The ABCs of ABA Funding: Part One of Four

By Attorney Franklin J. Hickman

When looking for sources of funding for Applied Behavioral Analysis (ABA) services, remember the following from your alphabet soup: EI, ACA, IDEA and EPSDT.   This article is the first in a series of four installments which will explain each of the programs and summarize the procedures needed to obtain ABA benefits.

Early Intervention (EI)
Early Intervention services are part of Help Me Grow, an Ohio program for services for children under the age of three who are eligible under requirements established by the Ohio Department of Health (“ODH”). Help Me Grow is administered by ODH and funded through Part C of the Individuals with Disabilities Education Act (“IDEA”). Help Me Grow requires an assessment of infants/toddlers with a disability and development of a service plan (“IFSP”) for the family, which is subject to periodic review. An eligible child is entitled to services which are necessary to meet the unique needs of the child and family to achieve results or outcomes identified in the IFSP.

Two recent developments affirm that Ohio’s Department of Health (“ODH”) has a duty to fund necessary ABA services for eligible children:

  • The US District Court in Young v. State of Ohio, 12CV967 issued a temporary order for emergency relief on January 14, 2013, which held, in part, that ODH’s blanket policy of refusing to provide ABA services under the EI program is a violation of Federal law.
  • At Several points during 2013, the Federal Office of Special Education and Rehabilitative Services instructed Ohio to alter its rules to allow funding for ABA services if ABA services are necessary. Ohio’s failure to comply would have risked losing Federal Funding. In response to these instructions, Ohio changed its rules in September 2013.

If ABA services have been determined necessary by appropriately qualified professionals, and the child is eligible for EI services, the child’s family should provide documentation to the team developing the Individualized Family Service Plan (IFSP). This documentation should clearly support the conclusion that ABA services are necessary to meet the unique needs of the child and family in order to achieve the results or outcomes identified in the IFSP. The team should include the professional recommendations in the IFSP.

If local resources are not available to fund the ABA services, the IFSP team should make a request to the ODH to provide funding through the Early Intervention System of Payments (EISOP). The amount of payments under EISOP is adjusted based on family resources and calculated using a formula set forth in the Ohio Rules. Rules for EISOP can be found in the Ohio Administrative Code (“OAC”) at 3701-8-08.1. Federal law permits the ODH to initiate interim payments while the EISOP authorizations are being processed. 34 CFR 303.510(b).

The IFSP must include the steps and services needed to ensure a smooth transition to pre-school services or other appropriate services. 34 CFR 303.344(h). These services are covered under Part B of IDEA – to be reviewed in the next article.

If there is a disagreement, Federal and Ohio law provide for dispute resolution, including complaints to the ODH, mediation or due process hearings. These procedures are at OAC 3701-8-10 and in the Federal Code of Regulations (“CFR”) 34 CFR 303.440-448.

Posted in Articles, Articles: Children with Special Needs.