As with every other state, Washington is experiencing a crisis when it comes to delivering appropriate, timely diagnoses and care for children with developmental concerns. Increased awareness and lack of qualified providers are the two main drivers of this crisis, with wait times to see a provider often taking up to two years.
Washington’s Answer – Center of Excellence (COE) Certification
To deal with these extremely long wait times Washington’s Center of Excellence (COE) program was established – a partnership with the state’s Health Care Authority (HCA) and the University of Washington. Interestingly, COE certification is only for individuals, and is not a credential for a medical group, facility or organization.
The purpose of the COE program is to expand provider coverage. This is done by allowing previously unqualified individuals to expand their scope of practice to diagnose, and in some cases provide treatment for, children with autism and other developmental concerns.
Eligible providers that can become certified as a COE include Developmental Behavioral Pediatricians, Psychiatrists, Neurologists, Psychologists, Medical Doctors (MD and DO) in specialties other than Developmental Behavioral Pediatrics, Nurse Practitioners, Physician Assistants, and Naturopathic Doctors. It is not required that any provider have formal education in Developmental Behavioral Pediatrics, or any previous experience in the diagnosis and treatment of autism or other development issues.
The process to become a certified COE involves four basic steps – take a prerequisite online course, which requires a few hours to complete, attend a one-day live Zoom class, attest to doing these steps, and being eligible to accept Medicaid. That’s it. Once these steps are completed, an eligible individual is designated a Center of Excellence for autism diagnosis.
Is The COE Program Really The Best Solution For Children And Their Families?
While it is critical to address the challenges that families are facing, Washington’s COE program does create some serious concerns.
Unlike many other medical conditions that can be diagnosed with laboratory testing, imaging studies, and a basic physical exam, autism is much more complex. Symptoms can be nuanced, with each child presenting differently.
Historically, it has been proven that Developmental Behavioral Pediatricians are the most qualified to diagnose autism and other types of neurodivergence. Their education takes years, not hours, and is highly focused. They have extensive clinical experience, specializing in the diagnosis and treatment of developmental and behavioral conditions. Experienced and specialized Psychiatrists, Neurologists, and Psychologists can also be highly qualified to care for these children.
Unfortunately, Nurse Practitioners, Physicians Assistants, and Naturopathic doctors do not have the education, clinical experience, and skill necessary to make an accurate autism diagnosis, or to provide the best individualized therapy plan. A three-hour online course and a one-day Zoom event will not change this.
And accuracy really is the key point here. There is a real risk of misdiagnosis when less qualified providers are involved – some kids with autism will not correctly be diagnosed, and some kids that do not have autism will be diagnosed with a condition they do not have. Also, a child could have other medical conditions in addition to autism or cause symptoms that mimic autism. These complex cases require the skill and expertise of a highly-trained specialist, not a provider with limited clinical experience and only a few hours of education.
To put things another way, as much as one may like their primary care physician, would they really feel comfortable having that doctor take a short online course and a one-day training session, and then diagnose a complex cardiac condition that requires corrective surgery? Probably not. This is not hyperbole. The is the same level of mismatch in care that parents are being asked to accept for their children.
It is also important to point out that many medical insurance carriers do not accept a diagnosis of autism or other developmental condition from a COE. This is most likely due to the fact that they too have concerns about the COE program, and question if these minimally trained providers can make an accurate diagnosis. This means that many children receiving a diagnosis of autism from a COE must still see a Developmental Behavioral Pediatrician to receive a formal diagnosis, creating additional stress and inconvenience for families.
A Better Way – Using Technology To Connect With The Most Experienced And Highly Trained Providers
Coralis Health was specifically created to solve two major problems – extraordinarily long wait times and a shortage of highly trained and experienced professionals.
Combining cutting-edge technology and world-class specialized care, we provide the accurate diagnoses, education and therapies these children and their families need and deserve. Services are coordinated by both compassionate human interaction and advanced technology, to provide personalized healthcare plans and assist families every step of the way. Both in-person and telehealth visits are available.
We are committed to bringing the highest level of care to children and their families, regardless of where they live – from the most rural parts of the country to the most dense inner cities. Our drive to transform how Developmental Behavioral Pediatric care is delivered is unrelenting. We look to a future where every child thrives and reaches their full potential!
To find out more, or if you have any questions or concerns, please reach out to us. We are always here to help!
