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While our discussion of the negative impact of BT/RBT turnover has been limited to the impact on BTs/RBTs and ABA organizations, obviously, the ultimate victim are the children we are supposed to be helping as they churn through one RBT after another and the parents who can do nothing but stand by helplessly as their mental health is deteriorating from the constant stress.

Ultimately, in order to adjust for the inequities inherent in our system, all participants – BTs/RBTs, BCBAs, ABA Organizations, and even parents – need to be willing to change their behavior for any sustainable improvements to take place.

But the stakeholder group that can make the greatest impact are payors. We need a rational reimbursement system in place that pegs reimbursement rates on the difficulty of the cases. If the more challenging cases were reimbursed at a higher rate, there would be an incentive for organizations to not only invest in developing RBTs to take on these challenging cases, but also reverse the current industry-wide trend of “”cherry picking”” the “”easy”” cases. Cases that can be handled by someone with just 40-hours of RBT training.

So what does this current trend of cherry picking the easiest cases with highest reimbursement rates mean for clients and parents who have the greatest need for ABA services? Those with challenging behaviors that most agencies decide are not worth the trouble to take on? Or frankly, can’t take on because the financial risk/reward doesn’t make sense?

I’m looking to talk to some agency owners who would be willing to share their data with me. My goal is to start by quantifying the cost of turnover for payor organizations. Once we have data, we have a starting point with which to attempt to engage the funding sources to collaborate with us to create a sustainable solution.”


Parent Waitlist Program


November 02, 2023 | 12pm-1pm PDT

Journey to Independence

Community-based program designed to support families on waitlist

Being an RBT for me was extremely fun because where were you going to find a place where you can be completely silly without having to worry what people thought about you? This was the only job that made me feel like I could make a dramatic difference while being myself.

I also liked to be surrounded by people that had the same goals of wanting to help kids and the teamwork made the job much easier and more enjoyable.

Change and progress was the ultimate goal for our kiddos. The early intervention program was seriously only a miracle because I saw changes in the kiddos that from day one, you wouldn’t even recognize who they were.

Changes from being able to utter 3-4 words where they can only make a syllable from when they started, the behavior decreases in which kiddo that used to engage in 30-40 0 self-harm to only half, learning how to wait during games, table work where they use to swipe and drop to the floor if they had to.

My favorite was when the parents would tell us what amazing progress they were making at home. I used to tear up and felt for these parents so much because it was already difficult for them and now, they can trust and rely on ABA and the therapists knowing their goal was ours.

By Emma Rogers, BA, RBT

Mother Child
Special Learning’s Free Hotline

This is an independent SL Hotline that is part of our VCAT service. This hotline has no connection with any other association or membership group.

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