Hello Governor Kaine!

I say that because we had the great honor of meeting him. The only reason I don't have a picture is because the nice man who offered to take a picture hit the wrong button on my phone (if we meet again, Mr. Governor, I would like a second chance of getting a photo of you and Jimmy together!)

So, when we met, I asked you about the possibility of mandating coverage of therapeutic and habilitative services for children with autism and other developmental disabilities. You asked if other states provided coverage for these services and I rattled off California, New York, and Indiana. This document from Connecticut actually indicates that there are sixteen providing coverage in some form or fashion. I personally am a big fan of Indiana's language as stated in this document:

"Indiana. Policies must include coverage for pervasive developmental disorders, including autism. Coverage may not be subject to dollar limits, deductibles, copayments, or coinsurance provisions that are less favorable to an insured than those that apply to physical illness. Insurers and HMOs cannot deny or refuse to issue coverage on, refuse to contract with, refuse to renew or reissue, or otherwise terminate or restrict coverage on an individual because of a pervasive developmental disorder diagnosis (Ind. Code §§ 27-13-7-14. 7 and 27-8-14. 2-1 through 27-8-14. 2-5)."

Pennsylvania has been considering legislation there, which the governor there endorses.

Currently, insurers in Virginia are not required to covered the needed habilitative services for autistic children, including but not limited to speech therapy, physical therapy, occupational therapy, and Applied Behavioral Analysis, a therapeutic approach that helps these kids achieve language, social skills, and appropriate behaviors so they can better integrate into social, school, and community settings.
Instead of covering these services, the health insurance companies are essentially passing these needs to the state and county governments. Early intervention programs and the public schools cannot meet the adequately meet the needs of this growing population of children with autism and other developmental disorders. When Jimmy was diagnosed at the age of 4, 1 in 166 children was diagnosed with autism. A year later, it was 1 in 150. Now in boys alone (boys make up 75% of diagnosed cases), the number is 1 in 94.

Florida has been considering legislative activity on this matter. Their Austism Society has a talking points document that illustrates the importance of this coverage. In Florida, Medicaid covers these needs and private insurance does not.

"Parents who consistently provide therapeutic services, with after tax dollars, often risk bankruptcy or sometimes fraudulently divorce to qualify for Medicaid. In many cases this increases the financial burden on the State, since the State must also then provide care for siblings and indigent spouses.

Insurance companies and health maintenance organizations are in a much better position to negotiate lower rates and better quality service. Eventually, coverage costs will decrease as more professionals are trained to work with autism. Coverage will assume the cost of treatment at a lower rate.

The average cost of cumulative therapy for children with autism is approximately $20,000 per year and steadily decreases when recommended frequencies are administered consistently.

The targeted interventions are scientifically proven effective treatments for autism. They have the equivalent effect as a surgical procedure or medication treatments for other afflictions.

The estimated increased cost to insurance providers is approximately $4 million, considering recent State increases in waiver eligibility, which would be spread over all policyholders. This represents less than a meager 1/12th of 1% increase, which equates to less than 4 cents per $500."

Although early intervention is best, intensive services (which reduce overtime as kids improve) can begin at any age and dramatically improve the quality of life for children with autism. From that same Florida document:

"Children who go without the essential treatment may never have the ability to master basic life skills and they may become a danger to themselves and to the community. For every $1 we spend before the age of 5 we save $7 on lifelong care."

Schools have a role in educating these kids. The state may have a role in helping with needs like respite (needed, since the divorce rate in families with autistic children hovers around 85%.) Medical insurers have a role too - they should made to share in the responsibilty for therapuetic interventions that this medical diagnosis requires to allow them improve and live a full and meaningful. That is what I want for my son Jimmy. It's what any mother wants.

I know you thought he was cute and he is. That is my baby. He's six, but he is my baby. I love him with every fiber of my being. As difficult as this has been, I don't think I could change a thing. My life is richer for having him in it. Although I wish he could be like everyone else, I thank God everyday for him. I hope you have an opportunity to meet him again. He's a lot of fun.

Sir, not to be over the top, but it was really an honor to meet you today. I look forward to hearing from your staff soon.

Many thanks,
Rachel Kirkland


And thanks to everyone else that I met there. From the bottom of my heart, thank you E.J. Scott for the invitation and to Ernie Porta for dragging me up there, pushing me past the State Police detail, and introducing me to Governor Kaine. I appreciate it greatly.