Autism spectrum disorder (ASD) is a neurodevelopmental disability affecting 1 in 44 children nationally. Timely referral to intervention and support services for ASD has consistently demonstrated significant long-term positive effects on symptoms and subsequent skills and family outcomes. This paper highlights a novel and innovative approach of short-term consultations for best practices to ultimately increase access to timely ASD evaluations and support through a state-wide school telehealth initiative. The goal of the initiative was to facilitate rapid access to ASD evaluation and support (within 2 weeks of referral in school-age youth) among under-resourced school systems in Central Texas. First, this paper provides background relative to current disparities that many children face when attempting to obtain ASD evaluations and support. Second, a statewide legislative response is described that created a mental health consortium targeting increased access to broad-based mental health services and supports, particularly in underserved areas. Next, the Texas Child Health Access Through Telemedicine (TCHATT) program is outlined with a particular focus on day-to-day operationality and concentrated efforts to increase mental health literacy among school teams relative to ASD symptoms and co-occurring behavioral health concerns. Year 1 utilization data metrics (September 2020-May 2021) and representative case examples are presented. Finally, early "lessons learned" and future directions are discussed.