Agency budget includes $1 placeholder for autism care recommendations

Florida’s top healthcare officials are acknowledging that, when it comes to providing applied behavior analysis to autistic children and other patients, it may take money to save money.

The state Agency for Health Care Administration has included a $1 placeholder in its legislative budget request for the coming year “to support the final recommendations of the Applied Behavior Analysis (ABA) Task Force concerning the delivery of ABA services.”

The $1 placeholder is included in the “Health Care Regulation” section of the budget request and specifically identified as funding for “contracted services.” The placeholder also appears as a recurring general revenue expense, meaning the agency would like the money to be annually appropriated in future budgets unless specifically eliminated by the Legislature.

Florida agencies are annually required to submit legislative budget requests in advance of the upcoming annual legislative sessions. The requests are meant to provide lawmakers with insights into the agencies’ needs in advance of the annual session.

Next year, Gov.-elect Byron Donalds will consider the requests as his prepares his legislative budget recommendations for the Legislature.

“The placeholder is intended to support recommendations concerning ABA services developed through the task force’s evaluation,” the document notes.

ABA uses structured interventions to decrease maladaptive behaviors and reinforce appropriate ones. It is common in the treatment of children diagnosed with autism spectrum disorder and for people with attention deficit hyperactivity disorder (ADHD), traumatic brain injuries, and intellectual and developmental disabilities.

About 60,000 poor and low-income children in Florida receive ABA at a cost of about $2.3 billion, according to Shena Grantham, Florida’s deputy secretary for Medicaid policy and quality.

The costs, and a switch in policy that requires contracted managed care plans to provide the care, were a driving reason behind the Legislature’s decision this year to create the 10-member task force to recommend ways to “improve care experience and service continuity for enrollees and families receiving ABA services, while safeguarding long term program sustainability.”

Specifically, the legislation directs the task force to submit a report to the Legislature and governor by the end of the year examining at least six ideas:

• Clinical care models that lead to best practices for provision of therapy at appropriate ages.
• Appropriate transitions for enrollees receiving ABA services across developmental, educational, and community settings.
• Quality metrics for ABA therapy services.
• Limits and controls related to the length of time applied behavioral analysis services may be authorized.
• Potential caps on the number of months an enrollee may receive ABA services.
• Ways to enhance Medicaid provider enrollment and billing standards for ABA services, to promote program integrity and fiscal accountability.

AHCA Secretary Shevaun Harris initially wanted to have the recommendations complete by the end of October but time ran short. The panel meets Nov. 17 and, according to its agenda, will vote on recommendations then.