We, as a community of providers of behavior analytic services, parents that are recipients of the services, and advocates of such services, strongly oppose all proposed Medicaid cuts. After three legislative sessions (2017, 2019, and 2021), the 97153 RBT rate was increased to a reasonable rate. However, the rate was still not commensurate with those across the United States. Given the significant cuts to medical providers for medically essential services, families will continue to encounter limitations to access such services due to a variety of factors, which include, but are not limited to:
-Reducing the 97153 and 97155 rates at the BCBA and BCaBA level will all but eliminate access to services to our state's large rural communities and substantially limit, if not eliminate, access in more populated regions. 
- Significant, continued delays via the Department of Public Safety background checks impact recruitment and retention at all staffing levels. In addition, these delays have affected the timely hiring and training of qualified professionals to treat those under our care across the state since at least 2020. 
-Continued wait lists to access our services, also due to the limited access to qualified diagnosticians and therapeutic services for the families and the children we collectively serve. Currently, in Las Vegas, Grant a Gift conducts the most significant number of diagnostic assessments statewide, reporting 5000+ individuals on their wait list. Per Grant A Gift's website, "Over 20,000 children each year leave the state for medical care. Autism is a primary example of the under-served need in Nevada. Autism patients must wait at least nine months for an initial diagnostic evaluation. Most of these patients are children."
-Due to exceedingly expensive insurance requirements imposed by the state to serve those receiving ATAP funding, new and highly qualified providers select not to apply to provide services to this category due to the individual or company fiscal impact. 

-The proposed rate cuts will be catastrophic to the consumers that depend on such services. While we understand that inflation is a reality, the cuts are not commensurate with the sustainability of the businesses that provide and render medically necessary services. Even more, consider the elimination of services to the rural communities that rely so heavily on access altogether. 

The community values the continued support of Medicaid recipients benefiting from our services, as these families are often the most in need. But unfortunately, the imposed regulatory changes will lead many providers to suspend such services.
 It should also be noted that a current reduction in reimbursement rates is taking a step back in the State of Nevada, which is even more disheartening for professionals, family members, community advocates, and, more importantly: taxpayers of the State of Nevada.
 Please support the community benefitting our services by voting against the proposed Medicaid reimbursement rate cuts. 
We'd appreciate your support.