[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
Autism Speaks Endorses Bill For Oregon Public Employees
January 27, 2014
PORTLAND (January27, 2014) — Autism Speaks has endorsed SB.1 Autism Speaks Endorses Bill For Oregon Public Employees 523 which would correct an oversight in Oregon’s 2013 autism insurance reform law by assuring that state employees, teachers and employees of the Oregon Health and Science University (OHSU) gain coverage for applied behavior analysis (ABA) and other treatments for autism.
Sponsored by Sen. Chip Shields, who chairs the Senate Consumer Protection Committee, the bill would amend the 2013 law by requiring the Public Employees Benefit Board, the Oregon Educators Benefit Board and OHSU to abide by requirements that autism treatments gain coverage. Because the health plans are self-funded, they are not governed under the state insurance coverage, thereby requiring special legislation.
The coverage would take effect next year if the bill is enacted.
Read more here in The Lund Report.
OHSU Prescribes ABA for Autistic Kids, but Keeps Treatment from Employees
President Joe Robertson said OHSU will comply voluntarily with proposed legislation from Sen. Chip Shields that mandates the medical school’s self-insured plan provide coverage in 2015. A second part of the bill corrects an oversight in an earlier autism bill and brings OHSU, OEBB and PEBB under the 2005 Oregon Mental Health Parity Act.Christopher David Gray
Editor’s Note: This article was corrected from an earlier version. Only the self-insured plans offered by OHSU and PEBB are exempt from the autism law passed last year.
Three years ago, Dr. Michael Kim left his position at the Mayo Clinic in Phoenix and took what he thought was a great career move — practicing medicine and coming on as a professor of otolaryngology at Oregon Health & Science University.
Kim would be able to raise his family closer to his childhood home in the Seattle suburbs. He could bring his highly specialized skill in the plastic surgery of the face, head and neck to Portland’s highly respected medical college.
But choosing to raise his son while working for OHSU had an unexpected consequence — to ensure his young son got the proper treatment for autism spectrum disorder, Kim would be forced to shell out $25,000 to $30,000 a year to pay for applied behavior analysis.
The Mayo Clinic’s health insurance plan pays for ABA therapy. OHSU — one of the leading centers for autism research and prescribers of ABA therapy — does not cover the treatment in its self-insured medical insurance policy.
“If I would have done more due diligence about what our insurance does cover, I would have thought long and hard about taking this job,” Kim told The Lund Report. “An institution that describes itself as a leader in autism research should be covering the basic treatment that helps kids on the spectrum.”
Sen. Chip Shields, the Portland Democrat and chairman of the Senate Consumer Protection Committee, has sponsored legislation for the February session that would force OHSU to cover ABA therapy, along with the Public Employees Benefit Board and the Oregon Educators Benefit Board. Those boards provide coverage for state employees, school teachers and their dependents.
Last year, the Legislature unanimously passed Senate Bill 365, the measure championed by Sen. Alan Bates, D-Medford, that mandated that private insurance companies in Oregon begin covering the leading treatment for autism in young children by 2016.
A key provision of that bill required PEBB and OEBB to cover ABA in 2015. Little did legislators or advocates know that the law would be moot because self-insured state health plans are exempt from the state insurance code as well as Oregon’s own mental health parity law.
Shields’ legislation will correct that, forcing all PEBB and OEBB as well as OHSU health plans to abide by the mental health law and cover treatment for disorders of the brain the same as it would other physical ailments. SB 365 does still apply to fully insured plans purchased by OEBB and PEBB, such as their Kaiser Permanente policies.
How no one noticed that the self-insured state insurance plans could ignore SB 365 was unclear until the law was passed.
“It seems that we solved this problem, but I didn’t think of the self-insured issue,” said Sen. Laurie Monnes Anderson, D-Gresham, at a legislative hearing last week.
Autism advocate Paul Terdal discovered the oversight when he began asking more and more specific questions of Insurance Commissioner Laura Cali, whom he said had been open to his concerns.
“Self-insured plans are not subject to the insurance code,” Cali told The Lund Report. She said that while she was the chief actuary when SB 365 was debated, she was not involved with the legislation.
She said state self-insured health plans are also exempt from the primary federal health insurance laws as well.
Terdal and the other advocates at Autism Speaks discovered the problem in the nick of time so that legislation could be drafted for the 2014 session. If it passes, PEBB and OEBB will be required to cover ABA next year as Bates intended.
“The [expense of SB 365] was built on the costs to PEBB and OEBB but it didn’t actually require it,” Terdal said, noting that the cost to the state general fund to provide the coverage to government employees was one of the biggest hurdles to passing SB 365. The new legislation, which has not yet been given a bill number, shouldn’t cost the state anything extra since the Legislature already budgeted the money last summer to provide the care in 2015.
Kim and other faculty at OHSU advocated for the hospital to cover ABA for months, to no avail. But with Shields’ legislation pending, OHSU President Joe Robertson finally responded to Kim’s concerns on Jan. 2, directing a human resources officer to arrange for coverage starting in 2015.
“Upon further review, I am instructing that OHSU follow PEBB and OEBB in regard to coverage of Applied Behavior Analysis in the OHSU employee benefit plan,” Robertson told Dan Forbes, in an email retrieved by The Lund Report.
OHSU spokesman Todd Murphy confirmed that OHSU would begin coverage of ABA next year, likely at the same time as OEBB and PEBB, but Murphy was unable to provide any more details by press time on the medical school’s current lack of coverage for its employees.
In the meantime, Kim purchased an individual policy for his son through Kaiser Permanente, which pays for ABA. He’ll have to switch to a Kaiser speech therapist but the family will stop having to pay for all of the intensive behavioral therapy out of pocket.
Kim is still not happy his son’s treatment will not be covered through his employer insurance at OHSU for another year. “If it’s right when it’s mandated, why is it not right to cover right now?” Kim asked. “OHSU’s stance is not to lead but to follow a mandate.”
Christopher David Gray can be reached at email@example.com.Jan 22 2014
The Autism Community Is Not The Autistic Community
Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid.
ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.
The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work.
What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.
The ‘cure’ for Autistics not born yet is the prevention of birth.
The ‘cure’ is a choice to terminate a pregnancy based on ‘autism risk.’ The cure is abortion. This is the same ‘cure’ society has for Down Syndrome.
This is eugenics 2021. Instead of killing Autistics and disabled children in gas chambers or ‘mercy killings’ like in Aktion T4, it’ll happen at the doctor’s office, quietly, one Autistic baby at a time. Different approaches yes, but still eugenics and the extinction of an entire minority group of people.
Fact: You can’t cure Autistics from being Autistic.
Fact: You can’t recover an Autistic from being Autistic.
Fact: You can groom an Autistic to mask and hide their traits. Somewhat. … however, this comes at the expense of the Autistic child, promotes Autistic Burnout (this should not be confused with typical burnout, Autistic Burnout can kill Autistics), and places the Autistic child at high risk for PTSD and other lifelong trauma-related conditions.
[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]
Fact: Vaccines Do Not Cause Autism.