Blue Envelopes in Vermont

 In The Politics of Autism, I discuss interactions between first responders and autistic people.  Some jurisdictions allow autistic drivers to ask for a blue envelope to disclose the driver's diagnosis in case of an accident or traffic stop.  Others have ID cards.

 Jenn Jarecki and Nathaniel Wilson at Vermont Public Radio:

The Vermont Department of Motor Vehicles recently unveiled a new program aimed at easing challenges for autistic drivers and the law enforcement officers who engage them.

Some autistic people experience the senses more intensely than neurotypical people: flashing police lights, for example. And there can be differences in communication, which can lead to behaviors being misinterpreted.

The DMV’s Blue Envelope Program is designed to make routine traffic stops feel safer and less stressful.

Vermont Public's Jenn Jarecki was recently joined in-studio by Vermont Department of Motor Vehicles Commissioner Wanda Minoli to learn more about the program. This interview was produced for the ear. We highly recommend listening to the audio. We’ve also provided a transcript, which has been edited for length and clarity.

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Jenn Jarecki: I understand that other states have similar programs, like neighbors in Connecticut and Massachusetts, to name just a couple. How much influence did that existing work have on what's ultimately been rolled out here in Vermont?

Wanda Minoli: Well, for us, we used the other states' model of the envelope and started there. Don't reinvent the wheel. If there's a successful program out there, then, you know, state to state, we try to model. And that's really, really important because when you think about this program, and you think about our residents and our New England states, we don't drive just in Vermont. We may take a vacation to Maine, we may be traveling to Massachusetts for something, and you possibly could be stopped roadside. And what we have now is consistent messaging for all law enforcement, and that applies for people driving into our state. So, when they hand the blue envelope over, all law enforcement is aware. They know exactly what they're getting and what this document means, and that's really important, too.

Editorial Boards v. Anti-Vaxxers

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

Outbreaks of preventable diseases have given editorial boards an opening to debunk the autism-vaccine notion.

St. Louis Post-Dispatch:

People opt out of vaccinations for various reasons. Some, like President Donald Trump, fear vaccines cause autism (they don't, as now-Health and Human Services Secretary Ben Carson tried to explain to Trump during a 2016 campaign debate). Others worry about various ingredients found in some vaccines, like aluminum (none of these are dangerous). Another group protests on religious grounds.

It's tempting to say government shouldn't force people to get vaccines, and that people deserve the freedom to make their own choices about vaccines. But those who forgo vaccinations aren't just making choices for themselves; they're making choices for the vulnerable populations that rely on herd immunity.

Burlington Times-News:

 As it is with other immunizations, rumors and incorrect information about this and many other vaccines have spread across the country, especially on social media. One of the leading misinformed theories is that the vaccines can cause autism. The initial research was found to be fraudulent and subsequent testing has thoroughly debunked the claim. Yet it has taken on a life of its own, gaining adherents and causing outbreaks of illnesses that had nearly been eliminated.

Asheville Citizen-Times:

Even more disturbing are those who base their opposition to immunization on the quack science that has been making the rounds on the Internet. The most noted example is the claim of a link between the measles-mumps-rubella vaccine and autism.

That claim was made in a 1998 British paper so poorly done that it later was retracted by its publisher. At least 12 follow-up studies have shown no link whatsoever. Nevertheless, a lot of people continue to oppose the MMR vaccine based on the original study.

That is sad, but it shouldn’t be surprising given the growth of anti-science attitudes in our society. The idea of subjecting ideas to rigorous testing is rejected to favor of saying something and assuming it to be true.

RFK Jr. Compares Vaccines and Cigarettes

At ThinkProgress, Sam P.K. Collins reports:

As Vermont lawmakers mull over the elimination of the state’s philosophical exemption for vaccines, a member of an American political dynasty is making a case for keeping them in place, arguing that the Centers for Disease Prevention and Control (CDC) has become a complicit partner in the spread of lethal substances.

Robert F. Kennedy, Jr., son of the former U.S. senator, attorney general, and presidential candidate, told state lawmakers that while he supports vaccination policies, some of the vaccines contain thimerosol, a mercury-based compound that could harm children.

However, those assertions — particularly the 1998 paper that said a vaccine-autism link exsisted — have been debunked. The CDC, American Academy of Pediatrics, and the Institute of Medicine, say that no evidence supports the view of some that Thimerosol causes autism and other brain disorders. In the 1990s, the Food and Drug Administration recommended its removal from vaccines given to infants as a precautionary measure despite the release of a report that dispelled any notion that the substance was harmful.

Vaccines have been effective in the near-eradication of many infectious diseases — including smallpox, polio, hepatitis A, tetanus, and varicella. Last month, a group of public health organizations announced that rubella had been eliminated from the Americas after 15 years. This happened due to the availability of the shot that protects against measles, mumps, and rubella (MMR).

During his testimony before the Vermont House Health Care Committee, Kennedy derided the CDC’s oversight process and said the agency has acted as a puppet of pharmaceutical companies, buckling under the pressure of highly influential pharmaceutical companies.

“You could design an epidemiological study that shows that cigarettes don’t cause cancer or sex didn’t cause pregnancy,” Kennedy said. “You just get rid of all the pregnant people or you get rid of all the people who have cancer and then you present your study,” he said. “That’s what CDC has been doing with these nine epidemiological studies that they point to.”

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Despite their platform, anti-vaxxers don’t represent the sentiment of most Americans. A poll conducted by C.S. Mott Children’s Hospital earlier this year showed that more than 80 percent of parents believed that all children in daycare should be up to date on vaccines. Anti-vaxxers faced scrutiny after a measles outbreak among people who visited Disneyland earlier this year affected nearly 200 people over the course of three months. A study later confirmed that those who were infected had vaccination rates well below the recommended threshold, putting thousands of people at risk with just one sneeze.

Insurance Action in Louisiana, Vermont, and Alabama

In Baton Rouge, Louisiana, The Advocate reports:

More children with autism spectrum disorders would be able to get health insurance coverage under legislation that sailed through the Louisiana House on Tuesday.

The House voted 96-0 for the legislation and gave bill sponsor state Rep. Franklin Foil, R-Baton Rouge, a round of applause after the vote. Seventy state representatives joined as coauthors of the House Bill 771.

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Foil’s measure would expand the mandatory coverage in current law for coverage of diagnosis and treatment of autism spectrum disorders. He said he is trying to provide some additional relief to parents faced with the cost of expensive therapies and children in need of care.
HB771 would raise from age 17 to age 21 the age for mandatory coverage and eliminate a lifetime maximum benefit of $144,000. The legislation would also extend the mandatory coverage to any plan issued to an employer with 50 or fewer employees. The new requirements would go into effect Jan. 1, 2014.

Foil said the current mandated coverage had been estimated to increase policy costs by $1.25 per month. The actual cost turned out to be 29 cents per month. He said the expanded coverage would add only 2 cents a month.

Autism Votes reports:

The Vermont Senate completed legislative action on a bill that would broaden the state's 2010 autism insurance reform law to cover more children and young adults and sent it to Governor Peter Shumlin for his signature. The bill, S.223, is one of several in the nation to expand existing autism insurance benefits and the first to be voted out of a state legislature. Similar bills are moving in Louisiana and Kansas.

Sponsored by Senator Anthony Pollina (D-North Middlesex), the bill would require coverage for the screening, diagnosis, testing and treatment of childhood development disorders, including autism, from birth through age 21. Under existing law. those benefits are limited to children aged 18 months through six years old.

Coverage includes state-regulated private indivdual and group health insurance plans, as well as Medicaid, the Vermont health access plan, or any other public health care assistance program. The Medicaid and public health plan provisions would take effect July 1; the private health plan coverage would begin October 1.

The bill also requires the Agency of Human Services, in consultation with Autism Speaks and health insurers, to assess whether eligible individuals are receiving evidence-based services, how the services could be improved, and their fiscal impact by January 15, 2014.

Alabama Live reports:

Alabama lawmakers gave final approval today to a watered-down version of legislation aimed at getting more insurance coverage for autism treatment.

The House of Representatives voted 96-0 for the bill, sending it to the governor for his signature.

The legislation requires insurance companies to offer coverage for the treatment of autism, including for a costly behavioral therapy that now is rarely covered. Businesses could choose whether to offer the coverage as part of their insurance options for employees.

An original version of the bill would have mandated the coverage, but the sponsor said he did not have the votes to get that passed.

"It's one more step down the road for providing benefits and better opportunities for those on the autism spectrum in Alabama," said sponsor Sen. Cam Ward, R-Alabaster. "Obviously it's not everything we wanted, but it's definitely still moving it forward."

Insurance Developments in West Virginia, Vermont, Missouri, and Virginia

At West Virginia Public Broadcasting, Adam Cavalier reports:

Kanawha County Democrat Mark Hunt told lawmakers that insurance companies such as Blue Cross Blue shield are not honoring a bill that is supposed to provide insurance coverage for behavorial therapy for these children. Hunt took his anger to the floor Thursday to talk about his own son who has autism.

“It’s already too late for my son,” Hunt said. “My son is where he is, my son will never be self sufficient. Now my wife is 10 years younger than me, and thank God for that, because when I die, there’s going to be at least 10 more years where someone is going to take care of my son. That he won’t be cold and hungry, he’ll be able to make the right decisions. While my son may be high functioning and can read and write – he goes to school everyday – if left to his own devices, he’d play video games all day and not eat. We have to tell him when it’s time to eat.”

House Bill 4260 cleans up the autism bill passed during the 2011 regular session. It was passed unanimously by the house judiciary committee yesterday. It heads to the house finance committee. The bill clarifies that evaluation of autism is to be covered by insurance companies.

AP reports on Vermont:

Some Vermont lawmakers are joining with advocates for people with autism to urge passage of a bill that would require private health insurance to provide coverage for treatments for people with autism.

It's already required for children up through the age of 6. The Legislature would expand that coverage to those older than 6.

Claudia Pringles of Montpelier said at a news conference Wednesday that programs for her 12-year-old daughter with autism stop at the end of the school day, because she can't afford the out-of-pocket expense for after-school tutoring and counseling.

Sen. Anthony Pollina of Washington County and Rep. Jason Lorber of Burlington also spoke in support of the bill.

The St. Louis Post-Dispatch reports:

Missouri's health insurance costs rose just one-tenth of 1 percent due to a requirement that some Missouri health insurers pay to treat autism, the state Department of Insurance reported Tuesday.

The state said Missourians filed 3,805 claims for coverage and they cost insurers $4.3 million. One out of every 350 people with coverage received autism therapy.

After a long campaign, parents of autistic children convinced the legislature to mandate coverage in 2010, and the mandate began to take efect in January 2011. The insurance industry opposed the bill, as it does most coverage mandates, claiming they raise insurance premiums.

"This report shows good news on two fronts," said John M. Huff, state director of insurance. "First, it shows that the new law has already helped thousands of Missourians. Second, it shows the autism mandate should have minimal impact on health care costs and insurance premiums."

At The Washington Post, Anita Kumar writes of Virginia:

Update at 4 p.m.: McDonnell spokesman Jeff Caldwell said the governor will sign the bill.

The General Assembly has passed a bill — again — to provideinsurance coverage for families with autistic children.

The Senate unanimously passed the bill Monday. The bill has already overwhelmingly passed the House of Delegates. It will now head to Gov. Robert F. McDonnell (R) for his signature.

McDonnell already signed a bill into law last spring mandating coverage, but Attorney General Ken Cuccinelli (R) determined that the legislation contained imprecise language that legislators needed to correct.

Since then, families who expected insurance coverage have continued to pay out of pocket — if they can afford it — or forgo treatments they say could help their children learn basic skills such as walking and talking.

Insurance Mandate: Vermont, Missouri, North Carolilna

AP reports:

Vermont lawmakers have approved a bill requiring health insurance companies to cover some therapies used to treat autism.

The bill applies to children with autism who are between 18 months and 6 years old. It calls for a study to determine whether a similar insurance mandate should apply for coverage of older children.

Autism is a complex biological condition that affects a person's ability to communicate and develop social relationships, and is often accompanied by behavioral challenges.

One mother of a 6-year-old with autism told lawmakers her family had been spending $30,000 a year on therapy for her son — a cost that would largely be covered by health insurance under the bill.

AP reported on Friday about another state:

Some health insurers would be required to cover as much as $45,000 annually of intensive therapy for autistic children under legislation passed yesterday by the Missouri Senate.

Some parents of autistic children, who have lobbied for several years for an insurance mandate, expressed hope that lawmakers finally have hit upon a version that can reach the governor’s desk by next Friday’s end of the legislative session.

The Senate’s 27-6 vote sends the bill back for final approval to the House, which passed a version with lower coverage caps earlier this year.

WFMY reports on North Carolina: