In Pennsylvania, Medicaid now recognizes a popular therapy for kids with autism — applied behavior analysis. But advocates are worried that demand for this therapy will outpace the supply of trained therapists.
After a lawsuit filed by the Disability Rights Network was settled over the summer, more than 40,000 Pennsylvania households received a letter notifying them that applied behavior analysis, known as ABA therapy, is now covered for those under 21.
The one-on-one therapy covers a wide range of interventions that are constantly evaluated to determine what works for an individual patient — and what doesn’t.
But special education lawyer Josh Kershenbaum said Pennsylvania lacks qualified therapists.
“The problem, from a systemic standpoint, is the more people know about it, you’re going to have more demand for these services,” he said. “And the rate of demand is going to increase much faster than the supply of qualified people.
“So, I think it’s very possible that, in the short term, the problem could get worse before it gets better.”
Before this settlement, the state didn’t require that behavioral health care workers be certified in ABA or have ABA training at all. Now, health care workers must submit in writing that they have some training, and the state will begin drafting regulations next year.
To compensate for the lack of certified therapists in-network, Medicaid has agreed to pay for out-of-network providers.
Kershenbaum noted that ABA therapy is time intensive and requires a lot of training.
“The only people that are going to be providing it are private entities,” he said. “And the only people that are going to be able to afford it are folks that can pay out of pocket, or school districts and public entities are going to have to pay those private entities to contract it out. And that’s very expensive.”
He’s hoping that now that its covered, more people will become certified to offer this kind of help.
If caretakers have concerns about accessing ABA therapy, the state Department of Human Services can be reached at ABA@pa.gov.