Concluding that your child may be struggling in ways his or her peers may not is a tough moment for most parents. Deciding what to do next is even tougher and frankly could be overwhelming. Early intervention should always be at the forefront, but who and when you enlist them to provide those services makes a difference. States recognize the need to assist parents in navigating early intervention, putting in place programs like Babies Can’t Wait (BCW) for Georgia’s children and families, but hindering access to services based on government instated timelines may not be in your child’s best interest. Let us explain why:
What is Babies Can’t Wait?
BCW is Georgia’s statewide interagency service delivery system for infants and toddlers with developmental delays or disabilities and their families. BCW is established by Part C of the Individuals with Disabilities Education Act (IDEA), which guarantees all eligible children, regardless of their disability, access to services that will enhance their development.
Part C early intervention builds upon and provides supports and resources to assist family members and caregivers to enhance children’s learning and development through everyday learning opportunities.
In layman’s term:
BCW is a government mandated program which provides assistance in coordination of medical and educational services needed for children with disabilities between the ages of birth to three. Families are provided with treatment and coaching within the home to encourage carryover opportunities throughout the child’s day.
What specific services does Babies Can’t Wait provide?
- Multidisciplinary evaluation to determine eligibility and multidisciplinary assessments to determine the scope of services needed.
- Service coordination that assists the family and other professionals in developing a plan to enhance the child’s development.
Both services are completed free of charge.
In layman’s term:
An evaluation is coordinated by an Intake Service Coordinator whom determines the primary area of concern and locates a team of state contracted professionals (which may include, speech, occupational, or a physical therapist) to evaluate and determine your child’s eligibility. If your child happens to have been previously diagnosed by a medical doctor with a category 1 disorder, they are automatically eligible for early intervention services in the area of primary need. Coordination and evaluation are completed free of charge.
Once determined eligible, an Individualized Family Service Plan (IFSP) is developed, which outlines the treatments a child will receive — whether it be speech and occupational therapy or speech therapy only, etc.
As it relates to paying for the services a family receives, BCW becomes the payor of last resort. This means if a family has insurance, the insurance (medicaid or private carrier) will be billed for therapy services provided via a BCW contracted therapist. If a family’s insurance denies payment, BCW will instead be billed for each treatment provided. If a family does not have insurance, a cost-participation model using a sliding fee scale is implemented.
Who provides services within Babies Can’t Wait?
Services are provided by agencies and individuals from both public and private sectors.
In layman’s term:
BCW has providers (therapists and instructors) and coordinators who are government employees, but in most cases, the team coming into your home and evaluating your child are comprised of contractors. The therapist and service coordinators or the companies they work for can be found right in your own community and you have access to these professionals just as you do your child’s doctor.
A search on google (paired with your zip code) can lead you to the same therapists and others. Many of these therapists are able to evaluation and provide services for your child in your home, daycare or other natural environments. This occurs without the wait and red tape associated with the laborious paperwork often required by government programs, such as Babies Can’t Wait.INFANT-TODDLER SCREENER
What BCW Does Not Say
- Families are not always aware of the timelines, shortages of health professionals (PT, OT, Speech) within the BCW program and lack of funding, which can add a considerable amount of time to the ever-closing window of opportunity in healthy child development. Once referred, BCW has 45 days to evaluate and then another 45 days to develop an IFSP and initiate services. Due to the lack of providers willing to serve within the BCW program, it is possible for timelines not be met.
- When seeking early intervention services via Babies Can’t Wait, you have the option not to provide your insurance information. If your child qualifies for early intervention, services cannot be withheld because of this. Be aware you may be responsible for payment based on a sliding fee scale, but you can then seek additional private services using your insurance. This results in your child receiving services from multiple providers (i.e. – therapist assigned to you by BCW + the therapist you’ve sought on your own).
- If you have insurance which covers your child’s the diagnosis, parents can seek a provider on their own. Many parents opt to go directly to Atlanta Speech Therapy in effort to not further delay the services they know their child may need. We are able to refer parents to the appropriate professionals (OT, PT, local school system) without the (90 day) wait. Use these talking points to guide your conversation with your insurance company to determine if you have coverage. We are in network with Aetna, Ambetter, Coventry, BCBS, PeachState, Amerigroup, Medicaid, and we are able to bill all major insurance companies including Tricare. Contact us and we’ll show you how to take advantage of your out of network benefits without breaking the bank.
- If there is a need for multiple therapies, BCW functions via a collaborative model (vs. a medical model) where, for example, a physical therapist will consult with a speech therapist to provide therapeutic speech techniques during the physical therapy session. In this instance, speech therapy would not be provided by a speech therapist. Additionally, it is not unusual for a child to receive services by a special instructor (often a former classroom teacher) in lieu of skilled therapist due to shortages in BCW providers.
- Other options in paying for all therapies needed outside of BCW includes the Katie Beckett Deeming Waiver which provides funding regardless of household income through Medicaid. Using this waiver, offers the opportunity for your child to receive services via a medical model, where each discipline evaluates and provides treatment to the child as needed.
- BCW is most beneficial for families without insurance, those who do not qualify for the Katie Beckett Deeming Waiver, families’ whose insurance does not cover their child’s specific diagnosis, or those who have a very high deductible. Our blog details 10 Questions to Ask When Contacting Your Insurance Company About Speech-Language Therapy.
- BCW offers a transition service that prepares your child for placement at the age of three to prevent a gap in services. Your child will be evaluated by their local school system to determine if they are eligible to continue receiving therapy via your neighborhood school and/or a special education classroom placement. The individual therapy your child received in BCW is often not what will be offered by a school-based speech-language pathologist. Public School Therapy differs from private therapy. Know, that you can elect to enroll your child in school-based therapies and still pursue private therapy. If your child receives Medicaid benefits, it is very important that you understand you have the right to deny the school access to your Medicaid benefits — this does not change the services your child is eligible to receive via an Individualized Education Plan (IEP).