Why do I have to be differnt?

Kaiser sued for discimination against autistic children:"Sham excuses"

News Release:

OAKLAND, Calif. — A class action suit filed today in state court in Alameda County charges that health care organization Kaiser Permanente directs a “blatantly discriminatory” policy against children with autism.

The class action suit, seeking relief on behalf of children with autism and their families who are members of Kaiser, was filed by Disability Rights Advocates (DRA), a Berkeley-based non-profit law center, and Chavez & Gertler, a national class action litigation law firm. Other major counsel are Gerard V. Mantese and John J. Conway. The suit seeks to end discrimination against disabled children and does not request money damages.

Parents of disabled children charge that Kaiser, the largest integrated health care delivery system in the country, has as a matter of policy systematically refused to provide treatment for children with autism. Kaiser’s status as a health care service plan provider, federal and state anti-discrimination law, statutory requirements, and Kaiser’s contract with its enrollees all prohibit Kaiser from implementing blanket refusals to treat children with autism. According to the suit, Kaiser is required to treat autism as fully as it would a heart condition or diabetes, but Kaiser refuses to do so

Background

Autism is a neurobiological disorder that is estimated to occur in one out of every one hundred and fifty births nationwide, and most often appears by age two. People with autism spectrum disorders (ASD) display severely impaired language and communication skills, impaired social interaction, restricted interests, repetitive behavior, resistance to change, obsessive attachment to objects, decreased motor skills, and lack of emotional connection or comprehension. Without proper medical care and treatment, ASD can be a debilitating condition, leading people to grow into adulthood without the ability to perform the most basic functions. With early and proper treatment, however, children with autism can see significant gains in their ability to interact and function in society. Early and effective treatment can also save hundreds of thousands of dollars in future medical costs.

Kaiser’s “sham excuses”

Kaiser cites a variety of reasons for denying treatment to children with autism. These include the excuse that treatment for autism is not a “health care service” and labeling treatment as “educational”. The lawsuit states that each of these reasons is explicitly invalid according to health and anti-discrimination laws, as well as Kaiser’s own Evidence of Coverage. For example, Kaiser systematically denies occupational, physical, and speech therapy to children with autism, despite prevailing opinion in the medical community that these are basic and necessary health services for patients with ASD. Furthermore, Kaiser provides occupational, physical, and speech therapy treatment for other disorders, but not for autism

Negative Effects

The lawsuit alleges several ways in which Kaiser’s policy negatively affects the child, the child’s family, and the public. The complaint refers to a body of research showing that there is a critical window of opportunity for treatment in the development of a child with autism, and that serious damage can occur if the family is denied coverage by its health care provider during this critical window.

Secondly, the medical treatments that Kaiser denies to a child with autism can place significant financial stress on families, who must already bear the strain of caring for a child with autism. It forces parents to weigh the emotional and mental burden of watching their child deteriorate against the financial cost of securing necessary treatment. Many families do not even have the financial means to make this tragic trade off.

Thirdly, denial of treatment puts an unfair strain on the public. Although Kaiser provides speech therapy and occupational therapy to its members for other physical and mental conditions, it insists that children with autism seek those services from publicly-funded school districts and regional centers for people with developmental disabilities, thus directly making taxpayers pay for treatment for which Kaiser is responsible and for which Kaiser collects premiums.

Anna Levine, an attorney for Disability Rights Advocates, commented: “Kaiser claims to help people holistically “thrive,” but denies children with autism basic care. Kaiser’s flagrant neglect of its duties as a health care provider has caused fully-insured families emotional pain, financial hardship, and irreversible damage to their children’s health and development. It’s time we hold Kaiser accountable.”

Mark A. Chavez, co-counsel on the case, commented: “Kaiser’s policy to deny treatment for autism is shameful and unlawful. Kaiser should not be allowed to continue treating children with disabilities unfairly. These children are the most fragile victims of an uncaring corporation, and we can no longer allow Kaiser to let them slip through the cracks.”

Playground angst

And, so it begins... I know it's rough out there. I remember it myself. Kids just know instinctively how to press those buttons. And, making fun of your little brother would naturally be a hot spot for Molly.

Yesterday, one of her little friends or classmates called Shea a "retard". She was being baited. Who knows what the surrounding conversation and/or antics were like. Perhaps Molly was spinning pretty fast and needed to be taken down a notch or two. It probably doesn't matter that much. The fact is that she trembled with rage at the obvious cruelty. She struck out and hit the girl with her coat. Well, I expect they got the reaction that they were seeking; anger. Sometimes Molly seems unflappable and I expect they were just trying to get a rise. Well, they did.

We talked it all though last night, of course. Shea has a speech delay and is learning to talk. There is no evidence of retardation at this time. Molly knows this but it doesn't really matter. Perhaps they weren't factually correct but Shea is "special" and someone was making fun of him for something he or we have no control over.

Fierce loyalties will always create a chink in our armor. People instinctively know this, even children. But, would I have it any other way?

I remember when I was quite small, 1st grade or so, my father told me to always stick up for my little brother. I must've listened or maybe it's hardwired because one day I caught wind of him being picked on by bigger boys on the playground. I charged right out there to protect my little brother (a kindergartner) and got into a scuffle and popped the boy in the nose.

Blood, the principals office; the whole 9 yards. I remember it vividly, the principal asking why I hit the boy. "Because my dad told me to protect my little brother." I replied and can still see the bemused expression on the adult's face. I didn't really get in trouble that day. I knew I was justified.

This is a tough one and it will come up again. It did bring up a good conversation about exclusion and how the special kids are treated at school. She's a sensitive little thing and picked right up on the injustice, the discrimination.

The world can be an ugly place, baby. Let's take that bruise and turn it into a shield.