Speech IEP and Tricare

[WagsWife]

So we took DD (9) to the base clinic to get a referral for some private speech therapy. We were told that Tricare will only approve speech therapy with an IEP through the school system. I have never had to deal with an IEP...not even totally sure what an IEP is...although I *think I have the general ideal.

I am a little concerned about this. We live in CA...and while I am not normally overly concerned or paranoid about HSing in Cali, I am also not crazy about the school system being involved at. all! If someone here has done this as well I have some questions.

First, will the schools even be *willing to do an IEP for a child not in their system. About a year ago, I contacted them asking about speech through the schools, and they said DD would have to be enrolled in their distant learning program...not really an option for us.

Second, what exactly is involved in an IEP. Once they identify any "issues" are they then going to want to be involved in fixing those "issues?" I am thinking the speech therapy...but also there is some attention issues that we do not feel needs to be addressed medically. I do not want them trying to push themselves into our lives using these issues as an excuse.

Lastly (for now :001_smile:,) Does it make sense that the insurance wants an IEP plan for a school she does not attend?

***OK...the school system just called and told me that the process needs to be started through the local principal...and since school just let out, there is nothing that can be done until at least Aug. Is there another way to get an IEP?

[Kinsa]

Been there, done that. I think I can answer all your questions, but I homeschool in TX, not CA, so it might be a little bit different. But I know that Tricare is the same everywhere.

1. Yes, the schools BY LAW have to evaluate anyone who requests an evaluation. It will be scheduled according to THEIR convenience, however, so be prepared to work around that. Since you are talking about a school-aged child, then they very well might require you to be distantly enrolled... although I just don't get why that would matter. I had to "enroll" my 3yo in the school system in order to RECEIVE the services, NOT to get the evaluation. I DID have my 10yo twins and my 8yo (at that time) evaluated, and I didn't have to enroll them. It might be to your advantage, however, to enroll your 9yo. The school puts a priority on "their own students", and private schooled or homeschooled students get funded out of a different pot of money, and that is limited.

2. During the evaluation, your child will be screened for any and all developmental issues. But you do NOT have to accept therapies for anything that you don't want him to have. The IEP (that's the treatment plan that is developed after the evaluations) will be determined by not only the teachers and staff, but also by YOU. You will certainly have your say in what occurs.

3. Yes, this is frustrating. We went back and forth for a LONG time with Tricare about the fact that we homeschool and don't want our children on the school system's radar, but they basically told us that we could choose to pay out-of-pocket for therapy if we didn't want Tricare's help. :glare: In the end (after two years of battling with them about this - in TX, the schools do not know who the homeschoolers are and we prefer to keep it that way), we did turn out accepting Tricare's payments.

So, here's how it has gone with my now-12yo twins:

We went to the school for the evaluation - no problems at all there.
We went back for the IEP meeting.
The school refused to offer services (based on lack of resources for school-aged, homeschooled kids).
I took the IEP and faxed it to Tricare.
Tricare sent a referral for one office visit to a service provider in our area.
We went to that one visit for the private provider to evaluate them.
The private provider contacted Tricare to confirm that they needed services.
Tricare sent us another referral good for 50-some visits to the private therapist.

And quite frankly, I think that the therapy they are getting from the private provider is much better than they would have gotten at the school. At first I was indignant over the fact that the school refused to provide services, but I now believe that they know the rigmarole that Tricare requires and they just played their part.

I hope this helps you in some way. Let me know if there are any other questions that I can answer for you. (A rep point would be appreciated, too! :D )

[Kinsa]

Oh, I forgot...

We had to go through the whole "wait until summer ends and everyone's back in school" rigmarole before we could schedule the evaluations. That was frustrating, as well. There's no other way to get an IEP that I'm aware of.

(Man, I've used the word "rigmarole" twice now! What does THAT tell you about the process? LOL!)

And the reason that Tricare makes you go through the schools first is because if there's even a SLIVER of a chance that they could get out of paying for something, they'll try it! LOL!

[newbie]

Tammy,
Is there a way to get it with another public school in area, or go through charter.

IEP is individualized education plan. They do it annually for any child who has special learning needs. Personally, I think they are a pain. I am an ed. advocate for my niece and best friend son. I have broken it down to where I conference call. I dont even show up at meetings.

I dont know how it will work hsing., we have went through public school and transferred both kids to private. There are a ton of services, but you have to keep up on everything.

I would try special needs forum board. There are alot who are homeschooling and getting services.

The IEP is the FINAL WORD on everything. You have to keep hold of it if you transfer schools, if you transfer states. Also, when they get older this qualifies them for community services. Ie, Social security, housing and employment with Dpt of Rehab. Fun stuff I am dealing with now.

Yes, even Social Security bases if she is qualified from an IEP. Now some community services rely on testing, like audio reports and recent psych eval. We just ran into that with Dpt of Rehab.

One has to stay vigilant.
Jeannette

[Jen3boys]

My ds had an IEP for speech (our insurance won't cover it at all). It took an entire year from the day I contacted the school system to the start of their speech therapy. Probably about 10 months until they got their IEP. We used a private speech therapist-well worth our money.

[newbie]

Thank goodness they provided care thru Tricare. Because going through some school systems are tough. One child was easy , the other fought to court. But we won.

I have studed it for many yrs. there are many helpful site, best is wrightslaw.com. I think there is good book they wrote and I followed to every letter and every code.

I cant remember term. But schools are set up like barrier of the funds. It start with teacher and than prinicipal and boards. They are set up so that no funds are passed out. They will also give out the we are tapped, excuse constantly. Its not a fun road, but if you can bypass with Tricare. Great.
Jeannette

[newbie]

My ds had an IEP for speech (our insurance won't cover it at all). It took an entire year from the day I contacted the school system to the start of their speech therapy. Probably about 10 months until they got their IEP. We used a private speech therapist-well worth our money.

Private, sometimes is way to go. It saves alot of time and trouble.

Jeannette

[Kinsa]

Er.... one more thing (LOL) just in case I haven't been clear...

My 12yo twins are receiving private therapy through Tricare.
It was determined that my 10yo does NOT need speech therapy.
And my 4yo receives his speech therapy through the public school.

(My 8yo and my 2yo are chatterboxes and certainly do NOT need speech therapy - MY LAND!)

[WagsWife]

At first I was indignant over the fact that the school refused to provide services, but I now believe that they know the rigmarole that Tricare requires and they just played their part.

I hope this helps you in some way. Let me know if there are any other questions that I can answer for you. (A rep point would be appreciated, too! :D )

Thank you for all the information...it was exactly what I was looking for. If Tricare will pay for it, I would MUCH rather go private than through the school system. Especially this school. The principal who told me they would not offer her any help with speech, also would not let her participate in a peer group for children who had deployed parents. She was having a very hard time with her dad being in Iraq, and this principal...the principal of a school *on a military installation would not let a little girl sit in with other kids and talk about how she was feeling :angry: (Don't get me started on how the *base should have offered those services...) So needless to say I am not looking forward to dealing with this guy. Thanks again! I am throwin some rep at ya :)

[WagsWife]

Tammy,
Is there a way to get it with another public school in area, or go through charter.

IEP is individualized education plan. They do it annually for any child who has special learning needs. Personally, I think they are a pain. I am an ed. advocate for my niece and best friend son. I have broken it down to where I conference call. I dont even show up at meetings.

I dont know how it will work hsing., we have went through public school and transferred both kids to private. There are a ton of services, but you have to keep up on everything.

I would try special needs forum board. There are alot who are homeschooling and getting services.

The IEP is the FINAL WORD on everything. You have to keep hold of it if you transfer schools, if you transfer states. Also, when they get older this qualifies them for community services. Ie, Social security, housing and employment with Dpt of Rehab. Fun stuff I am dealing with now.

Yes, even Social Security bases if she is qualified from an IEP. Now some community services rely on testing, like audio reports and recent psych eval. We just ran into that with Dpt of Rehab.

One has to stay vigilant.
Jeannette

I am not sure about using a charter school. The lady from the School District said it had to start with the principal of the school she would normally attend.

I am *not looking forward to dealing with this process. :glare:

*Edited to add...I tried to Rep you...but it said I needed to rep others first. Grrr :(

[asta]

1. The school liaison on post is supposed to be handling all of this. That he/she isn't is total BS. It is his/her JOB to be running interference with the school districts for anything and EVERYTHING regarding all military dependents' educational needs.

2. Start using the chain of command. The Liaison's boss is the Garrison Commander. The GC's boss is whichever General is feeling like they have the biggest cojones that day (on a multiple MACOM installation, that gets fuzzy at times...).

3. Use the most powerful weapon available: the pillowtalk network. More problems have been solved via a well placed "you won't believe what is happening to little Johnny" spoken in the presence of a bunch of women wearing their husband's rank.

4. You're being taken advantage of because your SM isn't there to advocate for you and you're not toeing the line ("but we have all these convenient systems in place... why aren't you IN them?") Grrrr...

I need to stop now. I'm on a tear. Nothing ticks me off more than people who won't do their jobs. Especially when their jobs are so bloody narrowly defined in the first place.


asta

[latinteach]

1. The school liaison on post is supposed to be handling all of this. That he/she isn't is total BS. It is his/her JOB to be running interference with the school districts for anything and EVERYTHING regarding all military dependents' educational needs.

Not necessarily true. Army, Navy and Marines EFMP handle both personnel AND resource functions with EFMP qualified dependents, but Air Force only handles the personnel function, meaning that they just do the paperwork for gaining and losing bases for transfers for special needs families. The Air Force has not allocated funds for the resource function because the resource function was an optional mandate, whereas the personnel function is a required mandate.

[Kinsa]

Not necessarily true. Army, Navy and Marines EFMP handle both personnel AND resource functions with EFMP qualified dependents, but Air Force only handles the personnel function, meaning that they just do the paperwork for gaining and losing bases for transfers for special needs families. The Air Force has not allocated funds for the resource function because the resource function was an optional mandate, whereas the personnel function is a required mandate.
:iagree: I was going to pipe up and say that MOST bases in the USAF do NOT have school liaisons anymore due to cost cuts... but you beat me to it. :D

[Mrs Mungo]

She was having a very hard time with her dad being in Iraq, and this principal...the principal of a school *on a military installation would not let a little girl sit in with other kids and talk about how she was feeling :angry: (Don't get me started on how the *base should have offered those services...)

I don't know where you're stationed but is there an Army base nearby? If so, you would have access to *their* services. If you do, go and talk to ACS and/or CYS. We've lived a lot of different places and my experience with ACS is that if you can show a need and you are willing to help, they will get you some money to start a program. Many of the places I've lived have held monthly mixers for families of deployed soliders or things like that. The program director for CYS here is helping homeschoolers start a homeschool support group (complete with funds).

I wish I knew more of the ropes of how it works on the AF side of the house but I don't. :confused: If you were an Army wife I could tell you exactly what to do.

I do have to agree with asta about the pillowtalk network. I can't tell you how many women I've helped just by being *aware* of a problem and informing the proper person. I don't like to think of it as wearing my husband's rank because *those* women are usually snooty and I'm not :D. But I'm not offended or anything, I know everyone thinks of these things in different terms.

[asta]

Sorry guys - I don't know who is attached to what service. I was trying to give general info.

I certainly don't believe all wives wear their SMs rank; but the ones who do get so busy-body about it, might as well use it to your advantage, ya know? ;-)


asta

[one l michele]

for speech therapy, I'd go private if I could do it all again. He had his evaluation early November, services didn't start until the end of January. It was recommended he go two 30 minute sessions per week, due to me taking him there, I thought 1 hour once a week would be better. I've lost count of the amount of times his therapist has either been late for class or called to cancel, always saying she had a meeting or something else scheduled during that slot. Very frustrating, he's in with a half dozen other public schoolers as it is so it's not like he's worked with one on one for that hour each week. I finally asked her for resources I can do at home with him. Together we do speech daily at home and he's making so much more improvement. We still may need to look at private for next year, I'd like to see an end of year eval to compare and see where he's at first.

[Christine]

We were told that Tricare will only approve speech therapy with an IEP through the school system. We live in CA...


Lastly (for now :001_smile:,) Does it make sense that the insurance wants an IEP plan for a school she does not attend?



We were in Monterey (area), any chance you are there?

OK, let's see. . .(most of your questions were answered, so I'm only going to add to information given)

At the time I was using the charter school (it was based in Salinas); it was fantastic. DS1 already had an IEP done though. . .or no, but the process had already been started (it only took a couple of months though).

We started homeschooling in CA, because our school was so "sub-standard". (My word, I was orignally going to go with "poopy", but decided it wasn't very educated sounding, which now makes me wonder why I'm stating it here. . .)

Anyway, at that time, we did DS1's speech through the school, but since we were homeschooling through the charter we did not use the local school, but a school that was in the charter's district (like a 10 min drive from us). We only dealt with the speech therapist (nothing to do with principle or teachers) after the eval was done.

Now, we are east coast, and our local laws will not allow school-aged home-schooled kids participate in school based special services (like speech). My two youngest require it, and have been receiving it at the school until they turned school age.

DS3 has been out of speech for over 1 year now. We had the IEP, the dr's referral, etc. BUT (and this is a big one) Tricare didn't actually have any speech (developmental) practitioners on it's "list". (Erm, that's not true, they have 2, and both of those have a waiting list of YEARS - we are on both waiting lists.) Tricare just got a 3rd therapy clinic signed up, and I was able to get into them "right quick".

However, I've been having to fight Tricare, even with the IEP; because they keep saying it's the state's obligation to provide care. However, again, the state law specifically says that if you are a homeschooler they do not have to provide care. And even though there was a waiting list, Tricare would not cover specialists (SLPs in this instance) outside of their network.

Thus the reason why DS3 hadn't been getting service for over a year. That and the fact that private practice (and payment out of my pocket) would have equaled my weekly grocery allotment. . .

Oh, and an IEP will travel with you. Regardless of any state or local you are in. If you were in public school, then it is mandatory that when you move, regardless of state, that the new school implement it (until they do their own eval). Of course, as a homeschooler, it will be dependent on each state's laws whether or not they have to honor it (only about 25 have to), all DODDs schools do though.

[Stacey in MA]

We used to live in CA and DS9's first year of homeschooling for K was done through the home charter! It WAS awesome...Mary Lou was our teacher/lead. She helped me cycle through curriculum to find the right programs for DS, and also discover his learning styles and issues. I'm glad we're on our own now, but that was a great way to dive into homeschooling!

Also DS9 saw a private speech therapist in Salinas for his dysfluency (studdering). She SPECIALIZED in children, and had experience w/ dysfluency (a speech problem that many therapists don't like b/c it's causes and treatments are often inconsistent). Anway, I call her the "best on the planet"! She worked magic with him!

By the way, are you still there? Did you like the area? Do you miss it?

Sorry to hijack! FYI, my sister is a speech therapist in the public school system in MA, and she has shared some things. They are somewhat obliged to please the parents so that the parents don't cause a stink with the school. So for example, if she assesses child to have problems A, B and C, and she feels C needs to be focused on, but parent feels A should be focused on, she better focus on A and show some results for A so that the parent backs off. KWIM? So, my reason in sharing this is that if you feel there are things that you DON'T want worked on, you make it clear to the speech therapist, and they better follow your lead. If they don't, you go to the powers that be (principal) and discuss how the therapist isn't "doing her job" or "respecting your family boundaries" or however you want to bring it into light, and she'll get the point.

HTH and GL! - STacey in MA

[Christine]

We used to live in CA and DS9's first year of homeschooling for K was done through the home charter! It WAS awesome...Mary Lou was our teacher/lead. She helped me cycle through curriculum to find the right programs for DS, and also discover his learning styles and issues. I'm glad we're on our own now, but that was a great way to dive into homeschooling!

By the way, are you still there? Did you like the area? Do you miss it?



Had to look this up, as you got me curious (the name "rang true").

Our teacher / lead was Mary Lea McDaniel. . . (close but no cigar). She was fabulous. Like you, I'm glad we are on our own now, but a it was terrific for "holding my hand" at the get-go (when I was terrified).

Not still there (last there 8 years ago). Did not like the area (fog out by 1000, in by 1600 -- massive bronchitis issues, that I've only ever had there, and I've lived there 3 times). Don't miss it. My oldest 2 didn't like it either (youngest 2 having never been there).

DH LOVED/S the area though, and threatens should we ever win the lottery he's going to move us there. (I ensure we don't PLAY the lotto. . . )

[TraceyS/FL]

I don't know which county you are talking, but when we were evaluated at a private school, in pre-school (VCA in Santa Maria), it was the County that did the testing. The county also provided services - they came in once a week for the kids that needed it (even in the elementary classes).

We didn't qualify :glare: (although a friend that was a certified tester for head start said she did qualify), so we went no further with it.

Here in FL, for the 3 year old, we just went to the County Education office for the testing and then the local school contacted us about the IEP meeting. Because it's for a pre-K student things operate differently.

My long drawn out point, is that try to find a private school willing to work with you, and call the County Health Department and see what they say.
But yes, you probably are out of luck for getting much done now - but try to schedule something early. We couldn't get tested until October back here. UGH.

[TraceyS/FL]

Not still there (last there 8 years ago). Did not like the area (fog out by 1000, in by 1600 -- massive bronchitis issues, that I've only ever had there, and I've lived there 3 times). Don't miss it. My oldest 2 didn't like it either (youngest 2 having never been there).

DH LOVED/S the area though, and threatens should we ever win the lottery he's going to move us there. (I ensure we don't PLAY the lotto. . . )

:lol:

I'm a 3rd Generation Central Coast Native, nope, can't say i miss that fog at all! Someone on Saturday was saying, wow, average of 70 year round - that owuld be GREAT. Sure dude, you go see how you like the fog burning off by noon - if you are lucky, and then rolling back in around 4... and the wind off the ocean is cold, and the wind ALWAYS blows in Santa Maria.

Nope, i left because of the weather! My oldest says she misses it - uh huh, the child you can't get to put shoes and socks on, EVER. Sure, you go back there and live in flip-flops all year....... :tongue_smilie:

[asta]

I knew something was nagging at my brain...

From the TriCare Humana Website:
My child is being home schooled. Can he/she still qualify for services under the Department of Defense Enhanced Access to Autism Services Demonstration?

If the child is homeschooled and not required by state law to have an Individual Education Plan (IEP) or an Individual Family Service Plan (IFSP), the child’s Primary Care Provider (PCP) or Specialized Autism Spectrum Disorder (ASD) Provider must certify that the child’s disability related to ASD results in dysfunction severe enough to require special education and other supportive services.

I'm not saying that your child is on the autism spectrum. However, this is like one of those math problems: all children with speech impediments aren't on the spectrum, but almost all children on the spectrum have speech impediments.

No one talked about ASD when I was growing up (the 70s). Certainly not if a kid was smart. No one figured it out in regards to me and one of my siblings until we were adults. Bingo: two people with speech impediments.

(and even if this doesn't apply to your kid, it appears to be precedent for not having to jump through the PS hoop. The website: http://www.humana-military.com/south/bene/health-wellness/Autism/autism-faqs.asp)



asta