In his State of the State, Gov. Steve Sisolak committed to reducing the waitlist for autistic children waiting for assistance programs, but autism advocates say there’s a much bigger issue that needs to be addressed.
The governor’s budget pledges an additional $5.3 million in state and federal funding over the biennium to address the waitlist for services related to the Autism Treatment and Assistance Program (ATAP), a statewide program created to assist parents and caregivers with the cost of providing autism-specific treatments to their child.
Autism treatments are typically tailored to the needs of individual children and can be expensive. For example, applied behavioral analysis (ABA) teaches new behaviors, redirects repetitive or negative behavior, and uses positive reinforcement to build progress in children with autism. It is widely regarded as the most effective early intervention treatment for autistic youth.
Elimination of the ATAP waitlist has long been on the wishlist of autism advocates. But in the long run, advocates believe the only way to get autistic children in Nevada the services they need is to increase the low Medicaid reimbursement rates for registered behavior technicians (RBTs), the paraprofessionals who administer ABA therapy.
“Eliminating the waitlist is great, it’s something we’ve been working very hard to eliminate for a long time, but that is only servicing kids that do not have Medicaid,” said Bailey Bortolin, outreach and policy director for the Nevada Coalition of Legal Service Providers. “It’s taking a step for some kids, but it’s not taking a step for other kids who are the most in need.”
Nevada has the fourth lowest Medicaid RBT rate. Most states pay an average of $16 an hour more than Nevada does. This has led to a lack of providers. Advocates say getting prior approval for ABA treatment and finding a provider willing to accept Medicaid often takes months.
The Nevada Commission on Autism Spectrum Disorders is joining with several community groups, service providers and families in supporting a bill to increase Medicaid reimbursement rates for RBTs.
The bill will be carried by State Sen. James Ohrenschall (D-Las Vegas), who passed a bill in 2009 requiring private insurers to cover up to $36,000 a year in autism therapies. Gov. Jim Gibbons signed that bill into law.
Advocates say the lack of behavioral interventions for children with autism spectrum disorders can prevent them from leading independent, meaningful lives and in some extreme cases lead them to run-ins with the criminal justice system.
As of December, approximately 290 children in Nevada were receiving ABA services through Medicaid. The Nevada Board of Education estimates about 8,500 children have some form of autism spectrum disorder; an estimated 30 percent of them qualify for Medicaid.
Additional funds are expected to cover a projected 239 children on the ATAP waitlist over the next two years. ATAP funds treatment for children diagnosed with Autism Spectrum Disorder from 18 months through 19 years of age.