By John Friedlein/Sentinel-News Staff Writer

John Hudson is breaking out of his autistic shell. His mother, Annette, thanks a Medicaid-funded program for the improvements, so she was disappointed when she found out administrators decided to deny him services.

The 3-year-old Simpsonville boy's case is part of a larger paring down of the Medicaid rolls.

John is one of many autistic children who have received letters saying their services will be cut off. Now clients must be worse off medically and their families must have lower incomes for them to receive services.

Emergency regulations went into effect April 4 to tighten Medicaid eligibility requirements to lower costs. John, however, was denied under the old regulations. The head of the Medicaid department serving him said he was not denied because of cost cutting, but because he and others like him had been added to the program by mistake.

The timing of the cuts coincided with the realization of these mistakes.

Annette, however, blames the denial on a government effort to balance the budget.

During an appeals process, John is still receiving a home-based service called Behavior Intervention for Autistic Children. A BIFAC therapist comes to the Hudson's home 18 hours a week to work with John. Activities include sorting shapes and working on speech skills.

Children with autism have trouble putting words together, often spin in circles and isolate themselves socially. Annette Hudson thinks John got autism after suffering a 106-degree fever from an immunization shot.

If people with autism do not receive services while young, they run a risk of being institutionalized. "Early intervention is the key," said the Hudson's lawyer, Gwendolyn N. Snodgrass.

Since the home visits began earlier this year, John's condition has markedly improved, his mom said. "They have really done wonders with him," she said.

John was non-verbal when he started the program, expressing himself with squeals and screams. Now he no longer bangs his head and can say some words.

"He's doing excellent," Hudson said. She expects further improvement if he continues in the program.

If administrators deny the Hudson's appeal, Annette and her husband, Michael, will pay for as much as they can with their own money.

Her goal is to bring John's development to a point where someone could not pick him out as autistic in a regular classroom.

In his free time, John likes to watch videos and play, especially on a backyard Jungle Gym. "He's a sweet boy," his mom said.

John has been getting about $3,000 worth of services each month. The Hudsons received the denial letter April 11 and she appealed the case last month.

John received services through a plan called Impact Plus. Some Impact Plus clients had been mistakenly referred to the program, said David Hanna, director of the Medicaid division for mental health and mental retardation services. Medicaid is a federal program administered by the state.

Hanna said his agency became aware of the problem of some clients receiving the services when they should not have been about the same time as other cost cutting measures.

"This was completely unrelated to cost cutting," he said.

People like John have lost this service because a medical professional has decided it is no longer medically necessary. Someone would qualify under the stricter requirements, for instance, if he or she was being fed through a tube, Annette Hudson said.

Snodgrass believes lawmakers should be working to make sure there is enough funding to continue programs like the one John receives. She said a General Assembly statute states lawmakers have given a high priority for funding programs that serve those with developmental disabilities.

"Legislation is the key," Snodgrass said.