PDFWAC 182-531A-0700

Applied behavior analysis (ABA)—Stage three: Delivery of ABA services.

(1) A provider must obtain prior authorization before delivery of applied behavior analysis (ABA) services. To request prior authorization, a provider must submit the following documents to the medicaid agency or follow the managed care organization (MCO) process:
(a) The comprehensive diagnostic evaluation and multidisciplinary clinical treatment plan completed by the center of excellence (COE) described in this chapter;
(b) The ABA assessment and ABA therapy treatment plan described in this chapter; and
(c) Any documents required by the agency's ABA provider guide.
(2) After the services are prior authorized, the lead behavior analysis therapist (LBAT) or a certified behavior technician implements the ABA therapy treatment plan in conjunction with other care team members. The LBAT is responsible for ongoing communication and collaboration with other care team members to ensure consistent approaches to achieving treatment goals.
(3) If services are rendered by a certified behavior technician, they must:
(a) Assess the client's response to techniques and report that response to the LBAT;
(b) Provide direct on-site services in the client's natural setting (e.g., in the home, office, place of employment, education setting, clinic, or community), or in the day services program;
(c) Be supervised directly by an LBAT for at least five percent of total direct care per week;
(d) Consult the LBAT if:
(i) Considering modifying a technique;
(ii) A barrier or challenge prevents implementation of the treatment plan; and
(iii) Clinically indicated.
(e) Ensure family involvement through modeling, coaching, and training to support generalization and maintenance of achieved behaviors;
(f) Document each visit with the client or family and include:
(i) Targeted behavior, interventions, response, modifications in techniques;
(ii) A plan for the next visit; and
(iii) Behavior tracking sheets that record and graph data collected for each visit.
[Statutory Authority: RCW 41.05.021, 41.05.160, and Thurston County Superior Court in J.C. and H.S. v. Washington State Health Care Authority, no. 20-2-01813-34. WSR 22-08-035, § 182-531A-0700, filed 3/29/22, effective 4/29/22. Statutory Authority: RCW 41.05.021, 41.05.160. WSR 15-19-121, § 182-531A-0700, filed 9/21/15, effective 10/22/15; WSR 14-24-083, § 182-531A-0700, filed 12/1/14, effective 1/1/15.]