Poor Oversight in Minnesota

 In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.   Scams plague the world of autism. Some involve shady or abusive providers.

James Walsh at The Minneapolis Star-Tribune:

To care providers, advocates and parents of children with autism, the development of the Early Intensive Developmental and Behavioral Intervention (EIDBI) health care program in Minnesota is so promising and so long-awaited, it’s no wonder its growth has been explosive.

But because of that surge of interest in the program, which serves people younger than 21 with autism spectrum disorder, and the lack of oversight, advocates and providers weren’t completely surprised by the revelations last week that the FBI is investigating alleged fraud at two — and possibly more — EIDBI centers.

“The state was interested in providing access to needed services [and] equity-based access to long-underserved communities,” said Eric Larsson, executive director of clinical services at Lovaas Institute Midwest in Minneapolis. “And, if everyone follows the rules, there’s no problem. Not everyone followed the rules.”

The program is funded by the state and federal government. Since 2017, the state reported nearly $700 million in Medicaid EIDBI reimbursements. That includes nearly $229 million in 2024 payments through Nov. 27. At the same time, the number of EIDBI providers who diagnose and treat people with autism spectrum disorder has increased from 41 in 2018 to 328 last year.

Last week, the FBI raided St. Cloud and Minneapolis autism centers as part of an investigation it said revealed “substantial evidence” of millions of dollars in fraudulent Medicaid claims. No charges have been filed yet.

FBI Searches Minnesota Providers

 In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.   Scams plague the world of autism. Some involve shady or abusive providers.

J. Patrick Coolican at The Minnesota Reformer:

The FBI served search warrants Thursday at two autism treatment providers, as part of a wide-ranging Medicaid fraud investigation first reported by the Reformer in June.

The search warrants were served at Smart Therapy Center in Minneapolis and Star Autism in St. Cloud.

FBI Special Agent Kurt Beulke wrote in an unsealed warrant application that the state autism program has exploded in both the number of providers and cost in recent years: “The investigation has found substantial evidence that many of these companies have been submitting fraudulent claims for (autism) services that were not actually provided or that were not covered.”

According to the warrant application, employees of Smart Therapy were “18 or 19-year old relatives of the owners who had no formal education beyond high school and no training or certification related to the treatment of autism.” Many of the children did not appear to be autistic, according to a witness. The same witness said they believed parents were being paid to bring their children as part of the scheme.

Both Smart Therapy and Star Autism billed the state even when the provider — who was ostensibly giving treatment to a child on the autism spectrum — was out of the country, according to the warrant.

Back-to-School Measles

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.

CDC:

As of August 29, 2024, a total of 236 measles cases were reported by 29 jurisdictions: Arizona, California, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, New Hampshire, New Jersey, New Mexico, New York City, New York State, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Vermont, Virginia, Washington, Wisconsin and West Virginia.

There have been 13 outbreaks (defined as 3 or more related cases) reported in 2024, and 69% of cases (163 of 236) are outbreak-associated. For comparison, 4 outbreaks were reported during 2023 and 49% of cases (29 of 59) were outbreak-associated.

 Sheila Mulrooney Eldred at Minnesota Public Radio:

A measles outbreak that began in May in Minnesota has spread to 30 people, primarily infecting children in the Somali community. One dugsi, or Islamic religious school, has voluntarily closed in order to curtail the spread, according to the Minnesota Department of Health.

About a third of the patients have required hospitalization, a state spokesperson said. All but one were unvaccinated.

The outbreak brings the state to 36 measles cases this year.

Measles is endemic in many countries, including African countries that Minnesota’s Somali families visit in the summer months. Seven people contracted the respiratory virus from travel, state health officials said.

“So when people who didn’t vaccinate and then travel outside of the country where measles is still existing, they contract it and then it spreads here because we have a close-knit community with big families,” said Sheikh Yusuf Abdulle, executive director of Islamic Association of North America. He has requested that people attending this weekend’s annual convention consider their vaccination status before attending.

“We’re concerned because 36 is a big number,” said Sheyanga Beecher, a certified nurse practitioner in pediatrics at HCMC and medical director of Hennepin Healthcare Mobile Health. “And, school’s around the corner. It’s been spreading a lot in child care centers, areas where people congregate. And next week kids are going to be congregating on buses, in classrooms, in hallways … so it has the potential to increase.”

Meira Gebel and Tina Reed at Axios Portland:

Oregon's recent measles outbreak — one of the largest in the state's history — is refocusing attention on declining childhood vaccination rates as kids head back to school.

Why it matters: Oregon has one of the highest vaccine exemption rates for kindergartners in the country, according to the Centers for Disease Control and Prevention.Studies have found an increased risk of infection from vaccine-preventable diseases, such as measles, which is potentially fatal, among exempt children.

Threat level: There have been 30 confirmed cases of measles in Oregon as of Wednesday, all among unvaccinated individuals. A dozen of those cases are in children under age 10.

Sarah Boden at Spotlight PA:

Preventing the resurgence of measles and other childhood illnesses, like polio, requires nearly universal vaccinations, which isn’t the case in Pennsylvania. During the 2019-2020 school year, the kindergarten vaccination rate for measles was 96.4%, according to data analyzed by the state Department of Health. In 2022-2023, that rate dropped to 94%. If the number of unvaccinated kids creeps further upward, Pennsylvania could face a public health crisis that is entirely avoidable.

 

An Investigation in Minnesota

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.   Scams plague the world of autism. Some involve shady or abusive providers.

Deena Winter at The Minnesota Reformer:

The state of Minnesota is investigating 15 autism providers and has already completed other investigations, withheld payments due to credible fraud allegations and forwarded cases to law enforcement “when appropriate,” according to the Minnesota Department of Human Services.

DHS said in a statement that these investigations “follow a national trend of identifying fraud in Medicaid-funded autism services.” DHS administers Minnesota’s version of Medicaid, known here as Medical Assistance, which is a federal-state health plan for poor and disabled people.

The Reformer reported in mid-June that the FBI is investigating possible fraud in Minnesota’s autism program, which has exploded in growth since launching in mid-2015.

The number of providers — who diagnose and treat people with autism spectrum disorder — has increased 700% in the past five years, climbing from 41 in 2018 to 328 last year. The amount paid to providers during that time has increased 3,000%, from about $6 million to nearly $192 million — according to DHS data.

“DHS has systems in place to identify fraud, waste and abuse, and the agency takes swift action when we suspect or find it,” the agency said in a statement to the Reformer. “Early identification and access to services are life-changing for people with autism – especially children. That’s why it’s so important to make sure every dollar spent on services is accounted for.”

Minnesota doesn’t license autism centers, but DHS is studying the prospect. When autism providers enroll for reimbursement through Medical Assistance, DHS verifies that they have the appropriate credentials. But beyond that, DHS is not out in the field checking in on what’s happening in autism centers.

Antivaxxer Loses in Minnesota

 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.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures.

Steve Karnowski at Associated Press

Democrat Tim Walz won a second term as Minnesota’s governor on Tuesday, fending off a challenge by Republican Scott Jensen, a family practice physician who grabbed national attention with his vaccine skepticism.

Walz led Minnesota through the COVID-19 pandemic -- including lockdowns, school shutdowns and business closures. He also led the state through the unrest that followed the police killing of George Floyd in Minneapolis in 2020. He made his support for abortion rights a centerpiece of his campaign.

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Jensen had a reputation as a sometimes-moderate maverick from suburban Chaska during his one term in the Minnesota Senate. But he veered sharply to the right in the early days of the pandemic, not only criticizing the Walz administration’s response but also flirting with questionable treatments and the anti-vax movement.

Before the election, Geoff Brumfel reported at NPR:

Anti-vaccine proponents used to exist in both Republican and Democratic circles, but the pandemic saw them shift definitively to the political right. It was there that they found allies fighting lockdowns and masks. Republican politicians, particularly on the far right, have eagerly brought anti-vaccine forces into their tent. Anti-vaccine activists appear regularly at some popular right-wing political events, and some politicians have appeared on anti-vaccine shows in recent years.

Among them was Scott Jensen, a Minneapolis-area physician and state senator, who pushed medical misinformation throughout the pandemic. Speaking to anti-vaccine activist Del Bigtree in 2021, Jensen said that hospitals distorted the number of COVID-19 deaths. He has also questioned vaccine safety and pushed ivermectin — a drug that has been proven to be ineffective at treating COVID but continues to be promoted as an alternative therapy in anti-vaccine circles.

 

Antivax Kook Running for Minnesota Governor

 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.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures.

 Andrew Lapin at JTA:

When the Minnesota GOP’s nominee for governor invoked Kristallnacht and Hitler at a recent anti-mask mandate rally, it was a by-now familiar scene: a public figure comparing life under COVID-19 restrictions to the days of Nazi rule.

But on Tuesday, former State Sen. Scott Jensen did something unusual: he doubled down.

“I want to speak to a little bit of a hubbub that’s been in the media lately about whether or not I was insensitive in regards to the Holocaust. I don’t believe I was,” Jensen said in a Facebook video. “When I make a comparison that says that I saw government policies intruding on American freedoms incrementally, one piece at a time, and compare that to what happened in the 1930s, I think it’s a legitimate comparison.”

It was a markedly different approach to a cycle that has continued on repeat since the initial COVID outbreak in 2020: A public figure declaring that mask mandates and lockdown measures, usually instituted by Democrats, have something in common with Nazi policies, before reversing course following pressure from Jewish groups and Holocaust memorial organizations. That was the case with Ohio Rep. Warren Davidson; New York City Councilwoman Vickie Paladino; antivax activist Robert Kennedy Jr.; and others.

But unlike those other figures, Jensen stood by his words, saying, “It may not strike your fancy — that’s fine. But this is how I think, and you don’t get to be my thought police person.”

Jensen, who received more than 90% of the Republican vote in Minnesota’s Aug. 9 primary, was responding to a recording of him at an anti-mask rally in the state in April, where he said that Democratic Gov. Tim Walz’s COVID policies were comparable to Kristallnacht, the “night of broken glass” that heralded the beginning of the Nazis’ antisemitic mass violence.

“If you look at the 1930s and you look at it carefully, we could see some things happening, little things, that people chose to push aside — ‘It’s going to be okay. And then the little things grew into something bigger,’” Jensen said at the rally, in a speech captured on video. “Then there was a night called Kristallnacht — the night of the breaking glass.

“Then there was the book burning, and it kept growing and growing, and a guy named Hitler kept growing in power, and World War II came about. Well, in a way, I think that’s why you’re here today. You sense that something’s happening, and it’s growing little by little.”

The rally was sponsored by Mask Off Minnesota, a group that spreads COVID-19 misinformation. Jensen, a licensed physician, is himself unvaccinated and has made public comments in which he has questioned the efficacy of COVID vaccines and other pandemic policies.

Subminimum Wage Issue in Minnesota

In The Politics of Autism, I write:

Political conflict involves ideas and arguments for which the information is often murky, incomplete, interpretive, and open to manipulation. Just about everything concerning autism is subject to dispute. What is it? What causes it? How many different kinds of it are there? Who has it? What can we do about it? Is it even the right problem to be thinking about? All of these questions, and many others, are the stuff of bitter political battles. The stakes are high: according to one estimate, the national cost of supporting people with autism adds up to $236 billion per year. Of course, such numbers themselves entail controversy. An alternative perspective is that they do not represent the cost of autism, but rather the cost of discrimination against people who have it, and the failure to help them lead independent lives.

Chris Serres at Minneapolis Star-Tribune:

Minnesota would become the fourth state in the nation to prohibit employers from paying people with disabilities less than the state’s minimum wage, under a proposed measure that would phase out the decades-old practice by 2024.

The legislation, which passed a state House committee this week, would force dramatic changes at approximately 100 centers across the state, known as sheltered workshops, that benefit from a loophole in federal labor law that allows them to pay people with disabilities based on their productivity, rather than a fixed hourly rate. In many cases, their pay amounts to just cents an hour for basic tasks, such as packaging merchandise, scrubbing toilets and shredding paper. These state-subsidized workshops, which provide a broad range of support services, employ nearly 10,000 people with disabilities — among the most of any state, according to Minnesota workforce officials.
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Proponents of the legislation maintain that a gradual phasing out of subminimum wages would enable the state to avoid costly sanctions and would give state workforce officials and families time to develop alternative employment options in the community. “Everyone deserves to earn a minimum wage,” said Jillian Nelson, policy advocate for the Autism Society of Minnesota. “But we can’t just kick people to the streets.”

Still, the measure faces vigorous opposition from many parents of people with significant intellectual and developmental disabilities, who fear their adult children will lose support services and have nowhere to go if the local workshops close. In many smaller towns, these parents maintain, the workshops — sometimes called “day activity centers” — are the only option for community engagement and employment. In some rural communities, workshops are also the primary source of transit, shuttling people to and from work and activities in the community.They also provide a vital source of social interaction for people who would otherwise be stuck spending their days at more isolating group homes, parents maintain.

Antivax Lawmakers in Minnesota

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.

Ricardo Lopez at Southernminn.com:

The small but vocal group of parents propagating fringe views about the safety and effectiveness of childhood immunizations have found unlikely allies — Minnesota lawmakers.

Through personal and official Republican Senate media channels on Facebook, as well as appearances at an anti-vaccination rally last year at the Capitol, more than a dozen state legislators in the House and Senate have lent the support of their elected offices to groups that medical professionals say are sowing disinformation about vaccinations. Other Minnesota lawmakers made appearances at a February 2019 event featuring vocal anti-vaxxer Robert F. Kennedy Jr. at the Minneapolis Club.

The Minnesota lawmakers include state Sen. Jim Abeler, R-Anoka, chair of the Senate Human Services Reform Finance and Policy committee, who formed the Minnesota Autism Council, an advisory panel. His decision to appoint two vaccine skeptics touched off criticism, given the 2017 measles outbreak in Minnesota, which was attributed to the work of anti-vaxxers spreading disinformation among the Somali community.

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Kolina Koltai, a researcher at the School of Information at the University of Texas, has been studying the social media behavior of those active in the anti-vaccination movement for five years. In the past two, Koltai said she has detected a shift in partisan ID for those opposed to vaccinations, with Republicans increasingly more likely to sponsor legislation undermining immunizations.

“There’s a politicization of science that is happening,” Koltai said, likening it to the debate over climate-change, in which skeptics include many prominent Republicans who continue casting doubt on the scientific consensus.

Studying Prevalence in Minnesota

The Politics of Autism discusses legislation before Congress.

On Tuesday, the House Energy and Commerce Committee held a hearing on several bills including the reauthorization of the Autism CARES Act.  The testimony of Amy Hewitt, Ph.D. the Director of the Institute on Community Integration, University of Minnesota

The Autism CARES Act has helped to build a critical infrastructure to further advance our understanding of autism. The Autism CARES Act supports several important programs. It supports the Autism and Developmental Disabilities Monitoring (ADDM) Network, a group of programs funded by the CDC to estimate the number of children with ASD and other developmental disabilities living in different areas of the United States. The CDC also established regional centers of excellence for ASD and other
developmental disabilities. They make up the Centers for Autism and Developmental
Disabilities Research and Epidemiology Network (CADDRE) that are working in part to
help identify factors that may put children at risk for ASD and other developmental
disabilities.

Findings from the Minnesota-Autism and Developmental Disabilities Monitoring  etwork (MN-ADDM) helps us to understand more about the number of children with  Autism Spectrum Disorder (ASD), the characteristics of these children, and the age at which they are first evaluated and diagnosed.

This is the first time Minnesota has been a part of the ADDM network, and we are building our geographic area. Through this work, we know that 1 in 42 8-year-old children were identified with ASD in 2014. We now know that boys were 4.6 times more likely to be identified than girls and that there were no significant differences found in the percentage of white, black, and Hispanic children identified with ASD.

The findings in our report reflect a limited number of children concentrated in a large metropolitan area. Through the reauthorization of the Autism CARES Act, we are hopeful that we will be able to increase our scope geographically and include the lifespan of individuals with autism. This is particularly important because in addition to the  race/ethnicity categories routinely studied by CDC, in Minnesota we were interested in understanding prevalence for our local Hmong, Somali and other immigrant populations. Expansion of the geographic area in which we gather data is the only way we will be able to know with certainty if differences exist among these groups in Minnesota.

1. Read the IEP 2. Trust No One. 3. Push Back

In The Politics of Autism, I write about special education and laws that affect students with disabilities, such as the Individuals with Disabilities Education Act.  School districts prevail in most due-process hearings.  Here are some reasons:

School districts have built-in expert witnesses in the form of teachers and staff.  They also have full access to all relevant information about a proposed placement, and often deny parents access to those programs in advance of hearings. When parents’ experts can observe children in class, districts can limit their observations.   More important, parents have to foot the bill for their experts because of a 2006 Supreme Court decision that IDEA does not authorize reimbursement of witness fees. “While authorizing the award of reasonable attorney's fees, the Act contains detailed provisions that are designed to ensure that such awards are indeed reasonable,” Justice Alito wrote for the majority. “The absence of any comparable provisions relating to expert fees strongly suggests that recovery of expert fees is not authorized.” It goes without saying that this decision disadvantages all parents, and especially those with modest incomes. 

At The Albert Lea Tribune, Sarah Kocher reports on an investigation into a Minnesota school district where parents raised concerns about their 18-year-old daughter graduating before she was ready.

Alexa Newman received special education services from Alden-Conger Public Schools since kindergarten. Legally, through a federal law called the Individuals with Disabilities Education Act, students with disabilities are eligible to continue receiving a free public education until they are 21 years old.

Parents Amy and Kory Newman filed a special education state complaint with the Minnesota Department of Education in May alleging the district violated IDEA and at times did not meet Alexa Newman’s individualized education program.

“It’s just unfortunate that you trust somebody … that they’re doing what’s best for your daughter and here to find out it’s like OK, they’re just going through the motions,” Kory Newman said.

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Kory Newman said he took full responsibility for not being engaged in his daughter’s IEP from the time she was in kindergarten all the way through her education.

“We didn’t know better,” Amy Newman said.

That has changed.

“I know more about special education now than I ever thought I would,” Kory Newman said. “I sat up at night reading.”

Amy Newman wondered how many children should have received services past 18 through SMEC and did not because their parents did not fight.

She said the couple is not filing a lawsuit. They have two younger children in the district. Now, they are looking ahead and behind at other families with students in special education. She said she wants other children to get what the law says they are entitled to: special education through age 21.

“We shouldn’t have had to fight this hard,” Amy Newman said. “… In our minds, too many have graduated, gotten their signed diploma and missed out on the opportunities.”

Tight-Knit Communities and Vaccine Hesitancy

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.   This bogus idea can hurt people by allowing disease to spread.

Sumathi Reddy at WSJ:

In 2017 it was a Somali community in Minnesota. In 2014 it was the Amish in Ohio. This year, it is Orthodox Jewish communities in New York and Eastern Europeans in Washington state.

Insular and close-knit religious or cultural groups have seen some of the worst measles outbreaks in the U.S. in recent years.

About 75% of measles outbreaks over the past five years—defined as three or more linked cases—took place in such tightknit communities, says Nancy Messonnier, acting director of the CDC’s Center for Preparedness and Response, and an expert on immunization and respiratory diseases. Such groups share the same culture and are often somewhat isolated from the larger community.

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In Ohio, when a measles outbreak hit an Amish community in 2014, they were willing to get the MMR vaccine when they saw the effect the disease was having, says Michael Brady, associate medical director at Nationwide Children’s Hospital in Columbus. The issue wasn’t the vaccine, he says, but their philosophy of not accepting anything from the government.

In Washington state where a measles outbreak has been contained, advocates and health experts say there is documented vaccine hesitancy in the Ukrainian and Russian-speaking populations.

Tetyana Odarich, a family medicine physician in Portland, Ore., sees many patients from the Ukrainian and Russian community in the area and says roughly half don’t want to get their children vaccinated.

The Cost of Measles Outbreaks

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  The antivax movement has led to outbreaks of measles, which are costly.

Maryn McKenna at Wired:

In 2005, a 17-year-old girl whose family belonged to a church that discouraged vaccination went on a mission trip to Europe. The day after the group arrived home, the church threw a party; 34 attendees caught measles from the teen or from someone she infected. Not including medical care, containing that outbreak cost $167,685. When they analyzed the spending, the CDC and the state health department calculated it had taken 3,650 work hours, 4,800 phone calls, and 5,500 miles of car trips to track the victims down. In 2008, an unvaccinated infected traveler brought measles to a hospital in Tucson; the cost of containing the outbreak, which spread to a second hospital, was almost $800,000.

The numbers can grow much bigger still. Researchers at the CDC estimated that handling 107 cases of measles that occurred in 2011 cost state and local health departments between $2.7 million and $5.3 million. In 2014, 42 people came down with the disease after passing through Disneyland at the same time as a never-identified person with measles—and subsequently infected 90 additional people in California, 14 more in other states, and a further 159 people in Canada. The cost of controlling the outbreak, just in California, totaled almost $4 million. And in 2017, a five-month outbreak of measles in Minnesota infected 79 people and cost the state $2.3 million, infected 79 people and cost the state $2.3 million

Antivaxxers on Minnesota Autism Council

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.

Jessie Van Berkel at the Minneapolis Star Tribune:

The MN Autism Council was formed last fall by Sen. Jim Abeler, R-Anoka, to discuss autism and advise the Legislature on public policy.

Abeler said he wants the group to represent diverse viewpoints and said it will be focused on issues like housing, employment and education, not vaccines.

But some advocates take issue with having people who have vaccine concerns on the council.

Anti-vaccination groups have focused on Minnesota’s Somali-American community in the past as they tried to perpetuate the hoax that vaccines cause autism, contributing to a drop in vaccinations and the largest measles outbreak in the state’s recent history in 2017.

“Even if it’s not something that’s discussed or that a policy is going to come out of, giving them this large contingency on this council is dangerous. It’s giving credence to a theory that’s false,” said council member Noah McCourt, an autism self-advocate who also serves on the Minnesota Governor’s Council on Developmental Disabilities.
...
Two of the more than 30 members on the council are known vaccine skeptics. One of them is Wayne Rohde, who is one of three initial members Abeler picked to help shape the group. Those three selected the rest of the members from a pool of applicants.

Medical Cannibis in Minnesota

In The Politics of Autism, I write:

The conventional wisdom is that any kind of treatment is likely to be less effective as the child gets older, so parents of autistic children usually believe that they are working against the clock. They will not be satisfied with the ambiguities surrounding ABA, nor will they want to wait for some future research finding that might slightly increase its effectiveness. They want results now. Because there are no scientifically-validated drugs for the core symptoms of autism, they look outside the boundaries of mainstream medicine and FDA approval. Studies have found that anywhere from 28 to 54 percent of autistic children receive “complementary and alternative medicine” (CAM), and these numbers probably understate CAM usage

These approaches sometimes include marijuana.

From JD Supra:

On August 1, 2018, some Minnesotans diagnosed with obstructive sleep apnea or autism will be able to use medical cannabis to alleviate symptoms associated with those conditions for the first time. Individuals diagnosed with either condition were eligible to begin the state’s registration and enrollment process on July 1, 2018, for access to medical cannabis beginning one month later. These most recent additions to Minnesota’s medical cannabis “qualifying conditions” list exemplify a significant shift in potential eligibility for medical cannabis. In the early years of medical cannabis, states often restricted eligibility to a short list of very severe conditions. However, several states have since expanded their qualifying conditions lists – meaning that individuals diagnosed with a wide variety of conditions may now be using medical cannabis. This raises a number of issues for employers; schools/childcare providers; and healthcare providers who are increasingly likely to have employees, students, or patients who are using or pursuing medical cannabis.

Official details here. 

Enlisting Muslim Help to Fight the Vaccine Myth

 In The Politics of Autism, I look at the discredited notion that vaccines cause autism.

At The Independent, Andrew Buncombe reports on Minnesota's efforts to improve vaccination rates among the state's Somali population. Measles had erupted after Wakefield convinced Somalis that vaccines cause autism.

“The biggest impact is connecting a condition that is one that challenges any parent who has a child with autism, and connecting that to immunisations, and specifically MMR,” Lynn Bahta, the immunisation clinical consultant with the Minnesota Department of Health (MDOH), told The Independent last summer as it fought to tackle the outbreak.

“Among our Somali American community we have their rates go from 92 per cent, which was higher than non-Somali rates, down to 42 per cent. And that puts them in a very, very vulnerable position.”

To help the state get its message delivered most effectively, officials asked for help from community leaders, in particular imams, who lead prayers at neighbourhood mosques.

Bahta said they told them that the MDOH does not believe that the information being given to them by Wakefield and others was true. She said the community was particularly vulnerable as it already believed there was a higher rate of autism among Somali American boys, something officials in the state say is not supported by data. In the end, more than 30 agreed to help.

“The imams are very concerned about their community and they are very willing to work with us in whatever way they can. They have appreciated the information that we have been able to give them about the outbreak and what they can do as spiritual leaders of the community,” Bahta said.

She said the imams provided officials with direct access to the community. In addition, she said the imams could “bring disease and prevention of disease within the context of their faith. That is something that we don’t have the words for, but they do”.

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One of the imams who was central to the state’s response to the outbreak was Sharif Abdirahman, the Muslim leader at the Dar al Hijrah mosque in the Cedar-Riverside neighbourhood of Minneapolis. He said he was able to appeal to people using both religion and science. He could also appeal as a parent.

“Islam is a religion of expertise,” he said, sat in the second-floor office of the community centre that also contains a mosque.

“Verses in the Quran say ... if you don’t a know subject ask the advice of people who know the subject very well.”

Segregation and Poverty in Minnesota

In The Politics of Autism, I discuss the civil rights of people with autism and other disabilities. 

At the Minneapolis Star-Tribune, Chris Serres reports on Minnesota's Olmstead Plan Quality of Life Baseline Report:

Nineteen years after a landmark U.S. Supreme Court ruling opened the doors to integration, thousands of Minnesotans with disabilities continue to live and work in segregated settings that keep them in poverty and limit their daily autonomy.

These are among the principal findings of the state’s first comprehensive survey examining the quality of life of nearly 50,000 Minnesotans with physical, intellectual and developmental disabilities who spend most of their time in settings such as group homes, nursing facilities and cloistered workplaces known as sheltered workshops.

The survey, released this week, also found wide earnings gaps for Minnesotans with disabilities. People who labor in sheltered workshops and day training programs earned just $3.30 to $3.50 an hour, on average — less than half the earnings of those who worked in more-integrated settings in the community.

People in sheltered workshops were also more isolated socially, mostly limiting their daily interactions to other individuals with disabilities, the survey found.

The findings echo those of a 2015 special report by the Star Tribune, which found that Minnesota is among the most segregated states in the nation for working people with developmental disabilities such as Down syndrome and autism. The series also found that hundreds of people with disabilities are being sent, sometimes against their will, to state-licensed group homes where they live with strangers in settings far from home.

Autism and Medical Marijuana in Minnesota

In The Politics of Autism, I discuss alternative treatments.

From the Minnesota Department of Public Health:

Minnesota Commissioner of Health Dr. Ed Ehlinger today announced the decision to add autism spectrum disorders and obstructive sleep apnea as new qualifying conditions for the state’s medical cannabis program.

“Any policy decisions about cannabis are difficult due to the relative lack of published scientific evidence,” said Commissioner Ehlinger. “However, there is increasing evidence for potential benefits of medical cannabis for those with severe autism and obstructive sleep apnea.”

This year, as in years past, the Minnesota Department of Health used a formal petitioning process to solicit public input on potential qualifying conditions. Throughout June and July, Minnesotans were invited to submit petitions to add qualifying conditions. The process included public comments, a citizens’ review panel and a set of research summaries for each condition prepared by Minnesota Department of Health staff.

Petitioners put forward a total of 10 conditions for consideration this year, including anxiety disorders, autism, cortico-basal degeneration, dementia, endogenous cannabinoid deficiency syndrome, liver disease, nausea, obstructive sleep apnea, Parkinson’s disease and peripheral neuropathy. There were also petitions to add cannabis delivery methods including infused edibles and vaporizing or smoking cannabis flowers. These requests were not approved.

Autism spectrum disorder is characterized by sustained social impairments in communication and interactions, and repetitive behaviors, interests or activities. Patients certified for the program because of autism must meet the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders – 5th edition) for autism. The health department’s autism research brief (PDF) found a growing body of research indicating that the human body’s endocannabinoid system may play a role in autism symptoms. In support of adding autism, the review panel report (PDF) noted the lack of effective drug treatments, the potentially severe side effects of current drug treatments and anecdotal evidence of Minnesota children with autism already receiving benefits from medical cannabis taken for other qualifying conditions.
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Under current state rules, patients certified to have autism or obstructive sleep apnea will be newly eligible to enroll in the program on July 1, 2018 and receive medical cannabis from the state’s two medical cannabis manufacturers beginning Aug. 1, 2018. As with the program’s other qualifying conditions, patients will need advance certification from a Minnesota health care provider. More information on the program’s certification process is available from the Office of Medical Cannabis.