Colorado approaching a health care crisis when it comes to autism services for children
Karmen Peak has two small children. Both were diagnosed with autism and both are thriving today.
"This is setting them up for success. It's giving them the tools they need to be social and to know how to cope with emotions and those are huge. Those are big deals," she said.
That success, she believes, is a result of their access to Applied Behavior Analysis therapy. ABA therapy can often mean up to 40 hours a week of one-on-one services.
"It's their livelihood," Peak said.
She and dozens of other families believe that access is in jeopardy for families across Colorado, after learning her provider, Hopebridge, will no longer offer the critical therapy.
"As parents we were just sent home a letter saying ABA services will be canceled Aug. 11, less than a month away," she said.
JJ Tomash is the CEO of BehaviorSpan, one of the providers still offering ABA therapy in Colorado.
"From the day that Hopebridge announced we started getting calls from families that had been there and it's been a constant stream since and we can't take everybody," Tomash said.
He and other advocates are now speaking out about what they see as a pending care crisis -- because Medicaid reimbursement rates are not keeping up with inflation.
"Providers have started leaving. Some of the smaller providers I know are talking about 'Will we make it through the year?'" Tomash said.
Kim Bimestefer is the Executive Director of the Colorado Department of Health Care Policy & Financing.
"We are disappointed when providers choose to potentially leave the area. We prefer for them to be active participants in the processes that we have to review what we're paying them now," she said.
Bimestefer says recent changes to the review process offer new opportunity for adjustments.
"We're very grateful to the joint budget committee working with us to increase the frequency of those reviews because in the last few years the increases in health care and the wages that are paid to health care workers," she said.
The latest across-the-board increase of 3% was made on July 1, and a state committee is currently considering another targeted increase that would go into effect the same time next year.
"If we have to wait another year there isn't going to be autism services in Denver anymore, we have already 30% to 40% of the centers that were open," Tomash said.
That thought is what scares families like Peak's the most.
"Just to see kiddos not having access to that it is, it's just like, it cannot be happening," she said.
The Medicaid provider rate review advisory committee will meet on Monday to continue the discussion about the targeted increase, but pediatric behavioral therapy providers are not the only ones being considered.
Anyone can attend the virtual meeting at this link: hcpf.colorado.gov/rate-review-public-meetings
