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PDFWAC 182-531A-0600

Applied behavior analysis (ABA)Stage two: Functional assessment and treatment plan development.

(1) If the center of excellence's (COE's) evaluating and prescribing provider has ordered applied behavior analysis (ABA) services, the client may begin stage two - ABA assessment, functional analysis, and ABA therapy treatment plan development.
(2) Prior to implementing the ABA therapy treatment plan, the ABA provider must receive prior authorization from the agency. The prior authorization request, including the assessment and ABA therapy treatment plan, must be received by the agency within sixty days of the family scheduling the functional assessment.
(3) The child's legal guardian selects the ABA provider and the setting in which services will be rendered. ABA services may be rendered in one of the following settings:
(a) Day services program, which mean an agency-approved, outpatient facility or clinic-based program that:
(i) Employs or contracts with a lead behavior analysis therapist (LBAT), therapy assistant, speech therapist, and if clinically indicated, an occupational therapist, physical therapist, psychologist, medical clinician, and dietitian;
(ii) Provides multidisciplinary services in a short-term day treatment program setting;
(iii) Delivers comprehensive intensive services;
(iv) Embeds early, intensive behavioral interventions in a developmentally appropriate context;
(v) Provides an individualized developmentally appropriate ABA therapy treatment plan for each child; and
(vi) Includes family support and training.
(b) Community-based program, which means a program that provides services in a natural setting, such as a school, home, office, or clinic. A community-based program:
(i) May be used after discharge from a day services program (see subsection (3)(a) of this section);
(ii) Provides a developmentally appropriate ABA therapy treatment plan for each child;
(iii) Provides ABA services in the home (wherever the child resides), office, clinic, or community setting, as required to accomplish the goals in the ABA therapy treatment plan. Examples of community settings are: A park, restaurant, child care, early childhood education, or school and must be included in the ABA therapy treatment plan with services being provided by the enrolled LBAT or therapy assistant approved to provide services via authorization;
(iv) Requires recertification of medical necessity through continued authorization; and
(v) Includes family education, support, and training.
(4) An assessment, as described in this chapter, must be conducted and an ABA therapy treatment plan developed by an LBAT in the setting chosen by the child's legal guardian. The ABA therapy treatment plan must follow the agency's ABA therapy treatment plan report template and:
(a) Be signed by the LBAT responsible for the plan development and oversight;
(b) Be applicable to the services to be rendered over the next six months, based on the LBAT's judgment, and correlate with the COE's current diagnostic evaluation (see WAC 182-531A-0500(2));
(c) Address each behavior, skill deficit, and symptom that prevents the child from adequately participating in home, school, community activities, or that presents a safety risk to the child or others;
(d) Be individualized;
(e) Be client-centered, family-focused, community-based, culturally competent, and minimally intrusive;
(f) Take into account all school or other community resources available to the client, confirm that the requested services are not redundant, but are in coordination with, other services already being provided or otherwise available, and coordinate services (e.g., from school and special education or from early intervention programs and early intervention providers) with other interventions and treatments (e.g., speech therapy, occupational therapy, physical therapy, family counseling, and medication management);
(g) Focus on family engagement and training;
(h) Identify and describe in detail the targeted behaviors and symptoms;
(i) Include objective, baseline measurement levels for each target behavior/symptom in terms of frequency, intensity, and duration, including use of curriculum-based measures, single-case studies, or other generally accepted assessment tools;
(j) Include a comprehensive description of treatment interventions, or type of treatment interventions, and techniques specific to each of the targeted behaviors/symptoms, (e.g., discrete trial training, reinforcement, picture exchange, communication systems) including documentation of the number of service hours, in terms of frequency and duration, for each intervention;
(k) Establish treatment goals and objective measures of progress for each intervention specified to be accomplished in the three- to six-month treatment period;
(l) Incorporate strategies for generalized learning skills;
(m) Integrate family education, goals, training, support services, and modeling and coaching family/child interaction;
(n) Incorporate strategies for coordinating treatment with school-based special education programs and community-based early intervention programs, and plan for transition through a continuum of treatments, services, and settings; and
(o) Include measurable discharge criteria and a discharge plan.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 14-24-083, § 182-531A-0600, filed 12/1/14, effective 1/1/15.]
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