State urged to boost proposed pay for autism technicians

CARSON CITY — Parents of autistic children and providers of early intervention services urged state officials Monday to increase Nevada's proposed rate of reimbursement for treating low-income children, saying to do otherwise will doom the program to failure and deny vulnerable children essential tools to lead productive lives.

They also told administrators for the Nevada Division of Health Care Financing and Policy that Nevada's proposed $29.61 hourly reimbursement rate through Medicaid does not take into account supervisory costs or national credentials that will be required when the program takes effect next year.

"The national examination goes into effect in December," said Charles Marriot, who provides autism treatment through his Las Vegas company, Autism Care West.

"Every individual is going to have to pass a national exam," he said, adding the requirement will severely limit the number of registered behavioral technicians, or RBTs, who work with autistic children one-on-one.

Nevada currently has fewer than 100 registered behavioral technicians and will require many more to help meet the demand once services are extended to Medicaid recipients.

Jan Crandy, with the Nevada Commission on Autism Spectrum Disorders, said the state will need thousands of new technicians to handle the increased caseload.

"We need an incentive for people to move here," she said.

Other states, critics said, have much higher Medicaid reimbursement rates. Washington state, for example, is $44 per hour; Virginia, $60; and California, about $52.

But state officials have said the new program will have multiple payment codes that will allow providers to bill for services in addition to the rate for technicians.

Chris Holcomb, a behavioral analyst and speech and language pathologist in Las Vegas, said Tricare, the military insurance program, reimburses at $50 an hour.

Gov. Brian Sandoval made funding for autism programs a priority in his 2015-2017 budget, increasing total spending to $73 million from $10 million in the previous, two-year budget cycle.

There are an estimated 6,000 children in Nevada diagnosed as autistic. The Medicaid program would cover about 1,879 low income children, with the costs shared with the federal government.

Barbara Buckley, executive director of the Legal Aid Center of Southern Nevada and former speaker of the Nevada Assembly, applauded the governor and legislators for the effort to make autism programs available to poor children.

But she said those efforts cannot be realized if there are not enough professionals to provide service.

"We have a chance to do this right," Buckley said. She suggested money could be found within the budgeted amount to raise the reimbursement rate and urged state officials to keep looking.

Comments made during Monday's workshop will be considered before the state submits its Medicaid program plan to the federal government for approval.

Contact Sandra Chereb at schereb@reviewjournal.com or 775-687-3901. Find her on Twitter: @SandraChereb