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State Autism Profiles: Colorado

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DEMOGRAPHICS

In 2000, 505 or 0.64% of children ages 3-21 who received special education services in Colorado have autism. In 2014-2015, 5,781or 6.23% of children with disabilities ages 3-21 who received special education services have autism.

Table 1-1: IDEA Part B - Children with Autism in Colorado for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

 53

480

Age 6-21

 452

5,301

Age 3-21

 505

5,781

Source: Reported by the State of Colorado in accordance with Section 618 of IDEA to U.S. Department of Education, Office of Special Education Programs

Table 1-2: IDEA Part B - Children with Disabilities in Colorado for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

8,202

12,553

Age 6-11

 34,364

39,323

Age 12-17

32,942

36,371

Age 18-21

 3,207

4,535

Age 6-21

 70,513

80,229

Age 3-21

 78,715

92,782

Source: Reported by the State of Colorado in accordance with Section 618 of IDEA to U.S. Department of Education, Office of Special Education Programs

STATE TASK FORCE

The Colorado Autism Commission
On April 14, 2008, Governor Bill Ritter, Jr. signed into law S.B. 163, which establishes the Colorado Autism Commission. The commission was comprised of 24 individuals, including self-advocates and parents of children with autism, appointed by the governor. The commission was charged with examining the current services offered in Colorado as compared to other states and formulating a 10-year plan to address the needs of the growing number of Coloradans diagnosed with autism. The commission submitted their final report to the governor and General Assembly on October 1, 2009.
http://www.jfkpartners.org/documents/Colorado%20Autism%20Commission%20Report_final.pdf

STATE INSURANCE COVERAGE

On June 2, 2009, Governor Bill Ritter signed into law S.B. 244, requiring insurance coverage for autism spectrum disorders by all plans issued or renewed on or after July 1, 2010. H.B. 13-1266 amended the statute, and now requires coverage of services or visits that are actuarially equivalent to the following dollar limits: coverage for applied behavior analysis (ABA) may not exceed $34,000 for children 8 and under and $12,000 for children ages 9 to 18. The law requires coverage of the assessment, diagnosis and treatment of autism spectrum disorders which is defined to include treatments that are medically necessary, appropriate, effective or efficient and shall include evaluation and assessment services; behavior training and management and applied behavior analysis; habilitative or rehabilitative care, including occupational, physical or speech therapy; pharmacy care and medication; psychiatric care; psychological care; and therapeutic care. (CO Rev Stat §10-16-104(1.4))

Colorado also has a mental health parity law which requires health insurance coverage for the diagnosis and treatment of biologically-based mental illnesses. Autism is not included in the definition of mental illnesses as defined in the statute. (CO Rev Stat §10-16-104(5.5)) A separate provision for autism states that “any sickness or accident insurance policy that provides coverage for disabilities due to sickness shall also provide coverage for autism as with any accident or sickness, other than mental illness.” (CO Rev Stat §10-16-104.5)

On April 16, 2015, the governor signed legislation clarifying the benefits available for autism spectrum disorder in benefit plans issued in Colorado. The legislature approved SB 15 to clarify the state and federal mental health parity application to  provides that ASD is a mental disorder for purposes of state and federal mental health parity laws, and therefore, the benefits for ASD must be no less extensive than the coverage provided for a physical illness; coverage under a health benefit plan for ASD benefits cannot contain any limits on the number of services or visits; and providing benefits for ASD that are substantially equivalent to benefits for a physical illness does not constitute an addition to the state's essential health benefits required under the ACA. The law is effective January 1, 2017.
https://legiscan.com/CO/text/SB015/id/1188476/Colorado-2015-SB015-Enrolled.pdf

Coordinated System of Payment for Early Intervention
On May 15, 2007, S.B. 4 was signed into law to establish the development of a state plan for comprehensive early intervention services in accordance with Part C of the Individuals with Disabilities Education Act (IDEA). The state plan includes an interagency cooperation agreement and the development of a coordinated system of payment for early intervention services for children from birth to 3 years with developmental disabilities or developmental delays. (CO Rev Stat §25.5-1-124)

ESSENTIAL HEALTH BENEFITS

Colorado will offer autism services including applied behavior analysis (ABA) on its state-run exchange. ABA is listed and defined as "Therapeutic Care." Colorado has chosen not to fit ABA into an established essential health benefit (EHB).
(Kaiser Foundation Health Plan of Colorado; Deductible/Coinsurance HMO 1200D)

MEDICAID

Beginning in 2016, Colorado Medicaid covers Pediatric Behavioral Therapies under traditional Medicaid as part of the Early Pediatric Screening Diagnosis and treatment (EPSDT) program. 
Colorado Home and Community-Based Services Waiver
Children with Autism Waiver
Implemented on January 1, 2014, Colorado offers a home and community-based services waiver for children under 6 years old with autism. In order to be eligible, a child must have received a diagnosis of autism by a licensed physician and be younger than six years old. Behavioral therapy services are covered at a maximum of $25,000 per year for 3 years or until the child’s sixth birthday. A maximum of 75 children can be enrolled at any one time. Behavioral therapy performed by a certified behavioral therapy provider is the primary benefit for children enrolled on the CWA Waiver. The child will also receive a Post Service Evaluation to provide data to the family and the state on the child's adaptive behaviors when exiting the waiver. This waiver is scheduled to expire on December 31, 2018.
https://www.colorado.gov/pacific/hcpf/children-autism-waiver-cwa

In 2015, the legislature passed and the governor signed HB 1186 which will eliminate the waiting list for Colorado’s Children with Autism waiver. The waiver is currently limited to 75 clients and has 330 on a waitlist for services. The new law raises the age limit from 6 to 8 years old, guarantees a three year stay on the waiver for children who enroll before their eighth birthday, eliminates the waitlist by allowing the waiver enrollment cap to fluctuate based on need, allows a one-time increase for the annual expenditure from $25,000 to $30,000 and requires annual program evaluation to measure effectiveness. CMS must now approve the plan to eliminate the waiting list.
https://legiscan.com/CO/bill/HB1186/2015
https://www.colorado.gov/pacific/hcpf/eliminating-medicaid-waitlist-children-autism-bill-signed

EDUCATION

Colorado Department of Education

Resources, brochures, fact sheets, and manuals for parents and educators of students with autism are available on the Department of Education website.
http://www.cde.state.co.us/cdesped/SD-Autism.asp

STATE LEGISLATIVE CALENDAR

The Colorado General Assembly meets annually on the first Wednesday of January for no more than 120 days. The 2016 General Assembly session convened on January 12, 2016 and adjourned on May 11, 2016. The 2017 session will convene on January 4, 2017 and is expected to adjourn in May of that year.
http://www.leg.state.co.us/

Sponsors of Autism Legislation

  • Sen. John Kefalas (D-Ft. Collins) District 14
  • Sen. Pat Steadman (D-Arapahoe) District 31
  • Sen. Irene Aguilar (D-Denver) District 32
  • Rep. David Young (D-Denver) District 50

Prepared by Easterseals, Inc.; November 2016.

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