I am a parent of two both diagnosed with forms of autism & a client of a certified RDI consultant for 3+years.  I am also an autism advocate & have dedicated years & thousands of hours researching coverage obstacles for individuals with autism.

I urge you & the RDI community to not make blankets statements especially when it comes to shaping public policies before you have a good understanding of what the obstacles to coverage are.  

RDI's assessments (RDA1, RDA2 & RDA3) as well as follow up consultations  ARE covered by insurance already, so long as the provider is a licensed mental health provider who is practicing within their scope of practice.

Having the professional certification that the Connections Center provides does not automatically make providers a "health care provider" in the eyes of the law.  Each state has regulations and rules of what education and competencies are required under that state's laws.

I.E. in Texas, both Dr. Gutstein and Dr. Sheely could bill insurance or provide invoices to families to get their services covered.  The disparities that exist in the level of coverage between families is dictated by the packages employers choose to provide & the limitations are not unique to autism.  

As the country's eyes are on congress towards meaningful health care reform, I urge you not to forge partnerships with legal minds in your community and states who are familiar with state health mandates & CMS HIPPA rules.

Respectfully,

Arzu Forough

Kirkland, WA

I am very confused by Arzu's comments.  The Autism Treatment Acceleration Act is being pushed VERY HARD by organizations like Autism Speaks and the Autism Society of America and unfortunately at this point the act is almost completely weighted toward coverage of behavioral therapies for autism.  What this group of RDI consultants is trying to do is get our representatives to see that there is another option that is working for many families and should be given as much weight in this act.  I don't understand Arzu's argument against that but maybe I'm missing something.

What I am wondering is whether or not a better or perhaps just as good place to push this would be with those organizations (Autism Speaks and ASA) that already have access to the legislators that are pushing this through.  I know those groups are also heavily weighted toward behavioral programs but they are certainly aware that developmental programs exist and that many families choose that route.

Any thoughts?

Carolyn

There are two issue  we are addressing: one is for the intervention of RDI to be specifically recognized in any legislation (as opposed to current language, which recognizes only behavioral methods), the other is that the law and insurers will recognize the designation of RDI Program Certified consultant as  the sole criteria for competence in administerting RDI programs.  The RDI certification can be considered a "parallel" certification to the BCBA certification.  The BCBA certification is sufficient to receive reimbursement currently, at least under Connecticut Law.  It appears the national legislation is heading in that direction also.  Our position is that, if BCBAs services are covered, then the services of RDI Program Certified Consultants should be also, provided they are practicing within the scope of their certification.  We have an extensive Code of Ethics we must abide by.

I hope that clarifies our position.

Laura DeAngelo, A.B., M.B.A.

RDI Program Certified Consultant and RDI Parent

Autism Family Services, LLC

Avon, CT

www.autismfamilyservices.com

I must respectfully disagree with the first comment stating that the limitations on coverage "are not unique to autism".  While I cannot speak for all states, it is most certainly the case in Michigan that some insurance companies explicitly exclude autism and related diagnoses from coverage that is offered under their plans.  For example, a family may have a mental health plan that provides coverage for the service codes I use for RDI assessments and consultations.  However, if the diagnostic code is autism or a related condition the service codes are not covered.  If the child had a diagnosis of another condition, such as mood disorder or depression for example, the company would cover those codes.  This is one of the reasons that groups in the autism community, including our RDI consultant group, are trying to advocate for change in the way coverage is provided for autism.  I certainly understand that if a family doesn't have mental health coverage as part of their health care plan then it doesn't matter what diagnosis their child has, the services are not covered.  However, discrimination based on diagnosis is a big problem, at least in Michigan.

-Nicole Beurkens, RDI Program Certified Consultant

Ditto what Nicole said, for the state of Illinois; from a Mom whose two sons with Autism recently got dropped from all health care coverage, just because they have Autism.  And this is in a state that is supposed to have just initiated an Autism Insurance coverage bill - ha!  A lot of good it has done us...  PLEASE, make those phone calls!!!

Susan Hudkins

Chicago area Parent and CIT

Hello parents, consultants and friends,

I made my first phone call today.  Living in Connecticut, I called Senator Lieberman's office this morning about including RDI in the pending autism insurance reform legislation.  His Health Legislative Aide was very helpful in guiding me to the right individuals to contact in this effort.

The Autism Treatment Acceleration Act is currently sitting in the Senate Health, Education, Labor and Pensions Committee.  Senator Kennedy had chaired that committee; now that he has passed and the committee is temporarily without a chair, committee activity is on hold.  

However, the bill would be eligible for "markup" or modifications while in the committee.  Individuals on the committee would decide on any modifications to the bill.  Consequently, it is these individuals that we need to contact.  Now would be a good time to call since the committe is in a lull.

Senator Dodd (from Connecticut) is a co-sponsor of the ATAA and also a key player on this committee. In fact, he may be named the new chair, according to Lieberman's aide.  

PLEASE CALL SENATOR DODD'S OFFICE TO MAKE YOUR VOICE HEARD IN SUPPORTING BROADENING THE SCOPE OF THE ATAA TO RECOGNIZE AND PROVIDE COVERAGE FOR DEVELOPMENTAL AND RELATIONSHIP-BASED INTERVENTIONS FOR AUTISM, SPECIFICALLY, RELATIONSHIP DEVELOPMENT INTERVENTION!

For those of you who don't live in CT, or would like to contact other key individuals on this committee, other members of the Senate Health Committee are Sen. Brown (Ohio), Sen McClusky, and Sen. Durbin.  These individuals are some of the co-sponsors of the ATAA who are also members of the Senate Health Committee.  

Please access this link for information on our efforts and see attachment for talking points:

www.rdiconnect.com/.../a-matter-of-urgency-ensuring-a-range-of-autism-treatment-options-for-families.aspx

Here is the contact information for Senator Dodd's office (phone number is on bottom of page at left - call Washington office):

http://dodd.senate.gov/

Thank you!

Laura

Laura DeAngelo, A.B., M.B.A

RDI Program Certified Consultant

Autism Family Services, LLC

I have been a pediatric occupational therapist for 34+ years.  I have no idea how any insurance company can classify autism as a mental health disorder.  It is a biological disorder and should be a covered service under the regular medical plans that families have, not through mental health plans.

I apologize there was a typing error in my message:

As the country's eyes are on congress towards meaningful health care reform, I urge you not to forge partnerships with legal minds in your community and states who are familiar with state health mandates & CMS HIPPA rules.

It should say " I urge you to forge partnerships with legal minds in your community and states who are familiar with state health mandates & CMS HIPPA rules".

I stand behind my original comments and urge you to consult experts in your states on this issue who can provide unbiased information about what the current obstacles in coverage are and which ones are solved through provider credentialing and which are solved through mandated benefits.  

Respectfully,

Arzu Forough

Kirkland, WA

My son has receives medicaid and  RDI is not covered by his medicaid insurance.  We live in NC and I don't know if this varies state by state.  

The funding should be included; that shouldn't even be questioned.

My very good Friends(family) has two children that have Autism.

The help that the need should be provided.

Why in this country should families struggle and Go broke giving and fighting for there rights of there children.

The best care shouldn't be at the finger tips of those who can afford it but should be at those who are human.

Care is for those with names and faces not for those with Dollar bills.

This funding should be included!!!!!!!!

I have found unless you are effected by something you have no interest.  People that have not been effected by autism have no vested interest and therefore has no knowledge what is needed to give these children a chance to progress.  

We have a beautiful child in out family, my grandson, diagnosed with autism in 2004, and my son and his wife searched for any and all help to give him opportunities in life.  They had no financial help and made many sacrifices to pay for his therapy.

It is time our country take responsibility to provide necessary medical help for our children that deserve a chance at life.  Autism is a disease and children that are diagnosed should receive all treatment available to them.  

Insurance covers treatment for addicts of all kinds but not children that haven't a choice.

Stand up for children that can't ask for help and parents that want to provide the best treatment for their children.

I think it is important to understand how insurance companies operate: they are driven by the medical model, which means that they will deny coverage for anything "unproven" or "experimental" until they can find no legitimate reason to deny coverage (the treatment is universally considered "best practices" and has an abundance of peer reviewed research to back it up); and they are looking for EVERY opportunity to reduce costs.

As this relates to RDI, there are two avenues to obtain coverage: the easiest being to be insurance reimbursable through your original discipline (occupational therapy, mental health, etc.). You are absolutely right, Nicole, there is discrimination against the autism diagnosis in mental health. I always give a primary diagnosis of something else. And insurance companies will deny RDI as an intervention because they do not pay for a specialized technique or methodology that a parent is requesting, only for a proper assessment and treatment of a clinical diagnosis. This leaves mental health practitioners on shaky ground, as well as other practitioners who may not survive an insurance audit.

The other route to take, asking that ALL RDI certified consultants be made insurance reimbursable is a tougher sell. On the plus sidel, I am pleased that Autism Speaks put RDI in the 100 day packet as a recommended intervention.  That is a major endorsement. RDI consultants all go through rigorous training. There are outcome studies that show promising results.

On the down side, I am picturing an insurance company's medical staff ( as I recall from my medical days ) evaluating the RDI research and figuring it it simply isn't enough to establish best practices for reimbursement criteria. That is where I think we need to put more of our attention in order to get on the playing field.

Insurance companies may cave in to political pressure from families. I am getting a few form letters from companies stating that they are trying to improve service delivery to families with autism, thanks to legislation efforts in my state. I have even successfully negotiated rate increases with some because of my autism specialty. If they can find a way to dismiss an intervention, however, they will.

The task for families who want RDI to be covered by insurance, and RDI consultants who want to continue to make RDI available for families, is to find ways in which insurance companies cannot dismiss RDI as a valid intervion.

Carrie Sheppard

RDI Consultant

WA

Someone concerned (and for a very long time and a certified Home Care Attendant).   I am not going to try to read through all of the comments to this article, but to: Ms. Carlotta Baird, or whom ever is the author of this article; why do you imagine that we need Congressional action or laws concerning treatment options for the persons under all of our care?  Young lady, my experience and care for those in need goes back long before you became concerned in this field.  I can't think of where a Congressional act is needed at all to find and apply treatment options for my brother or any of my clients over the last 50 (+) years.  This truly boils down to a matter of love and personal concern and being responsible.  You only need laws and Congressional acts in place when you are not responsible enough, caring enough, loving enough, simply, too lazy to take care of the burdens that God has appointed to "you".   (In the end you will find that you do not want to "dis-appoint yourself from what God has appointed you to bear.)   From many years of experience  I do not want any (more) government intervention in how I care for my burdens.  The options are out there (including RDI); I use these treatment options as I see fit and as I feel led.  And I am so thankful that many caring researchers are still out there looking every day for new clues and treatments for many things.  Again, I will only need laws in place when I am too lazy, too uncaring, too unloving to continue to care for my burdens; when I think I need to push them off on someone else.  Please don't try to tell me what a load it is.  What you think you know about this burden, what you think you have experienced, I probably have experienced twice over.