Legislature(2009 - 2010)CAPITOL 106
03/24/2009 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB187 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 187 | TELECONFERENCED | |
| *+ | HB 188 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 24, 2009
3:03 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative John Coghill
Representative Bob Lynn
Representative Paul Seaton
Representative Sharon Cissna
Representative Lindsey Holmes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 187
"An Act requiring insurance coverage for autism spectrum
disorders, describing the method for establishing a treatment
plan for those disorders, and defining the treatment required
for those disorders; and providing for an effective date."
- HEARD AND HELD
HOUSE BILL NO. 188
"An Act relating to the taxation of moist snuff tobacco, and
amending the definition of 'tobacco product' in provisions
levying an excise tax on those products."
- RESCHEDULED TO 3/26/09
PREVIOUS COMMITTEE ACTION
BILL: HB 187
SHORT TITLE: INS. COVERAGE: AUTISM SPECTRUM DISORDER
SPONSOR(s): REPRESENTATIVE(s) PETERSEN
03/12/09 (H) READ THE FIRST TIME - REFERRALS
03/12/09 (H) HSS, L&C
03/24/09 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE PETE PETERSEN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 187 as the prime sponsor,
responded to questions, and provided comments.
ASHLEY ROUSSON, Staff
to Representative Pete Petersen
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 187 for the prime sponsor,
Representative Petersen, and responded to questions.
JAMES BOUDER, COO
The Vista School and The Vista Foundation
Hershey, Pennsylvania
POSITION STATEMENT: Presented a Power Point and spoke about the
cost and benefit of HB 187.
DR. GINA GREEN
Board Certified Behavior Analyst
San Diego, California
POSITION STATEMENT: Testified about HB 187.
DENNIS BAILEY, Attorney
Legislative Legal Counsel
Legislative Legal and Research Services
Juneau, Alaska
POSITION STATEMENT: As the drafter of HB 187, responded to
questions about the bill.
CHRIS SADDLER
Eagle River, Alaska
POSITION STATEMENT: Testified in support of HB 187.
TONJA UPDIKE
Soldatna, Alaska
POSITION STATEMENT: Testified in support of HB 187.
LORI KING
POSITION STATEMENT: Testified in support of HB 187.
MILLIE RYAN, Executive Director
Governor's Council on Disabilities & Special Education
Office of the Commissioner
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 187.
KATHY FITZGERALD
POSITION STATEMENT: Testified in support HB 187.
LINDA HALL, Director
Division of Insurance
Anchorage Office
Department of Commerce, Community, & Economic Development
(DCEED)
Anchorage, Alaska
POSITION STATEMENT: Answered questions about HB 187.
ACTION NARRATIVE
3:03:52 PM
CO-CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:03 p.m.
Representatives Keller, Herron, Coghill, Cissna, and Seaton were
present at the call to order. Representatives Lynn and Holmes
arrived as the meeting was in progress.
HB 187-INS. COVERAGE: AUTISM SPECTRUM DISORDER
3:04:15 PM
CO-CHAIR KELLER announced that the first order of business would
be HOUSE BILL NO. 187, "An Act requiring insurance coverage for
autism spectrum disorders, describing the method for
establishing a treatment plan for those disorders, and defining
the treatment required for those disorders; and providing for an
effective date."
3:04:37 PM
REPRESENTATIVE PETE PETERSEN, Alaska State Legislature, read
from the Sponsor Statement [Included in the members' packets.]
and said that many children diagnosed with an Autism Spectrum
Disorder (ASD) would not receive treatment, even though
treatment had been shown to improve the symptoms of ASD. He
confirmed the exorbitant costs which families paid for
treatment, and the incremental societal costs for not treating
autism. He explained that "HB 187 would require insurance
coverage for autism spectrum disorders, including the behavior
therapies that after 30 years of study have shown to be the only
effective treatment of these disorders." He confirmed that the
cost savings from the treatments far outweighed the cost of
treatment or the incremental societal cost of no treatment,
which he observed would be "steep." He reported significant
savings to the state and local governments with HB 187. He
pointed out that the required insurance coverage for ASD would
bring qualified ASD professionals to Alaska to meet these needs.
3:07:32 PM
ASHLEY ROUSSON, Staff to Representative Pete Petersen, Alaska
State Legislature, explained the sectional analysis [Included in
the members' packets.] and highlighted that Section 1 amended
the current insurance statute to include coverage for autism
spectrum disorders. She detailed that treatment would be
covered as prescribed by a licensed physician or psychologist;
treatment would be provided by an autism service provider;
treatment would be outlined in a treatment plan, prescribed by
the physician or psychologist, and followed by a comprehensive
evaluation; and that treatment would include medically necessary
pharmacy care, psychiatric care, psychological care,
rehabilitative care, and therapeutic care. She reported that
the coverage would include people under the age of 21, and that
there would be a maximum annual benefit of $36,000, with an
annual inflation adjustment. She continued and explained that
Section 2 of HB 187 stated that the coverage would be applied
for policies issued on or after January 1, 2010.
3:09:44 PM
MS. ROUSSON informed the committee that experts were prepared to
testify.
3:10:29 PM
The committee took an at-ease from 3:10 p.m. to 3:12 p.m.
3:12:34 PM
REPRESENTATIVE SEATON referred to Section 1(a)(2) and asked if
the rehabilitative care was for care until there was no longer
progress, or was ongoing "as long as the person needs some
help."
3:13:43 PM
MS. ROUSSON referred to the definition of "medically necessary"
in Section 1(a)(1) which explained that the treatment and care
was described in subparagraphs (A), (B), and (C). She said that
the treatment would include prevention and amelioration for a
condition or disability, as well as assistance in achieving
maximum functional capacity with daily activities.
3:14:16 PM
REPRESENTATIVE SEATON asked to clarify that treatment services
would not have a termination date, if the medical analysis was
for progression of the condition.
3:15:04 PM
MS. ROUSSON agreed, but she pointed out the limitations to
coverage contained in the bill.
3:17:21 PM
REPRESENTATIVE PETERSEN said that HB 187 was to help people with
the disorder, that there had been significant improvements in
the treatments, and that there were greater successes,
especially when treatment was received at an early age.
3:18:59 PM
JAMES BOUDER, COO, The Vista School and The Vista Foundation,
explained that he was the COO of a private school in Hershey, PA
which provided services to children with autism. He detailed
that he had provided cost analysis testimony for similar
legislation in many other states. He presented a Power Point
titled "The Cost and Benefit of HB 187." [Included in the
members' packets.]
MR. BOUDER referred to slide 2, "Cost Benefit Analysis," and
said he would discuss the effect that mandating coverage would
have on commercial insurance rates and state employee claims if
the benefit were extended to dependents. He spoke about the
long-term savings considerations and he summarized the cost
effect to other states.
3:23:20 PM
MR. BOUDER pointed to slide 3, "Summary of HB 187," and he
stated that HB 187 required private insurance coverage for
autism, and provided coverage for a list of medically necessary
services.
3:23:49 PM
MR. BOUDER explained slide 4, "Commercial Insurance Cost
Estimates." He estimated that more than 48,000 Alaskans between
the ages of 2 and 20 had insurance under plans subject to HB
187. He explained the "treated prevalence rates" used to
establish low, mid, and high range estimates for the number of
children seeking treatment. He explained that the highest
expenses would be during the early childhood years. He said
that applied behavior analysis (ABA) was the most effective, and
the most expensive, treatment; and that this was usually
provided at younger ages.
3:25:56 PM
MR. BOUDER considered slide 5, also titled "Commercial Insurance
Cost Estimates," which continued the assumptions discussed on
slide 4. He declared that the assumption of 85 percent Medical
Loss Ratio was the industry standard, and described this as the
percentage of premiums collected that were spent on claims. He
directed attention to the estimated premium base of more than
$345 million in 2009, and he explained how he collected this
information. He declared that the final assumption was for an
adequate provider network to be in place by the effective date.
He noted that there was not an adequate provider network
currently available in Alaska, and that it would take time to
recruit, train, and deploy trained providers.
3:28:32 PM
MR. BOUDER discussed slide 6, "How Many? Eligible
Beneficiaries." He explained the table of eligible
beneficiaries, and announced that there would be about 48,000
eligible children in Alaska. He continued on to slide 7, "How
Many? Treated Prevalence Assumptions," and he noted that
community prevalence was not an assumption to use for autism, as
it had a range of severity. He referred instead to four
different studies that found about 1 in 500 children with
autism. He noted that his assumption was for a more frequent
occurrence. He explained that an adequate treatment program
would bring more people to utilize these services.
3:31:59 PM
MR. BOUDER showed slide 8, "How Much? Low Estimate (Treated
Prevalence 1 in 400)," and said that he used an estimate from
the actuarial firm, Mercer. He estimated the cost per person to
be $2.24 per member per month.
3:34:02 PM
MR. BOUDER continued on to slide 9, "How Much? Mid Estimate
(Treated Prevalence 1 in 325)." He said that this table used
the same actuarial estimates for this mid range estimate of
prevalence, and that the cost would be $3.60 per member per
month.
3:34:20 PM
MR. BOUDER presented slide 10, "How Much? High Estimate (Treated
Prevalence 1 in 250)." He noted that the cost would be $5.81
per month. He reminded the committee that all of these
estimates assumed that an adequate network of providers was
available.
3:35:00 PM
MR. BOUDER moved on to slide 11, "Short-Term Cost Estimates."
He explained the likely scenarios for cost increases over a four
year period with low, mid, and high prevalence rates.
3:36:26 PM
MR. BOUDER noted on slide 12, "State Fiscal Impact," that the
likely cost per state employee per month with a mid range
prevalence would be $3.02 per month.
3:37:15 PM
MR. BOUDER assessed slide 13, "Future Savings," and compared the
lack of investment in autism treatment to deferred maintenance
on a home. He explained that, according to the Jacobson study
in 1999, there was a $2 million savings per person with early
treatment. He noted that the Ganz study in 2007 showed the
incremental societal cost for not treating autism to be about
$3.2 million per person. He explained that this included the
care and lost productivity for the person with autism, as well
as the lost productivity for the parents or primary caregivers.
3:41:25 PM
MR. BOUDER directed attention to Attachment A. [Included in the
members' packets.] He explained that the first page showed the
completed cost analyses for autism legislation which has already
been enacted. He pointed out that the estimated premium
increase was between .33 and 1 percent.
3:43:34 PM
MR. BOUDER mentioned that page 2 of Attachment A listed national
actuarial firms hired to find the costs of the legislation, and
that all of the firms had agreed that the cost increase for
premiums would be one percent or less. He concluded that the
costs in Alaska would be similar to that of these other states.
3:44:54 PM
REPRESENTATIVE SEATON asked about the estimated percentage of
increase for premiums on slide 11.
3:45:38 PM
MR. BOUDER explained that the likely total claims impact in year
one would be 25 percent of year four; year two would be 50
percent of year four; and year three would be 75 percent of year
four.
3:46:23 PM
REPRESENTATIVE SEATON asked if transportation costs to the
facilities would be required should coverage be mandated. He
noted that there were not any transportation expenses in the
estimates which Mr. Bouder presented.
3:47:39 PM
MR. BOUDER replied that other states had limited provider
networks within the state. He noted that the $36,000 cap in the
bill would limit the fiscal impact. He explained that the types
of services for applied behavior analysis were ordinarily
provided in a home setting.
3:48:49 PM
DR. GINA GREEN, Board Certified Behavior Analyst, offered to
answer any questions about autism.
3:49:41 PM
REPRESENTATIVE SEATON asked that as treatment was to be
prescribed by a licensed physician or psychologist, would their
general knowledge be sufficient to determine whether the best
treatment was or was not the most expensive treatment.
3:50:49 PM
DR. GREEN responded that the American Academy of Pediatrics
endorsed applied behavior analysis as the preferred treatment
for autism.
3:53:23 PM
REPRESENTATIVE SEATON pointed to Section 1(e)(2) of the bill
which listed disorders that were all defined as "autism spectrum
disorders." He asked if there were different levels which
required different treatments.
3:54:10 PM
DR. GREEN acknowledged that the treatment and the needs for all
these disorders were similar. She explained that applied
behavior analysis treatment was very individualized. She
commented that there were all degrees of severity.
3:57:01 PM
DR. GREEN began her presentation and explained that applied
behavior analysis was a natural science approach to behavior and
that autism was just one of the areas of application. She
suggested looking at the skill deficits and then developing
procedures to reduce the problem behaviors and increase
independent functions: self care, communication, social skills,
and general awareness. She explained that this procedure was
highly individualized. She shared that the training of the
parent was also important to make available the opportunities
for the child to regularly practice these skills. She specified
that there was constant evaluation, so that if there was not
progress, the procedures and techniques were changed. She
expressed that there were many studies which evaluated specific
methods for reducing some of the problem behaviors, as these
were contributors to health care costs. She explained that the
most effective result for applied behavior analysis (ABA) was
for early, comprehensive, and intensive intervention.
4:01:29 PM
REPRESENTATIVE COGHILL asked to clarify at what age ABA worked
best.
4:02:11 PM
DR GREEN said that the brain is more able to absorb at a younger
age before behavioral patterns become established. She said
that older children would often have slower progress.
4:03:17 PM
REPRESENTATIVE COGHILL asked how a medical model could determine
the need to intervene early when the problem may be that a
developmental stage had not yet matured.
4:03:55 PM
DR. GREEN asked what Representative Coghill meant by "medical
model."
4:04:03 PM
REPRESENTATIVE COGHILL responded that the ABA was a technical
screening tool.
4:04:29 PM
DR GREEN clarified that ABA was a treatment, not a screening
tool.
REPRESENTATIVE COGHILL asked if every child could be
behaviorally suspect enough to be considered for the ABA.
DR. GREEN specified that the child's developmental difficulties
needed to meet the diagnostic criteria for autism. She pointed
out that trained professionals were good at differentiating
autism spectrum disorder from other developmental disabilities.
She shared that there was no evidence that people with autism
got better with maturity. She stated that without effective
intervention, people with autism would remain impaired, and
costly to care for.
4:05:46 PM
REPRESENTATIVE COGHILL referred to the subjective nature of the
diagnostics, and posed the question for finding and helping
people with a legitimate need, as opposed to paying people to
find a need.
4:06:14 PM
DR. GREEN agreed that there were not biological markers for
autism spectrum disorder. She declared that the behavioral
characteristics were clearly defined, and that experience with
these disorders allowed for differentiation. She explained some
of the behaviors distinctive to autism spectrum disorder.
4:07:28 PM
REPRESENTATIVE COGHILL said that he would maintain this as an
ongoing question.
4:07:43 PM
REPRESENTATIVE SEATON referred to page 5 of Dr. Green's letter
to the U.S Assistant Secretary of Defense for Health Affairs
[Included in the members' packets.] and he read: "With effective
treatment, military children and youths with ASD can lead
happier and healthier lives than they would otherwise." He
asked about the connection between military children and youth
with ASD.
4:08:11 PM
DR. GREEN responded that military health care covered ABA, and
that this letter explained the medical necessity of ABA
treatment for autism.
4:09:12 PM
REPRESENTATIVE SEATON asked how much ABA takes place in the
school environment.
4:09:52 PM
DR. GREEN explained that most public schools did not have the
expertise or the resources. She reported that the interventions
needed to be provided in the homes and communities, as well as
the schools, to address the needs of children with autism.
4:11:47 PM
REPRESENTATIVE SEATON referred to Section 1(b)(5) of the bill,
which stated that coverage "must cover treatment that is
coordinated with an education program, but may not be contingent
on the coordination of treatment with an education program."
4:12:06 PM
DR. GREEN, in response to Representative Seaton, said that it
worked best for children with autism to coordinate the school
and the out-of-school programming to provide consistency.
4:12:49 PM
REPRESENTATIVE SEATON asked who would finance the school
programs, as this was a mandated coverage.
4:13:27 PM
DR. GREEN, in response to Representative Seaton, opined that
financing was determined on a state by state basis. She pointed
out that all states were required to provide special needs
children with "a free and appropriate public education." She
reminded the committee that the early intervention treatments
started before school age, as it was necessary to teach the
child all the basic skills for success in a school environment.
She shared that the coordination of programs only became an
issue when children were capable of school participation.
4:15:01 PM
REPRESENTATIVE LYNN referred to TRICARE military insurance and
asked how many children of retired military were diagnosed with
autism spectrum disorder.
4:15:35 PM
DR. GREEN replied that TRICARE had a program for special needs
children of military families. She offered her belief that the
retired military insurance package did not include this
treatment benefit, but that it was being discussed.
4:17:10 PM
REPRESENTATIVE SEATON referred to Section 1(a) and asked the
reason for exclusion of a "fraternal benefit society."
4:18:01 PM
DENNIS BAILEY, Attorney, Legislative Legal Counsel, Legislative
Legal and Research Services, explained that with fraternal
benefit societies, such as the Benevolent & Protective Order of
Elks or the Loyal Order of Moose, the members provided benefits
for themselves which were not considered an insurance program.
He explained that this exception was common for mandated
coverages.
4:18:32 PM
CHRIS SADDLER said that she had a 10 yr. old son with autism.
She said that autism was a "huge health issue" in Alaska, as it
affected more kids than aids, diabetes, and cancer combined.
She shared that the Anchorage School District reported that 1 in
80 kids were on the autism spectrum. She reminded the committee
that autism was treatable, and that with early diagnosis and
intensive behavior treatment, a majority of the kids would lead
"productive, independent lives." She continued on to say that
without effective intervention, 80 percent of the kids required
more costly, life-long support services, at public expense. She
opined that it was a lot easier to deal with a toddler having a
tantrum, than an adolescent or adult having a tantrum. She
related that there were no intensive treatment programs for
autism in Alaska. She recounted that they were able to find a
private provider to set up a volunteer based home program
patterned after a University of Alaska Anchorage (UAA) research
project. She revealed that her son's early education
experiences lead to his extreme frustration and that there were
no programs for support. She said that the Anchorage School
District declined to provide the intensive behavioral program
that her son required. She relayed that she was directed, by
another parent, to Dr. John McEachin's Autism Partnership clinic
in Seal Beach, California. She stated that the clinic staff
determined her son's needs, and outlined an intervention
program. She shared that it took several months to hire and
train a volunteer staff member to provide the 30 hours per week
of one-on-one interaction. She emphasized that none of this
intervention was covered by either her federal or her husband's
State of Alaska insurance. She disclosed that, after a year of
documented improvement and tens of thousands of dollars of
expenses, they were able to submit a plan of care that was
approved by Medicaid, only because her son was also diagnosed
with an anxiety disorder. She said that this Medicaid funding
paid for the staffing, but did not pay for any of the oversight
and direction from Autism Partnership. She said that they were
finally able to file a successful due process against the
Anchorage School District. She shared that, at this point, they
had incurred a debt from the autism program of more than
$100,000. She said that the school district was now paying for
the current costs, but had declined to reimburse any of the
previous expenses. She shared that the resulting legal fees
were an additional $100,000. She summarized that early
effective treatment for children with autism reduced costs, but
that no single service system would bear the entire financial
responsibility for payment. She suggested that coordinated
support from education funding, Medicaid, and private insurance
was necessary. She stated that HB 187 would ensure that private
insurance carriers provided coverage of vital health care
services for children with autism. She opined that this would
save millions of dollars for the state of Alaska over the life
of each child. She appealed to the National Federation of
Independent Businesses (NFIB) to remove its opposition to any
new mandates on insurance coverage. She asked that autism be
given the same considerations for treatment as for polio,
cancer, or diabetes. She offered her strong support for HB 187.
4:25:22 PM
TONJA UPDIKE shared that her child was diagnosed with autism at
18 months. She declared that he began speech, occupational, and
physical therapies which all "helped tremendously." She said
that her husband's insurance did not cover everything. She
pointed out that this early intervention would save money in the
long term. She expressed that autism was a growing problem, but
that it was treatable. She emotionally described the
frustration and concern of trying to meet all of her son's
needs, without also having the insurance coverage. She voiced
her support for HB 187.
4:29:30 PM
LORI KING spoke about her daughter and pointed out the very
specific early signs of autism that doctors looked for, which
included aggressive behavior, tantrums, and early walking and
talking developmental signs. She shared that her daughter
required significant clinical treatment. She noted that when
her daughter, now 18 years of age, was young, there were not
many services available. She described a number of her
daughter's early indicators. She said that her insurance policy
at the time covered about 50 percent of mental health services,
which was the category for autism. She disclosed that the
problem was with the wait lists for the services. She explained
that most services were provided by non-profits, which needed
full payment from as many patients as possible. She reported
that as she was working, she did not qualify for Medicaid or
Denali Kid Care for her daughter's treatment. She stated that
not having "quite enough insurance" resulted in a three year
wait for services. She compared the HB 187 funding cap of
$36,000 per year to the actual costs of $70,000 for funded
services. She expressed her frustration at not having the
services available for those crucial first 5 years. She
described the necessity for early learning of the social skills.
She said that she supported HB 187.
4:39:23 PM
MILLIE RYAN, Executive Director, Governor's Council on
Disabilities & Special Education, Office of the Commissioner,
Department of Health and Social Services, said that the Council
was comprised of family members and representatives from state
agencies. She relayed that the Council had convened an ad hoc
committee on autism to improve the quality of services. She
shared that good progress was being made to increase the
availability of services. She said that the Council was very
supportive of HB 187.
4:41:07 PM
KATHY FITZGERALD shared that her daughter was severely autistic,
but that her behaviors were not recognized 26 years ago. She
reported that her husband's insurance with IBM included coverage
for families with special needs children, which paid for a lot
of the therapies. She described some of the problems
encountered with a severely autistic child. She offered her
belief that the insurance mandate would bring more providers to
Alaska and would have a "positive and wonderful impact on the
state of Alaska." She stated that Medicaid was a payer of last
resort, and that any of the services paid for with private
insurance would help. She described that this was an issue of
parity to ensure that services for autism were included, and
that this was a wise investment for Alaska.
4:45:58 PM
LINDA HALL, Director, Division of Insurance, Anchorage Office,
Department of Commerce, Community, & Economic Development
(DCEED), said, in response to Co-Chair Keller, that she did not
have detailed cost estimates. She said that about 40 percent of
the people covered by private insurance plans in Alaska were in
plans regulated by the Division of Insurance. She said that the
rest were pre-empted by Employee Retirement Income Security Act
of 1974 (ERISA), and therefore not required to follow any
mandates. She said that mandates in state statute had no impact
on self insured plans. She listed the types of insurance
coverage that would not be impacted by legislation, regardless
of being good public policy.
4:48:34 PM
REPRESENTATIVE COGHILL requested a pie chart to show the
insurance market, including ERISA. He opined that it was
necessary to review the money being paid toward the services,
and to determine if there was enough money to support a service
delivery system.
4:51:22 PM
MS. HALL explained that ERISA programs were private employers
who self funded the health care.
4:51:36 PM
REPRESENTATIVE COGHILL listed some of the ERISA employers to
include ConocoPhillips, and Alyeska Pipeline Service Company.
He asked if it was realistic for this group to support the
industry base needed to supply the benefit.
4:52:08 PM
MS. HALL referred to a prior hearing for application for
conversion from a "not for profit" to a "for profit" for Premera
Blue Cross. She mentioned that the studies from that hearing
were still available and could be transferred to a pie chart.
4:53:19 PM
REPRESENTATIVE COGHILL said that the pie chart would help gain a
realistic look of whether a smaller insurance group generated
enough pay-out to support the service industry.
4:53:55 PM
MS. HALL said that she would supply that data.
4:54:13 PM
REPRESENTATIVE CISSNA referred to an Institute of Social and
Economic Research (ISER) study and the Department of Health and
Social Services investigation of the uninsured. She mentioned
that an ISER report was also studying the "under-insured."
4:54:54 PM
MS. HALL replied that she had worked with both of them, and that
she would utilize those resources.
4:55:09 PM
CO-CHAIR HERRON asked Ms. Hall for her written opinion of a
mandate in HB 187 as opposed to a mandated offering.
4:55:42 PM
REPRESENTATIVE SEATON asked if there was any restraint on a
mandate for a condition when a patient claimed there were not
services within the state.
MS. HALL said that there was not any restriction.
4:56:32 PM
REPRESENTATIVE SEATON asked to clarify that the mandate required
that available services be made available, even if it meant
travel to another state.
4:56:54 PM
MS. HALL agreed.
4:57:05 PM
[HB 188 was rescheduled for Thursday, March 26, 2009.]
4:57:49 PM
REPRESENTATIVE SEATON asked that if coverage was mandated, would
that affect funding under Medicaid.
4:58:12 PM
MS. HALL, in response to Representative Seaton, said that for a
benefit to be mandated, it would be need to be placed in
legislation.
4:58:32 PM
REPRESENTATIVE SEATON noted that the ABA utilization dropped off
after early childhood intervention, and he asked why the bill
included coverage through the age 21.
5:00:12 PM
MS. ROUSSON said that ABA was one of the most effective
treatments for autism spectrum disorders (ASD), especially with
intensive treatment at an early age. She listed a variety of
other treatments, and noted that the severity of the ASD
determined a case by case review for treatment. She explained
that the cost analysis reflected necessary care, but that this
care varied for each diagnosis. She observed that the ABA was
also extremely stressful on the family, and that they did not
want the treatment to continue any longer than was necessary.
5:04:13 PM
REPRESENTATIVE SEATON asked again about the reason for mandated
coverage to continue until age 21.
5:04:42 PM
MS. ROUSSON said that the age limitation was based on other
similar states' legislation.
5:05:50 PM
CO-CHAIR KELLER closed public testimony.
5:06:07 PM
REPRESENTATIVE PETERSEN said that HB 187 was a good basic bill,
and that any additional questions could be answered.
5:06:37 PM
[HB 187 was held over.]
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:07 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Background - Autism Speaks.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Backup - Actuarial Cost Estimate.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Sectional Analysis.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Backup - table of contents & Cost Analysis.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Backup - Autism Definitions.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Backup - Gina Green letter.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Backup - Gina Green powerpoint.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| State Initiatives, Map.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Support letter.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |
| Backup - Newspaper article.PDF |
HHSS 3/24/2009 3:00:00 PM |
HB 187 |