The signs of autism began showing for Emma Larson when she was 18 months old.

She began losing speech and some other skills she had acquired. Her temper tantrums got stronger and stronger.

An evaluation by Lincoln Public Schools determined Emma had speech delays, and specialists began working with her one hour a week, said her mother, Terri Larson.

When she eventually was diagnosed with autism, a developmental disability that affects verbal and nonverbal communication, social interaction, behavior and educational performance, the Larsons learned from other experts that Emma could benefit greatly from 25 to 40 hours of specialized therapy a week.

Now, at age 3, she gets only 12.5 hours a week. Getting the full private therapy she needs would cost the family $55,000 a year, said David Larson, Emma’s father.

A bill (LB482) discussed Wednesday by the Legislature’s Health and Human Services Committee would require the state to expand Medicaid coverage of early intervention for autistic children younger than 9.

Sen. Joel Johnson of Kearney, who introduced the bill, said that in Nebraska, 1,400 to 1,500 children younger than 9 have been diagnosed with autism. The disorder occurs in one in every 150 children, according to the federal Centers for Disease Control.

“Autism, we think, is an urgent health concern,” Johnson said. “It’s growing at a rate of 10 percent a year.”

Early intervention, he said, eventually could save the state millions of dollars.

Getting the coverage would require families to meet an income requirement and share some of the costs. Children also would have to make progress on treatment goals.

Chrissy McNair, whose son has autism, said she and her husband, Matt, were excited to learn after his diagnosis that behavioral therapy could help their son to talk, learn, play and connect with other children and adults. But their hopes were dashed when they learned the cost.

It is a tragedy, she said, that the intervention is only available to those who can afford it.

It’s both a moral and a fiscal issue, she said.

The bill could aid 420 Nebraska children over the next five years, said Wayne Fisher, director of the center for autism spectrum disorder at the Munroe-Meyer Institute at the University of Nebraska Medical Center.

Sixty children would be served the first year and the rest phased in by the fifth year.

The lifetime savings with a type of behavioral therapy, in which a therapist asks a child to perform small tasks and then offers feedback to reinforce correct responses, is as much as $2.7 million per child, he said.

With the bill, the money invested by the state would be matched with private and federal dollars.

Gail Werner-Robertson, co-founder with her husband, Scott, of the Sunshine Foundation, which supports families affected by autism, pledged a private sector match of funds.

For every $2 the state commits, the private sector will commit $1, she said.

The bill would require the state to commit $1 million a year for five years from the Health Care Endowment Fund, not the state general fund.

She believes, she said, the investment would show improvements in the children who receive early intervention and savings to the state over the long term.

“If we don’t do something about this soon, we will be facing a cataclysmic funding crisis related to long-term care for these children when they reach adulthood,” Werner-Robertson said.

Mary Steiner, HHS Medicaid director, opposed the bill, saying it was an expansion of Medicaid in conflict with the fundamentals of Medicaid reform.

The bill seeks coverage of services not currently paid by Medicaid for children, many of whom are not eligible for the program, she said. Private insurance and most other state’s Medicaid programs do not cover the services.

Reach JoAnne Young at 473-7228 or jyoung@journalstar.com.