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  • RESOURCES
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FL. MEDICAID Behavior Analysis Services

59G-4.125 Behavior Analysis Services.


(1) This rule applies to all providers rendering Florida Medicaid behavior analysis services to recipients. 


(2) All providers must be in compliance with the provisions of the Florida Medicaid Behavior Analysis Services Coverage Policy, September 2023, incorporated by reference. The policy is available on the Agency for Health Care Administration’s website at the link below. 


(3) This rule is in effect for 5 years from its effective date.

Coverage Policy

New SMMC program

MEDICAID MANAGED CARE

Information

ABA SERVICES

AHCA

Information

BACB Newsletter

MARCH 2025

AHCA

State of Florida

HOMEPAGE

ANALYSTS

Please note these resources are tailored for the Analysts at Nory's Home Services.

https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-230119-a.pdf


https://www.casproviders.org/asd-guidelines


https://autismlawsummit.com/about/the-playbook/


Yes, if the recipient of services is attending a public school, a current IEP (within a year) must be submitted. If the recipient is enrolled in a private school and the private school does not provide any document, please ensure to mention this information in the school section of the behavior plan.


  • Use directly observed data: It is preferable to have at least three (3) directly observed data points before setting intervention goals.
  • Avoid weekly estimates or averaged data: Baseline data should be based on actual, specific observations rather than generalized estimates or averages.
  • Avoid relying solely on parent-reported data: While parent input is valuable, baseline data should primarily be gathered through direct observation by a qualified behavior analyst, rather than solely relying on reports from parents or caregivers.
  • Include baselines for all goals: All maladaptive behavior, skill acquisition, and parent training goals should have baseline data. This provides a clear starting point to assess progress.
  • Assess current performance levels: Evaluate the current level of performance for skill acquisition goals. Not all goals should start at 0%; it's essential to have a baseline that reflects the individual's current abilities.
  • Do not use indirect measures as actual data: Data from indirect measures, such as interviews or questionnaires, should not be considered as actual baseline data. Direct observation is essential to ensure accuracy.
  • Ensure direct observation as the standard: All baseline data must be directly observed and measured, adhering to the standard practices in the field of behavior analysis.


No. Those named interventions do not conform to standards within the field of applied behavior analysis.


Yes. Goals must be individualized. Make sure the replacement goals are directly related to the functions of the maladaptive behaviors and the individual's functional level.


  

  • Graphs must start at zero (0).
  • When presenting percentages or opportunities to respond, graphs must go up to 100%.
  • If the graphs show an undesired trend, a summary must be added, explaining      what will be done to address the undesired trend.


  • Review that names of other individuals are not in the plan.
  • Use the correct pronouns throughout the plan (He/She).
  • Ensure that the goals are related to the level of functioning.
  • Verify that the goals are addressing the functions of the problem behavior.


  • Consider removing a current intervention and adding a new antecedent strategy.
  • Add a procedure to reinforce functionally equivalent alternative/replacement behavior.
  • Modify consequence-based strategies.
  • Manipulate the schedule of reinforcement (add or remove reinforcement).

  

Additionally, address any potential human errors. It might be helpful to assess whether the RBT (Registered Behavior Technician) needs more training and increase Inter-Observer Agreement (IOA) to ensure consistency in data collection and implementation.


Positive Punishment

  • Overcorrection
  • Reprimands 
  • Response Blocking
  • Contingent Exercise
  • Response Interruption and Redirection (RIRD)
    • a. Motor RIRD: interrupt and redirect motor stereotypy
    • b. Vocal RIRD: interrupt and redirect vocal stereotypy.


Negative Punishment

  • Response Cost
  • Direct Fines
  • Response Cost
  • Time Out: 
    • a. Non-Exclusionary
      • 1.  Planned Ignoring
    • b. Exclusionary Time-Out
    • c. Seclusion Time-Out


  • Use it ONLY if you have attempted a reinforcement procedure that has failed.
  • Clearly explain in the plan why you need to use a punishment procedure.
  • Make sure to use punishment in combination with a reinforcement procedure.
  • Clearly explain the criteria for fading punishment.
  • Provide a clear explanation of the safeguards that will be considered when using punishment.


  1. Free of un-observable events: Containing words such as "wants," "does not want," "appear," "frustrated," and "bored." Limit the definition ONLY to observable behaviors.
  2. Must have and onset and offset: Based on the provided definition, observers cannot identify when the behavior starts or finishes, because the onset and offset are not defined. Example: Elopement: Any instance in which the onset involves the client running away from a supervised area (out of eyesight of those in the setting), including running to unsecure locations (e.g., open street) and the offset  involves the client returning to/being returned to eye-sight supervision. This definition excludes bolting but remaining within eyesight supervision.
  3. Must not overlap with other definitions: Verbal aggression, defiance, and task refusal are all related to verbal responses. If any of these behaviors occur, how will you provider will be able to identify what behavior to collect data on. Ensure that all behaviors are distinct and do not share any aspects that are related to or the same as another behavior.
  4. Must not topographically describe the same name of the behavior: Example: Hitting - "Juan is hitting others.” Definitions must depict the behavior that the analyst physically observes in a manner that enables anyone witnessing it to identify it easily.


RBT's

Please note these resources are tailored for the RBT's at Nory's Home Services.

https://www.bacb.com/wp-content/uploads/2022/01/RBT-Ethics-Code-230120-a.pdf


As an RBT, your role is to assist in the implementation of behavior intervention plans developed by a Board Certified Behavior Analyst (BCBA). This involves providing direct, one-on-one ABA therapy to individuals, collecting data on behavior, and following specific intervention procedures outlined in the behavior plan.


You don't on your own. As an RBT, you will assist the BCBA in conducting assessments, such as functional behavior assessments (FBAs) or skill assessments. Your role may involve observing behavior, collecting data, and providing input to the BCBA to help inform the assessment process.


When addressing challenging behaviors, you will follow the behavior intervention plan developed by the BCBA. This may involve implementing strategies such as positive reinforcement, prompting, and teaching replacement behaviors. Regular communication with the BCBA is essential to ensure effective behavior management.


To promote skill acquisition, you will implement interventions designed by the BCBA to teach new skills. This may involve breaking down skills into smaller steps, using prompting and fading techniques, and providing reinforcement for desired behaviors. Data collection is critical to track progress and make data-driven decisions.


As an RBT, you will collect data during sessions using specific data collection methods and tools provided by the BCBA. This may include frequency counts, duration recording, or ABC data collection. Analysis of data involves summarizing and interpreting the information to monitor progress and make informed treatment decisions.


As an RBT, you must adhere to ethical guidelines and professional standards set by the Behavior Analyst Certification Board (BACB) and your agency. This includes maintaining client confidentiality, respecting professional boundaries, following protocols, and policies & procedures. 


To continue your professional development, you can pursue further training and certifications in ABA. Attend workshops, conferences, and webinars to stay updated on the latest research and best practices in the field. Engage in ongoing supervision and seek guidance from BCBAs to enhance your skills and knowledge.


Remember to consult with your agency's policies, procedures, and the guidance of your BCBA for specific answers and recommendations related to your organization and ABA services.


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12966 SW 133rd COURT, MIAMI, FL 33186

(O) 305.255.6203 (F) 305.255.6205

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