Mayo insurance to cover intensive autism therapy

Sept. 15--When news reached Brad and Joan Trahan that Mayo Clinic's insurance would begin covering intensive autism therapy, the couple didn't waste any time celebrating.

They found some paper cups in their garage and popped open a bottle of champagne. The impromptu party capped off a nearly 14-year effort by the founders of RT Autism Awareness Foundation to convince Mayo Clinic leaders its employee health insurance plan should cover the therapy.

"It is so surreal. I just can't believe it. When you fight for something for just under 14 years, you just don't know if it's going to happen. And I'm just so happy that it has," Brad Trahan said.

Mayo Clinic spokeswoman Susan Barber Lindquist confirmed in a statement that Mayo's health insurance for employees will begin covering intensive behavioral intervention for autism. That includes a type of one-on-one therapy known as Applied Behavior Analysis.

"Mayo Clinic recognizes the medical challenges faced by parents of autistic children. We're now including intensive behavioral interventions, including applied behavioral analysis, to treat autism spectrum disorder within the employee benefits package," Lindquist said.

The coverage will take effect Jan. 1. It affects all Mayo employees in Minnesota, as well as those in Arizona and Florida.

The Centers for Disease Control and Prevention estimates one in 68 children in the United States has been diagnosed with an autism spectrum disorder. Autism spectrum disorder is the name given to a group of brain development disorders, according to Autism Speaks. These disorders often involve difficulties in social interactions, trouble with verbal and non-verbal communication and repetitive behaviors.

'A big step forward'

The decision by the state's largest private employer to include this therapy in its insurance coverage is being welcomed by advocates for people with autism.

Jon Sailor, director of the Rochester Center for Autism, applauded the move.

"It's obviously a pretty big step forward for Mayo to do that, and I think that's the right choice," Sailor said.

His center provides intensive autism therapy for children ages 1 to 13. The one-on-one therapy is tailored to meet the needs of each individual child. In some cases, it can require as much as 30 to 40 hours per week. While the therapy doesn't work for every child, he said research has shown it can make a big difference in the lives of children with autism.

"It's a great step forward for (Mayo Clinic) to say we're recommending it, we're going to pay for it," Sailor said.

A man on a mission

For years, Brad Trahan has waged a very public campaign to convince Mayo Clinic leaders that intensive autism therapy should be covered by the clinic's insurance. It began on Jan. 23, 2003, when his then 2-year-old son, Reece, was diagnosed with autism. A Mayo Clinic doctor recommended this type of therapy for his son to ensure he have the best quality of life possible. Then came the bad news.

"Even though the Mayo doctor said this is exactly what your son needs, the Mayo insurance side said, "Nope, we're not covering it,'" Brad Trahan said.

Frustrated, Brad Trahan left his job at Mayo Employees Credit Union while his wife kept working as a nurse at the clinic. Eventually, the Trahans decided to enroll Reece in Medical Assistance to get him the therapy. But the couple was faced with parent fees of $900 a month. They ended up deciding to stop the therapy due to cost.

"It just got to be too much. We had to decide. Are we going to keep a house over our head and food on the table or stop this therapy? And we had to stop it," Brad Trahan said.

But he wasn't about to give up on his fight to get insurers to cover the therapy. In 2013, he teamed up with two Rochester lawmakers -- DFL Rep. Kim Norton and GOP Sen. Dave Senjem -- to get a bill passed requiring large employers in state-regulated health plans to cover the intensive therapy. The measure became law despite opposition from insurance companies and some business groups concerned about the cost. The cost of the therapy can vary dramatically, ranging from thousands of dollars per year to tens of thousands of dollars. But the insurance mandate doesn't apply to employers who self-insure -- such as Mayo Clinic.

Brad Trahan kept up the pressure on Mayo, frequently sending emails to clinic President and CEO Dr. John Noseworthy. He urged politicians to take it up with clinic leaders and frequently posted about it on on his Facebook and Twitter accounts. One of those Facebook posts featured a photo of a now teenage Reece sitting by the Mayo brothers statues accompanied by an open letter to Noseworthy asking him to cover the therapy. It was shared 971 times.

"The bottom line is, as related to autism and this portion of it, they were failing," Trahan said.

'The right thing to do'

Norton said she repeatedly reached out to Mayo officials and asked them to begin covering the therapy. She is ecstatic about the clinic's decision to make sure this therapy is available to its employees' children.

"I'm thrilled that all those families and future families that have Mayo Clinic insurance will have the best possible treatment available for their kids. It's great news," Norton said.

Senjem also heralded Mayo's decision.

"We've come to understand and accept and realize that early treatment of autistic kids can go a long way toward changing their lives and giving them a larger role in society," Senjem said.

First District DFL Rep. Tim Walz recently met with Mayo officials and urged them to cover the therapy after talking with Brad Trahan.

"Brad has always been a tireless advocate on the issue of autism, both as a policy expert and as a father. This is the right thing to do, and I thank Mayo for doing right by its employees and their families on this issue," Walz said in a statement.

As for Brad Trahan, he said it is unfortunate that Reece wasn't able to get the therapy right away and do it for a longer period of time. Nonetheless, Trahan said he is delighted that other children will get access to this therapy thanks to Mayo's decision.

He added, "I'm very thankful to Dr. Noseworthy. I'm thankful to all the decision-makers who were involved in this. It took a long time, but it is definitely going to help our autism community. It's going to help these kids get this therapy much sooner."

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