California Healthline by David Gorn –
June 11, 2013:
Several health care provisions were conspicuously absent from the Legislative Budget Conference Committee’s budget agreement with Gov. Jerry Brown announced yesterday. The plan has no mention of repealing a 10% Medi-Cal provider rate cut nor a plan to fund autism services.
The agreement omitted a proposal to set aside $50 million in general fund money to pay for autism services. When matched with federal dollars, the state would have had $100 million to help pay for autism treatment, including applied behavioral analysis therapy, known as ABA therapy.
Whether ABA therapy will be covered as an essential health benefit starting in 2014 is still up in the air, but yesterday advocates were assuming the worst.
“It’s not a good day for people with developmental disabilities, especially autism,” said Kristin Jacobson, co-founder and president of Autism Deserves Equal Coverage, a not-for-profit advocacy group.
Less than a year ago, in September 2012, the state passed an emergency measure to fund ABA therapy for Healthy Families children. But soon after that emergency bill became law, the state announced plans for the phased elimination of Healthy Families, starting in January 2013. State officials assured families, advocates and legislators that Healthy Families beneficiaries would get continuity of care and services.
But most children receiving ABA therapy under Healthy Families have not been able to get that service once they were moved to Medi-Cal managed care, according to advocates. Yesterday’s omission of one year of funding means Medi-Cal children will not be receiving expanded ABA coverage, at least this year and likely beyond, Jacobson said.
“It’s incredibly disappointing the state would leave these kids in the lurch,” Jacobson said. “It is unconscionable that they pass emergency regulations in September, then take it away in June. The [Brown] Administration is well aware of the harm it’s causing by not taking care of these kids.”
Jacobson said it costs the state more when it doesn’t treat children with autism because many children without appropriate treatment fail to become contributing members of society. But even more than that, she said, there is a moral imperative to provide the medical standard of care to children.
“This is the most effective treatment for these kids so it’s the equivalent of denying insulin for diabetes,” Jacobson said. “Can you imagine denying diabetic kids insulin and then saying, ‘What’s the big deal’? They’re denying standard of care treatment.”
Jacobson, contending the state gave families of autistic children false hope that they might get ABA therapy, said it’s cruel to reverse field when the state budget is in better shape now than a year ago.
“Families feel completely let down. It’s a betrayal,” Jacobson said. “This is almost worse than not ever having the services at all because the state acknowledged that this is a public health crisis, that there’s a critical emergency, and then turned its back on the kids.”