Legal Advocacy Center Communication

Here is some info I recieved from a legal advocacy agency that specializes in the needs of the disabled. I spoke with someone there, they are doing research on the legality of what AZ is doing

Thank you for your email. I am not an attorney, however, I am writing in response to your email. Indeed, we are hearing about issues such as yours with AzEIP. The following is a link to the AzEIP Procedural Safeguards document for your review: https://egov.azdes.gov/CMS400Min/InternetFiles/Pamphlets/pdf/PAK-628.pdf

The Center is in the process of analyzing all of the cuts right now to determine what if any role we can play to maintain or restore services. However, we do not generally handle a lot of issues regarding AzEIP and have only limited information on those cuts at present, so what we would suggest is to make a request for written notice of termination of services and use your legally mandated procedural safeguards, available online at: https://egov.azdes.gov/cmsinternet/main.aspx?menu=98&id=2366&ekmensel=15074e5e_98_0_2366_9

and if there are appeal rights, appeal. Please note that there is some segue between early intervention and a child’s right to a Free and Appropriate Public Education (FAPE).

My understanding with respect to AHCCCS cuts is that most will not impact direct services to members, and in fact, under Arizona law, your AHCCCS health plan is required to provide “medically necessary” services. “Medically necessary” is defined in pertinent part as a “covered service provided by a physician to prevent disease, disability, and other adverse health conditions or their progression; or prolong life.”

A federal law that requires states receiving Medicaid funding, which includes Arizona, to provide Early and Periodic Screening Diagnosis and Treatment (EPSDT) services for persons under the age of 21 who receive Medicaid.

Under federal law, EPSDT services include preventative and rehabilitative services, including any medical or remedial services recommended by a physician or other licensed practitioner of the healing arts within the scope of their practice under State law, for the maximum reduction of physical or mental disability and restoration of an individual to the best possible functional level. You can review the AHCCCS EPSDT policy regarding services for persons receiving Medicaid/AHCCCS/ALTCS under age 21 at: http://www.ahcccs.state.az.us/Regulations/OSPpolicy/chap400/Chap400.pdf

Also, if you have not done so already, you may wish to apply for Arizona Long Term Care Services (ALTCS) if he meets their eligibility requirements, which basically requires that his disabilities are of such severity that he is “at risk of institutionalization.” I enclose our ALTCS Eligibility Fact Sheet for your review.

**Side note, I had applied for ALTCS for my son when he was discharged from the hospital on oxygen, I applied for services in October, they did not evaluate him until April, and at that time told me he was too healthy for services because he was off of oxygen