By Kaitlin H. Koffer Miller
The COVID-19 pandemic reshaped the landscape of healthcare delivery, making telehealth an important tool to improve continuity of care, or consistency of healthcare services. While telehealth is not new, it became more available during the COVID-19 pandemic, as a measure of necessity to ensure health and safety.
As we come up on four years since the pandemic started, it will be critical to continue supporting telehealth and virtual care options, particularly for mental health services. These options are critical for meeting the needs of autistic individuals and other neurodivergent populations and other populations who have benefited from the emergence of telehealth services.
Changes and permissions for telehealth services were granted during the public health emergency (PHE) that began in March 2020. As the PHE officially ended in May 2023, it will be up to states to continue to support telehealth services as a viable and necessary service to retain for the long term.
Telehealth services provide enhanced accessibility, comfort, and convenience for autistic individuals who may face challenges with traditional in-person visits to healthcare providers including mental health providers. The sensory overload and unfamiliar, possibly hostile, environments of clinical settings can lead to anxiety and discomfort, making it difficult for them to access the care they need. By embracing telehealth, autistic individuals can receive mental health services from the comfort and familiarity of their own homes. Comfortable spaces that are often created or defined by themselves, or a care-partner who best understands their needs. This not only reduces the barriers imposed by transportation challenges but also mitigates the potential for sensory overload, allowing them to engage in therapy or consultations in a more relaxed and conducive environment.
Maintaining and expanding coverage for telehealth services can also have a positive impact on the affordability of health care services, especially mental health services, for autistic individuals. Financial limitations often restrict access to necessary services, preventing many individuals from seeking the support they require. Telehealth bridges this gap by eliminating the need for costly transportation expenses and reducing the overall cost of care. By expanding coverage to include telehealth, individuals with limited financial resources or those residing in underserved areas can benefit from equal access to vital mental health services. This inclusivity ensures that no one is left behind and that all individuals, regardless of their geographic location or economic status, can receive the care they deserve.
Some states, like Pennsylvania, are forging remote supports as a specific service within 1915 (c) home- and community-based waivers for people with intellectual disabilities (ID) or who are on the autism spectrum, so people can continue to receive services via telehealth. This is an example of a state that saw success while temporarily using telehealth through the flexibility through the flexibility of modifying a Medicaid waiver through Appendix K (to make temporary changes during an emergency period) to a more permanent policy mechanism is needed to ensure the option remains stable for individuals who preferred this option. Other states are also to allow telehealth or certain aspects to remain intact. Twenty-one states have implemented permanent parity legislation that requires reimbursement to be the same for both telehealth visits and in-person visits, which is an incentive for providers to retain telehealth options.
It is essential for health care policies to continue supporting and prioritizing telehealth and virtual care options to ensure sustained accessibility, convenience, affordability, and continuity of care for this vulnerable community. By doing so, we can promote the well-being and mental health of autistic individuals, empowering them to lead fulfilling lives and reach their full potential.