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.
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------------------------- 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.
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Wednesday, February 20, 2008
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.
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"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.
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"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
Monday, January 21, 2008
District 15 Advocacy News
I have secured a meeting with Senator Nancy Cassis from district 15 in Oakland County which covers: Commerce Twp, Highland Twp, Holly Twp, Lyon Twp, Milford Twp, Northville city (part), Novi city, Novi Twp, Orchard Lake city, Rose Twp, South Lyon city, Walled Lake city, West Bloomfield Twp, White Lake Twp and Wixom city on February 8th. If you reside in this region, please forward me a letter (however brief) stating your support of the bills and I can hand deliver them. You can also send correspondence to her directly at: Mailing Address: Senator Nancy Cassis P.O. Box 30036 Lansing, MI 48909-7536 By Phone: (517) 373-1758 By Fax: (517) 373-0938 By Email: senncassis@senate.michigan.gov It is critical that she hear from her constituents as she was non-commital last time I spoke with her. She was concerned about added cost but is listening. Let's do our best to convince her! Thanks, Jim (248) 396-9426 jblood98@yahoo.com
DVD copies of the Committee Hearing Available!
The Health Policy Committee Meeting in December was recorded. If you would like to purchase a copy the cost is $25 if you pick it up or $30 if it is mailed. They can make DVD or VHS copies.
Contact:
Lois Ewen
Office Manager, MGTV (Michigan Government Television)
loise@mgtv.org
Contact:
Lois Ewen
Office Manager, MGTV (Michigan Government Television)
loise@mgtv.org
CRAIN'S DETROIT BUSINESS publishes an article covering the autism insurance legislation.
LANSING - Advocates of legislation to require insurance coverage for treatment of autism are hoping the new year brings new action.....
http://www.crainsdetroit.com/apps/pbcs.dll/article?AID=200851916017
http://www.crainsdetroit.com/apps/pbcs.dll/article?AID=200851916017
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