Parents and Therapists Fight to Provide Services in LouisianaBy Butterfly Effects Editorial Staff | 04/27/2012 |
Call to Action (updated 4-27-2012)
Families of the 2800 children in Louisiana identified as being on the autism spectrum are struggling to find help. The state has enacted some of the best insurance mandates in the country, yet less than 60 qualified behavioral therapists are available to them. While progressive providers such as Butterfly Effects look to bridge the gap, others who should know better are attempting to stand in the way and have taken their battle to the Louisiana State Senate.
Butterfly Effects is imploring parents and voters to step up and demand that their legislature do the right thing for Louisiana's children. Voters are being encouraged to contact their senators and let them know they oppose the licensure of behavior analysts by the Louisiana State Board of Examiners of Psychologists as it is proposed in SB191. Instead behavior analysts are proposing an autonomous board of Behavior Analysts to oversee and license behavior therapists in Louisiana.
A different kind of Amber Alert is sweeping across the state of Louisiana this week, as those trusted with the care of the state's children are threatening to make it much more difficult for nearly three thousand children diagnosed with autism to step out of harm's way.
Senate Bill 191, born but a few days ago, was considered on Wednesday and passed to the floor by the Health and Welfare Committee of the Louisiana state senate. Like most things rushed through a legislative body, this bill raises concerns that should give good citizens pause for thought.
Masquerading as a bit of housekeeping, SB 191 will have a direct impact on limiting access to services for children with autism. What the bill does is establish the Louisiana State Board of Examiners of Psychologists (LSBEP) as the state's licensing body for behavior interventions services based on Applied Behavior Analysis (ABA). ABA-based therapy is the only proven and widely accepted therapeutic intervention for children on the Autism Spectrum.
The bill could be voted into law as it stands, unless parents and other voters mobilize quickly and begin educating their legislators.
At this point, no one knows what exactly will come out of the committee as senators on the committee recognizing the concerns of citizens in attendance suggested there may be some amendments.
At first glance, the bill seems like it is just providing a way to monitor the delivery of behavior services in the state. However, for Board Certified Behavior Analysts (BCBA's), the move is considered neither welcome nor needed, At present, there are only 56 qualified Behavior Analysts in the state trained to deliver autism services. That number does not match up very well with the autism epidemic being experienced in Louisiana and every other state.
According to the state's report to the U.S. Department of Education, there are at least 2800 children diagnosed as being effectively impacted by autism in Louisiana. Odds are that number is low, as according to a 2012 Easter Seals report, no more than 20 percent of Louisiana's children are being adequately screened for developmental issues.
So while the state has pioneered and continues to advance requirements for private insurers to cover autism services, those requirements become but the lip service of good intentions if there are no services to access.
What Louisiana voters can do:
1) Call or visit with state senators
2) Email senators in the committee as well as your own senators
Dr. Michael Dorsey, a leading Behavior Consultant, explained in his testimony that behavior analysis is practiced by any number of people on a daily basis. He cited the examples of a regular education teacher implementing a token system in the classroom, a Sunday school teacher rewarding a child with a smiley sticker, or a teacher holding a child in from recess for misbehaving. Based on the LSBEP's interpretation, all of these individuals would be practicing psychology without a license and would therefore need to be sanctioned.
After listening to testimony from both sides, the committee members commented that everyone in the room supported the licensure and regulation of behavior analysts in Louisiana. They also said that they understood the behavior analysts desire to not be licensed by the LSBEP. They then suggested the possibility of creating an autonomous licensing board of behavior analysts that has administrative support from another entity until the behavior analyst board is able to support itself.
The committee then voted to pass the bill to the senate floor with the understanding that additional amendments will be proposed.
The last thing we need is another barrier to services.
It's 50 foot waters and 20 foot levees all over again and the American Psychological Association wants to pick a fight about who should be in charge of the engineers. At this point, instead of looking to invent a problem where there is none, those involved would be better served to solve the real problem: the state’s inability to attract qualified therapists. Those currently in the state are licensed by the Behavior Analyst Certification Board (BACB).
Since its inception more than a decade ago, the BACB has been recognized by several states and national healthcare insurers, including the military's TRICARE program, as the overseers of Applied Behavior Analysis. Despite this peer acknowledgement of ABA’s professionalism across several fields and disciplines, the American Psychological Association (APA), has sought to challenge the Behavior Analysts' ability to act autonomously and has requested that the state grant psychologists the power to issue licenses for behavior therapy.
“The last thing we need is another barrier to services,” said one parent of an autistic child. Like many families, hers is currently on the waiting list for behavior therapy. The official word from the Louisiana Behavior Analyst Association is that those in the field can see the benefit of licensure. However, they believe that if licensing is necessary, it should fall under the Board of Medical Examiners (BOME), which controls licensing for a number of other specialty fields including occupational and physical therapies.
Some speculate that the psychologists have too much of a personal agenda to act fairly. In recent years, psychologists have found themselves sitting on the sidelines with regard to autism treatment, as behavioral training is being recognized as the preferable and most effective treatment available, A few psychologists have gone the extra mile and obtained the BCBA acronym to place behind their PhD.
As much as any state, Louisiana has demonstrated a unique bit of moxie in dealing with autism.
Back in 2008, Louisiana was one of the very first states to mandate that private health insurers cover autism services. State legislators refused to buy into the panic that autism services would drive insurance premiums through the roof. And over the last four years, Louisiana, along with a few other states, has demonstrated that covering comprehensive autism services for children raises insurance premiums no more than 40 cents a month, making it an especially cost-effective measure. Thirty states have now followed suit to one degree or another.
This year, again much to the credit of its enlightened legislature, Louisiana is seeking to revise the 2008 regulation with yet another bill, House Bill 771. The bill, now in committee, eliminates any lifetime limit on funding and raises the age of eligibility to 21.
Intensive behavioral intervention therapy, based on the principles of Applied Behavior Analysis (ABA) as applied by BCBA's is not just the best, but the only treatment regarded "objectively substantiated as effective" by the Association for Science in Autism Treatment. This recognition has been repeated by the American Academy of Pediatrics, National Institutes of Health, U.S. Surgeon General, and the FDA.
Thirty years of research findings tells us that the earlier and more intensive the behavioral intervention, the more likely a child will develop the skills to succeed. ABA-based therapy can dramatically improve a child's speech, daily functioning, academic success, and even result in improved IQ scores, as well as curb dangerous behaviors.
Those in the field feel that If SB 191 passes, it will become yet more difficult to attract qualified behavior analysts to the state. According to Dodie Powers, who coordinates autism services throughout the state, "Many local families now have insurance that covers ABA services but they have never been able to access it for lack of therapists. To put another roadblock in place makes no sense. Putting psychologists in charge of behavior therapists will raise a lot of funding/reimbursement issues." Ms. Powers works as the regional director for Butterfly Effects, a national provider of ABA services. "The state is in desperate need for behavioral specialists, yet recruiting good people to the state will be impossible if we can't remove this threat to reimbursement, " says Ms. Powers.
While the Behavior Analyst Certification Board (BACB) has only been around since 1998, it is well respected across the country and is recognized by many states and insurance companies as the de facto governing board for ABA-based therapy. TRICARE, the military insurance provider known for their stringency, accepts the BACB as the legitimate licensing body. To be able to attach BCBA to your name requires a master's degree in a related field, appropriate course work, ongoing supervision and education, and the passing of a licensing exam.
Now is not the time for partnership, not partisanship.
With the new Centers for Disease Control numbers indicating that one in 88 children struggle with autism, no state can afford to be mired in any sort of licensing war.
"In Louisiana, as well as elsewhere, parents and all voters need to let their representatives, their schools, their governor know just how they feel," says Ms. Powers, who has worked both as a lawyer and social worker. "Let them know that anytime someone delays funding for children with autism, cuts back services, or even passes the buck, what one is hearing them say is that your children aren't worth the effort, aren't precious at all."
We have seen dozens of stories about how autism has personally touched the families of power brokers and celebrities and radicalized them to become advocates. Aren't we evolved and empathic enough to understand the importance of this battle without having to experience personal tragedy or do we have to wait until autism directly impacts all of us? -- as it will, if we continue to waste time.
Butterfly Effects has recently ramped up efforts to bring help into the Louisiana area.
The national provider prides itself in offering comprehensive services and case coordination to battle the fragmentation that often adds another level of difficulty for those families raising a child with autism. "In addition to ABA-based behavioral therapy," says Ms. Powers, "We can also match children with other services including speech, physical, and occupational therapies." To contact Butterfly Effects, call 888-880-9270.
Read the full alert from the Louisiana Behavior Analyst Association