State health officials this week said 105 children have received autism therapy since the Medi-Cal benefit was officially launched Sept. 15. Officials said the state would require a comprehensive diagnostic evaluation before those services would be covered.
First step toward collaborating systemwide to address need for treatments. Epidemiologists and geneticists joined neuroscientists and psychiatrists as more than 50 researchers from five UC campuses participated in the daylong summit at the UC Davis MIND Institute in Sacramento.
President Obama signed into law the bipartisan Autism Collaboration, Accountability, Research, Education and Support Act, or Autism CARES Act of 2014, into law. Autism CARES, which reauthorizes the Combating Autism Act, continues important investments in research, prevalence monitoring and services for both children and adults on the autism spectrum.
State officials said yesterday autism therapy clearly is a covered Medicaid benefit, and they hope to submit a state plan amendment by Sept. 30 to start the process to make it a Medi-Cal benefit for those under age 21.
Medi-Cal Funding For ABA Fails, But New Option Emerges: DHCS directed to add behavioral health treatment to state's Medicaid program, consult with stakeholders
SACRAMENTO (June 13, 2014) -- A $50 million appropriation sought for Medi-Cal to provide behavioral health treatment for autism failed to make the final cut in California's state budget negotiations. But the Department of Health Care Services (DHCS) will be directed to incorporate the treatment in Medi-Cal, which is the state's Medicaid program, and request the Legislature for an appropriation. "We are disappointed that this appropriation failed, depriving hundreds of California children with autism with access to medically necessary treatment that can make an enormous improvement in their quality of life," said Kristin Jacobson, state policy chair for Autism Speaks. "This is particularly frustrating given the acknowledgment by at least two state agencies that delaying treatment causes irreparable harm.
"However, we take heart in the Legislature's directive to DHCS to right this wrong by building the benefit into Medi-Cal," she added. "We commend Senate President pro Tem Darrell Steinberg (left) for his continued leadership on behalf of the California autism community." The issue arose in 2013 when the Healthy Families program was shuttered, resulting in the transfer of thousands of children into Medi-Cal. Children who were receiving Applied Behavior Analysis (ABA) behavioral treatment in Healthy Families lost the service when they entered Medi-Cal.
An attempt was made in the recently concluded state budget negotiations between the Legislature and Gov. Jerry Brown to add a $50 million Medi-Cal appropriation to restore the coverage, but it failed to make the final agreement. In its place, behavioral health treatment was determined to be a Medi-Cal benefit and DCHS, which administers the program, was directed to start the administrative process of including it. That process will require outreach to federal Medicaid authorities as well as stakeholders. DCHS would need to seek statutory authority on how to implement the new benefit, and determine eligibility criteria, provider participation criteria, utilization controls and a delivery system structure. The department would be required to develop an appropriations request, conditioned on assurances of federal financial participation.
The Legislature directed DHCS to add the benefit when it is federally required. "We believe ABA coverage is already required under Medicaid given successful lawsuits in other states, such as Florida, and the federal government's recent approval of ABA benefits added by Louisiana and Washington state," Jacobson said. "The Louisiana and Washington plans now cover behavioral health treatment as a benefit under EPSDT (Early Periodic, Screening, Diagnosis and Treatment). "EPSDT benefits may not vary from state to state, so if the benefit is valid in one state it should be required in all states," she said.
Autism Leg Package
Dr. Lou Vismara, Policy Consultant to Senator Darrell Steinberg, announced that his office is working with other Senators on a package of bills that are related to autism & developmental disabilities. Attached is a list of this legislation. We will post more information as these bills advance through the legislative process. Please forward this info to other interested individuals/organizations.
California lawmakers revisit policies on autism treatments
The Autism Hearing on the implementation of California's autism insurance mandate (SB 946) was convened by Sen. Steinberg and other members of the Senate Select Committee on Autism & RelatedDisorders. The video of the hearing is available here . Information on the hearing is attached; and a TV news story on the hearing can be viewed at this site.
Senate pro Tem Darrell Steinberg "Speaks Out" in Support of Autism Legislation
House Approves 'Kids First' Bill Adding Research Funding
WASHINGTON, DC (December 11, 2013) -- The U.S. House of Representatives today approved the Gabriella Miller Kids First Research Act on a bipartisan 295-103 vote. The bill was first announced by House Majority Leader Eric Cantor (R-VA) on April 2, World Autism Awareness Day, as a way to increase federal funding for pediatric research, including autism.
Sponsored by Rep. Gregg Harper (R-MS), the bill would redirect public funding now dedicated for the national Presidential party conventions to pediatric research, including for autism. The bill originally would have eliminated public funding for all elements of the Presidential campaigns, but it was modified to affect just funding for the conventions.
The bill moves next to the Senate. The bill was recently renamed after a 10-year-old girl who died in October following an 11-month battle with an inoperable brain tumor. It is estimated the bill would add $126 million for pediatric research grants over 10 years.
"Anova expects bumps in the road and finds out what makes these kids tick, what engages them, and what their strengths are. They focus on the positive attributes of each child, and by doing so undesirable traits fade away. Whereas others saw nothing but challenging behaviors, Anova sees an academically gifted, polite and sociable young person with great potential for success."
"At Anova, my son is taught by people who understand his needs, and respect and care about him. He is now a totally different child; he's a confident, happy, and funny boy with friends,good grades, and in an environment allowing him to reach his full potential...and he achieved it all because of Anova."
"Before Anova our family seemed caught in a web of confusion, of unanswered questions, of unsolved dilemmas, of anger and fear. At Anova we've been met with caring , compassion, competence, and most importantly, with people who truly have their hearts into helping these kids. I can't say enough about the integrity and mission of Anova, and for the quality and professionalism of the administrative as well as the teaching staff. For the first time I can breathe a sigh of relief knowing that my son is being taught to live in the world and to grow to the best of his ability by loving, professional people I trust and have faith in."
"Anova saved my son from being institutionalized. Prior to Anova, he was failing miserably and we were losing control of him...In all my years as a public school teacher and parent, I have never seen a more dedicated staff. They are working as hard as I am to make sure my child succeeds. Anova has not only given my son an opportunity at a rich and fulfilling life, they have given me my life back as well."
"The four months since our daughter began attending ACE have been the calmest in our family's life for the past 16 years. Rosie is happy and safe at ACE and, not incidentally, she is easier to live with. Prior to Anova, our daughter's teachers didn't understand her perspective or needs. As parents, we didn't fully understand her either. Anova faculty and staff value how she experiences the world and have a plan to meet her needs. Before attending Anova, never did Rosie get up willingly to go to school. Today, she is eager and independent, looking forward to the arrival of the bus each morning. What has Anova done for us? ...transformed our family life."
"Our son comes home each day with a smile on his face and stories to tell. He has friends, a teacher and staff who know what he needs and provide it to him. Anova has given my son a chance to be a student, a friend, and most importantly, a sense of belonging to something 'normal'."
"Anova Education listens. They listen to students. They listen to parents. They listen to our community. So many of us in the autism community feel that no one listens; that no one cares. I know I felt that way. I know my son felt that way. We don't feel that way any longer...thanks to Anova."
"Finding and nurturing students' strengths is what ACE is all about. All the teachers at ACE have made Nate a happier person, our lives richer and more peaceful, and the future so much brighter than we ever could have imagined."
"There are no words that could express how much we love our ACE teachers and staff. They took a boy that was damaged and molded him into a confident young man. They also took me, a cynical and distrustful parent, and showed me that there really are people that care. They are remembered in our prayers every day. We love you."
"Our son has ADHD and Asperger's Syndrome. Changes in school environments had been very painful and affected his self-esteem. Within 8 weeks after starting at Anova, he told me on the car trip to school that he really loved going to Anova. I replied, "that's great! Why do you like Anova so much?" His response was telling: "because they get me and I feel like I'm somewhere I can finally grow."
"Anova has changed our world. The opportunities that my son has at this school are so many. I have watched him gain confidence, make friends and keep them, and have a staff that creates an education plan meeting and fulfilling his needs. I really can't say enough about this school that is more than a school."
– Anova Parent
"I had a district representative tell me recently that in her 27 years of education, she thinks we are by far one of the most exceptional programs she has ever seen. She is new to the area and had never been to ACE. Heidi said, "After tours and IEP meetings, people are always telling me what a talented staff we have and it is so very true. I am grateful every day to have the opportunity to work with each and every one of them! They never cease to amaze me with their talent, dedication and passion for what they do. They change lives every day."
"We experienced an immediate, dramatic, and lasting improvement in our daughter's (and her family's) situation upon transferring her from her public high school to ACE. Other families at the school report similar experiences. "
"Our Asperger's child won his elementary school's spelling championship, won a regional spelling competition, and went on to compete in a county-level spelling contest before losing interest. Without his perfectly-trained Anova assistant and the individualized behavior plan developed by Andrew Bailey, this child would not have been able to tolerate the social aspects involved in competition and recognition."
"When you are the parent of a child with special needs, there is no mountain you will not try to move. When our son was overwhelmed and frustrated by high school we sought help through Anova. Anova found the perfect behavioral aide to stand shoulder to shoulder with our son, someone with strength and character who spoke to our son the way we wish every teacher could. Anova has this family's gratitude"
"Since starting my child at the ACE School, I have had the delight of watching my son blossom both behaviorally and academically. What's more, his teacher has helped me with a system that applies the social skills he is learning at school to our home environment. I am amazed at the changes I have seen."
"My son has been at Anova for over four years now and I can't believe he is the same child or young man. He is happy...happy with who he is...and he has friends! He has come so far. I will never be able to thank Anova enough for helping him find happiness again. My son will become an Eagle Scout this year. I never thought that would happen. The staff at ACE is so outstanding; words just don't say enough. They realize each and every child has different needs and try to meet them one way or another. Thank you from the bottom of our hearts!"