[Note: Shared for #AutisticHistory archive purposes. This is NOT An Autistic Ally.]
CA State Employees Gain ABA Coverage through Court Ruling
September 11, 2013
LOS ANGELES (September 11, 2013) — A California policy that allowed unlicensed but nationally board-certified ABA practitioners to provide therapy under some health plans but declared this illegal for plans covering lower-income families and state employees is “nonsensical” and void in light of California’s 2011 autism insurance reform law, a state appeals court has ruled.
The case was brought by Consumer Watchdog on behalf of state employees covered under the California Public Employees Retirement System (CalPERS) against the state Department of Managed Health Care (DMHC), which enforced the policy. The Autism Speaks Legal Resource Center, represented by Executive Director Dan Unumb, and Robert Barnes, Esq. of Kaye Scholer, intervened as a “friend of the court” on behalf of the successful plaintiffs.
“This decision is a victory for autistic children of firefighters, police officers, and low-income parents as it clarifies that they can’t be treated differently than those covered under private health plans,” said Consumer Watchdog attorney Jerry Flanagan.
A trial court in early 2011 ruled against CalPERS employees, concluding that DMHC could require ABA providers to hold a state license in order to be reimbursed by health insurance.
Autism Speaks, Consumer Watchdog and other advocates then worked with California Senate President pro Tem Darrell Steinberg to craft an ABA bill that ultimately passed the legislature and was signed by Gov. Jerry Brown in October 2011. The ABA bill provided that professional certification by the national Behavior Analysts Certification Board (BACB) would be sufficient for ABA practitioners to work in California, allowing their services to be covered by insurance.
The appeals court held that the 2011 ABA law served as an implicit legislative exemption to California’s psychology practice act that effectively recognized that unlicensed BCBAs can deliver ABA treatment in California, even under plans like CalPERS and Healthy Families that are not specifically covered by the ABA law.
The court concluded that this exemption had to be interpreted broadly, otherwise a BACB-certified practitioner would be acting legally in treating a child with autism, but if the family switched to CalPERS coverage, the same practitioner delivering the same treatment to the same child would be acting illegally. “Such a result would be nonsensical,” the court found.
As a result of the legislation and the lawsuit, “the DMHC can no longer use licensure as a barrier to ABA treatments for autistic children,” said Fredric D. Woocher of Strumwasser & Woocher LLP. “When we filed this lawsuit, HMOs were denying autistic children the most effective medical treatment that is available, with severe consequences for them, their families, and the state’s taxpayers. HMOs were blatantly violating California law.
“DMHC’s practice of requiring licensure led to the agency’s upholding HMOs’ denials and delays of this critical treatment for autistic children and their families at the time they need it the most,” Woocher said.
Although the appeals court only required coverage of BCBA-provided and supervised ABA for treatment occurring after July 1, 2012, the court offered strong support for ABA, noting that numerous studies have demonstrated that ABA is the most effective known treatment for children with autism and that the treatment has lasting results.
The 2011 ABA law is scheduled to expire on July 1, 2014. Legislation extending that deadline through 2016 has been approved by the Legislature and sent to Governor Brown.
State licensing issues involving ABA practitioners has frustrated the implementation of autism insurance reform laws in a number of states besides California, including New York, Virginia and Rhode Island and Autism Speaks continues to work through the courts, regulatory agencies and state legislatures to resolve these issues and insure that coverage reaches those in need
The Autism Community Is Not The Autistic Community
More With Autism Votes
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.