Settings and Funding Combinations

When my son was diagnosed with autism 22 years ago, most families could not afford ABA. Insurance did not pay for it, and schools in most states would not offer ABA (or at least not quality ABA) without years of litigation. My husband and I privately paid for ABA for several years, which was financially painful. I was grateful that we could make that financial sacrifice, but my heart broke for fellow autism parents who could not. That’s what led me to write legislation to require health insurance companies to pay for ABA.

These days, insurance-funded ABA is common and available in all 50 states. Most CASP members bill insurance for ABA services. But there are many other funding sources and models in use around the country.

As the head of CASP, I am still learning about different funding structures that various providers utilize. Recently, CASP staff sat down and tried to list the various settings/funding combinations we see represented among our membership:

• ABA delivered in a private family home paid by private health insurance.
• ABA delivered in a private family home paid by Medicaid pursuant to EPSDT program.
• ABA delivered in a private family home paid by the education system.
• ABA delivered in a private family home paid by a regional center, vocational rehabilitation, or other community/state agency.
• ABA delivered in a private family home paid by the family (or other private funds).
• ABA delivered in a clinic/center paid by private health insurance.
• ABA delivered in a clinic/center paid by Medicaid pursuant to EPSDT program.
• ABA delivered in a clinic/center paid by the education system.
• ABA delivered in a clinic/center paid by a regional center, vocational rehabilitation, or other community/state agency.
• ABA delivered in a clinic/center paid by the family (or other private funds).
• ABA delivered in a public school paid by private health insurance.
• ABA delivered in a public school paid by Medicaid pursuant to EPSDT program.
• ABA delivered in a public school paid by the education system.
• ABA delivered in a public school paid by a regional center, vocational rehabilitation, or other community/state agency.
• ABA delivered in a public school paid by the family (or other private funds).
• ABA delivered in a private school paid by private health insurance.
• ABA delivered in a private school paid by Medicaid pursuant to EPSDT program.
• ABA delivered in a private school paid by the education system.
• ABA delivered in a private school paid by a regional center, vocational rehabilitation, or other community/state agency.
• ABA delivered in a private school paid by the family (or other private funds).
• ABA delivered in a charter school paid by private health insurance.
• ABA delivered in a charter school paid by Medicaid pursuant to EPSDT program.
• ABA delivered in a charter school paid by the education system.
• ABA delivered in a charter school paid by a regional center, vocational rehabilitation, or other community/state agency.

• ABA delivered in a charter school paid by the family (or other private funds).
• ABA delivered in a residential congregate care setting (e.g., group home, residential supported living facility) paid by private health insurance.
• ABA delivered in a residential congregate care setting (e.g., group home, residential supported living facility) paid by Medicaid pursuant to EPSDT program.
• ABA delivered in a residential congregate care setting (e.g., group home, residential supported living facility) paid by the education system.
• ABA delivered in a residential congregate care setting (e.g., group home, residential supported living facility) paid by a regional center, vocational rehabilitation, or other community/state agency.
• ABA delivered in a residential congregate care setting (e.g., group home, residential supported living facility) paid by the family (or other private funds).

• ABA delivered in an adult day program paid by private health insurance.
• ABA delivered in an adult day program paid by a regional center, vocational rehabilitation, or other community/state agency.
• ABA delivered in an adult day program paid by the family (or other private funds).
• ABA delivered in an adult day program paid by a Medicaid waiver.

I know this list is general and not exhaustive (and options and terminology vary widely by states). So we at CASP are calling on our members, other providers, and consumers to help fill the gaps in the list. Please email info@casproviders.org if you see any funding/settings combinations missing from this list.

We will use these data to help inform parameters for future resource development and benchmarking projects. It is an important mission of CASP to support members who are accessing all varieties of settings and funding options so we can ensure our members are represented and supported with our resources and educational opportunities. Thank you!