Bill calls for increase in autism services reimbursement

Apr. 9—A House bill to increase funding for autism services by requiring the state Department of Human Services to seek additional funding sources and maximize federal matching funds continues to move through the Legislature.

A House bill to increase funding for autism services by requiring the state Department of Human Services to seek additional funding sources and maximize federal matching funds continues to move through the Legislature.

DHS' Med-QUEST division covers Applied behavior analysis (ABA ) services for people with autism up to 21-years-old. But med-QUEST patients are sometimes unable to access the services because of a lack of providers. HB 2712, which passed out of the Senate Way and Means Committee Thursday, calls for an increase in reimbursements for ABA services in an effort to attract more providers.

DHS Director Cathy Betts said in written testimony that a rate study for ABA services at the low end would require $6.5 million ($2.69 million state funds and $3.81 million federal ); and at the high end, $9.4 million ($3.9 million state funds and $5.5 million federal ).

Josliene Miller, BAYADA behavioral health service area director, said rates for ABA have not increased since 2015, despite the increased cost of living and increased costs for employers.

Miller said BAYADA has "struggled to meet the needs of children with autism on Med-QUEST due to the increased costs of operating a business without increased rates for our services."

"Wages have gone up nearly 30 % since 2015 in Hawaii, forcing businesses to shoulder the cost without proportionate rate increases, making it harder to attract candidates and businesses to the field of supporting individuals with autism and their families, " Miller wrote.

State Rep. Lisa Marten, (D, Kailua-Lanikai-Waimanalo ), said she introduced HB 2712 to allow younger people with autism to get the appointments they need.

Young people under 21 with autism, Marten said, need ABA services in order to "function more independently and more successfully ; currently, they're not able to access them because we do not reimburse providers enough for them to be willing to provide that service."

"If we don't do it, we are penalizing Medicaid recipients, " Marten said.

Meagan Ferguson, a 26-year-old mother in Makiki, has two sons who have been enrolled in ABA therapy through Medicaid. Ferguson enrolled her 2-year-old son, Cameron, who has "autism level three, which means it's the most severe and he needs a lot of attention and specialized care, " at Easterseals Hawaii.

"Like many other ABA providers, Easterseals Hawaii has struggled to recruit and maintain essential staff for our programs because of these wage and cost pressures, " Easterseals Hawaii said in written testimony. "Increasing Med-QUEST ABA rates will alleviate pressure on programs like ours and enable us to more effectively serve the community so that Hawaiians with I /DD (intellectual /developmental disability ) can acquire skills that enable them to live their best lives."

Ferguson said that she realized the shortage of service providers when her first son was put on a waitlist for 16 months.

Colin Fukami, a parent, also said his 10-year-old son with autism, Joshua, only started receiving ABA services recently from All About Behavior in Kapaa Quarry.

"We had trouble finding someone who wanted to take him even from the very beginning, " Fukami said.

He said he needs to coordinate with his wife, and sometimes needs to leave his job early to pick his son up.

Fukami said more funds for such services can make the workforce more attractive for providers, which could lead to extended clinic hours.

"If more funds are available for ABA therapy, the kids will win, " Fukami said.

Ferguson said that having more funding going towards increasing trained ABA specialists would allow for more clients to have access to the services they need ; it would also "lessen the financial and emotional strain on families, while also helping said clients towards their most enriching and independent lives in a dominantly neurotypical run society."

"Autism has always been around and I feel like just now though, it's starting to become more accepted, " Ferguson said. "We can't ignore them, they need our help. I feel like that's the spirit of the island or it's supposed to be."

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