Autism Insurance Reform

The CDC estimates that 1 in 88 children has been identified with an autism spectrum disorder. This is a 23% increase since their last report in 2009. ASD's are almost five times more common in boys, 1 in 54, than in girls, 1 in 252!

Applied Behavioral Analysis (ABA) is an 'evidence-based treatment' that has demonstrated success for children with autism, especially those who are younger.  It has its origins in behavioral therapy and teaches social, motor, and verbal behaviors as well as reasoning skills.  ABA treatment is especially useful in teaching behaviors to children with autism who may not otherwise "pick up" these behaviors on their own as other children would.  


ABA has been around for quite some time, but there has been barriers from accessing it.  First, it took many years of research for autism to be recognized as it is now.  Second, insurance companies haven't historically covered 'specialty treatments' for behavioral health.  ABA is a specialty treatment and very costly.  However, the long-term savings is great.  Lastly, even if this were a covered service there is a lack of professionals competent to deliver the service.  Very few areas in Michigan have a Board Certified Behavioral Analyst. 
   
This week the Michigan House of Representatives overwhelmingly approved a series of bills that, if signed into law, would compel insurance companies to cover autism diagnoses and treatments for children, specifically Applied Behavioral Analysis (ABA).  Governor Snyder is also setting aside funding for children on Medicaid or MI Child that need this treatment.  Additionally, there is a plan to develop provider networks and increase the number of certified professionals.

Shiawassee County Community Mental Health Authority is a strong advocate for young children and supports any reform that improves behavioral health care for this population.  Focusing on people's needs when they are young significantly improves their quality of life and in the long-term reduces cost.  However, as advocates will agree, it requires care that is 'gold standard' and evidence-based treatment proven to be successful.

Representatives from SCCMHA have been involved in a state level work group that will make recommendations regarding evaluation and covered ABA services for children with autism receiving Medicaid.  Focus will also be on increasing the number of providers across the state.  This role is an honor and a responsibility that is taken seriously.

Due to the increasing number of young children being referred for services and in preparation for the future, SCCMHA is recruiting a behavioral assistant to increase our capacity to serve young children with behavioral needs.  We are also recruiting a Certified Occupational Therapy Assistant to assist our Occupational Therapist in delivering much need sensory services to the increasing number of children being served in the Sensory Clinic.  One of the reasons for developing a robust team of professionals to provide ancillary specialty services is to more effectively serve children with complex issues, i.e. autism and other disorders on the spectrum.      

Shiawassee County Community Mental Health Authority looks forward to being a partner and playing an active part in treatment reform for children with autism.

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