Regulation .03 Participant Eligibility.
Regulation .03 Participant Eligibility.LinkCopy Citation
A.
A participant shall meet the eligibility conditions set forth in §B of this regulation.
B.
To qualify for ABA services, a participant shall:
(1)
Be younger than 21 years old;
(2)
Live in the community;
(3)
Be diagnosed with an ASD by a qualified health care professional;
(4)
Exhibit the presence of maladaptive behavior or developmental skills deficits that significantly interferes with home, school, or community activities;
(5)
Be medically stable and not require 24-hour medical or nursing monitoring or procedures provided in a hospital or an ICF-IID;
(6)
Have a comprehensive diagnostic evaluation by a qualified health care professional;
(7)
Be referred for ABA services by a licensed health care professional; and
(8)
Have a completed ABA treatment plan that shall:
(a)
Be participant-centered and family-centered, culturally competent, and based on individualized goals;
(b)
Consider the participant's age, school attendance requirements, and other daily activities;
(c)
Be developed by:
(i)
A licensed psychologist; or
(ii)
An LBA;
(d)
Ensure that the interventions are consistent with ABA techniques;
(e)
Delineate both the frequency of baseline targeted behaviors and the behavior intervention plan to address the behaviors;
(f)
Identify long-term goals, short-term goals, and objectives that:
(i)
Are behaviorally defined;
(ii)
Are customized to the participant;
(iii)
Are measurable; and
(iv)
Are based upon clinical observations;
(g)
Identify the methods that will be used to measure achievement of behavior goals, objectives, and estimated timeframes;
(h)
Identify the schedule of services planned, including number of hours per week and the providers responsible for delivering the services;
(i)
Include:
(i)
Care coordination involving the participant's parent or caregiver and other professionals as applicable;
(ii)
Support and training of the participant's parent or caregiver;
(iii)
A plan for generalization; and
(iv)
Measurable discharge criteria.