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State Autism Profiles: Tennessee

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DEMOGRAPHICS

In 2000, 1,088 or 0.86% of children ages 3-21 who received special education services in Tennessee have autism. In 2014-2015, 8,652 or 6.62% of children with disabilities ages 3-21 who received special education services have autism.

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

  1999-20002014-2015
Age 3-5

 153

967

Age 6-21

 935

7,685

Age 3-21

 1,088

8,652

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

  1999-20002013-2014
Age 3-5

 10,699

12,527

Age 6-11

 55,756

57,758

Age 12-17

53,161 

54,367

Age 18-21

 6,247

6,077

Age 6-21

 115,164

118,202

Age 3-21

 125,863

130,729

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

STATE TASK FORCE

In 2014, the legislature passed H.B. 2257/S.B. 2538 to create an Autism Spectrum Disorder Task Force and make recommendations to the General Assembly regarding ways to improve access to programs and services for early screening, diagnosis, and treatment of autism spectrum disorder in the state. The Task Force was created to promote a comprehensive, coordinated system of care for children and youth with Autism Spectrum Disorder. The Task Force will meet for the first time on December 3, 2015.
https://legiscan.com/TN/bill/HB2257/2013

In 2015, H.B. 1206, and companion bill S.B. 1390, were introduced to delete the existing Autism Spectrum Disorder task force and replace it with the Tennessee Council on Autism Spectrum Disorder. The Council would establish a long-term plan for a system of care for individuals with autism spectrum disorder and their families. The Council shall make recommendations and provide leadership in program development regarding matters concerning all levels of autism spectrum disorder services, including, but not limited to, health care, education, and other adult and adolescent services. The Council would terminate on June 30, 2017. The bills were referred to the House Health Subcommittee and the General Subcommittee of the Senate Government Operations Committee. No further action was taken.
https://legiscan.com/TN/text/HB1206/id/1122159/Tennessee-2015-HB1206-Draft.pdf
https://legiscan.com/TN/text/SB1390/2015

STATE INSURANCE COVERAGE

Tennessee insurance code (TN Code §56-7-2367) states that any policy that provides coverage for neurological disorders are required to also provide coverage for autism spectrum disorders for children under 12 years old. Copayment requirements and benefit limits may apply, and it is illegal for an insurance company to refuse to renew or to cancel a contract because of an autism diagnosis.

Legislation was again introduced in 2015 to require insurance to provide benefits and coverage for treatment of autism spectrum disorders that are at least as comprehensive as those provided for other neurological disorders to any person less than 16 years of age. H.B. 1017, and its companion bill S.B. 960, provides that coverage may not be denied for a treatment or dollar limits, deductibles, or coinsurance provisions imposed based solely on the diagnosis of an autism spectrum disorder. Coverage would be for medically necessary autism services including behavioral therapy defined as interactive therapies derived from evidence-based research, including applied behavior analysis, which includes discrete trial training, pivotal response training, intensive intervention programs, and early intensive behavioral intervention. Behavioral therapy is limited to $50,000 maximum benefit per year for an eligible person 9 years of age and under and $25,000 maximum benefit per year for an eligible person between 9 years of age and 16 years of age. H.B. 1017 was referred to the Insurance and Banking Subcommittee where no further action was taken. S.B. 960 failed in the Senate Commerce and Labor Committee.
https://legiscan.com/TN/text/HB1017/id/1121247/Tennessee-2015-HB1017-Draft.pdf
Legislation was introduced in 2013 to require state-regulated health plans to cover the diagnosis and treatment of autism. S.B. 1286, sponsored by Sen. Jim Tracy (R-Shelbyville), would require coverage for autism-related speech, occupational and physical therapy, as well as behavioral health treatment, including applied behavior analysis (ABA). No action was taken; the bill was deferred to 2014, but was not taken up again.

ESSENTIAL HEALTH BENEFITS

The Tennessee benchmark plan offers limited coverage for autism services on the federally-run exchange. The benchmark covers autism in children under age 12 for rehabilitative services. Rehabilitative services for children with autism spectrum disorder include physical therapy; speech therapy for restoration of speech; occupational therapy; manipulative therapy; and cardiac and pulmonary rehabilitative services. Each is subject to dollar limitations. Applied behavior analysis (ABA) is not mentioned, and is likely not required to be offered.
(BlueCross BlueShield of Tennessee; PPO)

EDUCATION

Tennessee defines autism as a developmental disability that severely affects communications and social interactions, generally evident before the age of three. For a child to be diagnosed as having autism and, therefore, be eligible to receive special education services, a child needs to undergo an evaluation. Included in the evaluation are a parental interview, observations and evaluations, a physical and neurological medical history, and an assessment of the child’s education needs. Included in the evaluation are the student’s parents, the student’s general education teacher, a special education teacher, a psychologist, a physician, and a speech therapist.
https://www.tn.gov/assets/entities/education/attachments/se_eligibility_autism.pdf

Applied Behavioral Analyst Licensing Committee
In 2014, the Applied Behavior Analyst Licensing Committee was created by the legislature to safeguard the health, safety, and welfare of Tennesseans by requiring those who practice applied behavior analysis within the state be qualified. The Committee awards licenses to qualified candidates who have met the qualifications for licensure as set out in the Practice Act. The Board interprets the laws, rules, and regulations to determine the appropriate standards of practice in an effort to ensure the highest degree of professional conduct. The Committee is responsible for the investigation of alleged violations of the Practice Act and rules and is responsible for the discipline of licensees who are found guilty of such violations. Rules are currently being promulgated. T. C. A. 63-1-101 et. seq. (Division of Health Related Boards) and T.C.A. 63-11-301 through 63-11-311.
https://www.tn.gov/health/topic/applied-behavior-analyst
http://www.tn.gov/sos/acts/108/pub/pc0918.pdf

STATE LEGISLATIVE CALENDAR

The Tennessee General Assembly meets annually beginning the second Tuesday in January. Each session meets for a total of 90 days over a period of two years. The 1090th General Assembly convened on January 12, 2016 and adjourned on April 22, 2016. The 2017 session is anticipated to begin on January 10, 2017.
http://www.legislature.state.tn.us/

Sponsors of Autism Legislation

  • Sen. Doug Overbey (R-Maryville) District 2
  • Sen. Jim Tracy (R-Shelbyville) District 14
  • Sen. Sara Kyle (R-Memphis) District 30
  • Rep. Kevin Brooks (R-Cleveland) District 24
  • Rep. Terri Lynn Weaver (R-Lancaster) District 40
  • Rep. Judd Matheny (R-Tullahoma) District 47
  • Rep. Mike Stewart (D-Nashville) District 52
  • Rep. David Shepard (D-Dickson) District 69
  • Rep. John J. DeBerry, Jr. (D-Memphis) District 90

Prepared by Easterseals, Inc.; November 2016.

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