According to state statistics released in May by the Department of Health Care Services, 1,123 children have received behavioral health treatment services, which include ABA therapy as of May 5. That's just 2% of the estimated 76,000 children under age 21 who are enrolled in Medi-Cal and have autism spectrum disorder.
State officials announced autism therapy as a Medi-Cal benefit on Sept. 15, 2014. The coverage is retroactive to July 7, 2014, when federal officials first issued guidance establishing autism therapy as a benefit.
Now, just under a year later, according to state statistics:
- Almost half of California's counties (24 of 58) have provided no behavioral health treatment through Medi-Cal managed care plans;
- 18 counties have fewer than 11 autism cases per county (an exact number can't be released due to privacy issues); and
- The remaining 16 counties provide behavioral services to 943 Medi-Cal managed care children, an average of roughly 59 children per county.
Norman Williams, deputy director of public affairs for DHCS, gave California Healthline an updated estimate on June 10.
"Between 1,500 and 2,000 Medi-Cal managed care members are currently receiving BHT (behavioral health treatment) services, and we expect to have updated numbers soon," Williams said in an email message. "This does not include the approximately 9,000 members currently receiving services from regional centers. Medi-Cal managed care responsibility for BHT services for the majority of these members will occur later this year. The number of individuals accessing BHT services seem in line with other states based upon our discussions with them."
Beyond the rates of coverage, there is another issue plaguing implementation of the autism therapy benefit, according to Kristin Jacobson, executive director of Autism Deserves Equal Coverage. She said the state is insisting on conducting a long diagnostic evaluation of children being considered for coverage.
"There's a long waiting list for that," Jacobson said. "Families are waiting six months to get an evaluation. In some cases the wait time is a year