Colorado has lost dozens of autism clinics as state struggles to shore up funding

Ahead of a December budget hearing, written responses from HCPF to lawmakers noted “well-publicized provider departures from the market” but disputed that there had been an overall decrease in providers. The department also said it was working on a “comprehensive review” of the benefits and market trends affecting provider costs.

The growing role of private equity investment firms also complicates matters, HCPF warned, as firms buy up providers and close down autism services when they don’t hit profit goals.

HCPF cited a national report from the Center for Economic Policy and Research that found private equity firms “move in and skim funds to pay high salaries to executives and outsized returns to private equity partners.” The study did not cite any Colorado-specific impacts but noted that many of the firms it looked at operate in dozens of states.

While some budget committee members were “agnostic” to ownership structures of autism providers, as one put it, Sen. Jeff Bridges was more skeptical. While the Arapahoe County Democrat ultimately voted to increase funding, he worried it would set a precedent that investment firms could demand money to pad profits to their liking — and hold autism services hostage to do so.

“To me, it feels like a monopoly,” Bridges said. “There’s a real problem here if private equity is coming in here and doing what they did to other markets to autism providers. If those folks are getting in the way, then we absolutely have to take the fight to them.”

Trade groups — local and national, with some private equity businesses among their members — say it still comes down to sustainable funding for services, whether it’s private equity firms that strive for scale or smaller operations.

Cremonie-Fernandez, from the national trade group, praised Colorado for pursuing a rate study.

With inadequate reimbursement rates, “there is a risk of smaller providers having to exit the network and larger multistate providers being able to remain,” she said. “It’s more concerning for small providers not to have adequate rates.”

But Ortengren, Ethan’s father, worries about people like his son who get caught in the middle.

Colorado has proven to be a game-changer for his family. He worries about what will happen to them — and families in similar situations — if funding isn’t sustainable for providers.

“People like Ethan can’t really advocate for themselves,” Ortengren said. “It’s up to the rest of us to do it for them. They don’t have a voice like the rest of the population, and it makes them a target for cutting the budget.”

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