Wow...
I really can't believe that's its been just over a year since I've written in this blog!
So much has happened:
The legislation we were working on was defeated in the State Assembly.
My daughter began and then we pulled her out of an inadequate and inappropriate placement in the Cedarburg School District, and we began battling with the district regarding their infringement of her civil rights.
My daughter completed her first year of her in-home ABA program.
I started my re-education.
So much to talk about...I'll have to catch everyone up on each of these things within the next few days...
Love & Kisses!
RJGwood
Wednesday, June 18, 2008
Thursday, June 14, 2007
MEDICAID AUTISM WAIVERS AND STATE AGENCIES SERVING PEOPLE WITH AUTISM
April 10, 2007
2007-R-0319
By: Saul Spigel, Chief Analyst
You asked (1) for a list of states with Medicaid waivers that cover services specifically for people with autism and (2) what agencies other states use to oversee service delivery to this population.
SUMMARY
Four states—Colorado, Indiana, Maryland, and Wisconsin—are operating Medicaid waivers covering home- and community-based services specifically for people with autism. All are limited to children. Massachusetts applied for a waiver in late 2006 and is waiting for approval.
Forty-four (44) states and the District of Columbia have received waivers to provide home- and community-based services to people with developmental disabilities (DD). Depending on each state's DD definition, these waivers may cover services to people with autism. This report focuses on the four states with autism-specific waivers. A future report will look at the states with DD waivers.
We found three states—Massachusetts, Pennsylvania, and South Carolina—that have a state government unit dedicated solely to overseeing or providing services to people with autism. Most other states include autism in their definition of DD and give the agency or unit that has programmatic responsibility for this population responsibility for services to those with autism, as well. Connecticut, though, is one of five states whose DD definition appears to exclude autism unless the individual's intellectual functioning means that he or she also has mental retardation (Alabama, Massachusetts, Mississippi, and Virginia are the others, but Massachusetts' recent reorganization of its Mental Retardation Department may indicate this has changed).
A subsequent OLR report will examine how states define DD and to which agency they give principal responsibility for delivering or overseeing services to people, particularly adults, with autism.
MEDICAID WAIVERS
Medicaid Waivers Generally
States have received Medicaid home- and community-based waivers for (1) people with developmental disabilities, generally, which can include people with autism, and (2) specifically for people with autism. Forty-four (44) states and the District of Columbia have received developmental disability waivers while four have received autism-specific waivers: Colorado, Indiana, Maryland, and Wisconsin. Some states operate both types of waivers but permit people to receive services only under one waiver at a time.
The waivers allow individuals who would otherwise need long-term institutional care to receive service in their communities. Each state determines the services it covers under the waiver. According to a recent Government Accountability Office (GAO) report on federal autism activities, states' autism waiver programs generally offer the same services as their developmental disability waivers; the primary difference is that the autism waiver may offer early intervention behavioral therapies targeted to young children (http: //www. gao. gov/new. items/d06700. pdf).
Although people with autism can potentially receive services under these waivers, many do not because they do not meet eligibility rules or because the states limit enrollment. A person is eligible for waiver services only if, without the waiver's availability, he or she would need long-term institutional care. Consequently, people at the higher functioning end of the autism spectrum, such as those with Asperger's syndrome, are typically not eligible for waiver services.
States can cap waiver enrollment, and some that do have long waiting lists. Because some autism interventions have been found to be effective only when started at an early age, children who remain on the waiting list for several years may no longer be eligible for services when an a slot opens. One (unnamed) state told GAO that its waiting list is five years long, and its autism waiver covers only one specific kind of intensive intervention, which must begin before age six. Since children are not usually diagnosed with autism until age three, this combination means that no child with autism has ever received waiver services in that state.
Autism-Specific Medicaid Waivers
Colorado, Indiana, Maryland, and Wisconsin have waivers specifically addressing autism. They all limit waiver services to children. The first three states' waivers are only for children with autism. Wisconsin provides intensive in-home autism treatment under two broader waivers, one for children with DD and the other for children with social and emotional disorders. In Indiana and Wisconsin, children eligible for autism-specific services are also eligible for services under other Medicaid waivers. Table 1 displays information about when the waiver began, the agency that administers the waiver, the ages the waiver covers, eligibility criteria, covered services, enrollment or cost caps, and other information.
Table 1: Autism-Specific Medicaid Waivers
Colorado
Indiana
Maryland
Wisconsin
Date of Waiver
2006
2002
2001
2004 (but state previously covered some autism-related services under Medicaid fee-for-service)
Administering Agency
Health Care Policy & Financing Agency
Bureau of Developmental Disabilities
Department of Education
Bureau of Long-Term Services in Health & Family Services Dept.
Age Range
0-6
0-22
0-21
0-22, must begin receiving services or be on waiting list by age 8
Eligibility
Autism, but not Asperger's or PDD/NOS*
Autism, but not Asperger's or PDD/NOS*
Autism, including Asperger's and PDD/NOS*; must receive early intervention services or at least 12 hours/week of special education services
Autism, including Asperger's and PDD/NOS*
Financial Eligibility
Medicaid-eligible; parents' income included
Medicaid-eligible; parents' income excluded for children under 18
Medicaid-eligible; parents' income excluded
• Medicaid-eligible; parents' income excluded
• Parents with incomes over 330% of federal poverty level pay sliding scale fee
Services Provided
Behavior, occupational, & speech therapy; psychological services
• Autism-specific services: Applied behavior analysis, community transition support, person-centered & individualized support planning
• Also eligible for broader range of services under DD waiver
Intensive, in-home individual support; respite care; family training; residential habilitation; supported employment; therapeutic integration (after-school); targeted case management
• Autism specific: Intensive, in-home autism treatment (20-35 hours/wk) for 3 years
• Also eligible for broader range of services under DD & mental health waivers
Enrollment & Cost Caps
75; $ 25,000 a year
400
None, but enrollment currently closed
None, but enrollment currently closed; Waiting list =250 (typical wait is 12-14 months )
Number Served (year)
75 (2007)
334 (2007)
900 (2005)
250 (2007)
*Pervasive developmental disability/not otherwise specified
Massachusetts applied for an autism-specific waiver in late 2006 and is waiting to hear about approval. If approved, the waiver will cover about 80 children up to age eight who will receive intensive, in-home behavioral supports. Maine has a waiver for adults with mental retardation or autism, but the services it provides—personal support; day habilitation, including behavior management and skills development; supported employment; communication assessment, and crisis intervention— are not specific to people with autism.
STATE OVERSIGHT OF AUTISM SERVICES
We found only three states—Massachusetts, Pennsylvania, and South Carolina—that have a distinct unit that is responsible solely for overseeing or providing services to people with autism. Massachusetts has an Autism Division in its Mental Retardation Department (which is part of the Executive Office of Health and Human Services). Pennsylvania's new (February 2007) Bureau of Autism Services is part of the Department of Public Welfare. And South Carolina's Autism Division is in its Department of Disabilities and Special Needs.
Most other states include autism in their definition of DD and give the agency or unit responsible for services to this population responsibility for people with autism. Connecticut is one of five states whose DD definition appears to exclude autism unless an individual's intellectual functioning means that he or she also has mental retardation (Alabama, Massachusetts, Mississippi, and Virginia are the others). Pennsylvania had been in this category, but its recent reorganization of its Department of Public Welfare to separate mental retardation and autism services suggests this in no longer the case. Massachusetts also recently took this organizational path, which may indicate it, too, has begun to include autism under its DD umbrella.
SS: ro
2007-R-0319
By: Saul Spigel, Chief Analyst
You asked (1) for a list of states with Medicaid waivers that cover services specifically for people with autism and (2) what agencies other states use to oversee service delivery to this population.
SUMMARY
Four states—Colorado, Indiana, Maryland, and Wisconsin—are operating Medicaid waivers covering home- and community-based services specifically for people with autism. All are limited to children. Massachusetts applied for a waiver in late 2006 and is waiting for approval.
Forty-four (44) states and the District of Columbia have received waivers to provide home- and community-based services to people with developmental disabilities (DD). Depending on each state's DD definition, these waivers may cover services to people with autism. This report focuses on the four states with autism-specific waivers. A future report will look at the states with DD waivers.
We found three states—Massachusetts, Pennsylvania, and South Carolina—that have a state government unit dedicated solely to overseeing or providing services to people with autism. Most other states include autism in their definition of DD and give the agency or unit that has programmatic responsibility for this population responsibility for services to those with autism, as well. Connecticut, though, is one of five states whose DD definition appears to exclude autism unless the individual's intellectual functioning means that he or she also has mental retardation (Alabama, Massachusetts, Mississippi, and Virginia are the others, but Massachusetts' recent reorganization of its Mental Retardation Department may indicate this has changed).
A subsequent OLR report will examine how states define DD and to which agency they give principal responsibility for delivering or overseeing services to people, particularly adults, with autism.
MEDICAID WAIVERS
Medicaid Waivers Generally
States have received Medicaid home- and community-based waivers for (1) people with developmental disabilities, generally, which can include people with autism, and (2) specifically for people with autism. Forty-four (44) states and the District of Columbia have received developmental disability waivers while four have received autism-specific waivers: Colorado, Indiana, Maryland, and Wisconsin. Some states operate both types of waivers but permit people to receive services only under one waiver at a time.
The waivers allow individuals who would otherwise need long-term institutional care to receive service in their communities. Each state determines the services it covers under the waiver. According to a recent Government Accountability Office (GAO) report on federal autism activities, states' autism waiver programs generally offer the same services as their developmental disability waivers; the primary difference is that the autism waiver may offer early intervention behavioral therapies targeted to young children (http: //www. gao. gov/new. items/d06700. pdf).
Although people with autism can potentially receive services under these waivers, many do not because they do not meet eligibility rules or because the states limit enrollment. A person is eligible for waiver services only if, without the waiver's availability, he or she would need long-term institutional care. Consequently, people at the higher functioning end of the autism spectrum, such as those with Asperger's syndrome, are typically not eligible for waiver services.
States can cap waiver enrollment, and some that do have long waiting lists. Because some autism interventions have been found to be effective only when started at an early age, children who remain on the waiting list for several years may no longer be eligible for services when an a slot opens. One (unnamed) state told GAO that its waiting list is five years long, and its autism waiver covers only one specific kind of intensive intervention, which must begin before age six. Since children are not usually diagnosed with autism until age three, this combination means that no child with autism has ever received waiver services in that state.
Autism-Specific Medicaid Waivers
Colorado, Indiana, Maryland, and Wisconsin have waivers specifically addressing autism. They all limit waiver services to children. The first three states' waivers are only for children with autism. Wisconsin provides intensive in-home autism treatment under two broader waivers, one for children with DD and the other for children with social and emotional disorders. In Indiana and Wisconsin, children eligible for autism-specific services are also eligible for services under other Medicaid waivers. Table 1 displays information about when the waiver began, the agency that administers the waiver, the ages the waiver covers, eligibility criteria, covered services, enrollment or cost caps, and other information.
Table 1: Autism-Specific Medicaid Waivers
Colorado
Indiana
Maryland
Wisconsin
Date of Waiver
2006
2002
2001
2004 (but state previously covered some autism-related services under Medicaid fee-for-service)
Administering Agency
Health Care Policy & Financing Agency
Bureau of Developmental Disabilities
Department of Education
Bureau of Long-Term Services in Health & Family Services Dept.
Age Range
0-6
0-22
0-21
0-22, must begin receiving services or be on waiting list by age 8
Eligibility
Autism, but not Asperger's or PDD/NOS*
Autism, but not Asperger's or PDD/NOS*
Autism, including Asperger's and PDD/NOS*; must receive early intervention services or at least 12 hours/week of special education services
Autism, including Asperger's and PDD/NOS*
Financial Eligibility
Medicaid-eligible; parents' income included
Medicaid-eligible; parents' income excluded for children under 18
Medicaid-eligible; parents' income excluded
• Medicaid-eligible; parents' income excluded
• Parents with incomes over 330% of federal poverty level pay sliding scale fee
Services Provided
Behavior, occupational, & speech therapy; psychological services
• Autism-specific services: Applied behavior analysis, community transition support, person-centered & individualized support planning
• Also eligible for broader range of services under DD waiver
Intensive, in-home individual support; respite care; family training; residential habilitation; supported employment; therapeutic integration (after-school); targeted case management
• Autism specific: Intensive, in-home autism treatment (20-35 hours/wk) for 3 years
• Also eligible for broader range of services under DD & mental health waivers
Enrollment & Cost Caps
75; $ 25,000 a year
400
None, but enrollment currently closed
None, but enrollment currently closed; Waiting list =250 (typical wait is 12-14 months )
Number Served (year)
75 (2007)
334 (2007)
900 (2005)
250 (2007)
*Pervasive developmental disability/not otherwise specified
Massachusetts applied for an autism-specific waiver in late 2006 and is waiting to hear about approval. If approved, the waiver will cover about 80 children up to age eight who will receive intensive, in-home behavioral supports. Maine has a waiver for adults with mental retardation or autism, but the services it provides—personal support; day habilitation, including behavior management and skills development; supported employment; communication assessment, and crisis intervention— are not specific to people with autism.
STATE OVERSIGHT OF AUTISM SERVICES
We found only three states—Massachusetts, Pennsylvania, and South Carolina—that have a distinct unit that is responsible solely for overseeing or providing services to people with autism. Massachusetts has an Autism Division in its Mental Retardation Department (which is part of the Executive Office of Health and Human Services). Pennsylvania's new (February 2007) Bureau of Autism Services is part of the Department of Public Welfare. And South Carolina's Autism Division is in its Department of Disabilities and Special Needs.
Most other states include autism in their definition of DD and give the agency or unit responsible for services to this population responsibility for people with autism. Connecticut is one of five states whose DD definition appears to exclude autism unless an individual's intellectual functioning means that he or she also has mental retardation (Alabama, Massachusetts, Mississippi, and Virginia are the others). Pennsylvania had been in this category, but its recent reorganization of its Department of Public Welfare to separate mental retardation and autism services suggests this in no longer the case. Massachusetts also recently took this organizational path, which may indicate it, too, has begun to include autism under its DD umbrella.
SS: ro
Wednesday, June 13, 2007
Call NY Gov: School Districts - Not Parents Should Bear the Burden!
PLEASE ACT IMMEDIATELY TO LET GOVERNOR SPITZER KNOW FIRST-HAND WE
NEED HIS SUPPORT!
PLEASE CALL OR FAX GOVERNOR SPITZER BEFORE 5pm TUESDAY OR WEDNESDAT
AT 518-474-8390 / 518-474-1041 or FAX (anytime)474-1513, and say/write:
"Governor Spitzer. I am a family member (friend) of a special
needs students. Assemblywoman Cathy Nolan and Senator Andrew Lanza
have introduced legislation, Assembly bill 5396 and Senate bill 5972,
that requires school districts, not parents, bear the burden of proof in
special education hearings. Please support this bill now and please
sign off on this bill when it passes Assembly and Senate. We are
asking you to help our most vulnerable families protect their child's right
to an appropriate public education."
ADDITIONAL BACKGROUND FYI:
This legislation would remedy the U.S. Supreme Court decision from a
year ago in Schaffer v. Weast, which turned the clock back decades
for children with disabilities. In the absence of a state law to the
contrary, this court decision forces parents to bear the burden of
proof in special education hearings over their child's Individual
Education Plan (IEP). Parents, therefore, are charged with
presenting their case, making legal arguments, examining and cross examining
witnesses, including hostile witnesses, and adhering to the
procedural requirements of a hearing. For those parents unable to afford legal
representation, this burden is unjust and often impossible. The
Legislature must restore the pre-Schaffer status quo that existed in
New York since 1975 which was the inception of special education.
Until this bill passes and is signed into law, most parents, especially
those of limited means, DO NOT STAND A CHANCE if they must defend their
child's right to a Free and Appropriate Public Education.
NEED HIS SUPPORT!
PLEASE CALL OR FAX GOVERNOR SPITZER BEFORE 5pm TUESDAY OR WEDNESDAT
AT 518-474-8390 / 518-474-1041 or FAX (anytime)474-1513, and say/write:
"Governor Spitzer. I am a family member (friend) of a special
needs students. Assemblywoman Cathy Nolan and Senator Andrew Lanza
have introduced legislation, Assembly bill 5396 and Senate bill 5972,
that requires school districts, not parents, bear the burden of proof in
special education hearings. Please support this bill now and please
sign off on this bill when it passes Assembly and Senate. We are
asking you to help our most vulnerable families protect their child's right
to an appropriate public education."
ADDITIONAL BACKGROUND FYI:
This legislation would remedy the U.S. Supreme Court decision from a
year ago in Schaffer v. Weast, which turned the clock back decades
for children with disabilities. In the absence of a state law to the
contrary, this court decision forces parents to bear the burden of
proof in special education hearings over their child's Individual
Education Plan (IEP). Parents, therefore, are charged with
presenting their case, making legal arguments, examining and cross examining
witnesses, including hostile witnesses, and adhering to the
procedural requirements of a hearing. For those parents unable to afford legal
representation, this burden is unjust and often impossible. The
Legislature must restore the pre-Schaffer status quo that existed in
New York since 1975 which was the inception of special education.
Until this bill passes and is signed into law, most parents, especially
those of limited means, DO NOT STAND A CHANCE if they must defend their
child's right to a Free and Appropriate Public Education.
Friday, June 8, 2007
SC Legislature overrides Governor's Veto of Autism Bill
07 June 2007
House overrides autism veto; bill now law
The House easily overrode Gov. Mark Sanford's veto of a bill Thursday
extending insurance coverage to children with autism.
The vote was 114-0.
After voting, House members turned toward the balcony and gave families
representing children who have the disorder a standing ovation.
Before the vote, Rep. B.R. Skelton, R-Pickens, chastised the governor
for striking down the measure.
"He has four healthy children and I don't think he has ever met anybody
who didn't have healthy children," Skelton said.
The Senate had previously overrode the veto, also unanimously.
The governor' s office maintains the provision will raise health care
costs.
House overrides autism veto; bill now law
The House easily overrode Gov. Mark Sanford's veto of a bill Thursday
extending insurance coverage to children with autism.
The vote was 114-0.
After voting, House members turned toward the balcony and gave families
representing children who have the disorder a standing ovation.
Before the vote, Rep. B.R. Skelton, R-Pickens, chastised the governor
for striking down the measure.
"He has four healthy children and I don't think he has ever met anybody
who didn't have healthy children," Skelton said.
The Senate had previously overrode the veto, also unanimously.
The governor' s office maintains the provision will raise health care
costs.
Sunday, June 3, 2007
Texas Gov: Sign Autism Bill!
Gary Scharrer
Austin Bureau
http://www.mysanantonio.com/news/metro/stories/MYSA060307.01B.autism.357329a.html
Source: mysanantonio.com
AUSTIN — Parents of children with autism cheered when Texas lawmakers revived a dead bill they say will give families hope, save some from bankruptcy and reduce long-term costs for taxpayers.
But the Texas Association of Business wants Gov. Rick Perry to veto House Bill 1919 because of an amendment that changes the definition of autism from a mental illness to a neurobiological illness — and requires insurance companies to cover treatment for 3- to 5-year-olds with the disease.
The autism insurance measure passed the Senate but languished in the House until just hours before the legislative session ended on Memorial Day, when lawmakers approved it as an amendment to insurance-related legislation.
"Somebody finally heard us," an emotional Cynthia Singleton of Houston said after legislators approved the amendment. "Parents have been struggling for years to be heard, and, I think, somebody finally cared enough to help make it happen."
Singleton said she and her husband have spent more than $100,000 on treatment for their 8-year-old son with autism. They financed the treatment by selling a four-bedroom home in Houston and renting a three-bedroom apartment for more than two years.
Most families can't afford the expensive, intensive intervention that offers some level of success if the treatment starts early.
By the numbers
1 million: The number of children, up to 18, that the Texas Department of Insurance estimates are privately insured.
1,111: Assuming a 1 in 150 prevalence of autism and that this bill covers three years of a child's life, it is estimated this many children will be covered in any given year. However, some of these children will not require extensive treatment.
$208,500: Dollars the state could save per child across 18 years of general revenue-funded educational services if the child undergoes early intensive behavior intervention, according to results from a University of Houston study.
$771.5 million: Amount the state will save in special education costs alone, within the first 10 years of the bill's passage.
$2 million: Average lifetime savings for a child with autism who receives early intervention, according to national projections.
Source: Office of state Sen. Eddie Lucio
"What we know about brain development is that when children are very young, their brains are very plastic. You can shape and change how the brain functions," said Theresa Diaz, president of the Autism Society of Greater San Antonio. "At its heart, autism is the brain processes information completely differently from a typically developing brain."
Diaz has a 5-year-old son with autism.
Intensive and early intervention helps the brain to rewire itself to the point that "children will still have autism, but they most likely will be able to be much more functional," she said.
But the costs are staggering without insurance coverage.
"We have families all over town who are declaring bankruptcy left, right and center because they are just trying to figure out how to get their children to function," Diaz said.
The Texas Association of Business, which routinely tries to fend off any governmental mandate on business, has asked Perry to veto the measure.
(Photos by Bahram Mark Sobhani/Express-News)
Theresa Diaz struggles to hold her son, Merced, as they make a peanut butter and jelly sandwich with his sister, Paloma.
Merced Diaz, who is autistic, plays on a backyard swing with his sister, Paloma, and mom, Theresa.
"It's not about autism. It's not about brain injuries. It's not about cervical cancer," said the association's Shelton Green. "We want to avoid placing mandates on employers, on their health benefit policies."
Such requirements increase costs for employers already struggling with annual insurance premium increases, he said.
"We want the free market to work," Green said. "We want to leave the discretion up to the employers and let them decide what health plans (to provide) and not the state."
Citing a February report by the Centers for Disease Control and Prevention that one of every 150 children has some level of autism, Diaz and others said taxpayers face a staggering future cost if those children do not receive treatment.
If insurance coverage for autism treatment is "such a good idea and such a cost savings, then employers should do it today without a state mandate," said Green, adding he had "nothing against those with autism or children and families dealing with autism. It's a tragic situation."
Perry spokesman Robert Black said the governor has not decided whether to veto the bill.
The number of Texas children with autism has nearly doubled in four years, reaching 17,282 in the 2005-06 school year, according to the Texas Education Agency. But experts contend the count is vastly understated and does not include large numbers of children with autism who are home-schooled.
Sen. Eddie Lucio, D-Brownsville, has been trying to pass the autism insurance bill for six years.
"Not only will this legislation save the state billions of dollars in the next decade alone, but it will bring renewed hope to many of these children and their parents," Lucio said. "We can honestly say we are giving children an opportunity for a more independent life."
Adults with autism who did not get treatment as children often need extensive care that can cost $100,000 per year per individual, Diaz said.
She and others wanted the coverage to extend to younger and older children but settled for 3-to-5 age range as a compromise.
In Bexar County, the average age of a child when diagnosed with autism is 7, Diaz said.
The warning signs for children with autism show up between 10 and 18 months "and the diagnosis should begin so that the intervention can begin," Diaz said.
If the bill becomes law, insurance coverage would help families pay for applied behavioral analysis, a tested approach for treating autism, and such services as behavior management, speech therapy, physical therapy and occupational therapy, said Singleton, the Houston mother.
She has been fighting for insurance coverage for about seven years and helped inspire other parents to contact lawmakers last month.
"People should not have to choose between getting treatment for their kids or having to sell their house," Singleton said. "There is no cure. Recovery is what they talk about."
Children with early treatment show average IQ, can do grade-level work and function independently in a general education classroom without support, Singleton said.
"We came very, very close to that," she said of her son's progress. "We had to stop doing some of the applied behavior analysis because we just ran out of money."
Austin Bureau
http://www.mysanantonio.com/news/metro/stories/MYSA060307.01B.autism.357329a.html
Source: mysanantonio.com
AUSTIN — Parents of children with autism cheered when Texas lawmakers revived a dead bill they say will give families hope, save some from bankruptcy and reduce long-term costs for taxpayers.
But the Texas Association of Business wants Gov. Rick Perry to veto House Bill 1919 because of an amendment that changes the definition of autism from a mental illness to a neurobiological illness — and requires insurance companies to cover treatment for 3- to 5-year-olds with the disease.
The autism insurance measure passed the Senate but languished in the House until just hours before the legislative session ended on Memorial Day, when lawmakers approved it as an amendment to insurance-related legislation.
"Somebody finally heard us," an emotional Cynthia Singleton of Houston said after legislators approved the amendment. "Parents have been struggling for years to be heard, and, I think, somebody finally cared enough to help make it happen."
Singleton said she and her husband have spent more than $100,000 on treatment for their 8-year-old son with autism. They financed the treatment by selling a four-bedroom home in Houston and renting a three-bedroom apartment for more than two years.
Most families can't afford the expensive, intensive intervention that offers some level of success if the treatment starts early.
By the numbers
1 million: The number of children, up to 18, that the Texas Department of Insurance estimates are privately insured.
1,111: Assuming a 1 in 150 prevalence of autism and that this bill covers three years of a child's life, it is estimated this many children will be covered in any given year. However, some of these children will not require extensive treatment.
$208,500: Dollars the state could save per child across 18 years of general revenue-funded educational services if the child undergoes early intensive behavior intervention, according to results from a University of Houston study.
$771.5 million: Amount the state will save in special education costs alone, within the first 10 years of the bill's passage.
$2 million: Average lifetime savings for a child with autism who receives early intervention, according to national projections.
Source: Office of state Sen. Eddie Lucio
"What we know about brain development is that when children are very young, their brains are very plastic. You can shape and change how the brain functions," said Theresa Diaz, president of the Autism Society of Greater San Antonio. "At its heart, autism is the brain processes information completely differently from a typically developing brain."
Diaz has a 5-year-old son with autism.
Intensive and early intervention helps the brain to rewire itself to the point that "children will still have autism, but they most likely will be able to be much more functional," she said.
But the costs are staggering without insurance coverage.
"We have families all over town who are declaring bankruptcy left, right and center because they are just trying to figure out how to get their children to function," Diaz said.
The Texas Association of Business, which routinely tries to fend off any governmental mandate on business, has asked Perry to veto the measure.
(Photos by Bahram Mark Sobhani/Express-News)
Theresa Diaz struggles to hold her son, Merced, as they make a peanut butter and jelly sandwich with his sister, Paloma.
Merced Diaz, who is autistic, plays on a backyard swing with his sister, Paloma, and mom, Theresa.
"It's not about autism. It's not about brain injuries. It's not about cervical cancer," said the association's Shelton Green. "We want to avoid placing mandates on employers, on their health benefit policies."
Such requirements increase costs for employers already struggling with annual insurance premium increases, he said.
"We want the free market to work," Green said. "We want to leave the discretion up to the employers and let them decide what health plans (to provide) and not the state."
Citing a February report by the Centers for Disease Control and Prevention that one of every 150 children has some level of autism, Diaz and others said taxpayers face a staggering future cost if those children do not receive treatment.
If insurance coverage for autism treatment is "such a good idea and such a cost savings, then employers should do it today without a state mandate," said Green, adding he had "nothing against those with autism or children and families dealing with autism. It's a tragic situation."
Perry spokesman Robert Black said the governor has not decided whether to veto the bill.
The number of Texas children with autism has nearly doubled in four years, reaching 17,282 in the 2005-06 school year, according to the Texas Education Agency. But experts contend the count is vastly understated and does not include large numbers of children with autism who are home-schooled.
Sen. Eddie Lucio, D-Brownsville, has been trying to pass the autism insurance bill for six years.
"Not only will this legislation save the state billions of dollars in the next decade alone, but it will bring renewed hope to many of these children and their parents," Lucio said. "We can honestly say we are giving children an opportunity for a more independent life."
Adults with autism who did not get treatment as children often need extensive care that can cost $100,000 per year per individual, Diaz said.
She and others wanted the coverage to extend to younger and older children but settled for 3-to-5 age range as a compromise.
In Bexar County, the average age of a child when diagnosed with autism is 7, Diaz said.
The warning signs for children with autism show up between 10 and 18 months "and the diagnosis should begin so that the intervention can begin," Diaz said.
If the bill becomes law, insurance coverage would help families pay for applied behavioral analysis, a tested approach for treating autism, and such services as behavior management, speech therapy, physical therapy and occupational therapy, said Singleton, the Houston mother.
She has been fighting for insurance coverage for about seven years and helped inspire other parents to contact lawmakers last month.
"People should not have to choose between getting treatment for their kids or having to sell their house," Singleton said. "There is no cure. Recovery is what they talk about."
Children with early treatment show average IQ, can do grade-level work and function independently in a general education classroom without support, Singleton said.
"We came very, very close to that," she said of her son's progress. "We had to stop doing some of the applied behavior analysis because we just ran out of money."
Wednesday, May 30, 2007
Our Legislation on the Radio!
This from Nadine Gratz in Sen. Robson's office:
At 6 am tomorrow morning (Thursday, May 31), Sen. Robson will be the special guest on Wisconsin Public Radio talking about the autism bill. She will be on Joy Cardin's show on the statewide "Ideas Network". Judy will be on from 6-6:30 am. In the 6:30-7 time slot, Joy may have someone representing the insurance companies that oppose the bill as an insurance mandate. It would be great if you could get the word out to your members to listen and possible call in with their personal stories and experiences. It would be helpful to have callers supporting Judy and the bill, but it is even more important to have the insurance industry challenged by real people with real needs.
Hope you can get the word out. Of course, we'll spread the word to other groups, organizations and legislators too. Thanks again.
Also:
Rob Ferrett of Wisconsin News Connection called me to do an interview. This is kind of a radio-news wire that will air interviews on 20-40 stations, so it seems as if
we'll get some coverage from them for the rally. He interviewed me for
about 5 mins. and will edit it into 20-30 second sound bites to be
played on radio stations throughout the state. I really focused on the
terrible time families have waiting for treatment and the unfairness
aspect of not treating autism.
If anyone hears this on a radio broadcast, please let me know.
At 6 am tomorrow morning (Thursday, May 31), Sen. Robson will be the special guest on Wisconsin Public Radio talking about the autism bill. She will be on Joy Cardin's show on the statewide "Ideas Network". Judy will be on from 6-6:30 am. In the 6:30-7 time slot, Joy may have someone representing the insurance companies that oppose the bill as an insurance mandate. It would be great if you could get the word out to your members to listen and possible call in with their personal stories and experiences. It would be helpful to have callers supporting Judy and the bill, but it is even more important to have the insurance industry challenged by real people with real needs.
Hope you can get the word out. Of course, we'll spread the word to other groups, organizations and legislators too. Thanks again.
Also:
Rob Ferrett of Wisconsin News Connection called me to do an interview. This is kind of a radio-news wire that will air interviews on 20-40 stations, so it seems as if
we'll get some coverage from them for the rally. He interviewed me for
about 5 mins. and will edit it into 20-30 second sound bites to be
played on radio stations throughout the state. I really focused on the
terrible time families have waiting for treatment and the unfairness
aspect of not treating autism.
If anyone hears this on a radio broadcast, please let me know.
Step It Up 4 Autism Rally Tomorrow!
Prior to the public hearing for SB 178, the bill that would insure that
people with autism had the right to treatment, there will be a rally on
the Capitol Steps (the rain location is the Rotunda of the Capitol).
Please bring signs and wear t-shirts or Autism pins, etc. as there will
be media present.
A strong showing here will allow our representatives to see that we are
committed and organized, making our bills journey through both houses
much easier!
Rhonda
people with autism had the right to treatment, there will be a rally on
the Capitol Steps (the rain location is the Rotunda of the Capitol).
Please bring signs and wear t-shirts or Autism pins, etc. as there will
be media present.
A strong showing here will allow our representatives to see that we are
committed and organized, making our bills journey through both houses
much easier!
Rhonda
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