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Attorney: Arizona’s Division Of Developmental Disabilities Still Denying Families Medically Necessary Speech Aid

By Ben Giles
Published: Tuesday, April 14, 2020 - 9:32am
Updated: Tuesday, April 14, 2020 - 9:40am

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Arizona Department of Economic Security
Sky Schaudt/KJZZ
The Arizona Department of Economic Security oversees the Division of Developmental Disabilities.

Arizona’s Division of Developmental Disabilities continues to deny speech-generating devices to nonverbal individuals, even after the state’s Medicaid agency ordered them not to, according to an attorney.

Lawyers at the Arizona Health Care Cost Containment System issued a “notice to cure” to the division on March 4 after learning that hundreds of requests for the equipment, known as augmentative communication devices, were denied in violation of state and federal guidelines.

Of the 314 requests the division evaluated between July 1 and the end of February, at least 301 were denied.

AHCCCS ordered the division to alter its policies for evaluating those requests, which are only submitted to the state after a lengthy process that requires nonverbal individuals to obtain prescriptions for the device from doctors and speech pathologists, among other steps.

→ Voiceless: Arizona Agency Denies Hundreds Of Families Medically Necessary Speech Aid

Anne Ronan, an attorney with the Arizona Center for Law in the Public Interest, said the division continued to issue denials based on flawed policies after March 4.

“What we have seen is there’s been no change; that (Division of Developmental Disabilities) staff have continued to issue denials using the same rationale and citing the same legal basis that the AHCCCS administration had told them in their notice to cure were in violation of federal and state law,” Ronan said. “We’ve seen daily, sometimes as many as 10 a day, of the exact same denials coming in from the division.”

In a letter to Ronan on March 30, AHCCCS’ deputy general counsel wrote that the division is required to hire an independent party to evaluate the medical necessity of requests for speech-generating devices.

That third party will evaluate any requests that were either previously denied or have not yet been processed.

AHCCCS officials also promised to provide oversight of a consultant that the division must hire to evaluate its eligibility criteria for speech-generating devices.

Essentially, that meant AHCCCS had ordered the division to stop evaluating requests effective April 1, Ronan said. Nonetheless, Ronan said she continues to hear that the division has failed to change.

“We have conveyed the information we've gotten from families and providers about these continuing violations of federal and state law. We've gotten some pretty aggressive responses from the AHCCCS administration, but we haven't seen any implementation or follow-through at (the division),” Ronan said. “So we are not at all clear what AHCCCS is saying to (the division), what they're telling them to do and whether or not they're making sure that this problem is resolved at the division level.”

Ronan said she has no faith that staff responsible for evaluating and issuing speech-generating devices at the Division of Developmental Disabilities is capable of complying with the AHCCCS order.

In a March 26 letter to AHCCCS Director Jami Snyder, Ronan wrote the individuals responsible for evaluating requests for augmentative communication devices don’t have expertise in that medical field.

Those staffers have denied requests against the advice of medical providers that are required to have “over six years and 1,000 hours of expertise with augmentative communication services,” Ronan wrote.

“This is not acceptable,” she wrote.

“We made it very clear to AHCCCS in several written communications that we did not believe the staff that had created the problem were capable of solving the problem, and the AHCCCS administration agreed with us,” Ronan said. “But despite that, we continue to see decisions that are being made on a daily basis by the same staff who created the problem.”

Officials at the Department of Economic Security, which oversees the Division of Developmental Disabilities, did not respond to a request for comment.

AHCCCS gave the division until May 1 to fully comply with state and federal law.

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