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Utah to Extend Autism Treatment to Children through Medicaid

More Utah children with autism will soon have access to behavioral therapy. The state is preparing to expand its Medicaid program to include autism services.

At the moment, there are fewer than 300 children with autism in Utah who are getting behavioral therapy paid for by Medicaid. Those families entered a lottery for a spot in this limited state program approved by a federal waiver. But Utah is phasing out that program. The Obama administration announced in July last year that standard Medicaid will now cover autism services for children under 21. State health officials estimate that more than 4000 children will be eligible. 

“It’s a very significant change,” says Tonya Hales of the Utah Department of Health. Hales led a public meeting Tuesday to present a draft of the policy change. So many people showed up, they had to put them in an overflow room, but Hales was not surprised. “We know that autism services are close to the heart of a lot of families that are struggling with this issue,” she says.  

Hales also anticipated the many questions and concerns she would hear from families, as well as service providers in the state. Who would qualify, how would they be diagnosed, what services would be covered, and who would provide them? Matthew Heimburger was there to see whether his daughter Lucy might qualify.  Lucy was one of the few who received behavioral therapy through the state Medicaid waiver, but when she turned seven in February, she aged out of the program.

“I was excited to think, well, wait a minute, there’s federal dollars and programs that the state hasn’t been taking advantage of,” Heimburger says, but he was disappointed to learn that his family would not qualify, since this program will only be available to those under a certain income level who traditionally qualify for Medicaid. He says the kind of intensive therapy his daughter was receiving would cost at least $30,000 annually out of pocket.

“So something that’s been a lifesaving therapy for my daughter is now going to be out of reach because we are in the middle income,” Heimburger says.

Utah Department of Health officials are encouraging people to submit their comments on the draft proposal. They hope to have the policy implemented in July this year.

Andrea Smardon is new at KUER, but she has worked in public broadcasting for more than a decade. Most recently, she worked as a reporter and news announcer for WGBH radio. While in Boston, she produced stories for Morning Edition, Marketplace Money, and The World. Her print work was published in The Boston Globe and Boston.com. Prior to that, she worked at Seattleââ
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