TRICARE’s New Policy on Military Children with Autism – EBCALA’s Letter

The following letter was sent to Senators regarding TRICARE’s autism therapy policy. Please reach out to your state’s senators and especially the members of the U.S. Senate Committee on Armed Services.

Dear Senator,

We are writing to ask for your intervention regarding TRICARE’s new policy for military children with autism and its impact on their access to a critical form of therapy called Applied Behavior Analysis (ABA). Autism is now at epidemic rates amongst America’s children and military families are no exception. According to the Centers for Disease Control, approximately 1 in 50 school-aged children have an autism spectrum disorder (ASD).

ABA has, according to June 2012 Senate Armed Services Committee testimony from Vera F. Trait MD, FAAP, the Associate Executive Director of The American Academy of Pediatrics

“proved effective in addressing the core symptoms of autism as well as developing skills and improving and enhancing functioning in numerous areas that affect the health and well-being of people with ASD. The effectiveness of ABA-based interventions in ASDs has been well documented through a long history of research in university and community settings. Children who receive early intensive behavioral treatment have been shown to make substantial gains in cognition, language, academic performance, and adaptive behavior as well as some measures of social behavior, and their outcomes have been significantly better than those of children in control groups.”

Until recently, TRICARE has only provided ABA therapy for active duty families, under a program called the Extended Care Health Option (ECHO). Notably, military families impacted by the medical retirement of a wounded warrior found their child with autism suddenly without therapy.

Military families and advocacy organizations lobbied Congress in 2012 to include language to correct the deficiencies in the ECHO program in the 2013 National Defense Authorization Act (H.R. 2288 and the Caring for Military Kids with Autism Act). The bills passed both the House and the Senate, but were significantly changed during the conference committee, resulting in a one-year pilot program, to be available to families no later than April 1, 2013.

In May 2013, U.S. Rep. John Larson introduced an amendment that was included in the House version of the 2014 NDAA, with more specific language to address the confusing multiple TRICARE programs that neither provides prescribed levels of care nor a permanent benefit for retiree and wounded warrior dependents.

On June 25, 2012, the details of TRICARE’s new ABA policy were finally announced. The new program is significantly more restrictive, growing from a four-page document to one containing more than 20 pages of conditions, requirements and restrictions, including an age limit and additional testing requirements outside of normal ABA best practices.

This new policy, is a huge step backward for all military families, active duty and retirees. Many children will lose access to the very therapy that gives them a chance at a successful, independent future and the strain is already so evident in these military families serving our great nation.

We ask for your assistance on three actionable items:

  1. Preventing the implementation of this new policy, set for July 25, 2013.
  2. To support the inclusion of equivalent language contained in the Larson Amendment in the Senate version of the NDAA.
  3. Work with the House and Senate Armed Services Committees to hold additional hearings on this issue to ensure Congressional intent is translated into appropriate regulations by TRICARE and DOD.

The Department of Defense has a duty to provide the medically necessary treatment for military members and their families at prescribed levels without imposing arbitrary limits only meant to add barriers to care.

Thank you for your time.

Sincerely,

Tim Adams, Esq.
Board Chair

C. Rick Ellis, Ed.D.
Licensed Clinical Psychologist and Board Member