92 - Co-Locating an Autism Diagnostic Clinic Within a Federally Qualified Health Center Increased Evaluations

Publication Number: 1084.92

Rusha Lev, University of Colorado School of Medicine, Golden, CO, United States; Daniel E. Spiegel, Soar Autism Center, Denver, CO, United States; Ana Flores, Denver Health, Denver, CO, United States; Abigail Wischkaemper, Soar Autism Center, Denver, CO, United States; Misty M. Manzanares, Denver Health, Denver, CO, United States

Background: At a large Federally Qualified Healthcare Center (FQHC) network in Denver, Colorado, we see the demographic change in autism as reflected by improved identification, outreach and access to services for historically underserved groups. Autism diagnosis is challenging due to resource limitation, insurance coverage, referral logistics and language/cultural barriers. In 2024, we hired an autism referral navigator to better serve our population with autism diagnostic services and ABA therapy. In 2025 we partnered with a co-located autism center in one of our pediatric clinics with the goal that 75% of the patients are FQHC patients.

Objective: To demonstrate that integrated care for autism allows for increased access, equity and early diagnosis in an FQHC setting.

Design/Methods: A full-time navigator was hired in 2024 to facilitate pediatric referrals for autism diagnosis and ABA therapy. Referral rates increased and referral demographics reflected our diverse population. In 2025, we began a relationship with Soar Autism Center, a local autism diagnosis and ABA provider. We evaluated referrals in our 0-5-year-old population from 2024 and compared them to those in 2025. We analyzed the patients evaluated by Soar from January through September of 2025. We compared this to the demographics of the pediatric FQHC patient population.

Results: Referrals in 2025 increased compared to 2024. Demographics of those referred did not significantly change and reflect the FQHC pediatric population. Males are over-represented in referrals, making up 70%, in line with national trends. 82 children were evaluated in the first 9 months of 2025 by the co-located Soar clinic and 95% of the children evaluated were FQHC patients. Average time to diagnosis was 107 days, decreasing to 79 days in the most recent 3 months, and the majority were diagnosed by age 3. Referrals to Soar did not change year-to-year, representing 30% of the total for pediatric patients age 0-5.

Conclusion(s): An integrated care system for autism at a large FQHC increases access to timely care allowing a diverse patient population with multiple barriers to traditional pathways for autism diagnosis to receive care. Demographics of referred patients reflect the changing face of autism diagnosis. A navigator can help negotiate language and insurance barriers, assist families with paperwork and logistics and close the loop with primary providers. Co-locating an autism clinic builds upon this support network that includes the clinic staff, pediatric providers and the navigator, fostering high rates of early autism diagnosis in traditionally underrepresented populations.

Table 1
Demographics of patients referred for autism testing ages 0-5 in 2024 and 2025

Table 2
Time from referral to diagnosis in this co-located clinic. This compares favorably to recent research presented at the 2023 CMS Health Equity Conference, "Wait Times and Processes for Autism Diagnostic Evaluations: A First Report Survey of Autism Centers in the U.S.", which surveyed 111 diagnostic sites across 14 states. They found that "Neary two-thirds of centers (61.26%) had wait times longer than 4 months, with 15.32% reporting waits of over one year, or waitlists that were so impacted they were no longer accepting new referrals"1
1. Kraft, Colleen, et al. Wait Times and Processes for Autism Diagnostic Evaluations: A First Report Survey of Autism Centers in the U.S. 2023.