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Telehealth Supervision

Scenario

“What are the current AZ State Statutes regarding providing behavior analytic services through Telehealth? As long as the practicing Behavior Analyst holds an Arizona license, is it legal to provide all supervision through telehealth?”

 

Committee Input (e.g., considerations for pathways forward, potential barriers, potential solutions):

More information would be needed in the above submission to provide more explicit pathways for exploration.  That said, various support options are outlined below.  We would encourage the person who submitted this concern to flush out the context and provide additional details if additional guidance is needed.

If the submitter is asking if telehealth is an appropriate method for client supervision, the LBA providing the service must consider the magnitude of any problem behavior, the level of hands-on training provided to the behavior technician, and the initial service requested of the funder.

  • If the funder did not specify telehealth as an option for reimbursement, consider A.R.S. 32-2091 12 (a), obtaining a fee by fraud or misrepresentation. The LBA would need to contact the funder to request a change in place of service and may not be in compliance with the Ethics Code 2.06 Accuracy in Service Billing and Reporting, and 3.12 Advocating for Appropriate Services.
  • If the client is engaging in dangerous behavior and/or staff has not had in-person training with a supervisor, this could be a violation of A.R.S. 32-2091 12(e), gross negligence in the practice of a behavior analyst.
  • In addition, they may also consider Ethics Code 2.01 Providing Effective Treatment, 2.19 Addressing Conditions Interfering with Service Delivery, 3.01 Responsibility to Clients, 3.03 Accepting Clients and 3.12 Advocating for Appropriate Services, 4.04 Accountability in Supervision, and 4.06 Providing Supervision and Training.

In the event that the submitter is asking about funder requirements:

  • The LBA will need to refer to their specific contracts about the ability to perform telehealth as a billable service. Billing for a service that is not allowable in the service contract could be a violation of A.R.S. 32-2091 12 (a), obtaining a fee by fraud or misrepresentation and the LBA may be required to reimburse the funder for payment.

Considerations for exploration:

  • If telehealth is the appropriate service modality for a client’s level of need, and the funder allows for billing telehealth, no changes are necessary.
  • If telehealth is the most convenient service modality but does not meet the needs of the client or technician, consider referring to a provider who has the availability to meet the client’s needs within funder requirements.
  • If this is a concern about a BCBA not meeting the needs of the client, first seek out additional information from that BCBA about clinical recommendations for the client. If a needs assessment was not provided for the client and the needs of the client are not being met, it would be appropriate to discuss concerns with the supervising BCBA.
  • The committee acknowledges that any breach in the BACB Ethics Code is reportable to the Arizona State Licensure Board. The Committee would encourage the reportee to explore filing a complaint with the licensure board, against the party in the organization who is inappropriately supervising a client, if mediation using other, more informal methods does not yield an improved result.
  • Always review your contract for billing allowances and be aware that individual plans may differ within the specific funder.

 

Ethics Codes (specific standards that could apply to support/oppose):

  • 2.06, 3.12
  • 2.01, 2.19, 3.03, 3.12, 4.04, 4.06
  • A.R.S. 23-2091 12(a)/12(e)
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