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State Autism Profiles: South Carolina

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DEMOGRAPHICS

In 2000, 973 or 0.92% of children ages 3-21 who received special education services in South Carolina have autism. In 2013-2014, 5,958 or 6.0% of children with disabilities ages 3-21 who received special education services have autism.

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

  1999-20002014-2015
Age 3-5

 121

913

Age 6-21

 852

5,767

Age 3-21

 973

6,680

Source: Reported by the State of South Carolina 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 South Carolina for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

 11,775

8,971

Age 6-11

 51,189

44,289

Age 12-17

39,497 

40,727

Age 18-21

 3,461

5,113

Age 6-21

 94,147

90,129

Age 3-21

 105,922

98,930

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

STATE TASK FORCE

The State of South Carolinadoes not have an active autism task force at this time.

STATE INSURANCE COVERAGE

In May 2007, the South Carolina General Assembly passed S.B. 20/H.B. 3468, known as “Ryan’s Law,” requiring health insurance coverage for autism spectrum disorder. Governor Mark Sanford vetoed the measure in June 2007. The State Senate and House promptly overturned the governor’s veto in a unanimous vote, thus enrolling the legislation into law. Effective July 1, 2008, or the renewal date of the health insurance policy after July 1, 2008, group health insurance plans and policies, including state employee health insurance plans, must provide coverage for autism spectrum disorder as prescribed by the treating medical doctor in accordance with a treatment plan. Health plans from small business employers with 50 employees or less, self-insured and individual health plans are exempted. Coverage may not be refused, denied, or terminated based on the diagnosis of autism spectrum disorder. A diagnosis of autism spectrum disorder must be achieved by eight years of age or younger in order to be considered eligible for benefits and coverage. Benefits and coverage are provided to eligible individuals under sixteen years old. Coverage for behavior therapy is set at a maximum of $50,000 per year. In order for the health insurance plan to make payments on claims, the treatment plan must include information, such as a diagnosis, proposed treatment, frequency, duration, anticipated outcomes, how often the treatment plan will be updated, and the treating medical doctor’s signature. The health insurance plan may request an updated treatment plan every six months, or more frequently upon agreement of the health insurance plan and medical doctor. S.C. Code Ann. § 38-71-280 (2007 S.C. Acts, Act 65; SB 20 of 2007: Fiscal Impact Statement)

In 2015, S.B. 135 was introduced to amend Ryan’s law to expand the coverage to those with small business or individual coverage. It also deleted previous eligibility requirements that limited the coverage to individuals diagnosed with autism by 8 years old and limited benefits and coverage to those less than 16 years of age. Finally, it deleted the maximum coverage limit of $50,000 for behavioral therapy. The bill passed the Senate on April 30, 2015 and was sent to the House where it was referred to the Committee on Labor, Commerce and Industry. It was recommitted to the House Ways and Means Committee in January 2016. No further action was taken.
http://www.scstatehouse.gov/sess121_2015-2016/prever/135_20150423.htm

ESSENTIAL HEALTH BENEFITS

South Carolina’s benchmark plan does not offer any autism services on its federally-run plan. Although South Carolina has an autism insurance mandate, it only applies to large group plans. The federal government is running the exchange.
(BlueCross BlueShield of South Carolina; Business Blue Complete)

MEDICAID

South Carolina Home and Community-Based Services Waiver: SC Pervasive Developmental Disorder
The waiver provides services to children ages three to ten years with pervasive developmental disorder requirement ICF/MR level of care and to children who do not qualify under Medicaid. Covered services under the Pervasive Developmental Disorder Waiver include case management and early intensive behavioral intervention. Once the participating child reaches eleven, the participating child may be transitioned into the Intellectual Disabilities Waiver. This waiver expires on December 31, 2014.
http://www.state.sc.us/ddsn/
http://ddsn.sc.gov/consumers/medicaidwaiver/pdd/Pages/default.aspx
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/Waiver-Descript-Factsheet/SC-Waiver-Factsheet.html#SC40181

OTHER STATE RESOURCES

South Carolina Department of Disabilities and Special Needs – Autism Division
Services for individuals with autism are administered by the Autism Division of the South Carolina Department of Disabilities and Special Needs. Services exclusive to individuals with autism include consultation for families, educators, and service providers; evaluations for eligibility determination; training for professionals and families; and treatment planning and planning for families
http://ddsn.sc.gov/consumers/divisions/Pages/Autism.aspx

Carolina Autism Resource and Evaluation (CARE) Center
Administered by the South Carolina Department of Disabilities and Special Needs, the Carolina Autism Resource and Evaluation (CARE) Center provides comprehensive services for individuals with autism in diagnosis, assessment, and treatment planning.
http://ddsn.sc.gov/providers/publications/Documents/Carolina%20Autism%20Resource%20and%20Evaluation%20Center%20%20(081811).pdf

STATE LEGISLATIVE CALENDAR

The South Carolina General Assembly meets on the second Tuesday in January of each year. The 2016 session convened on January 12, 2016 and is expected to adjourn on June 2, 2016. The 2017 session is projected to convene on January 10, 2017 with anticipated adjournment by June 2017.
http://www.scstatehouse.gov/


Sponsors of Autism Legislation

  • Sen. Joel Lourie (D-Columbia) District 22
  • Sen. Raymond E. Cleary, III (R-Murrells Inlet) District 34
  • Rep. Nathan Ballentine (R-Irmo) District 71

Prepared by Easterseals, Inc.; November 2016.

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