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Welcome!
WV Autism Insurance StakeholdersRoundtable
Sponsored by:TRAIN WV: Training and Resources for Autism Insurance Navigation in WV
MAP: Mountaineer Autism ProjectThe Benedum Foundation
Mountain Lakes Convention and Visitors Bureau of Lewis County.
Our Plan Today
The goal of this meeting is to
improve access to autism treatment services for young children with
autism and
develop collaboration and information exchange among all
stakeholders.
AGENDA8:30-9:00: Registration9:00-Morning Session
Welcome and IntroductionsSusannah Poe—Autism, MAP, Legislation, and TRAIN
Jill McLaury—Overview of the WV LegislationCindy LeGrand and Kathy Shapell—What is ABA?
WV Highmark Blue CrossThe Health Plan
12:15-1: Lunch at Stillwaters
1:00: Afternoon SessionMike Wasmer—Overview on Implementation Issues
Billy Edwards—Implications of Implementation For the ABA Provider.
Jackie Eckerd—Implications of Implementation For Parents and the Community.
Mike Wasmer—Self-funded Policies and Non-Mandated Coverage.
Group meetings: Insurers, ABA Providers, ParentsReports from the Stakeholders
Planning Our Next Step
What IS Autism?
Autism is a complex neurobiological/ behavioral disorder characterized by:
- severe, persistent, and atypical problems in
social interaction - severe, persistent, and atypical
problems in communication- accompanied by unusual or
repetitive behaviors, - occurring before age three.
Autism is…
A broad spectrum of disorders affecting– thought– perception– attention
…not just one disorder with a well-defined set of symptoms- ranges from mild to severe- occurs across all situations- is consistently inappropriate for the child’s age
Who Gets Autism?
An equal-opportunity disorder…any financial, religious, cultural,
geographic group…clusters
Boys more likely than girls1 in 88 in US
Incidence is Rising
Autism is an Epidemic
It is the fastest growing serious developmental disability in the US---More common than pediatric cancers,
diabetes, and AIDS combined.---CDC calls rise in autism an “epidemic”
that can’t be explained by improved diagnostic criteria, “transfer of labels,” or earlier exposure to younger children.
What we know about autism…
Early identification and referral to high quality, intensive treatment is critical for improving outcomes
Between ages of 2 and 6 are the critical times for learning and “recovering”
Research concludes that effective treatment is possible using the methods of ABA...any treatment other than intensive, 1:1, individualized has no scientific evidence to support its use—
Children with autism have more medical needs than typically-developing children but are usually excluded from the same benefits due to the autism diagnosis
The beginning…
Many years of effort paved the wayIn 2007, first WV autism insurance bill
introduced in Legislature2010 – Philadelphia Meeting, MAP was
formed2011– One Voice Campaign
Sunrise Process2012– Clean Up Bill
WVUCED identified/invited state leadersThe state team participated in facilitated
discussions to develop a plan and actionable priorities to bring home to
improve WV’s system to identify, assess, and serve young children with autism.
Region III Act Early Conference
Conference sponsored by:
National Center for Birth Defects and Developmental Disabilities, CDC, and MCH at Health Resources and Services Administration (HRSA), facilitated by AUCDD
Goal: enhance identification, assessment, service coordination and provision of services for children with ASD and related DD
1 ½ days to share, discuss, learn
Sharing best practices opportunities, challenges with peers from other states in the region
Impact Statement:
To develop a seamless, collaborative, comprehensive plan for screening,
early identification, assessment/diagnosis and family-centered services that meets the
needs of our state’s citizens.
MAP was born.
First step:
Asked to Present “Gaps in Services” to Senate Judiciary Committee
• Not enough well-trained diagnosticians able/willing to provide early identification
• Few in-state resources to provide evidence-based treatment
• Lack of financial supports for all families with special needs
• Existing services do not or can not reach all families
• Life span specialists generally unavailable in state
Question: What Was Needed:
Quicker Diagnosis
More Intensive, Available, Evidence-Based Treatment:
Less than 2 % of WV Children Received ANY Evidence-Based tx
More Trained Providers
Answer: Financial resources for treatment of this MEDICAL condition
Better outcomes for children and families—
And all of WV
Increase in employment
Market for Trained Professionals
MAP’s Commitment:Passing Insurance Legislation and
Increasing Community Resources and Access to Services
• With One Voice• Parent Involvement• Education and Awareness• Increase understanding that ABA is the
most recommended, mature, proven, medically-directed treatment for autism
In 2011, One Voice
Flash MobCupcakesWalk A MileIn Our ShoesTrail MixPresentations
Not Over Yet…2012
Board of Examiners Challenge led toSunrise Application
Incorrect Wording of the Passed Legislation
Led to Reintroduction of Corrected Bill
Passed. Signed.
On To Next MAP Goal:
Increase Awareness and Accessvia
TRAIN: Training and Resources for Autism Insurance Navigation in WV
Grant Funded by Benedum Foundationand in partnership with
Mountaineer Autism Project
TRAIN WV
Bring Together StakeholdersDevelop Information Exchange
Provide Access Information for FamiliesProvide Billing Information for BCBA’sProvide Tx Resources for Insurance
CompaniesOffer Demonstration Treatment Center
Outreach and Resource Center