At least one center that provides specialized therapy for children and young adults with autism has already closed in South Carolina, and others are in fear that they may have to make the tough decision to do the same.
Debbie Wardell owns and runs SC Interventionists out of Horry county.
She said because of new certifications that are being required, she's already lost four valuable employees.
Also, she's not taking on any new clients because she said medicaid isn't paying enough to reimburse providers for the money they are having to put into these new certifications.
"To know that I'm making an impact in children's families lives, I take that seriously," Wardell said. "To be told that I have to do with what they are giving me, it becomes impossible. Unfortunately that means I have to make tough business decisions."
Changes went into effect July 1, 2017. The South Carolina Department of Health and Human Services is expanding coverage to medicaid beneficiaries ages zero to 21, removing limits for treatment, and increasing medicaid reimbursement from $13.58 an hour to $17.28 per hour.
However, Wardell said it's not enough to continue operating her business the way she had been.
"A lot of children are not going to reach their therapeutic potential, and that is sad," Wardell said.
Wardell has no plans to close SC Interventionists, but she said changes will have to be made.
"This is my world and I will make it work, but unfortunately, it's not going to be the community it once was," Wardell said.
The medicaid rate for South Carolina ABA therapists, even with the increase to just over $17, is still one of the lowest compared to the national rate of around $43, according to Autism Speaks.