Frequently Asked Questions

Some common questions and answers about BHCOE Accreditation.

How is an accreditation score calculated?

To calculate accreditation status, The Behavioral Health Center of Excellence conducts an evaluation that reviews some areas of your practice:

  • Staff Qualifications
  • Staff Training
  • Treatment Programming
  • Collaboration
  • Accessibility of Services
  • Social Media & Online Presence
  • Consumer Satisfaction
  • Staff Satisfaction

These areas are measured using a qualitative semi-structured interview with the agency clinical leadership, a detailed staff qualification review, an examination of documents, and two anonymous staff satisfaction and consumer satisfaction surveys.

What are the possible accreditation decisions?

The BHCOE Accreditation is valid for one to three years, dependent on the provider’s assessment score. A score of 85-90% reflects a 1-year accreditation, 91-95% reflects a 2-year accreditation and 96-100% reflects a 3-year accreditation.

If a provider scores below 85%, they will be granted a provisional accreditation lasting 6 months and provided with a performance improvement plan. The performance improvement plan will outline performance improvement areas and supported documentation needed to show improvement after 6 months. You may consult with your evaluator to discuss suggestions for improvement or best practice strategies. If you wish to receive coaching, BHCOE can recommend external organizational consultants that can assist with preparation for your re-evaluation.

How are BHCOE standards developed?

The BHCOE evaluates best practices in domains based on guidelines established by leading authorities in the field of behavior analysis, such as the Behavior Analyst Certification Board, the National Standards Project, and the Association for Behavior Analysis International. The accreditation program accomplishes its mission by continually evaluating the adequacy and appropriateness of accreditation standards in accordance with the changing regulatory environment and through continued monitoring of accredited states.

How much does accreditation cost?

The BHCOE evaluation is like going to the doctor. You pay for the check-up, NOT for the diagnosis. Payment does not impact whether an organization will become a Behavioral Health Center of Excellence. The cost is a flat fee for the evaluation based on the size of the agency (1-50 employees, 50+ employees, etc.) and Incorporation Status (LLC, C-Corp, S-Corp vs. 501(c)3). The program is “at cost” for the time and materials that are required for a Board Certified Behavior Analyst to conduct the interview, administer the surveys and report the results. To gain information about the cost for your organization, you may email info@bhcoe.org.

Who completes the evaluation?

The clinical evaluation is conducted by a Board Certified Behavior Analyst who holds at least 5 years of experience in a leadership position at a behavioral organization and/or providing Organizational Behavior Management consultation. All auditors are trained by the BHCOE to provide impartial and constructive feedback throughout the evaluation process.

What about HIPAA?

What about HIPAA?

As clinical auditors, we will have access to protected health information (“PHI”) collectively referred to as “HIPAA.” The clinical auditor agrees to fully comply with requirements under HIPAA, throughout the term of the clinical audit. Further, every agent, employee, subsidiary, and affiliate of the Behavioral Health Center of Excellence to whom PHI is received will be required to fully comply with HIPAA, and will be bound by written agreement to the same restrictions and terms and conditions.

Your clients are protected under section 45 CFR 164.506 of the HIPAA Privacy Rule in which:

“Health care operations” are certain administrative, financial, legal, and quality improvement activities of a covered entity that are necessary to run its business and to support the core functions of treatment and payment. These activities, which are limited to the activities listed in the definition of “health care operations” at 45 CFR 164.501, include:

  • Conducting quality assessment and improvement activities, population-based activities relating to improving health or reducing health care costs, and case management and care coordination;
  • Reviewing the competence or qualifications of healthcare professionals, evaluating provider and health plan performance, training health care and non-health care professionals, accreditation, certification, licensing, or credentialing activities”

“Health care operations” are certain administrative, financial, legal, and quality improvement activities of a covered entity that are necessary to run its business and to support the core functions of treatment and payment. These activities, which are limited to the activities listed in the definition of “health care operations” at 45 CFR 164.501, include: Conducting quality assessment and improvement activities, population-based activities relating to improving health or reducing health care costs, and case management and care coordination; Reviewing the competence or qualifications of health care professionals, evaluating provider and health plan performance, training health care and non-health care professionals, accreditation, certification, licensing, or credentialing activities”

In addition consumers are notified prior to survey administration that the response to the survey is voluntary and will not affect their services in any way. They are also provided with an “opt out” option at the initial point of contact.

What about the BACB?

The Behavior Analysis Certification Board, Inc. ® (BACB) has a strict non-endorsement policy. As such, they do not partner or endorse any organizations within the behavior analytic community. The BHCOE consults with the BACB ® periodically on compliance-related issues to determine whether certain compliance concerns are related to the practitioner or the behavioral organization. We consider them an ally in our endeavor in shaping the quality of service delivery in Applied Behavior Analysis.

Does BHCOE provide any help in preparing for a survey?

BHCOE handles the surveys from start to finish. We provide a letter you may use to notify your staff and clients about the survey beforehand to explain the process and why they are being surveyed. We also send out weekly reminders to those who haven’t responded yet to ensure optimal response rates that can provide significant data.

Do we have to submit all our programs for accreditation?

No. Accreditation is specific to the applied behavior analysis component of your organization. In addition, separate offices are evaluated independently. An organization can choose to accredit all offices or select offices.

Can BHCOE accredit services provided by an individual?

Some payers require provisional accreditation prior to contracting to provide services. In this case, the BHCOE does accredit an organization who has not yet begun providing services to their clients. This can include individual practitioners, sole proprietors or licensed clinical psychologists. Provisional accreditation includes a document review and interview and lasts six months. Provisional accreditation can also be used to prepare for full accreditation.

What are the financial benefits of BHCOE Accreditation?

1. Liability Reduction: accreditation reduces the risk of allegations of negligence, professional misconduct, and breach of confidentiality can far exceed the cost spent on accreditation. In addition, providers can use accreditation to reduce their liability insurance rate.

2. Compliance with Funders: Many funders are moving towards requiring health care providers to hold accreditation for their organization. BHCOE has seen this in some states. Organizations already accredited by BHCOE may be compliant and need not undergo any additional surveys or inspections. In addition, other accreditations are much more expensive. BHCOE is priced as the most affordable accreditation that offers the clinical and administrative practice.
3. Reimbursement Rate Negotiations: Accreditation is currently a voluntary peer review process. It’s a great way to approach your funder for a rate increase to show compliance with quality standards and efficiency of your services. Rate negotiations likely only occur during the re-credentialing period. Providers should think about what the insurance business wants and where your organization fits in. On top of that, ABA providers must prove they’re an asset to the network and show how their services are vital to the network’s survival (for instance, through cost savings). The trick is to convey this information with as much hard data and analyses as possible. A provider can’t simply approach an insurance payer and say, “Can we have an increase?” Instead, an organization needs to come to the negotiating table with numbers, figures, arguments and, most importantly, strategy. Insurance payers have a much harder time saying no to numbers. The BHCOE Accreditation process is built to address this by providing your organization with sustainability data and client outcome. Most of the providers who have been successful in rate increases have taken their BHCOE Accreditation report to their negotiation meetings, along with other supporting documents (e.g. letters of support, etc.).
What happens if my organization does not agree with BHCOE's accreditation decision results?

Organizations that the BHCOE has conducted a review of and that have received a Preliminary
Accreditation, Full Accreditation, Provisional Accreditation or Non-Accreditation may appeal the
BHCOE to re-score their accreditation review within 30 days of completion of the review. All documentation is reviewed by an alternate auditor and confirmed by the Appeals Committee. All appeal decisions are final.

How Can I Get Involved?

The Behavioral Health Center of Excellence (BHCOE) is always looking for new community members who are passionate about Applied Behavior Analysis and the implementation of quality standards within our community.

The Behavioral Health Center of Excellence is looking for community members interested in serving on our Community Advisory Board (CAB). The CAB represents the applied behavior analysis community as clinicians, academics, and ABA agency owners. To learn more, please send your CV to info@bhcoe.org.

Do you have other questions about our organization or becoming a BHCOE?

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