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."
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."