Autism coverage improved
Jul 21, 2015 at 11:28 AM
The bills, expected to be signed by Gov. Rick Snyder, also create a state fund to reimburse insurers for treatment costs.
The autism bills passed with a 91-19 vote in the House and 30-8 in the Senate. Michigan is poised to join dozens of other states that require insurance coverage for children with autism.
“It’s huge,” said Grand Haven Township resident Katie Radley.
Her 3-year-old son, Jack, has shown autism symptoms since he was a year old.
“I felt blindsided that nothing was going to be paid for,” she said. “Now, knowing that I can hand (therapists and doctors) my insurance card, and it will be taken care of, is a big relief.”
Coverage will include various disorders on the autism spectrum, which is a group of developmental disabilities. Children with autism can be high-functioning, with their condition characterized mostly by impairments in social interactions or repetitive behavior. Others can be low-functioning, unable to communicate.
“Right now, we try to budget for how much therapy we can afford,” said Dan Radley, Katie’s husband. “This is a big relief because it’s going to open doors for us to add therapy that we wouldn’t have been able to afford.”
The Radleys said they spent about $12,000 — which included a $3,000 grant from the local Elks group — in the past year on autism-related doctor visits and therapy for Jack. While they will still accrue some medical bills, the cost will be considerably lower with this new legislation, they said.
“We’re going to still be spending some out-of-pocket expenses, but we’re going to be much more aggressive in getting Jack more therapy,” Dan said. “This will just allow us to do more for him and not stress about breaking the bank.”
Katie remembers the day she began noticing red flags in Jack’s development. He was about 12 months old and said only a few words. He wouldn’t gesture, point or nod his head ‘yes,’ or shake his head ‘no.’
“He never built upon his language,” she said. “And he would say things over and over again.”
Last spring, Jack was put into an autism observation center at the Ottawa Area Intermediate School District. A teacher observed Jack as he wandered around, did not engage in toys, walked on his toes and would not respond to his name.
Within a couple of months, officials there determined that the Radleys' son, then 2 1/2 years old — has evidence of autism, Katie said.
“I could feel what was happening,” she said. “But when someone actually says that, it’s devastating.”
Immediately, Dan and Katie armed themselves with information about autism and connected with leading therapists and doctors.
Jack now participates in various therapy sessions on a weekly basis at Generation Care in Grand Haven Township. He remains delayed in his speech and fine motor skills and social skills, but his parents say he has greatly improved his eye contact and other skills.
While Jack has an educational diagnosis for autism, a formal medical diagnosis will not be made until the family receives genetic testing results by a team at Michigan State University. The family received two test results on Friday that turned out negative for
Prader-Willi and Angelman syndromes — two common chromosome disorders that cause autistic characteristics — but they are awaiting results from 188 more tests, Katie Radley said.
The Radleys hope Jack will qualify for OAISD’s Early Intervention for Young Children with Autism program in Spring Lake — a preschool for autistic children — next fall. It’s a four-day-a-week program that services 3- to 5-year-olds from 9 a.m. to 3 p.m.
The Spring Lake location is one of eight in the county, noted Linda Elenbaas, a teacher with the program.
Elenbaas, who also serves as executive director of the Autism Society of West Shore, said Michigan, and Ottawa County especially, have been really good at training for identifying autism and creating early intervention programs.
“We know there are so many parents spending thousands and thousands of dollars on out-of-pocket expenses,” Elenbaas said of the recent legislation. “With insurance legislation, it’s going to open that door to help parents with those expenses.”
While various forms of therapy — from physical, occupational to speech — make up for a large part of those expenses, it also includes equipment, Elenbaas said.
“I think we’re going to better service these kids,” she said.
For Jack, who enjoys his outdoor swing and regular walks and car rides around his neighborhood, his parents couldn’t be happier to provide more care for their son.
“You have to put yourself aside and think of Jack,” Dan said. “He has his whole life ahead of him.”
The Detroit Free Press contributed to this story.