NBC Report on CARD and Private Equity

The Politics of Autism includes an extensive discussion of autism service providers.  Private equity firms now own many of them.   After its purchase by Blackstone, the Center for Autism and Related Disorders went bankrupt.

At NBC, Gretchen Morgenson reports: 

Many of the companies swarming the autism services industry are backed by private-equity firms. These entities use borrowed money to buy companies they hope to sell quickly for more than they paid. The industry has taken over a vast array of health care businesses in recent years, even as research has shown that patient care declines at some entities run by private-equity firms. A recent study by academics at Harvard University and the University of Chicago, for example, found that patients at hospitals owned by private-equity firms experienced far more infections and falls. And on March 5, the Federal Trade Commission and Department of Health and Human Services announced an inquiry into private equity and other corporate takeovers of healthcare entities to understand how the transactions might “increase consolidation and generate profits for firms while threatening patients’ health, workers’ safety, quality of care, and affordable health care for patients and taxpayers.”

Among buyouts of autism services companies from 2017 to 2022, 85% were done by private-equity firms, according to Rosemary Batt, a professor at Cornell University’s School of Industrial and Labor Relations. With Eileen Appelbaum, co-director of the Center for Economic and Policy Research, Batt co-wrote a study: “Pocketing Money for Special Needs Kids: Private Equity in Autism Services.” The research estimates that some 135 private-equity firms invested in for-profit companies providing ABA therapy. Because these companies are private, it is difficult to determine the total market share the firms control in autism services, but the top 12 private-equity-backed companies employed 30,000 people and controlled almost 1,300 locations nationwide, Batt and Appelbaum found.

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For ongoing CARD customers, things seem to be improving. The company’s founder, Doreen Granpeesheh, bought back most of its operations last August. A psychologist and board-certified behavior analyst, she told NBC News she’s dedicated to reviving the company’s services.

Doreen Granpeesheh Gets CARD Back

 The Politics of Autism includes an extensive discussion of autism service providers.  Private equity firms now own many of them.  There are critics.

Dietrich Knauth at Reuters:

The Center for Autism and Related Disorders, which operates 130 treatment centers in the U.S., received bankruptcy court approval on Wednesday to sell itself back to its founder for $48.5 million.

The Nevada-based company, which is majority-owned by private equity firm Blackstone (BX.N), filed for bankruptcy in June, saying its business had suffered from higher labor costs, unprofitable long-term contracts with government and commercial healthcare providers, and a long-term shift to telehealth services.

U.S. Bankruptcy Judge David Jones approved the sale at a court hearing in Houston, Texas, saying he was "pleasantly surprised" the company's bankruptcy auction had managed to drive up the sale price from an initial $25 million bid.

"This is an important asset," Jones said. "Not only does it provide jobs and fill a spot in the market, it also provides a very valuable service to a segment of our population that needs help."

CARD Closures

 The Politics of Autism includes an extensive discussion of autism service providers.

Laura Lovett at Behavioral Health Business:

The Centers for Autism and Related Disorders (CARD) is shutting down – or has already halted – operations in 10 states.

Backed by private equity firm Blackstone, CARD is one of the largest autism providers in the U.S. At the end of 2021, CARD was operating in 24 states across the country and had 221 locations. Following these closures, it will operate in 14 states.

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The company was acquired by Blackstone, whose investments also include virtual behavioral health provider Ginger and consumer genomics giant Ancestry.

The decision to pull back in certain markets comes after key CARD leadership changes. In February, Jennifer Webster came on board as CEO to replace Tony Kilgore, who resigned for undisclosed reasons.

CARD is just one of the many autism providers downsizing.

Looking at the autism space overall, investors and ABA providers grew national platforms as quickly as possible to try to gain market share and leverage in payer rate negotiations. Throughout 2022, some of these companies were forced to cut back operations to match economic realities in local employment markets and limited reimbursement increases.

Critical View of ABA and Private Equity

  In The Politics of Autism, I write:

As long as government funds so much research, politics will shape the questions that scientists ask and determine the kinds of research that receive funding.  Politics will even influence which scientists the policymakers will believe and which findings will guide public policy. In the end, science cannot tell us what kinds of outcomes we should want.  ABA “works” in the sense that it helps some autistic people become more like their typically developing peers.  Most parents regard such an outcome as desirable, but not all people on the spectrum agree.  

The book also includes an extensive discussion of autism service providers.

 Ariana Cernius at Fortune:

Private equity has shown initiative in its jump into autism services in recent years–a move that acknowledges the support autistic individuals and their families need.

In 2018, Blackstone acquired the Center for Autism and Related Disorders, the world’s largest autism therapy provider. Similar acquisitions by other firms soon followed.

In their efforts to streamline responsive services for this population, investors and others within and outside of the autism community should be aware of the paradigm shift happening around autism services as new evidence emerges, and particularly Applied Behavior Analysis (ABA) therapy, one of the main interventions for the disability.

ABA has been in my family’s life since my younger brother was diagnosed at the age of four in the 1990s, and I was about six years old. It is based on theories of behaviorism and operant conditioning, and is known as the gold standard by many in the caregiver and professional community.

However, several factors in recent years have compelled me to break away and try to shed some light on a troubling dynamic that exists in this space–and elevate the voices of those who have been hurt by ABA, in the hopes that others in both the professional and consumer communities will listen.

Last year, I retracted an article I wrote as a law student in a Harvard law journal, which gave a history of how health insurance came to provide coverage for ABA and argued for expanded access to coverage throughout the U.S.

The process of writing the initial article brought me into contact with several parent advocates and professionals in the community who then invited me to work with them as they launched a new organization centered around litigating to improve access to autism services, and primarily ABA, throughout the nation.

At the time, I didn’t realize the set of experiences I’d have over the next few years would be as significant and perspective-altering as they turned out to be.

Private Equity Investment in Autism Services

 The Politics of Autism includes an extensive discussion of autism service providers.

The Private Equity Stakeholder Project has a report titled "The Kids Are Not Alright: How Private Equity Profits Off of Behavioral Health Services for Vulnerable and At-Risk Youth." 

 In the last several years private equity investment in autism services, particularly in providers of Applied Behavior Analysis (ABA) therapy, has substantially increased. While a handful of private equity investments in autism occurred earlier, 2017 and onwards have seen a flurry of private equity acquisitions.134 For example, in 2018 The Blackstone Group acquired the Center for Autism andRelated Disorders, with close to 2,000 employees, for a reported $700 million. It was reportedly the largest single autism provider deal in history.135 The year before, FFL Partners bought Autism Learning Partners (3,600 employees) for $270 million.136 In 2019 Gryphon Investors acquired LEARN Behavioral, (3,400 employees),137 and in July 2021 Cerberus Capital Management acquired Lighthouse Autism Center from Abry Partners for over $400 million.138

Because private equity investment in autism services is relatively new, little is known about what it means for quality of care. However, the profit-seeking tactics seen in private equity’s ownership of other behavioral health services, particularly in intellectual and developmental disability services, raises concern for how the business model will impact autism services.

• 134 Pitchbook, accessed November 2021. 
• 135 Bailey Bryant, “Bolstered by Recent Tech Investments, CARD Gears Up for Growth in 2021,” Behavioral Health Business, October 22, 2020. https://bhbusiness.com/2020/10/22/bolstered-by-recent-tech-investments-card-gears-up-forgrowth-in-2021 
• 136 “FFL Partners seals $270M SBO,” Pitchbook, December 22, 2017. https://pitchbook.com/newsletter/ffl-partners-seals270m-sbo 
• 137 Aimen Hakim, “Gryphon Investors acquires majority stake in LEARN Behavioral,” S&P Global Market Intelligence, March 20, 2019. https://www.spglobal.com/marketintelligence/en/news-insights/trending/ifu2YjUfC-Y8bqIYXsJlUA2 
• 138 Sarah Pringle, “Cerberys buys Abry’s Lighthouse Autism Center in $200m-plus deal,” PEHub, July 22, 2021. https:// webcache.googleusercontent.com/search?q=cache:kpxncoJPWC4J:https://www.pehub.com/cerberus-buys-abrys-lighthouse-autism-center-in-400m-plus-deal/+&cd=3&hl=en&ct=clnk&gl=us

 

Private Equity and Autism

 The Politics of Autism includes an extensive discussion of autism service providers.

John Summers at The Nation:

The private equity industry is now making a play for this lucrative market. Blackstone acquired the Center for Autism and Related Disorders for a reported $700 million in 2018. The next year, Rothschild acquired New England ABA. Civitas Solutions, LEARN Behavioral, and Autism Learning Partners have been operating in Massachusetts as subsidiaries of other private equity firms since 2017. How have these acquisitions influenced the quality of clinical care? How many more agencies are courting investments?

We may learn the answers only after it is too late to refine the questions. Carolyn Kain, executive director of the Massachusetts Autism Commission, told me that “some discussion” has alighted on the issue. The Autism Commission is charged by statute to make policy recommendations in this area. “To be honest with you,” Ms. Kain replied to my inquiry, “I don’t have a lot of experience, information, or knowledge about private equity firms purchasing autism organizations. It was something that was raised, but there hasn’t been any further examination.” The trend has not attracted interest from researchers either. A 2019 editorial on “Private Equity Investment in Behavioral Health Treatment Centers” in JAMA Psychiatry, a journal of the American Medical Association, found “no peer-reviewed literature” on this subject. A handful of articles and papers report that agencies acquired by private equity employ under-trained, unlicensed therapists and engage in serial abuse. Those impressions appear to comprise the extent of disinterested knowledge.

In the ABA field itself, the private equity prospect evokes stronger feelings. I spoke with Vincent Strully, founder and president of the nonprofit New England Center for Children (NECC), a leading ABA agency provider. With an annual operating budget north of $100 million, NECC’s services include early intervention, day schooling, residential treatment, and professional training. NECC operates 65 “partner classrooms” in New England’s public schools, where ABA is the exclusive service model. For all these reasons, private equity has been circling NECC for years. “It’s running wild,” Strully laments of the private equity “craze.” Rather than joining established agencies, he told me, autism entrepreneurs in Massachusetts are striking out on their own, reaching $10 million in annual revenue, and then “recapitalizing” their organizations for venture capital’s bigger bucks. The investors are expecting a 15 to 20 percent return in five to eight years. “My advice to everyone involved is: ‘Don’t do it,’” Strully opined. “I think inevitably it is incompatible with quality service delivery. I think it is a mistake.” Strully declines to take what he regards as a radical leap. He foresees the current boom will crash when insurers balk and venture capitalists recalculate and realize they have overpaid.

“It’s astounding to me that you can become a multimillionaire behaviorist.” That is Dr. Paul A. Dores, a psychologist and behavior analyst in practice for 50 years, answering my further query. Dores worked as a behaviorist for many years in Massachusetts, concerning himself with ethics, before moving his practice to California. He points an accusing finger at a misalignment between the mechanisms of payment and treatment. “In the autism field,” he told me, “the people who are paying the money are separated from the people evaluating the results, and the ones connected to the results don’t always know good results from bad results. And so the feedback loop that would normally tell you, if you are bad at what you do, you should be out of business—that’s broken. There’s not enough accountability, and there’s more work than there are people to do it, and as a result we have a lot of really bad behavior analysis that’s going on while the people doing it are getting rich.”

CARD Opens Adult Center for Excellence

In The Politics of Autism, I discuss challenges and opportunities facing autistic adults.

A release from the Center for Autism and Related Disorders (CARD):

Center for Autism and Related Disorders (CARD) has opened its first CARD Adult Center of Excellence (ACE), expanding its reach and reaffirming its commitment to serving the individuals with autism throughout their lives. The new center will provide a unique, positive learning and training environment for teens and adults with autism spectrum disorder (ASD). As with its over 200 existing treatment centers, CARD ACE will deliver top-quality, evidence-based behavioral health treatment while also providing an age-appropriate space that focuses on social, leisure, adaptive, and independent living skills.

In addition to traditional clinic rooms for center-based services and parent/caregiver support, and a communal room for social skills training, CARD ACE features a mock kitchen, bedroom, laundry room, and office for independent, adaptive, and vocational skills development.

“We are excited to open the doors to the CARD Adult Center of Excellence to the autism community in Southern California,” said CARD Adults program manager Vanessa Alvarez. “This new location will provide invaluable services and resources to those who need a more mature setting to develop the skills that will help them increase their independence and pursue their social and vocational goals.”

“The Adult Center of Excellence is a natural progression for CARD, just as our CARD community will naturally graduate from adolescence to young adulthood,” added Doreen Granpeesheh, PhD, BCBA-D, founder of CARD. “We realize that navigating the unique challenges of autism does not end with childhood, and we are honored to be there with our patients as they grow and gain the skills that support them in adulthood.”

The center is located at 931 Buena Vista Street, Suite 200, Duarte, CA 91010. For more information, please contact CARD Adults program manager Vanessa Alvarez at v.alvarez(at)centerforautism.com.

About Center for Autism and Related Disorders (CARD)

CARD treats individuals of all ages who are diagnosed with autism spectrum disorder (ASD) at treatment centers around the globe. CARD was founded in 1990 by leading autism expert and licensed psychologist Doreen Granpeesheh, PhD, BCBA-D. CARD treats individuals with ASD using the principles of applied behavior analysis (ABA), which is empirically proven to be the most effective method for treating individuals with ASD and recommended by the American Academy of Pediatrics and the US Surgeon General. CARD has over 200 locations throughout the United States. For more information, visit http://www.centerforautism.com

Medi-Cal and Behavioral Health Treatment

In The Politics of Autism, I discuss state Medicaid services for people with intellectual and developmental disabilities

A release from CARD:

Center for Autism and Related Disorders (CARD) welcomes the announcement from the State of California's Department of Health Care Services (DHCS) that Medi-Cal will cover behavioral health treatment, including applied behavior analysis (ABA), regardless of an eligible beneficiary's diagnosis. Earlier this year, DHCS announced that Medi-Cal enrollees under 21 whose diagnosis may benefit from ABA, as determined by a physician or psychologist, have access to behavioral health treatment.

"ABA has been shown to be effective in the treatment of many diagnoses, such as substance use disorder, Down Syndrome, and eating disorders, to name a few," said Michelle LaBruzzi, MA, BCBA. "We are looking forward to expanding the families we can help in addition to those in the autism community."

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"We are happy to see California take the lead in expanding access to applied behavior analysis for our Medi-Cal community," said Doreen Granpeesheh, PhD, BCBA-D, founder of CARD.

In addition to traditional 1:1 intensive ABA programs, CARD offers focused ABA programs and several targeted programs, including feeding, pill swallowing, social skills groups, short and long-term treatment of severe problem behavior, and more focused parent training. Parents and caregivers are encouraged to participate in parent/caregiver training, which is available during non-traditional work hours and online

Blackstone Acquires CARD

The Politics of Autism includes an extensive discussion of autism service providers.

An April 13 release from Blackstone:

Blackstone (NYSE: BX) announced today that private equity funds managed by Blackstone have agreed to acquire the Center for Autism and Related Disorders, LLC (“CARD”), a leading provider of autism behavioral health services for children and adults affected by autism spectrum disorder. CARD Founder and CEO Dr. Doreen Granpeesheh and CARD management will invest alongside Blackstone in the transaction.

CARD offers center, school, and home-based behavioral therapy nationwide to children and adults diagnosed with autism. The company delivers rigorous clinical quality and positive outcomes through a highly credentialed and well-trained workforce of behavior analysts and behavior technicians, high engagement with patients and their families, proprietary software for treatment planning and ongoing monitoring, and an evidence-based, individualized approach to treating each child or adult. Dr. Granpeesheh will continue to lead CARD along with members of her experienced management team.

Bruce McEvoy, Senior Managing Director at Blackstone, said, “Dr. Granpeesheh has built an industry-leading provider of behavioral therapies for autism. We are thrilled to have the opportunity to partner with Dr. Granpeesheh and the rest of her visionary management team and look forward to supporting the company as it continues to expand access to treatment and services for those affected by autism.”

Dr. Granpeesheh, Founder and CEO of CARD, added, “We are proud of the high-quality services we provide and our commitment to helping individuals affected by autism achieve their full potential. Partnering with Blackstone will enable us to dramatically enhance our ability to serve the autism community through increased investments in people, clinics, technology, and research.”

The transaction is expected to close later this year. Blackstone was advised by Kirkland & Ellis LLP and Cain Brothers, a division of KeyBanc Capital Markets. CARD was advised by Nevers, Palazzo, Packard, Wildermuth & Wynner, PC, and Berkery Noyes.

California Governor Signs Bill to Make ABA More Available

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

A release from the Center for Autism and Releated Disorders:

California Governor Jerry Brown has signed Assembly Bill 1074, a bill authored by Assembly Member Brian Maienschein (R- San Diego) and co-sponsored by California Association for Behavior Analysis (CalABA) and the Center for Autism and Related Disorders (CARD). The bill received overwhelming support from both the California Assembly and Senate.

AB 1074 makes critical updates to California’s autism mandate, already regarded as one of the strongest in the nation. In addition to technical changes, AB 1074 removes the requirement for autism treatment professionals to be vendored with a state regional center and clarifies that evidence-based autism treatment includes clinical case management. Additionally, the bill removes a 6-month experience requirement for paraprofessionals who work one-to-one with individuals affected by autism spectrum disorder (ASD), a requirement that has limited the capacity of California’s autism treatment providers to meet the needs of California’s autism community.

“I’m gratified to have had the opportunity to increase access to treatment for individuals affected by autism. This bill clarifies California’s autism mandate to ensure behavioral health providers are not hindered by outdated requirements,” said Assembly Member Maienschein.

The bill’s co-sponsors worked together with Assembly Member Maienschein to identify how to increase access to evidence-based autism treatment without jeopardizing treatment quality or consumer safety.

“We are so thankful for Assembly Member Maienschein’s dedication to California’s autism community. AB 1074 ensures that individuals affected by autism have access to medically necessary treatment and that providers can increase their capacity to provide services without diluting treatment quality,” said Doreen Granpeesheh, Ph.D., BCBA-D, executive director and founder of CARD.

California is home to more autism treatment providers than any other state; yet, individuals diagnosed with ASD often encounter delays and waiting lists when seeking medically necessary treatment.

About California Association for Behavior Analysis (CalABA)
California Association for Behavior Analysis (CalABA) is the professional membership association representing behavior analysts in California. CalABA is dedicated to advancing, promoting, and protecting the science and practice of behavior analysis. For more information, visit http://www.calaba.org. 

About Center for Autism and Related Disorders (CARD)
CARD treats individuals of all ages who are diagnosed with autism spectrum disorder (ASD) at treatment centers around the globe. CARD was founded in 1990 by leading autism expert and clinical psychologist Doreen Granpeesheh, PhD, BCBA-D. CARD treats individuals with ASD using the principles of applied behavior analysis (ABA), which is empirically proven to be the most effective method for treating individuals with ASD and recommended by the American Academy of Pediatrics and the US Surgeon General. For more information, visit http://www.centerforautism.com or call (855) 345-2273.

The Need for Police Training

In The Politics of Autism, I discuss interactions between police and autistic people.   Police officers need training to respond appropriately.  When they do not, things get out of hand.  In the case of Buckeye, Arizona, an officer harassed a young autistic man who was merely stimming.

 As  Jim Pietrangelo writes at Healthline, the Buckeye incident illustrates the need for police training.

Healthline discussed the subject of law enforcement and autism with Elizabeth Rossiaky, a board-certified behavior analyst with the Center for Autism and Related Disorders (CARD).

Rossiaky works one-on-one with children who have autism. She has personal experience observing interactions between law enforcement and those children

“Throughout the country, you’re going to see a spectrum of officers and how they handle those situations involving individuals with autism,” said Rossiaky. “What it really comes down to is education and training.”

“The officers [in some Chicago suburbs] are required to have bachelor degrees,” she added. “They do go through more mental illness training. They go through more de-escalation training.”

However, there’s little to no standardization in levels of education and mental health training for officers throughout the country.

“Some officers have [less education] and receive maybe an eight-hour course on mental health. And that’s about it,” said Rossiaky.

Instead, “they often get way more training on how to physically manage an individual,” said Rossiaky. “That’s where you see an officer approaching a child, not knowing how to handle [them] not responding, and then the child ending up on the ground.”

Like what happened to the Arizona teenager.

“It’s because that’s where their focus lies,” said Rossiaky.

ABA and Autism: Experience Counts

In The Politics of Autism, I write:

Paul M. Shattuck and Anne M. Roux note that large businesses mine “Big Data” to measure performance and improve quality. “We need a corresponding measurement revolution for ASD services, including employment supports. An abundance of opportunities exist for collaborating with community agencies to create practice-based evidence. Scientists with advanced training in measurement and analysis methods are uniquely positioned to be useful in this endeavor.”

A release from Chapman University:

Leading autism treatment provider, Center for Autism and Related Disorders (CARD), announced today a joint study with Chapman University about the effects of variables in treating autism spectrum disorder (ASD). The evaluation provides the most up-to-date, scientifically sound evidence to CARD and other autism therapy specialists in order to provide the best treatment to those with ASD.

CARD and Chapman University analyzed a pool of more than 800 children from ages 18 months to 12 years. Results revealed important determinations in regards to supervision. For example, being a Board Certified Behavioral Analyst (BCBA) and the years of experience an analyst has have a significant direct impact on the autistic individual’s treatment success rate, while increased hours of supervision above the standard ratio and caseload of the BCBA do not. These findings will help guide those who treat individuals with autism better plan, allocate time and direct resources accurately toward treatment plans.

“We are consistently finding that the single most important factor in a child’s treatment outcome is the number of hours of therapy that they have received,” said Dr. Dennis Dixon, CARD’s Director of Research and Development. “What this new study adds is a better understanding of what matters in regards to supervision of treatment. We are now able to improve treatment efficiency while also improving outcomes for every child.”

The study is a collaboration led by CARD’s founder Dr. Doreen Granpeesheh and Dr. Dennis Dixon and Dr. Erik Linstead, Assistant Professor of Chapman University’s Schmid College of Science and Technology. The combined team of CARD and Chapman University proved to be successful in learning more about the best course of action for treating those with ASD.

“It is tremendously exciting to see such impactful work coming from this collaboration between CARD and Dr. Linstead’s team here at Chapman,” said Dr. Andrew Lyon, Dean of the Schmid College of Science and Technology. “The ability to use advanced analytics tools to make better decisions about clinical standards of care is likely to completely transform how we approach healthcare for future generations. With this research collaboration, we see a promising example of this shift in the context of ASD.”
The paper appears in the journal Behavior Analysis in Practice. A link to the full article can be found here: http://link.springer.com/article/10.1007/s40617-016-0132-1
About Center for Autism and Related Disorders (CARD)

CARD treats individuals of all ages who are diagnosed with autism spectrum disorder (ASD) at treatment centers around the globe. CARD was founded in 1990 by leading autism expert and clinical psychologist Doreen Granpeesheh, PhD, BCBA-D. CARD treats individuals with ASD using the principles of applied behavior analysis (ABA), which is empirically proven to be the most effective method for treating individuals with ASD and recommended by the American Academy of Pediatrics and the US Surgeon General. CARD employs a dedicated team of nearly 2,000 individuals across the nation and internationally. For more information, visit www.centerforautism.com or call (855) 345-2273.

Medi-Cal Requirements

In The Politics of Autism, I discuss state Medicaid services for people with intellectual and developmental disabilities.

David Gorn writes at California Healthline:

State officials last week released a draft of criteria for Medi-Cal beneficiaries to get autism therapy and children's advocates called the proposed requirements onerous and a barrier to accessing care.

The Department of Health Care Services released for public review on Nov. 12 a letter to managed care health plans that serve Medi-Cal beneficiaries.

The letter outlines the process for autism diagnosis and rules that need to be met in treating it. According to Julie Kornack, senior public policy analyst at the Center for Autism and Related Disorders, based in Woodland Hills, those requirements are excessive and will impede access to care for many of the estimated 75,000 Medi-Cal kids in California with autism.

"These are the most onerous [conditions] I've seen in the country because of the multi-disciplinary requirements," Kornack said. "For them to create administrative and diagnostic barriers, that's just putting up barriers to people who need services."
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Advocates criticized several specific parts of the guideline, including:

• A lengthy diagnostic assessment needs to be completed for every Medi-Cal beneficiary of autism therapy, even if a child has already been diagnosed;
• The state wants an assessment by a speech pathologist and occupational therapist before treatment can begin;
• Therapy cannot be conducted in a school setting;
• A cap of 40 hours has been proposed for autism services, and any hours spent in school count against those hours; and
• Participating providers need to file a status update every month to managed care plans.

"That's ridiculous," Kornack said, adding that she doesn't know of any other mental health therapy that requires monthly evaluations. "The plans can ask for that information anytime they want," she said. "For them to require monthly reporting, it's just onerous and limiting and it's going to make providers not participate."

California Legislation

A release from California Assemblyman V. Manuel Pérez:

AB 1231 and AB 1232 were heard in Assembly Committee on Human Services, both passing with votes of 6-0. AB 1231 [sponsored by the Center for Autism and Related Disorders (CARD)],authorizes the use of tele-health and tele-dentistry as treatment options within the State’s regional center system for developmental disability services. This will help ensure that Californians with Autism Spectrum Disorder (ASD) and other developmental disabilities have access to the services they require. ASD is the fastest growing developmental disability in California, affecting approximately two-thirds of all new consumers entering the State’s regional center system. As autism prevalence increases, innovative treatment models are needed to increase access to critical intervention services. This is not only beneficial for families living in remote or medically underserved parts of the state, but also because people with ASD experience a range of conditions that can interfere with the delivery of services in a traditional setting. Tele-health and tele-dentistry offer those with ASD the opportunity to interface with professionals in a preferred setting, such as their home or school, accompanied by professionals who can facilitate the interaction.

AB 1232 [sponsored by Autism Care & Treatment Today (ACT Today!)] seeks to ensure that California’s regional center system of developmental disability services is meeting the needs of an increasingly diverse consumer population. According to the “Preliminary Report by the Taskforce on Equity and Diversity for Regional Center Autism Services,” prepared by the Senate Select Committee on Autism and Related Disorders, many California families due to linguistic and cultural barriers lack access to vital behavioral therapy services. The State has had a quality assessment program in place for its regional center system for more than ten years, though it does not collect data on cultural and linguistic competency of services. That means that as the state grows more diverse, it is lacking important information related to the equitable provision and utilization of state services. AB 1232 addresses this critical issue in a cost-effective manner, gathering the data needed to ensure California’s developmentally disabled are being served in an equitable manner.

In The Desert Sun, Pérez writes:

The task force found that many California families — because of barriers related to language, culture, education level and/or where they live — lack access to vital behavioral therapy services. These barriers result in stunning disparities in service delivery. Annual spending in services per child with ASD is one illustration. In Orange County, an average of $16,686 in services is spent per child, whereas in the Coachella Valley the average is $4,920.

The work of the task force has also spurred changes in the service provider community. Among other things, both CARD and ACT Today! have translated parent training modules and outreach materials into other languages, and ACT Today! has launched a website, ACT Today Español. Also, ACT Today! has committed to fund $100,000 in grants to Coachella Valley families who have children with ASD that can be used to defray the cost of treatments, assessments and other necessary expenditures.

These actions enhance the work of dedicated local service providers, such as the Coachella Valley Autism Society of America. They also dovetail with other efforts to improve access to care in the Coachella Valley, such as the Clinton Health Matters Initiative and the California Endowment’s Building Healthy Communities.

Interview with a Military Mom

A number of posts have dealt with active-duty military members and veterans who have family members with ASD.  Autism Live interviews Shannon Strayhorn:

A Story of Recovery

KTLA in Los Angeles reports on CARD and a story of autism recovery. (The station uses the less accurate term, "cure.")

Peter Bell on "Autism Live"

Peter Bell, executive vice president for programs and services at Autism Speaks, appeared last week on "Autism Live," an Internet program from the Center for Autism and Related Disorders.  Among other things, he discussed the group's push for insurance mandates:

Discussion of Scarborough on Autism Live

On CARD's "Autism Live," Shannon Penrod talks about Scarborough, bestowing on him "The Autism Ignorance Award."

 

Training for Los Angeles Educators

A press release from the Center for Autism and Related Disorders:

The Los Angeles Unified School District (LAUSD), the second largest school district in the nation, has selected the Center for Autism and Related Disorders’ CARD eLearning™ program to provide the district with intense training in evidence-based principles of behavioral health treatment for individuals with autism spectrum disorders (ASD). Over 6,000 LAUSD teachers and support staff will participate in the training.

The Center for Autism and Related Disorders, Inc. (CARD) is the world’s largest provider of state-of-the-art, early intensive behavioral intervention for individuals with autism spectrum disorders. In addition to providing treatment for thousands of children worldwide, CARD develops and utilizes technology to increase access to training for professionals who work with individuals who have been diagnosed with ASD. The CARD eLearning™ program (http://www.cardelearning.com) trains educators and other professionals in the principles of applied behavior analysis (ABA), which has been empirically proven to be the most effective treatment for individuals with ASD and is recommended by the American Academy of Pediatrics and the U.S. Surgeon General.

CARD eLearning™ is a 20-hour online training course designed to facilitate effective intervention for children with autism spectrum disorders by equipping users with foundational knowledge in ABA. The training consists of nine video-based training modules which feature online note taking, quizzes, a final exam, and a certificate of course completion.

Studies to Know for an IEP

Dr. Jonathan Tarbox of CARD talks to Shannon Penrod about ABA literature that parents might want to consult before their next IEP meeting.  Here are the studies that he mentions:

• Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.
• Sallows, G., Graupner, T. (2005). Intensive behavioral treatment for autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110, 417-436.
• Cohen, H., Amerine-Dickens, M., Smith, T. (2006). Early intensive behavioral treatment: Replication of the UCLA Model in a community setting. Journal of Developmental and Behavioral Pediatrics, 27, S145-S155.
• Eikeseth, S., Smith, T., Jahr, E., Eldevik, S. (2007) Outcome for Children with Autism who Began Intensive Behavioral Treatment Between Ages 4 and 7. Behavior Modification, 31, 264-278.
• Eldevik, S., Eikeseth, S., Jahr, E., Smith, T. (2006). Effects of low-intensity behavioral treatment for children with autism and mental retardation. Journal of Autism and Developmental Disorders, 36, 211–224.
• Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G., Stanislaw, H. A. (2005). Comparison of intensive behavior analytic and eclectic treatments for young children with autism. Research in Developmental Disabilities, 26, 359–383.
• Eikeseth, S., Smith, T., Jahr, E., Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism: A 1-year comparison controlled study. Behavior Modification, 26, 49-68.
• Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S. (2009)  Meta-analysis of Early Intensive Behavioral Intervention for children with autism. Journal of Clinical Child and Adolescent Psychology, 38, 439-50.
• Eikeseth, S., (2009). Outcome of comprehensive psycho-educational interventions for young children with autism. Research in Developmental Disabilities 30. 158–178
• Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA Young Autism Project model. Journal of Autism and Developmental Disorders, 39, 23-41.

Also see:

• Reichow, B. (2012) Overview of Meta-Analyses on Early Intensive Behavioral Intervention for Young Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 42, 512-20.