As a provider of autism therapies for over 35 years, I’ve seen firsthand the immeasurable progress and growth that can happen when children receive the right support at the right time. I’ve also seen the pain and costs when parents aren’t able to access the care and therapies that help their child thrive.
I am disheartened on behalf of myself, other providers across the state, and the thousands of Colorado kids with autism spectrum disorder to see Gov. Jared Polis and the Office of Health Care Policy and Financing continue to cut Medicaid funding for proven autism therapies, and announce new cuts to funding the diagnosis of this condition. These children already face a one- to two-year wait for diagnostics due to poor funding; this will undoubtedly increase their wait time as more providers stop taking Medicaid.
The governor recently enacted almost $10 million in cuts to pediatric behavioral therapy, or PBT, including applied behavior analysis, or ABA, services. These are clinically proven to be successful therapies for children diagnosed with autism spectrum disorder and other disabilities, as part of cuts to reduce the state budget. While most medical providers received a 1.6% cut, providers of PBT and ABA therapy for children with autism and other disabilities were singled out to receive a 5% cut. While I understand that there must be tough cuts made to the budget in the current financial situation, it should not be disproportionately on the backs of some of our most vulnerable children.
ABA therapy is a gold-standard therapy for children with autism. It gives kids individualized treatment, teaching them to talk, play, be safe and do things other kids do to better prepare them for life. This medically necessary therapy is proven to build communication, social and life skills.
Decades of research show that when children with autism spectrum disorder get intensive ABA, they make strong gains in independence and require less support at school and in the community. It’s the right thing to do, and it saves Colorado money.
Why then is this critical therapy being targeted?
This isn’t the first time we have had to fight off cuts to autism care, even prior to the state’s current budget crisis. The Polis administration gives various reasons for these devastating and disappointing attacks on Colorado kids and families, from an increase in the use of services to allegations of misuse of federal monies related to HCPF’s failure to properly vet unqualified providers.
They are correct to say there has been an uptick in therapy for children with autism — but this is because it works and it’s for good reason. For decades, Colorado Medicaid didn’t provide adequate access to care for children with autism, covering only a small number through limited autism waiver programs. In 2018, Colorado Medicaid began finally covering autism care under a federal mandate.
The recent growth in spending and utilization is a direct result of the dtate correcting this historic wrong, and some children are finally receiving the care they need and are entitled to. Yet, about 75% of kids who need and qualify for these services still cannot access them because of poor funding and lack of providers.
Polis and HCPF have also announced unprecedented and burdensome additional regulations for access to ABA therapy, meaning it will be increasingly difficult, and for some families, impossible, to access Medicaid funding for care. These are disproportionately imposed regulations other medical services do not face, and will push providers out of Medicaid altogether.
Let me be clear: As providers, we welcome oversight that ensures quality care and safety. Most of the proposed regulations won’t do that; they’ll cost more taxpayer dollars, limit access for kids, and create an additional bureaucracy for us to pay for instead of providing treatment.
Regulation shouldn’t cause regression and restrictions on access.
HCPF has the obligation to ensure that Medicaid program dollars are spent responsibly. However, the state shouldn’t single out services for children with autism and treat them differently, and in a way that will cripple providers’ ability to help kids.
All PBT services already go through prior medical review for authorization with the state, including a full review of the treatment plan. Audits are already standard practice, just as they are with all state-funded plans.
These cuts and new regulations will disproportionately harm low- and middle-income families, rural communities and children with the highest needs. Many of our families already face monthslong waitlists and exhausting barriers. They don’t have the time or money to navigate a system that’s becoming increasingly hostile to their needs.
We know, and our kids and families know, that mental health care is health care and shouldn’t be treated differently from other medical services. We understand that the state is facing serious budget restrictions, but we cannot balance the budget on the backs of some of our most vulnerable children.
David Hatfield, of Denver, is the owner of Oliver Behavioral Consultants in Thornton.
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