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Up To Half Of ABA Clinics Could Shut Down With Licensure Requirement, Lawmaker Says

Jan 31, 2020

A bill that would exempt applied behavior analysis clinics from needing an expensive state license is headed to the Florida House floor for a vote in the next month.

Supporters of the proposed bill say clinics that treat children on the autism spectrum will face tough financial decisions if it doesn't pass.

The state Agency for Health Care Administration recently announced they will begin enforcing an old rule on the books requiring clinics that provide ABA therapy to have a specific health care clinic license by December 2020.

To see all of our ABA therapy coverage, click here.

“Month after month, we see new things, new ways for our profession to be kind of singled out and arbitrarily affected,” said Marucci Guzman, the executive director for the Santiago and Friends Family Center for Autism in Orlando.

She says this, and many other requirements for ABA therapists recently, boil down to fewer children getting therapy that helps them more easily communicate and avoid aggressive and self-harming behaviors.

RELATED: Autistic Children Face Medicaid Snags For Therapy

Many clinics in Florida don't meet the criteria for approval and would have to hire an additional licensed practitioner as the director. They'd also have to pay an annual fee.

HB 575 would exempt ABA clinics from the costly licensure.

“Right now, there's currently exemptions in place for other entities and other types of medical businesses,’ Guzman said. “What the ABA community is saying is that we want the same thing. We want that exemption, to show you that we're qualified entity to provide these services, but we don't follow under the health care requirements that require that clinic license.”

See the forms here and here that medical businesses must fill out for an exemption.

It will cost at least $30,000 for each clinic to comply, said Rep. Rene Plasencia (R-Orlando) who sponsored HB 575.

"It's important to understand that if this bill does not pass, especially the licensure component, you're going to see a lot of clinics -- and I would say anywhere between 30 to 50% of our clinics -- would be forced to close down,” Plasencia said.

The lawmaker and former teacher says some clinics have already shut down after the state began making changes to the Medicaid program two years ago in response to suspected ABA-related fraud in South Florida.

RELATED: AHCA Moves Forward With ABA Therapy Medicaid Changes

Citrus County's last clinic shut down in 2019. Providers say many clinics already have long waiting lists for children to get services, and this costly requirement could make that worse.

Plasencia says in order for a clinic to be in compliance, they have to hire someone who has a either a mental health license, or is a physician, to serve as your director of the facility. An administrative role, not a clinical one, he says.

“You essentially will be hiring someone to just sign a piece paper,” Plasencia said. “And that's going to cost each clinic anywhere from $30,000 to $50,000 a year, literally to have someone do something that takes them 15 seconds.”

Another aspect of the bill addresses the types of providers allowed into public schools to help students address behaviors and triggers in that environment. It redefines the term "private instructional personnel" to include behavior analysts and paraprofessionals providing applied behavior analysis services, like registered behavior technicians.

Currently, only board certified behavior analysts are allowed in schools.

Steve Coleman, public policy director for the Florida Association of Behavior Analysis, said this will allow providers to serve more children.

"We often practice by way of having technicians or other people spend numerous hours and providing service at a lower cost with supervision by a registered certified behavior analyst,” Coleman said.

“It’ll assist teachers in schools who otherwise are left with some very challenging children in their classrooms.”

He says there are only so many Board Certified Behavior Analysts and they’re already spread thin. Registered Behavior Technicians are more plentiful and cost less for clinics to employ.

A similar bill in the Florida Senate is scheduled for it's first hearing on Tuesday in the health policy committee meeting.