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SB 12-159 - Services for Children With Autism Under Medicaid Waiver Program

SB 12-159 - Services for Children With Autism Under Medicaid Waiver Program

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Published by: Senator Mike Johnston on Apr 02, 2012
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04/02/2012

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DRAFT 3/27/2012 9:23 PM For a complete list of fact sheets, visitwww.mikejohnston.org/in-the-legislature.
Office of Sen. Mike Johnston
Colorado General Assembly | 200 E. Colfax Avenue | Denver, CO 80203 | 303.866.4864
F
ACT
S
HEET
M
EMORANDUM
 
SB 12-159
Services for Children with Autism Under the Medicaid Waiver ProgramSen. Hudak & Rep. Kerr
Staff Name
: Gaby Corica
What the Bill Does
:The Home- and Community- based Services for Children with Autism Act (Act) applies to children who
are eligible for the state’s Medicaid program
and are from zero to age six who have been diagnosed withautism and are at risk of institutionalization due to the severity of his/her condition.
1
The Act provides
services to autistic children like speech, physical, and behavioral therapy, depending on the child’s care
plan.
2
No eligible child may receive services in an amount in excess of $25,000 annually.
3
 The Department of Healthcare Policy and Financing (DHPF) is responsible for adopting the rulesnecessary to implement and administer the provisions of the Act.
4
This responsibility includes anongoing evaluation process of each eligible child.
5
Under SB 12-159, an eligible child receiving servicesunder the Act is to be evaluated upon entry to the program, upon every six months while enrolled in theprogram and upon leaving the program. The DHPF is permitted to use an external evaluation contractor
for these purposes. Such evaluations must, at minimum, contain assessments of the child’s expressive
and receptive communication, adaptive skills (including self-help skills), and finally an assessment of the
severity of the child’s maladaptive behavior (including the child’s self 
-injurious/aggressive behavior).SB 12-159 explains that the Act is funded by the Colorado Autism Trust Fund (Trust) and resourceswithin the fund are limited. Therefore, the bill proposes that the DHPF will annually review the availablebalance in the Trust to determine whether additional eligible children may be provided services. Further,because funds are limited, the DHPF is to first ensure that services under the program are being directedtoward children with significant intellectual or adaptive impairments in addition to a diagnosis of autism.The bill also clarifies that money from the Trust may be used to pay for these evaluations.
Colorado Context
:In order to apply for the program, the child must first go to a Community Centered Board (CCB) to be
evaluated. CCB’s provide case management services and assessments necessary for the waiver. An
1
 
See
C.R.S. §25.5-6-802
2
 
Id.
at §804(1)
3
 
Id.
at §804(2)
4
 
Id.
at §804(8)
5
 
Id.

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