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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 Dr.J.Kumutha Expert Advisor (Child Health) National Health Mission
Process of Screening 3 Critical Questions
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
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
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
Felt need Individualized program implemented in a flexible manner
Training of HR • Training of the entire DEIC team at IPJMER Kolkata • National Institute for (NIPMED) Empowerment of Persons with Multiple Disabilities -Chennai
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
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
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
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
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
Way Forward Keys for success Early detection Early Intense MD care
Vision of our Mission Director/NHM- TN Dr. Darez Ahamed