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Mrs. GILLIBRAND. Madam President, I rise today on behalf of the 30,000 military families who have loved ones with disabilities, including those on the autism spectrum. Sadly, thousands of these Americans suffering from autism and other developmental disabilities are not receiving the treatment that best practices has determined they need.
For example, military families with children on the autistic spectrum are receiving fewer services than their civilian governmental counterparts across the country, many of whom have been rightfully aided by laws passed in over 60 percent of our States, representing over 75 percent of the American population.
Autism places such tremendous strain on our families--health strains, financial, and emotional. They take such tolls. I want to share briefly just a couple of the stories I have heard from struggling military families. They have done everything we have asked of them as a nation, but now they can't even provide for their children.
One veteran was severely wounded in Iraq while heroically serving his country. His injuries were such that he was forced to retire. Because he is retired, his autistic son Shane was no longer able to receive the applied behavioral therapies that were recommended. The wait list for the Medicaid waiver services where he lives was 9 years. So Shane's family had to sell their home to pay the roughly $5,000 per month out of pocket for the ABA treatment he so desperately needs.
The money is running out for their family, and they do not know what to do. But they want to do what is best for their son. Without this relief, we risk allowing brave military families just like this one to fall through the cracks.
Another story: A marine on Active Duty serving in Iraq and Afghanistan three times has maxed out all his ABA therapies to treat his 11-year-old autistic son Joshua. Joshua is nonverbal and his safety is a key concern for his family. So Joshua is prescribed 35 hours of ABA therapy per week. Because of the severity of Joshua's symptoms, the family is basically faced with the impossible decision of either foregoing the recommended care the doctor has prescribed for their son or paying these bills out of pocket for as long as they are actually able.
I don't believe this should ever happen to our military families. I don't believe it should happen to any child, and that is why I am introducing my amendment to require TRICARE to cover the recommended ABA therapies that a doctor prescribes. It would be a matter that is consistent with the best practices across this country and in the rest of the Federal Government.
Our children need this kind of support--Shane and Joshua need this kind of support--and we should be standing by our men and women who serve in the military because they stand by us. Every parent who has a child with autism or another disability faces challenges to ensure their child has access to the treatments they require. For these military families, the challenges are even greater and often compounded by frequent deployments overseas, the frequent moves to different bases across State lines, and sometimes significant gaps in their coverage.
Today, TRICARE coverage of ABA is severely limited. It is capped at $36,000 per year for an Active-Duty member, which falls far below what is medically recommended for so many of these children.
This care is limited to Active-Duty servicemembers only. Guard and Reserve families receive intermittent care, and children of retirees can't even get coverage at all. As a consequence, military servicemembers often must turn to State Medicaid Programs to help provide these services to their children. But the problem is that these services are often unavailable because of long--years--wait lists. In Maryland, for example, the wait list is 7 years, essentially eliminating ABA coverage during the early developmental years when a child needs it most. The wait list in Virginia is 10 years long.
Even more remarkable than TRICARE not covering these treatments is that the Office of Personnel Management has determined that such treatments may be covered as medical therapies for Federal civilian employees. A recent court decision, which the DOD is still reviewing and may appeal, determined that TRICARE must cover these treatments. But this decision is being applied under the most narrow definition in the interim, limiting the potential pool of providers. This amendment requires TRICARE to provide coverage and deliver services in a manner that is consistent with the best practices, thereby improving access to care for our military families and aligning the TRICARE policy with coverage that is basically available to anybody else in the civilian sector.
I believe we have a duty to stand by our military families. We have to address this difficult medical issue. We ask so much of our men and women who serve in the military. We must support their families. This amendment simply fulfills that promise.
I yield the floor.
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Mrs. GILLIBRAND. I thank my colleagues for their statements of support for meeting the needs of the children who do suffer from autism and other developmental disorders, and I do appreciate and believe their sincerity in wanting to make sure they are covered with the treatments they need.
I think we can work together to reform the TRICARE system. It is one that has not had the kind of reform it needs. But this is just an authorization for 1 year to meet the needs of these kids now because I don't want to wait until we figure it out and figure out the rest of the program.
In addition, we did have a hearing. We had scientists and doctors and those who are medical professionals come to testify in front of the Armed Services subcommittee. Through that testimony we established that the only reason the DOD wasn't covering this was because they believed it was an educational program. And what we established and what the medical literature says is that it is actually a medically necessary treatment in the same way you would give a child who is sick a medicine.
I want to address the needs of these kids now. I will commit to working with the Senators to reforming TRICARE so we can actually pay for programs over the long term and reform it in a way that is consistent with the benefits our troops so desperately need.
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Mrs. GILLIBRAND. I urge my colleagues to take a more lengthy time to consider how to reform TRICARE and pay for this program than just 1 or 2 hours.
I would like to pass this amendment now. Right now operations and maintenance has $174 billion a year in it. This is $45 million for 1 year just to get the treatments in place for these families. In 1 year's time, we will have more accountability and transparency on what the real cost is. This is just an estimate. So what we want to do is be able to have more facts and then go to reform the TRICARE system properly, and I commit to Senators that I will work with you on that. This is only authorized for 1 year.
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