Section 388-877A-0370. Recovery support services requiring program-specific certification—Applied behavior analysis (ABA) services.

Applied behavior analysis (ABA) services are a recovery support service that requires program-specific certification by the department's division of behavioral health and recovery.

(1) ABA services:

(a) Assist children and their families to improve the core symptoms associated with autism spectrum disorders or other developmental disabilities for which ABA services have been determined to be medically necessary; and

(b) Support learning, skill development, and assistance in any one or more of the following areas or domains:

(i) Social;

(ii) Behavior;

(iii) Adaptive;

(iv) Motor;

(v) Vocational; or

(vi) Cognitive.

(2) An agency providing ABA services must meet the:

(a) General requirements in chapter 388-877 WAC for behavioral health services administrative requirements;

(b) General requirements in WAC 388-877A-0300 for recovery support services requiring program-specific certification;

(c) Specific agency staff requirements in WAC 388-877A-0310; and

(d) Specific clinical record content and documentation requirements in WAC 388-877-640 and 388-877A-0320.

(3) The health care authority (HCA) administers rules in chapter 182-531 WAC for ABA services requirements. The rules in chapter 182-531 WAC include:

(a) Definitions that apply to ABA services;

(b) Program and clinical eligibility requirements;

(c) Prior authorization and recertification requirements;

(d) Specific ABA provider requirements;

(e) Covered and noncovered services;

(f) Billing requirements; and

(g) Requirements for:

(i) Referrals to and assessments by Centers of Excellence (COE) for evaluations and orders; and

(ii) ABA assessments and individualized ABA therapy treatment plans.

(4) The ABA therapy treatment plan must:

(a) Be developed and maintained by a lead behavior analysis therapist (LBAT) (see (5) of this section);

(b) Identify the services to be delivered by the LBAT and the therapy assistant, if the agency employs a therapy assistant (see (6) and (7) of this section);

(c) Be comprehensive and document treatment being provided by other health care professionals; and

(d) Document how all treatment will be coordinated, as applicable, with other members of the health care team.

(5) An agency must employ a lead behavior analysis therapist (LBAT).

(a) To qualify as an LBAT, an individual must meet the professional requirements in chapter 182-531 WAC.

(b) The agency must ensure the LBAT meets other applicable requirements in chapter 182-531 WAC.

(6) An agency may choose to employ a therapy assistant.

(a) To qualify as a therapy assistant, an individual must meet the professional requirements in chapter 182-531 WAC.

(b) The agency must ensure the therapy assistant meets other applicable requirements in chapter 182-531 WAC.

(7) If the agency employs a therapy assistant(s), the agency must ensure the LBAT:

(a) Supervises the therapy assistant:

(i) For a minimum of five percent of the total direct care provided by the therapy assistant per week (for example, one hour of direct supervision per twenty hours of direct care); and

(ii) In accordance with agency policies and procedures.

(b) Meets the requirements in this section;

(c) Completes a review of an individual's ABA therapy treatment plan with the therapy assistant before services are provided;

(d) Assures the therapy assistant delivers services according to the individual's ABA therapy treatment plan; and

(e) Meets at least every two weeks with the therapy assistant and documents review of the individual's progress and/or response to the treatment, and makes changes to the ABA therapy treatment plan as indicated by the individual's progress and/or response.

(8) To maintain department program-specific certification to provide ABA services, an agency must continue to ensure the requirements in this section are met.

[Statutory Authority: RCW 43.20A.550, 74.04.050, 74.08.090, chapters 70.02, 71.24 RCW, and Washington Autism Alliance and Advocacy, et al. v. Douglas Porter, U.S. District Court, Western District of Washington, Case No. 2:12-cv-00742-RAJ. WSR 14-06-094, § 388-877A-0370, filed 3/4/14, effective 4/4/14.]

RCW 43.20A.550, 74.04.050, 74.08.090, chapters 70.02, 71.24 RCW, and Washington Autism Alliance and Advocacy, et al. v. Douglas Porter, U.S. District Court, Western District of Washington, Case No. 2:12-cv-00742-RAJ. WSR 14-06-094, § 388-877A-0370, filed 3/4/14, effective 4/4/14.

Rules

388-877,388-877A-0300,388-877A-0310,388-877-640,388-877A-0320,182-531,182-531,182-531,182-531,182-531,182-531,