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20 April 2010

Tishaura Jones: Supporting Greater Options for Treating Autism, Statistics on St. Louis Area's Children

Supplemental Insurance Plan to Increase Number of Families Covered by Autism Mandate

At right: Rep. Tishaura Jones and Melissa Palmer from the Missouri Department of Insurance during the hearing for HB 2389 at the Special Standing Committee on Health Insurance.

Although Senate Bill 618 and House Bill 1311 have a few differences, their main idea is the same.  Both prohibit insurance companies from discontinuing coverage on an individual or their dependent because the individual is diagnosed with an autism spectrum disorder (ASD).  It also mandates that insurers cover the expenses for diagnosis and treatment of ASDs.  Coverage is limited to that which is deemed medically necessary by the insured individual's licensed physician or psychologist.  The House Bill specifies that coverage for individuals younger than 19 years of age for the applied behavior analysis (ABA) services will have a maximum benefit of $36,000 per year with no limit on the number of visits to an ASD service provider.  The Senate Bill covers individuals until the age of 21 and raises the maximum benefit to $55,000.

At left: Rep. Jones and the Gray Family celebrating April as Autism Awareness Month.
The problem is that both of these proposed mandates, if put into action, will only cover approximately 30 to 35% of families with insurance.  House Bill 2389 provides an alternative option for those not included in the mandates.  It requires the Missouri Health Insurance Pool to create a separate program that allows individuals to purchase supplemental health insurance coverage for the diagnosis and treatment of ASD.  The coverage would comply with all state and federal requirements for health insurance coverage for ASD.  This option would be less expensive than traditional health insurance because it offers lower benefit amounts (benefits would be the same as those offered in the finalized autism insurance mandate).  It will be funded primarily through premiums paid by participating families, similar to a general high-risk pool.  This bill does not replace the current mandate, it simply offers another option for those not covered by the mandate.

Facts from the 2009-2010 Children of Metropolitan St. Louis Report to the Community

  • More than 535,000 young people under the age of 18 reside in the five core counties of the St. Louis region (St. Louis City, St. Louis county, and St. Charles county in Missouri and Madison and St. Clair counties in Illinois)
  • Over 22% of children in the five-county area reside in ZIP codes where risks to their well-being are severe.
  • Of the 18 ZIP codes that fall within the boundaries of St. Louis City, 13 of them - or 72% - have a "severe" risk rating
  • 36 ZIP codes in the five-county region have a minority population about the national norm of 35%
  • Of these ZIP codes, 78% fall in the severe risk category, 14% are high risk, 8% are moderate risk and 0% are low risk.
  • 0% of the ZIP codes with a lower percentage of minority population qualified as severe risk, 3% were high risk, 23% were moderate risk, and 74% were low risk.
  • Rates of lead poisoning in the older neighborhoods of the St. Louis area have declined sharply with less than 7% of children testing positive for lead poisoning.
  • The report highlights six children's fundamental need areas including family support, early childhood development, maternal and child health, quality education, youth development, safe neighborhoods and strong communities.
  • The national alternative care rate per 1000 children under 18 was 6.8 in 2007.  Out of the 138 ZIP codes in the St. Louis area, 39 ZIP codes exceed the national rate and of those, 6 more than double the average.
  • In 2006, 3.6% of all births nationally were to mothers who had no or inadequate prenatal care.  Of the 138 ZIP codes in the St. Louis region, 64-46.4% have rates greater than the national percentage.  Of these, 27 have rates four times higher than the national rate.
  • The greater portion of St. Louis area school districts routinely report dropout rates lower than the national average.
  • In 2007, the national crime rate was 32.6 per 1000 residents while the violent crime rate was 4.7 per 1000.  Out of the 191 St. Louis area neighborhoods and municipalities, 72.8% had rates that were higher than the national average.

Rep. Jones receives Award for Advocacy for Families with Autism

On Tuesday, April 13, Rep. Jones received an award from the Gateway Chapter of the Autism Society of America for her work to bring attention to the struggles faced by urban families with Autistic children.  "Our families in Urban Areas are drowning and do not have access to early diagnosis and treatment.  On average, African-American children aren't diagnosed until age 7.  Which is too late for treatment to be effective."

Rep. Jones chosen as Honorary Co-Chair for 2010 NamiWalks for the Mind of America

Rep. Jones will lead the Virtual Walkers Team of the 2010 NamiWalks for the Mind of America.

Come join us and help this be our best WALK ever. Our goal is $175,000 and we don't want to disappoint.  If you're interested in being helping and want more information click here.

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