Help is on the way for autistic children in Nevada who have been desperately waiting for treatment and therapy.
The Centers for Medicare and Medicaid Services has informed states that Medicaid will now cover autism services under Early and Periodic Screening, Diagnostic and Treatment coverage, expanding access to programs for families in need.
The covered therapy, known as applied behavior analysis, is currently provided under the state’s Autism Treatment Assistance Program, and addresses communication and behavior, said Julie Kotchevar, deputy administrator with the Nevada Division of Aging and Disability Services.
“It’s a life-changing decision that will have a wide-reaching impact on these families that saw their children deteriorate while they sat on the wait list and will now have options,” Barbara Buckley, executive director of the Legal Aid Center of Southern Nevada, said of the federal change on Friday.
As of Thursday, the state’s program was serving 344 autistic children, with 477 on the wait list, Kotchevar said. State officials believe that about 40 percent of the children being served by the state’s program will be eligible for the benefits under Medicaid, while the remainder would continue to be covered by the state.
The federal decision to expand Medicaid coverage to autism services is expected to reduce the wait list, although state officials don’t know how quickly that will happen. That will depend on how soon Nevada prepares a plan for implementing the federal changes.
The backlog began when the program started in 2009, state officials have said. The program gets referrals from multiple sources, including families, schools and health care providers.
“We are very excited that Nevada will have the opportunity to give more children treatment,” Kotchevar said. “I think it will make a significant difference.”
The Nevada Department of Health and Human Services and the Nevada Division of Health Care Financing and Policy will hold a public workshop at 9 a.m. Sept. 15 at the Sawyer Building, 555 E. Washington Ave., to inform the community of the changes.
Buckley, whose organization had been working on the issue, said the Legal Aid Center sent a letter to the state earlier this summer requesting that it consider this change in anticipation of the federal government’s decision to cover some treatment for autistic children.
At the public workshop, issues around medical coverage policies, provider qualifications and reimbursement rates will be discussed. Kotchevar said officials are trying to spread the word about the workshop to parents.
The workshop is an important first step, but there are many more steps, Buckley said. For example, it still needs to be determined how many hours of therapy each child will be eligible to receive under Medicaid.
The treatment “needs to be well-thought out, and it needs to be tailored to the child’s needs,” she said. “If it’s not tailored to what the child needs, then it will not be successful.”
Buckley’s organization is working with state officials to set a date for enacting the new coverage, which she would like to see happen within 90 days. Other states are looking at 60 to 90 days to roll out the new coverage, she said.
Nevada originally said it would maybe take a year, Buckley said.
“We are understanding, but a year is just not acceptable for these children, so we will be pushing them to do it at the very earliest that can be done,” she added.
Her organization has been receiving complaints from parents who were getting letters from the state saying “autism spectrum disorder is an uncovered condition,” so her office will be addressing that with the state.
Jan Crandy, chairwoman of the Nevada Commission on Autism Disorders, said she would like to see Nevada follow in the footsteps of California, which will roll out Medicaid coverage for autistic services at the beginning of 2015.
Without treatment, 90 percent of autistic children will need some type of support the rest of their lives, but with treatment, 50 percent of children will live normal lives, Crandy said.
“We could make it happen soon, especially for the kids who are on the wait list,” she said of the new Medicaid coverage.
Nevada has been encouraged by the changes so far.
“We want it to be right, and we want it to help people,” Buckley said.
Contact Yesenia Amaro at firstname.lastname@example.org or 702-383-0440. Find her on Twitter: @YeseniaAmaro.