Health & Special Education Services for Military Children with Autism
The Department of Defense has been a leader in providing coverage for health and special education services for children with autism.
Military life, coping with disruption of routine or environment, is particularly difficult for children with autism and their families.
Based on the most recent prevalence data that 1 in 88 in children have an autism spectrum disorder, as many as 12,000 children in military families (active duty, reserve and guard) may have autism. These families are affected substantially by the financial and emotional costs of raising a child with autism. Updated Q and As on TRICARE, ABA, and ECHO Autism Demonstration (January 2015).
Updated Q and As on TRICARE, ABA, and ECHO Autism Demonstration (January 2015).
Autism Care Demonstration. The TRICARE Comprehensive Autism Care Demonstration (Autism Care Demo) covers(July 2014-December 2018) applied behavior analysis (ABA) for all TRICARE beneficiaries diagnosed with an autism spectrum disorder.
Autism Care Demonstration Simplifies Tricare ABA Benefits. All beneficiaries currently receiving ABA under TRICARE will transition seamlessly to the new benefit with no gap in coverage by Dec. 31, 2014. (June 2014)
June 7, 2013: A Federal judge Reverses Course on Tricare ABA Ruling. U.S. District Court Judge Reggie Walton said he overreached last year by ordering TRICARE to change the policy, and that he should have just remanded the case back to the agency to reconsider its policy.
January 3, 2013 President Obama Signs Bill Expanding ABA Care for Military Kids through TRICARE by creating a one-year pilot program. Will the legislation become permanent?
Caring for Military Kids with Autism Act (2013).One Year Pilot Program.
Military Family Input on Sec 735 of the 2013 National Defense Authorization Act. Report from the Military Special Needs Network.
TRICARE for Kids Provision in HR 4310, National Defense Authorization Act for Fiscal Year 2013 (full text).
Informing and Empowering Military Families. Focus on issues and concerns for military or EFMP families spotlighted on the Master List of Reports, Articles, and Regulations developed for the DoD Military Family Readiness Council.
When Will Military Kids Matter Enough? by Jeremy Hilton. Will the military appropriately handle this pilot program when they have been sued by an entire class of military families on this issue - and lost? We can hope that the Pentagon will do the right thing. (Time, 12/21/12)
Autism's Impact on the Military Family by Karen Driscoll, Marine Corps Wife, Mother of 3.
July 26, 2012: The Day the World Changed for Military Families Impacted by Autism. Military families get a major victory in their pursuit of insurance coverage for Applied Behavior Analysis (ABA) therapy for their dependents when a federal judge in Washington ruled in a class action lawsuit that the Department of Defense's (DoD) policy of limiting benefits to active duty members was "arbitrary and capricious." Kenneth Berge v United States of America.
July 3, 2012: Senate Hearing on Medical Necessity of Autism Care for Military Families. Is ABA as "medical therapy" mean that it was "medically necessary"? Why are thousands of military families still being denied ABA?
June 21, 2012: Military Families Affected by Disabilities: Act Today! Senate Armed Services Subcommittee on Personnel to conduct Senate Hearing on Thursday, June 21, 1430. Dirksen Senate Office Building, Room SD-10.
H.R. 2288: Caring for Military Kids with Autism Act introduced June 22, 2011. To amend title 10, United States Code, to provide for certain treatment of autism under TRICARE. The bill would clarify that military dependents with autism have access to medically necessary behavioral health treatments such as applied behavior analysis through TRICARE. Additionally, the legislation would ensure coverage for these services is available for dependents of retirees.
H.R. 2288 was referred to the Subcommittee on Military Personnel on July 19. Currently there is no additional information on the bill, when it will be reviewed or when we might expect to see a similar bill introduced in the Senate. Track the bill
Military Families Seek Injunction Against Department of Defense Over Therapy Denied to Children With Autism. Military families have filed a motion for an injunction to mandate that TRICARE cover medically necessary care needed by children with autism. Berge v. United States of America, et al., No.10-cv-00373-RBW (D.DC) - complaint.
On September 5, 2008, "Military Family Autism Equality Act," HR 3690 bipartisan legislation was introduced by Virginia Congressman James P. Moran (D-8) and Florida Congressman Jeff Miller (R). Retired military families who have children with autism will have their health care benefits protected if is enacted into law. This legislation will provide retired military families with children with autism the same health care benefits as families of active duty service members with children with autism. Department of Defense statistics indicate there are an estimated 8,784 retiree families that will benefit from this legislation.
"Caring for autistic children is expensive. Military families, already stretched thin by the high costs associated with the disease and long deployments overseas, are often left with a choice no parent wants to face: provide expensive treatments for their child or keep their family clothed and fed. This legislation will eliminate that painful decision," Moran said.
"This bipartisan bill to extend needed medical coverage for children of military retirees with autism is long overdue and I'm pleased Congressman Moran and I were able to address this issue together. Autism is an insidious disease inflicted upon our children and we should live up to our obligation to serve the children of those who have served this nation," Miller said.
Military Retirement Shouldn't End Autism Coverage - Letter of Support for this legislation from Congressman Miller and Congressman Moran.
A Lifeline for Military Families by Chuck Hagee in the Mount Vernon Gazette.
A Military Family's Experience with Autism by Kyla Doyle from Exceptional Parent Magazine.
The amendment addresses the difficulty faced by thousands of armed forces personnel and their families who are unable to obtain appropriate care for autistic children through the military’s Extended Care Health Option (ECHO). With passage of this legislation, autistic children of servicemen and women will receive a minimum of $5,000 per month of autistic services, which is double the current limit of $2,500 per month.
Approximately 8,500 children from these families have autism, which is the fastest growing serious developmental disability in the U.S; however, a recent estimate by the Congressional Budget Office shows only 700 autistic children are enrolled in ECHO because of long waits and limited coverage. ECHO’s limit on autistic care allows only five hours of therapy per week, while studies by the American Academy of Pediatrics and the National Research Council show that these youth need from 25-40 hours per week.
This amendment also requires a study by the Secretary of Defense that examines ways to improve autistic services.
You can track the progress of the bill as it continues to move through the Congress at the following websites:
On March 15, 2008, the Enhanced Access to Autism Services Demonstration, went into effect. This project allows reimbursement for educational intervention services, such as Applied Behavior Analysis (ABA), delivered by paraprofessional providers.
The Department of Defense Appropriations Bill for Fiscal Year 2008, which included H.R. 3222, provided $6.4 million for autism research.
In 2007, Congress provided $7.5 million for autism related research activities at the Department of Defense.
All active duty and retired military families can receive a FREE copy of ARI's book, "Recovering Autistic Children". To order your FREE copy of ARI's book, "Recovering Autistic Children" click here.