Previous posts have described Utah's pilot programs for funding ABA. The Salt Lake City Tribune reports on the Medicaid pilot:
Advocates are hoping the pilot — one of three — will show good results and lead to broader autism therapy coverage. But some providers now fear the Medicaid pilot will fail, based on its low pay and the minimum qualifications it requires for in-home therapists.
"I just don’t want to be a part of something that’s going to put the care and my profession at risk," said Jeff Skibitsky, owner of Alternative Behavior Strategies. "There’s no use in providing a service that’s going to be ineffective."
Adds Breanne Berg, with Apex Behavior Consulting: "It is just a waste of [the] money those parents have been fighting for for so long."
Both companies have signed up to provide services under the other pilots, but said they and others don’t plan to seek contracts for the Medicaid portion. All three will provide ABA, in use since the 1960s, to children between the ages of 2 and 6.
Skibitsky said the Medicaid contract makes more sense for therapy provided in a group setting, where a person with little experience could provide therapy but be constantly monitored. But under the pilot, the tutor will be supervised for one hour for every nine hours of unsupervised care, he said.
"You have a very fragile population here. There’s a chance people [could do] things that are completely inappropriate," he said.
Sandy MacLeod, a behavior analyst at the University of Utah, said the U. may apply to be a Medicaid provider under the pilot in order to maintain high standards, though it doesn’t yet employ in-home tutors. She agrees that tutors need more training than Medicaid is requiring.
"It isn’t an easy thing. It’s very, very specific and quite structured. It can make enormous changes if you do it right," she said. But she added: "You really need to know what you’re doing. You can cause problem behaviors to occur and not have any positive effect at all if you don’t have any training."