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Lessons Learned by Behavior Analysts From Areas Working on Fully Implementing an ABA Medicaid Benefit |
Sunday, May 30, 2021 |
4:00 PM–5:50 PM |
Online |
Area: AUT/DDA; Domain: Service Delivery |
Chair: Gordon Bourland (Trinity Behavioral Associates and TxABA Public Policy Committee) |
Discussant: Katherine Miriam Johnson-Patagoc (Texana Center and TxABA Public Policy Group) |
CE Instructor: Katherine Miriam Johnson-Patagoc, 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 discussions by behavior analysts from 4 areas of the United States regarding how behavior analysts have and could address public policy issues related to Medicaid programs funding ABA services. The activities and contributions of behavior analysts in 3 states and the Washington DCs will be presented. The sequences of events in each jurisdiction differ, but some general strategy recommendations will be addressed along with suggestions regarding with issues unique to a jurisdiction. Audience participation will be encouraged. |
Instruction Level: Intermediate |
Keyword(s): Medicaid coverage, public policy, social disadvantage |
Target Audience: Attendees will be most likely to benefit from the presentations if they are not only knowledge regarding behavior analysis principle, ABA services, but also have some exposure to and/ or experience regarding public policy, Medicaid funding if possible. |
Learning Objectives: The attendee will: 1. State the importance of Medicaid funding for behavior analysis services, 2. State the importance of having qualified professionals provide ABA services in state funded waiver programs, 3. State why behavior analysts should participate in the process of educating fellow professionals about the value of their services in the context of a team approach, 4. Identify at least 2 barriers that have arisen with Mediciad funding of ABA services, 5. Identify the importance of collaboration across stakeholders 6. Identify advocacy strategy for overcoming barriers to services 7. Identify strategies for navigating complex legislative landscapes |
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Illinois Medicaid for Applied Behavior Analysis Services |
JOHN M. GUERCIO (Benchmark Human Services) |
Abstract: This talk will detail the recent changes that have transpired with regard to the Illinois Association for Behavior Analysis (ABAI) and efforts to obtain Medicaid funding through the Department of Human Services in the state of Illinois. This talk will detail that sometimes arduous task of securing the appropriate professional qualifications to deliver ABA services in the Medicaid system. The many different service categories will be detailed along with how each service provider can sure that they are providing the appropriate services. The presentation will also detail the importance of active involvement by Behavior Analysts in the development of services at the state level. Suggestions will be provided related to the appropriate advocacy behavior for behavior analysts to engage in related to educating state lawmakers about the importance of ABA services and ensuring that the providers of these services have the appropriate credentials. |
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Texas’ Journey to Full Implementation of the Medicaid Funding for ABA Autism Services |
BERENICE DE LA CRUZ (Texas A&M University-San Antonio and TxABA Public Policy Group), Jeffrey E. Dillen (Texana Center and TxABA Public Policy Group), Rany Thommen (ABA Today and TxABA Public Policy Group), Mariel C. Fernandez (Blue Sprig Pediatrics and TxABA Public Policy Group), Duy D. Le (Child Study Center Cook Children's and TxABA Public Policy Group), Gordon Bourland (Trinity Behavioral Associates and TxABA Public Policy Group), Katherine Miriam Johnson-Patagoc (Texana Center and TxABA Public Policy Group) |
Abstract: The TxABA Public Policy Group will share information on the journey towards full implementation of the Medicaid coverage of Autism Services through Early and Periodic Screening, Diagnostic, and Treatment. On July 15, 2019, Texas became the 43rd state to have Medicaid coverage of ABA therapy. The signing of House Bill 1, including Rider 32, by Governor Greg Abbott authorized ABA as a benefit for people with Autism Spectrum Disorder under the age of 21. Behavior analysts from Texas will share barriers, solutions, and lessons learned. The integral goal of partnerships with local, state, and national organizations and the inclusion of parents and self-advocates will be examined. The vital role of a paid advocate and how fees were covered will be shared. Behavior analysts learned how to educate legislators at district and capitol offices, advocate for the needs of the community, become resources for legislators. The role of visibility and mutual benefit will be highlighted. Lastly, challenges in fully implementing the Medicaid benefit in Texas will be discussed. |
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Advocating for Medicaid in a Complicated Legislative Space |
AMANDA P. LAPRIME (University of Rochester Medical Center ), Maureen O'Grady (NYSABA Legislative Co-Chair and New Alternatives for Children), Deborah A. Napolitano (NYSABA Legislative Chair, Daemen College Department of Applied Behavior Analysis, and Golisano Institute for Developmental Disabilities Nursing at St. John Fisher College
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Abstract: The presenter will describe the complicated legislative landscape in New York as context for the fight for Medicaid funding of applied behavior analysis services for individuals with autism. The history of insurance-based services for individuals with autism and the current challenges faced by practicing behavior analysts in NY State will be described. The speakers will identify and define the barriers to implementation of Medicaid reimbursed ABA services and share problem solving approaches. The intensive collaboration across stakeholders will be highlighted, including NYSABA, medical/clinical providers, Autism Speaks, Community Based Organizations, and several lobbying firms. A model will be presented for translating the unique service tiers of insurance funded behavior analytic services for evaluation by state legislative and regulatory bodies. In addition, speakers will explain why this approach is a necessary step to overcoming the barriers of service delivery in NY State. Speakers will further identify the components of a large scale needs assessment, with a focus on the identification, operationalization, and remediation of barriers across multiple systems. |
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ABA Service Provision and Medicaid in the District of Columbia |
MARY CARUSO-ANDERSON (DC ABA), Lera Joyce Johnson (DC ABA; George Mason University), Cynthia Escobar (J &C Behavioral Therapy, LLC), Keven M. Schock (Aveanna ), Elena Zaklis (Rutgers University), Jacqueline Landa Jackson (DC ABA), Colleen Williams (BACB), Flor De Amelia Lizette Hoffman (DC ABA) |
Abstract: Medicaid is an important source of funding for medically-necessary services for children with autism. Although State Medicaid programs vary in their reimbursement practices, children receive a variety of services that address core deficits and behavioral challenges in autism, some of which may not be covered under commercial insurance plans due to benefit exclusions or other limits under private insurance. Data from 2005 showed that only 29 states provided Medicaid reimbursement for applied behavior analysis (ABA). The District of Columbia was excluded from this study due to poor quality data. Therefore, the purpose of this talk is to examine the process by which ABA services are obtained and reimbursed through Medicaid in the District of Columbia. The impact of this process on service providers will be evaluated to help identify barriers to obtaining ABA-based treatments through Medicaid in the District. Finally, we will explore the relationship between state licensure of BCBAs and Medicaid reimbursement. |
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