‘This is an impossible situation’: Medicaid services denied for autism therapy

HENDERSON, Ky. (WFIE) - In Henderson, one mother is speaking out after her son was denied Medicaid services for autism therapy.

Kayla Dunn says her son Lincoln is 9-years-old and has severe autism. Lincoln was diagnosed at the age of two, and his mother says they’ve been utilizing home and community based waivers, funded through Medicaid, to provide extensive therapy for him.

“He’s been on it for about 6 years,” said Dunn. “It’s been a lifeline for him, every therapy he has, every service he has, he accesses through this waiver.”

Kayla explains that Lincoln’s level of care is tremendous, with over 12 hours of speech and behavioral therapy each week. Without this waiver, there’s no way their family could afford it.

“It’s obviously very intense and obviously very expensive,” explained Dunn. “Most private insurances don’t cover it and if they do the co-pays are astronomical so these waivers gives families like ours access to that service.”

Recently though, that access changed.

Kayla says, “It’s worked out great for us for 6 years and then all of a sudden this year all these families with developmental disabilities are being denied.”

The family received a letter in the mail in April that said Lincoln’s Medicaid waiver had been denied.

“I honestly that it was a mistake so I wrote in for a reconsideration, I wasn’t worried about it but that reconsideration was immediately denied in just a few hours,” said Dunn.

Kayla says she’s not alone. Many families across Kentucky have also had their children’s medical waiver denied. She says it doesn’t make sense.

“They’re all being denied based on ‘they don’t meet the level of care requirements’ - but the level of care requirements haven’t changed and their needs have not changed,” said Dunn. “I know my son’s have only increased since he’s gotten older so it doesn’t make any sense that he would not meet the level of care now at nine but met the level of care six years ago.”

She’s hoping to raise awareness and get some answers.

“I’m not letting it go until all these questions are answered, my son has to have this waiver, his health and safety is at risk without it,” said Dunn.

However, those services already have an end date of May 27th, and without them, Kayla says her son’s life will change forever

“These skills he’s worked for years to obtain he will regress without that constant therapy in his life,” said Dunn.

Kayla says her son, along with other children across the state cannot be forgotten.

“To know that my child is going to needlessly suffer, and all these other children are going to needlessly suffer, its a complete and utter failure of the state and it has to be fixed,” said Dunn, “this is an impossible situation they’ve put us in.”

Kayla has filed for an extension of services, however, she has not heard back. She also says an investigation has been opened at the state level into why there’s been an uptick in waiver denials. She’s hoping a federal investigation can take place too.

She’s asking anyone who wants to help to reach out to your local and state legislator to bring more awareness to the issue, and push for a long-term solution.

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