[New post] ‘Taking ABA care makes their lives more difficult’: State’s underfunding of autism therapy challenges families, caregivers
Anne Delaney posted: "The loss of autism therapy services impacting up to an estimated 1,150 children in Colorado left at least a few local residents scrambling to fill gaps in care for their children. The Colorado Association for Behavior Analysis reported nine companies p" Greeley Tribune
The loss of autism therapy services impacting up to an estimated 1,150 children in Colorado left at least a few local residents scrambling to fill gaps in care for their children.
The Colorado Association for Behavior Analysis reported nine companies providing applied behavior analysis, or ABA, services in Colorado have closed, gone bankrupt or left the state over the last year or so.
The reason for the departures, which will include Hopebridge Autism Therapy Center in Greeley early next month, can be traced to lower rates of reimbursement from Colorado Medicaid. Colorado Medicaid, which is administered by the Colorado Department of Health Care Policy & Financing, covers ABA services for those who qualify based on income eligibility.
Medicaid covers medically necessary treatment, according to Behavioral Innovations. ABA is considered a medically necessary treatment for autism.
Applied behavioral analysis uses basic principles of behavior, special techniques and positive reinforcement to bring about significant and measurable change, according to Hopebridge, which has seven locations in Colorado and operations in 11 other states. Hopebridge's website also explains ABA as a way to shape and mold actions for effective communication and learning.
"What they're doing, and big picture is teaching social interaction skills, communication skills, coping with emotions and other life skills that might come naturally for another child," said Karmen Peak, a Greeley resident and mother of two children under 4 years old both diagnosed with autism in the last year.
Peak's 3 ½-year-old son, Ridge, began receiving treatment at Hopebridge in August 2022. Peak's daughter, Jovie, 2, was diagnosed earlier this year at 18 months old. She had been on a waiting list since January to get into Hopebridge but was not able to access services before it announced an end to ABA therapy.
Peak said her son's autism was diagnosed in part because the boy didn't respond when his name was called. While Ridge is talkative and repeats words and phrases, Jovie is nonverbal. Her speech delay was a big sign of her autism.
Jovie is a sensory seeker, Peak said. The girl looks for pressure squeezes and hugs as a calming mechanism. Ridge is often in motion and can wander off, which is known as eloping. He is attracted to water.
"With him, drowning is a huge issue, and we do safety programs," Peak said.
The Peaks and other Hopebridge families in early July learned of Hopebridge's plan to end ABA services in Colorado on Aug. 11.
Jovie Peak, left, 2, left, and her brother Ridge, 3 1/2, play in the backyard of their Greeley home Wednesday, July 26, 2023 while their father Rick watches. The children were both diagnosed with autism within the last year and rely on applied behavioral analysis as part of their therapy for managing daily situations. (Jim Rydbom/Staff Photographer)
"We got a couple of weeks' notice to change our whole life around," Greeley resident Blanca Rodriguez said earlier this month. "Children with autism don't do well with changes. They need structure."
Rodriguez's 6-year-old grandson Tristan has been at Hopebridge for about two months after being on the waiting list for more than a year. In the short time Tristan went to the center, for 7 ½ hours a day, five days a week, the boy has made significant progress in his development, his grandmother said.
"He shares," she said. "He'll take a toy to school and share it with other children. Going to Hopebridge, he's able to calm down and breathe. You can see the whole change in him."
In a frequently asked questions document on the end of ABA services, Hopebridge said it relies on the reimbursement rates from Colorado Medicaid to fund costs for labor, supplies and facilities. Hopebridge explained Medicaid reimbursement rates are typically lower than commercial payers.
State Rep. Mary Young, a Democrat from Greeley, said for an initial assessment, Colorado Medicaid rates of reimbursement are $796 below the average rate of other states — based on statistics from the Colorado Association for Behavior Analysis.
Direct therapy rates here are $11.16 below the average of other states.
"When you get reimbursement from Colorado Medicaid, the administrative paperwork is burdensome," Young said.
The lower reimbursement rates here added to inflation and a higher cost of living than in other states where Hopebridge operates, and it leads to infeasibility to continue the ABA services.
Hopebridge also said it has worked for years to negotiate for "stronger reimbursement rates in Colorado with no success."
"The state of Colorado is wholly unwilling to collaborate with us to create solutions to address the seismic inflation that is hindering our ability to provide adequate wages for our Colorado staff, whose cost of living has skyrocketed," Hopebridge wrote. "Colorado Medicaid has left us no other choice than to withdraw our ABA services."
Young said she didn't think it was the intention of the Department of Health Care Policy & Financing to be unwilling to collaborate "but they've sent that message."
Young said last week she will reach out to HCPF and be in contact with the department to discuss the issue.
"I'm hopeful when they realize the impact on the people who need services, we'll see adjustments," she said.
The company asked for Hopebridge families and staff, and those in the larger Colorado and American communities to reach out to Colorado Medicaid and elected officials to express frustration with the situation.
"Demand for ABA therapy is increasing exponentially and the current and future children of Colorado deserve access to quality care," Hopebridge said.
Last week, Peak arranged for in-home care for her children from Action Behavior Centers in Fort Collins to partly fill in for the services her son received at Hopebridge. Ridge will also soon be in preschool in Greeley-Evans District 6 and will qualify for services in the form of an individualized education program from the school district.
At Hopebridge, Peak said, her son's growth was amazing. The boy now responds to his name, and he makes contact with others.
"He's using functional language, and he's able to communicate his needs: I'm hungry. Water, please," Peak said. "He's using them in the right context, and for my son, that is huge."
Rodriguez said recently she was hopeful of connecting her grandson with services at another center in Greeley.
"If he was to have more time there (at Hopebridge), I can imagine he'll be successful," Rodriguez said. "Whatever he wants to do, we'll back him. Taking ABA from children like my grandchildren makes their lives more difficult."
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