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Insurance Coverage for Autism A Pioneering Initiative in Tamil Nadu

This initiative in Tamil Nadu provides insurance coverage for autism, offering screenings, diagnosis, and multidisciplinary care at the community level. The program includes training of professionals, individualized therapy, and monitoring through annual evaluations. Collaboration with NGOS and the Chief Minister's Comprehensive Health Insurance Scheme ensures accessibility.

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Insurance Coverage for Autism A Pioneering Initiative in Tamil Nadu

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  1. Insurance Coverage for Autism A Pioneering Initiative in Tamil Nadu Dr.J.Kumutha Expert Advisor (Child Health) National Health Mission

  2. Challenges

  3. Goal

  4. Screening Team

  5. Process of Screening

  6. Process of Screening 3 Critical Questions

  7. Screening & Diagnosis at DEIC MCHAT- For children less than 2.5 years If screen Positive further Assessment done by Indian Scale for Assessment of Autism (ISAA ) by the Psychologist

  8. Diagnosis

  9. Multidisciplinary Care At Community Level ( Block Early Intervention Centre) • 413 Block level Early Intervention centers have been established in schools under Education Department / one at Each Block

  10. Multidisciplinary Care • At Facility Level • 34 District Early Intervention centres situated at Govt Medical college& Hospitals/ District Headquarters Hospital • Dedicated 10 member team to give Multidisciplinary care for children with Disability Parents & Family

  11. Felt need Individualized program implemented in a flexible manner

  12. Training of HR • Training of the entire DEIC team at IPJMER Kolkata • National Institute for (NIPMED) Empowerment of Persons with Multiple Disabilities -Chennai

  13. Follow up

  14. Linkage with CMCHIS • Autism Spectrum Disorder Package was included in TN- Chief Minister’s Comprehensive Health Insurance Scheme in the Year 2016 • Empanelled Institutions Government Institution 36 NGO’s- 48

  15. Empanelment Criteria under CMCHIS The type of therapy should be individualised and planned collectively for each child by the qualified professionals Each Session is for 40 minutes

  16. Payment Claim model • Initial Assessment, Annual Re- Assessment & Quarterly Re- Assessments will be paid (Rs.1,000/- per assessment) separately • Overall maximum sessions including all disciplines is 10 Sessions / week

  17. Monitoring & Tracking • Complete Annual evaluation involving Paediatrician, Psychiatrist, Psychologist, Special educator (External) has to be done by the Insurance Company Assessment Criterion: • All Children must be assessed with the standardised Criterion using Indian Scale for Assessment of Autism, Childhood autism rating scale and IQ assessment as per chronological age

  18. Beneficiaries under CMCHIS

  19. Collaboration with NGO • National Health Mission (NHM-TN) • NGO- Amar Seva Sangam • To provide a software for the DEIC and BEIC team • A guide for Screening, therapy and Follow up of the children with Autism

  20. Way Forward Keys for success Early detection Early Intense MD care

  21. Vision of our Mission Director/NHM- TN Dr. Darez Ahamed

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