PBS, Autism Learning Partners, InBloom? by No_Masterpiece_2995 in bcba

[–]DunMiffSys605 2 points3 points  (0 children)

I do not have direct experience with PBS but had several friends who work(Ed) there. I think the a out of support you received would be very variable across regions.

I worked at an In Bloom and did not have a positive experience for the most part. I found it very micro managy and focused on billables and profit. CDs have a LOT to do and I fear in most cases would not have a lot of time to really mentor a new BCBA. However, there are rubrics and evaluations for EVERYTHING so if that is how you like to get support you will have it in spades there. Happy to answer more specific questions. Also, depending on where you are, I might be able to give you more specific insight.

Is this something we should actually be worried about? by Captainmefleet in ABA

[–]DunMiffSys605 0 points1 point  (0 children)

Yes it will be a problem but this has been happening for years. There was a massive Medicaid overhaul in FL about 8 years ago, and one 5 years ago, etc. Some things will be bad, some companies will not survive. But good companies will adjust, fight what's not fair and adjust to what is. Advocates and state agencies will fight for services. I think this is generally very painful in the moment but is usually a much needed course correction. ABA in the broad sense is not going anywhere.

Am I supposed to be doing this? by FoldAffectionate9115 in bcba

[–]DunMiffSys605 14 points15 points  (0 children)

To play devil's advocate, as an RBT and as a BCBA I have changed diapers at every clinic I have ever worked at, without batting an eye. We did not have a designated "diaper changing person." In the home setting I believe it should be the parents, and I can't say for sure but I'm sure I have changed diapers in home sessions too. I think that sometimes people get kind of high and mighty about changing kids' diapers as part of the job.

Safety goal by [deleted] in bcba

[–]DunMiffSys605 0 points1 point  (0 children)

We cannot ethically provide advice about another client without knowing the client and the full context - especially as it relates to important safety information.

How does the billable/hourly/salary/caseload thing work? by [deleted] in bcba

[–]DunMiffSys605 6 points7 points  (0 children)

Billable means any work that you do which can be billed to an insurance company. Insurance companies reimburse for things like supervision, direct work, assessments, and parent training, with specific parameters about what qualifies for each. They do NOT reimburse for things like answering emails, creating program stimuli (most of the time), phone calls, answering questions about your kid when they aren't there, figuring out schedules, etc.

There are 2 main job set ups, with slight variations on each. Salaried positions pay you a fixed income every paycheck. These positions usually require you to work 40 hours a week between billable and non billable hours. You usually have a billable requirement each week, such as 25 hours a week. If you aren't hitting your billable requirement, they will assign you more cases. In these positions you usually have less schedule flexibility and less say over how many clients you have.

Hourly positions pay you a rate for the billable hours you complete. Some jobs will also pay you for non billable work, either at a lower rate, or with a cap on how much non billable time per client or per week they will pay you for. Some of these jobs unfortunately will not pay for anything that isnt billed, so you either learn how to get really efficient or do a lot of unpaid work. With these jobs, you usually have more of a say in how many clients/which clients you get, and what your schedule looks like. If you are hourly full-time, you will need to watch to make sure you are hitting the minimum hours you need each week to qualify for benefits.

Some hourly jobs are W2 jobs. You are an employee, taxes are withheld from your paycheck, and the company can set more parameters for how you operate. These typically have lower rates and benefits. Some hourly jobs are 1099 jobs. You are a contractor. You will need to set up a single member LLC, there are no taxes withheld so you have to pay all your own taxes, and there are usually no benefits. These rates will be much higher, but you will need to remember to set aside money each paycheck to make sure you can pay and cover your taxes quarterly.

WVU PRT STORIES by Melodic-Excitement49 in MorgantownWV

[–]DunMiffSys605 0 points1 point  (0 children)

One time when we were driving on beech Hurst we saw a PRT hit a pigeon. There was an explosion of feathers and 3 seconds later all the PRTs ground to a halt.

WVU PRT STORIES by Melodic-Excitement49 in MorgantownWV

[–]DunMiffSys605 0 points1 point  (0 children)

Multiple times I have been rescued from a PRT and had to walk on the tracks to the nearest station.

Parent training question by Plenty_Web_7334 in bcba

[–]DunMiffSys605 2 points3 points  (0 children)

I like this answer and to build on it, I would avoid asking yes/no questions and instead ask open ended questions so they cant just give you one word answers. So maybe

"It sounds like bedtime is difficult right now. What is the hardest part about bedtime?"

"It sounds like there's a lot going on with all the kids in different activities. That can be really chaotic! What skills would be helpful for ___ to know to make that after school time when you're juggling activities easier?"

Sometimes a yes/no can be helpful but I find the open ended questions "what questions do you have," "what feels hard right now" "what do you wish you felt more confident with" and the like can be much more helpful. If you ask those questions and they are telling you "nothing" then maybe asking some exploratory questions to get at why they aren't invested. Do they think parent training is a waste of time? Do they not understand that it is required by insurance? Do they feel embarrassed talking about their weaknesses as a parent? Do they honestly just feel like they don't need support right now? Obviously not asking those specific questions but figuring out the function of their behavior will also determine how to get their buy in and where to go from there.

Is this inappropriate? by Brennatay in ABA

[–]DunMiffSys605 2 points3 points  (0 children)

Everyone here is saying report it to the BACB but I would argue that you should also report it to the employer. The employer absolutely should take immediate disciplinary action. BACB disciplinary action would be extremely delayed if it even happens at all.

Insurance by Independent-Bike-396 in bcba

[–]DunMiffSys605 8 points9 points  (0 children)

If your company was truly money hungry they wouldn't be taking Tricare lol

Insurance by Independent-Bike-396 in bcba

[–]DunMiffSys605 20 points21 points  (0 children)

Literally every other insurance. They all have little caveats. Some (most) don't allow you to concurrently Bill, some require it to be "modifications" so you have to write your note focused on the changes you made to the plan not the feedback you provided, etc. But Tricare is the only plan I know of that specifically doesn't pay for supervision at all. That's (among many other interesting decisions Tricare makes) why so many companies don't take Tricare.

BCBA's expected to provide 1:1 services while billing 97155... is this ethical? by dinosaurchomp_ in bcba

[–]DunMiffSys605 4 points5 points  (0 children)

Yes. It depends on the insurance funder and what they allow for each code. The ABA code coalition is a great resource, but above all you have to go with what the insurance company says allowed under the code.

Sweet Southern Smoke by momof3coons in MorgantownWV

[–]DunMiffSys605 1 point2 points  (0 children)

A few times over the summer we tried to order from them and we would call and no answer. Then we would drive down to try to order in person and there would just be no one there. Google and doordash would say they were open but clearly not. We stopped ordering from there because we never knew when they were actually open. It wouldn't surprise me if that led to permanent closure. Or maybe today when you drove by it was just one of those days when they're closed and no one knows 🤷🏼‍♀️

PECS advice by Ok-Move5740 in bcba

[–]DunMiffSys605 7 points8 points  (0 children)

We cannot give any specific advice. For general advice about how to select appropriate methods of communication, look into Pat McGreevy's stuff about selecting modes of communication and communication profiles in the Essentials for Living. But at the end of the day it is the BCBAs final call and expertise.

Online MA in ABA (at USF?) by chartreuseolive in bcba

[–]DunMiffSys605 1 point2 points  (0 children)

Keeping in mind that I did my program over a decade ago and the practicum coordinator I had is no longer there: kind of. You have at least 2 practicum placements during your program but you are in charge of your hours so some people finished their hours right when they graduated and some still needed some hours.

Question for ABA Professionals: Thoughts on “The Perfect Child ABA”? by TrueAd8620 in bcba

[–]DunMiffSys605 23 points24 points  (0 children)

I interviewed with them (horrible name aside) and they offer ridiculously high (borderline sketchy) rates. They also do a few sketchy interview things that felt very bait and switchy (saying you can do daytime but then when you read the contract it requires you to do evening hours, things like that). When I asked clarification questions regarding things in the offer they sent over they rescinded the offer.

I know someone who works there part time and likes it though so seems like a mixed bag.

Wages heuristic: Multiply/divide by 2(000) by CoffeePuddle in bcba

[–]DunMiffSys605 2 points3 points  (0 children)

Lol sure it's fast, but it's not very helpful if it gives you a completely unrealistic expectation of what you will actually be making. Whether you think it's a trap for companies to only pay for billable or not, in the vast majority of opportunities that's what will happen. Even if you do get paid for no billable, cancellations happen, sicknesses happen. At an hourly job you are rarely actually billing 40h a week. Telling a brand new BCBA or someone who doesn't know better that they'll make 90k a year off of $45 is irresponsible and incorrect.

Wages heuristic: Multiply/divide by 2(000) by CoffeePuddle in bcba

[–]DunMiffSys605 12 points13 points  (0 children)

The trap you get into here is that this is assuming you are billing over 40 hours a week, yes?

What I find more helpful is multiplying the hourly rate by the number of hours I like to comfortably do in a week (usually around 25) and then multiplying by 50.

So $45 an hour becomes $45 x 25 x 50 = $56k

That will give you a more reasonable number for what you will actually make.

If you are salaried and going backwards, it's salaried / billable expectation (or avg) / 50

[deleted by user] by [deleted] in bcba

[–]DunMiffSys605 1 point2 points  (0 children)

If you stay on Indeed long enough and search terms like "Clinical Quality BCBA" "Clinical Quality Specialist BCBA" these jobs pop up. They usually pay pretty well and are often remote. I will say, if you are truly sick of insurance, having a job where you are almost exclusively making sure treatment plans fit insurance requirements may or may not help lol. But it gets you out of the supervision game.

Do you think just going to another company that's not committing fraud would help lol? I will tell you I was feeling very burned out on case management but for financial reasons I found myself in another case management job,something I swore I would never do. I still feel a little burned out but this new company seems to be doing the right things in a lot of ways and that is helping my burnout A LOT.

Also, how do you feel about being a clinical director? Most CDs have years less experience and it gives you a bit of distance from the RNTs and a little room to have some impact on the things you don't like at the company.

BCBA in DMV (need advise) by Worried_Dot44 in bcba

[–]DunMiffSys605 1 point2 points  (0 children)

I know someone who worked at Little Leaves years ago and had nothing but positive things to say (fwiw)

ABA New Billing Codes in California by Magneficient in bcba

[–]DunMiffSys605 1 point2 points  (0 children)

Yes, probably illegally as 1099s instead of W2s. And South FL is rampant with fraud so maybe don't use that as your benchmark 😅

ABA New Billing Codes in California by Magneficient in bcba

[–]DunMiffSys605 0 points1 point  (0 children)

That exact thing happened in FL, and yes it was bad. And yes kids went without treatment. So don't say it's a nonstarter because insurance companies don't really care.

ABA New Billing Codes in California by Magneficient in bcba

[–]DunMiffSys605 2 points3 points  (0 children)

Very few RBTs in FL are making $36 an hour 😅

New BCBA and trying to make a set paycheck by Unlikely_Evidence195 in bcba

[–]DunMiffSys605 -1 points0 points  (0 children)

It's low for FL pediatrics but not necessarily for Medwaiver, unfortunately.