woodbury

 

Behavior Assistant

Provider Requirements and Service Limitations

From The May 2010 Florida Medicaid Provider Handbook

Information highlighted in yellow indicates a change since the July 2007 version of this handbook.

Behavior Assistant- Requirements To Receive

Description

Behavior assistant services are one-on-one activities related to the delivery of behavior analysis services, as defined under Behavior Analysis Services and Assessment, and are designated in and required by a behavior analysis service plan. Activities include monitoring of behavior analysis services, the implementation of behavioral procedures for acquisition of replacement skills and reduction of problematic behaviors, data collection and display (e.g., graphics) as authorized by a recipient’s behavior analysis service plan and assist the person certified as a behavior analyst or licensed under Chapter 490 or 491, F.S., in training of caregivers. The behavior analysis service plan must be designed, implemented, monitored, and approved in accordance with rule 65G- 4.009, F.A.C.

Behavior assistant services are designed for recipients for whom traditional residential habilitation services have been documented unsuccessful or are considered to be inappropriate for health or safety reasons and for children who require behavioral services, but for whom providing services in the family home will likely be more effective and least restrictive. Services should be provided for a limited time and discontinued as the support persons gain skills and abilities to assist the recipient to function in more independent and less challenging ways. Behavioral assistant services for children should supplement and support, transfer stimulus control and generalize behavior change, the acquisition and reduction plans designed and implemented by the primary source of services for children, the education system.

Documentation Requirements

Reimbursement* and monitoring documentation to be maintained by the provider:

  1. *Copy of claim(s) submitted for payment;
  2. *Copy of service log;
  3. *Quarterly summary of monitoring of program implementation including the who, what, when, and where of the monitoring events;
  4. • A quarterly summary for each quarter of the support plan year;

    • A quarterly summary for the third quarter of the support plan year also serves as the annual report and must include:

    • a summary of the fourth quarter of the previous support plan year, and

    • a summary of the first three quarters of the current support plan year.

  5. *Copy of the behavior analysis service plan must be in the recipient’s file prior to claim submission.
  6. *Monthly data displays;
  7. *A record of the LRC review of the behavior services plan and data displays must be provided if the targeted reduction behaviors meet the requirements identified in 65G-4.009, F.A.C.; and
  8. A record of the LRC review of the behavior services plan and data displays must be provided if more than 65 quarter hours of behavior assistant services are approved daily.

Documentation to be submitted to the waiver support coordinator by the provider:

  1. Copy of monthly service log;
  2. Quarterly summaries as follows:
  3. • A quarterly summary for each quarter of the support plan year;

    • A quarterly summary for the third quarter of the support plan year also serves as the annual report and must include: • a summary of the fourth quarter of the previous support plan year, and

    • a summary of the first three quarters of the current support plan year.

  4. Copy of the behavior analysis services plan within 90 days of providing the services; and
  5. Data displays if an increase in the level of services is being requested.
  6. Data displays at the third quarterly summary submission.

*Indicates reimbursement documentation.

Place of Service

These services may be provided in the provider’s office, the recipient’s place of residence or anywhere in the community. However, in all cases, behavior assistant services must also be provided in the setting(s) relevant to the behavior problems being addressed.

Special Considerations

The services of a Behavior Assistant must be approved by the responsible Behavior Analysis Services Local Review Committee Chairperson, as defined in rule 65G-4.008, F.A.C., and monitored by a person who is certified in behavior analysis or licensed under Chapters 490 or 491, F.S., in accordance with rule 65G-4.009, F.A.C.

Behavior Assistant Provider Requirements

 

Provider Qualifications

Providers of this service must have at least:

  1. A high school diploma and be at least 18 years of age;
  2. Two years of experience providing direct services to recipients with developmental disabilities or at least 120 hours of direct services to recipients with complex behavior problems, as defined in rule 65G-4.010(2), F.A.C., or 90 classroom hours of instruction in applied behavior analysis from non-university non-college classes or university or college courses; and
  3. 20 contact hours of instruction in a curriculum meeting the requirements specified by the APD and approved by the APD-designated behavior analyst. Instruction must be provided by a person meeting the qualifications of any category of behavior analysis provider as described above.

    A. Either a certificate of completion or a college or university transcript and a course content description, verifying the applicant completed the required instruction, will be accepted as proof of instruction.

    B. The 90 classroom hours of instruction specified under number 2. above shall also count as meeting the requirements of the 20 contact hours specified in this section

Training Requirements

Proof of training in the areas of Cardiopulmonary Resuscitation (CPR), HIV/AIDS and infection control is required within 30 days of initially providing behavior assistant services. Proof of annual or required updated training shall be maintained on file for review. The provider is responsible for all training requirements outlined in the Core Assurances.

Note: Refer to the Core Assurances in Appendix A for the provider training requirements.