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The Autism Waiver To:
PARENTS, PROFESSIONALS AND FLORIDA LEGISLATORS The incidence of autism in increasing in the State of Florida and around the Country. We are struggling and straining to keep up with the services our children require. In the 1999 session we
were unsuccessful in passing the Autism Insurance Bill in the House,
although it passed 39-1 in the Senate. The insurance industry claims the
Bill is too costly and that the Department of Education is responsible
for teaching autistic children speech and motor skills. The industry’s countless claim denials, asserting that “since children’s language is not ‘rehabilitative’ they must learn to speak in school,” are unjustified. Speech and occupational therapy services for children with autism are based upon the same medical concepts applied to stroke victims, i.e., training another part of the brain to speak. This identical therapy also facilitates a 4 year old's language to emerge and mastery of fine and gross motor skills. The insurance industry provides these services to other policyholders but denies autistic children. Unfortunately, since the Bill did not pass, many children have had to go another year without services and it becomes harder for them to function and harder for their families to endure. This legislative session, we propose to implement a potential solution that hopefully will be acceptable to all parties involved. Instead of finger pointing, we are investigating a plan to have children who are diagnosed with autism deemed automatically Medicaid eligible under the Autism Waiver, with precedence set in the State of Georgia. This would provide an opportunity for the DOE to receive reimbursement from the federal government, under the Medicaid Match program, for all school-based services provided to Medicaid-eligible children, if those services are medically based. In the event the school-based services are not sufficient, then a policyholder’s private insurance would kick in, with limitations that the insurance industry could support. If and when those benefits are exhausted, and the child needs additional intervention, Medicaid would become a tertiary coverage. According to this plan, the financial burden of care would be more amenable to all since it would be spread over more entities: the DOE, the Insurance Industry, Medicaid, Parents. Upon commencement of the plan, the legislature must initially provide a maximum increase in FTE funding for children with autism, so that services will be funded fully and can be provided in the schools. The State then would recover these funds under the Match program since the autistic children receiving services would all be Medicaid-eligible under the Deeming Waiver. This would become somewhat of an annuity. Hopefully, we can reach an agreement with the insurance industry and the State that is acceptable to all. Not only does the quality of life for many children depend on it, but in the end, the State ultimately must bear the full burden of care for these individuals. Intense early intervention has proven that autistic children can learn and become productive citizens. We must give them the chance. For every $1 we spend today we save $7 on future care. Please encourage all affiliated persons to favorably consider this solution and thank you. |