Most children with special needs are entitled to NJ State funded Early Intervention Program. However, the quality and experience of the therapists vary greatly. Many therapists have largely educational experience or may be treating geriatric population most of the time, but wanted to have different clinical experiences. Early Intervention service is either their side job or a stepping stone. These therapists although legitimate for the services they provide, they are, however, not the best for the medically complex and fragile children.
Parents who seek more and better therapies for their children often run into trouble with their medical insurance coverage. While some medical insurance companies deny anything “developmental” all together, the rest of them provide limited developmental therapy coverage. They typically offer between 30-90 visits combined therapies per year. Unfortunately, these provisions often are not sufficient to cover intensive therapies the children may need. As the reimbursement rates vary greatly between medical insurance companies, most outpatient rehabilitation facilities or services that accept medical insurances require their developmental therapists to see as many patients as possible a day to maintain their profit. Such time and cost pressure restricts a therapist’s ability to offer optimal therapy.
Increasingly true, particularly in NJ, many experienced and specialized developmental therapists go out on their own to become private practitioners. In private practices, they are able to offer these children appropriate and adequate therapies. However, medical insurance companies make it difficult for them to become in-network providers. Hence, many do not accept medical insurance although most do provide medical billings for parents to seek reimbursement directly from their own medical insurance companies.
Sammy’s Friends Foundation strives to help parents offset the out-of-pocket therapy costs using a rebate coupon system. Unconventional therapies that we are interested in supporting are: CME (Cuevas MEDEK Exercises), NDT (Neuro-Developmental Treatment), Hippotherapy, TheraSuit, Vital Stim, PROMPT (Prompt for Restructuring Oral Motor Phonemic Targets), RDI (Relationship Development Intervention), and Conductive Education.