The ABA in PA Initiative’s Analysis of ABA Providers in the Commonwealth of Pennsylvania

Background: Pennsylvania’s Department of Human Services was not ensuring appropriate availability or quality of Applied Behavior Analysis (ABA) for children with Autism Spectrum Disorder (ASD). This left individuals throughout the state unable to access this medically necessary intervention. ABA therapy is an evidence-based intervention proven to significantly help children with ASD in many developmental domains. The ABA in PA Initiative, a 501(c)(3) advocacy organization, supported the Disability Rights Network of Pennsylvania in a class action lawsuit (Sonny O. v. Dallas) filed in 2014 to hold the Pennsylvania Department of Human Services accountable. While the lawsuit was decided favorably, the terms of the settlement are now being implemented. As a result of the lawsuit, ABA must meet evidence based standards that are published by the Behavior Analyst Certification Board. This settlement opened the door for a large number of behavior analysts to move into the state. However, there is very little information currently known about the availability and quality of care delivered by provider agencies.

Objectives: We seek to evaluate changes in the landscape of ABA provider agencies over the years following the Sonny O v Dallas lawsuit settlement by measuring key agency and provider metrics.

Methods: The ABA in PA Initiative has maintained a directory of ABA providers for Pennsylvania since 2014. This directory is voluntary and agencies are added based on our own web-search for provider agencies and by an agency reaching out to us to be added. We use social media platforms (e.g., Facebook, Twitter, LinkedIn) for outreach purposes. Agencies qualify if they provide ABA services to children in PA. To learn about provider qualifications and availability, agencies will be queried via survey on a variety of agency characteristics.

Results: To date we have collected simple demographics (e.g., contact information, counties served) for 105 agencies. Cursory analysis indicates that 48% currently take Medicaid and 52% do not. All agencies indicate that they employ at least 1 BCBA/BCBA-D (Board Certified Behavior Analyst), 17% indicate they employ BCaBA’s (Board Certified Assistant Behavior Analyst) and 49% indicate they employ RBTs (Registered Behavior Technicians). An 11-item survey was developed to capture key additional information including 1) agency size, 2) number of providers that hold the BCBA, BCaBA or BCBA-D certification as well as those who hold the RBT credential, 3) The percentage of cases staffed with certified and credentialed providers, 4) payer mix to include Medicaid, and 5) hiring and staffing strengths and barriers. Survey questions have been created and a link embedded in an email will be used to request agency input. Participation is voluntary but each agency that responds will be entered to win a gift card. Surveys will be emailed every 6 months for 18 months and all responses will be kept confidential in REDCap.

Conclusions: While the Sonny O. v. Dallas class action lawsuit opened the door for behavior analysis in Pennsylvania, characterizing changes to ABA provider agencies using key provider metrics will be important to understanding the needs of children with developmental disabilities in the years ahead.