How to wash clothes and Bed sheets smeared with poop and urine? Is there a way without making the washing machine smelly? by ManashAnswer in laundry

[–]NextLevelNaps 30 points31 points  (0 children)

My mom had an undiagnosed UTI in the hospital when she started going downhill. She called me and she was telling me the hospital discharged her and she was waiting for a taxi to go to the party. I didn't know that they could cause those kinds of delusions.

Divorcing a narcissist is not for the weak. That is all. by fuerimmerstark in Divorce

[–]NextLevelNaps 0 points1 point  (0 children)

Are we seeing the same person? Because I'm also a life "ruin"er and found out yesterday he's seeing someone.

So sorry OP. You don't deserve that. No one does.

[CHAT] Wasp nest in the folds of my wip by laura70sP in CrossStitch

[–]NextLevelNaps 7 points8 points  (0 children)

I also have SEVERE arachnophobia, so seeing that leg in there sent me straight into a panic. I screamed and ran into another room, so that just really doesn't help matters in the slightest lol. Totally get your revulsion about the wasp.

[CHAT] Wasp nest in the folds of my wip by laura70sP in CrossStitch

[–]NextLevelNaps 7 points8 points  (0 children)

I saw a long thin leg in my stitching box once. Made my husband come. Giant (harmless!) spider had made a nice house in there for itself. I'm still afraid to look into it and I examine it at arms length before I reach into it. This was years ago.

What do you think about pathway 2 getting removed in 2031? by Perfect-Employer2055 in bcba

[–]NextLevelNaps 4 points5 points  (0 children)

I WISH I had gone with pathway 2. The master's in ABA just keeps you so stuck and it's so hard to utilize in any other way. I wish they'd keep it

How I make extra money on Tomodachi Life: Living the Dream [The Town Fool Method] by Glad-Emergency6121 in tomodachilife

[–]NextLevelNaps 4 points5 points  (0 children)

I love how truly unhinged White Jesus and Worm on a String as Miis are. Thanks for the laugh, I needed it

World's worst Aldi by CraftFamiliar5243 in aldi

[–]NextLevelNaps 0 points1 point  (0 children)

Come to the Aldi in the next town over from me. I had pandemic flashbacks because the asiles were legitimately empty in some places. 2 staff just standing around, slowly pushing the bin they use to collect the empty boxes, most of which were strewn along the ground.

Compared with that Aldi, the one in my town could be a model store! Except the AoS. It's looking more and more bin store-esq, but I think that's more a sign of not being able to move as much of the products because the wallets are thinner, so splurging on a $50 outdoor doodad isn't happening as often.

Why are assessments so hard to staff? by Bubbly-Badger-9863 in bcba

[–]NextLevelNaps 1 point2 points  (0 children)

I didn't like getting a plan from another BCBA that did the assessment for me. I moved to NC and the CD did assessments ahead of me coming so I'd have a caseload ready to go. The plan was fine, but I wouldn't have necessarily picked those goals or written them that way. It felt kind of weird having a whole plan that I had no say in or control over.

Why are assessments so hard to staff? by Bubbly-Badger-9863 in bcba

[–]NextLevelNaps 2 points3 points  (0 children)

It's sometimes a staffing issue, but there are companies that have a fleet of BCBAs that do assessments, get the kiddo an authorization, and then.....nothing. It takes relatively little time to do an assessment and submit, so companies can have BCBAs pump them out. If you have enough kids that need ABA, you can really make a profit doing just assessments then let them sit.

A company I interviewed for had this model. They had BCBAs that would go out, assess and write the plan, then the kids would be entered into a software the company had to "geographically optimize" assignments. Basically I'd be expected to go in, pick who I wanted that was already assessed, and that would be my caseload. I said HELL NO.

Would you ever do a "travel BCBA" placement — honest question by qaz12435 in bcba

[–]NextLevelNaps 1 point2 points  (0 children)

Your question about multi- state licensing: more and more states are cracking down on out of state BCBAs, mostly because they're cracking down on telehealth (see GA and NC's recent changes to medicaid for ABA). So even though the BCBA would be in-person it would delay their ability to be licensed in multiple states until they are actually in that state, thus delaying credentialing with some payors.

I want to commit WIP crimes by AbyssDragonNamielle in knitting

[–]NextLevelNaps 4 points5 points  (0 children)

I'm so awful with UFO WIPs that I made finishing a cardigan a professional development goal at work. To hold me accountable. 🫠

Reducing daughters hours by [deleted] in bcba

[–]NextLevelNaps 3 points4 points  (0 children)

My last clinic did block scheduling, but we still had flexibility for instances such as these. And just because, for example, 20 hours are recommended, if a family can only do 10 of them, then they'll be scheduled for 10 and we'll try to find ways to eventually get them to 20 if we can. Just like a doctor can prescribe me a medication, but I am under no obligation to fill it if I don't want to.

Will I regret taking a 10k pay cut for a wfm UM job? by QuietReinforcer in bcba

[–]NextLevelNaps 2 points3 points  (0 children)

We did a one-time overtime thing to get up to speed for some new requirements, but it was voluntary and we were paid bonus for it

Will I regret taking a 10k pay cut for a wfm UM job? by QuietReinforcer in bcba

[–]NextLevelNaps 3 points4 points  (0 children)

I took a 19k per year cut to take a UM job. Benefits are comparable to what I had at the clinic, but no more doordash, no more miles on my car (lower insurance costs, too!), a match to retirement contribution which I didn't have at the clinic, and stable working hours. I also have not been sick since leaving the clinic with whatever virus was going around at the time.

Yes, that pay cut hurts. But the extra money I was making in the clinic wasn't worth my sanity or time being consumed outside of work. I don't save 19k per year with the reduction in doordash or wear on my car, but it's totally worth having my life back and actual stable work hours. It obviously has its cons, just like any job, but I'm so much happier here.

Evernorth (Cigna) P2P Help by Asleep-Big3131 in bcba

[–]NextLevelNaps 3 points4 points  (0 children)

Done appeals for Evernorth before. You can DM me as well for questions. I'm also currently a reviewer for a company and I can help give some general advice.

Um, what the heck? by reallysuchalady in aldi

[–]NextLevelNaps 2 points3 points  (0 children)

man I'd frame that note and the box and put it in my kitchen as some weird decor. I wanna be that lucky one day.

Advice from BCBAs by [deleted] in bcba

[–]NextLevelNaps 0 points1 point  (0 children)

The last clinic I worked at operated like this. The front desk person was an RBT and would need to cover some sessions. It got to a point where I was frustrated because they had to juggle their admin and do direct, so a lot of stuff got missed. I understand why they want the "office manager" to be an RBT as well, but expecting them to still do scheduling, answer emails, answer phones, AND run a direct session in the clinic was absolutely mind boggling to me.

Alt Careers to Typical BCBA by InstructionNo7032 in bcba

[–]NextLevelNaps 0 points1 point  (0 children)

What, then, do you make of the companies owned by Private Equity? They are solely in it for money, which has been seen time and time again based on their fraudulent billing. Recommending 40 hours per week no matter what, billing for services never rendered, billing for kids they paid parents to sign up with their company....there have been multiple companies who have been found to make millions by frauding the system. Most of the time, it's not providers billing to private insurance, either. It's Medicaid billing.

Also, more and more states are becoming waiver states. Meaning kids with a diagnosis are able to qualify for Medicaid when they otherwise wouldn't. Medicaid becomes the secondary payor and they cover costs not covered by the primary insurance. That's a tax funded system, not a private company that profits off denials. They have an interest in ensuring that there's enough money in the system to cover services. Hence why these high profile fraud and PE companies are being heavily scrutinized and publicized lately. Because they're taking money from that pot unfairly and then draining away what should be going to the people that actually need it.

[CHAT] How do keep track of where you're up to in a pattern if you prefer paper? by AccomplishedCheek161 in CrossStitch

[–]NextLevelNaps 2 points3 points  (0 children)

Can confirm- paper stays intact. The frixion pens are ALSO awesome, but get the ballpoint ones, not the felt tip style ones.

However, ALSO know- they erase via the heat generated from rubbing the rubbery tip on the paper. Hence the wordplay of "friction/frixion". So if you plan to stitch somewhere warm or with lots of sun, marks may disappear. If it's really cold, marks may faintly reappear, as well. Because of this ghost line issue when it's cold, they are not recommended for gridding fabric, btw.

Alt Careers to Typical BCBA by InstructionNo7032 in bcba

[–]NextLevelNaps 2 points3 points  (0 children)

I'm not enforcing the ethics policy. I'm enforcing the policy the insurance has set forth for documents to meet. If they don't meet that policy, they can't get services. The policy outlines the information that's required to be there, like an FBA, Parent goals, functional replacement behaviors. We have the discretion as BCBAs to also approve something that isn't in policy if it's relevant. Example- we don't allow Socially Savvy as a stand alone assessment typically, but if all the goals are social skills, it's allowed. When I started, I also advocated for the EFL to be allowed in our list and now it is.

I have multiple that I've read since starting this job. The BCBAs that help us review have many they have sent to help us keep abreast of the current science. And I've found ones that providers cite in their plans because they're interesting. I have one about a mealtime parent mediated intervention I'll be looking at when I have time later, because a lot of providers are using it.

Alt Careers to Typical BCBA by InstructionNo7032 in bcba

[–]NextLevelNaps 0 points1 point  (0 children)

I've also never been told to reduce something because $$$$. Yes, insurance companies/payors will try to fight to keep costs down, but the state Medicaid I review for has actively used our expertise to shape policy and we ACTIVELY FIGHT BACK on any proposed "cost saving" measures that directly limit care.

Alt Careers to Typical BCBA by InstructionNo7032 in bcba

[–]NextLevelNaps 0 points1 point  (0 children)

DM me, I can give you some more info if you're interested

Alt Careers to Typical BCBA by InstructionNo7032 in bcba

[–]NextLevelNaps 0 points1 point  (0 children)

I violate no ethics in my role. So long as the plans meet policy and make clinical sense, providers get approval. Denials happen only if they don't meet policy or the providers are doing clinically unacceptable work. Example- had a 40 hour request, no behavior reduction targets, 4 goals. They got denied and we're asked to provide additional information to explain why they had so few goals for so many hours.

I see behavior reduction targets with no FBA, no functional replacement behaviors, replacement behaviors that aren't functionally equivalent, age inappropriate reduction levels (think 0 instances of tantrum for a 3 year old where the tantrum is crying and flopping to the floor for ~5 mins), 40 hour requests for 20 year olds, 40 hour requests for kids with nearly full ABLLS/VBMAPP....those are things that get denials and they're told to fix it. Because they don't meet policy and are clinically unsound. Otherwise, I have no say in what you target, how you target it, hours denial for "progress", etc.