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Wednesday, April 26, 2017

Insurance in South Carolina

The Politics of Autism includes an extensive discussion of insurance legislation in the states.

Ashleigh Holland reports at WIS-TV:
The parents of children with autism say their needs can fall through the cracks in South Carolina - especially if their families don't have the insurance coverage they need to pay for expensive treatments.
A bill in the State House now aims to expand insurance coverage for those with autism. Autism advocates are pushing for it to pass, but it has stalled in the House.
Rep. Nathan Ballentine (R- Richland) sponsors H. 3747 in hopes of adding more insurance coverage to the expansion passed 10 years ago, under Ryan's Law.
Ryan's Law required state employee insurance plans and fully-funded large group plans to fund treatment like Applied Behavior Analysis (ABA) therapy for children with autism.
The bill filed recently would further mandate people on small group plans, which is small-business insurance plans, and individual plans to be covered by insurance.

Autism Speaks advocate Lorri Unumb works with the nonprofit group to fight for better autism treatment coverage across the country. Unumb is also a parent and Ryan's Law is named after her son. He was diagnosed with autism at a young age. - Columbia, South Carolina

Tuesday, April 25, 2017

Careless Headline

In The Politics of Autism, I discuss various ideas about what causes the condition.  I also write:  "If the science were not confusing enough, its coverage in the mass media has added another layer of murk.  News reports hype tentative findings and weak correlations as “breakthroughs” in the quest for autism answers. "  

USA Today is running a story about research into marijuana as a treatment.  Though the text of the story explains that the studies are ongoing and not conclusive yet, the headline uses the word "miracle," which is not in the article.

This headline is bad for two reasons.

First, there is a long, long history of "miracle" cures that ended in deep disappointment for autism families.

Second, in this particular case, the reference to marijuana might lead some families to try it. Though some states have legalized it for medical or recreational use, the federal government has not.  In other words, it is encouraging families to break the law and attempt a "treatment" that could have unanticipated consequences.

Monday, April 24, 2017

Texas Fails Military Families with Special Needs Kids

I write in The Politics of Autism: "[T]ime is on the school district’s side. A child is in any one school for only a few years, so services delayed are services denied. And in the long run, there is no long run. IDEA only covers people until their 22d birthday: after that, public schools may cut them off."

Brian M. Rosenthal reports at The Houston Chronicle:
Texas, which is home to more members of the military than all but one other American state, loves to proclaim its support for the armed forces. But for soldiers who have children with disabilities, there may be no worse place in the country to live, the Houston Chronicle has found.
A decade long state effort to cut special education costs, which only recently ended after being exposed, had an especially large impact on public schools that serve military families, according to interviews and data.

Meadows Elementary is a prime example. The school, within the walls of Fort Hood and attended largely by the children of troops, provides special education services to just 7 percent of its students, state statistics show. That is less than the state average of 8.5 percent, which itself is by far the lowest in the United States. The national average is 13 percent.
In 2004, the Texas Education Agency set an arbitrary cap on students in special education.
There are many reasons why military families were disproportionately hurt by the cap, experts said. Military families move a lot and do not make a lot of money, leaving them less able to fight schools. Soldiers also are trained to obey authority and often are loath to cause waves.
"I'm not surprised at the percentages," said Jeremy Hilton, a Navy veteran who has traveled the country to speak about raising a child with disabilities as a veteran.
Most kids of active duty troops move at least half a dozen times during their school years, and districts know that, Hilton said.
"This knowledge creates incentives for school districts to roll the dice in withholding services and supports, knowing that a military family is unlikely to be able to effectively hold a school district accountable," he said.


Sunday, April 23, 2017

Trump, Science, Autism

Jon Reid reports at Morning Consult:
On the campaign trail, President Donald Trump met with prominent vaccine skeptics and ranted about the debunked theory that vaccines cause autism. But as the administration approaches its 100-day mark, the White House has given few indications about the direction of its vaccine policy.
Despite Trump’s inaction, anti-vaccine activists feel emboldened. Vaccine skeptics held a rally in Washington last month, when they also lobbied lawmakers on Capitol Hill.
Andrew Wakefield, the author of a since-discredited study linking vaccines to autism who met with Trump during the 2016 campaign, remains optimistic that the White House will act on his cause, though he said he hasn’t had contact with Trump since their meeting last summer.
“I truly hope that President Trump will follow through on this,” Wakefield said in a phone interview.
The Huffington Post:
President Donald Trump has long perpetuated the debunked theory that vaccines cause autism. In January, while still president-elect, he went as far as to request that Robert F. Kennedy Jr., a fellow vaccine skeptic, lead a commission to investigate vaccine safety.

This disregard for science is among the reasons Sabrina Solouki, a second-year Ph.D. student in immunology and infectious disease at Cornell University, made a pilgrimage to Washington, D.C., on Saturday for the March for Science, a mass protest to rally scientists against what they see as Trump’s backward policies.

“The administration, by forming this safety commission, isn’t really doing a good job of listening to science — of science-informed policy,” she told The Huffington Post.

Solouki also wants to unite the scientific community, to push for it to do a better job of engaging with the public at large, and to send a clear message that scientists are against Trump’s proposed cuts to science.

Saturday, April 22, 2017

Alabama House Approves Mandate

The Politics of Autism includes an extensive discussion of insurance legislation in the states.

On Thursday, the Alabama House unanimously approved an autism insurance mandate Trisha Powell Crain reports at
Rep. Jim Patterson, R-Meridianville, sponsored the bill, HB284, saying he wants to do the right thing for families who need help paying for the sometimes expensive therapy.
Introducing the bill on the House floor, Patterson said, "We're going to do something good for families in Alabama. This is what we come to Montgomery to do."

Alabama is one of five states with no requirement that insurance companies cover applied behavior analysis (ABA), the most common and scientifically supported treatment for autism.
Rep. Jack Williams, R-Vestavia Hills, worked to negotiate a compromise bill to contain costs while providing medically necessary services.
Williams added caps on coverage based on a person's age. There are higher caps for younger children, Williams said, because the earlier therapy can be started, the better the outcome.

Friday, April 21, 2017

Arresting a Ten-Year Old

In The Politics of Autism, I discuss interactions between police and autistic people.

With an utter lack of self-awareness, a sheriff's department that arrested an autistic ten-year-old is using its website to tout its support for Special Olympics.

Jacqueline Howard reports at CNN:
When John Haygood, a 10-year-old boy with autism, was arrested last week at a school in Florida, he kept repeating that he didn't know what was happening, as seen in shaky cellphone video taken by his mother.
"I don't know what's going on. I don't understand," he cried out. In the video, his hands are cuffed as two officers escort him to the back seat of a police car.
His mother, Luanne Haygood, followed behind them while recording the incident on her phone. In the video, John appears distraught, and yells some profanities.

Luanne is heard in the video speaking to the officers, "Excuse me, do you have any paperwork or anything you can say to me?"

John, a student at Okeechobee Achievement Academy in Okeechobee, Florida, was arrested at the school last week for feloy battery  against a teacher in an October incident, allegedly punching and kicking his teacher, which left scratches and marks, according to an incident report from the Okeechobee County Sheriff's Office (PDF).
The incident occurred after John was being disruptive in class, throwing paper balls around the classroom and hitting other students, the report said. His teacher asked him to go to time out. When John refused, the teacher attempted to remove him, and that's when John attacked, the report said.
The report also noted that John had allegedly made threats to kill the teacher in a previous incident. On November 1, the teacher requested to pursue criminal charges since John "had been given plenty of opportunities to change his behavior and has not," the report said.

Thursday, April 20, 2017

Mississippi Medicaid Limbo

The Politics of Autism includes an extensive discussion of insurance and  Medicaid services for people with intellectual and developmental disabilities

Bracey Harris writes about Medicaid at The Clarion-Ledger:
[A]lmost two years after Mississippi enacted a mandate requiring insurers to cover a type of autism therapy known as applied behavior analysis, providers say the state’s largest insurer of children is not reimbursing services.
Two problems:
The first is a matter of timing.
Mississippi submitted an amended state plan to the Centers for Medicare and Medicaid Services last year. The document details the scope of behavioral therapy services that will be covered for eligible beneficiaries under the age of 21 diagnosed with autism. CMS works on a 90-day turnaround schedule, meaning if the plan is approved before the end of this current quarter, the new policy will go into effect on July 1.
“Bottom line: We’ve got a tight window to deliver services. Every minute that passes by. It’s a grain of sand you don’t get to pull back. (I’m hopeful) this moves forward so children can start receiving services," said Jim Moore, director of the state Autism Board, which is charged with licensing board-certified behavior analysts.
The second and perhaps more pressing issue for providers is the reimbursement rates proposed by the division. In public comments, providers protested the fee schedule. Most insurers stipulate that applied behavioral analysis therapy programs must be supervised and coordinated by a licensed behavior analyst in order to receive payment.
The billing guideline proposed by Medicaid would have paid a behavioral analyst with a master’s degree $30 an hour. In neighboring Louisiana, the rate is $72 per hour.