Indiana Medicaid cuts could slash therapy for autism

INDIANAPOLIS — “No two children on the spectrum are the same,” said Morgan Herron of Selma.

Her 12-year-old daughter, Melody, was diagnosed with autism before the age of 3. She has received Applied Behavior Analysis, or ABA, for nearly a decade.

“We need this,” Herron said. “Our kids need this.”

ABA is designed to help people with autism with day-to-day challenges and life skills. The ultimate goal is more independence.

“It is an individualized treatment plan,” Herron said. “They look at Melody as a person.”

Right now, however, some Indiana families who have children with autism are asking for help ahead of a proposed change to the way their kids receive ABA.

The state’s Family and Social Services Administration’s Office of Medicaid Policy and Planning is proposing a cap on access to the behavior therapy.

Officials say the proposal will help cut down on Medicaid costs. In fact, the state’s previous Medicaid director told lawmakers last year, the cap would save the state about $115 million over the next two years.

The proposal would limit ABA coverage to 30 hours per week with a lifetime cap of three years. The state says that includes some exceptions, but did not give any more details.

FSSA Secretary Mitch Roob weighed in during a hearing in January.

“There is no question in my mind that ABA therapy is a tremendous benefit to children and families and schools,” Roob said. “I mean, we’re not going to discontinue it, but we have to manage that cost trajectory.”

Herron and other parents, however, call the move “scary.”

“What we can do now will help once us, as parents, aren’t here anymore,” Herron said.

“It’s a big thing that we all need,” says fellow mother Crystal Altic, “and I just hope they realize that this is going to have a trickle effect, and these kids’ lives matter.”

Altic’s daughter was diagnosed with autism when she was 2.

“She was nonverbal,” Altic said. “She was not potty-trained. She was terribly afraid of people.”

Her daughter, however, has now been in ABA for nearly a year.

“This place is fantastic,” Altic said. “It is a second home for us. She’s potty-trained now. She can talk, as you heard. She isn’t afraid of people.”

Angela Pickett’s son also receives ABA therapy. She worries what her son’s life would look like without it.

“It’s not a one size fits all category,” Pickett said. “I realize there is Special Ed in schools, but these kids who are in the ABA clinics tend to be the kids who can’t be in a school setting for various reasons. They need more.”

Janet Roepke’s son also received ABA for years. He’s now 22 years old.

“I can’t imagine if it was capped what would have happened,” Roepke said. “Instead, he has graduated from high school, and he’s a pretty content person right now. It wouldn’t have been possible without ABA.”

Allyson Wehlage works as a clinical compliance officer for Behavior Associates of Indiana.

“As long as I have air in my lungs, I will be a voice for these families and these kids,” Wehlage said, “especially the ones who can’t advocate for themselves.”

She worries a cap on weekly access won’t allow her and her colleagues the time to adequately care for her clients.

“I have seen how individualized it really is,” Wehlage said. “If we don’t have the hours and the time to do that, we’re not going to be able to do our jobs.”

Indiana State Rep. Sue Errington (D-District 34) says Indiana House Bill 1414 could provide some relief for families. The bill’s author, Rep. Becky Cash (R-District 25), is the mother of an autistic son who received ABA therapy.

“What their bill would do, it wouldn’t fix things, but it would buy some time,” Errington said.

HB 1414 would require the state to do a study on ABA, publish its findings, and put any ABA changes on hold until the study is complete.

Errington said everyone, including FSSA, wants the best solution for Indiana families.

“They too are concerned and are looking for a solution,” Errington said. “So it’s not like there’s a fight. People are working together to try to find a solution.”

“I am not only asking you to view it from a representative standpoint,” said Herron. “I’m asking for you to look at it from a mother’s standpoint and a father’s standpoint.”

“I want them to know that I’m listening,” Errington said. “I’m doing my homework. I’m hoping that together we can come up with a solution.”

Now through Feb. 14, Hoosiers can submit written comment on the proposed changes.

Emails can be sent to [email protected] with the subject line COMMENT RE: ABA THERAPY COVERAGE.

Letters may also be mailed to:

      FSSA, Office of Medicaid Policy and Planning
      Attention: Madison May-Gruthusen
      402 West Washington Street, Room W382, P.O. Box 7083
      Indianapolis, IN 46207-7083