Supreme court ruled in favor of parents in the Oregon case re:reimbursement of private school
June 27, 2009
By JESSE J. HOLLAND
WASHINGTON (AP) — The Supreme Court has ruled that parents of special
education students who opt for private school instead of trying the public
system cannot be barred from seeking public reimbursement for their tuition
costs.
The court ruled 6-3 Monday in favor of a teenage boy from Oregon whose
parents sought to force their local public school district to pay the
$5,200 a month it cost to send their son to a private school.
Federal law calls for school districts to reimburse students or their
families for education costs when public schools do not have services that
address or fulfill the students’ needs. Under the Individuals with
Disabilities Education Act, the nation’s special education students are
entitled to a “free and appropriate public education.”
Schools have argued that the law says parents of special education
students must give public special education programs a chance before
seeking reimbursement for private school
tuition.
But advocacy groups and parents of some special education students contend
that forcing them to try public schools first could force children,
especially poor ones, to spend time in an undesirable situation before
getting the help they need.
Justice John Paul Stevens said in his majority opinion that the federal
Individuals with Disabilities Education Act requires a school district to
pay for private special ed services if the public school doesn’t have
appropriate services.
“We conclude that IDEA authorizes reimbursement for the cost of special
education services when a school district fails to provide a FAPE and the
private-school placement is appropriate, regardless of whether the child
previously received special education or related services through the
public school,” Stevens said.
In the case before the Supreme Court, the family of a teenage Oregon boy
diagnosed with attention deficit hyperactivity disorder — who was
identified only as T.A. — sued the school
district, saying the school did
not properly address the student’s learning problems. The family is seeking
reimbursement for the student’s tuition, which cost $5,200 a month. The
family paid a total of $65,000 in private tuition.
In its appeal, the Forest Grove School District said students should be
forced to at least give public special education programs a try before
seeking reimbursement for private tuition. If not, parents would bypass
public schools and go directly to private school — and then ask for
reimbursement from school systems already burdened by ever-increasing
costs.
The court’s decision does not require reimbursement, but Stevens said
school officials “must consider all relevant factors, including the notice
provided by parents and the school district’s opportunities for evaluating
the child, in determining whether reimbursement for some or all of the cost
of the child’s private school education is warranted.”
Justice David Souter, Antonin Scalia and Clarence
Thomas dissented.
“Given the burden of private school placement, it makes good sense to
require parents to try to devise a satisfactory alternative within the
public schools,” Souter said in the dissent.
This is the court’s second attempt at resolving this issue. The high court
split 4-4 on a similar case from New York City two years ago. Justice
Anthony Kennedy recused himself in the New York case but was among those
who ruled on the Oregon case.
Nationwide, the number of special education students placed in private
schools at public expense has not changed significantly over the last two
decades, Justice Department lawyers said, citing statistics from the U.S.
Department of Education. Just under 67,000 pupils were in private
placements in 2007 — just 1.1 percent of the country’s nearly 6 million
special education students.
The case is Forest Grove School District v. T.A., 08-305.
Copyright (c) 2009 The Associated Press. All rights reserved.
Blue Cross Blue Shield of Michigan Forced to Pay for Autism Care In Landmark Case
June 20, 2009
Blue Cross Blue Shield of Michigan Forced to Pay for Autism Care In
Landmark Case
Release issued by Mantese and Rossman, P.C., on June 19, 2009
Detroit, Michigan. The family of an autistic child filed a motion in
federal court today to confirm settlement of a class action against Blue
Cross Blue Shield of Michigan. The family alleged in the suit that the
insurer wrongfully refused to cover behavioral therapy for children with
autism spectrum disorder (ASD), on the baseless ground that the care was
“experimental.”
Under the terms of the settlement reached at a court-ordered conference
on Wednesday, June 17, 2009, Blue Cross has agreed to reimburse all
families who paid for behavioral therapy for their children after May 1,
2003, and who were covered under a Blue Cross Blue Shield of Michigan
insurance policy. Blue Cross had earlier filed a motion seeking
dismissal of virtually
the entire case on legal grounds, but the
Honorable Stephen J. Murphy III permitted the case to go forward and
scheduled the matter for further proceedings, including a settlement
conference before Magistrate Michael Hluchaniuk.
The settlement was reached in the case of Christopher Johns v. Blue
Cross Blue Shield of Michigan, 08-cv-12272, filed in Detroit. In the
suit, the plaintiff alleged that Blue Cross’ pattern and practice of
characterizing the scientifically established Applied Behavioral Therapy
as “experimental,” and thus as excluded under its insurance policies,
was arbitrary, capricious, illegal and contradicted by many years of
scientific validation.
Under the settlement, Blue Cross will pay for behavioral therapy
rendered to over 100 children in the last six years. Plaintiff’s
counsel, Gerard Mantese and John J. Conway, were pleased with the
settlement. Mr. Mantese and Mr. Conway issued a joint statement
emphasizing: “No insurer should ever take this
approach to needed care
for children. Applied Behavioral Analysis therapy is supported by
science and is not ‘experimental.’ Delays by insurers in authorizing
this treatment, when it is covered by insurance policies, should not be
tolerated. Research shows that children with autism spectrum disorder
need this therapy early on in life and delaying treatment can
irreversibly prevent them from achieving their full potential.”
Mr. Mantese emphasized that the settlement includes even families who
never submitted a claim to Blue Cross, but who obtained this care for
their children and were covered by a Blue Cross policy. Mr. Conway
believes that this is the first such settlement addressing Applied
Behavioral Analysis (ABA) in the country.
ABA therapy is administered under the supervision of licensed
psychologists and other professionals. ABA applies one hundred year old
concepts of changing behavior through positive and negative
reinforcements. The federal suit in which
this settlement was achieved
centered upon the ABA treatment provided by prestigious Beaumont
Hospital and its HOPE Center, including Dr. Ruth Anan and Dr. Lori
Warner.
The case settled shortly after Plaintiff’s counsel obtained a court
order requiring Blue Cross to produce file documents which validated the
effectiveness of ABA therapy for treating children with autism spectrum
disorder. Among the documents in the Blue Cross files obtained by
Plaintiff’s counsel was a draft of a Blue Cross Blue Shield Medical
Policy for 2005, which acknowledged the following:
Applied behavioral analysis (ABA) is
currently the most thoroughly researched treatment modality for early
intervention approaches to autism spectrum disorders and is the standard
of care recommended by the American Academy of Pediatrics, National
Academy of Sciences Committee and the Association for Science in Autism
Treatment, among others.
Blue Cross’ own documents further acknowledged that:
The earlier
the disorder is diagnosed,
the sooner the child can be helped through treatment interventions.
Mr. Mantese stated, “After we compelled Blue Cross through motion
practice to produce all materials supporting its position that this care
was allegedly experimental, we received numerous file documents which
actually established that ABA therapy works and is highly effective in
increasing the functioning of these children.”
Mr. Conway emphasized, “We are pleased that we were able to obtain a
result which will require Blue Cross to pay for this important care and
will alleviate some of the financial strain imposed on over a hundred
families by having to pay for this care when it was covered under their
insurance policies.”
Contact information for the families’ attorneys follows:
Gerard Mantese, Esq.
Mantese and Rossman, P.C.
1361 E. Big Beaver Road
Troy, Michigan 48083
248-457-9200 Office
248-515-6419 Cell
John J. Conway, Esq.
John J. Conway, P.C.
645
Griswold St, Ste 3600
Detroit, MI 48226
313-961-6525 Office
313-574-2148 Cell
Lori J. Warner, Ph.D., BCBA-D
Licensed Psychologist
Beaumont Children’s Hospital
Director, HOPE Center
Center for Human Development
1695 West 12 Mile Road, Suite 120
Berkley, MI 48072
Phone: (248) 691-4774
FAX: (248) 691-8129
Website: www.beaumonthospitals.com/hope
summer is “take care of the caregiver” time
June 13, 2009
I won’t be blogging every day during the summer but probably once a week. I’ve made a commitment to myself that after almost 2 years since my son’s diagnosis, it is time to take care of myself. Two years of advocating for him in the schools and the medical system, figuring out what services he needs, finding him service providers, interviewing and managing therapists and teaching assistants, testing everything in his body for toxins, yeast, etc., reading lots of books, setting up positive behavioral supports in the home, worrying about him every day at school, dealing with judgements, seeing my own therapists, drop off and pick up at school every day, meetings with school, teachers, and therapists, fighting over homework, setting up playdates for social interaction and friendships, setting up my own non-profit, helping (or trying to help) numerous other parents through their ordeals, and all the while doing the “ordinary” mom things for two young kids, managing a household, AND holding down a CEO job. If that makes your head spin, imagine what my life has been like the past couple of years. I’ve never experienced anything like it. I know that I am by far THE MOST efficient and productive person I’ve ever known. No one can keep up with me. BUT, it’s time to take care of myself. I have full time nannies set up for the summer so that I can easily get my work done AND so that I can get my much needed exercise routine going. I actually signed up for a boxing/kick-boxing/martial arts type of class 4 days per week and it will go all through the summer. Pretty fun putting on the boxing gloves and punching and kicking the hell out of a bag!
last day of school!
June 12, 2009
It’s so hard to believe that another school year has come to an end. My kids were so excited about summer but so sad to say goodbye to their classmates and teachers. They had been asking for summer for so long and now that it is here they weren’t quite ready. Their teachers were so proud of them - impressed with my son’s progress, which has been quite remarkable, and amazed at my daughter’s social and academic abilities, she’s pretty advanced for being the youngest in the class, still just five. It’s amazing, though, to look at the report cards. My daughter received top marks across the board. My son - the opposite - except for science, he received a top mark in science. So, another year of remarkable progress. But, still so much more to go. I spent the afternoon working up his summer academic curriculum. Amazing being a mom of a child with Asperger’s. Suddenly I find myself creating acadmic curriculum which I know nothing about. I am afterall his case manager for everything Asperger’s and this is just another piece of the pie.
autism as genetic
June 11, 2009
The Extremely Male Brain
Elisabeth Eaves, 06.03.09, 06:00 PM EDT
Forbes Magazine dated June 22, 2009
What caused the explosion in autism diagnoses? Why are boys more affected by the disorder?
http://www.forbes.com/forbes/2009/0622/simon-baron-cohen-autism-ideas-opinions.html
popular with the ladies!
June 10, 2009
My son has always been popular with the ladies - but it is quite amazing just how popular. Apparently, many of the girls in his class really like him.
When I pick him up at school, I recall seeing a girl always coming up to him with these puppy dog eyes, batting her eyelashes, saying hello. I thought it was so cute but I had to really push my son to pay attention to her and to say hello back. He can be so unaware of people sometimes. And, he always forgets the girls names. He will sit next to one of the girls for weeks in class and he’ll have to ask what her name is. He says he just forgets names. Or if they look like another girl, then he can’t tell them apart.
One of the other mom’s told me she went to lunch with the class in the cafeteria the other day. She told me how popular he was with the ladies. He always takes the longest choosing his lunch in the cafeteria. He does not move quickly when it comes to tasks like this. So by the time he has his lunch and is ready to sit down, all of the seats are taken - and he doesn’t typically like sitting on the edge - he likes to be right in the middle of things. Well, all of the girls scoot aside and make room for him - wanting him to sit next to them. Apparently it is very cute.
He has been arranging playdates with the girls as well. How mature of him! If he could drive, he would have a busy date schedule!
After school the kids sometimes hang out in the playground for a while and the girls are always calling his name, asking him to come and play. You know I think it is because he is kind of oblivious to some of their social queues that perhaps he may appear to be playing “hard to get” - maybe that’s why they all try so hard for his attention. I think the girl who is ahead of him in their science interest will be the first to catch his eye!
puppet show
June 9, 2009
Would you believe that my son performed in a puppet show today - not only did he do this without a hitch but he was just awesome! This is just one example of why I love this school so much. Over the past two weeks, they made their puppets with paper maiche and all kinds of fabric scraps and decorations. They decided on what characters they wanted to be in the show and made their puppets accordingly but seemed to have lots of artistic freedom! They practiced their lines. For 1st graders to be able to make their own puppets, hide behind a table, know when it is their turn, read and say their lines into a microphone, peform their puppets with their hands and all this in front of an audience - it was amazing. They were all so cute and some were very animated. My son wasn’t very animated - more robotic in reading his lines - but, he was, afterall playing the role of a geologist - I don’t know how animated geologists are anyway!
At one point in the play, they each had made up their own dinosaur name - so for example, if their name was Wendy then their dinosaur name was Wendy-osaurus. My son knows his full name is his first, middle and last name. So, he HAD to say his osaurus name and add his last name at the end. It was very cute.
I am SOOOO proud of him! His teacher was extremely proud of him as well. Apparently this was not an “easy” task for him but he practiced hard. What a great guy he is!
end of school year
June 8, 2009
It is the last week of school and things are pretty crazy. But would you believe that at the last week of school, my guy is suddenly happy to go to school in the morning and not wanting summer vacation to come. Of course, that’s the way it must work - just my luck - he goes all year not wanting to go to school and NOW he decides he likes school!
Actually, he was having a really hard time with wanting to go to school each morning. So about 3 weeks ago, I made a plan with the teachers to think of something fun each day to get him psyched up about. That did the trick. But, I think now he’s had too much fun!
autism care takes biological toll on mothers
June 7, 2009
I was considering having my cortisol levels tested at the suggestion of one of my naturapath friends. Interesting study….
http://www.sciencenews.org/view/generic/id/44407/title/Autism_care_takes_bio
PARK CITY, Utah — Mothers with teenagers or young adults living at home face plenty of stress. If the young home-dwellers have been diagnosed with autism, the emotional intensity of caregiving surges dramatically in the mothers and may undermine the functioning of a critical stress hormone, a long-term study suggests.
Over a five-year span, women who had children with autism living at home reported many more challenges in their daily lives than women caring for typically developing teens and young adults, reported psychologist Marsha Seltzer of the University of Wisconsin–Madison on June 4 at the annual meeting of the Jean Piaget Society. Moms of children with autism spent nearly all of their time on caregiving activities, experienced an inordinate amount of daily fatigue, often got into arguments at home and at work, and reported having negative feelings far more often than positive ones.
Analyses of saliva samples collected from women near the end of the study period showed that those caring for offspring with autism produced unusually low levels of the stress hormone cortisol throughout the day. In mothers caring for teenage or young adult children free of developmental problems, cortisol levels rose sharply throughout the morning and then declined to a level that still remained well above that of mothers tending to kids with autism.
“We’re seeing remarkably low levels of cortisol activation in mothers caring for their children with autism, which may reflect the toll taken by chronic stress and fatigue in their lives,” Seltzer said.
Cortisol is known to increase in response to stress, and is believed to be a response that helps people deal with threats.
More than the language and social difficulties associated with autism, long-standing behavior problems of some diagnosed youngsters — including disobedience and physical aggression — showed a particularly close tie to mothers’ lowered cortisol levels.
Seltzer’s new findings underscore the urgent need to teach parents practical techniques for effectively raising children with autism, commented psychologist Tony Charman of the University of London’s Institute of Education. Charman and his colleagues have devised such a training program and find that many British parents of newly diagnosed kids welcome the assistance.
Until now, no one has examined the biological responses of mothers caring for youngsters with autism, Seltzer said. Many researchers shy away from families of these children for fear of being associated with once influential but now discredited claims that bad parenting causes autism.
It’s still not clear whether low cortisol activation in mothers caring for autistic children represents an adaptive response that makes it possible to handle prolonged stress or a maladaptive response that fosters physical problems down the road. Seltzer’s team plans to address this question by studying the same mothers over a total of 12 years.
At this point, there’s also no way to know if family members of people with autism and related conditions tend to produce low levels of cortisol in the absence of chronic stress. The researchers don’t know whether women in the study had low cortisol levels before caring for a child with autism.
Seltzer and her colleagues are studying 406 teens and young adults with autism, along with their immediate family members. Participants with autism are predominantly white, male and living with their parents in either Massachusetts or Wisconsin. The investigation began in 1998 and will conclude in 2010.
Comparison families include mothers with comparable education, family income and marital status to mothers caring for children with autism.
Mothers responded to interviews and questionnaires at three points during the study. Nearly five years after the study started, each mother also kept a diary of care-related feelings and events over eight consecutive days. Researchers collected four saliva samples from each woman on each of four diary days.
letters to editor about adults
June 6, 2009
My son is still very young and I have a while before I need to consider his adult needs. But it is certainly eye-opening, both on a personal level but also on a societal level, to think about the needs of each of these adults with autism and the prospect for the future - i.e. what will happen to these large numbers of children when they become adults - remember we’re talking about 1 in 150 - or in Washington State 2,000 adults and about 10,000 children with autism now. Look at these letters:
http://www.nytimes.com/2009/05/31/opinion/l31autism.html?_r=2
