* Task Force on Autism
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- October 8, 2026
Senator Keith Ingram
Unverified
0:00
Committee, please come to order. It's great to see everybody here on this brisk fall day. First item, first, let me say that my co-chair, Representative Justin Boyd, called me Monday, and I guess they're having, Health is having an emergency meeting, and he had to go to it. But Senator Irvin had called an emergency meeting, so he
certainly wanted to be here and want me to apologize, but he could not get out of that.
So, the first item of business, we see a quorum, would be the approval of the minutes from the May 16, 2019 meeting. Has everyone had a chance to review those? If there are no additions or corrections and no objections, then I would say that they are approved. The next item on the agenda is the implementation of the voluntary guidelines for the use of seclusion and restraint.
Aaron, please go to the end of the table and introduce yourself. And I will remind the committee that this is live streaming that is taking place in here. So introduce yourself and your position, please. Hi, I'm Erin Franks, Chief Legislative
Speaker 4
1:33
Affairs Director for the Department of Education. And if you don't mind, I'm going to call Ms. Courtney Solis-Ford to the table with me.
She's been a part of this since the beginning. regarding seclusion and restraints and she knows a lot more history going forward
Senator Keith Ingram
Unverified
1:53
excellent we're glad you're here please introduce
Speaker 8
1:59
yourself thank you courtney solace for deputy general counsel for the division of elementary and secondary education um so in may of 2012 the u.s department of education put out a restraint and Seclusion Resource Document.
After several failed attempts to pass legislation, they went the route of guidance and issued kind of 15 guiding principles for states to look at and consider and recommended that states, you know, do what they felt was best for their state in issuing guidance or legislation. We have no legislation or statutes that govern restraint or seclusion in schools in our state. So in 2014, the Department of Education convened a committee of stakeholders from school districts, practitioners, and developed our guidance that was issued, again, in 2014 to school districts.
Without any binding authority, these are guidelines that were sent out to districts recommending policies, recommending procedures for how they may use restraint and or seclusion in their school districts. We can't tell you how many school districts are actually following these to what extent because that's not required information, nor do we have the data on the use of restraint and seclusion, again, because that's not something that's required to be reported.
We do get questions occasionally from school districts, you know, on the legal liability of using such things, which is always referred back to local counsel. We know that several school districts have training done by the different organizations on different holds and restraint techniques. And then we do have guidelines on also the use of what we call timeout seclusion rooms in terms of the size of the room, how long a student might be placed in that room.
And districts do have to follow those requirements. And if not, a parent can file a complaint with the department. There has not been any complaints filed in the last 10 years in regards to the use of seclusion, so that would be the only data we are able to provide. But we'd be happy to
Speaker 12
4:22
answer any questions anyone might have. Thank you, committee. Any questions regarding this?
Katie Sursa
Unverified
4:31
Diana, you're recognized. So, at Diana Verity with the Arkansas Autism Resource and Outreach Center, while parents haven't been filing any complaints, we have been getting lots of phone calls about issues concerning specifically a few in recent months around the use of a timeout sick lesion room in a district, but multiple phone calls about concerns with the use of restraints.
And so one of the, of course, one of the concerns that I've had and continue to have is without some kind of a statutory authority for the Department of Education to move forward with actual regulations on the use of restraint, we're going to continue to be fielding phone calls and not be able to assist them in navigating the process of filing a grievance or filing a complaint
with the Department of Education. In addition to that, we, through our project, train all over the state, train just school resource officers and other public education staff, and they have lots of questions around the use of restraint, and there's a lot of conflicting information out there. And so again, I
I would urge, so this is great information. What it tells me is that we issued some guidelines, and we don't know if they're being followed, and we don't know if schools are using restraints appropriately. And so my concern, it's the same concern I had since 2014, is that without some muscle behind these guidelines,
we're going to continue to have districts that are really, they want to do the right thing, but they're getting conflicting information from everyone. I always point them to the guidelines, but many of them don't even know they exist. So what I would like to see this body do is, you know, we're charged with making recommendations for legislation, and I think it would be appropriate for this body to examine making a recommendation,
a specific recommendation for legislation around the use of restraints in public schools. We've kind of been talking about it and talking about it and talking about it for five years now, and we're no further along than we were back then. And so I guess it wasn't a question. It was more of a comment.
Senator Keith Ingram
Unverified
7:42
But thank you for coming and giving us an update. Courtney, would you walk us through if a
parent typically has an issue with a child with restraint?
I mean, I would think the first they're going to the superintendent of the school would be my first, probably, inclination. But if they're not satisfied, typically, where would they go? What would be the next step? So
Speaker 8
8:06
if they're unsuccessful in resolving their issues with the school administration, of course, they can go to the local school board. But beyond that, they can file a complaint with the Office for Civil Rights, which is a federal office. but they would have to base their complaint on a discrimination type of stance,
that their child was improperly restrained because of a disability, because of their race, because of a protected class. They could file a civil lawsuit for unlawful physical contact. If it rose to the level of abuse, of course, they could file something with the child maltreatment hotline. those would be the most common avenues available. The only way that we could have any authority at the department to investigate a complaint is if it was specific to seclusion or if it was along
the lines of a child having an IEP or a 504 plan that wasn't being implemented. Typically you don't see the use of restraint in an IEP or 504 but occasionally it does
Speaker 26
9:11
happen. And would you State, you said something earlier. You have not fielded a complaint regarding
Speaker 8
9:18
this in 10 years? Correct. I've been with the department for 10 years, working specifically with the special education unit, and we have not had any complaints about seclusion, which is something that we have the authority to investigate. We have received some complaints where one of the allegations was
regarding restraint, but as Ms. Verde stated, we don't have that authority to enforce anything, So it's not something we could proceed with an investigation.
Senator Keith Ingram
Unverified
9:46
Are you aware of surrounding states or any other states that might have model legislation regarding this?
Speaker 8
9:53
There are several states that do. I can't say which is the best or which, you know, we might be considered the best model. But, again, this task force has looked at this subject before, and I believe it was back in 2014,
that different states were looked at. I couldn't tell you specifically which ones right now, but I do have information from back then.
Senator Keith Ingram
Unverified
10:16
I would appreciate you providing that, please. We can
do that. Other questions? Any other questions from the committee? If not, thank you all for
your testimony. Thank you. Thank you. D, the next is Melissa.
Do you want to go to the end of the table, or do you want, yeah, would you go to the
Speaker 40
10:49
end of the table and introduce yourself to those that might not know
Speaker 43
11:03
you and your job title? Hi, good afternoon. I'm Melissa Stone, Director for the Division of Developmental Disability Services at the Department of Human Services. I have with me a bunch of people today.
I brought a whole crew. So Janet Mann is here, I think, for her first time. She is the Division Director for Medical Services, which we refer to as Medicaid. And then behind me, I have Paula Stone, who is Deputy Director for the Division of Medical Services, and Elizabeth Pittman, who used to work for me and was promoted. And now she's the other Deputy Director at DMS. And then, last but not least, we have Jenna Goldman.
Jenna just joined our Legislative Affairs Constituent Service Office, working under Mark White, and she will be assigned to the Medicaid divisions. So, she'll be working a lot with this crew. So, just wanted to bring everybody, because we all have been kind of touching
Speaker 46
12:08
the four topics that are on the agenda for today. But let me start, if you're
Senator Keith Ingram
Unverified
12:15
ready. Great, and welcome. I've known Jenna before, and certainly Paula and
Elizabeth, Janet, welcome to the committee and task force,
and we're proud to have
Speaker 43
12:29
you here and look forward to working with you. Okay, Melissa. Okay. So number one, update on the expansion of the autism waiver. So, as you guys probably know, Senator Ingram passed legislation during the last session to eliminate the autism waiver wait list. And at that time, there were 30 children on the wait list. So, we have drafted an amendment to the waiver to add in those additional 30 slots.
It's within the DHS internal review process, and we'll be putting that out for public comment and running it through legislative committee
Senator Keith Ingram
Unverified
13:11
meetings. And so we'll have public comment. So that has been submitted to CMS. Does that come before, help me with the public comment period, does that come before the submission or after
Speaker 46
13:25
the submission? So what we've historically done, because we're always running fast at DHS,
we usually submit to CMS when we start the public comment period. So right now it's in the internal review at DHS. It gets reviewed by the legal team to make sure we've done it correctly, and then it will be submitted and the
Senator Keith Ingram
Unverified
13:46
public comment will start. And we had 30 slots and 30 that were on the waiting list. In that window of when we
pass this until implementation, how many now children do we have on the waiting list? Do we know?
Speaker 54
14:02
No, I know that it's been added to. Robin,
Senator Keith Ingram
Unverified
14:14
right, 42, so we need these desperately. So walk me through the time frame and walk me through the public comment period and the time frame from there to when we start accepting children into the program.
Speaker 61
14:33
So public comment runs for 30 days, and then
Speaker 46
14:38
that's when the general public can submit concerns or questions, and then DHS formally responds to those questions. We have to have our response in to the
Speaker 53
14:50
legislature before the 15th of the month to be put on
Speaker 46
14:56
the next month's committee agenda. So what I'm really hoping for is we're on the January agenda with an immediate start date.
So I don't want to make promises for CMS, but oftentimes they'll retro back the start date for
Senator Keith Ingram
Unverified
15:13
us. And so, Melissa, once that, with an immediate start date, and we know that we've got 30 that we have, I assume, vetted, and then we have to make sure that they still qualify, but would these children be eligible for services in January or February?
Speaker 12
15:29
I mean, when would that start? I'm hoping February. Okay.
Speaker 43
15:40
All right. Okay. Number two, if y'all are ready, update on the EPSDT services. So would you, an acronym is driving me crazy. Yeah. So early periodic screening diagnostic testing treatment. Thank you. I was so close. I was looking at Diana. I'm like, that can't be right. You start saying acronyms so much you forget what they stand for.
Speaker 46
16:10
So ABA service is just one of many types of these early periodic screening and diagnostic treatment services that the Medicaid state plan offers. So those are services to children age zero to 21. So the federal government has said basically that if it's medically necessary for a child and it will ameliorate the condition or approve their functionality for
Speaker 43
16:41
their developmental disability in our particular case, that you can request
a service, even if it's not specifically listed underneath the Medicaid state plan. So, for this particular ABA service, right now, it has been a service that CMS has been And for years, I think partners would concur with this, saying, hey, you know, y'all have got to, you've got to provide this service, Arkansas, if the child needs it. If they
Speaker 53
17:12
meet the autism diagnosis and if this service will correct or assist with their deficit.
So it has been up until this
Speaker 43
17:22
summer, it's been a service that we've been providing, but on a case-by-case basis. and a provider had to turn in what we call paper claims or redline claims. They had to submit billing because there wasn't any billable codes where you could automatically go in. So Elizabeth Pittman behind me turned the codes on in May of this year so providers can direct bill for those codes.
We also opened up who can provide those services within certain bounds, but we did try to extend the window of who can provide them as much as we could because we know there's a shortage. And then we also added, which was very much needed, a psychology code because in order to get an autism diagnosis, it has to be from certain clinicians, and we did not have an appropriate billable code for one of those clinicians. So now there's a specific code for a psychologist to be able to do an autism diagnosis.
So those turned on in May of this
Speaker 53
18:29
year. We have a vendor, EQ Health. EQ Health is who reviews the request for all of those services. So the providers submit the request for the particular child and show
Speaker 43
18:44
why it's needed for that child with autism. And those services
Senator Keith Ingram
Unverified
18:52
are being approved. All right. Any questions regarding EQ health or the process?
We're glad that Elizabeth got that code turned on for us. Any other questions? All right. Then let's move. I'm sorry, Donnie.
Katie Sursa
Unverified
19:23
thing. So I'm glad you're here today. Thank you for coming, Melissa. One of the questions I have is we've been fielding phone calls from parents who unfortunately have felt pressured from their current ABA providers to stop getting those services in the home and to start coming to a clinic for all of their services.
Not a ton of phone calls, but enough to give me a pause. So has there been any consideration about looking at the codes and coming up with some kind of differentiated rate that would allow the providers to work in the home and community? Because I think that the rationale, the reason why they're asking them to come to the clinic is because it's, I mean, frankly, from a business perspective,
it makes more sense if I'm a provider. But from a best practices perspective, it does not allow the parents to participate in the same way they can in that treatment if the services are being provided in the home and community or both in the clinic in the home and community. And so is there anybody in your agency who's looking at that and considering that and maybe even considering some way to address this issue?
Speaker 53
20:59
So I have several comments to that. So the first is, as I started this, talking about the EPSDT, the federal requirements around that, Um, EPSTT on, you know, on the one hand that I already mentioned, it's very child specific and you have to show
Speaker 46
21:20
that the service under that category is going to work for that particular child. Same thing with the setting where the, where the service takes place. So, um, from my read of the federal law, each setting needs to be uniquely analyzed for
the particular child, for the particular service that's being requested. I understand your concern, especially because the way the waiver is set up and the autism waiver is so effective with the intensive treatment that involves a lot of parental involvement, which we cannot do that level of, we actually can't mandate parental involvement with a Medicaid state plan service under this program. So that's one of the differences on why we, in my opinion, we need both because the waiver
is very effective for children. So no, the short answer is no. We are not looking at incentivizing the
Speaker 53
22:16
particular service based on where the service takes place. We don't, we, to my knowledge, do not price a unit of service based on setting in the DD arena. We maybe just need to talk
Speaker 43
22:33
about working together to try to make sure families understand that, although it might be more convenient,
Speaker 46
22:41
that they get a choice in where their service takes place. And if they're at home and they want it at home, then that is a setting that they can have under this
Katie Sursa
Unverified
23:01
category of service. Yes, go ahead with the follow-up. So, thank you for that. I appreciate that. So maybe one way parents could, because since parents may not understand,
of course, we're always trying to provide parents with more information and empower them to make decisions and be active participants on the treatment team. Perhaps a little bit of outreach. Also to primary care physicians, since they are submitting the form that gets this going in the first place, I think parents sometimes feel a little bit timid, insisting on that, but if the primary care physician is making the request and specifically saying that the services needed to be provided in numerous settings, including home and community, does that make a difference?
Does that help assure that the service that's provided will be what the family truly needs? So, as
Speaker 53
24:04
you know, Diana, for everybody, the EPSDT, when you make a request to Medicaid for an EPSDT service, it's
Speaker 46
24:12
on a specific form that has a doctor prescription attached. That's what they write it on that's submitted to us. So, yes, it would make a difference. We
Speaker 43
24:23
actually have been talking internally about working with AFMC to do a PCP training on EPSDT
because we have several services right now hopping, including some day habilitation services that I think we need some additional just guidance on. And so this would be one of the topics. That's a great idea. I will say that the one thing I forgot to mention earlier, one of the safeguards to make sure that we are doing the right service in the right setting is we have asked EQ to only issue six-month approvals because we want to put children in the least restrictive setting for ABA therapy.
And so if they're asking for something restrictive, like a clinic setting, we're giving that a six-month approval
Speaker 46
25:07
and then asking why can't we move to something less restrictive than this type of setting before a new prior authorization is granted. All right. Representative Rye has
Senator Keith Ingram
Unverified
25:21
informed me he has a question. Why don't you just sit at the table there, Representative Rye, where we can get you on the microphone.
Speaker 80
25:31
Thank you, Representative Rye. I appreciate you letting me
Representative Johnny Rye
Unverified
25:38
do this, okay? Well, I'm sure I'll regret it, but go ahead. Well, a question I have, ma'am, Representative Rye, Arkansas District 54. Ma'am, I've had two calls in the last couple weeks, and it's from children's mothers and dads that actually said that they were inside of a school, that they were having problems, you know, getting into the program, and the children were not doing as good as they hoped that they would.
Speaker 84
26:03
Is there anything we can do? So we actually don't offer, let me,
Speaker 85
26:09
hold on. It's not a school setting, is it? So they're just
Speaker 42
26:14
not approving. Okay. Courtney. If you will send that to me, we'll get
Speaker 46
26:20
together with the Department of Education and see if we can help because I just confirmed just to make sure that you can receive ABA therapy at school. So if you'll send me those people, we will
Speaker 53
26:30
reach out to them. Thank you very much.
Speaker 91
26:34
Thank you, Senator Ingram. Anytime, Representative Brey. Next
Senator Keith Ingram
Unverified
26:41
question. Other questions? Okay. Then we... Is there someone in the audience? Yes,
please come forward and grab a mic there, a seat and a mic, and identify yourself, please.
Speaker 96
27:07
I'm Dr. Sheila Barnes. I'm with Hope for Autism and also with Oklahoma Baptist University starting an ABA program, master's level. And I've had several families that I have wanted to work with them in the schools in that transition. I have one right now that I would transition tomorrow if the schools would let us in. And so is there going to be some official guidelines that go to the school districts
because they will not let us go in support in the school? And we are, in my clinic, we do provide home-based and we go out to the community depending on where that family is very active. And in my intake, that's one of the things that I talk to families about is what are your needs, what placements are you having difficulty in, where does the child need the support, and one of the greatest places is in the school. Matt,
Speaker 101
28:05
you want to take that one? I want to defer to Sheila, because Sheila is one of our BCBAs that works in the schools,
and receiving that therapy is definitely an option in the school, and she's going to talk a little bit
Speaker 102
28:19
more about that. Thank you. You're recognized, Sheila. Okay, thank you. And I'm Sheila Smith, Behavior Support Specialist Coordinator. so I work with the behavior support specialist in the schools and we do we have had some questions and concerns related to outside service providers coming into the schools and providing those services some of the there are some school districts that are allowing that with that I do think that we do need some guidelines because what we are seeing is they're coming in they're pulling
the student out of the classroom, so that is their LRE, and providing one-on-one services and then putting the student back into the classroom. So we're not seeing any opportunities for generalization of skills. We're not seeing any consultation between that BCBA or RBT and the schools. It's another pull-out services. So we have concerns related to the student being pulled out of the LRE, as well as those services are not being provided as part of their IEP.
So I think guidelines would be extremely helpful in that situation. Dr. Barnes? Actually,
Speaker 94
29:28
Sheila and I have had a conversation about
Speaker 96
29:31
this. And that is one thing, is pulling them out and doing it as a pull-out program. But that's not actually the kind of service that we need to provide from my clinic. And what we want to see is being able to go in and provide some transition support in whatever placement they're in, whether it's a self-contained special ed classroom, a resource room, a general ed classroom,
but provide some behavioral supports by the front-line therapists or their behavior techs that have been working with the child and coming in as the BCBA and sharing our protocol, our procedures, what has been effective, our reinforcement systems, share that information with the school, and then we would like to pull out. We don't want to replace or be a pull-out service. We want to be in that classroom to support that child. I have a child that multiple times, he is perfect, 30 days, zero behaviors in the clinic.
we go back to the school. He makes it one or two days. He's right back put on homebound. His mom is a single mother. She cannot keep going to school. She cannot keep getting called from work and I've seen this happen with several due process hearings where families are being called to come get the children from school and if we could just provide some support in the school and share with the school, do some training, but not do a pull-up, and we're going to do discrete trial. The need that I see is the behavior need.
Speaker 102
31:02
Dr. May. And I agree. I agree that that would be the ideal service model, and Mr. Sewell just went to a training recently and shared a presentation in Michigan where they are doing a model where the clinic is working within the district to provide training and training the paraprofessionals and the special ed teachers, and that's what we need to happen to see generalization of skills so that those students can stay within their LRE.
I think that your intentions are great and pure, but I think there will be others, and we are seeing other providers who do not have those same intentions. And so I think with guidelines, that would help provide that structure. What we have seen, we've had a couple of cases reported as well, where BCBAs are going into the schools and providing services, and they're telling the parents that the school is not providing appropriate services
and recommending that they come into the clinic. They recommend to the parents that the parents homeschool the student and then bring them into the clinic for 30 to 40 hours a week as well. So I think there's a lot of potential for things that are not in the best interest of the students if we don't have those guidelines
Senator Keith Ingram
Unverified
32:28
to help structure what that may look like. All right. Well, speaking of guidelines, would that be something that the Department of Education would draft
and maybe get us, this task force, an opportunity to look at what, you know, might be best practices? Matt? Yes, sir. That's definitely
Speaker 101
32:50
something that we can look at moving forward is developing a draft guidance document for this group to look at. I think it's also important to keep in mind, too, that these services can be discussed as part of a student's IEP and implementing those through an individualized education plan. I know you don't like acronyms.
Speaker 110
33:10
And LRE is the least restrictive environment, and that's where a lot of the issues
Speaker 101
33:16
are taking place in the school is removing kids. They're missing something to get something else. When a lot of these principles that are being taught through BCBAs or applied behavior analysis, our teachers and paraprofessionals can be trained in those as well and then be able to use those in the classroom and help the student generalize those in all settings.
So I think it is an area that we can improve on providing guidance, But our school districts are definitely leery about allowing outside providers to come in, however they can, just like some school districts allow PT, OT, and speech to come in. But they need to help set the parameters on what those expectations are going to be through that IEP committee
Senator Keith Ingram
Unverified
34:06
decision-making process. I am aware of some school districts that have been very
leery simply because I guess the manner it was being conducted
and that it didn't appear it was group, not individual, and they had some uneasy feelings about it and stopped it. To get some of the guidelines, what are we talking about time-wise that could be turned around back to the task force?
Speaker 101
34:49
Okay. I would say probably in the next six months would be safe to say. That would give us opportunity to pull the people together that we need to have. And we also want to want to have a probably a stakeholder group as well to include school districts, folks from our advisory panel to take a look at this as we're developing before we bring that to you guys. That'd be great.
Senator Keith Ingram
Unverified
35:13
at that time frame, that would give us an opportunity to review it before the 2021 session.
Dr. Barnes, anything further? No, thank you so much. You're welcome. Any more questions regarding this item on the agenda? If not, the Eternal Pass implementation update. Please come
Speaker 118
35:45
forward. That's Ms. Stone. We've got Stone and Stone down here, y'all. We've got the Maconsville Law Firm. You're recognized.
Speaker 120
35:54
That's our backup plan when this goes south. All
Speaker 123
36:06
right, you're recognized. So, and I will have to say I'm not an attorney. I'm a clinician, so I would do the counseling part of the law firm. So for the PASS, we have been implementing PASS. We started in February of 2018 with just the care coordination piece,
and then we went to full risk PASS in March of 2019. So we've been at this for seven months now. And so what we saw in our first couple of months of implementation was what is typical when a state moves to a new system of paying claims for beneficiaries. And I think this was particularly challenging because it was not an entire population. It was a small, a fairly small population with very high needs.
But what we saw in the beginning, first probably three or four months, was a large focus on making sure that claims got paid. And then looking at our DHS processes to make sure that they were in line. So some things came out in all of that where we even had to go back and align our own processes internally to make sure that the passes were also able to pay claims. I think one of our bigger challenges in the first couple of months was rendering providers.
So we have agencies that are billing providers, and then for them works somebody who is the person that's providing the service, and so they're a rendering provider. And for those rendering providers, as we've been discussing, we have professionals that are rendering providers, and those are OTPT speech and BCBAs, the master's level clinicians, psychologists. But then for the population that we are serving through the past,
the approximately 40,000 people that we're serving, we have home and community-based services. And most of those home and community-based services are provided by paraprofessionals. The goal of those home and community-based services are providing them in those settings that keep people out of institutions. So that's our goal. So we are really not, nobody's coming into the PASS that really doesn't need those kinds of services or shouldn't be coming to the PASS unless they need those kinds of services. And then we're working to make sure that we have a full service array for them
because while we've made the services available in new ways, it doesn't mean that we have providers that have come in and decided to provide those services. So I think our next phase with PASS implementation is working with the PASSes to ensure that we have the right services in place and then looking at any of our policies that might be limiting their ability to pay for services in new ways or for new types of services. So that's our next round of work that we're doing.
I think that that's something that we're particularly focusing on individuals who have both a behavioral health diagnosis and an intellectual or developmental disability. That seems to be our area that we have the most, the highest need and the fewest services. And that is really not because of anything, but before the PASS system came into place, we really had two silos. So we had providers providing services for those with intellectual and developmental disabilities.
and they were in most part not certified or licensed to provide behavioral health services. So they existed on one side and then the behavioral health providers were licensed and certified to provide services to those with behavioral health. And if they crossed, they could get in trouble with Medicaid because you had to say which diagnosis you were treating and the codes were very specific. So one of the things that we are very excited about moving forward with is that ability for those providers to treat both populations and particularly those that have both diagnoses.
So that's our new piece of PASS. We're continuing to work on assessments and reassessments. So for the behavioral health population, they have to get reassessed every year to stay in the PASS. That's an annual reassessment for the intellectual developmental disability population. That's every three years. So we're already doing, we have been doing those reassessments for the past members with a behavioral health diagnosis. So that's another challenge that we're continuing to work with the processes
Speaker 122
40:45
and making sure that the care coordinators are doing that kind of outreach and getting them
Speaker 43
40:53
reassessed. the only thing i would add paula and i spent some time last week out of state we're actively looking for a model and and providers who are doing service for dual diagnosed clients in other states and there are some you'll hear us over the next couple of months talking about this new provider
Speaker 53
41:13
type as paula stated we've had these two groups we've either had dd providers or bh
providers. We are melding them together with a PASS home and community-based provider type that will go live this summer, which will be a provider type that's certified and highly trained to provide service to both a BH and a DD client. We believe that that will significantly improve the care to these members and so that's what
Speaker 46
41:45
we'll be talking about over the next couple of months and then some of you might
Speaker 53
41:51
hear from families we are
going to set up focus groups and we talked to the communications team about that last week we we want to include families more in the decision-making making process when we start tweaking services and we haven't been the best at that in the past but we have been at the past for the last seven months and we would like to hear feedback from families who are actually receiving these services where the holes are and their suggestions on what
is needed because we will be going in and making some changes to the service descriptions when we set up the new provider
Senator Keith Ingram
Unverified
42:38
type, so. The, uh, it escapes me, the, uh, we had a dual diagnosed program, our, uh, help
me, ArcStart, and that went away and this supplanted it, and it sounds like me, to me, if you just describe what you, you're going back to create a program like ArcStart that
was already operating for dual diagnosis? So
Speaker 42
43:03
no, no, we don't, we don't agree with that. So ArcSTART was a contract with DDS. It was a contract that I paid directly to ArcSTART. And then the contract parameters, they were contractually obligated to assist us with 100
Speaker 53
43:17
clients a year. We want a provider that will come in and serve 40,000 members if needed. So we're
Speaker 46
43:25
looking for a new provider type, like the, like the, um, we have a service under the
past called therapeutic communities. Um, Paula can speak more to therapeutic communities, but it's a service specifically under the past that would be actually a very,
Speaker 53
43:40
um, good service for clients with, um, BH and IDD. Um, but currently right now we only have two providers providing the service and it's solely for behavioral health clients. We,
Speaker 43
43:52
we're not, I'm not trying to get a particular, we're not looking for a particular model like the Arc Start model in terms of coming in and doing behavior plans and that sort of item and not
Speaker 46
44:07
to minimize them at all. We actually work still with Whitney Emerson. She works for one of the passes now. So, who was the executive director of Arc Start. So, she's been working with the passes and their other liaisons on changing the way we do crisis when the passes go out to try to stabilize clients
Speaker 43
44:28
that take them to the hospital. When we say new provider type, we're talking about there's particular providers in other states that have more of a step-down approach.
Speaker 42
44:39
So instead of coming out of our state hospital and the next step being an apartment with one-on-one staff, we maybe would have two interim steps in there. And, you know, I have clients all the time that are going to the state hospital and they need a step down. You cannot go from that type of
Speaker 46
45:00
environment and do well going back to your mom's house or going into an apartment. And so there are providers in other states that provide those services in between.
Speaker 43
45:13
and that's the provider types that we're looking for. And not just bringing in new, we're looking
Speaker 53
45:19
at working with the providers that we have to change their models to this new need, or this need we've always had, but now it's heightened because of the past model. We want to
Speaker 46
45:34
work with our providers to get to the place where they can serve clients with IDD
Senator Keith Ingram
Unverified
45:41
and behavioral health needs. You mentioned 40,000. There's that many, 40,000 dual diagnosis in the state of-
Speaker 53
45:48
No, I'm sorry, 40,000 in the PASS model that either have IDD or BH. But we will say this, when we're looking at the clients, specifically the clients with intellectual disability, there is a much, we believe there is a much higher percentage of the IDD clients that have
Speaker 64
46:05
a behavioral health need that we need to treat in a more effective manner. Gotcha. Okay.
Speaker 118
46:12
Other Ms. Stone, anything to add there?
Speaker 123
46:18
No, I think we're just really excited about the opportunity, as Melissa mentioned, therapeutic communities. And so one of the things we started working with those providers, we have only two providers in the state, and they've traditionally just taken adults out of the state hospital that have a mental health diagnosis, a pretty serious mental health diagnosis, and they move them into a community setting. It's below 16 beds, and some of them are apartments, and some of them are small houses, and they provide support and
supervision, and they provide some mental health services. So we're really starting to look at that instead of providing just the counseling. So we've been working with those providers to say, let's then start shifting how the services are being provided from providing a lot of counseling, group counseling and individual counseling and psychiatric intervention to what's really needed by those beneficiaries, by those past members, which is more of the supportive services, more of that training and those kinds of services that
help them, supportive employment, supported living. Some of those services that had never been available to the behavioral health population before, but had been provided on a different scale by different provider type to the DD population. So looking at those types of services, again, existing providers who may not yet be comfortable providing services, but how are we going to get them providing services to the new population or a newly identified population? Because quite frankly, I think that there are, we're going to see it come both ways.
So Melissa believes that they're going to come from those that have already been identified with an intellectual or developmental disability who also have a behavioral health. I've been in the behavioral health field for well over 25 years at this point. And so I think seeing that, I think that as behavioral health providers, we really didn't even know when somebody came to our door. We might know that something was going on, but we never even referred over to developmental disabilities to say, I think they may have also had that.
So we just, for years, just treated them for a behavioral health issue where they may have had some other underlying issues. So we're going to be able to have the passes. We're going to be identifying those individuals so we can then begin making sure that
Senator Keith Ingram
Unverified
48:46
they're assessed appropriately and getting the appropriate treatment. Thank you. Any questions from the committee?
Katie Sursa
Unverified
48:53
Diana, you're recognized. So for the individuals who are identified as duly diagnosed,
I know that you guys were working on a new instrument that was supposed to be able to assess someone appropriately who really kind of straddles the fence, so to speak, by Optum, because sometimes the Optum assessment that's being used in one or the other maybe is missing some things. Have you gotten anywhere with that? That's my first question. And the second question is, given the fact that someone who, I'm so short,
someone who has a dual diagnosis at least at some point is going to need some fairly intensive supports, maybe more intensive supports than even someone with a really significant developmental disability, the global payment for the premiums that go to the passes, is that going to be sufficient for that population? Is it going to be more than, say, the global payment for someone who just has an intellectual or developmental disability
or someone who just has a behavioral health diagnosis? so that the passes aren't struggling to provide appropriate coverage for that person. So I'll start with the optimum assessment.
Speaker 123
50:18
So I think most people know this, but the optimum assessment is not a diagnostic assessment. It's a functional assessment. So what we made sure to do in this is that they will not be making that diagnosis, that there's a dual diagnosis there.
We have a committee that's made up of behavioral health clinicians that work for DHS and the state hospital, and then the committee that's always looked at the intakes and the eligibility for DD. And so they'll be looking at all of the historical clinical documentation and making that call on that. So the passes are going to be sending in. And so they'll be gathering all of the historical clinical information from both sides.
So if it's a DD member, then they'll be sending in all the psychiatric historical information. So that committee has begun. And so then Optum. She's getting there. And so then. Yeah. So just to make sure that that. So then Optum will be doing a functional assessment that is specific for the dually diagnosed. So we'll have a third tool, which is really a combination since it's all the same tool, which is the men choices. It's making sure that we're getting the right scale.
So we've been working with Optum, and we're ready to, I think we're pretty close to being ready to launch that tool to make sure that once they come through this committee, they have the dual diagnosis, then they can get the independent assessment that correlates to their issues. And just to add to that, so, yeah, we've been testing. We had
Speaker 46
51:58
an email, I think, this morning from Optum. So we've been testing. What we're trying to avoid ultimately with the dual tool, I don't know, we've got to think of a new name,
is to not have clients that go through the DD assessment and then have
Speaker 53
52:14
a BH assessment and then maybe you're a DD3 and you're a BH2 and it's confusing for families, right? And we just don't want people to have to go through multiple assessments. So what we've been working on with the emails of late, we think the tool is ready and the scoring is ready. What we're trying to do is the logistics of it to say, if you don't score as a dual on this tool,
is there a way to rescore it to the appropriate other category? So we don't have to send you back through to do another one. And we think that we're going to be able to. So based on
Speaker 46
52:54
the emails today, I won't be too hopeful. But that's what we've been really trying to work on is just cutting down on all of those assessments, right, because we know that it's a lot for people. Also, we need, like Paula said, we wanted a diagnosis from clinicians that someone was dual
because oftentimes people say they're dual or people say, oh, I have all these duals. We do that at the HDCs, when someone has depression and they have IDD. That's not exactly the target audience we're looking for with the dual designation. We're looking at those clients that you're very familiar
Speaker 43
53:31
with, right, that have very significant needs in both categories. So that is the purpose of
Speaker 42
53:37
the dual tool. You want to talk about the payment that's
Speaker 123
53:41
tied to it? Yeah, so when we, before we launched the passes, we had an actuary come in and develop actuarially sound rates.
In that, they looked at the individuals in our system, looking at the claims that were, it was 2016 and 2017 claims, Medicaid claims. And so they looked at individuals that are getting both services, both DD and behavioral health services. Again, there were only a couple providers, so they had a proxy population that they could look at. And they did set a rate that was higher for that. And so once they come
Speaker 122
54:15
through that committee, then it will be a high rate because we recognize that the services are much more extensive.
Senator Keith Ingram
Unverified
54:25
Any further questions regarding this? Audience question? They're hidden back here.
Roxanne Daly
Unverified
54:46
Please come forward and give us your name and state your question. my name is Roxanne Daly and in the grand scheme of things this is really small but it's something that affects my life and my child so I've never done this before so please bear with me and I'm
going to read what I wrote because that's the only way I can probably make it through this I'm here today to share a concerning issue that we've had with our past with Empower It's an issue coordinating benefits with our commercial insurance, Blue Cross Blue Shield. My son has had the same PTA for about five to six years. She's self-employed, she has other school contracts, and she sees my son in our home two days a week. Medicaid had covered her services without issue for the last several years. Since the changeover to pass in April, she's not been able to file a claim with Empower or be reimbursed for her services.
She is credentialed with Empower for many other children and has been able to submit claims and has been paid for them as well. But because my son has Blue Cross Blue Shield, they have required her to jump through many hoops, and yet she has still been inaccessible on billing and or receiving payment. She's provided Empower multiple documents stating that Blue Cross Blue Shield does not cover physical therapy assistance, as well as proof that Blue Cross Blue Shield won't even let her in their portal to bill because of her credentials. She and I have both been passed around from person to person trying to reconcile the problem,
and yet nobody has an answer of why this is happening. I can provide you with names of people she and I have both spoken to about this issue over the course of the last several months. At first, they said that her documents obtained from Blue Cross Blue Shield were sufficient, and they didn't know why it wouldn't go through. But now it's turned into, sorry, we can't help you. If and when there's a resolution, we will let providers know. The last email stated, and I quote, Empower will have to adhere to the primary payer rules for commercial insurance plan,
which would mean not using assistance. Empower would cover the services that are allowed. However, Empower will not cover the service when there's a primary payer, which is very puzzling considering they cover her assistance services for other children. We've done our research and looked up all of their policies, and everything they have told us contradicts their requirements if and when the commercial insurance won't cover the services. I've reached out to Blue Cross Blue Shield multiple times, and they have told me there wasn't more they could do on their end.
I am currently waiting to hear if they can give us some sort of top document stating that they don't cover physical therapy assistance and will not cover these services. And the person who is helping me with that, I'm waiting on a phone call from her, but she's reached out to somebody who is a higher-up and not just customer service. But again, Empower has yet to offer up a way that we can resolve this so my son can continue his services and his physical therapy assistant can finally break through the barrier. I know that we're not the only ones that are going through this,
and you're probably wondering why we don't just get another physical therapist. And the answer would be that we live in a very small rural area, and good therapists are hard to come by. But even if that wasn't the case, why should my son have to change therapists because Empower either doesn't know what to do or doesn't want to fix the problem? They have yet to give us a solution, and that's all I'm asking for so that my son can continue to see the physical therapist that he knows and loves and is comfortable with. And even if I did go seek out another physical therapist, then my son would hopefully get a physical therapist that he needs, but what about her?
I cannot leave a person who has sacrificed her time and money to see my son for the last five to six years, I'm sorry, five to six months for no benefit to her, not to mention the countless hours over the years that she has went above and beyond the call of duty to help him have a better quality of life and help me problem solve, to console me all of the ways in which she was unpaid, but because she is a good therapist. And all I'm asking for is that she be paid for her time that she is owed and deserves, money to
Speaker 139
58:50
see my child for over the six months for free.
Speaker 133
58:54
Thank you so much for your time. Melissa, you were shaking
Speaker 46
59:05
your head down. Janet and Paul and I are very much aware of this issue. So we've been working on it and have a follow-up meeting, the three of us, with Elizabeth, I think, on Monday. It just got set. So this is, I don't know if the solution is going to be, a good solution for you, unfortunately. So there are rules.
There are rules with Medicare, and there
Speaker 53
59:26
are rules with commercial insurance policies, third-party liability, that it's not about the service. It's about the level of clinician. So if a service policy, and Medicare is one of these, and I could go look at your policy for Blue Cross Blue Shield, but if they will not cover physical therapy, occupational therapy, speech therapy, unless it's done by a licensed therapist and not by an assistant, then you cannot turn around and bill Medicaid for the assistant.
Medicaid is always the payer of last resort. And so if your primary will not cover the level of clinician or the level of paraprofessional in that primary insurance policy, Medicaid will not come in and pay for that service. Do you want to clarify any more on that? I mean, it is a hard and fast rule. Ms. Daly, yes, go ahead.
Roxanne Daly
Unverified
1:00:27
Then why has Medicaid been covering it for multiple years?
I don't under, that doesn't make
Speaker 142
1:00:35
any sense to me. Janet Mann, the Director of Medical Services, we were paying it incorrectly for many years. I'm just going to be honest. If we pay, as I say, it's just like a secondary insurance. The primary insurance leads, and Medicaid
Speaker 144
1:00:51
comes in and will pay what is appropriate. And I don't have a lot of wiggle room with the federal regs. I mean, I've been going back and forth trying to find some bandwidth to address this issue,
Speaker 142
1:01:06
because it's not just on the assistant issue. It's also a very large issue on services that are delivered by a different type of clinician for my dual eligibles. So
Speaker 144
1:01:18
this is an issue that's growing at the Division of Medical Services. I'm sorry to say that
Speaker 46
1:01:29
it's growing, but it is. And if I could add, we didn't get into this much earlier, But with the PATH implementation, it has shown us through implementing that process
that we were not doing certain things correctly on the fee-for-service side. And the way that the PATH's systems wouldn't allow the payment, and this is one particular instance, then it triggered to us where we investigated it and then realized that ours was not our system was paying incorrectly and this was this was one of those instances that Janet's talking about so the past program has shown us
things on the fee-for-service side that we're now having to go back in and and clean and this is one of those issues and she's right this is not just for PTAs or assistance this is a much broader issue with Medicaid providers where you have a primary and it came to light in the behavioral health arena last year and and Paula spent many hours working with them on honest and exact scenario
and so now with the past implementation the therapist assistant has started to deny at their level, which made us start looking at our
Senator Keith Ingram
Unverified
1:02:56
system. So what are we doing with people like Ms. Daly that have a
child and through no fault of her own, our mistake, what
Speaker 145
1:03:11
options are available to them? Janet? I apologize. I was taking notes, trying
Speaker 142
1:03:16
to, we are looking at different options.
a physical therapist is an option versus a physical therapist assistant. But I go back to the Blue Cross Blue Shield or the primary insurance. That's what leads. So if the primary insurance will not pay for the assistant, I have very little room to pay for an assistant that's not covered. And so it's an unfortunate situation that we are looking for a
Speaker 144
1:03:46
solution. I just don't have a good one at this time.
Roxanne Daly
Unverified
1:03:54
Go ahead. I just, I'm having a hard time understanding how someone, and I know she's not the only one, can be done these services
Speaker 148
1:04:02
for that long and have not known that they wouldn't be covered. Like, there should have been, I would imagine, something sent out for her to waste all of that time and money. I mean, she's driven to our house for six months, seen him two days a week, And then she's just, oh, well, sorry about your luck. We're wrong. And she's a good friend of mine.
Speaker 150
1:04:24
And we've, you know, these people, these therapists that are in the trenches with you, it's their blood, sweat, and tears. They're the ones that help. And I appreciate everything that you guys are doing. Listening to this just warms my heart. And it's a blessing to be here to know that you guys are fighting for our kids. but I don't know what to do to help her. We have two insurance policies that we pay for so that my son can be covered,
Speaker 148
1:04:56
and I don't know what to do to help her. And I'm sorry, but there's got to be some solution for these people who put their time and money into these kids and have nothing to show
Speaker 142
1:05:13
for it. I do want to get with you and get on the details. And you said two insurance policies and TEFRA. I will turn over every stone I can. At this stage, without knowing all of the details, I can tell you what my specific rules are when the primary leads.
But I am willing, I mean, to discuss it with anybody. And we've been looking at different federal rules. This came to light very loud and clear last fall with behavioral health, with the dual eligible population, which is an older population, and the type of services that they were receiving. And what came out of that was an agreement with CMS because we had changed policies and changed our plans. And I'm having to recoup from some providers on that level, of which leads to hearings and reconsiderations
and trying to find every way that we can implement those rules, but not try to do the least harm because the service was delivered. And this has become an issue in several other areas with delivering the service. And since joining the Division of Medical Services in February, we've been looking at every issue as they come up and turn them over. And that's the only commitment I can make is to continue to look for a solution. As Melissa stated earlier, the current solution is not necessarily a
Speaker 144
1:06:35
good one, but it's the only one we have right now.
Speaker 128
1:06:44
Thank you. Any other questions, Ms. Dudley?
Senator Keith Ingram
Unverified
1:06:50
All right. Any other questions regarding the pass
by the committee? If not, then let's take up D4, the licensure process, and who
Jennifer Kirby
Unverified
1:07:06
is going to speak to that?
Speaker 53
1:07:12
So when I read through this last week, I made the assumption that state licensure process was really asking about provider enrollment.
it. So maybe if I could get some clarification on who put this issue on here,
Katie Sursa
Unverified
1:07:38
then I could speak to it more intelligently. Diana, you're recognized. I think Karen and I actually are the ones who asked for this to be added to the agenda. So state licensure for board-certified behavior analysts or behavior analysts and ABA providers has kind of been on the radar for several years.
Ever since we started requiring private insurance to cover ABA and now that Medicaid is covering ABA, if you had asked me even six months ago whether or not we needed licensure for BCBAs, I would have said no, we don't need it, we don't want it, we don't want to go there. It is, the idea is good naturally to have a way to allow the state to provide some kind of oversight
and to make sure that providers of the service are accountable to some state entity over and above just Medicaid and insurance issues, but just in terms of being able to practice. What I would have said six months, a year ago, is the Behavior Analyst Certification Board is capable of regulating the credential, and they are capable of regulating the credential to a point.
But as we see more and more states provide coverage through Medicaid for this service, I think the capacity to regulate the services being provided is outpacing the ability of the BACB, the board, to provide sufficient oversight and regulation. And so I know that, I know several providers of ABA services who have advocated for licensure over the years, and I have suggested to them that that was a minefield.
And what we have seen in other states is a hostile takeover of applied behavior analysis by, frankly, psychology boards. Um, but, um, I think, I thought that this venue, and I think Karen agreed with me, um, and this committee was a good place to start talking about the, the, the need for that kind of state oversight for this particular, um, field of practice.
particularly given the number of calls that we are getting from families about concerns they have or issues they're having with providers and we are quite literally seeing an explosion of providers in the state thanks in large part to the coverage under Medicaid which I think is a wonderful thing by the way And thank you, thank you, thank you for making it easier for children to access ABA coverage.
But with that, I think we, as a state, have a responsibility to make sure that we're keeping an eye on it. I don't know if any of the BCBAs in the room have an opinion. I know several have had very strong opinions in the past and have advocated for licensure. Chair,
Jennifer Kirby
Unverified
1:11:42
any response from any of the committee members?
Speaker 61
1:11:49
Okay. If I could respond. Yes. So in terms
Speaker 53
1:11:54
of DHS involvement with such a thing, so wouldn't be in our scope. scope, but because you would think this would be treated very similar to OTPT speech, right? They'd have their own boards and then their license in good standing is uploaded to Medicaid when they pay to be a Medicaid enrolled provider as part of their process for revalidating
their Medicaid ID. And in terms of the
Speaker 46
1:12:25
therapy clinics, there is no plans on the horizon to do a new program within Medicaid. If
Speaker 53
1:12:33
we treated the BCBAs like OTPT speech, then they could sign up, I assume, as an individual or as a group, which
Speaker 46
1:12:45
is how they do it today. So we're used to the process.
We're just not the entity that would oversee the licensure. Diana,
Speaker 96
1:13:08
any other questions? Dr. Barnes. Hello, Dr. Barnes again. I am the initial president of the Revised Arkansas Association for Behavior Analysts, and we've been talking with Dr. Gina Green at the Association for Professional Behavior Analysts for over five years about licensure.
I ought to ask Jennifer Kirby to come, too, because she has an opposite viewpoint than I do, and we've had a lot of discussion among our members about whether we should have licensure or not. I am licensed in Oklahoma. Jennifer is licensed in Missouri, and one of our concerns is what's happened in New York and what's happened in Florida. New York is like the worst case possible, and then Oklahoma is a very simple process. You simply submit your BACB certification and pay $200 and you're licensed for two years.
So in talking with Gina Green, I would suggest if that is something that we are going to look at, that ARC-ABA be the organization that is our professional organization. We're affiliated with both ABAI, the Association for
Speaker 157
1:14:15
Behavior Analysts International, and we're associated with APBA. Any questions? Thank you. Any
Speaker 11
1:14:23
questions for Dr. Barnes? Okay. Well, thank you.
Jennifer Kirby
Unverified
1:14:32
Yes, in the back. Please come
Speaker 159
1:14:45
forward and give us your name. My name is Jennifer Kirby. I also am past president for Arkansas Association for Behavior Analysis and have been involved in those conversations. I also sat on the inaugural board for behavior analysts in the state of Missouri when licensure was passed there and was able to witness that
process. I agree that the process of licensing behavior analysts can be a minefield, and those are the discussions that we've had over time. And over time, however, things do change, and the tide can turn, and it can become important to put those safeguards in place. So I fully agree, however, that the Arkansas Association for Behavior Analysis can champion that conversation
in conjunction with the Association for Professional Behavior Analysis, which has been instrumental in rolling out those conversations across the country. So look forward to maybe reviving those talks. Thank you very much. Diana, are you
Katie Sursa
Unverified
1:16:08
for your organizations for future meetings for us to take a look at licensure in other states
and what APBA has been involved with and sort of what we would consider to be the
Speaker 22
1:16:23
gold standard of licensure in a state? Yeah, I think
Senator Keith Ingram
Unverified
1:16:29
if y'all would maybe bring some stuff back to the committee and you can work through
Diana, we'll get you on the agenda and sort of look because I'm certainly very interested in how bad New York is. So I'd be interested to learn that. So, yes, why don't we do that?
And Diana, if you'd get with them, please, that would be great. Any other items, any other comments? If
not, I've got one, just, Melissa, just we're five months removed from, you know, sort of the passes and the initial problems that we, and this might be a Paula question, has it calmed down the task force, anybody, the families that were, you know, having problems with the care coordinators that, you know, the schools were?
I mean, is that all sort of now we're in a process and it's sort of working to the most part or the number of complaints dropped to a reasonable level? Yes, sir.
Speaker 53
1:17:40
I was actually looking through the Exhibit
Speaker 46
1:17:43
B and reminding myself what we talked about at the last meeting. I would never sit here and say that there are no problems. Sure. But, yes, it's now more than, it doesn't feel like these widespread problems.
Speaker 43
1:17:58
It's more of isolated problems that Paul and I are working through. You want to
Speaker 123
1:18:04
comment on that? Yeah, I think that we're down to systems issues instead of those singular issues as we discussed today. Then it comes back to DHS and some of our systems and making sure that those are linking up so it's not individual paths and claims. I do know that, as Melissa said, everything's not perfect, and nor will it be.
As I referenced before, I was out in the field and actually supervised clinics and clinicians who worked in the field, worked in home and community settings before I came back to work for the state. And so know when you hire people and then you send them out and you don't have them under your roof and under your site every day, sometimes you have challenges and you're hiring a lot of people pretty quickly. And so I know that there have been some issues with care coordinators that they've had to either counsel
or they may have moved them on into other positions. And so I think as we are moving forward that there's more stability with those care coordinators and an ability to hire the right people because you're not trying to do a lot of hiring at the beginning. So I think that that has settled down. And I think our ombudsman office for, you know, parent questions as well as provider questions, while we still get phone calls and work through those issues, and sometimes if we see those issues as a pattern with either one pass or with the program itself,
Speaker 122
1:19:33
we address those immediately. So we're always trying to improve the program as we go. All right.
Senator Keith Ingram
Unverified
1:19:41
Thank you very much. Anything else for the good of the cause here? If not, I'd like to recognize Senator Greg Letting, who sat
in today from Fayetteville, who took, well, no, you didn't take, yeah, you did take Uvalde Street. That's right. who we all owe a great debt of gratitude
with Autism Task Force to Vivaldi Lindsay. With that, if there's nothing else to be discussed, we'll stand adjourned. You
Agenda
Call to Order
Approval of Meeting Minutes from May 16, 2019
Implementation of Voluntary Guidelines for use of Seclusion and Restraint
Melissa Singleton Stone, Director, Division of Development Disabilities Services
1. Update on Expansion of Autism Waiver
2. Update on EPSDT ABA Services
3. PASSE Implementation Update
4. State Licensure Process for BCBAs and/or ABA Therapy Clinics
Other Business
Adjournment
Documents
| Title | Type | Pages | Source |
|---|---|---|---|
| Agenda — TASK FORCE ON AUTISM, Oct 30, 2019 | Agenda | 1 | Official source ↗ |
| Exhibit B Draft Minutes 5-16-19 | Exhibit | 2 | Official source ↗ |
Speakers
Senator Keith Ingram
Unverified
Speaker 4
Speaker 8
Speaker 12
Katie Sursa
Unverified
Speaker 26
Speaker 40
Speaker 43
Speaker 46
Speaker 54
Speaker 61
Speaker 53
Speaker 22
Speaker 80
Representative Johnny Rye
Unverified
Speaker 84
Speaker 85
Speaker 42
Speaker 91
Speaker 94
Speaker 96
Speaker 101
Speaker 102
Speaker 110
Speaker 108
Speaker 118
Speaker 120
Speaker 123
Speaker 122
Speaker 64
Roxanne Daly
Unverified
Speaker 139
Speaker 133
Speaker 142
Speaker 144
Speaker 145
Speaker 148
Speaker 150
Speaker 128
Jennifer Kirby
Unverified
Speaker 157
Speaker 11
Speaker 159
Speaker 104