Huntsville

In The Politics of Autism, I discuss the neurodiversity movement.   

Jessica Penot at Psychology Today:

Huntsville is a haven for geeks just as the Silicon Valley of Silberman’s Neurotribes was. It isn’t surprising that Huntsville has also become a haven for autistic people. When I first opened my private practice, Tree of Life Behavioral Health, in 2015, people in Alabama still viewed autism as a disorder of nonfunctional boys who liked trains. I was high masking at the time and tried very hard to blend in with my neurotypical colleagues. I straightened my hair and tried very hard to master the art of small talk. Despite this, I very quickly noticed that most of my clients were oddballs who shared my passions. They loved dungeons and dragons, board games, horror movies, video games, and comic books. They were largely engineers or artists with passions that consumed them and with remarkable minds that often left me humbled.

It didn’t take me long to figure out that almost all my clients were autistic and that most of them came to me because of my weirdness and autism, not despite it. My practice flourished because I possessed all the traits, I had spent my life trying to hide. It flourished because Huntsville is a magical place filled with autistic people who are unique and brilliant beyond measure.

Alabama Legislation on Police Training

In The Politics of Autism, I discuss interactions between police and autistic people.  When cops encounter autistic people they may not respond in the same way as NT people, and things can get out of hand. Among other things, they may misinterpret autistic behavior as aggressive or defiant, and respond with tasers, batons, chokeholds, or worse.

Courtney Chandler at WIAT-TV Birmingham, Alabama:

A new bill by an Alabama state lawmaker will help police officers better respond to people who have disabilities.

Rep. Leigh Hulsey from Helena said HB356 will provide training for officers on how to deal with individuals who have sensory needs or invisible disabilities. HB356, also known as the Noah Cade Act, will provide officers with one hour of mandatory training every other year.

The bill is special to Hulsey because it’s her first piece of legislation she has introduced in the state house, and it’s named after her son who has autism.

Bill synopsis:

Under existing law, a law enforcement officer must successfully complete 12 hours of continuing education training approved by the Alabama Peace Officers' Standards and Training Commission. This bill would require the Alabama Peace Officers' Standards and Training Commission to collaborate with a nonprofit company to provide annual training about interacting with individuals with sensory needs or invisible disabilities. 

 Relating to law enforcement training; to require each law enforcement officer to undergo annual training related to individuals with certain sensory needs or invisible disabilities; and to provide that the Alabama Peace Officers' Standards and Training Commission shall collaborate with a nonprofit company to provide the training. 

 

Autism ID Cards in Alabama

In The Politics of Autism, I write:

[M]any police departments have trained officers and other first responders how to spot signs of autism and respond accordingly.[i] Some organizations have also published identification cards that ASD adults can carry in order to defuse potential conflicts. Virginia provides for an autism designation on driver licenses and other state-issued identification cards. Once again, however, the dilemma of difference comes into play. One autistic Virginian worries: “Great, so if I get into an accident, who’s the cop going to believe, the guy with the autistic label or the guy without it?” Clinical psychologist Michael Oberschneider is concerned about the understanding level of first responders: “I think many people still think of Rain Man or, more recently, the Sandy Hook Shooter, when they think of autism even though very few people on the autistic spectrum are savants or are homicidal and dangerous.”[ii]

Yesterday's post involved autism windshield decals in Florida.  Here is a related story from Alabama;

Leada Gore at AL.com:

Alabamians who have a diagnosis that falls within the autism disorder spectrum have access to a special identification card.

Alabama has created and implemented the first state-recognized Autism Identification Card in the U.S. The cards, distributed by county health departments, can assist with interactions with first responders and law enforcement officers during potentially stressful situations, such as a traffic stop.

Wording on the card explains that the holder falls within in the autism spectrum and may have difficulty communicating or understanding directions. The card also states that the person could become agitated if touched because of his or her medical conditions.

Unvaxxed Autistic Man Dies of COVID

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Half of COVID vaccine rejectors think that vaccines in general cause autism. 

María Luisa Paúl at WP:

These days, Christy Carpenter finds strength in her family and faith. But on some days, one question keeps ringing in her head: “Why?”

After weeks of battling through oxygen treatments, her 28-year-old son died in the hospital two months after being diagnosed with covid-19.

Now in Carpenter’s Alabama home, the room belonging to Curt, her “beautiful baby boy” and firstborn, remains empty — a painful reminder of a life that could have been saved if the family had decided to get vaccinated, she said.

“It took watching my son die and me suffering the effects of covid for us to realize we need the vaccine,” the mother said. “We did not get vaccinated when we had the opportunity and regret that so much now.”
...

Curt Carpenter was a young and otherwise healthy man. While at home, his mother said, he would spoil her with the “best hugs” and a daily dosage of kindness. Curt was autistic, but Christy Carpenter said he “lived life to the fullest” and had a passion for all things Pokémon, trains, video games and frogs.

...

 His last uttered phrase is still etched in Christy Carpenter’s mind: “This is not a hoax, this is real,” Curt said, according to his mother.

His mother said Curt Carpenter at first believed that the coronavirus was a hoax. The whole family was hesitant to get vaccinated when the shots became available.

“It took years to create other vaccines, and the coronavirus vaccine was created very quickly,” Christy Carpenter said. “That made us very nervous.”

Triage

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Those challenges get far more intense during disasters.  And coronavirus is proving to be the biggest disaster of all.

People with autism and other disabilities have faced discrimination in organ transplants.  Now they face discrimination in the availability of ventilators.

Amy Silverman at Pro Publica:

Advocates for people with intellectual disabilities are concerned that those with Down syndrome, cerebral palsy, autism and other such conditions will be denied access to lifesaving medical treatment as the COVID-19 outbreak spreads across the country.

Several disability advocacy organizations filed complaints this week with the civil rights division of the U.S. Department of Health and Human Services, asking the federal government to clarify provisions of the disaster preparedness plans for the states of Washington and Alabama.

The advocates say the plans discriminate against people with intellectual disabilities by deprioritizing this group in the event of rationing of medical care — specifically, access to ventilators, which are in high demand in treating COVID-19 cases. More than 7 million people in the U.S. have some form of cognitive disability.

Some state plans make clear that people with cognitive issues are a lower priority for lifesaving treatment. For instance, Alabama’s plan says that “persons with severe mental retardation, advanced dementia or severe traumatic brain injury may be poor candidates for ventilator support.” Another part says that “persons with severe or profound mental retardation, moderate to severe dementia, or catastrophic neurological complications such as persistent vegetative state are unlikely candidates for ventilator support.”

...
“What we’re seeing here is a clash between disability rights law and ruthless utilitarian logic,” said Ari Ne’eman, a visiting scholar at the Lurie Institute for Disability Policy at Brandeis University. “What this is really about at the end of the day is whether our civil rights laws still apply in a pandemic. I think that’s a pretty core question as to who we are as a country.”

Differences Among States in Autism Prevalence

In The Politics of Autism, I discuss the uncertainty surrounding estimates of autism prevalence. 

At The Journal of Autism and Developmental Disorders, R. Christopher Sheldrick and Alice S. Carter have an article titled" State-Level Trends in the Prevalence of Autism Spectrum Disorder (ASD) from 2000 to 2012: A Reanalysis of Findings from the Autism and Developmental Disabilities Network." The abstract:

Since 2000, the Autism and Developmental Disabilities Network (ADDM) has published detailed prevalence estimates for autism spectrum disorder (ASD) among 8 year-olds, which are widely interpreted as the U.S. national prevalence of ASD. Although differences in state-level ASD prevalence has been reported, state-level heterogeneity has not been explored systematically. We analyzed state-level estimates and trends in ASD prevalence from 2000 to 2012 using secondary data from bi-annual ADDM reports. Heterogeneity among state-level ASD prevalence estimates were apparent in 2000 and grew between 2000 and 2012. Findings highlight the need for greater understanding of how children with ASD are identified by the medical and educational systems, which has significant implications for the state-level resources required to effectively manage ASD.

New Jersey has the highest prevalence, Alabama the lowest.  Why?

From the article:

Consideration of such differences is important for at least two reasons. First, a large proportion of service delivery for ASD is managed at the state level. Strong differences in ASD prevalence at the state level therefore have implications for the resources required to provide adequate services (Wise et al. 2010). Second, improved understanding of the causes of observed changes in ASD prevalence may depend on a
more detailed understanding of heterogeneity. For example, the ADDM and others have speculated that trends in ASD prevalence over time may be attributable either to changes
in the true prevalence of ASD, for example resulting from trends in exposure to risk factors such as environmental toxins, or changes in the ascertainment of ASD, for example attributable to increased awareness of or sensitivity to ASD symptoms (Blumberg et al. 2013; Centers for Disease Control and Prevention 2014; Hansen et al. 2015; Idring et al. 2015). 

• Blumberg, S. J., Bramlett, M. D., Kogan, M. D., Schieve, L. A., Jones, J. R., & Lu, M. C. (2013). Changes in prevalence of parent-reported autism spectrum disorder in school-aged U. S. children: 2007 to 2011–2012. National Health Statistics Reports, 65, 1–11.Google Scholar
• Centers for Disease Control and Prevention. (2014). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, 2010. MMWR, 63(SS-2), 1–21.Google Scholar
• Hansen, S. N., Schendel, D. E., Parner, E. T. (2015). Explaining the increase in the prevalence of autism spectrum disorders. JAMA Pediatrics, 169(1), 56. https://doi.org/10.1001/jamapediatrics.2014.1893.CrossRefPubMedGoogle Scholar
• Idring, S., Lundberg, M., Sturm, H., Dalman, C., Gumpert, C., Rai, D., … Magnusson, C. (2015). Changes in prevalence of autism spectrum disorders in 2001–2011: Findings from the Stockholm youth cohort. Journal of Autism and Developmental Disorders, 45(6), 1766–1773. https://doi.org/10.1007/s10803-014-2336-y.CrossRefPubMedGoogle Scholar
• Wise, M. D., Little, A. A., Holliman, J. B., Wise, P. H., & Wang, C. J. (2010). Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders? Journal of Developmental and Behavioral Pediatrics, 31(6), 469–476. https://doi.org/10.1097/DBP.0b013e3181e56db2.PubMedGoogle Scholar

Organizing for the Alabama Mandate

The Politics of Autism includes an extensive discussion of insurance and the regulation of autism service providers.

At The Montgomery Advertiser, Brian Lyman has an oral history of the passage of Alabama mandate legislation.  This section deals with organizing:

Catey Hall, parent and advocate: A small group of parents and the Autism Society had done this for six years. What they did not have was a strong presence of advocates and parents self-advocating, asking legislators to support them. We decided we’re going to do that this year.

Lisa Whitson Riley, parent and advocate (son George was diagnosed with autism at age 4): The Autism Society sent out newsletters. I set up a Facebook page the first go-around that we all then started tapping into and using. We would use the Facebook page. We needed people who weren’t on the Facebook page. I posted everything. I did Facebook, Twitter and LinkedIn. And there was another parent who did Instagram and Snapchat. We flooded social media.

Hall: We would say ‘We need people here.’ And people came. It was hard for those families. The ones who couldn’t secure child care, they would bring their children with autism there.

Sen. Cam Ward, R-Alabaster: Catey was in the balcony videotaping the debates and streaming it live on Facebook. We didn’t have it on Facebook in 2012.

Bama Hager, policy and program director, Autism Society of Alabama: The grassroots support for the Alabama Autism Insurance Law was so tremendous that lawmakers soon became interested in learning more about the absence of insurance coverage for children who have autism. Parents, self-advocates living with autism, grandparents, aunts, uncles, teachers, neighbors and friends were advocating ferociously for this bill for their loved ones.

Derek Trotter, lobbyist: There were generally a couple of advocates in the State House on session days. We made sure they touched their members and their senator that represents them and whoever they could get in front of.

Riley: I had coffee parties. What I did was I posted on Facebook, ‘Hey, come meet me at the coffee house.’ We would pass out the list and call senators and members of the House and ask them to support this bill. We personalized it. Not just calling and saying ‘Support this because I want you to,’ but ‘I know someone.’

The Business Council of Alabama Has Some Explaining To Do

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

Mary Sell reports at The Times Record:

A group of lawmakers who fought for expanded insurance coverage for children with autism said they weren’t invited to the Business Council of Alabama’s summer conference at Point Clear next month.

The BCA was an opponent of the autism coverage legislation that was approved overwhelmingly by lawmakers, calling it an Obama-style mandate on employers that would increase premiums.

Rep. Jim Patterson, R-Meridianville, sponsored the bill in the House. He said this is the first time he hasn’t been invited to the BCA’s summer conference since he was elected in 2010.

“It looks like I’m in pretty good company,” Patterson said today. He also said he’s always had a good relationship with the BCA.

“I have a very good voting record when it comes to business,” he said. But on the autism issue, he said he listened to people in his area.

“I’m more concerned about pleasing my district than I am any group in Montgomery,” he said.

Brian Lyman reports at The Montgomery Advertiser:

Two senators said Thursday the Business Council of Alabama froze them out of an annual governmental affairs conference because of their support for legislation mandating coverage of autism therapies.

The House sponsor of the legislation and another senator who supported it said they also weren't invited, though they were not entirely certain why.

Sens. Dick Brewbaker, R-Pike Road and Cam Ward, R-Alabaster, who pushed hard for the legislation last spring, said in separate interviews they believed their support meant invitations to an annual summer conference hosted by BCA in Point Clear were withheld this year.

“I was viewed as the face of that bill,” Ward said. “That created some ill feelings with them and leadership.”

Nancy Hewston, a spokeswoman for BCA, strongly denied Thursday that the autism bill -- which BCA opposed -- was the reason they were not on the guest list, though a statement from Hewston did not give another reason.

Kyle Whitmire writes at the Alabama Media Group:

"They're mad at me because of the autism bill," Brewbaker said.

Brewbaker was a little more candid than others I spoke with. He's not running for reelection next year. He called the BCA a "punitive organization." While he supports 90 percent or more of what the BCA proposes, that apparently wasn't enough for them.

"That's the way politics is," he said. "It's a contact sport, and you have to have a thick skin. It's their conference and they can invite whoever they want. There are no hard feelings here."

Among a subset of anti-crony capitalism Republicans, BCA has been making enemies. State Rep. Ed Henry is among them. Like Brewbaker, he too, has said he won't seek reeelection and now he's not holding anything back.

"There's quite a few of us who tanked all their bull crap this year and now they're mad at us," he said.

Henry's no AEA Democrat or liberal snowflake. He supported Donald Trump before Trump was cool (at least among Republicans). He says his experience in the Legislature has been eye-opening.

"If corporate welfare is not as bad as regular welfare, it's right there on the cusp," Henry said. "We don't even know who is getting any of this stuff half the time when we vote on it."

Praising the Alabama Mandate

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

At The Gadsden Messenger, State Representative Craig Ford praises the Alabama Legislature for passing an autism insurance mandate.

According to the national Center for Disease Control, one out of every 175 children in Alabama has been diagnosed with some degree of Autism Spectrum Disorder. While treatment is most effective for children between ages two and nine, and coverage for children in this age range was already mandated by law, some children need further treatment going into their teenage years.

But the costs for Applied Behavioral Therapy treatment can be as high as $70,000 a year! So the legislature passed a new law that requires insurance companies to include in their group plans (defined as plans with 51 or more people participating) coverage for the treatment of children up to age 17.

This bill, which Gov. Kay Ivey has now signed into law, will improve the lives of thousands of children and their families. But it also shows what can be done when legislators work together.

Rep. Jim Patterson, R-Meridianville, worked tirelessly on this bill, and he didn’t make it a partisan issue. Rep. Patterson talked with Democrats and Republicans in both chambers of the legislature to come to a compromise that would limit the costs to insurers while still guaranteeing the coverage for our children.

As a result, this bill was passed out of the House with 102 votes in favor and not a single vote against it. In the state Senate, only one senator voted against it.

Another bipartisan success was our education budget. Budget chairman Bill Poole, R-Tuscaloosa, has always worked hard and listened to members of both parties when crafting the education budget. His tireless work has also led to unanimous support in the House for his budgets. And even more impressive is that he’s passed the education budget with unanimous support for three years in a row!

Both of these men have shown what can be accomplished when leaders reach across the aisle and work together instead of turning everything into a partisan issue.

Alabama Governor Signs Autism Insurance Mandate

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

Andrew J. Yawn reports at The Montgomery Advertiser:

Gov. Kay Ivey signed the autism insurance bill into law Friday at the Capitol, and afterward she was embraced by a few of the thousands of children the law will support.

Despite a late session effort to stymie the autism bill, it unanimously pushed through the House about 2 a.m. Thursday. Some concessions were made including an age cap and an exemption for business employing 50 people or fewer, but the law will make access to care easier for children on the spectrum whose applied behavior analysis (ABA) therapy will be covered by health insurance until the age of 18.

"The bill is real important," Ivey said. "This bill is about the quality of life of wonderful children, and I'm proud to sign this bill."

State Finance Director Clinton Carter's daughter Libby, 5, was one of the children on the spectrum to embrace Ivey after the signing.

Final Passage of Alabama Mandate

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

Brian Lyman reports at The Montgomery Advertiser:

The Alabama House of Representatives voted 103 to 0 early Thursday morning for a an amended version of legislation that would require insurers to provide the therapies for children 18 and younger. The final version was somewhat less than what supporters initially sought, and includes an exemption from the mandate for businesses that employ 50 people or less.

But Rep. Jim Patterson, R-Merdianville, the bill's sponsor, said after the 2:08 a.m. vote Thursday that it was an important first step in allowing families with autistic children access to critical treatment.

"It's hard to be against children who need help," he said. "103 votes, that's pretty strong."

The bill goes to Gov. Kay Ivey.

At oanow.com, Cynthia Williford reports that the legislation could help keep behavior analysts in the state:

For years, John Rapp, Auburn University’s applied behavior analysis program director, has seen students who get their masters leave Alabama for better, higher-paying or simply available, jobs. And those jobs are often in the 45 other states where insurance reform bills have passed.

“We like to try to recruit people outside Alabama to come to our program with the hope that they’ll stay, but, without gainful employment, they will gravitate to wherever the jobs are,” Rapp said, the director of one of the highest rated programs in the country. “Suffice it to say that Alabama has not been one of the higher paying regions. That has contributed to it, and again, where there’s a lot of demand, there’s an opportunity to pay better salaries.”

Odessa Luna, a board certified behavior analyst (BCBA) and doctoral candidate at Auburn, said she has trained and knows several who have found better jobs elsewhere. If the bill were to pass, Luna said it would be a “huge appeal” to BCBAs.

Alabama Senate Passes Autism Insurance Mandate

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

At The Alabama Media Group, Mike Cason reports that the Alabama Senate has passed an autism insurance mandate.

The Senate passed the bill by a vote of 33-1. That sends it back to the House, which had passed it 100-0 earlier.

If the House accepts changes made by the Senate, it could send the bill to Gov. Kay Ivey.
Rep. Jim Patterson, R-Meridianville, the sponsor of the bill, said he will ask the House to accept the Senate changes. Patterson said he expects that to happen on Wednesday.

Key Senate changes include making the mandate apply only to companies with at least 51 employees, making the mandate apply only to services for patients up to age 18 and delaying the mandate on public insurance plans until Dec. 31, 2018.

Patterson said he was disappointed in the delay for those plans but said overall the bill was a "victory." He said the advocacy group Autism Speaks, which has lobbied for the bill, urged him to accept the Senate changes.

Parents and advocates say applied behavior analysis can be a life-changing therapy for children with autism. But it's expensive and can be out of reach for parents if not covered by insurance.

Sen. Cam Ward, R-Alabaster, said the insurance mandate would mean that more families would be able to receive the therapy, which benefited his daughter, Riley.

Mandate Bill Advances in Alabama

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

Ben Bullard reports at The Cullman Times:

The Alabama Senate will vote this week on a mandate for insurers to offer coverage for intensive applied behavioral analysis (ABA) therapy, Senate President Pro Tem Del Marsh (R-Anniston) has pledged.

“We will have all day Wednesday to have debate on that bill,” Marsh said last week. “Our intent is to get an autism bill to the governor.”

The bill would require some insurers to cover ABA therapy, an intensive treatment that can cost $100 per hour — out of financial reach for many families. Business and insurance groups have voiced opposition to the proposed mandate, citing cost concerns.

...
Hostilities erupted among senators last Wednesday, shortly after the Senate budget committee approved the bill on a 14-2 vote. Committee Chairman Sen. Trip Pittman (R-Montrose) — who says he’s worried about costs to Medicaid and other state insurance programs — said afterward that he might hold the bill in committee by not reporting it to the floor in order to negotiate for changes.

After pushback from other lawmakers, he relented, but criticized the idea of mandating new, yet-to-be-tallied expenses.

“At the end of the day, we have to be able to pay for the costs of this, and there are a lot of unknown costs,” he said.

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 AL.com:

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.

Insurance Reform in Alabama

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

Amy Yurkanin reports at AL.com that the insurance committee of the Alabama House has approved an autism insurance mandate.

The meeting room filled to capacity several minutes before the hearing began, forcing dozens of people wearing buttons in support of the bill, HB 284, into the hallway, where they listened through open doors 

Committee members made several changes to the bill. The measure now requires the Alabama Medicaid Agency to provide applied behavior therapy to children covered under the program for low-income families. The state is already under investigation by federal regulators for failing to provide the therapy, according to Rep. Jim Patterson, R-Meridianville, the sponsor of the bill. 

Two other amendments also imposed caps for coverage and premium increases. Insurance policies would be required to cover the costs of therapy up to $40,000 a year for children younger than 10, $30,000 for those between the ages of 10 and 13, $20,000 for those age 14 to 18 and $10,000 for people age 19 and old

Insurance Push in Alabama

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

Now that Iowa has passed an autism insurance mandate, Alabama is one of only four states without one. Trisha Powell Crain reports at AL.com: 

Autism advocates are trying a new way to raising awareness about the need for insurance reform. Five billboards calling for "Insurance for Autism Now" are now up: three in Birmingham, one in Albertville and one in Montgomery.

The Autism Society of Alabama paid for the billboards to show their support for HB284, a bill calling for mandated health insurance coverage for behavioral therapy for eligible children with autism.

Opponents say insurance mandates are bad for business owners because it drives up the cost of insurance for their employees.
...
This is the first time the Autism Society of Alabama has used billboards this way, according to executive director Melanie Jones. "It's a grassroots advocacy effort," she said, that started with parents and advocates who wanted to let others in the community understand what not having insurance means for their families. 

.

Alabama Lobbyist v. Autistic Kids

The Politics of Autism includes an extensive discussion of insurance.

At The Alabama Media Group, John Archibald writes about an Alabama hearing on an insurance mandate:

Billy Canary, head of the Business Council of Alabama - who somehow serves as both the mouthpiece and rump roast of the Big Mules - quoted scripture about children as he railed against the bill to help children.

"Children are a gift from God," the verse goes.

It's like Darth Vader himself giving a lecture about the dangers of the Dark Side.

But the lesson - the primer on process and priorities - came when debate tumbled into a hall and Patterson and Canary exchanged words with uncharacteristic honesty.

AL.com's Trisha Powell Crain was there to take it down. Thank goodness.

Canary began with what can only be described as the lobbyist equivalent of "do you know who I am."

Why, he asked, did Patterson dare file the bill without coming to him first?

Holy cow. Why not just make Patterson and every other legislator kiss his ring? We know Canary's a big dog. He -a lobbyist with a paid point of view -- used to have weekly meetings with House Speaker Mike Hubbard to set the Statehouse agenda. That was before Hubbard was convicted of corruption - including charges of soliciting things of value from people connected to the BCA.

But Patterson - bless his heart -- called Canary's BS. Lobbyists typically come to the people who are elected to office, and not the other way around, he said.

That's how it's supposed to work, anyway.

Patterson has no personal reason to help autistic children. It's not a family matter and he's not a bleeding heart. He's sure not a guy out to get the insurance companies. He was asked to sponsor the bill and he never thought he'd do it.

Insurance and Medicaid, March 2017

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

Brianne Pfannenstiel  reports at the Des Moines Register:

The Iowa House of Representatives voted unanimously Wednesday to require that insurance companies cover a treatment for autism that parents say can help provide a better quality of life for their kids.

"Our oldest daughter is autistic," said Rep. Andy McKean, R-Anamosa. "And I can simply say that my wife and I would have very much wished that this legislation was in effect back many years ago."

House File 215 would require insurance companies to cover applied behavior analysis for children with autism if they're issuing health plans to companies with more than 50 employees, or for plans to public non-state employees. Coverage would become available for families with dependents younger than 19 who have been diagnosed with autism spectrum disorder.

Madeleine Hackett  reports at WTVY, Dothan, Alabama:

50,000 families in the Yellowhammer state are affected by autism, yet Alabama is one of only five states that does not require insurance companies to pay for certain treatments.

House Bill 284 is hoping to change that.

It would require private insurers to include coverage of "Applied Behavioral Analysis" (ABA) treatment.

As it stands, families must pay out of pocket for these costly therapy sessions.

It would also require treatments for things like speech and occupational therapy to be covered by insurance companies.

You can ask your state lawmaker to support autism insurance reform.

Chairman Kerry Rich
His email is kerryrich@mclo.org
You can call him at (334)242-7538

Robert Kittle reports at WSPA:

 Parents of autistic children in South Carolina are asking state lawmakers to increase the state’s Medicaid budget that provides autism therapy. Parents, children, and advocates rallied Wednesday at the Statehouse and held signs as state senators came into the Statehouse Wednesday.
...
The problem is that South Carolina pays providers the lowest rate in the nation for that therapy. South Carolina reimburses providers $14.48 an hour for that therapy, compared to $50 in North Carolina. Because of that, South Carolina has a lot fewer professionals who provide that therapy, known as Applied Behavioral Analysis, or ABA. Since there aren’t as many providers, South Carolina has a waiting list of about 1,500 children who need the therapy and can’t get it.
...
Rep. James Smith, D-Columbia, says they’re asking for lawmakers to add at least $10 million to the state budget to increase the reimbursements, which would mean more providers offering that therapy. While it’s difficult to get lawmakers to go along with a budget increase when there are so many things competing for that money, Rep. Smith says it costs the state up to $2.4 million for lifelong care for each child who doesn’t receive the therapy. “The reality is the cost of not spending that money is costing our state far more,” he says.

The House adopted its version of the state budget early Wednesday morning and it did not contain the additional money, so advocates are hoping the Senate will add it.

Sen. Tom Corbin, R-Travelers Rest, says he’ll fight for every dollar he can. His 19-year-old twin sons were born prematurely and were diagnosed with autism. “My wife decided to leave her career teaching school and stay home with our children and see that they got the early intervention and therapies that they need. Does it work? I’m proud to say yes, it works. Both of my sons, through tremendous effort on their part and through early intervention and all the therapists and all the help we received, graduated high school summa cum laude,” he says.

Alabama Mandate Legislation

The Politics of Autism includes an extensive discussion of insurance.  At the Alabama Media Group, Trisha Powell Crain reports on Alabama mandate legislation.

A bill to require insurance coverage for therapy for children with autism faces an uncertain future after the House Insurance committee chair, Rep. Kerry Rich, R-Albertville, this week called for compromise.

But the problem is the two sides couldn't be farther apart. And Rich made no promises that he will bring the bill up for a vote.

HB284, sponsored by Rep. Jim Patterson, R-Meridianville, calls for health insurance coverage for applied behavioral analysis, a type of behavioral therapy that is a primary treatment for children with autism.

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A competing version of the bill, SB57, calls for coverage of the therapy only for children from birth through nine years old and places the administration of the program under the Department of Mental Health. That version would also pulls $3 million from the state's education budget to provide no more than $40,000 of services per child in a given year.

Opponents of SB57 argued the financial burden doesn't belong in the education trust fund, nor should it be administered under a government agency.

According to Autism Speaks, 45 states cover behavioral therapy for people with autism. It is the primary therapy for children with autism and is as essential to treating autism as insulin is to treating people with diabetes.

Ashlie Walker, a board-certified behavior analyst, employs 24 certified behavioral analysts who work in Alabama, and calls the battle against HB284 "a war on kids with special needs."

Michael Wasmer with Autism Speaks said the cost to provide coverage was around 50 cents per member of the involved insurance pool. But Blue Cross and Blue Shield of Alabama lobbyist Robin Stone spoke in total costs of millions of dollars.

Wasmer said Stone's projections were faulty because they were based on the assumption of maximum usage of behavioral therapy, because not all children with autism need behavioral therapy, and those that do would not require maximum usage.

Even children with autism who need maximum therapy only need that level of usage for three to five years, Wasmer said.

Once a child with autism starts school, if a determination is made that behavioral therapy is necessary, schools shoulder the cost. Ultimately, that means taxpayers are paying for needed therapy that supporters of HB284 believe should be covered by insurance.

Alabama Mandate Bill

The Politics of Autism includes an extensive discussion of insurance.

At Decatur Daily, Mary Sell reports on an Alabama insurance mandate bill:

The chairman of the House Insurance Committee wouldn’t commit today to a future vote on a bill to require insurance coverage for an expensive therapy treatment for autistic children.

Parents at a public hearing this morning begged for help for their children, their voices cracking as they described their children’s needs and the challenges of paying out-of-pocket for the therapy. Business leaders and the state’s largest employer said coverage options should be up to employers and compared the proposed mandate to Obamacare.

Committee chairman Rep. Kerry Rich, R-Albertville, said he wanted both sides of the issue to work together.

Most insurance in Alabama doesn’t cover applied behavior analysis therapy. House Bill 284 sponsor Rep. Jim Patterson, R-Meridianville, would change that.

At the Alabama Media group, Anna Claire Vollers reports on a statement from an Alabama football coach:

Nick Saban and his wife Terry sent a letter Monday to the Alabama Legislature, urging its members to support HB 284, the Autism Insurance Reform Bill.

"Forty-five US states have laws requiring health insurance coverage for autism therapies," they wrote in the letter. "We are asking you to assist these families to get the help they need for their children and loved ones."