Fri, Sep 12 2014
Maria Cruz had never heard the word autism until her daughter, Shirley, was diagnosed as a toddler.
“I felt a knot in my brain. I didn’t know where to turn,” recalled Cruz, a Mexican immigrant who speaks only Spanish. “I didn’t have any idea how to help her.”
No one in her low-income South Los Angeles neighborhood seemed to know anything about autism spectrum disorder, a developmental condition that can impair language, learning and social interaction. Years passed as Shirley struggled through school, where she was bullied and beaten up. Now 9, Shirley aces math tests but can barely dress herself, brush her teeth or eat with utensils.
Shirley is like many autistic children from poor families: She hasn’t gotten much outside help. The parents often lack the know-how and means of middle-class families to advocate for their children at schools and state regional centers for the developmentally disabled.
A new initiative seeks to help level the playing field. Starting Monday, Sept. 15, thousands of children from low-income families who are on the autism spectrum will be eligible for behavioral therapy under Medi-Cal, the state’s health plan for the poor.
California is among the first states to respond to a recent rule by the U.S. Centers for Medicare & Medicaid Services that requires the therapy to be covered, when deemed medically necessary, as part of a “comprehensive array of preventive, diagnostic and treatment services” for low-income people 21 and under. (Medi-Cal is California’s version of Medicaid.)
This type of treatment includes the sometimes costly “applied behavioral analysis,” which uses intensive drills and rewards to teach kids how to communicate and interact socially.
In California, a huge percentage of the population that stands to benefit is Latino. About a third of beneficiaries speak Spanish as their primary language, yet historically their communities have been underserved because of a shortage of Spanish-speaking providers and meager outreach and education efforts.
Taking the lead
California, however, is ahead of many states: It already has programs in place that cover a portion of autistic kids through public school districts and the California Department of Developmental Services. Although several states, including Louisiana and Washington, have taken early steps to make behavioral therapy for autism, others offer little or no public coverage for it.
Roughly 1 in 68 kids in the country has been diagnosed with autism spectrum disorder, according to the federal Centers for Disease Control and Prevention.
“For as long as I can remember, when a family called me for help, I had to ask them what kind of insurance they had. If they had Medi-Cal, there wasn’t much I could do to help them,” said Kristin Jacobson of Autism Deserves Equal Coverage, a Burlingame, California-based advocacy group. “Now they’ll have access to this treatment that can help these children reach their potential.”
source : California To Broaden Autism Coverage For Kids Through Medicaid
