Tobacco tax to launch kids' autism program

BY SETH BLOMELEY
Posted on Monday, February 23, 2009

Lost in the debate over the $86 million cigarette and tobacco tax increase signed into law last week by Gov. Mike Beebe is a program the money would fund to help children with autism.

It would be one of 23 healthrelated programs benefiting from the tax, which also is to fund an expansion of ARKids First Medicaid health insurance for children, a statewide trauma system in emergency rooms, community health centers and a medical school in Northwest Arkansas.

The autism program's share would be $1.5 million a year.

Surgeon General Joe Thompson estimated it could serve about 100 children at any one time, with each needing between six months and three years of intensive treatment.

Thompson acknowledges the program won't meet the needs of all the children suffering from autism.

"The need is so great," said Leslie Henson-Kita of North Little Rock, mother of an autistic child. "But this is a really good starting place. If we prove the program works, hopefully more funding will become available."

Henson-Kita was the vicechairman of the Arkansas Legislative Task Force on Autism. She urged the creation of the task force and a law requiring the state to set up a Medicaid autism program - Act 1198 of 2007 by then-Rep. David Johnson, D-Little Rock, now a state senator - should funding become available.

In a 2007 survey, the University of Arkansas for Medical Sciences found that about one in 145 children had an autism spectrum disorder - the group of developmental disabilities characterized by inappropriate social behavior and difficulty communicating.

A spreadsheet put out by Beebe's office listing the programs funded by the tax increases doesn't include any federal Medicaid matching dollars for the autism program.

Thompson said the program hasn't been approved by the federal government so he didn't want to promise legislators specific funding levels from the federal government.

If approved, the state would be eligible for as little as a 50-50 match or as much as a 3-to-1 match, he said.

"I think with the money we can pay to have some experts come in and help us design the program and we can apply to the federal government to have a program in place similar to other states but tailored to our needs," Thompson said.

He estimated it would take six to nine months to get the program running.

He said "intensive therapy" for 3-, 4-, and 5-year-old children in other states has had "relatively good outcomes and decreased long-term needs."

If treated early, children with autism won't need as many services as they grow older, Thompson said.

Henson-Kita said her son, Collin, 5, was diagnosed with autism after she noticed him acting differently when he was 15 months old.

"He lost skills," she said. "He was starting to talk and then he just checked out and lost eye contact."

Henson-Kita, advertising manager for Arkansas Catholic newspaper, said she and her husband, an orthodontist, were able to pay for the intensive treatment their son needed, but it wasn't easy.

She said it costs between $30,000 and $75,000 a year.

"Most people in Arkansas don't have that money," she said. "We didn't either. My parents and in-laws were kind enough to start a college fund. I used his college money. My husband and I looked at each other and said if we don't spend this money on him now he may not need a college fund."

She looks to South Carolina as a model for what the Arkansas program could be. There is no maximum family income for eligibility and participants are chosen by a drawing, she said.

Henson-Kita paid a certified behavioral analyst to teach her how to provide the intensive therapy for her son.

"My son did improve, but we could only do 15 hours a week when 25 is what's recommended," she said. "He gained language skills. He was able to relate to us better. Most of these children have pretty severe language problems."

She called the treatment "applied behavioral analysis" and said it's different from typical speech therapy.

"It's a learning technique," Henson-Kita said. "It teaches them to take a task and process it and understand what you're asking for and they learn to respond. If your child is thirsty and wants a drink, and that child is nonverbal, he just sits on the floor and screams and you have to guess what the problem is. That's OK when the child is three months old, but not when they are three years old. They ought to be able to say, 'Juice, please.' [The treatment] breaks [communicating the need for drink] down in little bitty pieces so they can learn how to do it."

She said the services the state Medicaid program currently provides to autistic children are limited to the speech and occupational therapy and there is a sliding scale of co-payments depending on family income.

According to the federal Centers for Medicare and Medicaid Services, 10 states have Medicaid programs specifically designed for autism treatment. They are Indiana, Maryland, Wisconsin, Colorado, South Carolina, Maine, Massachusetts, Kansas, Pennsylvania, and Montana.

They served as few as 50 children in Kansas and as many as 3,000 people in Wisconsin.

Another goal of the autism task force is state-mandated insurance coverage of autism treatment.

There are eight states with such requirements according to the task force: Arizona, Florida, Indiana, Louisiana, Minnesota, Pennsylvania, South Carolina and Texas.

"What we're asking for is not unreasonable," Henson-Kita said.

She said in Indiana premiums increased by less than 1 percent as a result.

A bill for this legislative session is being worked on by Sen. Mary Anne Salmon, D-North Little Rock, and Rep. Gregg Reep, D-Warren, and the task force has asked Insurance Commissioner Jay Bradford for his support, Henson-Kita said.

"It's a heart-rending situation, and I have absolute understanding and great feelings for the people who are faced with this type of illness," Bradford said.

But he said he's hesitant to support a mandate on insurance companies because some autism treatments that seem to work for some patients haven't been proved widely effective.

Max Heuer, a spokesman for Arkansas Blue Cross and Blue Shield, said "employers and employees are struggling to maintain coverage" and any mandates would increase costs.

Source: http://www.nwanews.com/adg/News/253241/

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