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July 5, 2015

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What happens when a decision by regents to save money undermines Nevada’s quality of life

J. Patrick Coolican

J. Patrick Coolican

Rachelle Reynolds has two autistic boys and saw how their quality of life was improved by occupational therapy, which helps the disabled or people undergoing physical or cognitive changes become active and independent.

So she enrolled at the College of Southern Nevada, hoping to learn how to become an occupational therapy assistant.

As I reported last year, the program faced the loss of accreditation because the college couldn’t find a person qualified to run the program and another to coordinate students’ field work.

Now the Board of Regents is moving to eliminate the program, which is the only one of its kind in the state, after CSN couldn’t fill the necessary positions.

(The final line of that column last year was “Someone, please fix this.” That should show you how much influence I have.)

Last year, there were more than 75 openings for these jobs. Employment of occupational therapy assistants is expected to increase 43 percent nationwide between 2010 and 2020, and the jobs pay an average of $32.81 an hour in Nevada, according to the Bureau of Labor Statistics. The need is particularly great in Southern Nevada because we have a significant population of autistic children and disabled residents and — as with most medical specialties — not enough therapists to treat them.

It was a small program, with an average of nine graduates per year. But this feels like a more significant failure for a couple reasons.

First, Gov. Brian Sandoval’s prudent and humane decision to expand Medicaid — the government health insurance program for the poor and disabled — means that we’ll soon need more health care providers to meet the new demand. The failure to ameliorate the shortage of occupational therapy professionals doesn’t augur well for that future.

Second, we’re desperately trying to diversify our economy beyond tourism. A simple way to do so is to expand our health care capacity because we have a shortage of it in Nevada. In our new economic development strategy, the Nevada System of Higher Education is supposed to play a key role identifying needs and tailoring programs to fit them. Here we have a need, and the system isn’t providing the training needed to fill the empty jobs.

As a result, health care providers will have to look out of state, where applicants will be able to require higher salaries because of the demand here, which will push up costs for all of us.

An economic development source was blunt about this failure: “It’s a total fail. Penny wise and pound foolish.”

Darren Divine, vice president for academic affairs at CSN, told me that occupational therapists with the right credentials to become program directors generally make more than $90,000 in the private sector and between $65,000 and $75,000 to run college programs. He could only offer $62,000. The system does give administrators some salary leeway to recruit in hard-to-fill areas like health sciences, but Divine said if he bumped up the salary in one program, he’d face a pay equity situation in the other 19 health science disciplines.

Marcia Turner, vice chancellor of the Nevada System of Higher Education for health sciences, said she was disappointed: “It’s so unfortunate.”

Recruiting qualified personnel in the health sciences is difficult because they can make much more money in the private sector.

She told me the system is working closely with the governor’s office and the new economic development regime’s health care initiative. They’re trying to align academic programs with what’s needed in our health care market and then reaching out to high school students and displaced workers to educate them about the opportunities available.

The elimination of the occupational therapy assistant program is indicative of a financially challenged system, she said, while promising to consider starting the program anew if opportunity arises.

“We’ll keep it on our radar,” she said.

That’s cold comfort for Reynolds, who now is studying to become a physical therapy assistant. She’s happy with that but feels a twinge of regret about not being able to go into occupational therapy.

“It’s still kind of painful,” she said. She had wanted to give back to the community of caregivers who had helped her two sons, Sebastian, 8, and Eli, 6.

She’ll still get to work with kids, but not the autistic children with whom she could have given so much skillful therapy because of her experience with her two boys.

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  1. Simple: Life suffers.


  2. Continuing the "Too bad, so sad" meme she could move to another state...Arizona, California, Oregon, Washington, Idaho or Utah...take the courses and move back to Nevada. Except that she would likely find that the occupational license she requires would have some unique Nevada course required like Nevada Law and Regulation of Licensed Assistant Occupational Therapists offered by UNLV at some outrageous tuition with a large cut for the UNLV Department of OvertheTop Athletics. Then she'd have to pay bribes to Metro to get a work card and bribes to the State for the license [renewable every time we change our minds]. You ever wonder why people don't move back here?

  3. Please note there is a difference between an occupational therapy assistant (OTA), which requires a 2 year associate's degree, and an occupational therapist (OT), which requires a master's degree. Touro University (a private school) offers the only master's OT program in Nevada. UNLV does not have either an OTA or OT program.

  4. It is really simple. Stop spending more per capita on everything up north (from roads to education) and we could probably continue this program and many like it, without raising taxes.

  5. Article explains the SOP of Nevada's DHHS. Expanding Medicaid while not paying the providers.... Expanding Medicaid without authorizing cost of services for recipients--the doctors need to make enough to see those patients. What DHHS does results in insured and cash patients paying more to cover losses and spirals the ever-increasing costs of health care and insurance. I remain extremely skeptical about anyone labelled "autistic." Almost seems like if the doctor isn't absolutely sure what is wrong, here comes that label. And there is NO WAY that taxpayers can cover cradle to grave 24/7 for soooo many people with that label. We're going to reach a point where it is hopeless and just eliminate everything but subsistence in group homes for anyone medically disabled or medically unable. It's as if the K-12 people and the "health"-care providers are using the same script--baffle them (taxpayers) with b.s. and they will fund everything.

  6. Mr. Miller: In general, there is NOT more per capita spending "up north." Mucho mega-bucks federal funding goes DIRECTLY to City of Las Vegas and County of Clark where parallel funding for much of the rest of the State is funneled thru the State of Nevada. Has something to do with population in the City, population in the County. I'm not aware of a convenient link. It would take research into federal funding formulas and reading the fine print in public laws. OMB Circulars A-87, A-133...and on and on and on. One could start with CPS--Local Vegas gets direct aide while everyone else goes thru State DHHS programming. Pros and cons to this--like Vegas pays Social Workers MUCH MORE than State of Nevada does.