The Rhode Island General Assembly is entertaining two autism insurance bills - one, House Bill 7260, would define and cover applied behavior analysis as an autism treatment; the other, Senate Bill 2422, does not state either - it includes a provision to increase training and numbers of related personnel such as nurses, physical therapists, occupational therapists, and occupational therapist assistants.
House Bill No.7260 BY Palumbo, Naughton, Corvese, Jackson, Caprio D
01/28/2010 Introduced, referred to House Corporations
03/10/2010 Committee transferred to House Committee on Health, Education & Welfare
03/31/2010 Scheduled for hearing and/or consideration
03/31/2010 Committee postponed at request of sponsor
H.7260 defines applied behavior analysis, includes coverage of applied behavior analysis within "habilitative or rehabilitative care", however the delivery of applied behavior analysis is not defined nor are such as BACB certificants or of equivalent competency defined. A statement is made that an "Autism services provider" means any person, entity, or group that provides treatment.
Senate Bill No.2422 BY O`Neill E, Pinga, Cote, Raptakis, Maher
02/11/2010 Introduced, referred to Senate Health and Human Services
S. 2422 does not identify applied behavior analysis, nor does it specify it as a treatment modality. The bill does direct the state institutions of higher education to evaluate whether nursing, physical therapy, occupational therapy and occupational therapy assistant programs offer preparation for those who interact with ASD patients and families and present a plan, including financial and scholarship incentives to encourage study in these fields.
In the Kansas House, on motion of Representative Shultz, the House nonconcurred in Senate amendments to S. Sub. for HB 2160 and asked for a Conference Committee. Speaker O’Neal thereupon appointed Representatives Clark Shultz, Virgil Peck and Dale Swenson as conferees on the part of the House.[House Journal 3/22/10 page1193]
On the same day, on motion of Senator Teichman, the Senate acceded to the request of the House for a conference on Senate Substitute for HB 2160. The President appointed Senators Ruth Teichman, Karin Brownlee and Chris Steineger as conferees on the part of the Senate. [Senate Journal 3/22/10 p. 1231]
As of Friday, March 26, 2010, the Kansas legislative website shows that S.Sub HB 2160 was still in Conference Committee.
The Kentucky State Senate appears poised to pass as early as Monday, KY HB 159, a bill that would both provide coverage for applied behavior analysis for Kentucky children with autism and, in a recent version, establish a license and licensing board for Behavior Analysts. Autism Votes earlier today announced that HB 159 had passed unanimously in the Senate Licensing and Occupations Committee, and a news story followed up that the bill is on the Senate Consent Calendar,
"...The Senate Licensing and Occupations Committee approved HB 159 and placed it on the consent calendar — a spot reserved for legislation without opposition that is likely to pass with no discussion.
“We’re going to pass it,” [Senate President David] Williams said.
[Rep. Jeff] Greer said he was pleased that the bill could win final approval as early as Monday. “It’s going to change children’s lives — no doubt about it,” he said..."
The Kentucky Legislative calendar does not have specific bills posted but does show business being conducted in the Senate on Monday, March 29, 2010 commencing at 12:00 Noon EDT.
An amended reconciliation bill H.R. 4872 passed in the U.S. House Thursday night, March 25, 2010 by a vote of 220 to 207 on the motion to concur with the Senate amendments after its return from the Senate earlier in the day. In the Senate, the vote was 56 to 42. The vote split approximately down political party lines, with Republicans in both chambers unanimously opposed.
National Public Radio reports that the first task resulting from the new laws would be establishment of a federally funded "high-risk pool" program to cover those turned down for preexisting conditions by private insurance. Currently the law would call for 90 days to do so. NPR also describes some of the related details.
Among some of the questions still circulating is the cost of the laws.
The Congressional Budget Office (CBO) recently issued reports of their assessment and analysis of national costs/benefits of health care (and education) reform specific to this legislation (H.R. 4872 & H.R. 3950).
The Association for Science in Autism Treatment (ASAT), whose mission is is to share accurate, scientifically sound information about autism and treatments for autism, has announced that the Spring issue of ASAT's no-cost quarterly newsletter, Science in Autism Treatment will be issued next week.
Practitioners are welcomed and encouraged to sign up to receive the issue when it comes out - and to also encourage client families and colleagues to sign-up and browse the other resources that ASAT makes available to provide unbiased information on evidenced treatments for autism.
Three minor parlimentary challenges in the reconciliation act H.R. 4872, which would implement desired House amendments to the recently signed into law health reform bill H.R. 3590 , have flagged the measure for a return to the U.S. House of Representatives after U.S. Senate approval.
One problemative provision was in the educational portion of the bill dealing with the calculation formula of student Pell grants in the portion of H.R. 4872 dealing with restructuring of student education loans, another was characterized as insignificant and technical; both removed from the bill. A third is under review by the Senate Parlimentarian, but is also considered minor. None of these are considered significant enough to delay final approval of H.R. 4872.
Prior to these successful parlimentary challenges, Senators voted on and defeated 29 consecutive GOP amendments in a marathon voting session between 5:30 PM.EDT Wednesday and 2:45 AM EDT Thursday, when they recessed.
The Senate has been ordered to reconvene at 9:15AM EDT on Thursday, March 25. Some predictions are that voting on the reconciliation in the Senate will conclude sometime on Thursday, and that the House will readdress H.R 4872 on Friday, March 26, 2010.
The General Court of the State of Massachusetts is currently entertaining two licensing measures which would regulate practitioners and the practice of applied behavior analysis within the state.
H.B. 181 and S.B. 47, would impose criminal penalties on anyone practicing ABA without a license. These bills establish two levels of practitioner, at the doctorate and master’s levels, and define the scope of practice of ABA to include conducting ABA-based therapy, as well as planning and supervision services. Bill Histories show that both H.B.181 and S.47 are currently in the Joint Committee on Consumer Protection and Professional Licensure
“Licensed Independent Applied Behavior Analyst (LIABA)”, an individual who by training and experience meets the requirements for licensing by the board and is duly licensed to practice independent applied behavior analysis., and
"Licensed Applied Behavior Analyst (LABA)", an individual who by training and experience meets the requirements for licensing by the board and is duly licensed to practice applied behavior analysis.
as well as create a nine member separate professional licensing board - seven members to be drawn from the Licensed Applied Behavior Analysts of both levels and two members would be selected as representatives of the public.
Both bills describe in some detail the proposed operations, powers and duties of the licensing board, defines the scope of practice of applied behavior analysis, the qualifications and requirements of those applying for a license - which initially includes receipt of certification by the Behavior Analyst Certification Board, supervision competencies, responsibility to clients and colleagues, safeguards and penalties.
The bills state that the measures would not prevent specified members of other professions from doing work of an applied behavior analytic nature consistent with standards of their professions, but that they cannot present themselves to the public implying that they are applied behavior analysts or are licensed to practice applied behavior analysis.
In relation to special education the Massachusetts Department of Education would develop standards and implement policy necessary to include the profession of applied behavior analysis as a "related service provider".
Two events sponsored by Autism Speaks and the Autism Society of Ohio are scheduled for Wednesday, April 14, 2010 at the Ohio Statehouse:
A daytime rally and meetings with State Senators to raise autism awareness and to advocate for autism related bills in the Ohio legislature, and an evening reception for advocates and constituents to meet with legislators and other decision makers to discuss autism, and autism supports and services in Ohio districts.
Autism Awareness Rally 11:00AM - 12:00 Noon
The rally will be held April 14, 2010, 11:00am to 12:00 noon on the south lawn of the Ohio Statehouse Parking is available under the Statehouse or flat lots by the Statehouse. Informational handouts about HB 8 and SB 220/HB 399 will be available for all advocates and media.
Speakers will be addressing the bills,
HB 8: A BILL To amend section 1739.05 and to enact sections 1751.68 and 3923.84 of the Revised Code to prohibit health insurers from excluding coverage for specified services for individuals diagnosed with an autism spectrum disorder.
Passed in the Ohio House 12/8/2009;
Currently in the Senate Insurance, Commerce & Labor Committee.
SB 220 / HB 399: To amend section 955.011 of the Revised Code to revise the definition of "mobility impaired person" to include a person who is diagnosed with autism for purposes of the statutes governing assistance dogs.
SB 220 currently in the Senate Health, Human Services, & Aging Committee &
HB 399 is currently in the House Health Committee
and updating participants on other issues related to autism.
Attendees are requested to bring signs (without a pole) showing support for HB 8, saying thanks for passing HB 8 and listing his/her State Representative. It is also suggested that attendees call and set up an appointment with his/her state Senator to discuss HB 8 and SB 220/HB 399.
Special Guest Speaker - Stanley Jackson - WTVN pre/post game Color Analyst for OSU football, and former professional and Ohio State University quarterback.
There will be kids' activities, such as face painting, thanks to Oakstone Academy. Tables will be set up from Autism providers and advocacy groups.
Autism Awareness Legislative Reception: 5:00PM – 7:00PM
In the evening, an Autism Awareness Legislative Reception will be held in the Atrium of the Statehouse. Legislators have been invited to meet with constituents from their districts to learn more about autism and autism supports and services in their district. Department Directors, members of the Interagency Workgroup on Autism and the Governor’s office have also been invited. Appetizers and refreshments will be provided by Autism Society of Ohio.
For more information:
CONTACTS:
RALLY: Doug Krinsky (Parent of a child with Autism), CAC, Autism Speaks,
(614) 554-0802, yogi1125@aol.com
RECEPTION: Barbara Yavorcik, Executive Director, Autism Society of Ohio, (614) 537-4079, askASO@autismohio.org, www.autismohio.org
The Autism Speaks blog has put up a post in which they identify what is seen as the outcome from the passage of S. 3590 and the potential passage of H.R. 4872.
While the post is posed in general terms, there are comments related to those plans under the Employee Retirement Income Security Act of 1974 (ERISA) not being required to provide the essential benefits package requiring "behavioral health", and what they see as benefits and effects on state mandates.
Will health care reform directly benefit the autism community?
Does it apply to all insurers?
How does health care reform impact the state autism insurance reform effort?
The short version is that passage of the Federal health care reform, while projected as a positive outcome for the country as a whole, is not a universal solution to the coverage and reimbursement problems currently facing families with a child who has an autism diagnosis, and that Autism Speaks' assessment is that obtaining uniform coverage providing behavior analytic treatment for those with an autism diagnosis will require continuing advocacy and legislation at both Federal and State levels. That blog also welcomes comments and questions.
A.10372: Requires that individual accident and health insurance policies shall provide coverage for screening, diagnosis and treatment of autism spectrum disorder.
The New York legislative website shows that A. 10372 has been referred to Ways and Means.
As of March 24, 2010, both of New York's autism insurance bills, S.7000A and A.10372 have quickly and unanimously passed their respective committees, which suggests some promise for positive progress in this legislature.
Connecticut H.B. 5425: AN ACT CONCERNING SPECIAL EDUCATION.
To reconstitute the State Advisory Council for Special Education by reducing the number of members to make it consistent with federal law; to require boards of education to provide applied behavior analysis services to certain special education students; to establish that the burden of proof lies with the party requesting a special education hearing; and to require the school district from which a child transfers to pay for such child's special education costs for the remainder of the school year.
Amendments appear to be most pertinent to certain structural changes to the proposed Advisory Council for Special Education, and financial responsibility for special education students who change districts or commence special education services after the start of the school year.
A.10372: Requires that individual accident and health insurance policies shall provide coverage for screening, diagnosis and treatment of autism spectrum disorder
which is the Senate version of health care reform that was originally passed by the Senate on December 24, 2009. H.R. 3590 is scheduled to be signed into law by President Obama on March 23, 2010 at 11:15 AM EDT.
Within minutes of the passage of H.R. 3590, the House also passed by a vote of 220 to 211 a reconciliation bill,
which encompasses amendments to H.R. 3590 proposed by the House. The U.S. Senate still has to deliberate and approve H.R. 4872; it is required to commence those deliberations after H.R. 3590 is enacted into law by the President's signature, to allot at least 20 hours of debate to the matter, and due to technicalities the reconciliation bill requires only a simple majority for passage. The Senate calendar shows deliberation on H.R. 4872 commencing Tuesday, March 23, 2010 at 2:15PM EDT, although it is possible that could change.
H.R. 3590 does include a behavioral health provision for mental health and substance abuse treatment, however behavior analysts are not listed among those providers explicitly identified for reimbursement as part of a treatment team. It has also been noted by Autism Votes that the behavioral health clauses as enacted do not have sufficient reach to benefit more than a relative minority of families seeking ABA services, since this coverage is not required for all plans excepting,
(1) plans offered by state-based exchanges, through which individuals and small businesses can purchase coverage; and
(2) plans offered in the individual and small group markets outside the exchange.
The Arc struck a more optimistic note in changes that it sees as improvements in coverages, benefits and Long-Term Supports for those with developmental disabilities.
The reconciliation act, H.R. 4872 makes additional specification for covered professionals, under,
TITLE K--PROMOTING PRIMARY CARE, MENTAL HEALTH SERVICES, AND COORDINATED CARE
Sec. 1308. Coverage of marriage and family therapist services and mental health counselor services.
News reports and analysis will undoubtedly continue over the coming days clarifying the relative strengths and weaknesses of the enacted legislation, with some dependency on the outcome of the Senate actions yet to occur on H.R. 4872.
The Arc Applauds House Passage of Health Care Reform Legislation 3/22/2010
Washington, D.C. (March 22, 2010) - Press Release
Describes changes that The Arc sees as positive in coverages, benefits and Long-Term Services and Supports for those with developmental disabilities
S. 45 would classify and define detailed oversight of Level IV treatment interventions (those utilizing aversives as a last resort for dangerous or self-destructive behaviors which have failed to be resolved under less intrusive interventions) in facilities receiving public funding,
at the state level by a statewide committee of specific composition,
at a facility level by a facility peer-review committee of specific composition, and would require
direct supervision and physical presence as specified in the bill.
Standards of procedures, safeguards, required documentations, competencies of the committees and supervisors, and scope of use are defined in S.45.
S. 46 would establish a special commission to investigate and make legislative recommendation on the adequacy and effectiveness of laws and and regulations governing use of behavior modification techniques, including aversive procedures and the principles of applied behavior analysis across all public or private agencies in Massachusetts receiving public funding, including state agencies and contracted providers.
After its investigation, the commission would develop and recommend a unified set of standards for the use of behavior modification procedures in all agencies and programs licensed, funded and/or regulated in Massachusetts. The standards would include the minimum qualifications for staff involved in the development and direct implementation of aversive procedures and the review and monitoring requirements for such interventions. The commission is also required file a report the results of the investigation and recommendations with the clerks of the Massachusetts Senate and House of Representatives by a specified date.
The composition of the commission would be the following state officers or designees:
Governor, Senate President, Speaker of the House, Senate and House Chairs of the Joint Committee on Children and Families, the Chief Justice of the Probate and Family Court. the Commissioner of the Department of Developmental Services, the Commissioner of the Department Mental Health , the Commissioner of the Department of Early Education and Care, the Commissioner of the Department of Elementary and Secondary Education, the Commissioner of the Department of Children and Families, the Commissioner of the 26 Department of Youth Services, the Executive Director of the Disabled Persons Protection Commission, the Chairman of the Governor’s Commission on Mental Retardation, the Executive Director of the Massachusetts Psychological Association, and a Licensed Applied Behavior Analyst or Certified Behavior Analyst to be appointed by the Governor. The Governor would also appoint at least one disability advocate and one service provider whose agency conducts behavioral intervention programming.
New York and Maine's autism insurance bills received positive legislative action on Monday, March 22, 2010 - New York's S.7000A passing in the Senate Insurance Committee, and the amended version of Maine's SP 446/LD 1198 accepted in its 2nd reading in the Maine Senate.
New York - Autism Votes has reported that amended New York's S.7000A, was passed in the Senate insurance committee on March 22, 2010. The NY legislative tracking service shows that the vote was 13-2 in favor of the bill, and that the bill has been referred to the Senate Codes Committee. The identical Assembly bill, A10372, remains in the Assembly Insurance Committee where it was referred on March 19, 2010.