Raising children on the spectrum in Florida: navigating roads less traveled.

• Author: Keller, Ingrid A.

Robert Frost once wrote, "Two roads diverged in the wood, and I--took the one less traveled by, and that has made all the difference." (1) When a child with autism becomes a part of a family, that family embarks on an entirely different road than the one that they thought they had entered. The family faces many familial and legal challenges. Autism spectrum disorder (ASD) is a complex developmental disability that affects about one in every 150 American children and one in every 94 boys, according to data from the Centers for Disease Control and Prevention. (2) These children, who look perfectly normal, have communication, socialization, and/or behavior challenges. Some say the divorce rate of families with autism is nearly 80-90 percent. (3) Others disagree with that percentage and opine that it is subject to dispute and that marriages are made more stable when a child is diagnosed with ASD. (4) Nevertheless, autism parents contemplating separation or divorce should share common goals to ensure that the needs of these special children are provided for both on a short-term and long-term basis. These children are on the spectrum because they display differing characteristics--not one child on the spectrum is like another. This article discusses current legislation applying to the needs of these special children and discusses considerations to be addressed for Florida families and divorcing parents.

Legislative Update

During the 2008 Florida legislative session, Senate Bill 2654 was passed amending/creating several statutes relating to health insurance requirements and Medicaid services, resulting in expanded coverage for the treatment of autism spectrum disorder in children. This bill was approved by the governor on May 20, 2008, and the effective date of this legislation was July 1, 2008. The bill created F.S. [section]627.6686, requiring health insurance plans to provide coverage for screening and diagnosis, intervention, and treatment of ASD. The statute applies to health insurance plans as defined by statute that are issued or renewed on or after April 1, 2009. (5)

The Window of Opportunity Act, F.S. [section]624.916, has been created to require the Office of Insurance Regulation to convene a workgroup and, beginning February 15, 2009, submit reports annually to the governor, the president of the Senate, and the speaker of the House of Representatives regarding the implementation of the agreement negotiated concerning insurance and access to services for persons with developmental disabilities. In response to this new initiative, the Florida Psychological Association (FPA) ASD Network was formed to track the developments emanating from the Governor's Task Force on ASD. Members of the FPA ASD network serve children with autism and their families through efforts in hospitals, evaluation centers, universities, medical schools, educational settings, and private practice.

The Steven A. Geller Autism Coverage Act (F.S. [section]641.31098 and [section]627.6686) establishes requirements for some health insurance plans and health maintenance contracts to provide coverage for services for ASD. Those services include well baby and well screening for ASD, and treatment of ASD through speech therapy, occupational therapy, physical therapy, and applied behavior analysis. Coverage for such services is limited to $36,000 annually and may not exceed $200,000 as the total lifetime benefit. Coverage will be limited to those services described in a treatment plan by a treating physician. Eligible individuals include those children under 18 years of age, or students who are 18 years of age or older who attend high school. The disability must have been diagnosed prior to eight years of age.

This legislation will help assist families with children on the spectrum in covering expenses associated with various therapies that are now not being covered by health insurance plans which qualify under the statute...