www.baltimoresun.com/news/opinion/oped/bs-ed-autism-20120419,0,4484079.story

baltimoresun.com

Maryland again fails autism community

In face of a major national health emergency, state again declines to require insurers to cover needed therapies

By Ian Paregol

3:09 PM EDT, April 19, 2012

Advertisement

This week, Michigan became the 30th state to require insurance coverage for autism therapies. Meanwhile, here in Maryland, the General Assembly has for the fourth consecutive year failed families of children diagnosed with autism spectrum disorders — one of our most significant national health emergencies.

Autism is a complex neurological disorder that typically impacts an individual throughout his or her lifetime. It is found in all ethnic, racial and social groups, affecting a person's ability to communicate and relate to others. Perhaps most disconcerting, the prevalence of autism is growing, up 78 percent over the last decade.

If we consider the number of children born in the U.S. in 2010 (4.05 million), allocate Maryland's proportional share of those births (1.87 percent) and weigh those figures in light of the newly revised autism prevalence rate as determined by theU.S. Centers for Disease Control and Preventionof one child in 88 births, approximately 16 children will be born in Maryland each week — 832 each year — who will eventually be diagnosed with autism using the existing diagnostic criteria. These children will join the thousands who have already been diagnosed and who will not be afforded coverage for critical early intervention services through their health insurers — therapies that are mandated by legislation in 30 other states to be covered by insurers.

Why is early intervention important? Study after study has shown that providing a child diagnosed with autism with an array of services such as speech, behavioral strategies and socialization therapy before his or her 5th birthday can drastically reduce the number of supports that child will need throughout life. Maryland's health insurers balk at covering the costs of these empirically proven therapies, which not only address behavior and communication but also increase a child's ability to learn.

By continuing to listen to insurance company lobbyists lamenting the added costs associated with even limited coverage for evidenced-based early intervention services, Maryland lawmakers have done a disservice not only to the children and families in need of more services than public agencies can provide, but it has also done a disservice to the general public. The General Assembly has failed to recognize the added economic costs to its citizens who will be asked, through additional taxation and other means of revenue generation, to support the growing tidal wave of adults who will need additional supports because they did not obtain a more favorable outcome through early intervention.

Finally, data from four states that have benefited from insurance coverage for more than two years — South Carolina, Illinois, Florida and Arizona — suggest that the annual additional premium costs related to the provision of therapy coverage per policy-holder is about $4 per year, far below the insurance industry's initial projections. For what appears to be a negligible effect on premium cost, autism insurance reform holds the promise of significantly improving the lives of thousands of Maryland's children.

As the executive director for Community Services for Autistic Adults and Children (CSAAC), I have seen what a difference early intervention can make in the life of a child with autism. Of all of the supports that are provided at CSAAC for children and adults, our early intervention program is the "game-changer." With early intervention, fewer children will go to state-funded non-public schools; fewer adolescents will end up in state-funded group homes; fewer adults will need lifelong funding through the Developmental Disabilities Administration; fewer parents of children with autism will end their relationships in divorce; and more children will attain "best outcomes" — profoundly changing their lives and the lives of those around them for the better.

Ian Paregol is the executive director of Community Services for Autistic Adults and Children (www.csaac.org), a Montgomery County-based nonprofit that operates an Intensive Early Intervention program for ages 18 months to 7 years, two non-public schools, 52 community residences for children and adults and a supported employment program for adults. His email is iparegol@csaac.org.