What promise does Ohio hold for this autistic boy?
Parents say a scholarship program may help where Oklahoma falls short
What promise does Ohio hold for autistic boy from Oklahoma?
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79
By Michael McNutt
Published: May 30, 2008
Caroline Hall says her family has no choice but to leave Oklahoma because legislators didn't pass a bill requiring insurance companies to cover autism treatments.
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Opponents cite possible costs
Rep. Ron Peterson, R-Broken Arrow, refused to let the measure be taken up in his House committee. Peterson, who announced this week he's not seeking re-election, twice refused parents of autistic children to speak and once prevented Democratic members on the committee from bringing up the measure.
House Speaker Chris Benge, R-Tulsa, did not let the measure advance to the full House in the last days of the session, which ended last week.
House Republicans are concerned insurers would pass increased costs on to policyholders, which might make insurance unaffordable.
Benge is forming a task force to study health care costs in the state, including what effect adding autism coverage would have on insurance policyholders in Oklahoma. Other legislators are looking at studies involving autism.
Wayne Rohde, whose son, Nick, has autism and for whom Nick's Law is named, said he and other parents of autistic children plan to attend legislative task force meetings dealing with autism.
"We're looking forward to those studies basically to prove that what we've been asking for is correct,” he said. "Obviously, this is going to be a major, major issue for the House Republicans to address.”
Rohde, of Edmond, said he is aware of about a dozen Oklahoma families who are considering moving to states that require insurance companies to provide coverage for autism. He estimates about 6,000 children in Oklahoma suffer from autism.
"We're going to stay and win,” he said. "It's unfortunate we have to wait another year. There's going to be several hundred kids that are going to be basically locked into autism because they were unable to receive services and treatment because of this delay.”
Time is critical, mother says
Hall said her family has no choice.
"It's going to be at least another year before this gets considered and then maybe another six months to a year after that before it's implemented,” she said. "Dougie doesn't have time.
"When you're looking at any kind of neurological disorder, you have to think in terms of what's best for the child in critical phases,” she said.
"Those neural connections are forming at the most rapid rate when a child is between zero and 6 years old. … This golden triangle of when my son's brain is the most malleable will soon be over. He doesn't have time — he needs these interventions now to be functional.”
Hall said she and her husband, who is a critical care nurse, are fortunate that they have "portable” jobs. She will continue to work on a project she's been involved in at OU — she'll be paid by one of the grant partners instead of being on the university's payroll — and her husband should have no problem finding a job in Cincinnati, where the family is relocating, she said.
"For every family like us, there are probably 30 to 40 Oklahoma families who could never dream of picking up and leaving.”
Private school has helped Dougie
Hall said her family has drained nearly all its savings to send her son to a private school for treatment. Their son has flourished at the Rubicon School and Learning Center in Edmond since he started going there in August.
"It's a wonderful school,” she said. "They have done a wonderful job with him. We've seen a turnaround; it's not money down a rat hole. It has absolutely changed his life.”
Before he started the school, Dougie knew about 10 words and was not toilet-trained, she said. Dougie now knows how to use the toilet and "his vocabulary is close to 500 words and he is saying small sentences using a subject, a verb and an object,” Hall said.
He has received physical and occupational therapy at the school and some behavioral treatment as well as learning to develop social skills, she said.
"It's been quite expensive for us, and there's no help,” Hall said
In Ohio, the state provides up to $20,000 a year for either private schools or autism treatment, she said.
The family has private insurance, but it doesn't cover behavioral therapy for autistic children, she said. Her policy does cover speech, language and occupational therapy, but it's limited to 20 visits a year.
"That doesn't begin to cover what an autistic child needs,” Hall said.
Dougie, who was diagnosed as having autism about two years ago, goes to school five days a week and receives the equivalent of 12 visits a week, she said.
Related Topics:
U.S. Government, Culture and Lifestyle, Health and Fitness, Medicine, U.S. Congressional News, Child Development, Family, Parenting, Autism
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I'll try to explain one more time--VERY SIMPLY. If ANY therapy is submitted to an insurance company and it claims autism as the reason for therapy...it is DENIED. Speech and OT are only 2 therapies that assist in recovery of our children. They need ABA or other forms of behavioral therapy, none of which are covered because they are directly related to autism. They also need much medical coverage...if a diagnosis code of autism is used...it is DENIED. There is NO coverage for our sick kids. Most of which will rely on YOUR TAXPAYER dollars for care later in life without treatment.
We have paid into BCBS for 14 years for our family of 5. We never use our insurance. We are a healthy family. After our child was diagnosed with autism...we were denied any help. This diagnosis could just have easily been cancer or diabetes. No riders for those!!! And we don't want government hand outs. This is our point exactly...make the insurance companies do what they are supposed to do...provide insurance to spread the risk of loss. It is so sad that the state's politicians are putting insurance profits above the care of hundreds of children in the state. And even more sad that some in the public remain as poorly educated as Walter.
To Walter, you logic would mean that insurance should not cover you if you are the victim of a car accident unless you buy the rider to cover that. Superior ignorance instead of caring for your fellow man.
You said, “My son sees his OT and SLP 2 times a week” If you are telling the truth (which I doubt) The $4000 a month you supposedly spend equals $1000 a week or $500 a visit. Gee I’d like to get that kind of pay. If AETNA or BCBS offers coverage at the cost of $4000 a month it is because the purchaser is trying to purchase coverage AFTER the event has inflicted the damage. The whole idea of insurance is to purchase it before the claim occurs not after liability is established.
Walter, Edmond - May 31, 2008 10:08 PM"....So then Walter, I guess that all the people who tried to get State/Federal aid during this last little pittance of an ice storm, and the ones who cried that they needed the relief because they didn't buy insurance for protection are in the same boat? How many people on here cried about the lack of aid? How about those people in Picher that are still waiting on the Feds to bail them out, how about all the people who are looking for help from the government after a big tornado comes through? Why don't they have insurance? Why aren't they prepared for those scenarios?? Myself, I was prepared for the ice storm, had my generator all ready to go and because of it, I didn't have any need for looking for a handout. If you were affected by the ice storm, can you say the same?