Southern Nevada foster agencies have issue with state assessment

A Clark County foster care information booklet, March 2015. (Special to View/Las Vegas Review-Journal)

Southern Nevada specialized foster care agencies are denouncing the state of Nevada’s recent suggestion that only two-thirds of the children in their care have received behavioral health assessments.

“That number is much, much closer to 100 percent, if not 100 percent,” said Dave Doyle, operations director of the Eagle Quest foster agency.

The outcry follows a letter sent from Nevada Health and Human Services Director Richard Whitley to the Clark County Commission this month. In it, Whitley writes Medicaid data “suggests that 35 percent of children currently in the specialized foster care system have not received an assessment.”

The specialized system provides services to foster children with severe mental, physical and emotional disabilities.

“Continuing to provide services without assessments is potentially harmful to children, and as noted, limits the providers to bill for additional, eligible services,” the letter states.

But the state wasn’t telling commissioners the whole story, say Doyle and Valerie Hicks, executive director of the Specialized Alternatives for Families and Youth of Nevada foster care agency.

Hicks said it is problematic to use only Medicaid data to draw such a conclusion because the data does not include assessments for which Medicaid was not billed.

“We don’t have any child in our program that does not have an assessment,” Hicks said.

Agency leaders are also worried about the state’s plan to no longer allow specialized foster care agencies to assess foster children and determine what Medicaid-billable services they need. Starting Friday, that will be the responsibility of a so-far unnamed independent medical provider or providers.

Whitley’s letter suggests using one company, FirstMed Health and Wellness in Las Vegas, to assess all children who come through the county’s specialized foster care program.

Hicks said it would be a “huge challenge” for only one provider to conduct all the assessments, but FirstMed CEO Angela Quinn said her staff of 22 therapists and six doctors are trained and up to the task.

“We’re qualified and ready to do the assessments,” she said. “There’s no learning curve for us, and when you’re up against a deadline there’s no time for on-the-job training.”

Still, Assistant County Manager Kevin Schiller said the county is still determining who will conduct the assessments.

Nevada Division of Child and Family Services administrator Ross Armstrong said that the state believes having independent medical providers conduct the assessments will help the specialized foster care system “break out of a rut.”

Currently, every child receives basic skills training, a Medicaid-billable service that plays a major role in foster agencies keeping their doors open.

“This recommendation really revolves around ensuring the youth in specialized foster care are getting all the services that they need,” Armstrong said. “If the assessment is going to be used in order to trigger the ability to bill basic skills training, then it will need to be one that sufficiently shows the medical need of that service for the kid.”

Last week, the state and county recommitted themselves to finding a way to bundle other Medicaid-billable services to fill any funding gap caused by the shift away from basic skills training.

But Doyle said he is not convinced the new billing plan will be ready by January, when foster agencies will begin receiving less funding for basic skills training.

“We were told a year ago that it would already be in place, and it’s gone nowhere,” he said.

Contact Michael Scott Davidson at sdavidson@reviewjournal.com or 702-477-3861. Follow @davidsonlvrj on Twitter.