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Rising autism rates prompt bill


A bill to expand autism treatment by amending legislation passed last year that mandated insurance coverage for autism diagnosis and treatment in children is awaiting consideration in the Rhode Island General Assembly. 

The House of Representatives and Senate bills — sponsored by state Rep. Peter Palumbo, D-Cranston, and state Sen. Edward O'Neill, I-Lincoln, North Providence and Pawtucket — would slightly alter the wording of last year's law by adding psychiatric, psychological and pharmaceutical treatments to the list of services insurance providers must cover. The current law specifies mandatory coverage for speech, physical and occupational therapies.

The amendment would shift the focus toward earlier intervention in diagnosing and treating autism spectrum disorders, O'Neill said. The amendment would also require that practicing behavior analysts — specialists who work with and recommend resources to people recently diagnosed with autism and other brain-based disorders —  be licensed with the Rhode Island Department of Health. The law currently allows any licensed health care provider to practice applied behavior analysis.

The legislation moved forward after being endorsed by the state's Joint Commission to Study the Education of Children with Autism, said Judith Ursitti, the director of state government affairs for Autism Speaks, an autism advocacy organization. Ursitti, who has worked to get similar laws passed in other states, testified before the commission on the importance of both last year's legislation and the proposed amendments. Palumbo also chairs the commission.

Rising rates of autism diagnosis prompted the legislation, O'Neill said. O'Neill, whose adult daughter has autism, said he understands what it is like for parents to feel like there are insufficient resources for their autistic children. One in 110 children falls somewhere on the autism spectrum, according to data from a 2006 Centers for Disease Control and Prevention study.

Twenty-nine states, including Rhode Island, currently mandate autism insurance coverage for children, Ursitti said. But only a handful of states have licensing laws for behavioral analysts on the books, she said.

Expanded mandatory insurance coverage would give families easier access to diagnostic and treatment services than what insurance companies might otherwise offer due to autism's chronic nature, said Jane Carlson, clinical director of the adolescent residential program at the Groden Center, which provides educational care and other services for children under 21.

Concessions were made during last year's passage of the bill by capping mandatory insurance coverage at 15. Autism activists like Ursitti would have preferred no cap, she said, but compromise was necessary to appeal health care insurance providers and other businesses concerned about cost. The law currently caps the amount of coverage for treatments in behavioral analysis at $32,000 per person annually.

Early intervention at two to three years of age can make a critical difference in the degree to which children become familiar with the mainstream, Carlson said. The average age of autism diagnosis has dropped in recent years — from five or six down to two or three, in Carlson's experience — which has made it easier for treatment providers to instill social interaction, cognitive and other skills that allow children on the autistic spectrum to function in schools with their non-spectrum peers, she said.

A Jan. 24 article from the news website Stateline reported that Rhode Island had the highest percentage of students enrolled in special education classes, a statistic that suggests the state is doing well at identifying children with autism and other disabilities, Ursitti said. But that has not stopped some medical practitioners from leaving the state for nearby Massachusetts and Connecticut due to the lack of state funding, she said.

"This has been a year of unprecedented cuts for people with disabilities," Carlson said, referring to the General Assembly's move last year to cut $24 million in funding for disability programs.

Part of the problem is that "people with disabilities tend to be on the target list," Ursitti said, and those with brain-based disorders are often excluded in particular because "you can't do an MRI or an X-ray" to show concrete proof of disability.

But state Rep. Scott Guthrie, D-Coventry, is looking to restore much of that funding with a bill he introduced to the House last month. Guthrie's bill — which aims to provide broader disability funding to adults — would reinstate about $12 million of state funds that were cut, he said.

The House bill is currently scheduled for a committee hearing Wednesday.


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