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PDFWAC 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.]
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