Indiana could limit ABA therapy with Medicaid changes

 

SOUTH BEND, Ind.--- A state plan amendment, or SPA, is on the table in the Hoosier state, proposing changes to Medicaid with effects yet to be realized.

The proposed changes would limit how much Applied Behavioral Analysis (ABA) therapy people can receive using Medicaid.

"They're asking for a limit of 30 hours per week, so you can't get any more than 30 hours a week of service, three years. So, if you've had any therapy for three years, you're done," said Kristin Wier with the LOGAN Center in South Bend. "And if you think of this being a lifelong diagnoses, that would be really scary for a lot of families."

This would limit how much therapy kids like 12-year-old Emmerik can receive. His mom, Elizabeth Brennan, sat down with ABC57's Annie Kate Friday, to share her concerns.

"ABA Therapy here at LOGAN is kind of like our lifeline," she said. "The therapists not only help my kid but they help me learn how to teach my kid."

Emmerik has severe autism, so he's non-verbal and uses a communication device. Brennan said he also has a rare genetic disorder.

Right now, she says, he gets about 40 hours of ABA a week

"Basically [he learns] how to function in the world," she said. "ABA helps him to be able to participate in society and to communicate and to use his communication device. ABA is the most important service that he receives."

Brennan read Annie Kate part of a letter she wrote for state lawmakers pushing for these spending cuts.

"These changes prioritize cost savings over human lives, and that is unacceptable," she read. "The message being sent is clear: money is more valuable than people. That is disgusting."

Additional hours of therapy after the caps are reached will only be made available in certain cases. If the changes go through, Brennan says, Emmerik would go from 40 hours a week to anywhere from 15 to zero hours a week.

"And it wouldn't just affect Emmerik, it would impact our whole family," Brennan said.

"These restrictions would be detrimental," Wier said. "And they are supposed to go into effect April 1st of this year, which would be terrifying."

As the chief program officer for therapy services at LOGAN, Wier worries about how this could affect the outcomes of folks living with autism. She says roughly 50 percent of LOGAN clients utilize Medicaid as their primary insurance, but the rest have Medicaid as their secondary.

"All families will be impacted," Wier said. "And it is pretty terrifying for them right now."

The LOGAN Center and families like the Brennans are trying to mobilize folks to give their input on these proposed changes to Medicaid, which are in the middle of a public input period through February 14th.

To comment, email [email protected] or send letters to:

COMMENT RE: ABA THERAPY COVERAGE

Office of Medicaid Policy and Planning

Attention: Madison May-Gruthusen

402 West Washington Street, Room W382

P.O. Box 7083, Indianapolis, IN 46207-7083