Autism Services in Texas: 2018 Update from the TCDD

As the understanding of autism spectrum disorder (ASD) evolves, so do the programs and services that are designed to support people with ASD and their families. The Texas Legislature and the federal government have taken steps to expand and improve services for people with ASD, but many people still don’t have access to adequate supports and services. However, statewide planning for services and supports is challenging because understanding of ASD is evolving, individual needs can vary widely, and the availability of services does not currently meet the known demand.

This article from the Texas Council for Developmental Disabilities will help you learn about the programs and services that are available now, as well as what might be considered during the next legislative session.

State Funding for Autism Services

To prepare for the 86th Texas Legislature (2019), state agencies are developing their legislative appropriations requests (LARs), and many are inviting the public to submit ideas. The LARs being prepared now tell the legislature how much money an agency will need to provide services over the two years beginning September 1, 2019. LARs are detailed and agency staff must explain and justify requests.

Texas has provided state funding for autism services for 10 years. Below is a recap of how autism services were funded in recent legislative sessions, which may provide insights regarding what may be funded in the upcoming legislative session.

84th Texas Legislature

During the 84th Texas Legislature (2015), services for children and other items received significant attention:

THECB grants: A new allocation of $8.1 million to the Texas Higher Education Coordinating Board (THECB) was made to fund grants to public higher education programs to train parents and teachers about how to use applied behavior analysis (ABA) and to encourage innovative research. Specific amounts were designated for each type of grant, i.e., parent-directed training, board certified behavior analyst training for teachers and other school personnel, and research.

State Autism Program: Through funding of $14.4 million, more children were provided access to autism services (1,970 versus 295 in 2014) through the Health and Human Services Autism Program (then under the Department of Assistive and Rehabilitative Services, or DARS). Comprehensive ABA was phased out and focused ABA services were expanded.

Texas Autism Council: The Texas Council on Autism and Pervasive Developmental Disorders was discontinued pursuant to Senate Bill (SB) 200, which also transferred the programs of DARS to the Texas Health and Human Services Commission (HHSC). The HHSC executive commissioner subsequently established the Texas Autism Council to provide advice and make recommendations to ensure that the needs of people with ASD and their families are addressed and that resources are coordinated to meet those needs.

85th Texas Legislature

Action taken by the 85th Texas Legislature (2017) continued the funding pattern of the 84th Texas Legislature. One notable change for the THECB grants was that restrictions that required a certain portion of the funding to be spent on specific grants was relaxed so that funds could be spent on activities of highest demonstrated need. Another change expanded who could apply for grants to include private sector institutions of higher education.

Other legislation that addressed autism services during the 85th Texas Legislature:

BCBA licensure: During the 85th Texas Legislature, a bill to license Board-Certified Behavior Analysts (BCBAs) and licensed assistant behavior analysts passed, after failing to pass in the 84th Texas Legislature. Although BCBAs have national certification, state licensure is necessary to bill Medicaid for work done by people they supervise. Licensure will increase the number of BCBAs in Texas and will help to prevent unqualified persons from representing themselves as experts in behavior analysis. Licensing is administered by the Texas Department of Licensing and Regulation and rule-making, policy, and enforcement is vested in that department’s Behavior Analyst Licensing Board (see www.tdlr.texas.gov/bhv/bhvboard.htm). The board has promulgated rules and licensing will begin on September 1, 2018.

Education grants for programs serving students with autism: As a result of the passage of House Bill (HB) 21, the Texas Education Agency (TEA) must establish a grant program for public school districts and open-enrollment charter schools, including charter schools that primarily serve students with disabilities, to provide innovative services to students with autism. The grant programs serve students ages 3 to 9. A program is eligible if it operates as an independent campus or a separate program from the campus with a separate budget and gives priority for enrollment to students with autism. The grant programs are required to incorporate:

  • evidence-based and research-based design;
  • use of empirical data on student achievement and improvement;
  • parental support and collaboration;
  • use of technology;
  • meaningful inclusion; and
  • the ability to replicate the program for students statewide.

The new law prohibits the following:

  • charging a fee;
  • requiring a parent to enroll a child in a program;
  • allowing an admission, review, and dismissal committee to place a student in a program without written parental consent; or
  • continuing a placement after a parent revokes consent in writing.

Programs can alter instructional time, coordinate with private or community-based providers, enroll students without disabilities or with other disabilities, and adopt staff qualifications and staff-to-student ratios different from statutory requirements.

Up to 10 grants can be awarded per year with a maximum grant amount of $1 million per grant per year for two years. Collaborative efforts will be given priority and programs must reflect the diversity of Texas.

TEA is required to set aside $20 million from the foundation school program for the 2018 to 2019 biennium and reduce each district’s and charter school’s allotment proportionally to account for grant funds. TEA and programs may accept gifts, grants, and donations for the program. A student in a grant program is considered to be in a mainstream placement, regardless of the amount of time spent in a regular classroom setting. A report from TEA is required in December 2020, and the program expires September 1, 2021.

86th Texas Legislature

The 86th Texas Legislature commences on January 8, 2019. During the interim between legislative sessions, committees are charged to study key issues and research information that will help guide future legislative decisions. The following interim charge suggests one of the directions that the 86th Texas Legislature may take:

Examine programs in public schools that have proven results meeting the needs of and improving student achievement for students with disabilities, with an emphasis on programs specializing in autism, dysgraphia, and dyslexia. Recommend ways to support and scale innovative programs for these students, including providing supplemental services, or incentivizing public-private partnerships or inter district and charter school collaborations. Monitor the implementation and funding for the pilot programs authorized in HB 21 (85R) and review the Texas Education Agency’s compliance with SB 160 (85R), which prohibits special education student caps.

Federal Funding for Autism Services

In July 2014, the Centers for Medicare & Medicaid Services (CMS) issued a letter to clarify Medicaid’s coverage of services for children with autism. The letter instructed states to make all covered services available in order to meet each child’s individual needs. States were instructed to cover the services under the Social Security Act, including:

  • Services of other licensed practitioners
  • Preventive services
  • Therapy services
  • Services funded under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT, or Texas Health Steps) program:
    • physician services
    • private duty nursing
    • personal care services
    • home health
    • medical equipment and supplies
    • rehabilitative services
    • vision, hearing, and dental services
    • speech, occupational, and physical therapies

Texas Medicaid officials began working in 2014 to make services — like those available to children enrolled in EPSDT — available to adults on a statewide basis as part of the Medicaid State Plan. When the plan is updated and implemented, Texas may be closer to providing the full array of services and supports necessary to meet the individual needs of every child and adult diagnosed with ASD.

For more information, please visit the Texas Council for Developmental Disabilities (TCDD) website –http://www.tcdd.texas.gov/texas-autism-services-updates/

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