Nevada senators considered three bills Wednesday that aim to increase access to autism-related services in a state where waitlists for diagnostic and therapeutic resources number into the thousands at some facilities.
Senate Bill 174 would increase reimbursement rates for registered behavior technicians, mental health providers who work with children with autism to teach social skills. The rate increase would bring hourly reimbursements from about $31.31 an hour to $48, the median of 34 states, according to testimony from Bailey Bortolin, who represented the Legal Aid Center of Southern Nevada.
The move constitutes an effort to retain existing providers and draw new ones to Nevada. The state is ranked at the bottom consistently for access to mental health services.
“The problem comes down to the fact that we simply do not have enough registered behavior technicians,” said bill sponsor Sen. James Ohrenschall, D-Las Vegas. “These changes would not only make the … profession more attractive, they would almost make Medicaid reimbursement rates more competitive with that of private insurance.”
$18 million for two years
Parents of autistic children testified in support of the bill, who said early intervention for their children helped them get jobs and drive cars as they grew older.
The state’s Division of Health Care Financing and Policy in the Department of Health and Human Services projected the increase would cost just more than $18 million over the biennium, $6.4 million of which would come from the state general fund.
The bill would also call for an audit of the programs that cover autism-related services to identify gaps in service coverage. Bortolin said the audit could provide “clear and answers and a path forward” to address those gaps.
Senate Bill 202 would require the state health and education departments to collaborate to report on barriers that might keep children from accessing autism-related services through Medicaid or the state’s Autism Treatment Assistance Program.
The reporting requirements would necessitate two additional administrative assistants, which the division estimated would cost about $178,700 for the biennium, more than $89,000 of which would come from the general fund, according to a fiscal note.
It would also require departments to coordinate so that only one evaluation is required to determine a person’s eligibility to participate in state programs such as the Autism Treatment Assistance Program, which provides financial assistance to cover some costs of therapies on a sliding scale basis depending on family income.
“The goal of this bill is to make life a little easier for families,” said bill sponsor state Sen. Marilyn Dondero Loop, D-Las Vegas.
With parent or guardian consent, the bill would allow state departments to share information about students in an effort to allow state officials to conduct outreach to families with an autistic child and share information on available services.
That outreach, which the state health department estimated would span nearly 8,500 children and their families — tripling the agency’s caseload — would cost an estimated $48 million over the biennium and more than $66.8 million in future biennia.
A third bill, Senate Bill 216, would create through statute the Nevada Commission on Autism Spectrum Disorders, which was previously created through an executive order by former Gov. Brian Sandoval.
The creation of a permanent commission would require additional staffing, which the state health department estimated would cost nearly $131,000 over the biennium, according to a fiscal note.
Gov. Steve Sisolak included an additional $5.3 million for autism services to address long waitlists and access to resources through the Autism Treatment Assistance Program in his budget proposal.
The CDC estimates about 1 in 59 children nationwide have autism.