Section 182-531A-0400. Applied behavior analysis (ABA)—Client eligibility.

To be eligible for applied behavior analysis (ABA) services, a client must:

(1) Be under twenty-one years of age;

(2) Be covered under Washington apple health (WAH);

(3) Provide documentation created by a clinician that:

(a) Establishes the presence of functional impairment; delay in communication, behavior, or social interaction; or repetitive or stereotyped behavior;

(b) Establishes that the client's impairment, delay, or behaviors adversely affect development or communication, or both, such that:

(i) The client cannot adequately participate in home, school, or community activities because the behavior or skill deficit interferes with these activities; or

(ii) The child's behavior endangers the child or another, or impedes access to home and community activities available to other children of the same age; and

(c) An agency-recognized center of excellence (COE) has confirmed that:

(i) The child meets all requirements in (a) and (b) of this subsection;

(ii) The child has a qualifying diagnosis;

(iii) There is a reasonable calculation the requested services will result in measurable improvement in either the client's behavior, skills, or both; and

(iv) Either:

(A) Less intrusive or less intensive behavioral interventions have been tried and have not been successful; or

(B) No equally effective and substantially less costly alternative is available for reducing interfering behaviors, increasing prosocial skills and behaviors, or maintaining desired behaviors.

[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 14-24-083, § 182-531A-0400, filed 12/1/14, effective 1/1/15.]

RCW 41.05.021 and 41.05.160. WSR 14-24-083, § 182-531A-0400, filed 12/1/14, effective 1/1/15.