This past week, Athena aged out of the Colorado Early Intervention program (EI). I wish I could say that leaving the program is bittersweet, but if I’m being honest, it’s more bitter and less sweet for our family.
Now that Athena can no longer receive services from EI, our family is at the mercy of our local school district to provide Athena with the supports she needs to thrive.
It’s no secret that I’ve been far from impressed with the services Apollo’s received at school thus far — so it should be no surprise that my excitement for Athena to use the same services is nonexistent.
If you’ve read my most recent blog post: “Colorado Early Intervention Changes” you know that our primary (private) insurance doesn’t cover any habilitative care. So unless we win the lottery, or can somehow figure out a way to pay approximately $2,000+ each month out-of-pocket for outpatient therapies, leaving the EI program means that Athena will no longer be receiving ongoing occupational or behavioral therapies.
I’m devastated, feel powerless, and feel like I’m failing my child…
It upsets me that Medicaid allows families to get their children help for little to no cost, but Justin and I pay thousands of dollars a year for private health insurance that doesn’t even cover any habilitative therapies — the therapies Athena NEEDS.
I’m not bashing on Medicaid recipients, so please don’t misunderstand, I’m just expressing my frustration with the private insurance sector . . . it’s beyond broken.
I know we are not the only family out there currently struggling to get their child(ren) help. In my experience, most private insurance companies don’t cover habilitative care services, period. Knowing this, I shudder to think about the many children out there, like Athena, that are currently without therapies after the age of 3 because of the inability to pay for it out-of-pocket.
Without the CES waiver, our family couldn’t afford to get Apollo the current supports he has — so while one of our children is able to get help, one currently is not.
I’m not giving up. I have reached out to our Community Centered Board (CCB) to see if Athena’s challenges could somehow qualify her for the CES waiver (the same waiver her brother, Apollo, is on).
While Athena exhibits many of the same challenges her brother currently faces, and has been in therapy for said challenges through EI, Athena has no formal diagnoses.
On Monday, I submitted Athena’s preschool testing/evaluation along with her current IEP (to receive services through our school district this Fall) to our county’s CCB, and I’m waiting to hear back if the testing completed for her IEP will meet the waiver’s determination requirements. If not, I will be on the hunt for a healthcare professional that can complete the required testing for the waiver determination. I asked Apollo’s current psychologist if she could complete the required testing, and she is unfortunately not able to do so.
For those of you that pray, please pray that Athena’s current testing/evaluation is enough. If not, Athena may be forced onto an extensive waiting list to be evaluated elsewhere. Unfortunately, in Colorado, many kids wait well over a year for evaluations to be completed, and even longer to begin receiving services thereafter.
I know there are so many people out there that are in the same boat. While a sad reality, knowing that there are other families out there that can relate is comforting.
Wish us luck!