our-programs-autism.jpg

State Autism Profiles: Washington

Download a PDF* of this page

DEMOGRAPHICS

In 2000, 1,684 or 1.42% of children ages 3-21 who received special education services in Washington have autism. In 2014-2015, 11,626 or 8.17 % of children with disabilities ages 3-21 who received special education services have autism.

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

  1999-20002014-2015
Age 3-5

 64

1,066

Age 6-21

 1,620

10,560

Age 3-21

 1,684

11,626

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

  1999-20002014-2015
Age 3-5

 11,760

14,912

Age 6-11

 54,426

57,298

Age 12-17

47,725 

54,597

Age 18-21

 4,940

6,652

Age 6-21

 107,091

118,547

Age 3-21

 118,851

133,459

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

STATE TASK FORCE

The Caring for Washington Individuals with Autism Task Force
In 2005, S.B. 5311 was signed into law and established “The Caring for Washington Individuals with Autism Task Force.” An initial report was submitted in 2006 proposing 31 changes to autism services in Washington. The task force was commissioned to submit a second report and did so the following year. In the December 2007 report focused on six major priorities for improving services provided to individuals with autism. In 2007, the task force received funding to continue its work through June 30, 2008 so that the task force could create the Washington State Autism Guidebook, prioritize recommendations form the 2006 report, develop implementation plans and cost estimates for the highest priority recommendations, and monitor federal legislation and funding opportunities. Other priorities included establishing regional autism centers throughout the state; developing a proposal to ensure all individuals with autism receive comprehensive health care and coverage; recommending all children in Washington be screened for autism before the age of 3; outlining services and strategies to help families of individuals with ASDs stay together; and requiring each Education Service District to employ at least one trained autism technical assistance specialist. The Task Force held their final meeting on June 23, 2008.
http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Autism/AutismTaskForce.aspx

STATE INSURANCE COVERAGE

Though not created through legislation, Washington state does require coverage of autism services in insurance. As the result of a series of federal and class action lawsuits, Washington state Insurance Commissioner Mike Kreidler in October 2014 ordered the state’s private insurers to stop enforcing blanket exclusions for medically necessary mental health coverage. The letter to insurers directed that claims for medically necessary services could no longer be denied on the basis of blanket or categorical exclusions. Insurers were also ordered to reevaluate claims back to 2006. (For the history of the lawsuits, see Administrative Agencies and the Courts below) The court decision on which the letter was based involved autism services, including applied behavioral analysis, which had previously been denied based on an erroneous interpretation that the mental health parity law in Washington did not apply to those services. Washington state’s mental health parity law states that it is illegal to discriminate against individuals with mental illnesses. Health insurance coverage and benefits for mental health conditions are required at the same level as with medical conditions. (RCW §48.41.200)
http://www.insurance.wa.gov/about-oic/newsroom/news/2014/10-20-2014.html
http://www.insurance.wa.gov/about-oic/newsroom/news/2014/documents/kreidler-supreme-court-decision-mental-health-parity.pdf

ESSENTIAL HEALTH BENEFITS

Washington’s benchmark plan does not specifically include autism services or applied behavior analysis (ABA) in its Essential Health Benefits package. However, under the October 2014 order from the State Insurance Commissioner (see State Insurance Coverage above and Administrative Agencies and the Courts below) new health plans sold under the Washington Healthplanfinder, the state’s ACA Marketplace, are covered and cannot deny medically necessary mental health services under a blanket or categorical exclusion. This should mean inclusion of autism services under plans sold in the Marketplace. Washington runs its own exchange.
(Regence BlueShield; Regence Innova)

MEDICAID

The 2015 legislature passed and the Governor signed S.B. 5317 requiring screening for autism and developmental delays for children in the Medicaid program according to the bright futures guidelines issued by the American Academy of Pediatrics. The new law also requires provider payment for said screenings.
http://lawfilesext.leg.wa.gov/biennium/2015-16/Pdf/Bills/Senate%20Passed%20Legislature/5317-S.PL.pdf
 
Medically necessary applied behavior analysis is a covered benefit under Apple Health (Medicaid). In order to obtain services, a recognized Center of Excellence (COE) must conduct a comprehensive evaluation, and write an order for ABA and then find an ABA approved Medicaid provider.
http://www.hca.wa.gov/medicaid/abatherapy/pages/index.aspx

EDUCATION

The Department of Health applied for and was awarded one of only nine competitive state grants under the National Combating Autism Act of 2006 to fight autism through research, surveillance, awareness, and early identification. Autism Awareness: Partnership for Change is a three-year, $900,000 grant focused on bringing awareness to the importance of early identification and treatment; educating service providers and other professionals on diagnosis and treatment; and improving service systems in Washington State for individuals with autism spectrum disorders and other developmental delays. To guide the efforts of the Autism Awareness Grant, the Combating Autism Advisory Council was formed to carry out the state’s strategic plan to explore and improve needed changes and connect autism-related information, services, and research to the public. The grant was for three years, through August 31, 2011.
http://www.doh.wa.gov/Portals/1/Documents/Pubs/970-NonDOH_AutismGrantSummary.pdf
http://www.doh.wa.gov/Portals/1/Documents/Pubs/CAAC.pdf
http://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Autism/AutismTaskForce

Licensure of Behavior Analysts
S.B. 5488, passed by the 2015 legislature and signed into law by the Governor on April 15, 2015, creates licensure of behavior analysts, assistant behavior analysts, and behavior technicians. The new law also creates the Washington State Applied Behavior Analysis Advisory Committee and requires the Department of Health to consult with the committee in determining the qualifications for licensure or certification.
http://apps.leg.wa.gov/billinfo/summary.aspx?bill=5488&year=2015

EDUCATION PROGRAMS AND ACTIVITIES

Autism Outreach Project
The Autism Outreach Project (AOP) is a statewide system that helps school districts, parents, and agencies identify, place, and serve students with autism spectrum disorders. The services provided by the AOP are designed to enrich the lives of individuals with autism and include information, referrals, special events, training, needs assessment, and technical training. Starting September 2015, AOP will no longer be funded as a state needs project by the OSPI Special Education Department. The NWESD/Special Programs and Services Department plans to continue the statewide lending library and resource-linked website. The lending library will be re-cataloged and expanded to include resources for educators and parents with special education needs. Once the cataloging process is complete, we will re-open library services.
https://www.nwesd.org/autism

AMINISTRATIVE AGENCIES AND COURTS

In June 2012, a federal court ruled that the Washington State Health Care Authority (HCA) violated the Mental Health Parity Act by refusing to cover Applied Behavior Analysis (ABA), occupational, speech, physical, and other therapies after age six. The class action case, Z.D. v. Group Health Cooperative, was heard by U.S. District Court Judge Robert Lasnik. Judge Lasnik issued an immediate injunction.
http://www.washingtonautismadvocacy.org/updates/wp-content/uploads/77-Order-signed-Granting-Pls.-Mot.-for-Summ.-J..pdf

In a separate case in June 2011 in Washington State Superior Court, in the case of D.F. et. al v. Washington State Health Care Authority, No. 10-2-294007 SEA, Judge Susan Craigshead found that the Washington State Health Care Authority violated the state’s Mental Health Parity Act when it excluded all coverage of applied behavior analysis therapy (ABA), a mental health treatment for individuals with autism. D.F. et. al v. Washington State Health Care Authority is a class action lawsuit filed by two families whose children with autism were denied behavioral and neurodevelopmental therapies by the Health Care Authority’s self-funded insurance plans.

In July 2013, the plaintiffs and the Health Care Authority announced a settlement including the creation of a special fund to reimburse families for their out-of-pocket ABA expenses. A $3.5 million common fund would be created for current and former state workers enrolled in the Uniform Medical Plan to seek reimbursement for their out-of-pocket expenses for ABA from January 1, 2006 through December 31, 2012.

In May 2014, the plaintiffs and Premera Blue Cross announced a settlement removing restrictions on neurodevelopmental therapy for autism including the creation of a $3.5 million fund to reimburse policyholders who paid for the service out of pocket. Premera will also remove any age and treatment limitations from any medically necessary occupational, physical or speech therapy.

Finally, in October 2014, the Washington State Supreme Court ruled in O.S.T. v. Regence Blueshield, no. 88940-6, Supreme Court of Washington, En Banc., filed October 9, 2014, that health insurers must cover certain developmental therapies, such as those used to treat autism, if they are medically necessary. The Justices rejected an appeal by Regence BlueShield which claimed that the state mental health parity law did not require coverage of neurodevelopmental therapies. Regence subsequently settled the two class action lawsuits for $6 million.
http://scholar.google.com/scholar_case?case=12433842744219122888&hl=en&as_sdt=6&as_vis=1&oi=scholarr
http://seattletimes.com/html/localnews/2023644322_premerasettlementxml.html
http://www.nba-autism.com/sites/default/files/documents/DF%20Press%20Release%20-%20070813.pdf

Following the O.S.T decision the state Insurance Commissioner ordered the state’s private insurers to provide coverage. (see State Insurance Coverage above)

OTHER STATE RESOURCES

In April 2015, the Governor of Washington signed S.B. 5486, which creates the parents for parents program, providing outreach for and education to parents with children who have autism spectrum disorder. The goal of the new law is to increase parents’ independence and equip them with the tools and resources required to confidently support their child. Funding for the program is provided by the Office of Public Defense, whilst the program is administered by a non-profit organization that has extensive experience in child welfare parent mentors.
http://apps.leg.wa.gov/billinfo/summary.aspx?bill=5486&year=2015

STATE LEGISLATIVE CALENDAR

The Washington State Legislature meets annually beginning the second Monday in January for 105 days in odd-numbered years and for 60 days in even-numbered years. The 2016 session convened on January 12, 2016 and adjourned on March 10, 2016. The 2017 session is projected to convene on January 9, 2017.
http://www.leg.wa.gov/pages/home.aspx

Sponsors of Autism Legislation

  • Sen. Rosemary McAuliffe (D-Bothell) District 1
  • Sen. Pam Roach (R-Auburn) District 31
  • Sen. Steve Hobbs (D-Seattle) District 44
  • Sen. David Frockt (D-Bellevue) District 48
  • Rep. Timm Ormsby (D-Spokane) District 3
  • Rep. Maureen Walsh (R-Walla Walla) District 16
  • Rep. Christopher Hurst (D-Sumner) District 31
  • Rep. Ruth Kagi (D-Shoreline) District 32

Prepared by Easterseals, Inc.; November 2016.

*This document is in the Adobe PDF format. You will need to download free Adobe Acrobat Reader software to view these documents. If you do not have Acrobat Reader, you can download it for free by clicking on the Adobe graphic below.

Get Adobe Acrobat Reader

Powered by Blackbaud
nonprofit software