Autism & the Law

Dear EBCALA Supporter,

Welcome to EBCALA’s inaugural issue of our bi-monthly newsletter, Autism & the Law. In each issue we will add comment to current legal issues and stories in the media to further our mission in educating attorneys, advocates and parents about the legal issues surrounding autism. We hope you find EBCALA’s newsletters useful and educational.

Rebecca Estepp, Director of Communications

Attorney Alan Phillips Addresses the “Firing” of Patients by Pediatricians Who Are Not Fully Vaccinated

By Mary Holland, Esq.
EBCALA Managing Director

There are lots of stories about families being turned away from pediatricians’ offices if they are unwilling to follow the American Academy of Pediatrics’ recommended vaccine schedule. In a letter dated February 29, 2012, lawyer Alan Phillips responds to this practice, focusing on the issue of religious exemptions. He points out that if families have asserted a lawful religious exemption, they are enjoying the First Amendment right to “free exercise” of religion. Doctors who terminate patients in the face of these lawful exemptions may be causing irreparable injury and might be liable for damages. He also points out that termination violates many ethical principles for doctors and contributes to the public erosion of confidence in the medical profession. We are pleased that Alan Phillips will be speaking about medical and philosophical vaccination exemptions at EBCALA’s annual “Know Your Rights” conference on May 24, 2012 in Chicago. This letter will be a useful reference to anyone who has encountered a pediatrician unwilling to treat children with a religious exemption.

Michigan mental health advocates ask for insurance parity

By Jodi Bouer, Esq.
EBCALA Board Member

There is a fight going on in Michigan about whether the proposed autism insurance mandate should be expanded to include compulsory coverage for all mental health conditions. Some pundits are asserting that separate mental health parity legislation should be enacted in Michigan instead, to protect the general mental health community. 

Parity acts typically do not compel insurers to cover any mental health conditions at all. Rather, if the insurer chooses to cover mental health, these mandates will usually compel the insurer to provide coverage for (statutory named or unnamed) mental health conditions under the same conditions, policy limits, deductibles, coinsurance rates, preauthorization requirements and like, as is provided under the insurance policy terms that cover medical conditions. Federal law pursuant to the Wellstone Act currently requires parity in all self-funded and large group plans. State parity acts extend parity to small group and individual plans in the particular state where the plans are issued. 

In stark contrast, insurance mandates require insurers to cover specifically named mental conditions, like autism. They usually require insurers to reimburse insureds for certain types of therapy or treatments like ABA therapy or speech therapy, and often compel minimum limits for such therapy. Coverage for conditions like autism that are specifically named in mandates is normally required, regardless of whether the policy covers mental health conditions at all.   

The question posed is whether the inclusion of mandatory coverage for other mental health conditions will kill the proposed Michigan autism insurance mandate because of the increased costs to insurers and thus, increased lobbying efforts. 

Mental health advocates in Michigan assert that regardless of that risk, there is a need for mandated coverage because insurers typically provide more limited coverage to mental health conditions than medical conditions and as a result, people suffering from mental health conditions often forgo treatment. 

There is a key distinction, however, between autism and other mental health conditions that warrant the enactment of the Michigan insurance mandate solely to protect children on the autism spectrum. In the case of other mental health conditions, insurers typically cover key services like psychological therapy, whereas families with children on the autism spectrum have to fight insurers to make them cover basic therapies like speech, occupational and ABA therapy. It seems more appropriate to avoid the increased lobbying efforts that would no doubt occur if other mental conditions are included in Michigan’s mandate, and instead have the state enact a mental health parity act to address the issue of less coverage being available for other mental health conditions. 

Of course, if at some point, it becomes clear that certain other mental health conditions need the protection of statutory mandates because insurers generally refuse to cover basic therapy, a statutory mandate for those particular disorders is the appropriate response. Until then, the proposed Michigan autism insurance mandate should continue to focus its protection on the community that clearly needs the mandatory coverage, the autism community. 

Do Crimes Involving Those With Autism Receive Proper Investigation by Police Forces?

By Mary Holland, Esq.
EBCALA Managing Director

This article discusses serious problems in California’s state-run institutions for people with developmental disabilities.  It spotlights crimes that have apparently been committed against disabled residents, including severe injuries, rape, and murder that have all met with lackluster investigations and no accountability.  Sadly, these problems are only likely to get worse as state budgets tighten and "the autism generation" that was born in the early 1990’s ages into adulthood, as is happening now.  How can people with developmental disabilities remain safe in these institutions?  This is a question we will continue to cover.

Coming Soon!

EBCALA’s Know Your Legal Rights Law Seminar at Autism One

Thursday, May 24
9 a.m. – 6 p.m.
Lombard, Illinois

Read conference schedule

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