Indiana
Families say autism therapy helped their kids. Indiana's Medicaid cuts could put it out of reach
INDIANAPOLIS — Shaunna Thompson was running out of childcare options. Her daughter Abbie was expelled from daycare in 2022 because of “all over the place” behavior. Thompson found an in-home provider for the toddler, but was told Abbie was “too much” to watch every day of the week.
The experiences motivated Thompson to seek assistance for her daughter, who also was missing developmental milestones. Abbie, now 3, was diagnosed with autism spectrum disorder in October of last year.
By March, Thompson enrolled her in applied behavior analysis — a therapy based on learning and behavior focused on improving communicative, social and motor skills — at a local facility in northern Indiana for 40 hours a week. Abbie, nonverbal most of her life, has since said her first word: “Mom.”
“It brought tears to my eyes” Thompson said.
But Thompson and other families reliant on Medicaid worry changes coming in January will limit access to the therapy as Indiana attempts to limit the cost and, along with other states, cut the size of the low-income health care program.
Indiana’s Family and Social Services Administration said the cost of Medicaid reimbursement for the behavioral therapy, commonly referred to as ABA, has ballooned in recent years because of the growing number of children seeking the services and the amount that providers have billed the state. The state plans a universal, hourly reimbursement rate for the therapy, but the planned amount is lower than what providers have previously received on average.
Advocates and centers worry this will mean accepting fewer patients or even closing, as has happened in other states such as Colorado this year.
Elijah Hill plays with his letter while sitting in the floor of his room, Saturday, Dec. 11, 2023, in Westfield, Ind. Families reliant on Medicaid worry changes coming in January will limit access to the therapy as Indiana and other states cut the size of the low-income healthcare program. Credit: AP/Darron Cummings
“Companies just kept leaving and it just kind of turned into a crisis situation,” said J.J. Tomash, who leads an ABA provider in Colorado called BehaviorSpan. He blamed Medicaid reimbursement rates that have not kept up with the cost of living.
Medicaid began covering the services in 2016, and providers in Indiana set their own rates until now. But centers say the new rates are still not enough to keep them running and are far below the previous statewide average of $97 per hour.
Indiana Act for Families, a coalition opposing the new rates, said the proposal is 10% below providers’ operating costs. Although Indiana has said the new rates are aligned with pay in other states, the coalition argued the state used outdated data in their comparison.
Miles Hodge, owner and co-founder of Shine Pediatric Therapy in Indianapolis, said the effects of the new rates will take their toll over time. The state said the rates will be up for review every four years, a time frame Hodge said does not keep up with inflation.
Elijah Hill looks outside of his bedroom window, Saturday, Dec. 11, 2023, in Westfield, Ind. Families reliant on Medicaid worry changes coming in January will limit access to the therapy as Indiana and other states cut the size of the low-income healthcare program. Credit: AP/Darron Cummings
“It could leave a lot of people underwater,” he said.
About 6,200 children and young adults received the services under Medicaid in 2022, the state said.
With a standard patient to therapist ratio of 1-to-1, ABA is an “extremely staff intensive model,” Hodge said. Across the state, he expects staff pay and benefits to be hit, which he said could lead to high turnover and inconsistent care for patients.
Hodge predicted his center will have to take fewer patients who are on Medicaid because of the changes.
The Indiana agency overseeing Medicaid said the therapy is the only major service category that did not have a uniform reimbursement rate, and the rising cost of the services was unsustainable. ABA expenditures increased more than 50% per year for the last three years, according to the agency.
In 2022, ABA claims represented $420 million in Medicaid spending, the state said. Total Medicaid expenditures in state fiscal year 2022 totaled more than $16 billion.
The move comes at the same time as states unwind pandemic-era protections that kept millions of people covered by Medicaid. In Indiana, the number of people enrolled in Medicaid steadily grew every month from March 2020 until May 23, when the federal budget law ended the protections.
Indiana’s total enrollment has fallen every month since then.
States setting universal rates is common, but low reimbursement endangers access to key services for individuals with disabilities, said Jennifer Lav, senior attorney with the National Health Law Program.
Lower rates in a time of high inflation can lead to staff turnover and shortages, issues that can compound in rural areas, she said.
ABA is not without critics. Zoe Gross, advocacy director at the Autistic Self-Advocacy Network, said ABA’s goal is to eliminate behaviors considered autistic and teaches children to conform with neurotypical behaviors.
“It teaches you that the way you naturally behave is not OK,” she said.
But families who have found it helpful find it hard to imagine a future without access.
In Westfield, a suburb of Indianapolis, 29-year-old Natasha Virgil said her family’s ability to participate in activities outside their home markedly improved once 6-year-old Elijah Hill began ABA therapy.
“My biggest thing is making sure that he has a fighting chance to be able to live in this world and have the skills to survive,” Virgil said, holding her 4-month-old daughter and watching Elijah play with soap bubbles near the family’s Christmas tree.
It’s difficult already for parents of children with disabilities to hold jobs between numerous therapy sessions and doctor’s appointments, Virgil said.
“I don’t think I would ever be able to be where we are if we didn’t pursue ABA,” she said
Chanel McClure, mother of 2-year-old King, said she has lost sleep over the pending change. She interviewed multiple centers before finding the ABA therapy she wanted for King. He was on a waiting list for another 11 months.
Now almost 3, King is nonverbal and attends speech, occupational and developmental therapy. Since beginning ABA, McClure said he has learned new ways to communicate and is comfortable playing with other children. His therapists are working to address elopement or wandering that can be common in children with autism.
“King just bloomed like a flower,” McClure said.
Podcast: IU football is 6-0, and no one wants this to be the end
Insiders Zach Osterman and Mike Niziolek break down the Hoosiers’ 41-24 win over Northwestern.
EVANSTON, Ill. — Indiana football defensive end Mikail Kamara knows how much Curt Cignetti loathes handing out praise.
Kamara has been with Cignetti going back to 2020 as the first verbal commitment for James Madison’s coaching staff during that recruiting cycle.
There’s a small window when Cignetti lets down his guard after games — just a tiny bit — and that happened Saturday in the wake of IU’s 41-24 win over Northwestern. It was the type of gritty victory that was missing from IU’s resume, and after the game he had to admit something he doesn’t like to put out in the public.
“We are 6-0 as a football team, proud of the team up this point,” Cignetti said. “Which I’m not supposed to say.”
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Kamara said that sentiment will be a distant memory once the team gets back to Bloomington as everyone turns their focus to Nebraska, but that small bit of praise from Cignetti was still a meaningful moment given the high bar of success he sets.
“It’s like we are playing so well he has no choice but to tell everybody,” Kamara said with a chuckle.
The final 12 minutes of the game is what Cignetti will remember the most from Saturday.
Indiana’s offense kept on putting points on the board, but the defense struggled to come up with a stop for much of the second half. Northwestern quarterback Jack Lausch orchestrated a six-play, 61-yard scoring drive early in the fourth quarter and got the crowd on their feet with a 47-yard completion to Bryce Kirtz that was the team’s longest play of the day.
The Wildcats’ upset hopes evaporated after that.
Indiana starting quarterback Kurtis Rourke connected with the team’s leading receiver Elijah Sarratt three times on the ensuing drive to get right back into the red zone where Ty Son Lawton rushed his seventh touchdown of the season.
Rourke and Sarratt connected again to convert on a 4th-and-5 late in the quarter to set up another score.
The Hoosiers defense swarmed Lausch on Northwestern’s final two drives — they had four quarterback hurries from four defenders — and the secondary locked things down. Lausch was 6-of-15 during that stretch and barely avoided turning the ball over on a near-sack from Kamara.
“I really liked the way we finished the game on defense with the last two drives,” Cignetti said. “I really liked that a lot, that was awesome.”
Indiana is the first team in the FBS that is bowl eligible. That wasn’t mentioned at the podium by Cignetti and it wasn’t uttered in the locker room either.
The Hoosiers have national title aspirations — not a typo — and Cignetti loves that there will be people doubting his program every step of the way. He would much rather players lean into that than read any positive coverage about the team’s historic start.
Indiana is 6-0 for only the second time in program history (1967) and haven’t trailed for a single second.
“I’m not concerned with them reading about their accolades on social media and the paper cause they have been around the block a little bit,” Cignetti said of his veteran team. “They’ll be reading a lot about how we aren’t good enough to do this and that. I want the chip on their shoulder to keep growing, is what I want.”
Michael Niziolek is the Indiana beat reporter for The Bloomington Herald-Times. You can follow him on X @michaelniziolek and read all his coverage by clicking here.
Indianapolis (Ind.) Warren Central edge rusher Damien Shanklin revealed his commitment to Brian Kelly and the LSU Tigers in early July.
Then, just weeks after announcing his pledge to the Bayou Bengals, Shanklin doubled down on his commitment to Kelly’s program.
The four-star EDGE took to social media to announce he would be shutting down his recruitment entirely and remain locked in with LSU.
Shanklin will not entertain other colleges or college coaches with all focus shifting to the Early Signing Period in December where he will put pen to paper with LSU.
“I will be closing my recruitment,” Shanklin said. “I’m 1000% committed.”
LSU currently boasts America’s No. 3 recruiting class with 26 commitments in the 2025 cycle to this point.
Now, LSU EDGE coach Kevin Peoples has made his way to Indiana to check in with the state’s top prospect in Shanklin.
Peoples was on the sidelines watching his future edge rusher in person during the open date while on the road checking in with recruits.
LSU On300 edge commit Damien Shanklin with a QB pressure. Future position coach Kevin Peoples is in Indianapolis tonight watching him. https://t.co/93di3OJKA0 pic.twitter.com/R4Gq9rvEIB
— Steve Wiltfong (@SWiltfong_) October 4, 2024
The most recent commitments come in five-star prospects (DJ Pickett (No. 1 CB) and Derek Meadows (Top 10 WR), Aidan Anding (4-star CB), Kade Phillips (4-star CB) and more.
Pickett is rated as the No. 1 cornerback, according to both On3 Sports and 247Sports while Meadows is locked in as a five-star wideout in the 2025 class, according to 247Sports.
It’s a talent-rich class with Shanklin serving as a major recruiting tool for the program. Once he verbally committed to LSU, he took to social media to become an advocate for the Tigers on “The Trail”.
Who makes up LSU’s 2025 recruiting class? A look into a few headliners:
Bryce Underwood: No. 1 Quarterback in America
Height: 6’4
Weight: 215 pounds
The Rundown, per On3 Sports: “Bryce Underwood made an immediate impact on the varsity level as a freshman at Belleville (Michigan) High School. Underwood threw for 2,888 yards and 39 touchdowns with only four interceptions. He also added six rushing scores in his freshman season to lead Belleville to a state championship. Underwood was named the Michigan Associated Press Division 1-2 Player of the Year after the stellar first season. He then led Belleville to a perfect 14-0 record and another state title in 2022. Underwood threw for 2,762 yards and 37 touchdowns as a sophomore. To make things even more impressive, Underwood could technically be a 2026 prospect, but he’s completing school early as part of the 2025 class.”
Harlem Berry: No. 1 Running Back in America
Height: 5’10
Weight: 182 pounds
The Rundown, per On3 Sports: “St Martin’s Episcopal School coach Marcus Dizer isn’t shy about heaping on the praise for Harlem Berry. ‘In all my years, I have never coached or seen a better player than Harlem,’ Dizer said. Through his first two seasons of varsity football, Berry had 4,723 all-purpose yards and 67 touchdowns. He also won the Louisiana 1A state titles in the 100 (10.57) and 200-meters (21.43) during his sophomore year. As a sophomore, Berry rushed 193 times for 2,237 yards (11.6 yards per carry) and 37 touchdowns. During his junior season, he was named the Greater New Orleans Quarterback Club player of the month in September after rushing for 805 yards and 16 scores – in just four games. ‘He’s brilliant,’ Dizer said. ‘We do not win games without him.’”
DJ Pickett: No. 1 Cornerback in America
Height: 6’4
Weight: 180 pounds
The Rundown: Per 247Sports, “Lanky two-way playmaker that allows the mind to get pretty creative when it comes identifying potential roles, but warrants a look as a field corner given one-of-a-kind frame and quick-twitched lower half. Measured right around 6-foot-4, 180 pounds the summer before senior season, making him one of the tallest defensive backs to come out of the high school ranks in recent cycles. More notably, came in with a near 6-foot-8 wingspan. Has dominated rural Florida-based competition the past few years, making an impact as both a wide receiver and a deep safety. Has what it takes to emerge as a true game-breaker on offense with his size and foot speed, but ability to generate turnovers with his advanced ball skills while also mirroring in reverse makes him an intriguing option in both man and off-coverage.”
Derek Meadows: Five-Star Wide Receiver
Height: 6’6
Weight: 205 pounds
The Rundown: Per 247Sports, “Meadows is a jumbo receiver and one of the more intriguing players in the ’25 class. He has a rare combination of size, athleticism and body control and is only scratching the surface of how good we think he can be. At 6-6, 200 pounds and an 80” wingspan, he’s a matchup nightmare for smaller defensive backs and should be an immediate red zone threat. He can run as well and is one of the region’s top track athletes although a hamstring injury has limited him this Spring. He was the Gatorade Track and Field Athlete of the Year as a sophomore and is one of the region’s top hurdlers. He has a big frame and it wouldn’t shock us if he eventually grows in to a pass catching tight end who would be lethal working against linebackers and safeties down the middle of the field.”
Carius Curne: No. 2 Interior Offensive Lineman in America
Height: 6’4
Weight: 320 pounds
The Rundown: Curne is a late bloomer on the gridiron after starting his playing career just three years ago in the ninth grade. Fast forward to the end of his junior campaign and he’s blossomed into the top-ranked interior offensive lineman in the country with the chance to play defensive line if need be. Curne, the No. 1 player in Arkansas, is a game changer that will elevate the LSU offensive line for years to come.
Charles Ross: No. 10 Linebacker in America
Height: 6’0
Weight: 200 pounds
The Rundown: Ross is a fast-rising prospect in the 2025 cycle with an opportunity to continue elevating his status for the long haul. He’s launched from a player outside of the Top 300 to a Top 100 recruit due to his sheer speed and athleticism at the second level. The speedster is a dominant athlete on the track and it carries over to his game on the field.
Tyler Miller: Top 10 Interior Offensive Lineman
Height: 6’5
Weight: 315 pounds
The Rundown: Laurel High coach Ryan Earnest isn’t afraid to brag about Tyler Miller. “His size, his strength and he’s just freakishly athletic,” Earnest told the Hattiesburg American about Miller, who led Laurel to the Mississippi 5A title game in 2023. “He presents some problems for people on the other side of the ball. And we’re never afraid to say that we’re just going to run behind him and let him pave the way. That’s how talented he is.”
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Follow Zack Nagy on Twitter: @znagy20 and LSU Tigers On SI: @LSUTigersSI for all coverage surrounding the LSU program.
INDIANAPOLIS (WISH) — Each and every Saturday, WISH-TV highlights a local company together with our partners at Indiana Grown.
This week, Josh and Mindy Ellis from Modoc Gardens join News 8 at Daybreak!
Modoc Gardens, located in Modoc, an hour east of Indianapolis, is a small family farm that focuses on using environmentally friendly and sustainable practices to produce beautiful flowers and agricultural experiences available to the area.
The Ellises say the gardens offer many activities, including a sunflower trail, a petting farm, a pumpkin patch, play areas, and a pick-your-own flower garden.
Many events are open to the public, but the gardens also host private affairs such as weddings, birthday parties, and more. The Ellises say they are currently booking private events for the 2025 year, which can be done on their website.
To learn more, visit their Facebook, and enjoy the full interview above!
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