Senate panel hears bill to allow applied behavior analysis in schools; statewide education leaders warn of legal, fiscal risks

Senate sponsor James Orenshaw, joined by parents and providers, presented Senate Bill 174 to the Senate Finance Committee as a measure to allow outside applied behavior analysis (ABA) providers to deliver medically necessary therapy during the school day while preserving district oversight and billing protections.

The bill’s supporters said permitting outside providers to work in classrooms would keep students in school and avoid repeated removals to restrictive settings. Annette Logan Parker and representatives of Cure for the Kids and other providers said local care would reduce family hardship and return millions in out‑of‑state spending back to Nevada. A Tripp Umbach analysis provided to the committee estimated the state could redirect existing out‑of‑state payments and generate increased local health revenue if a local program were accredited.

But representatives of Nevada’s public school districts and state education officials warned SB174 risks conflicting with federal special education law and could create legal and fiscal exposure for school districts. Susan Kima, executive director of the Nevada Association of School Superintendents, read into the record a letter from district special education directors stating that “medically necessary ABA therapy is not considered special education or related service under IDEA,” and warning that permitting non‑IEP medical services during instructional time “creates both educational disruption and legal liability.”

Brad Keating, representing Clark County School District, told the committee the district is opposed to the bill in its current form and raised Medicaid‑billing and reimbursement concerns. Keating said allowing external Medicaid billing without a coordinated system “would divert essential funds from public education despite the district remaining responsible for FAPE compliance.” He also flagged potential unbounded fiscal exposure if families request assistive technology or services that create mandates for districts.

Senate sponsors and pro‑bill witnesses said they had amended earlier drafts to address some fiscal concerns. Zachary Khan, Nevada Department of Education, said the department’s fiscal note was reduced from about $609,000 to $289,000 under the amendment, because the proposal deletes some reporting requirements and reduces staff needs. Sponsor Orenshaw told the committee the amendment also clarifies privacy, insurance and billing requirements and relieves districts of billing responsibility under section 5.

The committee heard extensive testimony from parents and advocacy groups who urged passage on the grounds that children were being excluded from classrooms and that Medicaid and insurance commonly pay for many of the therapy hours now delivered out of school. Stephen Cohen, an advocate who worked on last session’s therapeutic absence amendment, said families still lack consistent guidance from the Nevada Department of Education on how schools should implement therapeutic absences.

Opponents repeatedly urged the Legislature to work with districts to resolve the outstanding legal and fiscal issues. Tom Clark of the Nevada Association of School Boards said the bill as written leaves districts with uncertain security, supervision and oversight responsibilities and could generate new costs for background checks, coordination and space. Several witnesses asked the committee to preserve the distinction between medical services and special education required under IDEA and to avoid mandating that districts accommodate non‑IEP medical services during instructional time.

The hearing closed without a committee vote. Sponsors said they would continue working with school districts, NDE and stakeholders on amendments before any work session.

Ending: The committee took testimony for and against SB174 and left open the possibility of further amendments; no formal vote on the bill occurred at the hearing.