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State Autism Profiles: District of Columbia

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DEMOGRAPHICS

In 2000, 119 or 1.13% of children ages 3-21 who received special education services in the District of Columbia have autism. In 2013-2014, 730 or 6.7 % of children with disabilities ages 6-21 who received special education services have autism.

Table 1-1: IDEA Part B - Children with Autism in the District of Columbia for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

16

169

Age 6-21

103

685

Age 3-21

119

854

Source: Reported by the District of Columbia in accordance with Section 618 of IDEA to U.S. Department of Education, Office of Special Education Programs

Table 1-2: IDEA Part B - Children with Disabilities in the District of Columbia for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

374

1,429

Age 6-11

4,844

4,619

Age 12-17

4,592

5,208

Age 18-21

749

916

Age 6-21

10,185

10,743

Age 3-21

10,559

12,172

Source: Reported by District of Columbia in accordance with Section 618 of IDEA to U.S. Department of Education, Office of Special Education Programs

STATE TASK FORCE

The District of Columbia does not have an active task force on autism at this time.

STATE INSURANCE COVERAGE

The District of Columbia passed Law 16-198, the “Health Insurance Coverage for Habilitative Services for Children Act of 2006.” Under the law, health insurers are required to provide coverage for habilitative services for children with a congenital or genetic birth defect, which includes autism spectrum disorders and cerebral palsy. Habilitative services covered include occupational therapy, physical therapy, and speech therapy. Health insurers are not required to cover services provided through school or early intervention services. Coverage is provided at a minimum at the same level as other conditions. (D. C. Code § 31-3271). Limited health insurance coverage also may be available under the mental health parity law, which requires health insurers for employers and individual to offer coverage for the medical and psychological treatment of drug abuse, alcohol abuse, and mental illness. Mental illness is defined according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and International Classification of Diseases (ICD-10) Inpatient treatment is to be covered for a minimum of 60 days per year and outpatient treatment is to be covered at minimum rate of 75% for the first 40 visits, and a minimum rate of 60% for any additional visits that year. (D. C. Code §§ 31-3102, 31-3104)

ESSENTIAL HEALTH BENEFITS 

In 2013, the District of Columbia further refined its definition of “habilitative services,” required through previous legislation, as an essential health benefit under its benchmark plan. The new definition includes “health care services that help a person keep, learn, or improve skills and functioning for daily living, including applied behavioral analysis for the treatment of autism spectrum disorder” (emphasis added) for small group and individual plans unless grandfathered (issued prior to March 23, 2010). Council Bill B20-0302; The Better Prices, Better Quality, Better Choices for Health Coverage Temporary Amendment Act of 2013. The Washington, D.C. exchange is run by the D.C. government.
(Blue Preferred PPO Option 1)

On October 6, 2015, legislation entitled “Health Insurance Coverage for Autism and Other Special Needs Amendment Act of 2015” was introduced before the DC Council. The legislation would expand the previous legislation, currently only requiring insurance coverage in the small group insurance market, to include the large group market. It also would remove the limitation of coverage to only persons under 21 years of age.
https://d3n8a8pro7vhmx.cloudfront.net/charlesallendc/pages/307/attachments/original/1444150441/2015-10-06_Health_Insurance_Coverage_for_Autism_Act_of_2015.pdf?1444150441

STATE LEGISLATIVE CALENDAR

The District of Columbia Council meets twice each month, excluding the month of August. The 2016 Session convened on January 5, 2016 and will meet throughout the year.
http://dccouncil.washington.dc.us/

Sponsors of Autism Legislation
  • Mayor Muriel Bowser
  • Councilmember Vincent Orange (At Large)
  • Councilmember Elissa Silverman (At Large)
  • Councilmember Brianne Nadeau (Ward 1)
  • Councilmember Brandon T. Todd (Ward 4)
  • Councilmember Charles Allen (Ward 6)

Prepared by Easterseals, Inc.; November 2016.

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