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Utah kids get a second chance at free autism therapy

Published June 18, 2013 8:42 am

Lottery will decide next 35 patients of a pilot Medicaid program.
This is an archived article that was published on sltrib.com in 2013, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Children who lost out in the first lottery have a second chance at free autism treatment, or applied behavior analysis (ABA) therapy, paid for by a pilot program under Medicaid.

The Utah Department of Health has openings for 35 children and is taking applications through July 12. The slots will be assigned to different regions of the state based on population and filled via a lottery, not on a first-come, first-served basis.

The pilot is one of three testing the benefits of ABA; advocates hope it will sway insurers to cover therapy.

It ended the year with extra money because it took about six months to get providers enrolled, said health department spokeswoman Kolbi Young.

To avoid children aging out of the program before receiving a full year of therapy, the Legislature extended it to 6-year-olds. The two-year pilot was originally designed to serve children through age 5.

The extension has eased frustrations for Cami Egelston, whose son turns 6 this summer.

"We've just been grateful from the get-go to have treatment, so we've tried to be patient and careful about getting all the paperwork in on time so we could start therapy as soon as possible," said the South Jordan mom.

Egelston describes her son as high functioning. This year he enrolled in kindergarten and received speech and occupational therapy through the public school system.

He started his 12 hours of weekly ABA therapy in February and has made significant gains in four months, she said. "He had some fine motor struggles and was wanting to write more, which he's doing now because he has the confidence. He's off the charts in reading now and learning to control some of his anger and outbursts."

The program pays for therapy and respite care for families.

To be eligible, a child must be a Utah resident with a date of birth between January 1, 2007 and July 31, 2011.

Unlike with traditional Medicaid, there is no income test. But to qualify, a child may not have assets (such as a bank account or trust fund) of more than $2,000 in his or her name.

Children enrolled in traditional Medicaid are not automatically eligible for the program and need to apply.

Applications must be received by Friday, July 12. Parents can apply online at health.utah.gov/autismwaiver. Or they can print the application and send it by fax to 801-536-0153 or by mail to: UDOH, P.O. Box 143112, Salt Lake City, UT 84114.