autism child in these areas may fail to get accurate and timely diagnosis which may greatly impact service delivery (McKinney et al., 2014). Though a lot of autism services are home based, there are those which are not including vocational training. There are treatment centers and school based services that are placed in the junctions and epicenter states but they may not be equipped by specialist’s consultants or medics.
Cultural and Linguistically Challenges
According to McKinney et al., (2014), there are notable differences in the access to healthcare for children from linguistic and minorities. The children suffering from ASD from minorities faces late diagnosis, delayed vital treatment that could have mitigated progressive lags. In the state of Arizona, there is need for culturally custom-made of ASD services for Native American and Hispanic populations that include cultural and lingual providers that are proficient in the provision of ASD services.
Social Economic Hurdles
The barriers that results from social economic may thwart or prevent the low-income families from accessing healthcare. The families may face challenges in transportation both in urban and rural areas (Parish, S. L. 2014, January). They may also lack time off from their workstations to take their children for medical checkup. They also fear that there may be other costs associated with Medicare. Further, those families that have acquired their health insurance for the first time may face challenges in navigating the health system so as to have quality services. The low-income families and those accessing the services for the first time should get support from health workers, navigators and support staff so that they can understand on the best way to use their coverage.
Staffing and Human Resource
There is shortage in the supply of licensed ASD specialists. It impairs the provision of dental services to children with autism. The study shows that there is shortage of personnel’s who are trained to treat key discipline in ASD. The shortage has been brought by the rapid demand for ASD services, complexity cases that demands compound practitioners, distinctive roles played in the efficiency of interferences for children suffering from ASD, and the level of meticulousness requisite in the approaches of ASD scheme conveyance.
Efficient Strategies in the Management of Growing Consumer Demand in the Milieu of Financial Constraints
The state needs to create effective strategies to curb the growing demand of dental services facing children with ASD. There is a surge in the number of children relying on Medicaid and CHIP for treatment of ASD. The paper has explored on four strategies that may be effective in managing the growing demand for ASD services (Lewis et al., 2015).
Evidence-Based or the Promising Practice Requirement – A number of states have decided to limit their coverage in terms of service delivery with a promising practice. Such practice as from our study is ABA. There have been a number of deaths of qualified ABA practitioners in different states limiting the coverage and delivery of services. The states have heightened family education so that they can understand the services that their children are receiving and the support that they can get from their homes. The practice will decrease call for inflated and timewasting services.
Rate Decrease – A number of state have worked hard to minimize the rate that is payable to benefactors in a bid to upsurge the probable quantity of children that benefit from the Medicaid program. The new approach will decrease cost and increase the number of children who benefits from dental care under the Medicaid and CHIP programs.
Intensive Care Management – Wisconsin is one of the states that have introduced more healthcare administration policies for its population. The funds ensuing from the scheme have been ploughed to boost the delivery of services and also to increase the coverage for the mounting populace.
Restraints on the quantity of children aided – A number of states have the Medicaid waiver target precise populace limiting the quantity of kids that may be assisted by the relinquishment at any specific period. In Missouri State, the autism waiver shields less than or equal to 149 kids at any specific period. Further, the provision of facilities is restricted to $ 21,000 annually per kid (McKinney et al., 2014).
Developing Issues and Opportunities
Maintenance and Development of Long-term Funding – the Medicaid and CHIP program needs political su...