Up until now, autism was not covered by health insurance in Utah, but that’s about to change. Treatment options available in the state are adapting to the new policies. One partnership is going to expand the number of children with autism who can be treated.
Last year, the legislature passed a bill that says Applied Behavior Analysis – an intensive and often expensive treatment for autism - is medically necessary. By next year, certain types of insurance companies and Medicaid will be required to cover it. In preparation for this change, Utah Autism Academy will be taking over management of Clear Horizons Academy in Orem.
“This will just allow us to reach more families and more kids with autism,” says Tricia Nelson, Executive Director of Utah Autism Academy. Until now, Clear Horizons has had to rely on the ability of family members and donors to pay for the play-based autism treatment that it provides. That meant they had to cap enrollment at 45. But now they are merging with Utah Autism Academy in order to shift to the evidence-based treatment that will be covered by insurance or Medicaid.
Nelson says staff will be trained and certified in this treatment model, allowing them to triple enrollment, and also triple its employees. That sounds good to Jon Owen, President of the Utah Autism Coalition and father of a child with autism. Owen is concerned that when families suddenly have insurance coverage, there won’t be enough providers to handle all of them.
“It’s something we’d like to see all around the state in a way, Owen says. “I don’t know where all the caregivers are going to come from to provide the therapy for the kids who need it.”
Medicaid will cover autism services for children under 21 in Utah beginning this fall. State health officials estimate that more than 4000 will be eligible. And starting January 1st, Utah law will require plans on its individual and large group insurance markets to provide coverage for autism.