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State Autism Profiles: Montana

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DEMOGRAPHICS

In 2000, 203 or 1.06% of children ages 3-21 who received special education services in Montana have autism. In 2014-2015, 680 or 4.00% of children with disabilities ages 3-21 who received special education services have autism.

Table 1-1: IDEA Part B - Children with Autism in Montana for 1999-2000 and 2015-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

 23

83

Age 6-21

 165

597

Age 3-21

 188

680

Source: Reported by the State of Montana 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 Montana for 1999-2000 and 2015-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

 1,635

1,620

Age 6-11

 8,482

7,591

Age 12-17

8,324 

7,290

Age 18-21

 872

531

Age 6-21

 17,678

15,412

Age 3-21

 19,313

16,474

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

STATE TASK FORCE

Montana Autism Task Force
The Montana Department of Public Health and Human Services convened an informal Autism Task Force in August 2007 to determine whether the state should move forward with a Medicaid waiver for autism. Additionally, the task force considered how the waiver should be focused and developed a strategy to provide services for adults with autism. The task force was comprised of a state legislator, providers, regional state developmental disability staff, and families of an individual with autism. The task force continued through December 2008 and presented a report of its findings to the Joint Human Services Appropriations Subcommittee in 2009. (Refer to section on Medicaid.)

STATE INSURANCE COVERAGE

On May 5, 2009, Governor Brian Schweitzer signed into law S.B. 234 (sponsored by Sen. Kim Gillan and known as “Brandon’s Law”), requiring health insurance coverage for autism spectrum disorders for children 18 years old or younger. Coverage for applied behavior analysis (ABA) is limited to a maximum benefit of $50,000 for children ages 8 and under and $20,000 for children ages 9 to 18. Coverage must include habilitative or rehabilitative care, medications, psychiatric or psychological care, therapeutic care and other specified care. The law went into effect on January 1, 2010. Mont. Code Ann. § 33-22-515 (2009 Mont. Laws, Chap. 359, S.B. 234 of 2009, Fiscal Note

In 2016, legislation was introduced to expand autism coverage to children in the Children’s Health Insurance program (CHIP). Introduced by Senator Mary Caferro, S.B. 366 would have covered habilitative and rehabilitative services (medically necessary and evidence based, including applied behavioral analysis), medication, psychiatric and psychological services, therapy services including OT, PT and speech. The bill passed the Senate but died in the House.
http://laws.leg.mt.gov/legprd/LAW0210W$BSIV.ActionQuery?P_BILL_NO1=366&P_BLTP_BILL_TYP_CD=SB&Z_ACTION=Find&P_SESS=20131

Montana also has a mental health parity law, which includes coverage for severe mental illnesses. Effective July 1, 2009, policy or certificate of health insurance or disability insurance must provide a level of benefits necessary for the care and treatment of severe mental illness, including autism. Benefits include inpatient hospital services, outpatient services, rehabilitative services, medication, and services by a licensed physician, licensed advanced practice registered nurse with a specialty in mental health, licensed social worker, licensed psychologist, or licensed professional counselor whose services are part of a treatment plan prescribed by a licensed physician.
Mont. Code Ann. § 33-22-706 / http://leg.mt.gov/bills/mca/33/22/33-22-515.htm

ESSENTIAL HEALTH BENEFITS

Under the Affordable Care Act, Montana will continue to offer autism services including applied behavior analysis (ABA) on its federally-run exchange. Montana has categorized ABA under “rehabilitative and habilitative services.” The benchmark plan imposes dollar limitations on habilitative services, including ABA.
(Blue Cross and Blue Shield of Montana; Blue Dimensions)

MEDICAID

Autism Services in Traditional Medicaid
The Montana Department of Public Health and Human Services (DPHHS) evidenced its intention effective January 1, 2016 to amend the Preventive Services State Plan to add autism treatment as a Medicaid state plan option. Applied Behavior Analysis and evidence-based treatment will be provided for members up to age 21 who have an autism diagnosis or related condition. There will be two levels of services based on medical necessity criteria. Lower intensity members will be eligible for a treatment plan and implementation guidance to coach and educate guardians on implementing the treatment plan. Higher intensity members will be eligible for additional intensive treatment that will be delivered face to face in the member’s home or other community environments that are a part of the member’s typical day. In anticipation of providing autism services in Medicaid, Gov. Bullock included a new proposal (NP-1010017) for a $12 million Medicaid appropriation for the 2016-2017 biennium in his proposed budget to the 2015 session The joint Human Services Appropriations sub-committee approved half that amount, which was cut to $4.2 million by action of the full House Appropriations Committee. The Senate passed and the Governor signed H.B. 2 with that appropriation in place.
http://dphhs.mt.gov/dsd/developmentaldisabilities/DDPmedicaidwaivers
http://dphhs.mt.gov/dsd/developmentaldisabilities/DDPAutism
http://www.medicaid.gov/medicaid-chip-program-information/by-topics/waivers/waivers_faceted.html

EDUCATION

As part of the comprehensive educational evaluation and re-evaluation process requirements under the Administrative Rules of Montana, an additional team member is required in the initial evaluation of a student with a specified disability, including autism. For students with autism, a school psychologist and speech-language pathologist is required for the initial evaluation. (ARM 10.16.3321) In order to be identified as having autism, the student must meet certain criteria, including documentation that supports the existence of a developmental disability prior to the age of three years and difficulties with verbal and non-verbal communications and social interaction. Assessments should include documentation of the significant delays in verbal and non-verbal communications and social interaction and other characteristics associated with autism. A student may be identified as having autism after the age of three years if assessments can document significant delays in verbal and non-verbal communications and social interaction, and other characteristics associated with autism. However, a student cannot be identified as having autism “if the student’s educational performance is adversely affected primarily by an emotional disturbance.” (ARM 10.16.3011)

Montana Autism Center
Several entities at the University of Montana have combined resources with colleagues across Montana and the U.S. to develop a proactive, evidence-based approach to learning about and helping individuals, families and professionals thrive in this age of ASD. The Montana Autism Center, housed in the Rural Institute for Inclusive Communities at the University of Montana, is a statewide collaboration to improve ASD resources in Montana.
http://autism.ruralinstitute.umt.edu/

STATE LEGISLATIVE CALENDAR

The Montana Legislature meets in Regular Session every odd-numbered year for no more than 90 days. The Regular Session convened on January 5, 2015 and adjourned on April 28, 2015. The Legislature did not meet in 2016. The next session is expected to convene in January 2017 and adjourn April 2017.
http://leg.mt.gov/css/default.asp

Sponsors of Autism Legislation

  • Sen. Mary Caferro (D-Helena) District 40

Prepared by Easterseals, Inc.; November 2016.

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