We, the Public Policy Committee of the Virginia Association for Behavior Analysis, have the following comments on the Draft Development Disabilities Waivers Appendix A Provider Manual. We thank you for the opportunity and partnership. Many of our members are providers of Therapeutic Consultation as Licensed Behavior Analysts and Licensed Assistant Behavior Analysts.

On page 60, the section titled Therapeutic Consultation, Occupational Therapists, Physical Therapists, Speech- Language Pathologists, Board Certified Behavior Analysts, Licensed Behavior Analysts, and Rehabilitation Engineers:

In the title, we respectfully ask that you delete the reference to Board Certified Behavior Analysts and list Licensed Behavior Analysts and Licensed Assistant Behavior Analysts. In the Commonwealth of Virginia, Board Certified Behavior Analysts are not permitted to practice unless licensed. 

The unit of service is currently 1 hour. However, a 15 minute-unit would be more efficient and less open to waste. Frequently, providers of therapeutic consultation provide services over or under the hour mark and then must adjust for billing purposes. Often this results in the provider not being paid for services provided under 30 minutes or the provider being paid for services not provided but rounded up to the next hour.

Please clarify that since ABA is not covered under the State Option Plan, as Speech, OT, and PT are, that waiver recipients should be able to access ABA through EPSDT AND Therapeutic Consultation.

On page 63, the section titled Therapeutic Consultation Behavioral Services:

There is a need to define who is legally able to provide this service. “Behaviorist” as a term is undefined in Virginia Code including DMAS and DBHDS regulations. It should be made clear that only professionals who have been trained to perform a functional assessment and have the services in their scopes of practice should be allowed to perform these services. 

We thank you for the opportunity to comment and welcome your continued partnership.