by IABA Team | Dec 21, 2021
ABA Therapy & Medicaid
ABA therapy is not cheap. Thankfully, many insurance companies provide coverage for the cost of the therapy. But what if you don’t have private insurance?
Applied Behavior Analysis is the only empirically-based therapy for children with autism. As research findings validated this, researchers and parent advocates began the hard work of passing legislation that required insurance carriers to cover ABA services for children with autism. In Illinois, in 2008, the Autism Mandate was passed stating children with autism were entitled to ABA therapy and thus insurance must cover this therapy. However, because this was a state law self-funded plans and national plans (like Medicaid) did not have to follow the law. In 2017, Medicaid passed a federal mandate that state plans provide ABA coverage to children with autism. However, because BCBAs hold a national license, not a state license, Illinois Medicaid pushed back.
For the past five years, providers and parent advocates have been working with Illinois law to find a way to get ABA coverage on Medicaid. Finally, in October of 2020, the ABA benefit was awarded on Medicaid insurance for children with autism with the requirement that BCBA’s are supervised by clinicians that also hold state licensure. This means that for over 13 years children with autism and Medicaid funding were largely left without access to the only evidence-based treatment.
While this is great, it can still be very difficult to find a provider who will accept Medicaid for payment due to the lower reimbursement rates of Medicaid insurance and the new supervision requirement of BCBAs..
How Do I Get Medicaid to Cover ABA Therapy & Services?
Your child must be diagnosed with ASD by a certified professional before any steps can be taken. If your child has not been formally diagnosed with ASD, the Medicaid website has resources to get you started.
To get Medicaid coverage on ABA therapy you need to find a service provider who accepts Medicaid. Representatives at Medicaid should be able to give you nearby providers that accept the benefits. You can always call local service providers to see if they accept Medicaid (as their website or database may be missing an update).
As of December 2021, the majority of ABA service providers have not signed up for the Medicaid Program. Make sure to ask any provider you speak to about Medicaid coverage.
What Does Medicaid Cover for ABA Therapy?
Therapy & services provided by an ABA clinic will not differ from Medicaid or private insurance families. ABA providers use the only evidence-based therapy for ASD; the program will be used for all children, Medicaid or not. Programs will be modified based on individual needs.
Medicaid coverage for ABA therapy only covers services provided by Board Certified Behavior Analysts (BCBA) and Registered Behavior Technicians (RBT). Any ABA services provided by or overseen by other professionals will not be covered. Any program covered by Medicaid must be supervised by a licensed clinical psychologist or licensed clinical social worker who will oversee BCBAs and RBTs. All ABA goals must be authorized by Medicaid.
The coverage Medicaid provides for ABA therapy will vary from person to person. Speaking to the billing department at any clinic will help you understand what will be covered on an itemized basis. Medicaid will cover all provider expenses.
More Help With ASD & Medicaid
Recently, many Medicaid programs, both nationally and in-state, have upped the support offered for ASD. ABA therapy was ruled to be included in Medicaid benefits over 5 years ago, but Illinois (and other states) have only recently caught up to Medicaid requirements. Aside from just financial assistance, Medicaid programs are making a concerted effort to have more ASD services widely available.
As Medicaid coverage becomes more comprehensive in regards to provider reimbursement, it will be much easier for families to find the help they need. The program is still young, so the number of providers that accept Medicaid for ABA and other ASD therapies & services should grow quickly over the next few years.
IABA Consultants & Medicaid
Here at IABA, we are working very hard to have everything ready to accept families with Medicaid by March 2022 for Naperville & Oak Lawn and May 2022 for Glenview. We are finishing the enrollment process which will let us bill Medicaid quickly and efficiently.
We have been helping families for almost 10 years now and Medicaid will allow us to help those who might otherwise have no options. We are looking forward to being able to accept any family in need of ASD services regardless of their insurance standing.
Accepting Medicaid strongly supports our mission and core beliefs. Our foundation was built on several principles, one being no child with autism will ever be turned away, regardless of funding source. Being able to accept funding from Medicaid greatly expands our ability to help children from all backgrounds. Every child deserves equal care, no matter their background or funding source.
If you have any questions on getting Medicaid to cover ABA therapy & services, please send us an email. We’d be happy to answer any of your questions or put you in touch with one of our associates who can help meet your needs.
by IABA Team | Nov 30, 2021
Many ABA therapy programs take place in-home. The comfortable setting makes in-home treatment more conducive to the needs of some children with ASD. In-home ABA therapy may differ from the therapy held in a clinical setting but what do those differences look like?
Family Involvement
Some children with ASD may require in-home ABA therapy to address issues with family members. This also allows family members to interact and learn how to use some of the ABA methods when treatment is over.
Other at-home issues may also require specific in-home therapy. Learning to properly use or interact with integral appliances, routines, and schedules may require the expertise of an in-home ABA therapist.
ABA Therapy Space
In-home ABA therapy usually requires designated spaces to be used. Each program is different and may use different spaces. All or most of the therapy programs will be conducted in these spaces, so be ready to slightly alter your daily routine if a specific room is off-limits for any amount of time (unless required to be there).
Being comfortable with a space may be beneficial to an ABA treatment program, so be sure to talk to your child’s therapist about therapy spaces.
In-Home ABA Therapy Scheduling
In-home ABA therapy is usually recommended to be conducted with a schedule that will be used during weekends & holidays. Creating a matching schedule for therapy and non-therapy hours can make transitions easier.
Talking to your child’s therapist can help you make a great schedule your child can follow. Be sure to include times, as moving times around can cause issues. Activities, free time, playtime, errand time, sleep schedules, meal times, and any other important family needs should be factored into both the therapy and regular home schedules.
Parents at Home
ABA therapists are not babysitters and should not be used in that capacity. Having a parent or guardian home is imperative during in-home ABA therapy sessions. If you are unable to be there for a specific time or something unmissable comes up, be sure to have a guardian take your place and not an unrelated babysitter.
Talking to your therapist about needs and duties as a parent can help you understand why you need to be home during therapy and what your role may require. Be sure to take any important notes and schedule any new activities.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
by IABA Team | Nov 23, 2021
Applied behavior analysis (ABA) is such a broad ASD therapy approach making it difficult to define what a typical program will look like. The amount of therapy and level of parent involvement varies, often according to the specific needs of the child.
ABA skills training programs and techniques can require several hours each day. While skills training programs are usually implemented by behavior therapists or teachers, parents are often taught critical skills to help their children transfer what they have learned in therapy to everyday life, especially at home.
ABA skills training programs for young children are often based in the home and require special materials and a dedicated area for working. ABA behavior modification therapy may include 1-2 hours of parent training per week with the parents using strategies they learn in between visits. An ABA therapist may also consult with teachers to help support positive behaviors in the classroom.
Strong ABA Therapy Programs
Strong ABA programs will all be different, as they should be tailored to the individual needs of each client. That said, all strong programs will also have some similarities on a general level.
Supervision
The program should be designed and monitored by a Board Certified Behavior Analyst (BCBA) or someone with similar credentials. Supervisors should have extensive experience working with children with autism.
Training
All participants should be fully trained, with supervisors providing support, monitoring, and ongoing training for the duration of the program.
Programming
The program should be created after a detailed assessment has been conducted and tailored to the child’s specific deficits and skills. Family and learner preferences should be given consideration in determining treatment goals. Generalization tasks should be built into the program to ensure the performance of skills in multiple environments.
Functional Programming
The goals selected should be beneficial and functional to the individual and increase or enhance his/her quality of life. A mix of behavior analytic therapies should be used so that the child has an opportunity to learn in different ways.
Data Collection
Data on skill acquisition and behavior reduction should be recorded and analyzed regularly. This data should be reviewed by the supervisor and used to measure the progress of the individual and provide information for program planning.
Family Training
Family members should be trained in order to teach and reinforce skills. They should be involved in both the planning and review process.
Who Provides the Actual ABA Services?
The top certification board for an ABA therapist is a Board Certified Behavior Analyst (BCBA) and comes from the Behavior Analyst Certification Board. Further certification can be issued in the form of a BCBA-D, indicating the therapist has a doctoral degree. Another license is the BCABA, which means having an ABA education at the level of a bachelor’s degree.
Some ABA therapists may indicate they have several years of experience but are not BCBAs. Individuals in this position should not be providing services unsupervised. Only board-certified BCBAs should be overseeing programs and implementing therapy methods.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
Sources
Autism Speaks
by IABA Team | Nov 11, 2021
ABA therapy is the only evidence-based ASD therapy, but the treatment only works if it is done with care. Not all ABA service providers are the same. How can you tell if your child’s treatment is being conducted correctly?
There are some red flags you can look for if you feel your child is not progressing or benefitting from ABA therapy. The points we are going to talk about won’t cover everything, but they will cover some of the most easily observable ABA therapy red flags.
We have split this article into two parts, as we want to mention why these red flags can be harmful and what you can do to notice them. Click here for part 1.
Not Listening
Every parent has concerns about their children. ASD parents usually have more things to be concerned about. If you have voiced specific major concerns to your child’s ABA provider without an acceptable response, you may need to rethink things.
By voicing major concerns we are talking about lack of progress, not sharing enough information, billing too many hours etc. These are things that should be addressed as soon as possible. Smaller concerns may slip through the cracks so you may need to repeat them in order to ensure they are taken seriously.
If all of your concerns go unaddressed by an ABA therapy provider, it may be time to look for a new one.
Only Using a Few ABA Therapy Techniques
Relying on a small pool of ABA therapy treatments and techniques can lead to a poorly developed program. If you notice your child is being treated with the same methods all the time, you may need to look at their overall program.
Some programs may focus on a small number of treatments for a set period of time, so be sure to ask when or if the program will change or progress. Your child’s ABA therapist should have a good answer why certain treatment methods are or aren’t being used.
All children with ASD are different, so be sure not to question a treatment program after a short amount of time. Have a discussion with your ABA provider to learn about the program that was designed for your child.
Templated ABA Therapy Programs
Similar to only using a few aba therapy methods, templated programs can be a major red flag for ABA programs. Every child with ASD is different and requires a different approach tailored to their strengths and needs.
This red flag can be seen relatively early in selecting an ASD treatment program or clinic. If you are presented with a brochure of programs or therapy ‘packages’ mentioned in a consultation, you need to really look at what is being offered.
In order to get the most out of ABA therapy, each child needs a custom-built program. ABA programs built on general needs will not help each child enough to address specific behaviors and needs.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
by IABA Team | Nov 9, 2021
ABA therapy is the only evidence-based ASD therapy, but the treatment only works if it is done with care. Not all ABA service providers are the same. How can you tell if your child’s treatment is being conducted correctly?
There are some red flags you can look for if you feel your child is not progressing or benefitting from ABA therapy. The points we are going to talk about won’t cover everything, but they will cover some of the most easily observable ABA therapy red flags.
We have split this article into two parts, as we want to mention why these red flags can be harmful and what you can do to notice them.
Too Many Hours of Therapy
ABA therapy is a billable medical expense. Like most medically billable services, some ABA therapy providers will look to bill for as many hours as possible. Most people don’t require 40+ hours a week of ABA treatment.
Be sure to look at your child’s program and what exactly is being done from a therapy standpoint. Does the program cover everything your child needs? Are the hours reasonable for the needs of your child?
A note that some people do need a lot of therapy, just not everyone. ABA therapy is not supposed to last forever. Your child will eventually be able to live an independent life with honed social skills. Too many hours of therapy is not something that will necessarily help with ABA therapy.
No Observation or Information
One of the most important aspects of ABA therapy is continuing a program at home. If an ABA service provider refuses to share information or allow observation you may want to take a closer look at the program.
Information should always be available on how your child is progressing. Daily records should be available to parents if they want to know what is going on in treatment. If an ABA service provider is unable to share information, it may be time to take a closer look. Quick note: information and records may take a few days to be logged, each clinic is different.
If you are not allowed to visit your child’s ABA clinic to observe treatment and progress you may have a problem on your hands. Dropping by without notice is not recommended, the situations we are talking about are never being able to observe your child’s clinic & program.
Another red flag related to this is a provider only using telehealth methods (phone calls, video chats etc) for BCBA supervision. A BCBA should be directly involved in each child’s program. The only exception to this is ABA providers located in rural areas, as they may be spread very thin and have a limited number of BCBAs.
Extremely Strict Behavior Requirements
ABA therapy works to help people with ASD adapt to neurotypical social norms. Having strict requirements to not allow normal ASD behaviors may lead to issues with many people.
If a therapy program doesn’t allow things like stimming, forces social interaction, or has eye contact requirements, you may want to take a closer look. Forcing behavior changes through programs or (worse) aggressive interactions is a huge issue for any ABA therapy program.
Some behaviors and issues will need to change over time, but forcing the issue through strict programs or adherence to certain behaviors is not the way to go. Be sure to routinely check your child’s program and progress if you think any requirements of the program are too strict.
ABA Therapy from IABA Consultants
If you have questions regarding autism treatment, education, or plans using ABA therapy, we are here for you! Our goal is to make sure no family is turned away due to financial constraints. Our therapy team would love to talk to you. Find the location closest to you and give us a call. We’re here for you.
