AIM Michigan and Autism Votes announce that there will be a legislative task force meeting on autism insurance reform hosted by Michigan Senators Randy Richardville and Tupac Hunter. Although Michigan's House in June 2009 passed two autism insurance bills,
that proposed to cover ABA and other evidenced treatments, the bills have subsequently stalled in the Senate's Economic Development and Regulatory Reform Committee. Autism Votes states that these meetings represent the Michigan Senate's effort to determine what would best meet the needs of Michigan's families and children impacted by autism spectrum disorder.
The most tightly controlled study to date on the gluten-free casein-free (GFCF) diet found that application of the diet resulted in no significant change in autistic behavior or improvement in symptoms.
"...The researchers undertook a randomized, double-blinded (meaning neither the participants nor the researchers knew which treatment anyone received), placebo-controlled study.
Fourteen children who were put on the diet for at least four weeks were then given snacks containing gluten, casein, both or neither. The researchers evaluated the children for changes in attention, sleep, stool patterns and characteristic autistic behavior. The study did not show significant changes in any of these symptoms for any of the groups..."
"Dr. Leonard Rappaport, chief of the Division of Developmental Medicine at Children's Hospital in Boston, called the findings 'disappointing.'
'Even though I did not believe it really made a difference, I was hoping I was wrong,' Rappaport said. "
...
" 'Actually, I don't think that many parents will be disappointed," Amaral [David Amaral, president of the International Society for Autism Research and professor at the University of California at Davis] said. 'On the contrary, it is very difficult to maintain children on the [GFCF] diet. Some parents who may have failed in maintaining the diet may feel relieved to hear that it might not be a benefit to their child even if they had persisted.' "
...
"[From Dr. Stefani Hines, a development-behavioral pediatrician at William Beaumont children's hospital in Royal Oak, Michigan] 'So far the research that has been the most promising has been aimed at applied behavioral analysis,' she said. 'We still have much to learn regarding best treatment practices for children with autism.' "
Mudford, O., Blampied, N., Phillips, K., Harper, D., Foster, M., Church, J., Hunt, M., Prochnow, J., Rose, D., Arnold-Saritepe, A., Peters, H., Lie, C., Jeffrey, K., Messick, E., Sumpter, C., McEwan, J., & Wilczynski, S. (2009). Technical review of published research on applied behaviour analysis interventions for people with autism spectrum disorders: Auckland Uniservices Ltd. Wellington, New Zealand: Ministry of Education.
Those interested in the report are directed to the Executive Summary page, where that summary and the full 126 page report can be directly accessed, respecting the note,
"Reports from Auckland UniServices Limited should only be used for the purposes for which
they were commissioned. If it is proposed to use a report prepared by Auckland UniServices
Limited for a different purpose or in a different context from that intended at the time of
commissioning the work, then UniServices should be consulted to verify whether the report is
being correctly interpreted. In particular it is requested that, where quoted, conclusions given
in UniServices reports should be stated in full."
For further information "Technical Review of Published Research on Applied Behaviour Analysis Interventions for People with Autism Spectrum Disorder"
Executive Summary and links to full report
Education Counts Author: Mudford, O., Blampied, N., Phillips, K., Harper, D., Foster, M., Church, J., Hunt, M., Prochnow, J., Rose, D., Arnold-Saritepe, A., Peters, H., Lie, C., Jeffrey, K., Messick, E., Sumpter, C., McEwan, J., & Wilczynski, S. (2009).
Date Published: 15 January 2009 - Revised 16 January 2009
Released on Education Counts: April 2010
"The new members will bring additional points of view and expertise to the IACC...'By adding new voices to the IACC and expanding the number of organizations represented on the committee, we hope to broaden our perspectives and increase coordination efforts,' said Dr. Thomas Insel, IACC Chairman and director of the National Institute of Mental Health, part of the National Institutes of Health (NIH)."
New Members of the Interagency Autism Coordinating Committee:
Dr. Dawson is the Chief Science Officer for Autism Speaks, working with the scientific community and stakeholders to shape and expand the foundation's scientific vision. She also is a licensed clinical psychologist with a research focus on early detection and intervention, early patterns of brain dysfunction and the identification of biological markers for autism genetic studies. Dr. Dawson also serves as Research Professor of Psychiatry at the University of North Carolina at Chapel Hill, Adjunct Professor of Psychiatry at Columbia University and Professor Emeritus of Psychology at University of Washington.
Dr. Fischbach is the Scientific Director for the Simons Foundation, where he oversees the Autism Research Initiative. He has spent his career as a neuroscientist studying the formation and maintenance of synapses, the junctions between nerve cells which allow signals to be transmitted. Before joining the Simons Foundation, Dr. Fischbach served as the Director of the National Institute of Neurological Disorders and Stroke (NINDS) from 1998 to 2001 and as the Executive Vice President of Columbia University Medical Center and Dean of the faculties of medicine from 2001 to 2006.
Mr. Ari Ne'eman is the Founding President of the Autistic Self Advocacy Network, where he works to increase the representation of autistic people in public policy discussions. He is an adult on the autism spectrum and a leading advocate in the neurodiversity movement. Mr. Ne'eman has served on the New Jersey Adults with Autism Task Force and the New Jersey Special Education Review Commission, where he authored a minority report advocating legislative action against the use of aversives, restraint and seclusion. He is a board member of TASH, an advocacy group for people with disabilities, and is involved with the Maryland Coalition for Inclusive Education.
SB 204, AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO AUTISM SPECTRUM DISORDERS COVERAGE.
currently in the Senate Finance Committee. SB 204 defines applied behavior analysis, includes it for coverage under the "habilitative or rehabilitative care" category, and includes among those denoted as an "Autism services provider", "practitioners with the national certification of board-certified behavioral analyst",or any person, entity, or group meeting the standards set by the Department of Health and Social Services.
Meeting information:
Date: Friday, May 21, 2010
Time: 1:00pm - 6:00pm (hourly sessions)
Location: Autism Delaware Newark Office
Street: 924 Old Harmony Road, Suite 201
City/Town: Newark, DE View Map
RSVP at Facebook and/or to Kim Siegel, kim.siegel@delautism.org
Attendees will able to learn more about the latest information on SB 204 and write letters to legislators. Talking points, contact information, sample letters, paper, envelopes, and refreshments will be provided.
Every hour there will be a review of the legislation and what it will (and will not) accomplish and answer questions before beginning letter writing. The first hourly session starts at 1:00pm, sessions will continue through the afternoon, with the last session beginning at 5:00pm and ending at 6:00pm.
Again, please RSVP at Facebook and/or to Kim Siegel, kim.siegel@delautism.org to sign up for a time slot so that organizers can ensure that there will be enough volunteers, supplies, and snacks during the session.
Summary of some state and Federal legislation and statute
May 16, 2010
Note: While this is a best effort to track and report legislation for the purposes of education and reference, no claim is made of comprehensiveness, completeness or accuracy, and posting does not constitute legal advice.
Readers are urged to consult noted references and relevant governmental sources to obtain exact legislative and statutory language.
Red dots = states with passed licensing law (7) Yellow=states with passed autism insurance law Green = states with autism insurance legislation in progress Gray= states with autism insurance legislation that failed to pass in 2010.
Licensing legislation - passed (red dots)
(BACB)=BACB certification alone is competency for license
(BACB+) = BACB and additional requirements
(other) = other requirements
Arizona (2008)/January 1, 2011 - Note: this is year delay, via HB 2207 (2009) which specified certain deposits and accounting changes to enact Laws 2008, Chapter 288. (other). State Board of Psychologist Examiners
Missouri (2010)/ HB 1311 - (BACB). Behavior Analyst Advisory Board under the State Committee of Psychologists [blogpost] 5/16/10 awaiting signature of Governor Jay Nixon.
Nevada (2009)/May 29, 2009 for purpose of establishing licensing and certification requirements. July 1, 2011 for all other purposes. Language of AB 162 as enrolled. Ch. 331. (BACB). Board of Psychological Examiners, adding 2 more members, one of whom is a licensed behavior analyst. Also certifies autism behavior specialists.
Oklahoma (2009)/November 1, 2009 - license and training program. Licensing Act language at the BACB. (BACB). Licensed by the Developmental Disabilities Services Division of the Department of Human Services.
Pennsylvania (2008)/ 1 year from effective date of regulations promulgated or July 1, 2012 - license is for "Behavior Specialist". Licensing requirements as outlined in Act 62 from PA DPW (other). State Board of Medicine
Wisconsin (2010)/30 days after publication date; Publication date May 25, 2010. SB 667/2009 Wisconsin Act 282 - (BACB). Department of Regulation and Licensing; an advisory committee may be appointed to advise on regulation. [blogpost]
Licensing legislation - in progress (open red dot)
Autism insurance legislation - passed (yellowon map) - red below indicates also a license in that state.
NB- legislation does not affect ERISA self-insured plans or may have other state specific coverages, restrictions or exclusions depending on state's statute and regulation.
Kansas (2010)/upon publication in the Kansas Statute Book. SS for HB 2160. Limited pilot program under Kansas State Employees Health Care Commission for evaluation for future possible expansion. (BACB + additional conditions) See Autism Votes Kansas [blogpost]
Missouri(2010)/January 1, 2011 or after, when new plan issued.HB 1311Behavior Analyst Advisory Board to Board of Psychologist Examiners.(BACB). 5/16/10 awaiting signature of Governor Jay Nixon.
See Autism Votes Missouri, [blogpost]
New Hampshire HB 569-FN (2010)/January 1, 2011 - . Bill is clarification of existing statute. 5/16/10 awaiting signature of Governor John Lynch.
See Autism Votes New Hampshire [blogpost]
Vermont S. 262. (2010)/July 1, 2011 but no later than July 1, 2012. Limited to children age 18 mos. to 6 yrs. Law includes feasibility study for expansion to older minors, other programs and coverage of BCBAs. 5/16/10 awaiting signature of Governor Jim Douglas.
See Autism Votes Vermont [blogpost]
District of Columbia B18-0528 Introduced on November 19, 2009. Last hearing on March 24, 2010. May be inactive, but status is unclear. Autism Votes District of Columbia
North Carolina (subject to change by conference committee) HB 589 = S 375 - specifies "behavioral therapy, including but not limited to ABA. Service provider not specified. Legislative session commenced May 12, 2010 runs through mid July, dependent on adjournment resolution. Autism Society of North Carolina, Autism Votes North Carolina. [blogpost]
Ohio HB 8. ABA included under habilitative or rehabilitative care. Provider not specified. Passed House on 12/8/09; in Senate Insurance, Commerce & Labor Committee since 12/9/09. Autism Society of Ohio, Autism Votes Ohio
Rhode Island HB 7260. Covers ABA. Bill being held for further study; Rhode Island legislature adjourns late June. S.2422. Does not cover ABA. Instructs higher ed to evaluate increasing preparation programs for PT, OT, nursing program and financial and scholarship incentives. Autism Votes Rhode Island [blogpost];
Autism insurance legislation - failed to pass or modified (M) from original purpose in 2010 (gray on map)
Alaska HB 187; (May be on hold pending task force review) Did not specify competencies of "autism service provider". Legislature adjourned 4/18/10. [blogpost]
(M) Georgia SB 161 - Insurance; require certain coverage for autism spectrum disorders; provide definitions. Modified by House Committee on Insurance to appoint a task force for study of education and services. Legislature adjourned.
Maryland HB 1091 & SB 1028; Legislature adjourned before significant action taken [blogpost]
Minnesota HF 359; language transferred to House HHS Omnibus Health Care bill; excised in Conference Committee [blogpost]
Mississippi SB 2055, SB 2129, SB 2175, SB 2363, SB 2607, HB 1496. All "Died" in House and Senate Insurance Committees.
Missouri SS/SB 618. Similar bill HB 1311&1341 passed in 2010 legislature. [blogpost]
Virginia SB 464; reduced amount and age of coverage. Tabled by House Commerce and Labor committee. [blogpost]
Washington HB 1210 & SB 5203; Carried over from 2009. No significant action taken in special session. [blogpost]
California SB 1282 Applied behavior analysis services: California Behavioral Certification Organization. [blogpost]
Massachusetts S. 45 Level IV Treatment Interventions & S. 46 Special Commission on Behavior Modification. [blogpost]
Massachusetts S 2293, formerly S. 223 "An Act to improve augmentative and alternative communication opportunities for children with disabilities" Bill History. Problematic reference is inclusion of "facilitated communication" as communication modality.
New York S.03676 Provides an exemption for individuals performing behavior analysis. [blogpost]
Other significant legislation on hold or "failed".
Alaska HB 425 (On hold pending task force study). Would have created intervention system for ABA and provided supervised experience towards BACB certification. Legislature adjourned 4/18/10. [blogpost]
Mississippi SB 2457 ("Died" in Education; Appropriations Committees). would have phased in training of personnel and routine school use of "applied behavior science" for the state's students with ASD.
Missouri SB 1030 Creation of Behavior Analyst Advisory Board and licensure. Language rolled into autism insurance bills SS/S. 618 and passed HB 1311&1341. [blogpost]
*Federal legislation in progress
Restraint and seclusion legislation
S. 2860 "A bill to protect students from inappropriate seclusion and physical restraint, and for other purposes". [blogpost]
Note: Many states are currently in the process of reviewing regulation or creating legislation issue of restraint and seclusion under the urging of Secretary of Education Arne Duncan and prompting of this Federal legislation. Please refer to your state legislature or Department of Education for the status of such actions.
Thomas.gov (Search engine of the Library of Congress)
Federal Register: Tuesday, February 2, 2010 Part IV:
Department of the Treasury, Internal Revenue Service, 26 CFR Part 54
Department of Labor, Employee Benefits Security Administration, 29 CFR Part 2590
Department of Health and Human Services, Centers for Medicare & Medicaid Services, 45 CFR Part 146
Interim Final Rules Under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; Final Rule http://edocket.access.gpo.gov/2010/pdf/2010-2167.pdf
ASAT has a request that those who find these newsletters and other resources offered by ASAT of value, help spread the word to families and colleagues about ASAT, the resources offered, and the newsletter so that as many as possible know where to go to get good information on evidenced treatments and interventions for autism spectrum disorders.
A news report indicates that North Carolina is poised to bring autism insurance bills for legislative consideration,
"On Tuesday [May 11, 2010], Joint Study Committee voted to move the bill from the study phase to the legislative approval process.
North Carolina now joins a growing list of states where autism insurance reform is underway. Nineteen states have enacted autism insurance reform since 2007 and with this action North Carolina becomes the eleventh additional state to introduce autism insurance reform legislation. The legislation now moves to House and Senate subcommittees for review and recommendation."
The General Assembly website shows that the referenced bills which were postponed since August 7, 2009 , and are currently listed under conference committee study are,
House Bill 589 (= S375) (2009 Title): An act to require health benefit plans and the state health plan to cover hearing aids and replacement hearing aids; and to require the state health plan for teachers and state employees to provide coverage for autism treatment disorders.
The most recent version of the legislation stated coverage for "behavioral therapy" including, but not limited to applied behavior analysis, classified under habilitative and rehabilitative care, with treatment including care provided or ordered by a licensed medical doctor or a licensed psychologist who determines the care to be medically necessary. The service provider or competencies of the delivery of behavioral therapy or applied behavior analysis is not defined.
For further reading Family Pushes For NC Autism Insurance Coverage Bill In NC House, Senate Could Relieve Financial Burden
POSTED: 6:18 pm EDT May 12, 2010
UPDATED: 6:53 pm EDT May 12, 2010
Update, 5/12/10, 6:20PM PDT - The Missouri Senate newsroom reports that the licensing provisions for Behavior Analysts have been retained in the final passed bill,
"In addition, a state Behavior Analyst Advisory Board is established under the State Committee of Psychologists within the Division of Professional Registration. The new board is charged with establishing and overseeing licensure and registration requirements for behavior analysts and assistant behavior analysts who provide therapies for children with autism spectrum disorders."
On Tuesday, May 11, 2010 a joint House-Senate conference committee of the Missouri Legislature drafted a Committee Substitute for the Senate Committee Substitute for House Committee Substitute for House Bill Nos. 1311 & 1341 .
On Wednesday, May 12, 2010 this Conference Committee Substitute was adopted and passed by both the House (144-16) and the Senate (27-6) of the Missouri Legislature.
News stories report that the coverage for autism spectrum disorders is $40,000/year for ABA up to age age 18, but the full and exact language of the Conference Committee Substitute, or whether any changes were made to the licensing conditions for Behavior Analysts is unavailable at this time. It is expected that Missouri Governor Jay Nixon will sign the passed legislation.
Despite concerted last minute actions by interested stakeholders, the final version of the Minnesota HHS Omnibus bill determined by Conference Committee and passed in the Minnesota Legislature did not contain the insurance provisions for autism treatment which were contained in the House version. The Committee split on this inclusion, with all of the House members voting in favor of inclusion and those in the Senate opposed. While discussion of this Conference Committee version was allowed on the floors of the Legislature, amendment was not, so that the reported version was in essence the final version.
This legislation now goes to Minnesota Governor Tim Pawlenty. It is reported that he may veto it in its current form because of Medicaid changes; this would send it back to the Legislature, but re-inclusion of the insurance coverage even in that eventuality seems a distant possibility.
**5:35 PM PDT, Tuesday 5/11/10 - Minnesota Northland Association for Behavior Analysis (MNABA) has posted on Facebook the latest update, which is that the Senators on the conference committee voted against adoption of the autism insurance language. There may still be time to weigh in, but the word is that deliberation is in the evening of 5/11 Please see their action alert at Facebook for the specific information action to be taken. **
The Autism Advocacy Law Center blog is currently following closely the legislative conference on the House (HF2614) and Senate (S2337) versions of the Health and Human Services Omnibus Bill. That blog, and a perusal of the bills' comparative language indicates that the House version of the Omnibus Bill contains the language originally found in the House bill, HF 359, the Autism Healthcare Protection Act, and the Senate version does not.
96.3 (b) A health plan must provide coverage for the diagnosis, evaluation, assessment,
96.4 and medically necessary care of autism spectrum disorders that is evidence-based,
96.5 including but not limited to:
(...)
96.8 (2) applied behavior analysis and intensive early intervention services, including
96.9 service package models such as intensive early intervention behavior therapy services
96.10 and Lovaas therapy;
97.13 (5) services must be provided by a mental health professional or, as appropriate, a
97.14 board-certified behavior analyst, a qualified mental health practitioner, or a qualified
97.15 mental health behavioral aide.
97.16 (e) Providers under this section must work with the commissioner in implementing
97.17 evidence-based practices and, specifically for children under age 21, the Minnesota
97.18 Evidence-Based Practice Database of research-informed practice elements and specific
97.19 constituent practices.
A mental health professional who uses the services of a qualified mental health
97.29 practitioner, board-certified behavior analyst, or qualified mental health behavioral aide for
97.30 the purpose of assisting in the provision of services to patients who have autism spectrum
97.31 disorder is responsible for functions performed by these service providers. The qualified
97.32 mental health professional must maintain clinical supervision of services they provide
97.33 and accept full responsibility for their actions. The services provided must be medically
97.34 necessary and identified in the child's individual treatment plan. Service providers must
97.35 document their activities in written progress notes that reflect implementation of the
97.36 individual treatment plan.
(...)
98.13 EFFECTIVE DATE. This section is effective August 1, 2010, and applies to
98.14 coverage offered, issued, sold, renewed, or continued as defined in Minnesota Statutes,
98.15 section 60A.02, subdivision 2a, on or after that date.
Although Missouri was one of the first state legislatures to forward autism insurance legislation in this session, with the support of Governor Jay Nixon and the stated support of the Speaker of the Missouri House - as a Friday, May 14, 2010 adjournment for the General Assembly approaches it may come down to the wire whether one of the bills passes. One news story reported that the Senate President Pro Tem was optimistic that an autism insurance bills would pass before the week ends.
The bill with potentially the highest probability of passage is,
the Senate Committee Substitute for HB 1311 & 1341, which was listed on the House Calendar under the heading of
In lay terms, the House refuses to concur with the passed Senate version and requests that the Senate recede from that version or, failing to do so, to grant the House a conference. **As of 6:00PM PDT, May 10, 2010 the Senate refused to recede and a Conference has been granted.**
The related,
Senate bill, SS/SB 618 Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions
was passed on March 18, 2010 in the Senate and sent to the House where it received relatively little action until the end of April. At the current time, SS/SB 618 has been reported with a Do Pass with House Committee Substitute, but is not showing on the House Calendar.
One of the clauses of the House Committee Substitute for SS/SB 618 was to change the reimbursement condition in the perfected Senate version from reimbursement for Board Certified Behavior Analysts to reimbursement for licensed practitioners and to include language specifying establishment of a Board and other relevant details.
At this point, both SS/S 618 and HB 1311& 1341 both have clauses for the,
Establishment of the Behavior Analyst Advisory Board under the State Committee of Psychologists within the Department of Insurance, Financial Institutions and Professional Registration to establish licensure and registration requirements for behavior analysts, assistance behavior analysts, and line therapists who provide applied behavior analysis therapies for children with autism spectrum disorders. The board shall consist of the following 7 members:
1) 3 licensed behavior analysts;
2) 1 licensed behavior analyst holding a doctoral degree;
3) 1 licensed assistant behavior analyst;
4) 1 professional member of the committee; and
5) 1 public member.,
and defines function, duties and conditions of licensing.
As stated in the summary of the House Committee Substitute sumamary, "the licensing provisions are similar to those contained in the perfected version of HB 1311 and 1341 (2010)."
These clauses mirror the language of the now defunct SB 1030, which was a standalone licensing bill.
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.
