Expect Spin With Autism Mandates

This is to be expected as mandates across the states now start to take effect. “Creative” maneuvering by the insurance companies is going to delay, defer, or deny coverage for ABA as much as possible due to the effect on their bottom line. ABA costs money. A lot of money. Most families in states who have recently passes autism mandates already know this and are going broke providing ABA and other interventions to their children with autism.

This article is not surprising though. Insurance points at the schools and says, “This is a governmental, educational problem.” The schools point at insurance providers and say, “This a medical problem and the insurance companies are responsible.” Unfortunately, parents are left in the lurch.

Gamesmanship will be played full swing as the statistics of autism increase, mandates are put to the continued observance and execution test and providers try to manipulate their insured with lunatic requirements that realistically can’t be met – such as is the case in Michigan.

Having lived in Michigan, I can attest to the shortage of providers and the long waiting lists for services. I can’t imagine how families who qualify for the mandate will jump through the hoops that insurance providers are creating. It is sad as well as disconcerting, and I hope that some semblance of enforcement of plausible terms can be created.

Please click here to read the entire story...

“A state law requiring insurance companies and health plans to pay for treatments for children with autism goes into effect today, but autism advocates and parents say that while the new measure is a significant step, many families may get little, if any, help from the new statute anytime soon.

Michigan has far too few medical professionals who offer the specialized therapy autistic children require, they say, and some insurers appear to be setting conditions that could make autistic children and their families wait many months for help — if they get it at all.

In the meantime, families with autistic children either go without the treatment that can help their sons and daughters learn to function, or teeter on the brink of financial ruin…”

In Advocacy,

Mike

Jeremy Hilton Testimony to the Senate Armed Services Committee

Write Your State Representative!

Later this week Jeremy Hilton, the 2012 Military Spouse of the Year and dedicated advocate for military families caring for special needs children, will be testifying to the Senate Armed Services Committee. At a time when CKMAA has great traction on the Hill, this testimony highlighting the unique challenges that military face in their endeavors to provide for their exceptional children comes with excellent timing.

I have a great respect for Jeremy Hilton and the tireless efforts he puts forth on behalf of families like mine and the tens of thousands of military families doing their best with limited resources in raising special needs children.

With his permission I have posted the written account of the testimony that he will provide later this week. Our thoughts and prayers go out to him as he works share the plight that many of us endure. Go Jeremy!

Hilton Senate Testimony 20 June 2012

In advocacy,

Mike

Caring For Military Kids with Autism ACT (CKMAA) Perspective

Here is a great post about the CKMAA that I stumbled across. As a military service member I can appreciate both of the benefits and areas of improvement in organizations such as EFMP, ECHO, Tricare and others. There is much good, but there is also much that needs vast improvement on.

This a a great outside perspective on an inside issue that for sure, I believe, to be very relevant.

Some changes can be made with little pain or increase in budgets. Beginning with the passage of the CKMAA would be a huge boost in the right direction to correct some of the coverage deficiencies and stigma associations that exist for military families living with autism.

Here is a brief snippet of the post and a link to read the whole thing.


Caring for Military Kids with Autism Act- Why It Matters To All of Us

About two years ago I met a family who just moved to our school. Their child had a severe speech delay and developmental issues. Upon meeting the mother, I asked about her provider. “What? Provider for what?” After explaining that she was eligible for a minimum of behavioral, speech, and occupational therapy for her child and may qualify for more, she looked shocked. I told her about what we were doing for our girls, what we were getting through ECHO (the military’s supplementary insurance program), and what she needed to do. She said, “ECHO? Wow, that must be something new. I will look into that. My husband just won’t let us apply for EFMP.”

For those of you lucky enough not to understand the acronyms, EFMP stands for Exceptional Family Member Program. This basically puts your family member in a “level of care” category based on the needs of that family member. The military then decides, based on this category, where they can and cannot send the service member. Or, so they say.

EFMP carries with it a stigma that many service members cannot separate from. It means that this person really cannot (or should not) go anywhere and do anything. It is hard to get the qualifications needed to promote to the next level and pay grade if you can’t go anywhere and do anything. It could mean the difference in retiring at 20 years or 30 years. It could mean thousands of dollars more a month in retirement for the rest of the service member’s life. Many people don’t want to take the risk. As a result, their child does not get the help and services they need. Such was the case with the family I met.

I am sure that those of you on the outside may ask yourself, “How could someone let this happen?” or “How could you simply….

Please click HERE to open a new window and read the rest of the post.

In Advocacy,

Mike

CARA Passes! On It’s Way To the Prez Now!

It’s on its way to the president now! In an environment where cutbacks and rejections rule the day in Washington it is very pleasing for me to see that this legislation will continue. Although, I believe that is only a drop in the bucket and is certainly not commensurate with the true need to truly help “combat” the growing epidemic of autism, at least the efforts are in the right direction.

I received this today from the Autism Society:

Dear Michael,

We did it!

The Autism Society is pleased to report that the Combating Autism Reauthorization Act (CARA) passed in the Senate last night. The bill now goes to the President, who has already indicated he would sign it into law.

CARA is very important legislation as it helps many living with autism by funding research, training and education. But it does not accomplish everything that needs to be done to help all those living with autism. We must do more.

As we celebrate today, we must address a critical concern with the bill. The re-authorization continues the Interagency Autism Coordinating Committee (IACC), a federal advisory committee that serves as a key coordinating body for delivery of services and addressing autism research efforts. The Autism Society does not currently have a seat at this table. With government funding reduced, the need for the Autism Society, the largest grassroots organization helping families today, has never been as critical. The Autism Society continues to work with lawmakers and the President’s staff to secure our seat at this table, as well as representation for our partner autism organizations.

With CARA passed, the Autism Society is setting its sights on reforming Medicaid. We need to ensure that valued Medicaid service funding provided to so many through state waivers is properly addressed in the current deficit reduction committee deliberations. Already, lobbyists are lining up to advocate for continued funding of various Medicaid efforts, which have been found not to be nearly as effective as the important in-home and community services provided by states through the Medicaid waiver. Without the Autism Society’s involvement in this discussion, we fear the voices of those needing Medicaid services will not be heard.

Our collective work on the Combating Autism Reauthorization Act shows the success we can have when grassroots autism advocates and groups such as the Autism Society, Autism Speaks, the ARC of the United States and the Association of University Centers on Disabilities (AUCD) work together to help all those living with autism.

Sincerely,

Scott Badesch
Autism Society President and COO