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| Scaling Mount Medicaid: Behavior Analysts' Role in Securing ABA Coverage |
| Saturday, May 23, 2020 |
| 4:00 PM–5:50 PM |
| Walter E. Washington Convention Center, Level 2, Room 201 |
| Area: AUT/DDA; Domain: Service Delivery |
| Chair: Gordon Bourland (Trinity Behavioral Associates and TxABA Public Policy Group) |
| Discussant: John M. Guercio (Benchmark Human Services) |
| CE Instructor: John M. Guercio, Ph.D. |
| Abstract: Many people who could benefit greatly from ABA services cannot gain access to them due to lack of financial resources and insurance. Medicaid funding of ABA services is one mechanism to enable financially and socially disadvantaged people to benefit from ABA services. The session will involve behavior analysts from 4 states discussing how behavior analysts have and could address public policy issues leading to state Medicaid programs funding ABA services. The activities and contributions of behavior analysts in 4 states will be presented. The sequences of events in each state differ, but some general strategy recommendations will be addressed. Audience participation will be encouraged. |
| Instruction Level: Intermediate |
| Target Audience: Licensed Behavior Analysts and BCBAs/BCBA-Ds who are leaders in state behavior analysis organizations |
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| Medicaid Coverage of ABA Services: Missouri and Illinois |
| JOHN M. GUERCIO (Benchmark Human Services) |
| Abstract: My section will cover both Missouri and Illinois Medicaid coverage of ABA services. The Missouri section of the talk will discuss how the Missouri autism waiver was eventually replaced with Missouri HealthNet coverage and how that process works now for individuals under the age of 18. The Illinois discussion will address some the provider definitions of who can provide behavioral services in the state of Illinois under the guise of Medicaid. There are some concerning issues here that are being addressed by the Illinois Association for behavior analysis that will be covered in detail. |
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| Medicaid Coverage of ABA Services: Oklahoma |
| TIFFANIE MOORE (Blue Sprig Pediatrics) |
| Abstract: In September 2019, Centers of Medicare and Medicaid (CMS) approved a state plan amendment to add applied behavior analysis (ABA) coverage to SoonerCare (Oklahoma Medicaid) under Early Periodic Screening, Diagnostic and Treatment (EPSDT). This presentation aims to provide an overview of effective advocacy efforts, relevant legal cases, ongoing barriers and corresponding solutions for ABA treatment for individuals with autism spectrum disorder (ASD). This presentation will include a brief history of ABA coverage in Oklahoma, including establishment and involvement of the state licensure board and crucial stakeholders (i.e. parents, professionals, educators, and legislators) in ongoing advocacy efforts. The current status of ABA Medicaid coverage in Oklahoma will be discussed. |
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| Medicaid Coverage of ABA Services: Texas |
| BERENICE DE LA CRUZ (PACED Behavior, LLC and TxABA Public Policy Group), Katherine Miriam Johnson-Patagoc (Texana Center and TxABA Public Policy Group), Jeffrey E. Dillen (Texana Center andTxABA Public Policy Group), Mariel C. Fernandez (Blue Sprig Pediatrics and TxABA Public Policy Group), Rany Thommen (ABA Today and TxABA Public Policy Group), Duy D. Le (Child Study Center and TxABA Public Policy Group), Gordon Bourland (Trinity Behavioral Associates and TxABA Public Policy Group) |
| Abstract: The Texas Association for Behavior Analysis, Public Policy Group (TxABA PPG) will share information on its history. The focus of the talk will be on how TxABA PPG organized grass roots efforts to positively affect the lives of children with autism and their families in Texas. These efforts first led to the passing of legislation for licensure of behaviors analysts. TxABA PPG continued efforts have more recently led to the State of Texas passing legislation for Medicaid coverage of ABA therapy for children with Autism Spectrum Disorder (ASD). After the passing of this legislation, TxABA PPG continued to be involved in the roll out process by seeking stakeholders’ input and providing guidance to the State of Texas on the policies and procedures that impacted how the program was implemented. The final part of the presentation will report on the current status of Medical coverage of ABA for children with ASD in Texas. |
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| Medicaid Coverage of ABA Services: Georgia |
| SHERRY L. SERDIKOFF (Savannah State University) |
| Abstract: Effective January 1, 2018, Georgia’s Medicaid program began providing coverage for adaptive behavioral services for individuals under age 21 with Autism Spectrum Disorders (ASD). Provision of services is not limited to BCBA/BCBA-Ds, but we are included among the professionals who may apply to the state to become an approved provider, along with licensed physicians and licensed psychologist; at this time, we do not have licensure for behavior analysts. Although they cannot be providers, BCaBAs and RBTs can provide services under the supervision of a provider, with a limit such that providers may supervise up to six BCaBAs or RBTs at any point in time. In this presentation I will cover how the introduction of this coverage this has impacted not only service provision in the state of Georgia, but also the Georgia Association of Behavior Analysis (GABA), educational opportunities for behavior analysis in Georgia, and interest in licensure for behavior analysts in our state. |
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