On facebook yesterday, someone was asking a fairly direct question regarding the Governor’s recent announcement that Sanford and Avera were bringing forth plans to provide ABA coverage in insurance policies in the individual market in 2020, helping to bridge the gap between now and when the coverage of ABA therapy is added as an essential health benefit in 2021.
Their question was what did Kristi have to do with it? And as I pointed out, a lot.
Governor Noem’s administration was part of negotiating this (The Avera and Sanford offerings) with the carriers, and immediately before this, the Division of Ins under Gov Noem took the initiative to add ABA therapy to the state’s basic level of coverage, which is something that we parents who have been fighting this battle for several years now have been hoping for.
Adding it to the basic level of coverage was an extremely technical change, but it paved the way for getting it started, and I believe helped move the individual health carriers on board.
I wish ABA therapy could be covered by insurance for all kids w/autism, and we could cover everyone tomorrow, but having been involved in this fight and winning a law change for some group policies, among other things, these things do not change overnight. It’s a series of baby steps, taking the time to make our case at the legislature, and it’s moving in the right direction.
You can dislike the pace of change, and I wish it could happen far faster. But as a parent involved in this fight (and I wish I could do as much as Lisa Stanley who has been at session EVERY year on this), I’ll tell you that Governor Kristi Noem gets it, and has been very good to families affected by autism.
As an afterthought, I also noted another point which should be in the forefront of people’s minds as we work towards helping kids and formulate policy. particularly the capacity to deliver these services. Because as we fill ABA therapy coverage gaps in insurance, we also need to be aware of the gaps in services.
As we work on moving forward in filling ABA coverage gaps for the future, people need to understand there is another very significant challenge that we face that has nothing to do with insurance companies, which is that there is a very limited universe of providers/therapists for ABA services in South Dakota, and as more kids need services and can access them, we’re quickly going to hit the wall on capacity.
(BCBAs right now in South Dakota have a $10,000 hiring bonus they are in such demand.)
That problem is going to take creative problem-solving that could conceivably involve organizations such as the healthcare side of Avera & Sanford. It’s good that they are taking part in helping to solve the ABA problem.
In fact, with healthcare systems embedded across the state, Avera and Sanford might be two of the most important partners that South Dakota families affected by Autism have as we move forward with ABA coverage, because there’s a service delivery issue that hasn’t been discussed much yet.
When my family started our adventure in attempting to secure ABA services after our group policy dropped coverage, and we fought that battle, we were often having to drive from Brookings to secure services in Sioux Falls because that’s where the program and people were.
Services are available in Brookings now, but as more and more people seek these types of treatment for kids with Autism Spectrum Disorder, actually being able to get the services is the next big problem that parents of children with Autism Spectrum Disorder face.
Who provides ABA services?
A board-certified behavior analyst (BCBA) provides ABA therapy services. To become a BCBA, the following is needed:
- Earn a master’s degree or PhD in psychology or behavior analysis
- Pass a national certification exam
- Seek a state license to practice (in some states)
ABA therapy programs also involve therapists, or registered behavior technicians (RBTs). These therapists are trained and supervised by the BCBA. They work directly with children and adults with autism to practice skills and work toward the individual goals written by the BCBA. You may hear them referred to by a few different names: behavioral therapists, line therapists, behavior tech, etc.
To learn more, see the Behavior Analyst Certification Board website.
These plans and programs are being designed by people with masters and doctorates in psychology or behavior analysis. They have therapists who deliver it, but even then these are not specialties that are often available in some mid-size communities in the state. It’s gotten a little better, but especially for those living in rural communities, provider numbers and capacity are going to be big factors in receiving services.
As we fill in the insurance coverage gaps for ABA therapy, provider availability is going to be the next big challenge.
This is good news. I applaud the governor for stepping up to the plate.
$100,000 dollars a years seems a little over the top when you can do the therapy at home. https://www.youtube.com/watch?v=Lbins7IVf4Y
“ABA therapy programs also involve therapists, or registered behavior technicians (RBTs). These therapists are trained and supervised by the BCBA. They work directly with children and adults with autism to practice skills and work toward the individual goals written by the BCBA”
Parents often learn how to reinforce the skills, which are the same ones delivered by the technicians, who are the licensed practitioners who deliver the skills in a clinical setting. The BCBA’s design the programs for each child. They’re the ones who are fairly scarce in the job market.
It is worthwhile to become familiar with the preparation required to become a board certified behavior analyst(BCBA) here are the standards for content knowledge and expertise for BCBAs from the National Behavior Analyst Certification Board:
https://www.bacb.com/wp-content/uploads/2017/09/170113-BCBA-BCaBA-task-list-5th-ed-.pdf
In addition to completion of the required extensive coursework in philosophical underpinnings and conceptsl,measurement, data display and interpretation collection, behavior assessment, behavior change procedures and personnel supervision/management coursework, all BCBA candidates must complete a supervised practicum of 1500 hours – this means there must be a BCBA who is acting in direct supervision of the professional training to become a BCBA.
This rigorous preparation program is what ensure the quality and fidelity of ABA therapeutic interventions. It can’t be learned by watching a few videos nor is the location of the delivery of services relevant to cost – with the exception of those families living in rural and remote locations who must travel long distances to obtain the services of a Board-certified behavior analyst.
I bet many people that work with the hundreds of autistic children in SD are not certified and I bet they do a fine job. Just like there are college and tech school instructors that don’t necessarily have college degrees, but they are great educators.
Tara, you’re not reading for content, are you?
Not sure what you mean by your statement Pat. Could you re-phrase it please.
Tara, he means you’re expressing yourself without engaging your brain. Read the content woman.
ok, I’ll work on it. I think my brain is pretty engaged or I wouldn’t be doing the research and questioning that I do. Sounds like Pat was deflecting because he doesn’t agree with my statements.
Or you didn’t read mine.
I read all of your stuff Pat except for some of the fluff weekly articles that are sent to you.
There is a reason that historically, students travel to the teacher, not the other way around.
That’s why we have institutions of higher learning, boarding schools for the deaf, blind, gifted, Native Americans, preppies, and facilities for those requiring hospitalization or skilled nursing care.
There are always shortages of people with the skills to provide these services, and institutionalization of the recipients is the norm.
I don’t see any insurance company paying for a therapist to work 40 hours a week in a private home with one client. I just don’t see that happening