Autism Insurance
Reform in Rhode Island
Dr. Andrea Chait
Director, Pathways Strategic Teaching Center
A program of the J. Arthur Trudeau Memorial Center
Steps toward insurance reform in
RI

Special House Commission to Study the
Education of Children with Autism in the State of
RI





To make a comprehensive study of the education of
children with autism particularly those with the
diagnosis and assessment
The prevalence of numbers in this state; the effect on
and the role of families
The appropriate goals for education
Effective interventions and education programs
Public policy approaches to ensuring access to
appropriate education and personnel preparation
Special House Commission
 Commission
began in 2008 with members
from:







Clinical Psychology
Education
Colleges & Universities
Department of Health
Medicine
Service Providers
Local Organizations
Steps toward insurance reform
 Commissions
focus turned to insurance
 Autism Speaks representatives Lorri
Unumb (VP, State Government Affairs)
and Judith Ursitti (Director, State
Government Affairs) attended several
meetings to offer expertise
 Commission drafted the legislation
Steps toward licensure
 Debate
among language regarding the
credentials of providers

Major points:
• BCBAs should be supervised by licensed
psychologists
• Both BCBAs and licensed psychologists should be
independent providers

Unanimous commission agreement that
BCBAs and licensed psychologist should be
independent providers of ABA.
Public Hearings/House Bill
 At
the initial public hearing, a psychologist
representative of the commission withdrew
support for the bill requesting that only
licensed professionals provide ABA
 With the support of Judith Ursitti, family
members affected by autism, and
professionals, the bill continued to move
forward as written
Public Hearings/Senate Bill
 Initially
the bills were identical
 At this point, private meeting were held to
negotiate with the insurance companies
 Outcome:



Age cap at 15
Monetary cap of $32,000
Credentials of providers required licensure
and BCBA
 Bill
passed
Effective January 1, 2012
Any individual proving ABA shall be:
1. Individually licensed by DOH as a healthcare
provider/clinician and nationally certified as a BCBA
and credentialed by the insurer
OR
2. Individually nationally certified as a BCaBA
supervised by a BCBA who is licensed by the DOH
as a psychologist, social worker or therapist and
credentialed by the insurer
As of Oct. 2011

There are a total of 61 professionals certified by
the Behavior Analyst Certification Board
Credential
BCBA-D
No.
8
BCBA
49
BCaBA
4
Qualified Providers
 The
exact number of professionals
licensed & BCBA or BCBA-D is
undetermined but our best guess is
approximately 5 professionals meet this
criteria in the state of Rhode Island
Movement for Licensure
 With
the support of Judith Ursitti, we met
with the Senate Policy Director and
Deputy Director to begin drafting licensure

Advocates: Dr. Sheila Quinn, Brian
McGovern, Judith Ursitti, & Dr. Andrea Chait
• We pushed for the BACBs model licensure act and
they used components from that act
• Policy director stated she would be contacting
RIPA to discuss further
Movement for Licensure
 The
next meeting was held to review the
draft with:


The head of the psychology licensing board
and RIPA legislative representative
The manager of public affairs and government
relations for RIPA
Concerns of Psychologists
 BCBA’s
have a limited scope of practice
 Experts in the field would be excluded
from providing services because they are
not BCBA’s
 They did not want to include reference to
the BACB in the licensure
 Medicaid will possibly deny claims when
passed on by private health insurance due
to the lack of providers
Senate Policy
 Revised
draft
 Second meeting
 Additional concerns by psychologists
expressed
Psychologist Concerns

They do not want a bachelors level license (i.e., they want
BCaBAs excluded from licensure)
 They want the licensing standards similar to other masters
level licenses (i.e., post grad experience/supervision) prior to
licensure
 They would like the board to offer temporary permits as a way
to enable people to practice with appropriate supervision until
licensed
 They want to make sure that LBA records will be considered
medical records and patients privacy will be respected
 They want to add a coordination piece with other healthcare
providers
 They want to specify the role of supervision (for the BCBA)
 Their primary concern was the competent psychologists who
have been practicing ABA for years will no longer be able to
practice without obtaining a second license and their BCBA
Questioning the BACB Credential
A. Degree Requirement:
 Possession of a minimum of a bachelor's
and a master's degree that was conferred
in behavior analysis or other natural
science, education, human services,
engineering, medicine or a field related to
behavior analysis and approved by the
BACB
Next Steps
 Senate
Policy will revise draft based on
feedback and submit to the DOH and
Insurance Representatives for further
discussion
 Anticipate submission of bill in January
Thank You
Judith Ursitti,
Director State Government Affairs, Autism Speaks
Lorri Unumb
VP State Government Affairs, Autism Speaks
Dr. Sheila Quinn
Salve Regina University
Brian McGovern
Behavior Analyst, Pathways
Caitlin Thomas-Henkel & Marie Ganim
RI Senate Policy Office