New Clinic Provides Medical & Dental Care For Developmentally Disabled

By Sara Bridget Au

Imagine if you had to take your child to the doctor, but none of the physicians in your neighborhood, your side of town, even in the whole city, would see him. In fact, the closest doctors willing to treat him were in Gainesville, Tampa or Miami.

If you have a child with moderate to severe autism, you probably don’t have to imagine it.

“And if you think getting medical care is hard, dental care is impossible!” rues Robert E. Wright, Ph.D., RN and CEO of the Threshold Center for Autism on Goldenrod Road. “The medical field has not fully caught up with its responsibility to captain the healthcare ship for all people.”

So Wright is setting out to captain that ship himself. This month, he’s opening a medical and dental clinic designed with the specialized equipment to treat even the most severely handicapped or developmentally disabled patients. These people, many of them children, are often non-verbal, at times physically violent and destructive to property. The Threshold Medical & Dental Center is the first of its kind in the nation, to Wright’s knowledge, and he knows the business model is set up to lose money.

The hole in the system through which many of the developmentally disabled fall is smack in the middle of the tangled web called Medicaid, which ironically is supposed to be a safety net for the most vulnerable people in our society.

It often takes two to five times longer to diagnose and treat the developmentally disabled, such as those with moderate to severe autism, for which physicians are reimbursed below cost via Medicaid. “That works out to virtually no pay at all – a physician can’t do that and stay in business,” Wright explains.

While he understands that business decision, during his five-years at Threshold he’s been continually frustrated in his efforts to care for the twenty seven autistic individuals who live fulltime at the center, the others who attend classes there, and the eighteen thousand children and adults in the state on the Medicaid wait-list for services. There was the time a doctor stood in the doorway and attempted to diagnose an illness without even touching the child. Another time, a doctor simply walked out of the room, threw the patient’s chart at his assistant and said, “You know we don’t take care of these people here.”

For Wright, faith is a family trait, and the frustration is personal. His brother, Ben, 43, has both a severe form of autism and cerebral palsy. When Ben was born, Wright’s parents, Teena and Ben Willard, were told to “put him in an institution and forget you had this child.” While the Willard’s instead kept and loved Ben, and eventually founded Threshold in 1976, many other parents in the same situation did what the doctors told them. One such “forgotten child” is Susan, now in her 40’s and a resident at Threshold since it opened. Wright says her parents actually had another child and named her Susan, as if their first daughter never existed. Wright says with the explosion of autism diagnoses, currently one in every 150 children, there is another huge hole in the system: caring for autistic adults. Wright observes, “Eighteen to 70 is a whole lot longer than zero to 18.”

The new Threshold Medical and Dental Clinic will treat people with any kind of disability, as well as their extended family and any others who walk in the door. “We will be prepared for the worst cases, and so we can deal with anything less,” Wright states. “Because the divorce rate after an autism diagnosis is 95%, we will also provide counseling for parents and siblings. We’re here for the entire community.”