COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions / Whitney SCHOTT in Autism, 26-4 (May 2022)  

Public ISBD [article]  inAutism > 26-4 (May 2022) . - p.975-987 Titre : COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions Type de document : Texte imprimé et/ou numérique Auteurs : Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay SHEA, Auteur Article en page(s) : p.975-987 Langues : Anglais (eng) Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder/epidemiology  COVID-19/epidemiology  Humans  Intellectual Disability/epidemiology  Medicaid  Mental Health  United States/epidemiology  COVID-19 risk  autism  comorbidities  intellectual disability Index. décimale : PER Périodiques Résumé : Autistic adults, adults with intellectual disability, and adults with other mental health conditions may have higher risk of contracting COVID-19 or experiencing more severe illness from COVID-19 if infected. We used data from Medicaid to look at whether autistic adults and other adults with intellectual disability and other mental health conditions were more likely to have risk factors for COVID-19, such as living in a residential facility, receiving services regularly in the home from outside caregivers, having had a long hospitalization, having had avoidable hospitalizations, and having high-risk health conditions. We found that autistic adults had higher odds of living in a residential facility, receiving in-home services from outside caregivers, having had an avoidable hospitalization, and having a high-risk health condition, compared to neurotypical adults without mental health conditions. Adults with intellectual disability had similar odds of having these conditions. Adults with other mental health conditions were also more likely to live in a residential facility, receive services from outside caregivers, and have had avoidable hospitalizations compared to the neurotypical population without mental health conditions. They had three times higher odds of having a high-risk health condition. High risk of COVID-19 among autistic adults and adults with intellectual disability and mental health conditions should be recognized by clinicians, and these groups should be prioritized for vaccine outreach. En ligne : https://dx.doi.org/10.1177/13623613211039662 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=473 [article] COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions [Texte imprimé et/ou numérique] / Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay SHEA, Auteur . - p.975-987. Langues : Anglais (eng) in Autism > 26-4 (May 2022) . - p.975-987 Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder/epidemiology  COVID-19/epidemiology  Humans  Intellectual Disability/epidemiology  Medicaid  Mental Health  United States/epidemiology  COVID-19 risk  autism  comorbidities  intellectual disability Index. décimale : PER Périodiques Résumé : Autistic adults, adults with intellectual disability, and adults with other mental health conditions may have higher risk of contracting COVID-19 or experiencing more severe illness from COVID-19 if infected. We used data from Medicaid to look at whether autistic adults and other adults with intellectual disability and other mental health conditions were more likely to have risk factors for COVID-19, such as living in a residential facility, receiving services regularly in the home from outside caregivers, having had a long hospitalization, having had avoidable hospitalizations, and having high-risk health conditions. We found that autistic adults had higher odds of living in a residential facility, receiving in-home services from outside caregivers, having had an avoidable hospitalization, and having a high-risk health condition, compared to neurotypical adults without mental health conditions. Adults with intellectual disability had similar odds of having these conditions. Adults with other mental health conditions were also more likely to live in a residential facility, receive services from outside caregivers, and have had avoidable hospitalizations compared to the neurotypical population without mental health conditions. They had three times higher odds of having a high-risk health condition. High risk of COVID-19 among autistic adults and adults with intellectual disability and mental health conditions should be recognized by clinicians, and these groups should be prioritized for vaccine outreach. En ligne : https://dx.doi.org/10.1177/13623613211039662 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=473

"Everyone should at least get a Kia": Policymaker perspectives on equity of Medicaid among transition age autistic youth / Kaitlin H. KOFFER MILLER in Research in Autism Spectrum Disorders, 118 (October 2024)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 118 (October 2024) . - 102482 Titre : "Everyone should at least get a Kia": Policymaker perspectives on equity of Medicaid among transition age autistic youth Type de document : Texte imprimé et/ou numérique Auteurs : Kaitlin H. KOFFER MILLER, Auteur ; Dylan S. COOPER, Auteur ; Sha TAO, Auteur ; David S. MANDELL, Auteur ; Robert I. FIELD, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : 102482 Langues : Anglais (eng) Mots-clés : Mixed-methods  Disability  Health care financing  Health policy  Medicaid  Autism  Transition Index. décimale : PER Périodiques Résumé : Background This study examined the challenges faced by transition age autistic youth in accessing Medicaid services, considering the historical focus on children in autism research and services. The study aimed to explore Medicaid enrollment and support for this population. Method The study involved Medicaid and Protection & Advocacy (P&A) representatives from states with varying performance levels in eligibility, access, and service use. Discussions with experts focused on waivers, Early, Periodic, Screening, Detection, and Treatment (EPSDT), and barriers to service access. Results The findings highlighted the need to improve service access for transition age autistic youth. States identified the importance of maximizing EPDST utilization before aging out of childhood systems and pursuing waiver enrollment. These insights emphasized the significance of addressing service gaps during the transition to adulthood. Conclusions The study's implications for practice are substantial. Policymakers and service providers must acknowledge the limitedservice access for autistic individuals as they transition from child systems. The study emphasized the value of strategies like maximizing EPDST utilization and pursuing waivers to ensure ongoing support for autistic youth during their transition to adulthood. By addressing these challenges, practitioners can better meet the needs of transition age autistic individuals and facilitate their access to essential services. En ligne : https://doi.org/10.1016/j.rasd.2024.102482 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=540 [article] "Everyone should at least get a Kia": Policymaker perspectives on equity of Medicaid among transition age autistic youth [Texte imprimé et/ou numérique] / Kaitlin H. KOFFER MILLER, Auteur ; Dylan S. COOPER, Auteur ; Sha TAO, Auteur ; David S. MANDELL, Auteur ; Robert I. FIELD, Auteur ; Lindsay L. SHEA, Auteur . - 102482. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 118 (October 2024) . - 102482 Mots-clés : Mixed-methods  Disability  Health care financing  Health policy  Medicaid  Autism  Transition Index. décimale : PER Périodiques Résumé : Background This study examined the challenges faced by transition age autistic youth in accessing Medicaid services, considering the historical focus on children in autism research and services. The study aimed to explore Medicaid enrollment and support for this population. Method The study involved Medicaid and Protection & Advocacy (P&A) representatives from states with varying performance levels in eligibility, access, and service use. Discussions with experts focused on waivers, Early, Periodic, Screening, Detection, and Treatment (EPSDT), and barriers to service access. Results The findings highlighted the need to improve service access for transition age autistic youth. States identified the importance of maximizing EPDST utilization before aging out of childhood systems and pursuing waiver enrollment. These insights emphasized the significance of addressing service gaps during the transition to adulthood. Conclusions The study's implications for practice are substantial. Policymakers and service providers must acknowledge the limitedservice access for autistic individuals as they transition from child systems. The study emphasized the value of strategies like maximizing EPDST utilization and pursuing waivers to ensure ongoing support for autistic youth during their transition to adulthood. By addressing these challenges, practitioners can better meet the needs of transition age autistic individuals and facilitate their access to essential services. En ligne : https://doi.org/10.1016/j.rasd.2024.102482 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=540

Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States / Whitney SCHOTT in Autism, 27-7 (October 2023)  

Public ISBD [article]  inAutism > 27-7 (October 2023) . - p.2145-2157 Titre : Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States Type de document : Texte imprimé et/ou numérique Auteurs : Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay SHEA, Auteur Article en page(s) : p.2145-2157 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  COVID-19  medical comorbidity Index. décimale : PER Périodiques Résumé : Children are at risk of short- and long-term morbidity and mortality from COVID-19. We examine whether autistic children and children with mental health conditions have higher odds of underlying health conditions at high risk of severe disease from COVID-19. We use claims data from a national sample of Medicaid-enrolled children for the years 2008-2016. We examine (1) children with claims for autism and (2) a random sample of children covered by Medicaid, without autism claims but with mental health condition. The comparison group is a random sample of children without autism or any mental health condition. There were 888,487 autistic children, 423,397 with mental health conditions (but not autism or intellectual disability), and 932,625 children without autism or mental health condition. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had higher odds of having any underlying condition (odds ratio=2.17; 99% confidence interval=2.14-2.20), as did children with mental health conditions (odds ratio=1.71; 99% confidence interval=1.68-1.73), adjusting for basic demographic characteristics. Children with diagnoses of autism and mental health conditions may be at higher risk for severe COVID due to high-risk condition prevalence.Lay abstractChildren are at risk of varying severity of illness and even death from COVID-19. We aim to determine whether autistic children or children with mental health conditions have more underlying health conditions that put people at risk of severe illness from COVID-19. We use data from a national sample of Medicaid-enrolled children for the years 2008-2016. These data include children across the 50 states and the District of Columbia. We compare the prevalence of underlying conditions among autistic children and children with mental health condition to that of other children in Medicaid. This study included 888,487 autistic children, 423,397 with any mental health condition (but not autism), and 932,625 children without any of these diagnoses. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had over twice the odds of having any underlying conditions, when accounting for age, race, sex, and other characteristics. Children with mental health conditions had 70% higher odds of having these underlying conditions. Mitigation measures in schools and other areas could minimize risk of short- and long-term impacts from COVID for autistic and all children. En ligne : http://dx.doi.org/10.1177/13623613231155265 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510 [article] Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States [Texte imprimé et/ou numérique] / Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay SHEA, Auteur . - p.2145-2157. Langues : Anglais (eng) in Autism > 27-7 (October 2023) . - p.2145-2157 Mots-clés : autism spectrum disorders  COVID-19  medical comorbidity Index. décimale : PER Périodiques Résumé : Children are at risk of short- and long-term morbidity and mortality from COVID-19. We examine whether autistic children and children with mental health conditions have higher odds of underlying health conditions at high risk of severe disease from COVID-19. We use claims data from a national sample of Medicaid-enrolled children for the years 2008-2016. We examine (1) children with claims for autism and (2) a random sample of children covered by Medicaid, without autism claims but with mental health condition. The comparison group is a random sample of children without autism or any mental health condition. There were 888,487 autistic children, 423,397 with mental health conditions (but not autism or intellectual disability), and 932,625 children without autism or mental health condition. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had higher odds of having any underlying condition (odds ratio=2.17; 99% confidence interval=2.14-2.20), as did children with mental health conditions (odds ratio=1.71; 99% confidence interval=1.68-1.73), adjusting for basic demographic characteristics. Children with diagnoses of autism and mental health conditions may be at higher risk for severe COVID due to high-risk condition prevalence.Lay abstractChildren are at risk of varying severity of illness and even death from COVID-19. We aim to determine whether autistic children or children with mental health conditions have more underlying health conditions that put people at risk of severe illness from COVID-19. We use data from a national sample of Medicaid-enrolled children for the years 2008-2016. These data include children across the 50 states and the District of Columbia. We compare the prevalence of underlying conditions among autistic children and children with mental health condition to that of other children in Medicaid. This study included 888,487 autistic children, 423,397 with any mental health condition (but not autism), and 932,625 children without any of these diagnoses. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had over twice the odds of having any underlying conditions, when accounting for age, race, sex, and other characteristics. Children with mental health conditions had 70% higher odds of having these underlying conditions. Mitigation measures in schools and other areas could minimize risk of short- and long-term impacts from COVID for autistic and all children. En ligne : http://dx.doi.org/10.1177/13623613231155265 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510

Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid / Jessica E. RAST ; Sha TAO ; Whitney SCHOTT ; Lindsay L. SHEA ; Edward S. BRODKIN ; Connor M. KERNS ; Charles E. Leonard ; Michael J. MURRAY ; Brian K. LEE in Journal of Autism and Developmental Disorders, 55-1 (January 2025)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.258-266 Titre : Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid : Journal of Autism and Developmental Disorders Type de document : Texte imprimé et/ou numérique Auteurs : Jessica E. RAST, Auteur ; Sha TAO, Auteur ; Whitney SCHOTT, Auteur ; Lindsay L. SHEA, Auteur ; Edward S. BRODKIN, Auteur ; Connor M. KERNS, Auteur ; Charles E. Leonard, Auteur ; Michael J. MURRAY, Auteur ; Brian K. LEE, Auteur Article en page(s) : p.258-266 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Children with autism frequently present with complex mental health diagnoses and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The purpose of this study is to provide rates and patterns of psychotropic medication use, and predictors thereof, in children and youth with autism enrolled in Medicaid across the US. This study examined national Medicaid claims from 2008 to 2016 of all children and youth with autism ages 0-21 years enrolled in Medicaid. Psychotropic medication use was examined across several child and youth characteristics, including age, co-occurring mental health conditions, sex, and race and ethnicity. About half of children and youth with autism enrolled in Medicaid had at least one psychotropic prescription in a year, a number that decreased slightly across the study period due to decreases in the prescription of antipsychotics. As new medications for autism or co-occurring conditions are developed and deployed, and as the understanding of the characteristics of the population of children with autism evolves, studying rates of medication usage helps to understand utilization patterns and differences in access to quality care. En ligne : https://doi.org/10.1007/s10803-023-06182-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546 [article] Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid : Journal of Autism and Developmental Disorders [Texte imprimé et/ou numérique] / Jessica E. RAST, Auteur ; Sha TAO, Auteur ; Whitney SCHOTT, Auteur ; Lindsay L. SHEA, Auteur ; Edward S. BRODKIN, Auteur ; Connor M. KERNS, Auteur ; Charles E. Leonard, Auteur ; Michael J. MURRAY, Auteur ; Brian K. LEE, Auteur . - p.258-266. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.258-266 Index. décimale : PER Périodiques Résumé : Children with autism frequently present with complex mental health diagnoses and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The purpose of this study is to provide rates and patterns of psychotropic medication use, and predictors thereof, in children and youth with autism enrolled in Medicaid across the US. This study examined national Medicaid claims from 2008 to 2016 of all children and youth with autism ages 0-21 years enrolled in Medicaid. Psychotropic medication use was examined across several child and youth characteristics, including age, co-occurring mental health conditions, sex, and race and ethnicity. About half of children and youth with autism enrolled in Medicaid had at least one psychotropic prescription in a year, a number that decreased slightly across the study period due to decreases in the prescription of antipsychotics. As new medications for autism or co-occurring conditions are developed and deployed, and as the understanding of the characteristics of the population of children with autism evolves, studying rates of medication usage helps to understand utilization patterns and differences in access to quality care. En ligne : https://doi.org/10.1007/s10803-023-06182-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546

Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence / Meghan E. Carey in Autism, 28-3 (March 2024)  

Public ISBD [article]  inAutism > 28-3 (March 2024) . - p.780-785 Titre : Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence Type de document : Texte imprimé et/ou numérique Auteurs : Meghan E. Carey, Auteur ; Katherine ARDELEANU, Auteur ; Steven C. MARCUS, Auteur ; Sha TAO, Auteur ; David MANDELL, Auteur ; Andrew J. EPSTEIN, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : p.780-785 Langues : Anglais (eng) Mots-clés : adolescents  autism spectrum disorders  health services  policy Index. décimale : PER Périodiques Résumé : Medicaid is a major insurer of autistic people. However, during the transition to adulthood, autistic individuals are more likely than people with intellectual disability to lose their Medicaid benefits. Individuals with intellectual disability may have greater success maintaining Medicaid coverage during this time because most states provide coverage to individuals with intellectual disability throughout adulthood, which is not the case for autism. Using national Medicaid data from 2008 to 2016, we estimated the probability of intellectual disability diagnosis accrual among autistic Medicaid beneficiaries. Medicaid beneficiaries ages 8 to 25 with 1+?inpatient or 2+?outpatient autism spectrum disorder claims, but no intellectual disability claim, in a 12-month eligibility period were included. We used a person-month discrete-time proportional hazards model. Disruptions in Medicaid coverage were operationalized as 2+?consecutive months of no coverage before coverage resumed (yes/no). One in five autistic individuals ages 8-25 accrued an intellectual disability diagnosis. The probability of accruing an intellectual disability diagnosis was higher among autistic individuals who had disruptions in Medicaid coverage compared to those without disruptions, and peaked at age 21 (during the transition to adulthood). Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual and improve health outcomes for autistic adults. Lay abstract What is known? In most states, Medicaid waivers provide individuals with an intellectual disability diagnosis generous healthcare coverage throughout adulthood. By comparison, fewer Medicaid programs are available for autistic individuals, and they are more likely to experience disruptions, or gaps, in Medicaid coverage and subsequently not re-enroll. What this paper adds? One in five autistic individuals with Medicaid coverage between ages 8 and 25 accrued a new intellectual disability diagnosis. The probability of a new intellectual disability diagnosis was higher among those who had previous disruptions in Medicaid coverage. Implications for research and policy. Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual. Input from autistic individuals and their families regarding their health insurance access and healthcare experiences is critically important to understanding next steps for research. En ligne : https://dx.doi.org/10.1177/13623613231177559 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523 [article] Short report on navigating access to care for Medicaid-enrolled autistic youth and young adults: Examining accrual of intellectual disability diagnoses in adolescence [Texte imprimé et/ou numérique] / Meghan E. Carey, Auteur ; Katherine ARDELEANU, Auteur ; Steven C. MARCUS, Auteur ; Sha TAO, Auteur ; David MANDELL, Auteur ; Andrew J. EPSTEIN, Auteur ; Lindsay L. SHEA, Auteur . - p.780-785. Langues : Anglais (eng) in Autism > 28-3 (March 2024) . - p.780-785 Mots-clés : adolescents  autism spectrum disorders  health services  policy Index. décimale : PER Périodiques Résumé : Medicaid is a major insurer of autistic people. However, during the transition to adulthood, autistic individuals are more likely than people with intellectual disability to lose their Medicaid benefits. Individuals with intellectual disability may have greater success maintaining Medicaid coverage during this time because most states provide coverage to individuals with intellectual disability throughout adulthood, which is not the case for autism. Using national Medicaid data from 2008 to 2016, we estimated the probability of intellectual disability diagnosis accrual among autistic Medicaid beneficiaries. Medicaid beneficiaries ages 8 to 25 with 1+?inpatient or 2+?outpatient autism spectrum disorder claims, but no intellectual disability claim, in a 12-month eligibility period were included. We used a person-month discrete-time proportional hazards model. Disruptions in Medicaid coverage were operationalized as 2+?consecutive months of no coverage before coverage resumed (yes/no). One in five autistic individuals ages 8-25 accrued an intellectual disability diagnosis. The probability of accruing an intellectual disability diagnosis was higher among autistic individuals who had disruptions in Medicaid coverage compared to those without disruptions, and peaked at age 21 (during the transition to adulthood). Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual and improve health outcomes for autistic adults. Lay abstract What is known? In most states, Medicaid waivers provide individuals with an intellectual disability diagnosis generous healthcare coverage throughout adulthood. By comparison, fewer Medicaid programs are available for autistic individuals, and they are more likely to experience disruptions, or gaps, in Medicaid coverage and subsequently not re-enroll. What this paper adds? One in five autistic individuals with Medicaid coverage between ages 8 and 25 accrued a new intellectual disability diagnosis. The probability of a new intellectual disability diagnosis was higher among those who had previous disruptions in Medicaid coverage. Implications for research and policy. Expanding Medicaid to cover autistic people of all ages could decrease the need for intellectual disability diagnosis accrual. Input from autistic individuals and their families regarding their health insurance access and healthcare experiences is critically important to understanding next steps for research. En ligne : https://dx.doi.org/10.1177/13623613231177559 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=523

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