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Lawmakers scale back ambitions on autism treatment after bills come out with multimillion-dollar price tags

Michelle Rindels
Michelle Rindels
Health CareLegislature
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Lawmakers are scaling back several bills on autism treatment services that were initially estimated to cost up to $80 million every two years but may now come at no extra cost to the state.

Democratic Sen. James Ohrenschall presented an amendment on Thursday to SB174, which originally sought to raise the Medicaid reimbursement rate from $31.30 to at least $48 an hour for registered behavioral technicians who deliver intensive therapies to children with autism. Advocates say Nevada’s relatively low rate has made it difficult to recruit and retain practitioners to the field, leading to long waiting lists for the treatment.

Ohrenschall’s changes nix the rate increase but retain a call for a legislative audit of autism treatment delivery in Nevada. The study seeks to determine why the state appears to be serving only a fraction of the 8,500 Nevada children who are believed to have autism.

“Understanding that there are a lot of budgetary demands this session and that the rate increase may not be able to happen, I’m hoping that the audit would be something this committee would consider,” Ohrenschall said. “I think it’ll give the 81st session and the Legislature during the interim very valuable information about where needs are being met for kids on the spectrum in this state, and where needs are not being met.”

It wasn’t the only autism-related bill to be scaled back because of budget constraints.

An amendment to SB202, a bill sponsored by Democratic Sen. Marilyn Dondero Loop, eliminates a requirement that the state ensures that children with autism receive all services for which they are eligible. It also eliminates a provision that calls for a single assessment to determine a child’s eligibility for state autism and special education services; those can sometimes require a separate medical and educational diagnosis.

Now, the bill requires that the state provide information about the services it offers to districts, which can pass that along to parents of children in special education programs. It also calls for an annual report from districts on how many children have individualized education programs, and what diagnoses those children have.

The state initially put a high price tag on the bill based on the assumption that it would need to do proactive outreach to all of the children in the state who have autism and then connect or provide them with services such as Applied Behavioral Analysis through the state-run Autism Treatment and Assistance Program (ATAP) or Medicaid.

SB174 is headed to a vote of the full Senate, while SB202 awaits a vote in the Senate Finance Committee before it can proceed through the rest of the legislative process in the remaining four days of the session. Though it appears lawmakers will not provide the tens of millions needed to enact the bills as written, advocates for children with autism will likely see some improvement in their quest for treatment.

Gov. Steve Sisolak proposed in his budget to add $7 million to ATAP in the coming biennium to eliminate a wait list that numbered 444 children at the end of 2018.

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