The Next Big Autism Bomb - David Kirby

David Kirby

The Next Big Autism Bomb: Are 1 in 50 Kids Potentially at Risk?

On Tuesday, March 11, a conference call was held between vaccine safety officials at the US Centers for Disease Control and Prevention, several leading experts in vaccine safety research, and executives from America's Health Insurance Plans, (the HMO trade association) to discuss childhood mitochondrial dysfunction and its potential link to autism and vaccines.

It was a sobering event for all concerned, and it could soon become known as the Conference Call heard 'round the world.

The teleconference was scheduled by a little known CDC agency called the Clinical Immunization Safety Assessment (CISA) Network, a consortium of six research centers working on "immunization-associated health risks," in conjunction with the CDC's Immunization Safety Office and the health insurance lobby -- whose companies cover some 200 million Americans.

The hot topic of the day was mitochondria - the little powerhouses within each cell that convert food and oxygen into energy for use by the body. Recent news events have implicated mitochondria in at least one case of regressive autism, following normal development.

To read more click here.

A grandmother's plea for Nick's Law

As the grandmother of a young child with autism, I have seen first-hand what a burden this disease places on families emotionally, physically and financially.

I have also witnessed first-hand the positive results of one-on-one ABA therapy. This therapy is recognized to be one of the most beneficial treatments for autism and gives parents much reason to hope for a brighter future for these children. Unfortunately, it is very costly, and without any outside assistance, it is out of reach for many parents, most of whom are young adults trying to raise a family and pay their bills.

Our state legislature recently had an opportunity to help these young people by passing SB 1537, known as "Nick's Law," which would require insurance companies to cover some of the costs for therapy and other related treatments for autism.

We asked our own senator, Todd Lamb, to support this bill only to be told he would not support a bill which placed mandates on insurance companies. (Some form of coverage for the treatment of autism is mandated in 17 other states, and studies have shown that any increase in insurance premiums is minimal.)

Apparently Mr. Lamb and many of his colleagues are more interested in catering to insurance companies than in helping Oklahoma's children. What a travesty. I hope many voters, will remember this when these politicians come up for re-election.

Donna Greve
11501 Richaven Rd.
Oklahoma City, OK 73162

As autistic children age, society faces challenges

Saturday, March 22, 2008

By JANET ZIMMERMAN
The Press-Enterprise

The state of California has been dealing with the explosion of autism cases among young children for more than a decade, but there is another wave coming.

The oldest children, the first in a spike in autism cases that began in the 1990s, are moving into adulthood, which has experts, educators and service providers bracing for the new and unique needs of that population.

"What's uncharted is the sheer volume, which then affects the number of resources you have to develop to meet their needs," said Julia Mullen, a deputy director with the state Department of Developmental Services.

Diane Woolsey, of Wildomar, began looking at options a few years ago for her son Brandon, who at 22 "ages out" of the school system this year.

Brandon Woolsey is severely autistic and functions at a first-grade level. He needs one-on-one care, which is rare in the adult day care programs currently available, she said. He also wouldn't do well in a workshop setting because the noise and number of people would overwhelm him, Woolsey said.

But Brandon is good with his hands and does well outside, so Woolsey and her friend are hoping to start a ranch where Brandon and a few other autistic men could live and work in a structured environment tending a garden and horses.

"I said my son is always going to live with me, but the reality is he can't unless we outlive our kids," Woolsey said. "As he got older, I started thinking about what's fair to him as a young man. He deserves to be as independent as possible."

The highest functioning people with autism, with some personalized help, will be able to go to college, hold jobs and live independently.

Those with severe autism may need residential care, day programs and transportation -- all more costly to the system than children being cared for by their families.

Of the 36,952 people with autism now receiving disability services from the state, 31,376 -- 84 percent -- are younger than age 21. The state is in the process of making population projections for the next few years.

Among the developments for serving adults with autism:

The Inland Empire Autism Society and Riverside County Office of Education are working to develop more job-specific training programs for teens and young adults with autism.

Legislators last year increased the rate paid for state-approved providers who develop jobs suitable for those with autism. Such jobs require consistent supervision, little distraction and tasks that can be broken down into small, learnable steps, Mullen said.

Several local schools and agencies have hired consultants to coach them on developing micro-enterprises, which are small businesses such as coffee carts and mobile shredding services to allow people with disabilities to work at their own pace.

Colleges are accommodating students with autism with such services as note takers, private dorm rooms, distraction-free areas for taking tests, and social, academic and independent living support.

Services such as Nashville, Tenn.-based College Living Experience, a company that provides help for students with learning disabilities, are including autism. Six sites across the country, including Monterey, offer apartments within walking distance of college campuses. Advisers help with academic tutoring, social outings and independent living skills, said Mark Claypool, the company's president and chief executive officer. The program, which costs $35,000 a year, not including college tuition, has grown from 50 to 178 students in two years, he said.

Reach Janet Zimmerman at 951-368-9586 or jzimmerman@PE.com

The Hartford Courant

LETTERS TO THE EDITOR

Insurers Should Pay For Diagnosis

March 23, 2008

Harriet Clark's March 15 letter ["Services Accessed Through Schools"] contained some inaccuracies, but more important, it also missed the point of my testifying before a legislative subcommittee.

I, like many people, have spent a very large percentage of my income on health insurance because, like many people, I expected my insurance to pay for the basic medical needs of my family. It was only when my son was diagnosed with autism that I learned that somehow my insurance company, like most in this state, was not required to pay for my son's medical needs due to autism.

Although I applaud Ms. Clark for directing people to birth-to-3 services, those services, as well as the ones provided by public school systems, are not a substitute for the medical intervention for which my insurance company refused to pay. It is out of the scope of practice for the birth-to-3 or public school speech and language pathologists, teachers, and occupational or physical therapists to diagnose autism. This is a medical diagnosis and must be done by someone such as a neurologist or physician who specializes in developmental disorders.

This rather expensive medical diagnostic was not paid for by my insurance company. I testified before the legislative subcommittee to ask that the General Assembly mandate that insurance companies pay for medical coverage such as this for children with autism.

If readers agree, they should ask their state representatives to back House Bill 5696.

We, the citizens of Connecticut, spend our hard-earned money to buy health insurance to pay for our families' medical needs. It's time that insurance companies be forced to do what we pay them to do: provide for the basic health care needs for all of their customers — including those with autism.

Barbara Zachs

An Epidemic, a Vacuum and an Opportunity

By Caryn Sullivan
Article Last Updated: 03/25/2008 06:59:55 PM CDT

The federal compensation court settlement of Hannah Poling's autism/vaccine claim has shined a spotlight on an emotionally charged controversy within the autism world. Since our son's autism diagnosis, I've sat on the sidelines of this rabid dispute, deliberately focusing on the fix, not the culprit. In the wake of the Poling settlement, however, it's hard to ignore the polarization that media coverage has illuminated. Angry parents point fingers at the Centers for Disease Control and Prevention, saying, 'gotcha,' while the CDC refuses to give them their fiercely sought concession — a mea culpa.

Despite emphatic statements by the CDC, the American Academy of Pediatrics and the Institute of Medicine that the thimerosal in vaccines did not cause or contribute to Autism Spectrum Disorder (ASD), many parents and organizations like the Coalition for SafeMinds, Generation Rescue and Autism United point to evidence they believe supports both a causal link and a cover-up.

The debate continues because there are many questions but few answers. It's easy to understand why some parents engage in the battle, and why the CDC is so resistant, for that matter. Much is at stake. Parents feel they followed the rules but their children's future was hijacked because those charged with protecting them failed to do so. Experts warn that failure to follow vaccination schedules subjects children and society to significant health risks. Heads spinning, all parents must decide whether to vaccinate their children. So this issue affects more than the thousands of families with ASD challenges.

When our son was diagnosed in 1993, ASD reportedly occurred in 1 in 10,000; current estimates are at least 1 in 150. The vaccine debate is one of many that thrive in the dearth of concrete answers about the cause of and treatment for ASD. The absence of answers created a vacuum that has been filled by theories, distrust and activism. Fortunately, increased awareness has resulted in increased funding for researchers. As researchers peel back the layers of the onion, there seems to be a growing consensus that both genetic and environmental factors are implicated in the disorder. Bit by bit the mystery is unfolding.

Although there are vastly more resources for families today than when autism plowed through our door, there's no playbook. Consequently, too many families must navigate this complicated disorder by the seat of their pants. Parents are given a diagnosis based on observations, not medical tests. With a few exceptions, there is scarce hope for a cure.

Frantic parents search for answers where there are few, always conscious that the earlier their child receives treatment, the better his outcome. Many deplete their emotions and finances, abandon careers and strain marriages beyond repair in a desperate attempt to get their kids to talk, use the bathroom, find the right school, make a friend, get a job, live independently. The broad constellation of needs affects a host of Minnesota's systems that are already under siege — education, health care and social services, in particular. While the individual's needs may change over time, the cost to both families and taxpayers to manage this lifelong condition will be considerable.

There is some good news. Early intervention programs using educational and therapeutic approaches have documented success and are on the increase. Yet those approaches do not address the concurrent medical issues of a considerable segment of this population. There is not yet a universally accepted body of evidence-based medicine to guide practitioners, principally with respect to gastrointestinal and sleep issues. There are medical practitioners, however (many of them not MDs), who follow a bio-medical protocol including medicine, nutraceuticals, therapies and special diets that are presumed to do no harm but are often reported, especially by parents, to produce results. Because these treatments have not been subjected to gold standard research, they are typically not practiced by "mainstream physicians" and aren't covered by health insurance.

The bottom line is there is a critical need for evidence-based research that explains the condition and provides appropriate treatment options that will be covered by insurance and provided by well-trained physicians. To achieve this requires significant funding and staffing.
We have a world-class university and medical school in our backyard that is well positioned to make a notable contribution. While some faculty members are dedicated to the cause, the administration seems more comfortable putting a toe in the water than jumping in with both feet. It's time for our state and university leaders to acknowledge the epidemic and commit greater resources to support the work of those who are searching for causes and treatments for ASD. It's time to fill the vacuum and end the finger pointing.

Caryn Sullivan is a Minnesota attorney and writer. Her column appears occasionally on these pages. Her essay, "Dancing with Despair," is featured in "Special Gifts: Women Writers on the Heartache, the Happiness, and the Hope of Raising a Special Needs Child" (Wyatt-Mackenzie, July 2007). Her email address is carynsullivan@comcast.net

Nick’s Law – the Politics of Health Care Mandates

By Robyne and Wayne Rohde

Oklahoma’s Legislature is considering Nick’s Law. Nick’s Law will allow parents to obtain a timely diagnosis and effective treatments for their children with autism. It is the cornerstone for providing a wholesale and systemic change in the way families in Oklahoma care for their autistic children. Private insurance will be required to cover the diagnosis, treatment, and medically necessary therapies these children must have to become independent adults.

Autism is the fastest growing disease in the country and per the CDC is more prevalent than all pediatric cancers, Aids, Down’s syndrome and diabetes, COMBINED. Autism affects 1 in 150 children, nationwide. It is the silent epidemic.

Autism is a neurologic disease. It is a medical condition with the onset of symptoms occurring within the first 18 months of life. Most children with autism lose the ability to speak and suffer from severe gastrointestinal problems. Many develop seizures.

Costs to diagnosis and effectively treat this disease range from $3000-$5000/month or more. Autism crosses all racial and socio-economic boundaries with 400-500 children added each year to the existing thousands in Oklahoma.

Without treatment, these children will be forced through the public school system, unable to read, write, or communicate their most basic needs. Once they turn 18, they will be added to the state welfare roles at an estimated cost to each Oklahoma taxpayer of $700-$800/year. The estimated lifetime cost to care for a child left untreated is $3.2 million, per a 2006 Harvard study.

Nick’s Law will prevent the financial devastation of 1000’s of Oklahoma families. The divorce rate among families with autism is around 80%. Instead of depleting their retirement accounts, families will be able to plan for their future and start funding their retirements again.

The insurance industry is lobbying to convince our legislators that mandates will increase the cost of insurance, resulting in more people becoming uninsured. In actuality, Nick’s Law will prevent the largest mandate forced on all Oklahoma taxpayers.

This month, Arizona joined the list of states that recently passed similar legislation. Texas, South Carolina, and 10 other states provide autism insurance coverage for our nation's most vulnerable population of children.

Oklahoma is one of the least mandated states in the nation. At the same time we lead nearly all states in the number of uninsured. So what’s really driving insurance costs in Oklahoma? It can’t be mandates. Maybe it is the excess use of alcohol, tobacco, and rise in obesity rates, or the use of emergency rooms as a primary care physician.

By defending the anti-insurance mandate mantra, our legislature is driving Oklahoma to state run health care.

Since 80% of these children are under the age of 15, without effective treatment, the first big wave of these children will be applying for state and federal aid in less than 4 years. This coincides with the first big wave of retiring baby boomers. As one state senator said, it is the perfect storm. Autism, the quiet epidemic, will be the loudest sonic boom ever heard!

Arizona passes Insurance Coverage

Arizona passes new law requiring insurance coverage for autism.

March 21, 2008 - 10:15PM

FROM STAFF AND CRONKITE NEWS SERVICE

Siding with parents over insurance companies, Arizona Gov. Janet Napolitano signed legislation Friday that eventually will require insurance companies to provide coverage for autism.

To read more click here.

Questions to ask Legislators who oppose Nick's Law

During the debate on why Nick's Law is very important to the families and their children who are diagnosed with autism, several questions need to be asked of our legislators who opposed Nick's Law.

Q1. If you are not wanting to support Nick's Law, then what is your health care solution for the hundred's of autistic children?

Q2. Since Oklahoma is one of the least mandated states in the nation and one of the greatest % of uninsured (20%), what is causing this?

Q3. The cost of Nick's Law is estimated to cost less than 1% according to CAHI.org. Agree?

Q4. What is your solution for helping stop the ever escalating divorce rate in the autism community that is currently 80%.

Q5. What is your solution for the parents and grandparents who have redeemed all their retirement savings to pay for the therapies and treatments?

Q6. Do you know what the potential yearly cost to each Oklahoma taxpayer because of supporting the insurance lobby instead of the taxpayers? clue to the answer (somewhere between $ 500-750 per year).

Q7. In your opinion, what are the leading causes in Oklahoma for rising insurance rates? Keep in mind Q2. It can not be from mandates since we are one of the least mandated states.

Q8. Does the insurance industry need an excuse or reason to raise rates? If so, can you provide us with one. Remember your answer from Q2 and Q7.

Q9. Do you believe that children with autism can recover?

Q10. Why is that you support the taxpayers in all discussions regarding budget, immigration, education, and homeland security, yet your support changes to insurance industry when the topic changes to health care?

Q11. Do you support the insurance lobby's efforts to rollback or remove existing health care mandates? If so, which existing mandates would you remove?

Q12. Would you support an unbiased study of health care costs in Oklahoma?

Q13. How much money have you received in campaign contributions (last election cycle) from the health care insurance lobby?

Q14. Please rate from 1-5 the largest contributors to health care costs in Oklahoma.
* Personal Wellness
* Paperwork inefficiency
* Health Care mandates
* The use of the Emergency Room instead of your primary care physician
* The overlapping of new technology

Q15. What was the last health care mandate passed into law in Oklahoma? Was there any substantial cost increases reported by the insurance industry?

Q16. How many taxpayers are in the state of Oklahoma? How many private insurance policy holders? (clue = policy holders are nearly 1/2 of the amount of taxpayers)

Q17. Should the parents and families of autistic children that are paying for health care insurance, drop their policy in favor of using that money for treatments?

Q18. Should the general public, who are paying for health care insurance, drop their policies because they do not want to pay for an existing mandate that they will never need? (Men paying for breast cancer, non smokers paying for lung cancer treatments)

Q19. Please provide your definition of Universal Health Care. Remember, you might be helping getting us to that scenario faster than you think.

Q20. Should health care insurance pay for medical conditions such as child birth, broken legs, drug and alcohol rehab, well baby check ups, and mental health conditions. Why not autism?

Q21. How many children are being diagnosed in Oklahoma aith autism each year using CDC statistics?

Q22. When these children age out and become adults, as the first big wave of them will start in the next 4 years, do you know what the cost to the state of Oklahoma will be for the lifetime care for each individual? (Harvard study 2006 - clue = starts with a 3 and has 6 zeros behind it.)

Q23. What do you propose to handle the bankruptcy rate that is 5 times greater than the average?

Q24. What do you propose to handle the foreclosure rate that is 3 times greater than the average?

Q25. Do you believe that insurance companies should provide medical coverage or should the state of Oklahoma provide medical coverage?

Q26. It has been said that if Oklahoma allows Nick's Law as a mandate, then insurance companies will leave the state. Where will they go? To another state that has more mandates?

Connecticutt introduces Autism Insurance Legislation

Autism insurance legislation has been introduced into the Connecticutt legislation.

Just another state recognizing this injustice by insurance companies. The Oklahoma House of Representatives need to understand that insurance coverage is crucial to thousands of families that pay their health insurance premiums without receiving health care coverage.

Click here to watch the video

Sen Jay Paul Gumm press conference on News9

Click Here to watch video of Senator Jay Paul Gumm's press conference on Nick's Law

OETA coverage of HB 3111

Click Here to watch video regarding HB 3111, a bill to stop health care mandates.

Video coverage provided by OETA-Jason Doyle

Sen Jay Paul Gumm press conference on OETA

Click Here to watch the press conference on Nick's Law in the Senate

SB 2071 to be heard in House Higher Ed Sub Committee

SB 2071 will be presented by Rep Ken Miller to the House Higher Ed Sub Committee on Monday, March 24, 2008, 9am, room 512A.

Please contact the following House committee members and ask them for their support to pass SB 2071.

Rep Terry Ingmire, Chair
Rep David Derby, Vice Chair
Rep Terry Hyman
Rep Charlie Joyner
Rep Bill Nations
Rep Pam Peterson
Rep Jabar Shumate

SB 2071 will establish a BCBA Curriculum and Autism Training at UCO for advance graduate coursework and therapy practicum internships. This is crucial for us to develop and retain the necessary therapists to work with our autistic children.

Lawmakers debate health insurance mandates

By Melissa Maynarich, NEWS 9
March 11, 2008
Click Here to watch video.
There's a debate among lawmakers when it comes to health insurance issues.
Lawmakers at the capitol are deciding on House Bill 3111 that could put the brakes on potentially expensive insurance mandates.

"When I first came to the legislature, we would have maybe one or two mandates every few years," said Rep. Ron Peterson. "Now we have over a half a dozen mandates that I've talked to people about just in this last year."

If it's passed, House Bill 3111 would require a cost-benefit analysis and a one year wait before any insurance mandate is voted on.

Sen. Jay Paul Gumm is the author of Nick's Law, named for a young boy with autism whose family can hardly pay for his therapies. If Nick's law makes it through this session now as an amendment to another bill, it would require private insurance companies to cover autism therapies.

"These are parents who are paying for health insurance and expect to be able to depend on health insurance only to be told, because it's autism 'we can't help you,'" Gumm said. "I think that's fundamentally wrong."

Stephanie's law is similar, named for a young brain cancer patient whose family was hit hard with medical bills. It's another mandate that could require private insurance companies to pay for routine care for patients taking part in clinical trials.

"My fear is we are on a death spiral of ever increasing costs and we are going to have more people drop off the insure rolls and therefore premiums go up even higher," Peterson said.
Peterson also said House Bill 3111 doesn't say no to mandates, it's just a more balanced approach. The bill would allow for the weighing of fiscal and social impacts before the vote.
Steffanie's law has made it out of committee. It is expected to be voted on the Senate floor Wednesday.

An amendment to Nick's law passed the Senate Monday; it will now go to the House for approval.

Teacher Training Bill SB 1686 passes House Common Ed Sub Committee

SB 1686, known as the Autism Teacher Training bill passed the House Common Ed Sub Committee today on a vote of 6-0. Rep Jeannie McDaniel, House Sponsor of Senator Mary Easley's bill, expertly presented the bill today as a very necessary educational tool for the teachers, administrators, and school staff.

The bill now goes on to the full House Education Committee for their consideration next week.

Thank You to all Parents

We want to thank all of the parents, grandparents, and friends for a wonderful job helping pass Nick’s Law out of the Oklahoma Senate. It was truly an inspiration to see all of you making appointments with your legislators, informing them on autism effects your daily life and what Nick’s Law would mean to your family. We have been told by many of the legislator assistants, that the number of phone calls, letters, and emails were incredible. All of you are to be congratulated for a job well done.

We are now half way home. Nick’s Law is now in the House. Next week we will have an announcement regarding the course of action. Nick’s Law Steering committee and Anne Roberts, Exec Dir, Oklahoma Institute of Child Advocacy, will be meeting to develop an action plan.

The 3 bills that have Nick’s Law as an amendment are:

SB 2157 – Sen Barrington and Rep Charlie Joyner.

SB 1895 – Sen Aldridge and Rep Ron Peterson

SB 2118 – Sen Sparks and Rep Doug Cox, MD.

A request from the steering committee. Since all three bills passed with great bipartisan support, we ask that you write a personal thank you card to your senator and mail it. Then write a thank you card to Sen Gumm and Sen Easley. They carried Nick’s Law as amendments last week in the Senate. It is truly amazing on their commitment!!

You can obtain your senator address at http://www.oksenate.gov/.

Also, please send a note of support to the House sponsors mentioned above as well.

www.okhouse.gov/Members/MemberListing.aspx.

Last thing; You have walked with us this far, are you willing to go a little further?

Thank You

Nick’s Law Steering Committee

Nick's Law Passes the Oklahoma Senate

Editors Note. Nick's Law passed the Oklahoma Senate as an amendment on SB 2157, SB 1895, and SB 2119.
To download the press release, click here.

OFFICE OF SENATOR JAY PAUL GUMM

Atoka, Bryan, Coal, Johnston & Marshall Counties

March 10, 2008

Contact: Senator Jay Paul Gumm

State Capitol: (405) 521-5586

Durant: (580) 924-2221

Mobile: (580) 920-6990

Email: gumm@oksenate.gov

Mandated Autism Coverage Passes Senate; Gumm Says Coverage Responsible to Oklahoma Families

OKLAHOMA CITY – An amendment that would require health insurance policies to cover diagnosis, treatment and therapy for autism disorders passed the Oklahoma Senate on a bipartisan vote today.

The plan, called “Nick’s Law,” will give Oklahoma families a better opportunity to fight a disability affecting more children than ever. Senator Jay Paul Gumm, D-Durant, the amendment’s author, attached his plan to a pair of bills that were subsequently approved and sent to the House of Representatives.

Gumm said empowering parents and holding powerful insurance companies accountable to their policyholders is the right thing to do. He said the proposal is fiscally responsible to taxpayers and morally responsible to children in Oklahoma.

“The fact that many Democrats and Republicans joined hands in passing Nick’s Law shows that this is an issue that transcends parties and politics.” Gumm said. “Today we took a giant leap in protecting these families who face extraordinary challenges in the struggle to improve the life experience of their children.”

Autism is a growing national epidemic afflicting as many as one in 150 children. Studies have shown that the early treatment and diagnosis – coverage for which is mandated by Nick’s Law – gives autistic children the best chance to reach their God-given potential, Gumm said.

Across the nation, 17 other states – including Texas – have similar mandates requiring insurance providers cover autism disorders, which is characterized by impaired social interaction and verbal communication. Children with autism also suffer from numerous physical ailments including allergies, asthma, epilepsy, digestive disorders, persistent viral infections, and sleeping disorders.

Wayne Rohde – father of 10-year-old Nick, the inspiration for the bill – said families that have been denied coverage for their autistic children face higher divorce and bankruptcy rates.
“Today, the Oklahoma State Senate has spoken loudly for the children who can not speak for themselves,” Rohde said. “I applaud the senators for passing this dramatic change in the way we seek care and treatment for autism. I think it is fair and just. We pay for our health policy premiums and expect the policy to cover our family.”

OETA coverage of SB 2114

Click below to view OETA's coverage of SB 2114

Talk about passing the buck.

One of the most exciting developments in the autism community that gives many parents and caregivers tremendous hope is the groundswell of autism insurance coverage. There are 10 states that provide some form of coverage with Indiana, South Carolina, and Texas being the most comprehensive. There are many other states that are currently entertaining legislation or reviewing possibilities.

The insurance industry is under tremendous pressure to stop the onslaught of state legislature initiatives to mandate coverage, from policyholders who are seeking monetary damages for denied services, and from the public demanding affordable policies.

What is common about the above is that the insurance industry could have prevented all of them by working with industry groups, employers, and being honest and up front with policyholders.

Recently, a California woman who was diagnosed with breast cancer was awarded a large monetary award from an insurance company that canceled her insurance policy. Statements were introduced into the legal record that the insurance company would cancel policies to save money.

We have all heard of many stories of families purchasing discounted insurance policies with the understanding that medical conditions and treatments would be covered. Yet, to their dismay, when their children are stricken with leukemia or other disease, the majority of costs are not covered. The family is now on the hook for several hundred thousand dollars.

Here in Oklahoma, Nick’s Law (Autism Insurance Coverage), is still alive and well as our legislature is nearing deadlines to approve legislation. It has withstood a lot of political pressure, and in its’ present form as an amendment on several other bills, children and parents are very optimistic of its passage. With autism diagnosis at epidemic proportions, parents are meeting with their legislators asking for insurance coverage for this medical condition.

Most insurance companies have been inserting exclusionary phrasing into the policies for the last several years or just flatly denying claims with such reasons as treatments are considered experimental. The financial devastation that comes from the parents providing the necessary treatments has led several states to mandate coverage.

The insurance lobby is working overtime to pressure legislators to stop or prevent health care mandates from becoming law. The statements that are being mentioned in the state halls are outrageous and insulting to the intelligence of the general public.

The most common misleading statements are:

1. Increased mandates will lead to more expensive insurance, therefore many people will not be able to afford insurance more people will become uninsured. This is the go-to comment for insurance companies. The forces that are driving up costs are not mandates, but rather inefficient use of technology, personal wellness, using of the ER instead of a primary care physician, frivolous lawsuits, and personal irresponsibility of obtaining health care insurance.

2. Mandates will cause insurance companies to leave the state. Another ridiculous statement for the simple fact of where are they going to go? Many of the states that are considering autism insurance mandates are generally some of the least mandated states. So are the companies going to leave a state and move to a more mandated state?

3. Mandates will not be covered by the insurance company but just passed on to the consumers. Once again, insurance companies are just passing the buck. They do not need a reason to raise rates, yet keeping threatening the policyholders with this action. Check your state’s record of recent health care mandates. Compare that with the increases in insurance rates. Something other than mandates is driving up the costs.

By the way, a memo to the insurance industry: By stating that a health care mandate is bad for the policyholders, how about recognizing that all you are doing is passing the buck onto the taxpayers. That is called a taxpayer mandate.

With all the debate in the presidential campaigns regarding health care, one must be reminded why so many are calling for some sort of universal health care. Polling shows that many people are unhappy with the downward trend of coverage of disabilities, medical treatments, and other conditions. Yet insurance premiums continue to rise. Once again, insurance companies are ever increasing the use of the denied button in search of lower costs.

A popular movement within the insurance industry is to develop a very low cost, very basic insurance product that can be sold to single, young customers. These policy holders will not require many services and seldom posses the health risks that older policy holders will require. Therefore the profit margins will be greater even with lower priced policies. Are they trying to skip out on their responsibility of the much higher cost/lower margin policies?

Another popular insurance initiative is to roll back existing mandates that were passed into law. Many state legislatures are considering such legislation that will either eliminate or curtail existing law. This is very dangerous since we are now allowing our government to provide preferential treatment to an industry that supersedes the public welfare and heath care of its citizens. Once again this is an effort to help lower costs by eliminating coverage benefits that are purchased in the form of a legal binding contract.

What the insurance industry should be working on is to help reduce the inefficient systems that cause as much as 30% of all dollars spent to be wasted. Now, that would be a good way of passing a buck or two!

Health insurance bill falls short

By ANGEL RIGGS World Capitol Bureau
3/7/2008

It would have required insurers to cover any procedure a doctor deemed medically necessary.

OKLAHOMA CITY -- Senate Democrats were aggravated Thursday with the defeat of a measure that would have required insurance companies to pay for all procedures doctors deem medically necessary.

"We talk about people who don't have access to health care in Oklahoma, but we have people who have health-care coverage who still cannot get access to care," Sen. Kenneth Corn, D-Poteau, said.

Opponents contend that the measure would force insurance companies to raise their rates by mandating that they cover everything.

Corn and several other Senate Democrats met with reporters after the bill failed to get the 25 votes needed for passage.

Senate Bill 2114 by Sen. Jim Wilson, D-Tahlequah, could be reconsidered within three legislative days if enough support is gathered.

The bill failed by a 24-19 vote. It takes 25 votes for a measure to pass in the Senate. The Senate is tied with 24 Democrats and 24 Republicans; Democratic Lt. Gov. Jari Askins can break ties.

"The profits are out of this world for insurance companies," Corn said.

He added that it's wrong for "a clerk at an insurance company" to decide whether someone will get the "medically necessary treatment that their physician has chosen -- the guy that went to school, who paid all of the money to become a medical doctor, who has all the knowledge."

But Sen. Bill Brown, R-Broken Arrow, argued that if the bill passed, "insurance companies would have to raise their premiums to a point where employers would not be able to afford health insurance for employees."

Brown, co-chairman of the Senate Retirement and Insurance Committee, said health care is a difficult problem but that the market, not the Legislature, should dictate what insurance companies cover.

Sen. Mike Mazzei, R-Tulsa, said the bill would "so drastically, negatively impact small business owners and significantly escalate higher insurance costs that it will lead to thousands of more folks in Oklahoma being uninsured."

Several Senate Democrats noted, however, that the measure would help people now paying premiums who think they're covered, only to find out that they're not or have only limited coverage.

Sen. Tom Adelson, D-Tulsa, said the country's health-care industry is broken and that the law would help Oklahomans get the medical care their doctors say they need.

"Any industry that's set up to make money by charging as much premium as they can, and then denying as much service as they can, is a broken system," he said.

Angel Riggs (405) 528-2465
angel.riggs@tulsaworld.com

SB 2114 Fails to pass 24-19

Click Here to see the voting record.

Senate Bill 2114, Senator Wilson, failed along party lines this morning with a vote of 24-19. The bill needed 25 votes to pass. Several Republican members failed to vote on the bill due to pressure from special interests. It appeared that they "walked" instead of voting for or against.

The bill would require insurance companies to provide coverage for what is declared as medically necessary by a doctor or therapist. Nick's Law was added as an amendment by Senator Jay Paul Gumm. The amendment passed by a very loud voice vote, however, the recorded roll call of the entire bill was decided along party lines. All democrats voted in favor of the bill.

However, the bill's author, Senator Wilson, is hopeful that the bill can be reconsidered by next week's deadline.

As the deadline approaches

The Oklahoma Senate has until Thursday, March 13th to vote on legislation before moving it over to the House. This would include the bills that have or will have Nick's Law as part of the legislation.

Senator Jay Paul Gumm has filed amendments on 6 bills currently and is working on several other pieces of legislation.

5 of these bills are currently on the agenda for the week of March 3-6th. The include SB 2114, SB 2118, SB 2119, SB 2102, and SB 1895. Senator Gumm's SB 1407 will also include Nick's Law as an amendment, but that bill is positioned to be heard by the entire Senate the week of March 10-13th.

Please contact your senator and ask them to vote for Nick's Law as an amendment and then vote to pass the bill as amended.

Senate Passes Easley Bill On Autism Professional Development Training

The Oklahoma State Senate approved legislation Tuesday that encourages school districts to include a special emphasis on autism as part of any professional development program on special education that may be provided to teachers in the district.

Senate Bill 1686 is authored by State Senator Mary Easley, D-Tulsa, and will now go to the House of Representatives for consideration.

Senator Easley said she is particularly passionate about this piece of legislation because autism personally touches her life every day through interaction with a special family member.

“Autism is affecting a growing number of families both here in Oklahoma and nationwide and many of them aren’t receiving the help they need,” Easley said. “There is a gap in training and preparing educators to deal with these students. As more and more Oklahoma children are diagnosed with some form of autism every day, we must prepare our school systems and our teachers to be able to handle these educational needs. This legislation takes a positive step in that direction giving our educators the additional tools they need to work with these children.”

Rene’ Daman, director of the Oklahoma Autism Network, said one in every 150 children will be diagnosed with some form of autism, making it more common than pediatric cancer, diabetes, and AIDS combined.

Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests. These behaviors can range in impact from mild to disabling. Scientists aren’t sure what causes autism and there is no cure.

Robyne Rohde is a member of the Oklahoma Autism Coalition. She and her husband Wayne are parents of a son Nick, who was diagnosed with autism. They support Senator Easley’s legislation.

“I hope the passage of this bill means Oklahoma educators get the autism training they need,” Robyne Rohde said. “Every adult, teachers and administrators, in the school should be able to approach an autistic child, who on the surface will look like most kids yet might lack the ability to communicate in a manner of which the teacher is accustomed. Teachers should be as prepared as possible to interact, teach and mentor these students and Senator Easley’s bill will give them the tools they need to do just that.”

For more information contact:
Senator Easley's Office: (405) 521-5590

Fight for Nick's Law Continues

Tuesday, March 4, 2008; Posted: 5:20 p.m. (CDT)

to view video, click here.

Oklahoma City -- An emotional story continues to unfold at the state capitol. Last week a bill dubbed Nick's Law, designed to help families affected by autism, was denied a hearing in committee, but one state senator hasn't given up. Dozens of families shared their stories in hopes of pushing the bill forward. KSBI-TV's Kealey McIntire has more.

Christina Newendorp is searching for a better future and she's going door to door sharing her touching story with state senators. "I think that if they understand this is affecting real people that live in their district it makes a big difference," says Newendorp.

Her two sons, ages five and seven, both have autism. They have several medically recommended treatments that help improve life for kids with autism. The Newendorp's say they are forced to pay for treatment themselves because insurance companies don't provide coverage. Nick's Law would change that.

"This was the first year that a legislative effort was brought forth to try to do something about this so I'm totally in support of it. I really hope we can come up with a solution to this problem," says Newendorp.

State Senator Jay Paul Gumm, D-Durant, author of the bill, says it would mandate that health insurance cover autism diagnosis and treatment. "That is an incredibly important thing to do because these are families who are doing the right thing. They are paying their health insurance premiums, but they're not getting help from the insurance companies and we believe that is something that insurance ought to do," says Gumm.

Nick's Law was denied a hearing in committee. Gumm has now attached the measure as amendments on six different pieces of legislation. Those bills will be heard on the senate floor this week.

However, another bill has been filed that would do away with most insurance mandates, including Nick's Law. Gumm hopes the presence of dozens of families, like the Newendorp's, will keep that bill from passing.

"There are times when government should move slowly, there are times when government should move quickly. This is an issue that government should move quickly because we've moved slowly for too long," says Gumm.

Autism affects one in 150 Oklahoma children. Newendorp hopes pairing a face with the statistic will convince lawmakers to give her sons and hundreds of others a brighter future.

Those who oppose Nick's Law say insurance mandates have driven up premium costs by 40 percent in recent years, but Gumm says taxpayers would save money.

Kids who receive treatment live healthier, more self-sufficient lives. Gumm says kids who are left untreated often end up wards of the state whom taxpayers are responsible for.

Parents Day at the Capitol Part 2

Parent's Day at the Capitol will resume on Tuesday, March 4th. This is the second visit to the capitol for many of the parents to discuss with their legislators, the importance of Nick's Law and Autism.

Dee Blose, chairperson of Nick's Law Steering Committee along with other members of the committee will be at the capitol to assist parents and family members with information and directions to offices.

Because Nick's Law is now known as amendments to many bills in the Senate, it is very important that we all discuss how autism has effected our daily lives and how it effects the state of Oklahoma.

HB 2459 is still a live bill in the House waiting on a committee hearing. However, it appears that Rep. Colby Schwartz's bill will not heard in a hearing, therefore, it will suffer the same fate as SB 1537 in the Senate.

However, Senators Gumm, Anderson, Easley, along with Rep Schwartz have many options to use.

As Senator Gumm mentioned in his press conference last week, "There is an awful amount of talk in this building about family values. I don't believe you have the right to talk about family values unless you support the policies that value the families like this. This is why we were sent here."