August 11, 2022 marks the 11th anniversary of the landmark Shayan's Settlement, which became the benchmark of insurance coverage for all children, adolescents, and adults with intellectual and developmental disabilities in the state of Washington.
Washington Autism Alliance founder Arzu Forough advocated for her son Shayan and other families in similar situations to clarify Washington State's Mental Health Parity Act for those diagnosed with Autism Spectrum Disorder (ASD).
“My children desperately needed and deserved the medically necessary behavior therapy and neurodevelopmental therapies they were entitled to,” Forough shared about sons Shayan and Darian. The boys were 10 and 9 years old at the time she started on this journey in Washington and were named plaintiffs in the first lawsuit against the state of Washington.
“I am a tenacious researcher and knew Washington already had passed a law (Washington State Mental Health Parity Act) that required this coverage, but it wasn't implemented,” she explained. “I had been lobbying the legislature to end this discrimination. The biggest challenge we faced was the legislature was unwilling to pay for the cost of care, until they were forced to do so as a result of the settlement agreement.”
Since its signing in 2011, Shayan’s Settlement has mandated coverage of medically necessary ASD screening, diagnosis, and treatment, including Behavior therapy. It applies to Individual Plans, Fully Insured Large Group Plans, and Fully Insured Small Group Plans, and coverage is not limited by age, dollar, or number of visits.
Services covered by Shayan’s Settlement are:
- Screening and Diagnosis
- Neurodevelopmental Therapies (speech, occupational, and physical therapies)
- Behavior Therapy including Applied Behavior Analysis
- Pharmacy Care
- Psychiatric Care
- Psychological Care
- Therapeutic Care
- Any care for individuals with developmental disabilities, including autism spectrum disorders, that is demonstrated, based upon best practices or evidence-based research, to be medically necessary
WAA continues to advocate for Washingtonians of all ages with intellectual and developmental disabilities and autism and their families who struggle to access care and services in homes, schools, and communities. Read more about our current advocacy efforts, including a push to bring Enhanced Behavior Support Homes to Washington state.Please join us as we continue to build a community of supporters by becoming a member of WAA. With a free membership, you gain access to our Insurance Portal resources to navigate private insurance as well as Medicaid, and our Special Education Legal Library.