Some autism providers and treatment facilities in Colorado overbilling, completely unregulated, according to report

A new report by the Colorado Department of Human Services says a lack of oversight at facilities that provide therapy for kids with autism has resulted in dozens of complaints of child abuse.

It comes after a federal audit found the state Medicaid program made at least $78 million in improper payments to the facilities, some of which are owned by private equity firms that the state agency overseeing Medicaid says have exploited the lack of regulations to maximize revenue.

Pam Bisceglia has dedicated her life to improving the lives of people with disabilities as Executive Director of Advocacy Denver and parent of a daughter with autism.

She says the facilities sprang up across Colorado when the state and federal government began requiring private insurance and Medicaid to cover Applied Behavioral Analysis, or ABA -- a one-on-one therapy for kids with autism that has proven effective at improving language and socialization.

"Some of these places are incredible and do a great job," said Bisceglia. "There are others where we have questions and we're not certain if they've ever met a person that they wouldn't diagnose with autism."

She says, regardless of a child's level of autism, many providers recommend 40 hours of therapy a week, operating more like day cares. She says staff are often high school graduates with no training, certification, or background checks.

Not only are kids not getting help, Bisceglia says, some are being physically harmed, locked in rooms, and restrained.

"We've heard of situations where the child was restrained for 45 minutes," said Bisceglia.

She says parents have turned to child protective services only to learn counties don't regulate the facilities.

No one does, she says.

"There are no protections for children going into these places," Bisceglia said.

The Colorado Department of Human Services says it only learned about the facilities in 2024 when it received complaints including restraint of an 18-month-old child, physical abuse, children receiving raw meat and contaminated food, facilities with moldy walls and dilapidated structures, and staff criminally charged with child abuse.

The department is now pushing for licensure and regulation, saying there are more than 400 ABA facilities in Colorado.

"We are doing our absolute best to make sure we are balancing both regulation and access," said state Rep. Lindsay Gilchrist.

She and state Rep. Kyle Brown plan to introduce a bill that would license both facilities and providers.

"It is urgent, and we have to make sure we regulate the space to keep kids safe, and we do it with the sensitivity that we know these families do need support," Gilchrist said.

Bisceglia says those families should not have to roll the dice when choosing care for some of the state's most vulnerable kids.

"We believe that with the licensing, it will make it a stronger field and it'll recognize it as a professional field and people will have to step up to the plate and do what's right," she said.

Under the bill, Human Services would be tasked with developing rules around everything from training and background checks to treatment plans, staffing ratios, reporting requirements, and building safety.

The department is currently investigating more than two dozen facilities and says, while most providers recognize the need for regulation, some don't think the laws around restraint and seclusion should apply to them.

Colorado is one of only 11 states that doesn't license providers of ABA therapy.