Medford City Council Saw No Opposition to Push MassHealth to Reform Autism Care

After a 6 – 0 – 1 vote, Medford is now the second city to approve a resolution that urges MassHealth to acknowledge assistant-level Board Certified Behavioral Analysts who are licensed by the Department of Public Health.

“Thousands of children in Massachusetts aren’t able to receive essential care. Creating a third tier of care is a“Establishing a three-tier delivery system is a necessary step to provide critical care to thousands of children who are in waiting lists and deserve better here in Massachusetts. A three-tier model, creates new jobs, treats more children, and prioritizes healthcare.”

— Medford City Council President Isaac “Zac” Bears

Tonight, Medford passed a resolution urging the Executive Office of Health and Human Services and MassHealth to fully recognize Board Certified Assistant Behavioral Analysts (BCaBAs) who are licensed by the Department of Public Health (DPH) and provide them with reimbursement for their services. This step would establish a three-tier delivery model for Applied Behavioral Analysis (ABA) services consistent with the framework created by DPH.

In Massachusetts, some 2,000-3,000 children are waiting for access to clinically appropriate services. Early intervention and consistent, timely treatment are essential to achieve the best outcomes. The biggest reason for this waitlist is that there are not enough ABA providers, given the constraints of the Commonwealth’s current 2-tier delivery model.

BCaBAs serve as a mid-tier supervisor for the provision of autism services, operating under the direction of a licensed BCBA. This 3-tier model is used successfully in other states and carries three principal benefits. First, the clinical competency of brand new BCBAs is enhanced as they spend significant time as a mid-tier BCaBA supervisor, shadowing experienced BCBA clinicians and gaining hands-on experience that is unavailable under a 2-tier model. Second, access to care is almost doubled under a 3-tier model as one BCBA is able to oversee 10-16 clients in a 3-tier model (with support from 1-2 BCaBAs), but only 6-10 in a 2-tier model with no support supervision. Lastly, per child costs are lower when a BCaBA mid-tier supervisor is part of the care-team, as the reimbursement level for a BCaBA is below that of a BCBA.