[dbmat] Re: My answer to Heather's Question about therapies in DB-MD waiver

  • From: Leslie Stevens <lesliestevens07@xxxxxxxxx>
  • To: dbmat@xxxxxxxxxxxxx
  • Date: Sat, 3 Jan 2015 00:02:57 -0600

I wonder...speaking of trying to getting hippo/aqua/etc. therapies
covered...Does it make any difference if the therapist providing services
was, say, a certified PT who billed it as physical therapy, but just
happened to be providing that physical therapy to the client in a pool, or
on a horse...?  For example, Olivia does therapeutic horseback riding
through SIRE (wonderful organization, BTW), but her riding instructor is
not a certified PT or OT.  I believe in order to be truly termed as
"hippotherapy" (rather than just "therapeutic horseback riding" or some
variation on that), the provider has to be a certified PT or OT...So I just
wonder if that makes any difference then in how they are able to classify
the services provided and if it might be covered under one of the waiver
programs that does include PT.  Maybe I'm way off...just a
thought/question!

Leslie

On Tue, Dec 30, 2014 at 10:18 PM, Stephen Schoen <stephenschoen351@xxxxxxxxx
> wrote:

> Waivers can only offer services which are in their menu. Hippo, aqua, and
> music therapies are not in the DB-MD waiver menu   I don't think there is
> any loophole with prescriptions.  But I applaud CC's usual creative
> thinking. By now, some of the parents of children who are getting in the
> waiver are realizing the benefit of  their child's new Medicaid
> eligibility.  Happy New Year to all tomorrow.  Be safe!
> On Dec 30, 2014 9:18 PM, "Melanie" <dmarc-noreply@xxxxxxxxxxxxx> wrote:
>
>> I think it has to be a prescription from a physician, but with that
>> said...I am sure a Doc would do that
>>
>> Sent from my iPad
>>
>> On Dec 30, 2014, at 6:20 PM, "Davis,CC (DARS)" <CC.Davis@xxxxxxxxxxxxxxxx>
>> wrote:
>>
>>  I’m just wondering here, … but, … what I’m thinking is this:  Can a PT
>> or OT write a prescrip for something like aqua and hippo therapy, … and can
>> a speech path prescribe music as therapy.  Just wondering – I know the
>> benefits are there for those needs.  Steve would probably know though, … as
>> he’s been in that system in the past.  I know that the overall cost has to
>> be considered.  - CC
>>
>>
>>
>> *From:* dbmat-bounce@xxxxxxxxxxxxx [mailto:dbmat-bounce@xxxxxxxxxxxxx
>> <dbmat-bounce@xxxxxxxxxxxxx>] *On Behalf Of *Heather Withrow
>> *Sent:* Monday, December 29, 2014 11:21 PM
>> *To:* dbmat@xxxxxxxxxxxxx
>> *Subject:* [dbmat] Re: My answer to Heather's Question about therapies
>> in DB-MD waiver
>>
>>
>>
>> Thank you so much for clarifying this for me, Steve!  The link helped.
>> Much appreciated!
>>
>>
>>
>> We have private health insurance (although it is crummy) for the basic
>> OT/PT therapies but like Lauren’s mom said earlier- go for the DBMD waiver
>> for the interveners.  I can’t imagine anyone NOT going for the intervener
>> enlightenment!  The DBMD waiver is the first of any waiver that even
>> contacted us about the opening, it’s a no-brainer.  It’s a question of
>> which agency I pick to work through.  I appreciate all the other assistance
>> we can get.  I’m seeing the light at last!
>>
>>
>>
>> Many, many thanks for the input.  I’m listening.
>>
>>
>>
>> Heather,
>>
>> Orion’s mom
>>
>>
>>
>> On Dec 29, 2014, at 10:08 PM, Stephen Schoen <stephenschoen351@xxxxxxxxx>
>> wrote:
>>
>>
>>
>>  I'm taking the liberty of answering Heather's question.   I'm not sure
>> what the case manager for the DB-MD provider is referring to by
>> "recreational therapy."  There is no such service for people of any age in
>> the DB-MD waiver.   The one service which adults can get and children can't
>> in the DB-MD waiver is Assisted Living.   Assisted living means living in a
>> residence other than your families (such as a small 6 or fewer bed group
>> home.)
>>
>>
>>
>> The DB-MD waiver does not (and never has)  provide hippo therapy, aqua
>> therapy, and music therapy for people of any age. The only Medicaid Waiver
>> which provides those services is the CLASS waiver.   Here is a link to
>> description of the DB-MD Waiver services directly from the current Texas
>> Administrative Code.  It is worth the time to read all of these services,
>> and ask questions about any which are not clear.  (Division 3 has the
>> majority of services and definitions.)
>>
>>
>> http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=5&ti=40&pt=1&ch=42&sch=F
>>
>>
>>
>> Steve Schoen
>>
>>
>>
>>


-- 
Leslie Stevens
lesliestevens07@xxxxxxxxx
713-408-4470

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