November 28, 2022

State Senator Paul R. Feeney Secures $200,000 for Pilot Program

To Support Individuals Over The Age Of 21 To Receive Applied Behavioral Analysis (ABA) Treatment

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State Senator Paul R. Feeney (D-Foxborough) announces the successful passage of $200,000 for a pilot program operated by The Arc of Massachusetts designed to expand access to Applied Behavior Analysis treatment (ABA) to individuals over the age of 21 with developmental disabilities who cannot access these critical services due to gaps in state-insurance coverage. As it currently stands in the Commonwealth, ABA services are only covered by MassHealth up until the age of 21 despite the proven success of this treatment for patients 21 and older.

The Arc of Massachusetts is the leading advocacy organization for and with people with autism and intellectual and developmental disabilities (IDD). The Arc’s mission is to enhance the lives of individuals with autism and IDD and their families. They fulfill this through advocacy for community supports and services that foster inclusion, self-determination and equity across all aspects of society.

ABA is recognized as the most effective treatment for people with autism. It is a therapeutic intervention that is based on the science of learning and behavior. ABA can help increase communication and other skills and decrease unsafe or harmful behaviors. The need for this treatment, which is prescribed by a doctor when medically necessary, does not simply go away when the individual turns 21. However, if they are covered by a MassHealth plan, they lose access to this treatment. Without access to ABA treatment, many individuals fall off the proverbial “services cliff”. This is a critical transition time, when supports are necessary to avoid setbacks, or to keep an individual safe. ABA can also help provide opportunities for continued growth as an individual transitions into adulthood.

“People with autism and intellectual disabilities don’t stop needing support services like ABA when they turn 21. And like many healthcare issues, this is an equity issue. I am proud that this amendment takes steps to bridge the gap in coverage between MassHealth and private insurance to close loopholes that leave those who are unable to afford private insurance behind. Thank you to everyone from The Arc of Massachusetts for continuing to fight for these protections and for uplifting the voices and the stories of those who will benefit from expanded ABA service coverage,” said Senator Feeney.

The pilot program would designate service providers of day habilitation programs to choose approximately 50 adult individuals, over the age of 21 with a diagnosed developmental disability, an intellectual disability, or autism spectrum disorder, to receive ABA treatment for a six-month period. The pilot will collect data on the impacts of ABA services on this target population. The goal is to demonstrate the efficacy and impact of these services on the individual in order to facilitate legislative action, which would require parity with private insurance coverage.

“The Arc is grateful to Senator Feeney for his leadership as well as the opportunity to implement this much needed ABA pilot program for adults on MassHealth,” said Maura Sullivan, The Arc of Massachusetts, Sr. Director of Government Affairs and Health Policy. “Equitable access to health care services is a policy priority for The Arc. The outcome measures of this pilot will help us advocate for ABA services with MassHealth through regulatory change or legislation. The Arc is currently working with three expert providers to ensure a successful pilot: Amego, Inc, Nashoba Learning Group and The Northeast Arc.”

The Arc will be required to collect clinical data and submit a report to the House and Senate Committees on Ways and Means and the Joint Committee on Children, Families and Persons with Disabilities detailing (a) the total cost of providing applied behavior analysis services, (b) the number of individuals served by the program, (c) the cost of services per individual, savings associated with the provision of applied behavior analysis services and (d) aggregated benefits to individuals associated with applied behavior analysis services.

This pilot program was included as amendment #622, filed by Senator Feeney, to the $52.7 billion Fiscal Year 2023 (FY23) spending package which was signed into law by Governor Baker on July 28, 2022.

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