As reported by the New Britain Herald, March 8, 2008.

Bill Would Force Health Insurance Companies to Cover Autism Treatment

By Fran Morales

NEW BRITAIN — Connecticut may soon join a handful of states in the effort to force health insurance companies to cover the cost of treatments for children with autism.

The state Legislature heard from parents of autistic children during a public hearing Thursday. If passed, new legislation would require health insurance coverage until the age of 26 for treatment of pervasive development disorders including autism.

Among supporters of the bill were state Rep. Catherine Abercrombie and House Speaker James Amann. Opponents of the bill fear the mandates could increase health care costs statewide. The bill would result in overall savings in the long run in medical costs and special education, Amann said.

“Research has shown that by providing these treatments and therapies to a child with autism spectrum disorders (ASD) early in their life will decrease the lifetime costs of treating and providing services,” Amann said. “These treatments and benefits provide a good cost benefit to the people of Connecticut.”

By state law, health insurance policies are required to cover certain mental illnesses. Although the diagnosis is covered, not all treatments are. As a result, many families like Al and Janet Chmura of New Britain have had to fork over thousands of dollars for treatment of their 13-year-old son, Albert.

Connecticut does not have a law that mandates full coverage for autism. Sixteen other states including Illinois, Indiana and Georgia, prohibit health insurance companies from denying autism treatment coverage.

Studies show that with every new child diagnosed with autism the family spends an estimated $3 million over the child’s lifetime. Current practices of health insurance companies are unfair and not cost effective in the long run for the state, Amann said.

It’s been a long time coming for working class families like Kim Davis, who has two autistic adolescent children.

By day, Davis takes care of her two sons, Jordan, 14, and Tyler, 13. At night she works as an EMT in New Britain. Her two sons were both diagnosed at the same time in 1998. She said the occupational and speech therapy for her sons is costly.

Albert is a well-mannered seventh-grader who attends regular classes at Slade Middle School. Albert, Tyler and Jordan are a few of the estimated 75 children in the school district who suffer from autism.

Davis and Sharon Beloin-Saavedra of the city’s Board of Education have formed a tight friendship, fighting through heartache, while advocating for services to help their autistic children in the city school district.

Beloin-Saavedra has drawn from her own experiences with her two autistic children, Alex and Noah, to help other city families like her own. She has become a leading advocate for autism.

School programs

It’s been a learning process for not only families but for the school district as well. As the number of autistic children in the system continues to climb, some schools are becoming better prepared in dealing with children with special needs.

“Autism is a growing issue in our school system because of its prevalence,” said Doris Kurtz, superintendent of schools. “We still have a lot to learn on how to best service children with autism.”

Gaffney and Chamberlain elementary schools offer a self-contained highly specialized model of instruction for autistic children. Two out of the city’s three middle schools also have self-contained learning and sensory environments for children with pervasive development disorders. Their needs prevent them from participating in mainstream instruction, Beloin-Saavedra said.

Mainstreamed students like Noah, Albert and Tyler get assistance from paraprofessionals and speech therapists.

If the bill becomes law, it could alleviate some of the cost to the school district because they would cover the cost for treatments and it would put more resources in the reach of working class families. Health insurance policies would be required to cover psychological, physical and occupational therapy. Although autism is treatable through continual therapy, there is no cure. Autism is a neurodevelopmental disorder that impairs social interaction and communication.

The numbers of autistic cases have soared since the 1980s and continue to rise. One in 150 children — or up to 1.5 million people in the United States — are diagnosed with autism, according Larry Scherzer, a pediatrician at the University of Connecticut Health Center.

The rise could be due to more inclusive diagnoses Scherzer believed. For example, illnesses such as Asperser’s Disorder, is now included under the umbrella of ASD.

Government health officials have conceded that childhood vaccines worsened a rare, underlying disorder that ultimately led to autism-like symptoms in a Georgia girl, and that she should be paid from a federal vaccine-injury fund.

Medical and legal experts say the narrow wording and circumstances probably make the case an exception — not a precedent for thousands of other pending claims.

The government “has not conceded that vaccines cause autism,” said Linda Renzi, the lawyer representing federal officials, who have consistently maintained that childhood shots are safe.

However, parents and advocates for autistic children see the case as a victory that may help certain others. Although the science on this is very limited, the girl’s disorder may be more common in autistic children than in healthy ones.

Although there are markers that help identify children as early as 18 months, ASD is normally diagnosed by age 3, Scherzer said.

There are different levels of autism that range from high functioning to severe. Those with severe autism portray forms of mental retardation, and are often mute or have impaired language delays, for example. Children with autism can appear to be closed off to social environments.

Although there is no definite cause of autism, studies have indicated it may be genetic.

It is estimated that 40 to 50 percent of autistic children have a genetic diagnosis due to an abnormality of chromosomes, Scherzer said.

“Although there won’t be a family history, chromosomes could mutate,” Scherzer said.

In some cases, a mother’s lifestyle may also contribute to autism, Scherzer noted. For example, mothers are warned not to eat fish that contain mercury because it could contaminate the fetus’ nervous system.

Autism is a diagnosis on the entire family — it affects everyone.

“Autism is bigger than a school issue,” Beloin-Saavedra said. “It’s a community issue of acceptance, understanding and appreciation. It is the ability to forgive what is not understood and appreciate and value the life that is. That is what I want for my son and daughter.”

Janet Chmura said: “They say that children who are autistic go to college and live pretty normal lives. I’m hoping that he does. I just want him to have a normal life and experience what it’s like to have job.”

The Associated Press contributed to this story.