[Isaac]

In Andrew Kavchak’s recent post about “the last things autism families need is more bureaucracy,” he makes an excellent point:
“Regarding the bureaucracy issue… I wonder why the Department of Health or Public Health Agency of Canada cannot be mandated with the creation of an ASD division…Does the government create such separate “partnership bureaucracies” for other disorders/illnesses/syndromes, etc?”, [https://featbc.org/discussions-board/topic/room-three/#post-22467]
The insight is spot-on.  Autism is a health issue.  Responsibility and oversight for the disorder belongs in the Department of Health or the Public Health Agency of Canada. In the landmark Auton ruling, the court said the same thing, via its central finding of fact.  That determination of the court still stands today (findings of fact are never overturned on appeal, only legal arguments).
Here is what the 2000 Auton decision concludes regarding the nature of autism:

– [54] Currently, … diagnosis of [autism] comes under [Ministry of Health] jurisdiction.
– [88] … I consider [autim] to be primarily a health issue …
– [153]… The inability [to access autism treatment] is primarily an issue of health care, not education or social services.

(http://www.courts.gov.bc.ca/jdb-txt/sc/00/11/s00-1142.htm)
In the collective mind of government, autism treatment has always been – and must therefore forever be – excluded from the health care system.  It’s a very rigid mindset. Andrew Kavchak is exactly correct. Autism is a health care issue and belongs in the various health departments that already exist, not in a new bureaucracy that only provides the optics of doing something for families.
Change the rigid mind set, and all else falls into place.

[Isaac]

Hello Everyone,

I’d like to thank Andrew, on behalf of our discussion group, for regularly keeping us apprised on the debacle that is government’s endless dithering on the autism treatment issue, and its ongoing refusal to even consider putting children afflicted with autism into Canada’s health insurance plan (Medicare).

A Study in contrast between Canada and the U.S. polity is reprinted below, but first I’d like to offer some thoughts on the highly disturbing policy divide between Canada and the U.S.

Florida’s governor just signed into law (May 2008) a mandate that health insurance providers in that state must cover autism treatment

Contrast this U.S. reality with Canada. My B.C. Medicare card doesn’t work for autism treatment. The nation’s vaunted, nationalized health care system excludes children afflicted with autism, yet Medicare is supposedly a defining feature of Canadian nationhood! How is it possible that a whole class of Canadians remain excluded from a key national health care program that defines the nation? How is it possible that parents still struggle to provide autism treatment on their line of credit, and are derided by government (or simply ignored) for suggesting that their children actually deserve to be included in the national health insurance plan too!

Perhaps the next time you happen to speak with your MP or provincial member of legislature, you can ask him or her why it is that Florida’s legislature and Governor seem to FULLY understand the gravity of the autism health insurance crisis and have moved to action to resolve it. Canada’s owners of the health insurance plan (i.e., government) continue to dither and turn a blind eye to the tragedy that is the life of many thousands of uninsured Canadians — parents of children afflicted with autism.

The obvious conclusion, for any honest observer, is that where there is NO conflict of interest in health insurance, members of the legislature actually DO work in the best interest of their constituents (e.g., Florida‘s new law to protect health insurance rights of kids with autism). In sharp contrast, where there IS a conflict of interest (as in Canada … government owns health insurance) the legislature turns its back on the health insurance rights of children afflicted with autism.

Systemic health care conflict of interest in Canada, and its resultant failure in proper political representation for a big-time health care issue, is quite the study in contrast, I would think.

Isaac

****************************************************************************
Reprinted from BusinessInsurance.com

Florida mandates autism coverage

By Colleen McCarthy
May 21, 2008

TALLAHASSEE, Fla.—Florida Gov. Charlie Crist signed legislation Tuesday that will require insurance companies to pay for diagnosis and treatment costs for autistic children up to $36,000 annually with a lifetime cap of $200,000.

Under the Window of Opportunity Act, SB 2654, major insurance companies that operate in the state of Florida, and companies with more than 50 employees, will be required to offer coverage for autism-related disorders.

The legislation gives insurance companies until January 2009 to negotiate a compact with the state to develop autism-coverage plans, before the mandate takes effect in 2010.

The legislation also calls on insurance companies to enhance consumer awareness of the benefits.

****************************************************************************

[Isaac]

Hello everyone,

I'd like to add some thoughts to Andrew's kind contribution to the forum, regarding the CIHR report.

Andrew states:

"While Clement stated that 'research is the backbone for all truly effective policies and therapies' and that 'the more we share knowledge, the more we gain … ,' he completely ignored the fact that research has shown for over 20 years that there is an effective, evidence-based treatment available."

Apparently Minister Clement has also chosen to ignore relevant research presented by an Ontario researcher at Clement's autism symposium. Dr. Nancy Freeman informs that a MAJOR study on the effectiveness of Intensive Behavioural Intervention has already been conducted in Ontario, and the findings are very positive.

The CIHR report includes a summary of the new research:

– "Dr. Nancy Freeman presented research data from a major Ontario study on the effectiveness of the province's Intensive Behavioural Intervention (IBI) program."

– "According to Dr. Freeman, the study found that IBI significantly reduced the severity of autism symptoms …"

– "She also noted that there were significant and sometimes dramatic improvements in cognitive and developmental skills, including self-help skills, social skills, motor skills, and cognitive scores."

– "The results support the effectiveness of IBI, when provided in a large community-based program, she concluded."

(Source: http://www.cihr-irsc.gc.ca/e/36237.html)

"Significantly reduced … autism symptoms" and "significant and sometimes dramatic improvements" both sound like very clear and unambiguous research conclusions to me, and probably to most impartial observers as well, I would think. The implications of the research suggest that for the Province of Ontario, the evidence is largely in regarding what's effective for the treatment of autism. Why the federal government is ignoring this fact and permitting a national autism strategy vacuum to persist is the question to ponder.

Assuming that everyone is working in good faith (i.e., to rule out dithering and obfuscation from the equation) then one could reasonably ask, "exactly how much research does the Health Ministry require to reach their threshold 'for truly effective policies,' so that SOME type of a national autism strategy — with uniform treatment policy guidelines — can be developed?

On a separate, but related note, how does Dr. Nancy Freeman’s research now affect the Supreme Court of Canada? Well, when research on Ontario's autism treatment program shows evidence of "significant and sometimes dramatic" results, for an otherwise intractable disorder, we have nothing less than an invalidation of the factual underpinnings of the Supreme Court's Auton ruling of 2004, wherein the court essentially based its entire ruling (incorrectly, it would now appear, according to Dr. Nancy Freeman’s research) on the central notion that intensive behavioral treatment is "novel" and "emergent." We all knew that was an excruciatingly sloppy decision back then (to be generous). Now we have additional "evidence-based" support for that view. Truth is a stubborn thing — even the Supreme Court can't make it go away.

Isaac

[Isaac]

Hello Everyone,

I'd like to add some thoughts to those already voiced by Barbara Rodrigues, Monika Lange and Debra Antifaev, regarding Tony Tamer's posted article –> http://tinyurl.com/3ufnzn.

The "Blame-the-Mother" theme for autism is quite LEGENDARY. It's getting very old and tired, but apparently still gets traction and simply will not die.

Please don't let this get you down!

So-called autism experts really don't have a clue as to what's really going on in our homes and in our lives. I'd argue most wouldn't survive six months in our shoes.

Isaac

[Isaac]

Hello everyone,

On the topic of the “autism tracking” research questionnaire I discussed recently in the FEAT-BC forum (survey at –> http://www.asdsurveillance.ca), some salient commentary came across my desk today regarding the severely flawed nature of this survey. Part of the commentary states:

"If [the Public Health Agency of Canada] thinks that the survey on http://www.asdsurveillance.ca is acceptable to those who understand and do surveillance for a living…it is not! Stop wasting TIME and MONEY and get serious."

I think it’s important to share the entirety of the message with our group. This is a very worthy read, in my view.

Isaac

********************************************************************

Over the past few months, the Public Health Agency of Canada has been working with the Autism Society Canada, the Autism Spectrum Disorders-Canadian American Research Consortium (ASD-CARC) and the Canadian Autism Intervention Research Network (CAIRN) to consult with individuals, families, doctors and ASD researchers to see what can be done to track ASDs in Canada. These groups are asking members of the autism community, individuals with ASD, family members and other caregivers, doctors and service providers who diagnose and treat ASD, school teachers and early childhood educators, adult service providers, those involved in policy and program development, and researchers to fill out a questionnaire on-line at http://www.asdsurveillance.ca

Unfortunately this is not how Surveillance or Policy works in PHAC. The questionnaire on line is poorly designed and is not relevant to the issues identified in core surveillance programs, which include: Incidence of the disorder (how many new cases of autism are being identified), prevalence (how may cases exist at the present time), time trends (how does the incidence and prevalence of autism changes over time), demographics (age, sex, geographic location), patient history (date of diagnosis, diagnostic tests, developmental test scores, changes in severity over time), Treatment history (date treatment started, types of treatment, treatment outcomes, costs of treatment), time-space clustering of the disorder.

It appears that the survey was thrown together by people not trained in surveillance methods. Why does PHAC not use their abundance of Epidemiologists, Statisticians, and Research Scientists to develop a proper tracking program similar to other PHAC tracking programs (cancer, diabetes, enteric infections, sexually transmitted diseases)? Why is PHAC giving money to outside Autism groups when they have people trained within the Agency who are experts in the tracking of diseases/disorders? It appears that money is being thrown around to give "the appearance" that something is being done. If PHAC thinks that the survey on http://www.asdsurveillance.ca is acceptable to those who understand and do surveillance for a living…it is not! Stop wasting TIME and MONEY and get serious. Develop a Division of Autism within PHAC. Hire trained Statisticians, Epidemiologists, Research Scientists, Policy Analysts and Community Medicine experts to develop a program for Autism including surveillance, policy, guidelines, program evaluation and strategic planning (similar to their Cancer, Cardiovascular Disease, Mental Health divisions). If PHAC is serious then a National Strategy for Autism needs to be developed into a Memorandum to Cabinet. Writers and researchers need to be hired to develop the Memorandum and Health Minister Clement needs to present the Strategy to the house in September, 2008. Time is running out. This survey is unacceptable by research and political standards and does not collect the information needed for a National Strategy for Autism.

Please fill out the questionnaire and in the blank spaces where you can write, please write your concerns. Also write to Health Minister Clement and your MP to let them know that this is unacceptable.

********************************************************************

[Isaac]

Courtesy of the Autism Society of B.C, I’d like to share a message with the group (a note from the President of the Autism Society of Canada). It references a request for family participation in an on-line survey. I encourage everyone to take a few moments to review, and hopefully fill out as I did, the survey form at http://www.asdsurveillance.ca.

We want B.C. voices to be well represented!

The Autism Society of Canada has apparently partnered with the Public Health Agency of Canada, to conduct a survey that tracks the incidence of Autism Spectrum Disorder in Canada (among other issues). This seems like a good thing, I think.

The message from Christine Dade, President of the ASC, is below. I filled out the survey form tonight and sent it in. My supplementary comments on the survey form are reproduced at the bottom of this post, for those who may be interested on my thoughts on the topic.

********************************************
By Christine Dade, ASC:

Over the past few months, the Public Health Agency of Canada
has been working with Autism Society Canada, the Autism
Spectrum Disorders-Canadian American Research Consortium
(ASD-CARC) and the Canadian Autism Intervention Research
Network (CAIRN) to consult with individuals, families,
doctors and ASD researchers to see what can be done to track
ASDs in Canada. Now we need your help.

Tell us what you think we should be tracking . Together we
have developed an on-line survey to gather input on what
information about ASDs is important to track among the group of Canadians with ASDs.

We want to hear from all members of the ASD community …

What do governments need to track to better understand
Autism Spectrum Disorders (ASDs), and improve policy,
programs and services for individuals and their families?
Tell us now at http://www.asdsurveillance.ca. The survey should take no more than 10 minutes to complete.

Thank you
Christine Dade
President, ASC
********************************************

Comments by Isaac Tamir (RE: Canada Health Agency tracking of ASD):

It's certainly important to track autism incidence in Canada, but I would submit that it’s also important to track the number of Canadian health policy analysts that are even REMOTELY thinking about having a conversation on how to include medically necessary autism treatment for children in Medicare i.e., universal health care access vs. Visa-card autism treatment (the current standard in Canada).

Of course, the number of health policy folks in Canada looking into the systemic side of this health policy disaster approaches zero; that’s the biggest problem. The elephant in the room is obvious. We have a devastating neurological disorder that is diagnosed by health professionals, tracked by the Public Health Agency of Canada (hopefully soon), but where the treatment of same is concerned, the children remain WHOLLY IGNORED by all of the publicly funded Medicare programs across Canada. That’s clearly an intolerable situation, if the Canadian social contract is supposed to actually mean something.

Is autism a health issue? Is it an education issue? Is it a social services issue? It’s important to figure this out, as a nation, because as things stand now, all public policy vis-à-vis children afflicted with autism is organized around the notion that autism is the latter — a social services issue. This is a huge problem, that a recognized health issue stubbornly remains under the purview of the child protection department for the purpose of vital autism treatment that they are ill-equipped to deliver and can hardly understand.

Tracking ASD is important, yes, but tracking "who pays the freight" to treat this disorder is important too. For my daughter’s core health need (autism treatment) the heavy "freight" bill has been paid by me and my wife, for many years. The privately funded autism health care tab over here runs well over $500,000 to date.

No government agency is 'tracking' that travesty, I’m quite certain.

The financial demise of thousands of Canadian families, due to the nature of catastrophic autism health care costs, should also be a topic worthy of tracking by federal government agencies, as well as the incidence of autism and all the other data.

Isaac

[Isaac]

Hello everyone,

I would like to thank Andrew, very much, for his incisive post to the group. That he shares his thoughts with us is a sincere privilege.

"Since when is UCLA in Texas? It may sound trivial, but it is just one example of flaws that suggest to me that THE DECISION WAS MADE BEFORE THE HEARING and the briefings submitted by the families were simply not read." (emphasis added, by poster 'tamir')

Quite a bold suggestion, but hardly a trivial notion (i.e., a possible corruption of the highest court for policy purposes). I too am of the view — and have always been — that the outcome of Auton was predetermined, insofar as it was the sacred cow of Medicare under assault in the case. The ruling was an extraordinarily sloppy, find-the-nearest-exit type of judgment that actually overturned findings of fact (a big red flag AND a big no-no on appeal)

All powers that be in Ottawa were in full-blown panic mode, given the looming prospect of a successful use of the courts (and the Charter) to breach the walls of Medicare. The notion that the great unwashed can possibly influence health policy via the courts is anathema to policy makers, in the extreme. If Trudeau's vaunted Charter had to be trimmed back 'a bit' to achieve the objective of quashing the case (via a packed court) then so it had to be, in their view.

Chief Centurion at the gate, of course, was Irwin, significantly aided and abetted by health policy prostitutes from across the land, as discussed by Sabrina, in her weighty tome.

Isaac

—– Original Message —–

————————————————————
FeatBC Discussion Board: Room Three: Discussions about Government Topics
————————————————————

Posted by Andrew Kavchak (Kavchak) on Friday, April 11, 2008 – 6:16 am:

On Wedneday an announcement made (see below) that Justice Michel
Bastarache will be retiring from the Supreme Court of Canada. He was
appointed to the Supreme Court of Canada on September 30, 1997.

Some of you may recall that he was one of the Justices who supported
the disgraceful unanimous November 2004 written decision of Chief
Justice Beverley McLaughlin in the Auton case which effectively gutted
the equality provisions of the Charter and rendered them considerably
less than meaningful.

I frequently reflect on the sloppiness of the decision. When I
attended Osgoode Hall Law School in the 1980s many of my professors
routinely made fun of the "Supremes". I used to think that they were
unjustifiably disrespectful…but that was before I found out the hard
way just how truly defective our justice system is. My favourite part
of the decision was where McLaughlin wrote that so much of Lovaas'
groundbreaking work was done in Texas. Since when is UCLA in Texas? It
may sound trivial, but it is just one example of flaws that suggest to
me that the decision was made before the hearing and the briefings
submitted by the families were simply not read. Getting the facts
straight was immaterial detail that should not get in the way of the
court's desired outcome and the whole thing was not even worth some
elementary "fact checking" by an articling student.

Let us all mark and celebrate this retirement as it deserves to be!

Let us further pray that the next judge to occupy the seat will have
the wisdom, courage and sense of right and wrong to be able to
withstand the intimidation and culture of political correctness in
Ottawa and actually believe that "equality" in the Charter might mean
something.

One of the other elements of the shameful treatment of the Auton case
in Ottawa was that the federal Justice Department lawyers intervened
against the kids with autism. At the time the Minister of Justice was
"human rights lawyer" Irwin Cotler. I subsequently sent him a letter
asking him "how could you?", to which he replied that under the
Constitution his job was to advise the government. I gathered that
this meant that his "human rights" work would take a back seat to his
desire for a successful career in politics. His removal from the
Justice portfolio at the hands of the electorate was also an event
that was celebrated in some households!
_______________

OTTAWA, April 9, 2008 – The Rt. Hon. Beverley McLachlin, Chief Justice
of Canada, announced today that Justice Michel Bastarache has written
to the Minister of Justice, the Honourable Robert Nicholson, to advise
that he will retire at the end of the spring session of the Court,
effective June 30, 2008. "Justice Bastarache has served on the Court
with wisdom, and made enormous contributions to the Court and to
Canada. He is a valued colleague and a friend, who will be missed by
all the members of the Court", said the Chief Justice.

For his part, Justice Bastarache said, "It is a great honour and
privilege to be asked to be a member of the Supreme Court of Canada.
There are but a small number of jurists who have had the opportunity
to serve their country in this capacity, and to have had the chance to
participate so directly in the development of the law. I am extremely
grateful for the privilege of serving as a member of the Court."

Justice Bastarache was appointed to the Supreme Court of Canada in
September 1997, after serving on the New Brunswick Court of Appeal.

"I know that the Canadian Government will consider the appointment of
a new justice with the care and deliberation required", Chief Justice
McLachlin added. "I am hopeful that the appointment will be made in
time for the fall session of the Court, in October 2008."

For further information contact:

Jill Copeland
Executive Legal Officer
Phone: (613) 996-9296
Fax: (613) 952-3092

————————————————————

[Isaac]

Hello Everyone,

Chalk one up for the good guys! A mother of a child afflicted with autism has won a battle to get autism treatment covered by health insurance in South Carolina. The article is very good (highly recommended … click on the link below to read).

–> http://tinyurl.com/25a8u8

Do keep in mind, when reading the piece, that the excuse used by U.S. health insurance companies to deny autism treatment coverage is, in fact, "Made in Canada," (in British Columbia, specifically) by the B.C. Office of Health Technology Assessment, at the CHSPR at U.B.C (Centre for Health Services Policy Research). Their so-called autism treatment research — made specially to defend government in court — was thrown out of B.C. Supreme Court as obviously biased in nature and of minimal value (see the Auton 2000 ruling; also, 'Science for Sale in the Autism Wars' covers the whole saga). Always up for a challenge, senior Ontario and Ottawa lawyers re-packaged the "experimental" theme authored by Canadian health policy academics and introduced it as new evidence at the Supreme Court of Canada Auton hearing in 2004 (i.e., they threw the same **** at the wall, as lawyers do, to see if it would stick). Based on this junk science, the S.C.C., stunningly, ruled that intensive behavioral treatment is "novel and emergent" and the case was tragically lost.

That’s just some quick background to this excellent article, so you know the headwaters from whence the toxic river flows.

Isaac

[Isaac]

Hello everyone,

More on the shameful divide that separates Canada and the U.S. on autism treatment (please visit the link below).

Warning: this not what you will likely hear on the CBC anytime soon.

–> http://www.azcentral.com/arizonarepublic/news/articles/0318autismbill0318.html

[Isaac]

Hello Everyone,

The eminent Dr. James Mulick is coming to town to give a talk. Some of you may already know of Dr. Mulick, but for those that are new to our group, he’s a professor of pediatrics and psychology at Ohio State University. He also happens to be a recognized top-drawer expert in the field of ABA/IBI, and the science that surrounds same.

The ASBC is sponsoring his upcoming lecture in B.C. The registration form is available at this address: http://tinyurl.com/yscya3

More details on Dr. Mulick’s April 19 presentation are below.

************************************************************

DR. JAMES MULICK
Probing the efficacy of therapies for the treatment of autism from diagnosis to adulthood

When:
Saturday, April 19, 2008

Where:
Executive Hotel and Conference Centre
4201 Lougheed Hwy
Burnaby, BC V5C 3Y6
Cost: $25 – $75
(please refer to the registration form for breakdown)
Who Should Attend: This conference is designed for parents, professionals, including speech and language pathologists, educators and anyone who has an interest in scientifically sound information about autism and effective information

Presentations

1. Understanding Fad & Controversial Therapies (90 min)
This presentation will examine the reasons that people adopt and believe in unsupported therapies for Autism and other Developmental Disabilities. Examples of such therapies will be reviewed. Ways to resist their apparent appeal will be suggested.
2. Behavior Analysis & Positive Behavior Support (60 min.)
The science of behavior will be contrasted with the recently promoted approach called Positive Behavior Support (PBS). It will be made apparent that the useful aspects of PBS are neither unique to it nor particularly innovative, but rather that the PBS movement represents an aggressive marketing approach.
3. Science & Early Intensive Behavioral Intervention (EIBI) for Autism (120 min)
Research relevant to the effectiveness of EIBI in ameliorating some of the most debilitating aspects of autism will be reviewed. The primary emphasis will be placed on the importance of intervening in early childhood.
4. Lifespan Applications of ABA (60 min)
An overview of the uses of applied behavior analysis in solving problems in learning and behavior management throughout the lifespan will be introduced. Specific examples will be described together with a survey of basic procedures.

Registration form: http://tinyurl.com/yscya3

************************************************************

[Author]

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