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Michigan Autism Insurance Reform for Kids

The state finally passed a law in 2012 requiring insurance companies to cover treatment. As it takes effect Oct. 15, how will the medical community handle the influx of new patients?

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Because of this, Allen says, Michigan just doesn't have many ABA therapists, despite both Eastern Michigan and Western Michigan universities offering well-respected BCBA programs. Until now, professionals who were trained in Michigan have left the state for better employment opportunities, but AAoM is working to change that.

"There are significant efforts around the state to bring these BCBAs in. We started at 30 BCBAs in April; we're already to 41," Allen says. "We're recruiting alumni to come back and start centers."

The work seems to be paying off. Allen says other states that have enacted this legislation have taken three to five years to ramp up services to sufficient levels.

"I see Michigan taking one to two years for supply and demand to even out. We're taking implementation very seriously," she says. "Through Autism Alliance, we're working with universities, providers, insurers, parents. … That coordinated effort just hasn't been done anywhere else. We're really breaking new ground."

In the trenches

Kaufman Children's Center in West Bloomfield provides speech and occupational therapy, along with ABA.

Kerry Peterson, M.A., CCC-SP, BCBA, is co-director of autism programs at KCC, and says ABA is the most expensive intervention. She estimates it can add up to $50,000 a year to meet the national best practices guidelines for ABA therapy for children under age 6.

"For most families, cost has been a barrier," she says.

Right now, about 17 families are enrolled in KCC's ABA program, administered by Peterson and one other BCBA-certified professional. Peterson expects demand to increase in light of Michigan's new laws.

"We are worried. I have calls every day from families interested in getting on the waiting list. We are trying to figure out how we are going to adapt to all the families seeking this service," Peterson says. "At this point, we're trying to determine to what extent we're really able to grow our program and still maintain the quality."

As autism insurance reform plays out, Peterson says the center may consider expanding its facility and hiring more BCBAs. But therapists with experience are hard to find.

"We're desperate for good behavior analysts," she says.

Still, Peterson feels the new legislation will open doors for families who previously were locked out of treatment.

"I think it's going to be enormously helpful, because families have been really frustrated by the toll that it's taken financially," she says. "We have families take out second mortgages on their homes and grandparents spend their retirement savings in order to get the recommended treatment for their child or grandchild."

Professional testimony

For Stacie Rulison, ABA made such a difference for her son, she changed careers to become a therapist herself. Rulison left a high-profile job at EDS to take a position as operations director for AAoM, and pursue a master's degree in BCBA.

Rulison's son, Ryder, was officially diagnosed with autism at age 3. He was non-verbal, non-responsive to family members and, like many children with autism, appeared lost in his own world. Through 30 hours of ABA therapy each week, at an out-of-pocket cost of about $1,000 a month, Ryder made "amazing" progress, Rulison says.

"Within two weeks, he was saying 'mom' and 'dad.' Eventually, his phrases grew into sentences," Rulison says. "The therapy was so successful, it changed our lives."

Today, after two years of ABA therapy, Ryder is mainstreamed in second grade and, aside from some social struggles, common for children with autism, he is excelling behaviorally and academically.

Rulison enrolled in an online program through Arizona State University to become BCBA-certified. She also helps Dr. Colleen Allen present programs throughout the state to educate parents on how to take advantage of the opportunities afforded by Michigan's insurance reform.

Many parents are eagerly awaiting the release of information from insurance companies, so they get official diagnoses and make appointments for therapies they are eager to pursue. So far, insurance companies are slow to release information as they scramble to prepare for a flood of demand. About 2,000 children are expected to seek therapy under insurance reform in the first year, according to the State of Michigan.

Rulison encourages parents to reach out to their insurance companies for help navigating new benefits.

"Now the real work starts," she says. "But I don't know of any other state that's gone to such lengths to get programs into effect before the insurance takes effect."

Sep 26, 2012 06:45 pm
 Posted by  Carolyn

I am actually disappointed in this article for a couple of reasons. One it doesn't show both points of view on the legislation and also doesn't provide adequate information for those seeking support in what to do other than be directed to AAoM.

I was contacted by Ms. Buskirk about this piece, as a parent of a now twenty one year old son living with autism who has been actively involved now within disabilty policy for over two decades. I advised her of the view of many in this state and across the country. We are seeing bad policy being passed to build a cottage industry that at best will assist very few individuals on the autism spectrum. Data shows that.

Additionally what was not said in this article is the legislation does not provide for medical choice for families. Many research studies now show that many individuals living with autism have medical concerns that need to be addressed that behavioral intervention will not. It only comes to reason also if a child is in pain, and cannot communicate that, then they may have behavioral challenges.

We as a community have recognized this and many medical professionals in MI are now treating the root medical cause of many symptoms in children and adults with autism. It should be an option and also covered by insurance.

Only depicting those connected to the field of ABA and those that will benefit financially from this other than Ms. Espinoza, also does not assist those looking for other options that work like PLAY,RDI,& biomedical.

Lastly the bill S-981 is a discriminatory piece of legislation that uses tax dollars to pay private insurers to continue to discriminate. Limiting these bills by age and disability and using those funds for private enterprise also is a violation of ADA. It's unfortunate a new organization like AAoM, who has not been supporting those with ASD in the state, didn't realize that actively passing this legislation. Many groups that support families daily did not support these bills.

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