Friday, February 22, 2008
Letter
Should Michigan require autism coverage?
End insurance bias
I read the Feb. 19 article with a mixture of hope and dismay ("Parents of autistic kids fight for aid"). The News quoted some parents and experts in the autism field. That was very encouraging. The article did not mention the support of the Michigan Education Association or some intermediate school district superintendents for these bills, and that was disappointing.
I and many other residents are tired of insurance companies discriminating against people with autism. I know of one family that has an autistic child who was refused therapy but another child without autism was covered for the identical therapy.
...................................................................................
Try alternative to mandate
I have empathy with anyone who cannot pay for medical care for their children. Such parents and their advocates, however, should use caution in expressing their frustration to avoid a backlash. There is no "deliberate" exclusion from insurance coverage for autistic children. Most health programs are developed from the needs of the participants in the plan. If those who initially accepted a plan did not see a need for a given protection, it was not included, and this kept costs down.
Rather than mandating coverage, perhaps insurance companies could provide riders that potential parents could purchase for noncovered conditions that they could then pray not to have to use.
...................................................................................
Other states see benefits
Does anyone believe numerous states would pass autism mandate legislation if the resulting increase in cost was 45 percent as stated in the article? Why have many other states passed autism legislation despite concerns about duplicate services? Is it because these concerns are propaganda? My family has Blue Cross coverage, and we have always been told that autism is not a covered benefit under our plan. This legislation will end the discrimination.
...................................................................................
Explaining autism's rise
Don't tell me we have better systems of detection and reporting autism than in the 1950s. Ask 70-year-old or 80-year-old former teachers if they knew about autism 25 years ago. Now every unruly child a teacher meets is either autistic or has attention deficit disorder.
...................................................................................
Early intervention works
As a professional who provides regular diagnostic and intervention services to children with Autism Spectrum Disorder, I can attest to the desperate needs of families to seek affordable help for their children. This is a disorder which takes a significant toll on the emotional and physical well-being of families. Add to that the financial burden of intervention, and you can understand why 85 percent of marriages in the families of a child with ASD end in divorce.
However, recent research has shown the significant effect of early intervention on the later learning and functional outcomes for children with ASD; what cost is expended early on will come back tenfold as these children progress through their school years. This is why we owe it to these parents to support health coverage for this disorder.
...................................................................................
Getting therapy is a battle
I would like to refute the claim by Jon Ogar of Blue Cross Blue Shield of Michigan that it is already covering autism therapies/treatment. I have been refused the cost of even covering the diagnosis of my son's condition, let alone the therapies that he should be getting. I had to fight for more than a year to get even the original diagnosis covered. Then I was told that the therapies that were deemed medically necessary by my son's doctors would not be covered.
Saturday, February 23, 2008
Wednesday, February 20, 2008
Call to Action! Write letters to the Detroit News Editorial Page and show your support!
There are several points in the Detroit News Article (Printed Feb 19th) that were misleading. Please take the time to write the editor and let the Detroit News know that insurance coverage for Autism is important to you and that you expect high standards in the integrity of their reporting.
*The article incorrectly reports costs up to 45%...... FACT:There is research that supports that additional costs would be less than 1%.
*The article supports the idea that Blue Cross is providing services, which is untrue for most cases of Autism.
*Duplicate services: A lack of understanding in the intensity needed for children with Autism. Other states have passed legislation without using this excuse as an obstacle.
*Employers should have a say in what to include in policies. This option does not exist. Some companies that we have spoken with would like to cover these therapies but it is not an option at this time.
******************************************************************
You can send letters to The Detroit News Editorial Page three different ways:
E-mail letters@detnews.com.
Fax us at (313) 222-6417.
Mail a letter to The Detroit News, Letters, Editorial Page, 615 W. Lafayette, Detroit, MI 48226. Please include home and work phone numbers, plus city of residence, for verification.
We prefer letters of 250 words or less. Direct rebuttals to editorials may be up to 300 words. Letters are subject to editing and become the property of The Detroit News. We do not consider letters to other publications.
Commentary
The Detroit News accepts submissions of commentaries between 600 and 750 words on current public policy and societal issues on the local, state, national and international scene. The work must be the author's own and it must be exclusive to The Detroit News in Southeast Michigan. We do not accept articles that have been submitted to the Free Press.
Please submit to Richard Burr, Associate Editor / Features, Editorial Page, The Detroit News, 615 W. Lafayette, Detroit, MI 48226, or fax to (313) 222-6417, or e-mail to comment@detnews.com.
*****************************************************************
------------------------- A SAMPLE EDITORIAL LETTER ----------------------------
I found it disappointing that many of the words chosen in the writing of the autism legislation article were unsupportive. We are struggling to provide adequate intervention for our child. Why must we read: ARGUING, FIGHT, FORCE, LUXURIES, CONTROVERSIAL, REQUIRE? Why were these negative descriptions selected in the writing of this article? The article speaks of small luxuries while most parents I know are not moaning over lost vacations, they are struggling to put food on the table. Why must we "fight for aid" and why is it written that we must "force insurers to pay for therapy"?
Does anyone believe that numerous states would pass autism legislation if the resulting increase in cost was 45% as stated in this article? Where is the reference to the research data backing up this unbelievable claim? Where is the credibility? Why have many other states passed autism legislation despite concerns about duplicate services. Is it because these concerns are only propaganda?
My family has Blue Cross and we have always been told that Autism is not a covered benefit under our plan. This legislation will end the discrimination that exists. If your child, grandchild or family member had autism could you stand idly by and not provide these life changing interventions for them? Many families in Michigan are losing their homes & life savings to provide these intensive interventions for their children & grandchildren.
------------------------------------------------------------------------------------
*The article incorrectly reports costs up to 45%...... FACT:There is research that supports that additional costs would be less than 1%.
*The article supports the idea that Blue Cross is providing services, which is untrue for most cases of Autism.
*Duplicate services: A lack of understanding in the intensity needed for children with Autism. Other states have passed legislation without using this excuse as an obstacle.
*Employers should have a say in what to include in policies. This option does not exist. Some companies that we have spoken with would like to cover these therapies but it is not an option at this time.
******************************************************************
You can send letters to The Detroit News Editorial Page three different ways:
E-mail letters@detnews.com.
Fax us at (313) 222-6417.
Mail a letter to The Detroit News, Letters, Editorial Page, 615 W. Lafayette, Detroit, MI 48226. Please include home and work phone numbers, plus city of residence, for verification.
We prefer letters of 250 words or less. Direct rebuttals to editorials may be up to 300 words. Letters are subject to editing and become the property of The Detroit News. We do not consider letters to other publications.
Commentary
The Detroit News accepts submissions of commentaries between 600 and 750 words on current public policy and societal issues on the local, state, national and international scene. The work must be the author's own and it must be exclusive to The Detroit News in Southeast Michigan. We do not accept articles that have been submitted to the Free Press.
Please submit to Richard Burr, Associate Editor / Features, Editorial Page, The Detroit News, 615 W. Lafayette, Detroit, MI 48226, or fax to (313) 222-6417, or e-mail to comment@detnews.com.
*****************************************************************
------------------------- A SAMPLE EDITORIAL LETTER ----------------------------
I found it disappointing that many of the words chosen in the writing of the autism legislation article were unsupportive. We are struggling to provide adequate intervention for our child. Why must we read: ARGUING, FIGHT, FORCE, LUXURIES, CONTROVERSIAL, REQUIRE? Why were these negative descriptions selected in the writing of this article? The article speaks of small luxuries while most parents I know are not moaning over lost vacations, they are struggling to put food on the table. Why must we "fight for aid" and why is it written that we must "force insurers to pay for therapy"?
Does anyone believe that numerous states would pass autism legislation if the resulting increase in cost was 45% as stated in this article? Where is the reference to the research data backing up this unbelievable claim? Where is the credibility? Why have many other states passed autism legislation despite concerns about duplicate services. Is it because these concerns are only propaganda?
My family has Blue Cross and we have always been told that Autism is not a covered benefit under our plan. This legislation will end the discrimination that exists. If your child, grandchild or family member had autism could you stand idly by and not provide these life changing interventions for them? Many families in Michigan are losing their homes & life savings to provide these intensive interventions for their children & grandchildren.
------------------------------------------------------------------------------------
Tuesday, February 19, 2008
The Detroit News publishes an article about the Legislation...
Tuesday, February 19, 2008
Parents of autistic kids fight for aid
Controversial bills would force insurers to pay for therapy
Christina Stolarz / The Detroit News
CLAWSON -- Life has been a struggle -- emotionally, mentally, but most of all, financially -- since Bob and Shannon Gougeon's son, Travis, was diagnosed with autism.
Small luxuries they once considered a way of life -- dining out, vacations -- are no longer affordable to the parents who work three jobs between them to pay down the $100,000 debt they've wracked up providing Travis with essential speech and behavioral therapies.
The 6-year-old, who still doesn't speak, was diagnosed before his second birthday with the condition associated with limited communication and repetitive behavior.
Advertisement
"We continue to try to find ways to pay for stuff to benefit his life," said Bob Gougeon, 34, of Clawson. "It's going to take years and years and years to dig out of the hole we've put ourselves in. But how do you put a price on your child?"
The Gougeons and other parents of autistic children are lobbying state lawmakers for financial relief. Advocates say incidences of the neurological disorder are skyrocketing among young people, from 4,700 cases in Michigan in 2000 to 11,000 in 2006, according to federal statistics.
Arguing that autistic children deserve better coverage, they're backing two controversial House bills that would require health insurers and HMOs to pay for early intervention, behavioral analysis and therapy.
Similar legislation is in effect in at least 13 states, according to the Council for Affordable Health Insurance in Alexandria, Va. But critics say the mandates would drive up health care costs as much as 45 percent, force insurers to pay for treatments that some already cover and may duplicate some services already provided by Michigan intermediate school districts.
Critics say mandates add cost
Foes of the bills also argue that employers should have a say in what to include in policies.
"If they don't have an employee who has a child with autism they may not want this to be part of their benefit package," said Wendy Block, director of health policy and human resources at the Michigan Chamber of Commerce. "We know that each and every mandated benefit would add to the cost of health insurance. It's difficult to say how much."
The average annual total premium cost nationwide was $4,479 for individuals and $12,106 for families in 2007, according to the Kaiser Family Foundation, a California-based nonprofit that researches major health care issues.
But supporters say the bills are crucial because early intervention of autism increases chances of normal futures, said Catherine Lord, director of the University of Michigan's Autism and Communication Disorder Center.
"It's just been a tragedy that they've been deliberately excluded from the insurance coverage," Lord said. "Compared to all the other things people get from health insurance, it's not that much if it could improve the chances that the child would be independent."
Autism is a severe developmental disability -- typically diagnosed by age 2 -- that can cause children to become withdrawn, nonverbal and avoid eye contact. In extreme cases, some hit their heads against walls or hurt themselves. There's no cure, but research shows that early intervention through intensive therapies and other services can improve a child's development, according to the U.S. Centers for Disease Control and Prevention.
Like other Metro Detroit intermediate districts, the Macomb County Intermediate School District offers classes and therapy to its more than 1,000 autistic children, said Beth Alberti, assistant superintendent of special education and student services. Assistance varies by need: Some students may receive occupational therapy on basic skills such as using scissors for 30 minutes twice a month; others receive more help.
"We are not treating autism in schools," she said. "We are really focusing on the educational aspect of the kids." While intermediate districts provide some services, many parents seek additional, more intense programs.
Lord said the out-of-pocket costs parents pay for autism treatment programs, offered at hospitals and community service agencies, vary greatly. Some are as low as $3,000 a year, while others can be as high as $40,000 a year, depending on the length of treatment and intensity.
State Rep. Kathy Angerer, D-Dundee, acknowledged premiums would increase slightly, but argued long-term costs -- including hiring full-time teachers for autistic students and paying for group homes -- would decline significantly.
"The cost of doing nothing for these children is more serious," said Angerer, who is sponsoring the legislation with Rep. Richard Ball, R-Bennington Township outside Lansing.
But foes, including the Michigan Health Purchasers Coalition, counter that the measures would drive up insurance costs for employers and, by extension, employees who are increasingly asked to pay more out of pocket when premiums rise.
"In other states, piling on state health insurance mandates has resulted in many employers dropping all health benefits," Larry Horwitz, spokesman for the group comprised of 40 members that include companies, business associations, labor unions and about three insurers. "There's scarce money, and you can't do everything that everybody wants."
Mandates can boost policy costs 20 percent to 45 percent, depending on the state, according to a study by the Council for Affordable Health Insurance.
Blues oppose bills
Michigan's largest insurer, Blue Cross Blue Shield of Michigan, opposes the mandates, but now pays for multiple autism services, spokesman Jon Ogar said in a statement. For example, an initial speech therapy evaluation is covered under most benefit plans, as are follow-up speech therapy services if it's determined that the child has a chance to improve or restore verbal function.
Since Travis Gougeon has participated in the intense one-on-one applied behavior analysis therapy, his parents say he's made tremendous strides -- he can recognize letters in his name and will sometimes sit and color. But at a monthly cost that ranges from $1,200 to $1,700, they couldn't afford to keep him enrolled.
Health coverage would be considered a "lifeline" that would allow them to continue that service, Shannon Gougeon said.
"I just don't understand why we're unable to get any type of services," she said. Instead, she said, they pay $536 a month for speech therapy and about $200 a month for biomedical vitamins and food that helps him stay focused. Travis also attends the Clawson School District, where he spends three hours a day -- with a teacher assistant at his side -- in a classroom and then receives speech therapy in an autistic impaired classroom.
Parent Cara Culver, 39, has seen her 3-year-old daughter, Judit Beired, make great strides since they began an intensive applied behavior analysis treatment program in their Birmingham home nearly a year ago. The 14-hour a week program -- about $2,000 a month -- has helped her learn how to talk and play.
"I'm very happy with what I've seen. She knows the names of 250 objects and 30 verbs," Culver said. But, "(the treatment) is outrageously expensive. It should be covered, because somebody who smokes, they (add on costs) to themselves. We don't know why my daughter got this."
You can reach Christina Stolarz at (586) 468-0343 or cstolarz@detnews.com.
Parents of autistic kids fight for aid
Controversial bills would force insurers to pay for therapy
Christina Stolarz / The Detroit News
CLAWSON -- Life has been a struggle -- emotionally, mentally, but most of all, financially -- since Bob and Shannon Gougeon's son, Travis, was diagnosed with autism.
Small luxuries they once considered a way of life -- dining out, vacations -- are no longer affordable to the parents who work three jobs between them to pay down the $100,000 debt they've wracked up providing Travis with essential speech and behavioral therapies.
The 6-year-old, who still doesn't speak, was diagnosed before his second birthday with the condition associated with limited communication and repetitive behavior.
Advertisement
"We continue to try to find ways to pay for stuff to benefit his life," said Bob Gougeon, 34, of Clawson. "It's going to take years and years and years to dig out of the hole we've put ourselves in. But how do you put a price on your child?"
The Gougeons and other parents of autistic children are lobbying state lawmakers for financial relief. Advocates say incidences of the neurological disorder are skyrocketing among young people, from 4,700 cases in Michigan in 2000 to 11,000 in 2006, according to federal statistics.
Arguing that autistic children deserve better coverage, they're backing two controversial House bills that would require health insurers and HMOs to pay for early intervention, behavioral analysis and therapy.
Similar legislation is in effect in at least 13 states, according to the Council for Affordable Health Insurance in Alexandria, Va. But critics say the mandates would drive up health care costs as much as 45 percent, force insurers to pay for treatments that some already cover and may duplicate some services already provided by Michigan intermediate school districts.
Critics say mandates add cost
Foes of the bills also argue that employers should have a say in what to include in policies.
"If they don't have an employee who has a child with autism they may not want this to be part of their benefit package," said Wendy Block, director of health policy and human resources at the Michigan Chamber of Commerce. "We know that each and every mandated benefit would add to the cost of health insurance. It's difficult to say how much."
The average annual total premium cost nationwide was $4,479 for individuals and $12,106 for families in 2007, according to the Kaiser Family Foundation, a California-based nonprofit that researches major health care issues.
But supporters say the bills are crucial because early intervention of autism increases chances of normal futures, said Catherine Lord, director of the University of Michigan's Autism and Communication Disorder Center.
"It's just been a tragedy that they've been deliberately excluded from the insurance coverage," Lord said. "Compared to all the other things people get from health insurance, it's not that much if it could improve the chances that the child would be independent."
Autism is a severe developmental disability -- typically diagnosed by age 2 -- that can cause children to become withdrawn, nonverbal and avoid eye contact. In extreme cases, some hit their heads against walls or hurt themselves. There's no cure, but research shows that early intervention through intensive therapies and other services can improve a child's development, according to the U.S. Centers for Disease Control and Prevention.
Like other Metro Detroit intermediate districts, the Macomb County Intermediate School District offers classes and therapy to its more than 1,000 autistic children, said Beth Alberti, assistant superintendent of special education and student services. Assistance varies by need: Some students may receive occupational therapy on basic skills such as using scissors for 30 minutes twice a month; others receive more help.
"We are not treating autism in schools," she said. "We are really focusing on the educational aspect of the kids." While intermediate districts provide some services, many parents seek additional, more intense programs.
Lord said the out-of-pocket costs parents pay for autism treatment programs, offered at hospitals and community service agencies, vary greatly. Some are as low as $3,000 a year, while others can be as high as $40,000 a year, depending on the length of treatment and intensity.
State Rep. Kathy Angerer, D-Dundee, acknowledged premiums would increase slightly, but argued long-term costs -- including hiring full-time teachers for autistic students and paying for group homes -- would decline significantly.
"The cost of doing nothing for these children is more serious," said Angerer, who is sponsoring the legislation with Rep. Richard Ball, R-Bennington Township outside Lansing.
But foes, including the Michigan Health Purchasers Coalition, counter that the measures would drive up insurance costs for employers and, by extension, employees who are increasingly asked to pay more out of pocket when premiums rise.
"In other states, piling on state health insurance mandates has resulted in many employers dropping all health benefits," Larry Horwitz, spokesman for the group comprised of 40 members that include companies, business associations, labor unions and about three insurers. "There's scarce money, and you can't do everything that everybody wants."
Mandates can boost policy costs 20 percent to 45 percent, depending on the state, according to a study by the Council for Affordable Health Insurance.
Blues oppose bills
Michigan's largest insurer, Blue Cross Blue Shield of Michigan, opposes the mandates, but now pays for multiple autism services, spokesman Jon Ogar said in a statement. For example, an initial speech therapy evaluation is covered under most benefit plans, as are follow-up speech therapy services if it's determined that the child has a chance to improve or restore verbal function.
Since Travis Gougeon has participated in the intense one-on-one applied behavior analysis therapy, his parents say he's made tremendous strides -- he can recognize letters in his name and will sometimes sit and color. But at a monthly cost that ranges from $1,200 to $1,700, they couldn't afford to keep him enrolled.
Health coverage would be considered a "lifeline" that would allow them to continue that service, Shannon Gougeon said.
"I just don't understand why we're unable to get any type of services," she said. Instead, she said, they pay $536 a month for speech therapy and about $200 a month for biomedical vitamins and food that helps him stay focused. Travis also attends the Clawson School District, where he spends three hours a day -- with a teacher assistant at his side -- in a classroom and then receives speech therapy in an autistic impaired classroom.
Parent Cara Culver, 39, has seen her 3-year-old daughter, Judit Beired, make great strides since they began an intensive applied behavior analysis treatment program in their Birmingham home nearly a year ago. The 14-hour a week program -- about $2,000 a month -- has helped her learn how to talk and play.
"I'm very happy with what I've seen. She knows the names of 250 objects and 30 verbs," Culver said. But, "(the treatment) is outrageously expensive. It should be covered, because somebody who smokes, they (add on costs) to themselves. We don't know why my daughter got this."
You can reach Christina Stolarz at (586) 468-0343 or cstolarz@detnews.com.
Peter Wright (of Wrightslaw) to speak here in Michigan!
MI Advocacy Training Conference
Your Child's Rights
http://gekidslearning.googlepages.com/wrightslawadvocacytraining2
April 23rd, 2008
Laurel Manor Banquet Conference Center
Livonia, Michigan 48150
Peter Wright will be in Livonia on April 23rd to personally conduct a Special Education advocacy training. Mr Wright in not only one of the top Special Education experts in the country, he’s also the lawyer behind one of the landmark Supreme Court victories for children with special needs in the country. Besides being a top level attorney and legal expert Mr. Wright is also an expert at helping train parents to become advocates for their own children. Don’t miss this rare opportunity to be trained by Mr. Wright in a rare Michigan visit.
If you have any further questions please contact: Great Expectations * Livonia, MI * 734-762-0332 * info@mygreatkid. com
Your Child's Rights
http://gekidslearning.googlepages.com/wrightslawadvocacytraining2
April 23rd, 2008
Laurel Manor Banquet Conference Center
Livonia, Michigan 48150
Peter Wright will be in Livonia on April 23rd to personally conduct a Special Education advocacy training. Mr Wright in not only one of the top Special Education experts in the country, he’s also the lawyer behind one of the landmark Supreme Court victories for children with special needs in the country. Besides being a top level attorney and legal expert Mr. Wright is also an expert at helping train parents to become advocates for their own children. Don’t miss this rare opportunity to be trained by Mr. Wright in a rare Michigan visit.
If you have any further questions please contact: Great Expectations * Livonia, MI * 734-762-0332 * info@mygreatkid. com
Subscribe to:
Posts (Atom)