Doyle wants cut in help for autism
10:50 PM 5/11/03
JR Ross Associated Press

The cost of a state program providing free intensive in-home therapy to children with autism exploded from $2,363 in 1994 to almost $32 million last year as the number of children diagnosed with the developmental disability grew, according to the state Department of Health and Family Services.

Experts say Wisconsin followed a national trend over the past decade in which autism became a more common diagnosis in children. But officials also say roughly 10 percent of the children in Wisconsin's autism program moved here from other states to take advantage of the state's expansive autism services.

Gov. Jim Doyle has proposed scaling back the program to serve a little more than one-fourth of the almost 1,100 children currently receiving intensive in-home therapy as Wisconsin grapples with a budget deficit.

But his proposal includes no residency requirements to prioritize who gets services first, and the parents of older children who would no longer receive the intensive in-home therapy say the plan leaves their children behind.

"We can't just leave these kids," said Deb Mandarino, whose 9-year-old daughter Lainey now receives in-home therapy under the program. She moved to Fitchburg from Rhode Island to get her daughter into the program.

Autism, typically diagnosed by age 3, affects the brain's normal development in the areas of social interaction and communication skills. A decade ago, it was estimated only about four per 10,000 children were affected; research now suggests it may be 10 times higher, but the cause is unclear.

Under the current program, children can receive 25 to 35 hours a week of intensive in-home therapy until they turn 16. That includes one-on-one attention from therapists who work with the children on skills such as communication and socialization.

Doyle originally proposed eliminating the intensive in-home therapy portion of the autism program in his budget plan after the federal government notified Wisconsin the program would no longer qualify for federal aid that covers 60 percent of the cost.

Doyle said Wisconsin could not afford the therapy on its own because of a $3.2 billion budget deficit for the period through June 30, 2005. Doyle, a Democrat, planned to eliminate the program as one of the many spending cuts he proposed to fix the shortfall.

That plan would have left about $4 million a year to pay for other autism services such as occupational and speech therapy through community and school programs.

He changed his mind and presented a scaled-back version of the program after parents of children who are autistic appealed to him to keep it. The state has applied to the federal government for help in paying for it.

Doyle spokesman Dan Leistikow said the governor's quandary over the program illustrates the difficult decisions forced by Wisconsin's fiscal woes. The program Doyle proposes is expected to cost $66.5 million over the next two years; if the current program were left intact, it was projected to cost close to $90 million.

He stressed that under Doyle's proposal, older children would still be eligible for limited in-home therapy as well as community and school based programs. But Doyle focused the program on younger children because research shows they benefit the most from intensive therapy.

Doyle's proposal would limit the program to three years of in-home therapy for children between the ages of 3 and 7. They would need to show progress to remain in the program, and their parents would pay for some of the therapy.

The revamped program would serve 250 children.

The federal government will not allow Wisconsin to establish a residency requirement. But if the program fills up, the state can use residency as a factor in prioritizing children on waiting lists for services.

Kermit Bergs of Madison said the intensive in-home therapy was crucial for his 16-year-old son, Alex, who used up his eligibility for the services in March.

Alex had to be restrained four to five times a day just three years ago. He would stomp his foot until it broke and has broken a window with his head. He needed the one-on-one attention the service provided him at home that he wouldn't have received in a school setting, his father said.

Kermit Bergs would like to see a residency requirement for the state program so Wisconsin children are not forced to wait for the services while those who move in just to qualify for the program get the treatment.

Bergs is continuing private therapy for his son in the hope he will someday be able to make his own lunches, bathe himself and cross the street safely.

"We're not looking at trying to get our kid into college. We're just trying to get him to the functioning level of a 10-year-old," Bergs said.

Leistikow said the state believes the new program would be sufficient to ensure no Wisconsin child is forced to wait for services.

Wisconsin does not track the number of autistic children. But the number of students with autism as their primary disability increased from 443 in the 1994-95 school year to 2,580 last year, according to the Department of Public Instruction.

The Madison School District had 232 students with autism this year compared with two in 1994.

Jack Jorgensen, executive director of educational services, said parents as far away as Ireland and Spain have asked about Wisconsin's services for children with autism. He said much of the recent increase in autistic children in the district stems from those moving in from elsewhere.

Mandarino and her husband, both doctors, discovered Lainey was autistic in 1997 and moved to Wisconsin after researching the quality of its autism program.

Mandarino said she hates the thought of denying any autistic child the state service.

"You see a face on that kid waiting to come in and it's so sad," she said. "They're desperate."