Senate Bill 791, also known as Luke’s Law, passed late Friday night. It is named after Luke, a 14-year-old with autism who lives on Hawaii island. His mother, Geri Pinnow, advocated for the bill’s passing and attended numerous hearings throughout the legislative session.
The bill passed as part of a grass-roots effort. Families all over the state sent testimonies to local representatives to support the law. Without insurance, families pay up to $60,000 annually for autism treatment for each child, according to Hawaii Families for Insurance Fairness. In a recent news conference, this group asserted that by treating these children early, they have a better chance of being mainstreamed. Early treatment supports not only quality of life and daily functioning for autism patients and their families, but also reduces the need for intensive health care resources in adulthood.
Hawaii is still behind the national curve on insurance coverage for autism. The bill was originally proposed to cover $50,000 for patients up to 21 years old. However, health insurers were opposed to the bill with concerns that cumulative costs would be untenable. The bill was amended and will be limited to children under 14 and ensures up to $25,000 per year of health services. The new bill will take effect in January and will cover medically necessary treatment for autism including psychiatric, psychological, pharmaceutical and therapeutic care. Families are celebrating the new coverage that includes occupational therapy, physical therapy, speech and language pathology and applied behavioral analysis.
Autism is A complex range of neurodevelopmental disorders that can include social impairment, communication difficulties and limited, repetitive, stereotyped patterns of behavior. The disorder is more common than most people realize, now comprising 1 in 68 children and 1 in 48 boys. Without care these children tend to remain in their own world, might become increasingly isolated and encounter challenges in typical daily functioning.
Crystal Amelang is a registered occupational therapist and sensory integration specialist. Amelang is the owner and founder of SPROUTS Therapy, a pediatric treatment facility where 80 percent of patients are diagnosed with autism.
The staff of nine therapists offers over 300 treatments per week. Up until now the majority of SPROUTS patients’ families have been paying out of pocket.
"It breaks my heart to know how many more children need our services but do not have the family resources," says Amelang.
She has done her best to fill in the gaps by applying for small grants to get these families in the door.
There is a pent-up demand for health care services for patients with autism. Since Senate Bill 791 passed, patients are already scheduling for services beginning in January, and facilities that offer covered care have begun to see long waitlists.
Luke’s Law provides much-needed benefits to the people of Hawaii who suffer from autism. Kudos to the Hawaii Legislature for getting this one done.
Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.
