Senate committee hears bill to broaden who may diagnose autism; sponsors say change will reduce wait times

Senate Bill 257, introduced by Sen. Marilyn Dondero Loop, was heard by the Nevada Senate Committee on Health and Human Services in a hybrid hearing in Carson City and Las Vegas. The bill would revise existing Nevada law about autism diagnosis to allow any ‘‘provider of health care’’ acting within his or her scope of practice to perform direct observations, assessments and render diagnoses consistent with a statewide standard.

Supporters told the committee that the change aims to reduce long diagnostic wait times and move children more quickly into early intervention services. Dr. Mario Gaspar de Alba, associate professor of developmental and behavioral pediatrics at the Kirk Kerkorian School of Medicine and medical director at the Ackerman Autism Center, said current prescriptive language requiring comprehensive evaluations has lengthened waits. “Removing prescriptive language surrounding the diagnosis of autism reduces the administrative burdens on providers, especially primary care providers, and facilitates their effort to provide more timely access to needed support services,” he told the committee.

Why the change matters: proponents said earlier diagnosis and prompt entry into services improve long‑term outcomes. Witnesses cited recent prevalence and age-of-diagnosis figures presented at the hearing: the rate of autism nationally was given as 1 in 36 children (2024), and Nevada’s average age of diagnosis was reported as about 5.5 years—higher than neighboring states. Dr. Gaspar de Alba and Dr. Julie Beasley, a pediatric neuropsychologist and clinical director at the Ackerman Center, said allowing appropriately trained pediatricians, nurse practitioners and primary care clinicians to diagnose when clinically appropriate would shorten waits for families and reserve specialist neuropsychological evaluations for cases that need comprehensive assessment.

Bill structure and sponsor explanation: Sen. Dondero Loop summarized the bill’s sections on the record. She said the draft (a) defines provider of health care for the bill’s purposes, (b) replaces a requirement that the statewide standard include a single prescriptive protocol and a particular standardized instrument with language that the standard align with best‑practice guidelines and include direct observation and assessment, and (c) requires insurers to accept a diagnosis rendered in accordance with the statewide standard regardless of which qualified provider performs it.

Support testimony: parents, advocacy organizations and clinicians gave examples of delayed access and improvement after diagnosis. Jonathan Norman of the Nevada Coalition of Legal Service Providers described a foster‑care case in which expedited diagnosis permitting insurance‑funded services produced marked gains: “Within a year, he went from not being able to take care of basic hygiene to…taking out the garbage,” Norman said. Representatives of the Ackerman Center, the American Academy of Pediatrics (Nevada chapter), the Nevada Association of School Superintendents, legal aid groups and other community organizations voiced support for SB257.

Opposition and concerns: the Nevada Psychological Association and other clinicians urged caution. Spencer Flanders, representing the Nevada Psychological Association, said changes in section 3 remove certain required components—cognitive, language and adaptive function assessment—that are central to a rigorous autism diagnosis and help distinguish autism from other conditions. “It eliminates the assessment for cognitive function, language functions, and adaptive functions, which are all crucial components,” he said, arguing the change could increase misdiagnosis and inappropriate treatment plans. Other clinicians urged the committee to add clearer language on minimum qualifications or required elements of an assessment so less‑experienced providers are not permitted to perform complex differential diagnoses without appropriate training.

Committee discussion: committee members asked whether existing law currently prohibits primary care providers from diagnosing autism. Dr. Gaspar de Alba said there is no absolute ban, but the prescriptive statutory language requiring comprehensive evaluations has been interpreted by insurers and others as a de facto requirement for specialist testing, creating long wait lists. Senators pressed proponents on whether greater diagnostic capacity would translate into faster access to therapy, given provider shortages for behavioral interventions; proponents acknowledged provider capacity is a separate workforce and reimbursement issue.

Outcome and next steps: the hearing record was completed and the sponsor asked for the committee’s consideration; no committee vote on the bill’s merits was recorded during the hearing. The committee received both written and oral testimony supporting and opposing the bill. Additional drafting or amendments were discussed informally; the bill will return for further committee consideration in accordance with legislative procedure.

Ending: witnesses and advocates emphasized early diagnosis as the bill’s core goal while acknowledging remaining questions about insurance policy, workforce capacity and specific assessment standards.