Provider Manual

IMPORTANT INFORMATION REGARDING FUNCTIONAL BEHAVIORAL ASSESSMENTS

The cornerstone to delivering Behavioral Health Rehabilitation Services (BHRS) to all children and adolescents is an individualized treatment plan designed to meet the needs of the child or adolescent. Using a Functional Behavioral Assessment (FBA) to determine the treatment approach and ultimately develop a treatment plan is currently the standard of care for treating children and adolescents with behavioral health needs compounded by developmental disorders, such as autistic disorder and other pervasive developmental disorders, who present with challenging behaviors.

Effective January 1, 2009, the Commonwealth of Pennsylvania Department of Human Services (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) requires that Functional Behavioral Assessments (FBAs) conducted by credentialed (certified) Behavioral Specialist Consultants (BSCs) will be available for children and adolescents with behavioral health needs compounded by developmental disorders, such as autistic disorder and other pervasive developmental disorders, in both the fee-for-service delivery system and in HealthChoices.

In order to qualify for credentialing, a BSC must complete FBA training and demonstrate competence in conducting the FBA or complete one of the Board Certified Behavior Analyst (BCBA) credential programs offered by a university.

An FBA should be conducted as early in the treatment planning process as possible, at the beginning of service delivery or before the current authorization period expires if there is significant change in behavior, or deterioration in behavior that may indicate the need for a different level of care. The interventions and hours of ongoing treatment recommended from the FBA form the basis for developing the ongoing treatment plan and in formulating a crisis intervention plan.

The initial FBA will take an average of twelve to fifteen hours over four to six weeks to complete, but could take longer, depending on the complexity of the child’s needs. The length of subsequent FBAs or updates to an FBA will similarly depend on the child’s needs and the circumstances that prompted the need for the new or updated FBA.

Physicians and licensed psychologists who conduct evaluations for this population of children should know about the availability of an FBA when prescribing BHR Services.

A family may choose not to have an FBA conducted for their child. A request for BHR Services may not be denied because an FBA was not conducted.

A Health Choices Contractor may not deny a request for BHR Services because an FBA was not conducted.

Please refer to OMHSAS Bulletin number OMHSAS-09-01 issued January 9, 2009 and effective January 1, 2009 for information. Title “Guidance for Conducting Functional Behavioral Assessments in the Development of Treatment Plans for Services Delivered to Children with Behavioral Health Needs Compounded by Developmental Disorders.”