California

California Autism News:

June 7 Update

Federal Appeals Court Reaffirms Order on Autism, Mental Health Parity Act

SACRAMENTO -- A federal appeals court has reaffirmed that California health plans must cover all medically necessary treatment for mental disorders as they do for physical illnesses under the state's Mental Health Parity Act, according to the California Department of Insurance.

"This is a critically important decision that will help end unfair challenges so many families face when seeking autism treatment for their children," said state Insurance Commissioner Dave Jones. The Insurance Department had filed a friend of the court brief in the case, which was an appeal brought by Blue Shield from the court's August 2011 decision.

Read the Insurance Department release here.

State Insurance Department Reaches Autism Settlements with Health Net, Cigna

SACRAMENTO, CA (February 28, 2012) -- The California Department of Insurance announced that it has reached favorable settlements with two major health insurers, Health Net and Cigna, to cover behavioral therapy for autism when deemed medically necessary.

"We are pleased that Health Net and Cigna now recognize their current obligations to provide crucial behavioral health treatment to the thousands of children who must live with autism every day," said state Insurance Commissioner Dave Jones. "And we are pleased to reconfirm and acknowledge Anthem Blue Cross of California for providing this treatment as the Department of Insurance has directed since November 2009. These agreements mean more families with autistic children won't have to lose sleep over whether or not they can afford a therapy that's been proven to transform lives."

Read the Department of Insurance release here.

CalABA Honors Autism Speaks' Lorri Unumb with Leadership in Advocacy Award

MORRO BAY, CA (February 22, 2012) -- The California Association for Behavior Analysis (CalABA) has named Lorri Unumb, Esq., Autism Speak's vice president for state government affairs, as the recipient of its 2012  Leadership in Advocacy Award. 

The presentation was made at  CalABA's annual conference on  February 17 at the Hyatt Regency in Garden Grove. The award is presented annually to an individual who has demonstrated exceptional leadership in advancing the science and practice of behavior analysis by influencing public policy.

"It would be difficult to overstate the positive difference (Unumb has) made in the lives of thousands of Californians diagnosed with autism spectrum disorders and their families," said CalABA President Jill M.. Young, Ph.D., BCBA-D.

Referring to Unumb's work in helping to craft California's 2011 autism insurance reform law, Young said, "You, personally, were crucial to producing an outcome that will (now) permit many children, adolescents, and adults access to high quality ABA treatment....We feel fortunate to have you and Autism Speaks as allies in changing public policy to better the lives of those with special needs."

DMHC Names Autism Speaks’ Lorri Unumb to Autism Advisory Task Force

SACRAMENTO, CA – The California Department of Managed Health Care (DMHC) has named Lorri Unumb, Esq., Autism Speaks vice president for state government affairs, to the Autism Advisory Task Force created under the state’s new autism insurance reform law.

The 18-member task force was created under SB.946, authored by Senate President pro Tem Darrell Steinberg, to develop recommendations regarding medically necessary behavioral health treatments and the qualifications and licensing of providers. SB.946, signed into law by Governor Jerry Brown in October, requires coverage of behavioral health treatments starting in July.

Autism Speaks’ California State Chair Kristin Jacobson also was named to the panel. Unumb and Jacobson played pivotal roles in the enactment of the new law last summer, working closely with Steinberg and other legislative champions in hammering out compromise language.

"I am honored to serve on this task force and to contribute to making California’s autism insurance reform law one of the most effective in the nation,” said Unumb. “Autism Speaks welcomes this opportunity to work with the DMHC.”

The Task Force will focus on:

• Scientifically validated Interventions that have demonstrated clinical efficacy and measurable treatment outcomes
• Patient selection, monitoring and duration of therapy
• Qualifications, training and supervision of providers
• Provider network adequacy
• Requirements that unlicensed providers must meet in order to obtain licensure from the state

AB.171 Voted Out of Assembly 50-18 

SACRAMENTO, CA (January 26, 2012) -- The Assembly  yesterday approved AB.171 50-18 and sent it to the Senate for further consideration.

Introduced in 2011 by Assemblyman Jim Beall (D-San Jose), the bill would end any remaining discrimination for health insurance coverage for occupational therapy, physical therapy, speech and other medically necessary treatments for people with autism. A provision covering behavioral health treatments was deleted in Assembly committee due to the enactment last year of SB.946.

Autism Speaks Develops FAQs on the New Autism Insurance Law

To help guide parents and health care consumers, the Government Relations staff has developed a Frequently Asked Questions document now available online here.

State Insurance Commissioner: Autism Benefits 'Long Overdue'

SACRAMENTO (Oct. 11, 2011) -- California Insurance Commissioner Dave Jones applauded Governor Jerry Brown's signing of SB 946, the autism insurance reform bill, as "long overdue" recognition that behavioral treatments should be treated as covered medical benefits. The state Insurance Department took a leading role in arguing that behavioral intervention therapies, such as Applied Behavioral Analysis (ABA), should be viewed as a mandated treatment under California's Mental Health Parity Act (Act). Read more...

LA Times' David Lazarus: 'Autism treatment law again shows insurers' need for therapy'

In a column and video in the Oct. 11 edition of the Los Angeles Times, columnist David Lazarus reacts to Gov. Brown's enactment of SB.946, the autism insurance reform billl.

"When I read that Monday, my first thought was: Why aren't such treatments already covered?" Read more...

Autism Speaks Hails Gov. Jerry Brown for Signing SB.946, Making California the 28th State to Enact Autism Insurance Reform

Coverage for Behavioral Health Treatments to Start July 1, 2012, Lead to Job Creation, Save Taxpayers $140 Million

NEW YORK, NY (October 9, 2011) – Autism Speaks, the nation’s largest autism advocacy organization, today hailed Gov. Jerry Brown for making California the 28^th state to enact autism insurance reform by signing SB.946, which will require coverage of proven behavioral treatment therapies starting in July 2012.

“Courage and common sense have prevailed as Governor Brown has chosen to side with California families and taxpayers, rather than the health insurance lobby,” said Autism Speaks Co-founder Bob Wright. “Autism Speaks singles out Senate President Pro Tem Darrell Steinberg whose unwavering leadership and commitment led to this success.”

The signing of SB.946 was announced during a Walk Now for Autism Speaks rally in Sacramento (right),  attended by 8,000 advocates who marched past the Statehouse.

Read more here.

Autism Speaks Commentary in Capitol Weekly Warns Insurers Want to Shift Costs to Taxpayers

SACRAMENTO (Oct. 6, 2011) -  Capitol Weekly today published  'Health insurers want taxpayers to pick up the tab for autism care,' a commentary by Peter Bell, Autism Speaks executive vice president for programs and services. The opinion piece was in response to assertions by the California Association of Health Plans that behavioral therapies, such as applied behavior analysis, should be provided by public schools at taxpayer expense rather than by trained medical professionals.

Los Angeles Times Endorses SB946: 'Gov. Jerry Brown Should Sign It'

LOS ANGELES (September 30, 2011) - California's largest daily newspaper, the Los Angeles Times, in an editorial published today urged Gov. Jerry Brown to sign SB.946, the autism insurance reform bill sponsored by Senate President Pro Tem Darrell Steinberg.

Read 'An autism treatment worth funding'

Autism Speaks Joins Sacramento Rally Urging Gov. Brown to Sign Steinberg Reform Bill

SACRAMENTO, CA (September 26, 2011) -- Autism Speaks joined with Senate President Pro Tem Darrell Steinberg, other California autism organizations and families at a Statehouse rally today to urge Gov. Jerry Brown to sign SB.946, an autism insurance reform bill sponsored by Steinberg.

Read Senator Steinberg's release here 
View Coverage:
 KGO (ABC) San Francisco

Senate President Darrell Steinberg Organizes 2nd Rally Urging Gov. Brown to Sign SB 946

SACRAMENTO, CA (September 28, 2011) -- California Senate President Pro Tem Darrell Steinberg has announced a second rally in Berkeley on Friday, Sept. 30 to urge Governor Jerry Brown to sign SB 946, the autism insurance reform bill, following Monday's successful Statehouse rally in Sacramento.

The bill was passed in the final hours of the state legislative session on September 9 through the leadership of Senator Steinberg (right), Assembly Speaker John Perez and Assembly Member Jim Beall.

The Monday Statehouse rally was attended by Shelley Hendrix, Autism Speaks director of grassroots development (above.) 

Autism Speaks Hails California Legislature for Final Passage of Autism Insurance Bill, Urges Gov. Brown to Sign SB 946 into Law

Assembly, Senate Votes on Final Day of Legislative Session Offer Families Hope for Reform

NEW YORK, NY (September 9, 2011) – Autism Speaks, the nation’s largest autism advocacy organization, today applauded the California Legislature for approving an amended autism insurance reform bill, SB 946, on the final day of the legislative session and urged Gov. Jerry Brown to sign it into law. Read more.

Summary of Amended Autism Insurance Reform Bill:

Senate Bill 946

Not all insurers and health plans in California are subject to the bill. For those that are:

• Coverage must be available for treatment to "develop or restore, to the maximum extent practicable, the functioning of an individual with pervasive developmental disorder or autism"

• Treatment must be recommended by a licensed doctor or psychologist and provided under a treatment plan, which must be reviewed by the provider at least every six months

• Reimbursement must be made for the services of Board Certified Behavior Analysts, as well as the professionals and paraprofessionals whom they supervise

• Coverage for behavioral health treatment must be subject to no specific age limit or dollar cap

• The availability of insurance coverage does not reduce any obligation to provide services under an individualized education program or an individualized service plan

• Health plans and insurers must maintain an adequate network that includes qualified autism service providers 
  Autism Speaks Urges California Legislative Leaders for Fast Action on Autism Insurance Bill

Senate President Pro Tem Steinberg Offers the ‘Right Answer’ for California Families

NEW YORK, NY (August 17, 2011) – Autism Speaks, the nation’s largest autism advocacy organization, joined California families today in applauding Senate President Pro Tem Darrell Steinberg on his effort to amend legislation that would give families caring for children with autism access to insurance coverage for critical therapies. (Read Senator Steinberg's release.) Read more....

Autism Speaks Urges California Legislature to Follow Lead of 27 Other States, Act Quickly on Autism Insurance Reform Bill

NEW YORK, NY (July 15, 2011) – Action on an autism insurance reform bill before the California Legislature is more urgent than ever in the wake of a settlement the state reached with a major health plan which does little to improve coverage for families, Lorri Unumb, Esq., Autism Speaks’ vice president of state government affairs, said today. Read more...

Senate Select Committee on Autism Convenes Informational Hearing on Insurance Coverage

Autism Speaks' Lorri Unumb Discusses Impact of Federal Health Reform on Behavioral Intervention Therapy

NEW YORK, NY (July  13, 2011) – The California Senate Select Committee on Autism & Related Disorders, chaired by Senate President Darrell Steinberg, held a hearing today to hear expert testimony on autism insurance coverage and behavioral intervention therapy. Lorri Unumb, Esq., vice president for state government relations for Autism Speaks, addressed the impact of the new federal health care law on behavioral intervention therapy.

To view a video of the hearing, click here.
 For a copy of the agenda, click here.

Summary of Existing California Insurance Law:

Although existing law (AB 88) provides for mental health parity, in practice, health care service providers and insurers often deny coverage for autism and do not provide access to professionals with adequate training and expertise. 

In 2008, Senator Don Perata  proposed, and the state's Legislative Blue Ribbon Commission on Autism chose to support, legislation (Senate Bill 1563) to create an autism workgroup to review the autism and PDD-NOS guidelines adopted by the Department of Developmental Services, identify the existing gaps in insurance and health care coverage and submit recommendations to the legislature.

This bill was vetoed by Governor Arnold Schwarzenegger on September 27, 2008.

Governor's SB 1563 Veto Message:

To the Members of the California State Senate:

Sincerely,
Arnold Schwarzenegger