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1. NASDDDS Mid-Year Meeting Autism Policy and Service Strategies in South Carolina
	Stan Butkus, PhD
	Kathi Lacy, PhD
	Daniel Davis, LMSW 
2. DEPARTMENT OF DISABILITIES AND SPECIAL NEEDSOffice of Policy - Functions 
3. South Carolina Department of Disabilities and Special Needs  29,334 people supported statewide
Of this, 10.7% or 3135 have a diagnosis of autism
70% of those with autism also have an intellectual disability
$560 million annual budget (hoping to add $12-13 million more in state funds in July 2008)
Most service delivery is contracted out to qualified providers
About 82% live in own home or familys home
 
4. State Policy Initiatives FY 2007 General Appropriations Act
AKA The PDD Pilot Program
FY 2008 Senate Bill S. 20
AKA Ryans Law
FY 2008 SCHIP, Title XXI of SSA
AKA Healthy Connections Kids
 
5. Pilot Pervasive Developmental Disorders Program  July 2006 Act required DDSN and DHHS to write a HCB waiver with services to begin no later than January 1 2007
DDSN appropriated $3.0 million in FY 2007  covers those in waiver AND state-funded only
Treatment as authorized by DDSN
Not to exceed $50K per year/child with a 3 year maximum of treatment
 
6. Covers children with autism, Aspergers syndrome and PDD-NOS; those that do not meet ICF/MR LOC are served in the state program
The HCB waiver application is on our web site www.state.sc.us/ddsn/
 
7. Lessons Learned about PDD Program Find  your 3 autism angels
Work with Medicaid and CMS at onset
Include supplies needed to implement interventions in benefit package
Be specific about type and length of treatment; base on literature
Have system in place to evaluate provider qualifications
Have system in place to evaluate progress of children 
8. Ryans Law Amended Code of Laws of South Carolina so as to require health insurance coverage for autism spectrum disorders (Section 38-71-280)
Pre-filed in Senate 11/29/06
Ratified on 5/31/07
Vetoed by Governor 6/6/07
Senate and House override veto: 0 nays 
9. Ryans Law Covers autism, Aspergers syndrome and PDD-NOS
Law mandates Group Policies with more than 50 employees and the states health plan to cover behavioral therapy
Excludes self-insured plans and those plans written outside of SC*
Coverage effective upon renewal after July 1, 2008
 
10. Ryans Law Treatment based on medical doctors prescription
Child must be diagnosed by age 8 
Benefits up to age 16 years
$50K annual benefit
Treatment plans from MD due to insurance company every 6 months for medical necessity evaluation 
11. SCHIP Provides coverage to uninsured children up to age 19 with family income between 150 to 200% FPL
Eligibility guaranteed for 12 months unless child moves out of state, reaches age 19 or becomes incarcerated
Child must be uninsured for 3 months
Benefit package is substantially equal to package of State Health Plan 
12. SCHIP Administered by MCOs only
Capitated rate paid to the MCO
Approved by CMS
For further information, visit the DHHS website at www.scdhhs.gov division of care management.
 
13.                 The Autism Division:             Organization & Services 
14. Primary Services 
15. Spartanburg  AD Office 
      & Greenville CARE Locations 
16. Evaluations The Autism Division provides the evaluation for services through:
? CARE Centers 
17. Primary Goal of CARE Centers To conduct in-dept assessments of individuals with complex needs 
To provide training for students and professionals in evaluation techniques  
18. Autism Division Training Standard 
Advanced
Specialized 
19. Consultation The Autism Division Consultants 
     provide support to
         people with autism, 
               their families, and the
                    agencies serving them. 
20. Types of Consultation  Individual
 Team
  
21.   In Home Intervention Program                      (IHIP) 
22.   In Home Intervention Program (IHIP) ? Serve children birth to 7 years
 Provide Program Coordination & Follow-up 
23.  Limited Program   
 Strategies to help the family 
       work more effectively with their child
           in their home & other environments. 
24. Intensive Program Average length is one year
In-home therapy (1-on-1): 15-40 hrs/week 
Supervision 
    ? Program development 
    ? Data reviews 
    ? Material updates 
Additional therapist
       recommended  
25. Model Classes 
26. Model Classroom Approach Local Autism Division office makes an agreement with a School District.
Autism consultants work with one specific classroom and staff. 
27. Model Classroom Steps Autism Division staff: 
Assesses the target class
Reviews findings with class staff
Makes a plan with class staff
Helps set up/adjust room & make materials
Demonstrates teaching & running the class
Trains & coaches the class room staff 
28. Model Classroom Process ? Through a combination of:
     ? specialized instruction
     ? team building activities 
     ? modeling 
     ? coaching 
? The classroom staff build their own teaching skills & create their own areas of expertise.