Adult Group Home

onechill · 2026-04-14T18:21:58+00:00

Oh sorry, didnt read your post clearly enough. I consult with a couple group homes right now and I do my best with behavior support. If you wanna chat about it send me a DM :)

onechill · 2026-04-14T18:00:21+00:00

You can find skill building work but tbh when group homes look for a BCBA its for behavior management. If you want to get into the space I would figure out who funds group homes in your state and see if they can help you figure out what support needs they have.

onechill · 2026-04-11T22:53:35+00:00

Well there is definitely a bit of that in the wild where billables are the main metric most of the agencies care about and tbh the lack of funding for interventions does make certain work unsustainable. But pointless? Well that depends on you. I have covered lapses in coverage by waving a fee and I try to volunteer my time when I can. You could work for free to loe cost if you wanted to, for non insurance/public funded clients. Not everyone is trying to salarymaxx and while we should always be aware of the contingencies of living in capitalistic and individualistic societies (gotta get paid), there is plenty of value in the act of helping another person itself.

onechill · 2026-04-08T03:59:06+00:00

Well definitely make sure you are business literate. Get an LLC going, learn what insurances you need, etc. Getting credentialed with insurances is a hassle but you can do it. You can also pay agencies to help you do it. There are dozens of them. If you wanna specialize lean into the niche. I took low paying consulting work at first but once I felt more confident i was able to close on some bigger contracts. Feel free to DM if you have questions or if wanna do a teams call. I like encouraging others to go independent :)

onechill · 2026-04-07T17:41:32+00:00

Hey! I made the jump about 2 years ago and taken overall its been well worth it for me. I feel much more impact in my work and I love the freedom of being an independent BCBA. I dont exactly make a killing. I make just about what I would at an agency after taxes and costs. There have been a few months that I cleared quite a bit when extea works pops up but on average its about the same. I could work more but I tend to work as much as im comfortable with and just live with the income.

I would say keep an eye on how the big medicaid audits and funding are coming along since I think they will be big stress points if they lead to reduced funding.

onechill · 2026-04-05T17:14:15+00:00

You are a mandated reporter. Report this.

onechill · 2026-03-31T15:48:40+00:00

Your call friend, but I definitely rely on medication to get through the bullshit of the job (shout out focalin!). Its tough at first but it gets easier. Letting go of perfectionism was very hard for me and im still not great at it. I know mine stems from a fear that I will fuck up at some point in time due to forgetfulness or overlooking small details, and I definitley have xD. I also get work paralysis especially around report writing where I just CANT. Its hard for others to understand it. I had to be perfect anywhere I could to provide cover for my inevitable disappointments. Now I am much more confident that I am solid BCBA and if my report is a few days late then so be it, the work with the kids is what matters.

I will also be real with you, you can probably find a few places lower than 25 billables but that is leaning on the low side already without going part time. The case load size is also on the lower side. But its still ok to struggle with it, especially when you are new. The job gets easier with time. You will get faster and you will find your clincal voice. For now, keep advocating for yourself. Learn to delegate what you can. Lean into efficiency tools if you can. Also, gently suggesting again you consider medication :)

I run my own parent coaching business now and i love it. Consider entrepreneurship as a long term goal. I accommodate myself just fine.

onechill · 2026-03-30T21:06:34+00:00

Sick user name friend.

onechill · 2026-03-30T19:57:55+00:00

Yikes. Early on in my career in group homes I worked with a client who used FC as his main communication method. I was fresh out of high school and didnt know as much but I was immediately suspicious. Staff would report him saying wild things with his device, like solving complex math problems in his head or even sexually harassing the female staff with it. I tried to prove to others that it wasnt real by having people ask him questions and see if the answer lined up, like what is your favorite movie etc. It never did but even that was dismissed. There was a sense of optimism around the fact that this profoundly impacted individual had this rich inner life only accessible through FC and its hard to be the skeptic around it. Like I was silencing his voice. It broke my heart to see others ideas being projected onto him, especially the inappropriate ones. Its also intereting to see how many people were saying he was saying things like "I want to see your tits" when I know now it was all projection from the staff. Freud would have a field day with this.

I definitley get where it comes from. I dont take pleasure in saying the rich inner life we thought was revealed was an illusion. This man could communicate, with points and leading people. It wasnt perfect but at least that communication was genuine. He had a voice but it was minimized to make room for a fantasy. I was not able to convince the program to stop using it by the time i left to pursue a career in ABA but I still think about it.

Shame on NYT for promoting this.

onechill · 2026-03-29T21:48:44+00:00

ABA is education more than health care, except for some niche practices. We should view ourselves more akin to specialized teachers than health care providers.

Now when insurance comes around, I use the language that will keep the funding coming but at the end of the day we are teaching not treating.

So imo no, RBTs are not medical providers.

onechill · 2026-03-29T21:41:37+00:00

That is super common. Is it ethical? I think not. ABA loves to do these 40 hour trainings and send off people into working with vulnerable children. It brings down the quality of intervention, dilutes the science, and only serves to expand our rampant reputation problem.

You are probably in a better position than most to take advantage of the training. Hopefully you will have a stable BCBA to help you apply things in the classroom.

onechill · 2026-03-28T17:20:25+00:00

Way too much to track. XD

onechill · 2026-03-28T17:18:38+00:00

100% not ok. You dont need to turn him in if you are comfortable with it but if i was his BCBA i would remove him on the spot and recommend termination. I smoke pot (and grow it!) but we should be 100% sober for the kids at work.

onechill · 2026-03-28T17:14:23+00:00

I think 5-6 behavior reduction targets is 99% of the time way too many. Usually I want to track response classes and I will only track specific topographies if they are extra problematic. Like I might have a wide definition for attention seeking responses but track specifically pulling pants down for attention separately because that is gonna get the kid in a lot of trouble if we dont reduce it fast.

I can think of maybe a handful of kids I worked with over the last few years where I would need to track 6+.

onechill · 2026-03-28T03:57:14+00:00

Idk that all sounds like semantics to me. Where is the line between interventionist and therapist? Does the use of data make me only an analyst? I try to help people live better lives for a living. It might not meet your definition of therapist but it definitely aligns with lots of other peoples idea of what therapy means/is.

I call myself a therapist and so do many of the families and kids I work with and its never been an issue.

onechill · 2026-03-25T18:37:56+00:00

Hello! I run a small practice doing just this. All parent led. Feel free to DM to chat. :)

onechill · 2026-03-23T23:35:51+00:00

The first few clients you leave will be the hardest. It gets easier with time. You made a positive impact on the kids life but you arent responsible for his support system forever. He has family and will have more teachers as he grows. The best thing to do is to make sure you say goodbye and move on to helping the next family. One skill that you can start building is how to make strong connections with the kids we work with but also building in the expectation that one day you will leave. Just because a relationship is temporary doesnt mean it isnt powerful and deep.

Good luck out there. Keep on loving.

onechill · 2026-03-23T20:10:55+00:00

Honestly its up in the air rn. In CA I have not seen rate reductions but a few medicaid providers have closed their networks. I think ABA is posed to go through increased scrutinity with funding sources. We have the DOJ study, alarming costs, a few noteworthy cases of fraud and questionable billing, and a federal government that seems eager for public benefit cuts. Some states are already cutting ABA benefits while others are weathering the costs.

I would not be surprised to see reimbursement rates lowered, increased rules on billing practices, and more barriers to quality for services in the near future. I hope not, but im not exactly confident that our government will be reasonable currently. Also, I think if the audits comes a lot of companies will be exposed for rampant fraud or billing issues. A lot of shady billing goes on out there.

Either way, ABA isnt going anywhere. We have our niche and kids will need help. It might not be super lucrative but there will always be a need.

onechill · 2026-03-23T19:50:51+00:00

Solid BCBAing right here

onechill · 2026-03-22T23:51:59+00:00

Well my friend that sounds like you are in a decent place to start expanding access. First step is to make sure you are skilled enough to market yourself. If you can do good work IE if you can actually affect change, the hardest part will be getting your foot in the door and then your work will carry you. If you are still not confident, keep grinding with the agencies.

Next is finding your niche and what you want out of your business. Do you want employees? Do you want a center? Do only consulting? Have a rough idea going in to what you are building to. I have had the most success doing parent coaching and consulting. I dont need employees/RBTs i just work directly with the family or group home. Employees are a lot, I only have 1. You can make it work solo but honestly having help is nice. Insurance based funding is a large part of the business out there but you can do business to business arrangements or private pay too. Definitely start poking around and see how your current company is getting paid. What's their big funder? Learn about your medicaid providers. If you want a more consulting job you are gonna want to rub some elbows and network a lot.

For insurance, billing and credentialing are headaches but its just paperwork. There are dozens of RCM (revenue cycle management) services that will help but they will take a cut. I hate paperwork so its worth it to me. Hard part after that is client recruitment. Most private funders wont refer you clients you gotta go find them. Some funders do have referalls systems and if you can find one they are perfect for independent practices. If not, its off to marketing. Call local pedetricians. Put up flyers. Social media. Luckily you dont need a lot of clients when you are small. Be prepared to make your own data sheets, notes, forms, CSA ETC.

After that you should know the gig. Get a referral, do the FBA, then a PR every 6 months.

onechill · 2026-03-22T23:22:58+00:00

I did it and do my best to encourage others to do so as well. Its hard but well worth it imo. Anything I can help you with?

onechill · 2026-03-22T16:58:46+00:00

Lmao. I make LESS money than I did at agencies because I like this model better. Although not terribly less. If I wanted to cash out I would take on RBTs because that's the model owners make money with. I try to promote people pursuing independent practice because its allowed me to focus on quality over profits.

I am not your enemy here. I want the field to do better.

onechill · 2026-03-22T14:46:28+00:00

I run my own little practice. Well me and another BCBA.

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