Las Vegas Sun

August 1, 2014

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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  1. Unions, causing lost jobs, as usual. They are starting to get what they deserve. Ask the teachers, making beans, paying dues, getting nothing in return. The Fireloafers have the best deal, the Culinary does help a low paid industry, but other than that, NADA. How are the Union construction jobs doing?

  2. The unions have ZERO to do with this! The early intervention workers must have advanced degrees in child development. The salary they are currently paid does not even cover basic living expenses not to mention student loans. Take a look at those job listings. Not a whole lot of money in it.

    Remember the situations these workers also must go into. The poor little boy who died in his family car in the driveway at 3 years old was one of those clients and his childhood development teacher went to court to say how filthy the home was but not entirely unusual for the caseload.

    Federal law requires home visits because it is these visits that prevent childhood deaths. Our state already has a high rate of death by abuse we can't push it any higher.

    Our state needs highly qualified child development professionals. Non-profits are well intentioned and do a good job - but they can also go away. Look at how many homeless youth have no services because of a scandal at the top. Every non profit is one scandal away from having to cut services. Health and welfare are duties of the state and we need the state to fix its problems.

    We all benefit when children enter school with the appropriate level of services. My oldest son has autism. Today in high school he is in the regular classroom. This never would have happened if it were not for the early intervention services that took my little boy who could not talk at age 2 and helped him break through that.

  3. As a humane and civilized society, we must support those who are less fortunate, the weakest links in our chain, because strength lies with the WHOLE chain supporting the weight of life. We can all do our parts. Our government system has identified children services worthy of support, and to CUT that support, reduces the ability for society to function at its fullest.

    These vulnerable beings only have the voice of those who have such compassion. When we assist our community and country's children, we can be assured of a better future.

    Blessings and Peace,
    Star

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