moving question about California or New York

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we are considering relocating to the US for my husband's work. He is a US citizen and our kids are as well (I'm not ). The best states for his profession are New York and California. We want to know what type of services are available for kids on the spectrum in both states, is there public services or does it all have to go through health insurance? Would insurance companies refuse to insure our daughter because it is a preexisting condition? How is the schooling for spectrum kids? My husband left America when he was single with no kids so we have no knowledge how the system works for ASD kids there.

California is cutting services like a ninja. If your kids have an IQ above 70, they probably won't get services outside of what school offers. That is how the system works in both of those states. I don't know much else about New York. Neither state is a really great place to live right now. That being said, the services and special educations programs, both public and private, are ahead of most of the developed world.

If your kids are dependent minors, I don't think they can be rejected for a pre-existing condition.

If we talk via PM I can provide you a little more information on California.

We've done OK in CA but stories vary widely. If you are in an area with a cluster it is usually OK, but there are a lot of variables at play here. I think you'd need to have it narrowed down further before you can get a solid answer.

Both California and NY State have economies headed into the toilet, with California leading the way. Their state governments have spent decades of over spending and mismanaging their budgets, and kowtowing to the state unions demands for excessive pay and excessive benefits. Because of this neither state is a good pick for living in. I recommend living in a state adjacent to either California or NY, but near the state border, and your husband can commute to work.

All of our states' economies and budgets have been mismanaged for decades, but some are not as bad as others, yet, and we may still be able to save some of them. Out west, Arizona and Nevada would be an improvement over California, to live in and commute to California. Back east, Pennsylvania, and New Jersey would be an improvement over living in NY. I have lived in New Jersey and Pennsylvania, and am now living in NY, so I know something about all three of them. I think Pennsylvania is probably less mismanaged than New Jersey, but if your husband is going to work in or near NY City, then New Jersey would be a shorter commute. Some of the counties in New Jersey are better than others, so do some home work on that. I lived in Morris, Somerset, and Middlesex counties in New Jersey, but they are not all that near to NY City, so I don't know which of the closer counties would be better run by the county governments. Unfortunately, the counties that are closer to NY City are also more expensive to live in, and buy a home in, because a lot of commuters want to live in them. If your husband doesn't need to actually work in the NY City area, perhaps he could look for work in the south central and south western parts of NY State, which would put him close to the border with Pennsylvania. The northern border counties of Pennsylvania are definitely cheaper places to live, than places close to NY City. On the down side, they are less likely to have the services you need and want, because they are more rural. There is another alternative that might help some. If your husband could pick a different city in the state of NY, it would be cheaper to live in the suburbs or rural areas of NY near those other cities, than it would to live in the suburbs of NY City. Being near any of those cities would increase the chances of getting the services you need.

Buffalo and Rochester NY both get too much snow due to what we call the lake effect. They are each next to one of the Great Lakes, and get a lot of lake effect snow, in addition to any regular snow storms that come their way. I live a good distance east and downwind of Buffalo, so I get some of their lake effect snow, but by the time those systems get here they have already dropped much of it, so I get a lot less than they do. Not far from here are a big town, Corning, NY, and a small city, Elmira, NY. Both of these would be good areas to work in, and would be cheaper to live in or near, than NY City. There are also Albany and Syracuse, which are north east of Corning, and Ithica, and Senaca Falls, which are north of Corning. There are a lot of other nice places around here, too. The far west and the northern NY State get a lot of snow, so getting to work can be a problem in the winter. The area I'm in is in the south west/south central part of NY. Parts of it are called the Finger Lakes, parts are called the southern Tier, and other parts are called the Twin Tiers. These areas don't get quite as much snow, and are very nice places to live. There will still be a good bit of snow though, as it is a northern state, and these parts of the state have a lot of mountains. No matter where I go here, there are always mountains surrounding me. Since I love mountains, it's great for me. There are also a lot of lovely lakes in the region.

I think if your husband doesn't need to work in NY City, the areas I mentioned in south west, and south central NY would be much better. If you get a house with a yard, you could keep costs down by having a garden, too. However, if he does need to work in NY City, then living in eastern New Jersey and commuting to work would probably make more sense.

Good luck with your move, and remember, we on the spectrum are all:

A Different Drummer

If a man does not keep pace with his companions,
Perhaps it is because he hears a different drummer.
Let him step to the music which he hears,
However measured or far away.

--Henry David Thoreau

I'm not sure of any signifigant employment hubs in CA within commute range to NV or AZ, Unless you want to work in the hospitality industry, then Lake Tahoe is easy.

In California, children with an IEP (individual education plan) may qualify for county based services outside of school, funded by the states medical coverage for low income and disabled individuals, Medi-Cal, but Medi-Cal has recently been restructured into a state subsidized HMO so I'm not sure how the program works exactly anymore.

If your children are relatively "mild" and not disruptive in class, you will probably have to wrestle with the school to get an IEP and the services associated wit it.

There are treatment programs for children though many of them are going to be more likely to accept private insurance. The UCLA Semel Institute has a program for children and teens on the spectrum, though compared to the UK, I believe services for those on the "mild" end of the spectrum still lag in the US.

Currently I don't believe private health insurance companies can deny insuring individuals with pre-existing conditions, however if it's a PPO they may charge high premiums. Likely though, your children will be insured through your husband's place of employment, and so I don't think you will have as much of a problem with the insurance companies if you were buying the insurance independently. You will need to look into it more though.

I don't know the services in New York are. New York is a much smaller state than California though, and there may be services in the adjacent states which are within a two hour drive.

I don't know how much googling you've done but I found a couple interesting articles on the subject. Unfortunately, they give conflicting information:
http://www.autismkey.com/finding-the-be ... -services/
http://www.autismspeaks.org/about-us/pr ... ave-autism

Most states have their DHS information online somewhere; you might take a look at services there. I would guess that the severity of your kids' disability would have an impact on the services offered. http://www.dhs.ca.gov/ and http://www.health.ny.gov/

Another thing: most jobs in the US offer private insurance - make sure this is something you are looking for as your husband looks for work, and ask specifically about the pre-existing condition when you get to that stage in negotiations.

What does your husband do for a living, if you don't mind me asking. Since you mention NY and CA I am thinking it's IT related?

I am in the exact same situation as you (living abroad but moving to the US.) We are moving to Massachusetts, as it is supposed to be the best in the nation in terms of services. Not to say it's perfect of course, and I can't relate any personal experiences as I am not there yet.

Have you considered moving to the Boston, MA area? Also, right now MA is the only state that has anything close to universal health care. Insurance companies are also required to cover autism treatments.

As for the pre-existing condition thing from what I understand as long as you have insurance NOW you should be covered, you will just have to show evidence for it. I don't think your current country of residence should matter.

You are right, he works in IT, webdesign that type of stuff, he had quite a lot of family in New York which is why it is a consideration, but california has a lot of IT work. My husband is bi-linguel, speaks spanish and english which is another reason why we are considering states with big hispanic populations (except texas, it's too hot!). We have considered New England but doesn't seem to be alot of work there. We live in a country with a universal health care system so we don't need health insurance, so currently don't have any. Our aspie is quite mild, but still does need a teacher aide, mainly to keep her from getting distracted (has ADD too). The school here is very good with her, it is the only thing that is keeping us here at the moment.

Ok I see. Well, I'm not sure how the health insurance thing would work then. All I can say is be very careful what state you move to because every state is different, every state has different laws. Like I said MA has the closest thing to "universal," so if you do not have insurance through work, you can get it from the state. However they will only subsidize you if you are low income. Read more about it here.

http://en.wikipedia.org/wiki/Massachusetts_health_care

There are a lot of technology companies in the Boston area but I think it's mainly work in programming or research, that sort of thing. And I think there are definitely less Spanish speakers than you'd find in NY or CA (espcially CA!)

Anyway good luck in whatever you decided to do.

With recent health care reform there are no pre-existing condition exclusions for children.

As Kauliamom pointed out, that really isn't possible in CA. Neither San Francisco or LA are anywhere near a state border.

Thanks for putting that in there. I wasn't sure when it took effect so I didn't feel I could comment. I just knew it was scheduled into the health care reform act.

In the past, pre-existing condition limitations, as applied in company health plans, usually ended after a specified amount of time, usually about a year, I think. So even if health care reform gets repealed, it wouldn't be a permanent exclusion. This is a question that can be confirmed with the HR department of a company you are interviewing with.

There is a huge cluster of autism in the Silicon Valley area so odds are good that you could ask the prospective employer for information on the local services for your child, and they would actually have that information.

As I noted earlier, services and personal experiences seem to vary quite a lot within this state, so it isn't a simple answer. Our school has been excellent, but my son is lightly affected, and you wouldn't necessarily be moving into our district.

It is true the state budget is down to the bare bones, and a lot of services have been cut, to the point where even if something is covered you will be wondering if you are going to be allowed "enough." We all are filling in gaps at school and elsewhere with our own dollars, and it is something to budget for going in, if you are going to live in this state. You will be constantly asked for your time and money, even in public school.

I rather love it in CA anyway, however.