Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.34 - DEVELOPMENTAL DISABILITIES PROGRAM › Subchapter 37.34.19 - Applied Behavior Analysis Services › Rule 37.34.1902 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
The definitions applicable to Applied Behavior Analysis (ABA)
				  therapy services are as follows:
(1)
				"Applied Behavior Analysis" (ABA) means a type of therapy that applies human
				behavior principles to improve a member's adaptive functioning and reduce
				problem behaviors due to a psychiatric and/or behavioral condition.
(2) "Autism spectrum disorder" (ASD) means a
				condition as defined in the Diagnostic and Statistical Manual of Mental
				Disorders, Fifth Edition (DSM-5) of the American Psychiatric Association. The
				DSM-5 ASD definition is adopted and incorporated by reference. The DSM-5
				defines and classifies mental disorders. A copy is available for public
				inspection at: Department of Public Health and Human Services, Behavioral
				Health and Developmental Disabilities Division, Developmental Disabilities
				Program, 111 N. Sanders, Helena, MT 59604-4210. A copy may be purchased online
				at
https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
.
(3) "Behavior identification assessment"
				(BIA) means a developmentally appropriate assessment that identifies strengths
				and weaknesses across domains and potential barriers to progress. Areas of
				assessment may include challenging behaviors and skill deficits, co-occurring
				medical and psychiatric conditions, cognitive, adaptive, and developmental
				functioning, and family dynamics.
(4) "Board Certified Behavior
				Analyst®" (BCBA) means an individual with a
				graduate-level certification in behavior analysis who has been certified by the
				Behavior Analyst Certification Board (BACB). Professionals certified at the
				BCBA level are independent practitioners who provide ABA services.
(5) "Board Certified Behavior
				Analyst-Doctoral®" (BCBA-D) means a Board
				Certified Behavior Analyst who has earned their PhD, in addition to their
				Master's and/or Bachelor's degrees, and had been certified by the BACB. Any
				reference to a BCBA in these rules includes BCBA-Ds, unless indicated
				otherwise.
(6) "Board Certified
				Assistant Behavior Analyst®" (BCaBA) means an
				individual with an undergraduate level certification in behavior analysis who
				has been certified by the BACB. Professionals certified at the BCaBA level
				provide behavior analysis services under the supervision of a BCBA.
(7) "DD eligible" means a member found
				eligible for the receipt of state-sponsored developmental disabilities services
				pursuant to ARM 37.34.201.
(8)
				"Department" means the Montana Department of Public Health and Human
				Services.
(9) "Developmental
				disability" (DD) means a condition or disability that meets the definition of
				"developmental disability" set forth in
				53-20-202(3),
				MCA.
(10) "Diagnostic evaluation"
				means an evaluation performed by a qualified health care professional with
				expertise in the diagnostic area, that establishes the qualifying diagnosis
				through interview, observation, and formal assessment tools appropriate to the
				condition for which services are requested. The qualified health care
				professional with expertise in the diagnostic area may use assessments from
				professionals outside of their fields to obtain information that contributes to
				the diagnostic process.
(11)
				"Eligibility criteria" means those criteria established for the purposes of the
				program of ABA services authorized by the department, as specified in the
				Montana Medicaid Applied Behavior Analysis Services Manual (ABA Services
				Manual), dated July 1, 2023. The department adopts and incorporates by
				reference the ABA Services Manual which provides the public with greater detail
				about ABA services. Any conflict between these rules and what is outlined in
				the ABA Services Manual should be resolved in favor of what is written in these
				rules. A copy of the manual may be accessed on the DPHHS website at the
				following link:
https://medicaidprovider.mt.gov/manuals/appliedbehavioranalysisservicesmanual
or a paper copy may be obtained from the department by a request in writing to
				the Department of Public Health and Human Services, Behavioral Health and
				Developmental Disabilities Division, Developmental Disabilities Program, 111 N.
				Sanders, P.O. Box 4210, Helena, MT 59604-4210 or at
https://medicaidprovider.mt.gov/76
.
(12) "Functional impairment criteria" are
				defined in the ABA Services Manual.
(13) "Member" means a person enrolled in
				Montana Medicaid who is eligible to receive ABA services.
(14) "Provisional qualifying diagnosis" means
				a member's diagnosis that qualifies the member for initiation of ABA services
				but that has not yet been confirmed by a qualified health care professional
				with expertise in the diagnostic area. The diagnosis must meet functional
				impairment criteria and be:
(a) SED;
(b) ASD; or
(c) DD eligible.