Autism Care Demonstration Policy Changes Benefit Military Families

If you’re an active-duty military family with a child diagnosed with autism spectrum disorder, you’ll want to learn more about the comprehensive changes to the Autism Care Demonstration authorized by the Defense Health Agency. The changes expand the ACD to center around the needs of the individual child, integrating all potential services to achieve the best possible outcomes.

These updates to TRICARE’s ACD program help TRICARE better address the needs of family members with ASD and give parents more input in developing the care plan for their child. Parent training is an important new focus of the ACD and providers must now start parent training within 30 days of the initial authorization period.

Understand ACD changes

The ACD changes should improve the quality of and access to care and services for military children and also increase parental input into their child’s care plan. These changes should also increase the management and accountability of regional contractors and ABA providers.

Some highlighted improvements include:

• Addition of the Parenting Stress Index to provide families and provider teams clear, consistent measurements over time.
• Change in settings where ABA coverages occur to include some group services, medical team conferences, etc.
• Removal of a diagnosis confirmation requirement — Primary care managers can now make an initial ASD diagnosis without referral to a specialized ASD-diagnosing provider.
• No referral needed for diagnostic testing plus expansion of possible diagnosing providers.
• Telehealth extended beyond the pandemic for training and parental guidance.
• 28-day access to care standard — ABA providers must complete initial assessment within 28 days of referral and begin treatment within 28 days.

An autism services navigator is assigned to new beneficiaries and will act as their primary care coordinator. (ASNs are assigned to those who don’t currently receive ABA services under the ACD and started in the program after Oct. 1, 2021). The role of the autism services navigator includes:

• Collaborating with all stakeholders for the beneficiary.
• Overseeing assessment, planning, facilitation, care coordination and evaluation.
• Serving as the primary health care advocate and point of contact for the beneficiary and family.

Military families can benefit from their ASN who will:

• Develop a comprehensive care plan.
• Improve care transition support.
• Provide greater care coordination support.

What didn’t change

Features of the ACD program that remain the same include:

• The coverage for the diagnosis of ASD
• Referral from an eligible TRICARE-authorized provider
• Prior authorization for services
• ABA provider completion of assessment and treatment plan

Get more information

Use the following resources to learn about new program features and how they might affect you and your family member.

• Review past presentations and webinars, check out the Q&As and sign up for ACD-specific email alerts at health.mil/autism.
• View the steps to get started in ACD and stay abreast of the current and upcoming changes at https://www.tricare.mil/autism. You may also want to read TRICARE Autism Care Demonstration Evolves.

If you have questions on ACD or need more information on the Exceptional Family Member Program, contact the EFMP Family Support staff on your installation. You can also connect with Military OneSource at 800-342-9647 or use live chat to schedule an appointment with a special needs consultant. OCONUS/International? View calling options. Appointments are available seven days a week.