To stanch the flow, Colorado lawmakers boosted funding for those types of programs by about $10 million, including federal matching dollars, through a midyear budget adjustment in February.

“When you lose those providers, it’s not something that can just come back online easily,” said state Sen. Rachel Zenzinger, an Arvada Democrat and member of the Joint Budget Committee. “Once they’re gone, they’re pretty much gone. … We’re trying to send a signal to hold on.”

Losing providers means fewer people can access the services, she said. Treatment for autism can be a time-sensitive affair, Zenzinger said, and better treatment early on can help set children up to reach their full potential.

But missing that critical window means setting them up for “a lifetime of disadvantage.”

Rebecca Urbano Powell, executive director of Seven Dimensions Behavioral Health, said she watched her waitlist balloon from two months to six months as the industry contracted in recent years. And with low reimbursement rates, she’s lost entry-level staff to Starbucks and Walmart, she said, effectively cutting off entry into the behavioral health workforce before workers can get their feet under them.

“They could choose to work with kids with very severe, dangerous behaviors, or go work at Starbucks as a barista, and make the same — if not more — as a barista,” said Urbano Powell, who also is board president of the Colorado Association for Behavior Analysis.

Facing increasing business costs and limited growth in state funding, Urbano Powell said she’s had to reduce the number of Medicaid patients she sees just to make ends meet — even, she said, as it “violates my own personal values.”

The association estimated a 42% increase in business costs in 2022 and 2023 alone, while reimbursement rates increased just 6.2% between 2019 and 2023, according to a survey of members.

Brian Lopez, founder of the JumpStart Autism Center in New Mexico and a Colorado native, opened a clinic in his home state in 2015. But he closed it about a year ago because, he said, he just couldn’t make the math balance out to keep it open without cutting corners — no matter how he tried to scale up.

It simply cost more to provide appropriate treatments than he’d get reimbursed by the state, he said. While losing clinics has an immediate impact on patients and their families, Lopez worries about the downstream effects if it’s not a sustainable business.

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