Utah's Medicaid Autism Waiver Program is open for enrollment

SALT LAKE CITY (ABC 4 Utah) - Finding one-on-one help for a child with autism is very expensive and rarely covered by insurance, but here in Utah there's another option for families.

The Department of Health's Medicaid Autism Waiver Program is now open for enrollment. It provides in-home therapy for about 290 children ages two through six.

The waiver program started as a pilot program two years ago, but was so successful this year lawmakers turned it into an ongoing program. ABC 4 Utah spoke with one mother who called the program a godsend.

Jandee Jones was running out of options for therapy for her son Isaac. Isaac is 5-year-old. He was diagnosed with autism when he was 20 months.

"I was kind on at a place where I knew he needed something every day, but our insurance wasn't covering it and the private options were just really expensive,” explained Jones.

A therapist who comes to your home can run upwards of $150 an hour and Jones told ABC 4 Utah one school she looked at cost as much monthly as their mortgage.

Then their pediatrician recommended the Medicaid autism waiver program.

Jones said, "Now with the waiver the interventionist comes and actually does them with Isaac every day for 3 hours. It has been a heaven send."

In the year he's been in the program Isaac has seen some big improvements.

“He's made big gains in, first, vocabulary. He's learned a lot of new words,” said Jones. “He's followed a routine better and just being able to be more regulated. Regulated is the word I’m using for not having a melt down all the time."

Isaac isn't the only one seeing improvements. The Utah Department of Health says almost all of the children in the waiver program have seen major growth especially when it comes to their vocabulary.

Department of Health Spokesperson Tom Hudachko told ABC 4 Utah, "You hear from a lot of these families who have a child that is 3, 4, 5 years old that wasn't speaking, and they spend several months or a year in this program, and all of the sudden their child is speaking with them verbally and that is a milestone that a lot of these families never thought their children would see."

There are only 35 spots available, but applicants are not selected on a first come, first serve basis. If more applications are received then there are spots, a lottery system will be used. Applications are due by Sunday, May 18th.  

To be eligible for the program, a child must have a clinical diagnosis of ASD and be a Utah resident with a date of birth between December 1, 2007 and May 31, 2011.  The child must also not have assets (bank accounts, trust funds, etc.) of more than $2,000 in his or her name. Unlike traditional Medicaid, a parent’s income and assets are not considered when determining the child’s eligibility.  Children currently enrolled in traditional Medicaid will not be automatically eligible for the program and will need to apply.  

Applications can be submitted online at www.health.utah.gov/autismwaiver.  Parents can also print the application and submit it by fax (801-5360153) or by mail (UDOH, PO Box 143112, Salt Lake City, UT 84114).

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