The organization who approves Ryan’s supports and therapy in school is called Community Behavioral Health. In the most basic terms the provider who supplies the support collects the evidence of need. They have been fighting on Ryan’s behalf for more support in school for over two years. They keep asking for approval from Community Behavioral Health for more support for Ryan and he usually receives 1/4th of the services the provider thinks are necessary. Then the provider collects more data, then they sent it off to Community Behavioral Health. They love to use terms like “not medically necessary” when it comes to Ryan needing help in school. Over time the support provider has bent over backwards trying to get additional help for Ryan.
I spoke with the Developmental Pediatrician via email on Friday. I told her with little hope of finding an ADHD drug that could work for Ryan appearing in the near future, I wanted to pursue more behavioral supports. She agreed. She said that ADHD medication may never be a possibility for Ryan and we should pursue other treatments including additional behavioral support. Then she sent me a signed letter on letterhead saying that Ryan should have full time TSS as well as other supports to keep him on track, safe, and learning at school because of his adverse side effects and allergic reactions to the ADHD medications. These reactions make the behavioral supports a medical necessity.
I am sad that there are no medications for Ryan to take for his ADHD. I know it would make his life easier to be able to take the meds but we always knew this could be a challenge for him. I am happy that I have more ammunition to throw at Community Behavioral Health to prove the medical necessity of additional supports in school. Next up is a meeting with the support providers to send off a big packet of evidence proving the additional need along with their evaluations. Fingers crossed people.