Autism medical waiver increases therapy enrollment

Published: Saturday, Oct. 19 2013 4:43 p.m. MDT

Benjamin, left, Zander and Ty participate in circle time with tutors Kris Bradford, back left, and Madison Fujimoto during the Autism Bridges program at Kids on the Move in Orem, Tuesday, Oct. 15, 2013.

Ravell Call, Deseret News

OREM — A little boy looking at his mom and saying "hi" may not seem significant for many, but it is for the mother whose son wouldn’t even acknowledge her before he started treatment for autism spectrum disorder.

This is just one success story to come out of a Kids on the Move program called Bridges, which provides services for children ages 2–8 with autism spectrum disorder. The program has grown immensely over the past year for a variety of reasons, from 30 children to nearly 100.

The Centers for Disease Control and Prevention reports that 1 in 47 individuals in Utah are on the autism spectrum — the highest rate in the United States.

Rising statistics over the past decade can be attributed to increased awareness and less stringent criteria for diagnosis, according to Deborah Bilder of the Autism Spectrum Disorder Clinic. Consequences from this can be seen in rising enrollment numbers at autism clinics and schools, particularly because Utah government funding is facilitating more treatment at places like Kids on the Move.

Without the autism treatment account grant, Tara Hendriksen’s son Ty wouldn’t be able to participate in Bridges therapy to the large extent he is now. The grant pays for him to attend 20 hours a week for what would otherwise cost the Hendriksens $37,000 a year.

Hendrickson said her son has received life-changing services that took him from being nonverbal and throwing 15 tantrums a day to developing language skills and having meltdowns just once or twice a day — if at all.

“He’s a completely different kid than he was just a year ago,” Hendriksen said. “His little personality has been able to come through and … he tells me all the time, ‘Mom, I’m happy.’

"You can just see how much happier he is because he can express himself.”

Bridges, which began with just four preschool children in 2010, started providing services through an autism treatment account and a Medicaid autism waiver at the beginning of 2013.

“I’m really grateful that the state has taken the initiative to put some funding toward this because when we first started our program, it wasn’t available, and it was very devastating to watch parents just yearning and begging for something and not having access to it,” said Laurie Bowen, director of Bridges.

Therapy costs can run up to $60,000 a year, a cost Bridges tries to keep lower for its families. Still, autism services simply aren’t affordable for many families.

During the 2012 legislative session, a bill was passed for a two-year pilot program to help provide autism services. The three legs of the bill are the Medicaid waiver program, an autism treatment account (funded both privately and by the Legislature) and the public employees health plan.

The Medicaid waiver requires a valid autism spectrum disorder diagnosis and Medicaid financial eligibility to be met.

“But that’s a little bit different than standard community Medicaid eligibility, said Tonya Hales, director of the Bureau of Authorization and Community Based Services. “Only the child’s income and assets are considered, so things like child support could come to play. ... But we didn’t have any children who weren’t available based on income.”

All 300 eligible applicants received the waiver, which provides about $29,000 a year for children ages 2–6 to receive applied behavior analysis therapy.

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