Las Vegas Sun

May 24, 2015

State Government:

Nevada may push more children’s services onto community groups

Unable to provide services to the state’s youngest children with physical and developmental disabilities, the state is considering shifting more of the responsibility to nonprofit community providers.

State officials acknowledged Tuesday that the state’s Early Intervention Services, serving newborns to 3-year-olds, had been out of federal compliance for years because it is not providing children with as many services as they need.

Possible solutions include steering more children toward nonprofits, which can provide the services cheaper, per child, than the state, according to a new study. In the past, such moves have been opposed by state employee unions.

“I’m not sure how much more time we can spend thinking it’ll work with the status quo,” said Assemblywoman April Mastroluca, D-Henderson. “We need to figure out a better way. We need to do it quickly because these families can’t wait.”

Lawmakers and the governor cut Early Intervention Services — which serves children with autism, Down syndrome and other developmental delays — to save money last year. As a result, the state failed to provide all the services children needed as much as 75 percent of the time in some counties.

Additionally, a cost-saving plan passed by the Legislature in 2011 to provide services at clinics, rather than in homes, violated federal law, an internal investigation found.

As they wait for the agency to figure out a long-term solution, lawmakers on Tuesday approved transferring more than $600,000 from different accounts to keep services at current levels through June 30.

Senate Majority Leader Steven Horsford said he wants a new plan by June to bring Nevada into federal compliance.

The state is required to evaluate children within 45 days and start services to those eligible within 30 days. Federal law also requires the state to provide all the services caseworkers believe are necessary.

Mary Wherry, deputy administrator of clinical services at the state Health Division, said the state is considering pilot programs in the north and south that would shift most services to community partners. The state would pay a fixed rate for children receiving services and hold an oversight role.

The state currently provides early intervention services to 2,500 children. Most children are served by state workers and therapists contracted by the state.

Others are referred to community nonprofit organizations such as Easter Seals.

A cost study released in June found that such organizations can provide services cheaper than the state. The average cost to nonprofits was $511 per child per month. The state’s average cost was $607 per child.

The state pays nonprofits $565 per child.

State employee unions opposed legislation last year that would have encouraged the state to rely more on nonprofits.

Vishnu Subramaniam, chief of staff of the state chapter of the American Federation of State, County and Municipal Employees, called past legislation “over-reaching.”

“What is most important is what best serves the children of our state,” he said Tuesday. “We look forward to seeing such a plan.”

Sen. Ben Kieckhefer, R-Reno, said the state should focus on getting services to the children who need them.

“At this point, it seems like utilizing the community providers is the best way of accomplishing that,” he said.

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