By Megan Hart
August 29, 2016
A Saline County mom has a message for state officials wrestling with a difficult budget: Leave an autism diagnosis program alone.
Allison, who wanted to be identified only by her first name to protect her family’s privacy, said a telemedicine program — funded in part by the Kansas Children’s Cabinet —made it easier to find out if autism was behind her 9-year-old son’s behavioral symptoms.
“It makes it nice when they can do that instead of my husband having to take off work” to take their son to a specialist in Kansas City, she said. “It was kind of shocking that they were thinking of cutting that.”
The autism diagnosis program is one of three under the Children’s Cabinet flagged for possible cuts next fiscal year.
Cuts aren’t guaranteed, because the Legislature crafts the final budget, but administration officials asked Children’s Cabinet staff to submit a starting budget for fiscal year 2018 with 5 percent cuts to the autism program, a child care quality initiative and the early childhood block grant.
The three programs would lose a combined $833,181 if the Legislature approves that budget. The Legislature already approved $3.3 million in cuts to Children’s Cabinet programs for the current fiscal year.
If another round of budget cuts goes forward, even fewer families will get services, said Lee Stickle, director of the Autism and Tertiary Behavior Supports project under the state’s Technical Assistance Support Network.
The budget cuts this fiscal year mean the project will serve about 20 fewer kids than the 140 it helped to get appointments with autism specialists last year, Stickle said. A projected 5 percent cut for next fiscal year to the project’s roughly $43,000 budget would reduce services even more, she said.
“We anticipate seeing between 15 and 20 percent fewer kids,” she said.
The Children’s Cabinet uses the Children’s Initiatives Fund to make grants to organizations working on youth health, education and development. The Children’s Initiatives Fund money comes from a 1998 settlement with large tobacco companies to compensate states for health costs associated with smoking.
Four other state agencies also oversee funding for children’s programs, but most haven’t released details on potential budget cuts. The Kansas State Department of Education has said that it doesn’t plan to make cuts to Parents as Teachers or the Kansas Preschool Program.
A diagnosis, closer to home
The diagnosis program pays to train local teams in underserved areas of the state to screen children for signs of autism spectrum disorder, Stickle said. If the screening shows the child might have autism, they pay for a specialist at the University of Kansas Medical Center to meet with the family via telemedicine to make a diagnosis, she said.
After a formal autism diagnosis, children are eligible for some support services through Medicaid, and most commercial insurers will pay for speech therapy and other interventions, Stickle said.
Without telemedicine, some families have to wait months to see an autism specialist in Kansas City or Wichita, she said, or they can’t make the trip at all.
“That is such a critical time in the life of a child,” she said. “Any delay (in starting therapies) compounds the issues they’re going to have.”
Allison said the experts asked questions about her son’s behaviors and decided to have him take a different medication for his attention deficit hyperactivity disorder before making a diagnosis. They will see him again if the symptoms haven’t resolved and his teachers still suspect autism, she said.
“I hope they don’t find anything, but if they do, it’s good” to have the diagnosis, she said.
Reduce services or numbers?
The child care quality initiative also would lose almost $22,000 next fiscal year under the proposed cuts, bringing its budget to about $408,000. The additional cuts would leave its budget 18 percent lower than in fiscal year 2016, when it received $500,000.
Child Care Aware of Kansas administers the grant, which it uses to train child care providers and early childhood educators on how to identify stresses in families that could lead to child abuse or neglect, said Leadell Ediger, the Salina-based nonprofit’s executive director.
Providers receive training and support as they engage more with families and can apply for small grants to fund events with parents, Ediger said.
The idea is to encourage parents to take an active role in their child’s learning and reduce any feelings of isolation, Ediger said. Providers invite families to attend low-cost or free social events where they can play with their children and meet other parents, she said.
“It is showing that they’re not in this alone,” she said. “Together, we’re building a community that can learn to support each other.”
The initiative paid for about 60 providers to participate last year, Ediger said, but could only take 40 providers this year. She isn’t sure how many it could take with an additional 5 percent cut.
“We would just not be able to provide them the level of service we had in the past, or their sheer numbers would have to be reduced,” she said.
‘It goes on and on’
The largest cut, in raw numbers, would be to the early childhood block grant, which would fall by more than $800,000 to about $15 million. The block grant already lost about $2.3 million since fiscal year 2016.
That year, grants were made to Kansas schools and nonprofits to offer pre-kindergarten classes, developmental screenings and home visits to about 10,000 children in 63 counties, according to a report from the Children’s Cabinet.
Janice Smith, executive director of the Children’s Cabinet, estimated the programs were serving about 2,000 fewer kids following the cuts and would serve about 125 fewer if the 5 percent cut for FY 2018 moves forward.
The Children’s Cabinet typically makes the same percentage cut to every organization receiving money from the early childhood block grant, Smith said, but it may not do that because of the risk of losing funds for programs that receive matching federal grants.
In June, organizations that used their grants for matching funds learned they wouldn’t face cuts, while those that didn’t took a 14 percent cut.
The Children’s Cabinet submitted an alternative budget that would undo this year’s cuts, but even its supporters acknowledged it has little chance of getting through, given the state’s persistent revenue shortfalls.
The Legislature likely won’t resume work on the budget until January, unless Gov. Sam Brownback were to convene a special session. Still, Smith said she hopes the early discussion will help organizations to prepare for the possibility of more cuts.
“I wanted to make sure people are aware of it,” she said. “One of the advantages of having advance notice is you can make plans to cope.”
Stickle said programs eventually reach the point where they can’t avoid cutting services and reducing the number of families they serve, however. That can be particularly difficult for families with a child who has autism, because they often use multiple types of services, she said.
Losing diagnosis services “is one of the first ways the cuts hurt some of these families,” she said. “But it goes on and on for them.”