BHCOE Accreditation Standards

BHCOE’s Accreditation Standards include 11 sections relevant to the clinical, professional and ethical behaviors, processes, and systems of organizations providing Applied Behavior Analysis services, along with suggested evidence of compliance.

The 2021 standards are effective January 1, 2021, for all BHCOE Accredited organizations. Along with these standards, BHCOE Accredited organizations must obey all applicable federal, state and local laws related to health, safety and employment.

By initiating the BHCOE Accreditation process, the organization acknowledges that they have read and are familiar with BHCOE Standards for the BHCOE Accreditation process. The outcome of an accreditation evaluation may result in awarding the clinical practices with Behavioral Health Center of Excellence Accreditation. Receiving Behavioral Health Center of Excellence Accreditation allows the use of the accreditation badge on marketing material and in press. Any organization who engages in the BHCOE Accreditation process agrees to abide by the (i) BHCOE logo usage guidelines (Guidelines), (ii) BHCOE Standards of Excellence and (iii) the terms of the Engagement Letter (Terms). If an organization is found to be out of compliance with the BHCOE Standards, Guidelines or Terms, they will be notified by the BHCOE Compliance Department. Upon notification from the BHCOE Compliance Department, the organization agrees to take steps to become compliant with the BHCOE Standards, Guidelines and/or Terms. BHCOE has established a compliance, disciplinary review and appeal process for matters of noncompliance.

BHCOE has established a compliance, disciplinary review and appeal process for matters of noncompliance that gives equal consideration to both the complainant and the accredited organization. The goal of the compliance process is to support the organization in establishing compliance, when possible.

Looking for BHCOE’s current standard development activities and public commentary guidelines? Find them here.

Select the toggles below to read our standards for each type of accreditation:

2021 Full Accreditation Standards

A. Ethics, Integrity, & Professionalism

A.01 The organization acts in the best interest of the patients they serve at all times.

A.02 The organization, and its subsidiaries are in compliance with all applicable healthcare regulatory and licensing laws.

A.03 The organization, subsidiary, or any of its owners, officers, and directors are not currently and have not been convicted of, charged, or under an investigation or subject to any enforcement action or legal proceeding by any governmental authority arising out of or relating to any healthcare regulatory law within the past year.

A.04 The organization acts honestly and responsibly to promote ethical practices of its employees and supports certified employees in complying with ethical and professional requirements of their certifying and/or licensing body. The organization never directs employees to act in violation of those requirements and resolves any conflicts between the company policy and those requirements.

A.05 The organization is dedicated to ethical and fair competition and will not improperly coordinate to sabotage, speak ill of, or undermine other ABA service organizations.

A.06 The organization ensures employees avoid dual relationships that might impair the ability to make objective and fair decisions.

A.07 The organization protects the privacy of its workers.

A.08 The organization does not offer incentives or remuneration to current patients in exchange for attendance or recruitment of other patients. Remuneration refers to cash, cash-equivalents, or anything of value.

A.09 The organization provides employees, patients, and volunteers a confidential means to report suspected impropriety or misuse of organizational resources. The organization has a policy prohibiting retaliation against persons reporting improprieties.

A.10 The organization has a designated ethics officer and/or ethics committee to address ethical issues such as patient programming, the organizational, employee, and/or patient concerns.

B. Diversity, Equity, & Inclusion

B.01 The organization has a diversity statement.

B.02 The organization has access to and when necessary utilizes translation services for oral and written communication and communicates availability of translation services to patients.

B.03 The organization has representation of diverse individuals at a minimum including age, gender, race/ethnicity, and disability. Instructional, training, and marketing materials include diverse images and narratives.

B.04 The organization makes closed captioning available for its videos. This item is not applicable for organization does not have video content.

B.05 The organization provides cultural humility training and competency checks to all employees upon hire, annually, and as required by state and federal guidelines.

B.06 The organization actively recruits and engages in retention strategies to promote a diverse workforce.

B.07 The organization demonstrates engagement in fair hiring practices, as regulated by Equal Employment Opportunity Commission (EEOC).

B.08 The organization engages in self-assessment of diversity efforts at least annually.

B.09 The organization’s physical location is compliant with the Americans with Disabilities Act.

B.10 The organization has a means to and actively allows qualified low-income patients access to services.

B.11 The organization assures that leadership have completed conflict resolution training and has process(s) for responding to bias incidents.

C. General Requirements & Liability

C.01 The organization has processes in place to ensure it maintains state and local requirements regarding business registration, incorporation, and licensing.

C.02 The organization sufficiently protects against claims resulting from injuries or damages by maintaining general, property, and liability insurance.

C.03 The organization obtains workers’ compensation insurance.

C.04 The organization has protections to ensure the organization, its employees, and patients are protected from a cyber-related incident by obtaining cyber or data privacy insurance.

C.05 The organization has processes and systems in place to assure accuracy of payroll calculations, deductions, and expenses

C.06 The organization develops a strategic plan to account for growth and/or improvement, at least annually.

C.07 The organization develops a budget to forecast expenditures, income, and profitability.

C.08 The organization maintains an ongoing relationship with legal representation.

D. Recruiting, Hiring, & Retention

D.01 The organization has qualifying questions to screen candidates, and standard interview questions, for each position.

D.02 The organization has an organization-specific employment application and offer letter.

D.03 The organization has administrative and clinical onboarding checklists for new hires.

D.04 The organization conducts state and federal background checks on all employees prior to hire.

D.05 The organization verifies all employees hold a valid driver’s license, motor insurance, and clean motor vehicle record for those employees who transport patients.

D.06 The organization does not engage in hiring practices that could restrict non-executive clinical employee’s future employment, such as by requiring non-executive clinical employees to sign non-compete agreements. This does not preclude an organization from relying on non-solicitation and non-disclosure agreements.

D.07 The organization has job descriptions for each position with minimum qualifications, lines of reporting, hierarchy, and job duties.

D.08 The organization utilizes an employee handbook in line with state-specific labor laws.

D.09 The organization retains clinical director employees who hold master’s or doctoral level certification/license in behavior analysis and/or related field and have at least 3 years supervising cases or equivalent experience.

D.10 The organization employs supervisors who hold a graduate-level certification in good standing in Applied Behavior Analysis from a nationally accredited certifying body, meet the certifying body’s current standards for supervision, and hold a graduate degree. When applicable, supervisors should also be licensed in their state. An organization may apply for a staff exception on an individual basis.

D.11 The organization employs direct care employees who hold at least a high school diploma, GED certificate, or a degree from post-secondary institution, are certified/licensed as a direct care employee by a nationally accredited certifying body, or are required to obtain such certification or licensure as applicable, within 6 months. Organization may apply for a staff exception to this item on an individual basis.

D.12 The organization provides training in clinical tasks and administrative tasks for each level of employee upon hire.

D.13 The organization evaluates and assures the competence of employees prior to providing treatment to patients.

D.14 The organization ensures employees at every level receive continuing education, training, and oversight in line with their certification and specific areas of need.

D.15 The organization utilizes employee performance evaluation processes such as goal-setting, performance measurement, regular performance feedback, self-evaluation, and appropriate corrective or positive consequences for each level of employees.

D.16 The organization regularly measures employee satisfaction and makes reasonable efforts to resolve employee concerns or grievances.

D.17 Organization has a plan to ensure it is prepared for senior leadership changes.

E. Patient Intake

E.01 The organization clearly communicates how patients can initiate services with the organization to ensure patients have equal access to services.

E.02 The organization has a standard operating procedure for ensuring timely and efficient onboarding of new patients.

E.03 The organization has a process in place to facilitate the verification of benefits in a timely manner.

E.04 The organization seeks initial authorization from payor before providing assessment or other services, when appropriate.

E.05 The organization regularly monitors credentialing requirements and contract and fee schedule expiration date for each payor.

E.06 Prior to the implementation of services, the organization provides, in writing, the terms of consultation, requirements for providing services, patient rights, financial agreements, and responsibilities of all parties. If terms change, the organization will notify caregivers and/or patients in advance of the new terms taking effect.

E.07 The organization makes reasonable efforts to fulfill all therapy hours recommended within the patient’s clinical assessment.

E.08 The organization collects and monitors data on waitlist length and estimated waitlist time.

E.09 When an organization places a patient on a waitlist, the organization notifies them of the estimated wait time, shares resources about the value of timely access to treatment, and provides suggestions on how to access care in a timely manner.

E.10 The organization recognizes, in its policies, procedures, and business practices, that the direct recipient of services is its primary patient, along with the parent or guardian of the direct recipient of services, even if a third party is paying for the services. The organization resolves any conflicts in the best interests of the direct recipient of services.

E.11 Organizations act in the best interests of the patient, including the direct recipient of services and their caregiver to avoid interruption or disruption of service. The organization does not terminate services without 30-day notice, and without efforts to transition, unless the patients’ needs require prompt termination.

F. Service Delivery

F.01 The organization utilizes evidence-based developmentally appropriate assessments to evaluate patient outcome annually, or more frequently if needed.

F.02 The organization collects and monitors individual patient outcome data.

F.03 The organization collects and monitors clinical outcomes across all patients.

F.04 The organization has a quality assurance officer.

F.05 The organization exclusively utilizes evidence-based clinical practices.

F.06 The organization trains for and measures generalization and maintenance throughout treatment.

F.07 The organization ensures goals are appropriate based on current developmental level, chronological age, and the developmental order in which skills are acquired in individuals with typical development.

F.08 The organization provides treatment recommendations by relying on best practices such as decision models, research, and professional judgment. Treatment recommendations may include hours, amount of supervision, setting, approach, or frequency of treatment.

F.09 The organization ensures clinicians carry a caseload that enables them to provide appropriate supervision and oversight to facilitate effective treatment.

F.10 The organization regularly measures patient satisfaction and makes reasonable efforts to resolve patient concerns or grievances.

F.11 Organization ensures intervention is delivered as written in the treatment plan. Organization ensures that implementation of services adhere to prescribed protocols

G. Clinical Documentation

G.01 The organization has a standard clinical assessment activity template.

G.02 The organization has a standard clinical assessment report template.

G.03 The organization has a standard progress report or treatment plan template.

G.04 The organization has a standard supervisor case note template.

G.05 The organization has a standard mid-level and/or direct care employee case note template.

G.06 The organization has a preference assessment policy and procedure.

G.07 The organization collects daily data related to patient progress.

H. Collaboration & Coordination of Care

H.01 Before the commencement of service delivery, the organization informs caregiver and/or patients how they can file complaints and grievances internally and externally about any service provided by the organization and with BHCOE once the organization is accredited

H.02 The organization has a policy regarding non-evidence-based practices that includes refraining from participating in such practices, resolving conflicts when such practices interfere with ABA services, and educating patients about how to choose effective services.

H.03 The organization educates caregivers of patients on the therapeutic impact of their involvement.

H.04 The organization makes reasonable efforts to involve caregivers of patients in care planning and does not make significant changes to treatment plans without consent.

H.05 The organization establishes minimum caregiver participation/training goals regardless of funding source.

H.06 The organization makes reasonable efforts to involve caregivers and/or caregivers in the treatment implementation process.

H.07 The organization appropriately documents caregiver participation or lack thereof in treatment sessions and planning.

H.08 The organization makes reasonable efforts to collaborate with other professionals on a treatment team such as occupational therapists, school employees, speech-language pathologists, and/or physicians to maximize patient’s progress.

I. Health, Safety, & Emergency Preparedness

I.01 The organization has a policy to protect against abuse or allegations of abuse.

I.02 The organization conducts and documents fire drills at least annually.

I.03 The organization provides access to first aid kit supplies to employees and/or has a first aid kit available in all locations where therapeutic activities take place.

I.04 The organization has policies and procedures for safely transporting patients, if applicable.

I.05 The organization has guidelines for safe medication management, if applicable.

I.06 The organization has a written emergency plan for disaster and casualties.

I.07 The organization provides safety/crisis management training for employees.

I.08 The organization has an employee policy and procedure on mandated reporting requirements including a policy, documented training, and procedure

I.09 The organization has a patient illness policy and procedure.

I.10 The organization has a location-specific patient safety checklist(s).

I.11 The organization has a policy in place to ensure a planned or ad-hoc review occurs as a response to injuries and safety incidents.

J. Media, Communications, & Representation

J.01 The organization accurately represents the services it provides to patients, employees, and/or other stakeholders.

J.02 The organization does not engage in misleading, false, or deceptive statements to patients, employees, and/or other stakeholders.

J.03 The organization has guidelines for how the organization is represented in social media.

J.04 The organization does not permit clinical employees to solicit or use testimonials about behavior-analytic services from current patients on their webpages or in any other electronic or print material.

J.05 The organization does not permit clinical employees to share or create media likely to result in the sharing of any identifying information (written, photographic, or video) about current or past patients and supervisees within social media contexts.

J.06 If an organization utilizes current or past patients to share stories, the organization does not solicit individual patients but, rather, uses an open casting call approach, or use stories provided unsolicited by patients.

J.07 If an organization utilizes current or past patients to share stories, the organization does not conduct such activities during regularly scheduled treatment hours.

J.08 If an organization utilizes current patients to share stories, the organization has clear protocols to ensure separation between the clinical and marketing departments.

J.09 The organization provides opportunities for patient video or photo releases to be renewed annually and provides clear instructions regarding how to revoke consent, if requested.

K. HIPAA & Compliance

K.01 The organization, prior to the implementation of services, informs caregiver in writing a notice of privacy practices.

K.02 The organization uses HIPAA-compliant electronic communication that includes a confidentiality disclaimer.

K.03 The organization uses HIPAA-compliant cloud or server-based storage.

K.04 The organization utilizes a HIPAA breach policy and procedure.

K.05 The organization provides HIPAA compliance training to employees upon hire, annually and as required otherwise.

K.06 The organization limits access to Protected Health Information (PHI) only to personnel who require such access in the course of their job duties.

K.07 The organization utilizes a policy and procedure for the protection of facilities and equipment storing PHI.

K.08 The organization has determined where PHI will be located and how long it will be maintained.

K.09 The organization has an appointed HIPAA privacy/security officer

K.10 The organization has a data backup policy and procedure.

2021 Preliminary Accreditation Standards

A. Ethics, Integrity, & Professionalism

A.01 The organization acts in the best interest of the patients they serve at all times.

A.02 The organization, and its subsidiaries are in compliance with all applicable healthcare regulatory and licensing laws.

A.03 The organization, subsidiary, or any of its owners, officers, and directors are not currently and have not been convicted of, charged, or under an investigation or subject to any enforcement action or legal proceeding by any governmental authority arising out of or relating to any healthcare regulatory law within the past year.

A.04 The organization acts honestly and responsibly to promote ethical practices of its employees and supports certified employees in complying with ethical and professional requirements of their certifying and/or licensing body. The organization never directs employees to act in violation of those requirements and resolves any conflicts between the company policy and those requirements.

A.05 The organization is dedicated to ethical and
fair competition and will not improperly coordinate
to sabotage, speak ill of, or undermine other ABA service organizations.

A.06 The organization ensures employees avoid dual relationships that might impair the ability to make objective and fair decisions.

A.07 The organization protects the privacy of its workers.

A.08 The organization does not offer incentives or remuneration to current patients in exchange for attendance or recruitment of other patients. Remuneration refers to cash, cash-equivalents, or anything of value.

A.09 The organization provides employees, patients, and volunteers a confidential means to report suspected impropriety or misuse of organizational resources. The organization has a policy prohibiting retaliation against persons reporting improprieties.

A.10 The organization has a designated ethics officer and/or ethics committee to address ethical issues such as patient programming, the organizational, employee, and/or patient concerns.

B. Diversity, Equity, & Inclusion

B.01 The organization has a diversity statement.

C. General Requirements & Liability

C.01 The organization has processes in place to ensure it maintains state and local requirements regarding business registration, incorporation, and licensing.

C.02 The organization sufficiently protects against claims resulting from injuries or damages by maintaining general, property, and liability insurance.

C.03 The organization obtains workers’ compensation insurance.

C.05 The organization has processes and systems in place to assure accuracy of payroll calculations, deductions, and expenses

C.06 The organization develops a strategic plan to account for growth and/or improvement, at least annually.

C.07 The organization develops a budget to forecast expenditures, income, and profitability.

C.08 The organization maintains an ongoing relationship with legal representation.

D. Recruiting, Hiring, & Retention

D.01 The organization has qualifying questions to screen candidates, and standard interview questions, for each position.

D.02 The organization has an organization-specific employment application and offer letter.

D.03 The organization has administrative and clinical onboarding checklists for new hires.

D.04 The organization conducts state and federal background checks on all employees prior to hire.

D.05 The organization verifies all employees hold a valid driver’s license, motor insurance, and clean motor vehicle record for those employees who transport patients.

D.06 The organization does not engage in hiring practices that could restrict non-executive clinical employee’s future employment, such as by requiring non-executive clinical employees to sign non-compete agreements. This does not preclude an organization from relying on non-solicitation and non-disclosure agreements.

D.07 The organization has job descriptions for each position with minimum qualifications, lines of reporting, hierarchy, and job duties.

D.08 The organization utilizes an employee handbook in line with state-specific labor laws.

D.09 The organization retains clinical director employees who hold master’s or doctoral level certification/license in behavior analysis and/or related field and have at least 3 years supervising cases or equivalent experience.

D.10 The organization employs supervisors who hold a graduate-level certification in good standing in Applied Behavior Analysis from a nationally accredited certifying body, meet the certifying body’s current standards for supervision, and hold a graduate degree. When applicable, supervisors should also be licensed in their state. An organization may apply for a staff exception on an individual basis.

D.11 The organization employs direct care employees who hold at least a high school diploma, GED certificate, or a degree from post-secondary institution, are certified/licensed as a direct care employee by a nationally accredited certifying body, or are required to obtain such certification or licensure as applicable, within 6 months. Organization may apply for a staff exception to this item on an individual basis.

D.12 The organization provides training in clinical tasks and administrative tasks for each level of employee upon hire.

D.13 The organization evaluates and assures the competence of employees prior to providing treatment to patients.

D.14 The organization ensures employees at every level receive continuing education, training, and oversight in line with their certification and specific areas of need.

D.15 The organization utilizes employee performance evaluation processes such as goal-setting, performance measurement, regular performance feedback, self-evaluation, and appropriate corrective or positive consequences for each level of employees.

E. Patient Intake

E.01 The organization clearly communicates how patients can initiate services with the organization to ensure patients have equal access to services.

E.02 The organization has a standard operating procedure for ensuring timely and efficient onboarding of new patients.

E.03 The organization has a process in place to facilitate the verification of benefits in a timely manner.

E.04 The organization seeks initial authorization from payor before providing assessment or other services, when appropriate.

E.05 The organization regularly monitors credentialing requirements and contract and fee schedule expiration date for each payor.

E.06 Prior to the implementation of services, the organization provides, in writing, the terms of consultation, requirements for providing services, patient rights, financial agreements, and responsibilities of all parties. If terms change, the organization will notify caregivers and/or patients in advance of the new terms taking effect.

E.07 The organization makes reasonable efforts to fulfill all therapy hours recommended within the patient’s clinical assessment.

E.09 When an organization places a patient on a waitlist, the organization notifies them of the estimated wait time, shares resources about the value of timely access to treatment, and provides suggestions on how to access care in a timely manner.

E.10 The organization recognizes, in its policies, procedures, and business practices, that the direct recipient of services is its primary patient, along with the parent or guardian of the direct recipient of services, even if a third party is paying for the services. The organization resolves any conflicts in the best interests of the direct recipient of services.

F. Service Delivery

F.07 The organization ensures goals are appropriate based on current developmental level, chronological age, and the developmental order in which skills are acquired in individuals with typical development.

F.08 The organization provides treatment recommendations by relying on best practices such as decision models, research, and professional judgment. Treatment recommendations may include hours, amount of supervision, setting, approach, or frequency of treatment.

F.09 The organization ensures clinicians carry a caseload that enables them to provide appropriate supervision and oversight to facilitate effective treatment.

F.11 Organization ensures intervention is delivered as written in the treatment plan. Organization ensures that implementation of services adhere to prescribed protocols.

G. Clinical Documentation

G.01 The organization has a standard clinical assessment activity template.

G.02 The organization has a standard clinical assessment report template.

G.03 The organization has a standard progress report or treatment plan template.

G.04 The organization has a standard supervisor case note template.

G.05 The organization has a standard mid-level and/or direct care employee case note template.

G.06 The organization has a preference assessment policy and procedure.

H. Collaboration & Coordination of Care

H.01 Before the commencement of service delivery, the organization informs caregiver and/or patients how they can file complaints and grievances internally and externally about any service provided by the organization and with BHCOE once the organization is accredited.

H.02 The organization has a policy regarding non-evidence-based practices that includes refraining from participating in such practices, resolving conflicts when such practices interfere with ABA services, and educating patients about how to choose effective services.

H.03 The organization educates caregivers of patients on the therapeutic impact of their involvement.

I. Health, Safety, & Emergency Preparedness

I.01 The organization has a policy to protect against abuse or allegations of abuse.

I.02 The organization conducts and documents fire drills at least annually.

I.03 The organization provides access to first aid kit supplies to employees and/or has a first aid kit available in all locations where therapeutic activities take place.

I.04 The organization has policies and procedures for safely transporting patients, if applicable.

I.05 The organization has guidelines for safe medication management, if applicable.

I.06 The organization has a written emergency plan for disaster and casualties.

I.07 The organization provides safety/crisis management training for employees.

I.08 The organization has an employee policy and procedure on mandated reporting requirements including a policy, documented training, and procedure

I.09 The organization has a patient illness policy and procedure.

I.10 The organization has a location-specific patient safety checklist(s).

I.11 The organization has a policy in place to ensure a planned or ad-hoc review occurs as a response to injuries and safety incidents.

J. Media, Communications, & Representation

J.01 The organization accurately represents the services it provides to patients, employees, and/or other stakeholders.

J.02 The organization does not engage in misleading, false, or deceptive statements to patients, employees, and/or other stakeholders.

J.03 The organization has guidelines for how the organization is represented in social media.

K. HIPAA & Compliance

K.01 The organization, prior to the implementation of services, informs caregiver in writing a notice of privacy practices.

K.02 The organization uses HIPAA-compliant electronic communication that includes a confidentiality disclaimer.

K.03 The organization uses HIPAA-compliant cloud or server-based storage.

K.04 The organization utilizes a HIPAA breach policy and procedure.

K.05 The organization provides HIPAA compliance training to employees upon hire, annually and as required otherwise.

K.06 The organization limits access to Protected Health Information (PHI) only to personnel who require such access in the course of their job duties.

K.07 The organization utilizes a policy and procedure for the protection of facilities and equipment storing PHI.

K.08 The organization has determined where PHI will be located and how long it will be maintained.

K.09 The organization has an appointed HIPAA privacy/security officer.

K.10 The organization has a data backup policy and procedure.

2020-2021 Telehealth Accreditation Standards

(T)A. Organizational Compliance

(T)A.01 Organization has a valid business license to deliver telehealth services in accordance with mandates in each state in which it operates.

(T)A.02 Organization has appropriate documentation from payors allowing the use of telehealth.

(T)A.03 Organization has liability insurance with a telehealth addendum and cyber and/or data privacy policy.

(T)A.04 Organization has an employee handbook which clearly defines the telehealth services provided by the employee.

(T)A.05 Organization has a description of services provided via telehealth for each level of care. 

(T)A.06 Organizations operating in multiple states must comply with licensing requirements in each state where telehealth services are delivered. 

(T)A.07 Organization has patient safety policy.

(T)B. Human Resources

(T)B.01 Organization has updated job descriptions incorporating minimum qualifications, telehealth duties, and associated expectations.

(T)B.02 Organization has systems in place for training staff providing telehealth services on clinical procedures.

(T)B.03 Organization has systems in place for training staff providing telehealth services on technology usage.

(T)B.04 Organization reviews mandating reporting requirements with staff prior to providing telehealth services.

(T)B.05 Organization provides safety & crisis management training to staff prior to initiation of telehealth services and annually.

(T)B.06 Organization has systems in place for evaluating competency of staff providing telehealth services on clinical procedures.

(T)B.07 Organization has systems in place for evaluating competency of staff providing telehealth services on technology usage.

(T)B.08 Organization has designated technology professional who is responsible for the effectiveness of equipment and health information systems utilized in the delivery of telehealth services.

(T)C. Patient Intake

(T)C.01 Organization has electronic patient intake form.

(T)C.02 Organization conducts a screening of appropriateness for telehealth prior to initiating services.

(T)C.03 Organization conducts a screening of staffing needs for telehealth prior to initiating services.

(T)C.04 Organization requests additional consent from patients to provide telehealth services.

(T)C.05 Organization educates patients about the telehealth process and the risks and benefits involved in utilizing telehealth technology.

(T)C.06 Organization has a systematized process for set up of session, including technological requirements, programmatic requirements, and environmental prerequisites.

(T)C.07 Organization has a patient home safety checklist to ensure the home is a safe and appropriate workplace for employees who are supervised via telehealth.

(T)C.08 Organization has a parent/guardian participation and interaction policy specific to telehealth services.

(T)D. Clinical Practice

(T)D.01 Organization has program goals created to address patient’s clinical needs which are updated as needed.

(T)D.02 Organization collects data to monitor the progress of patient goals.

(T)D.03 Organization has systems to document clinical interactions using ANSI/BHCOE 101 documentation requirements.

(T)D.04 Organization monitors patient outcome to address effectiveness of telehealth services.

(T)D.05 Organization has guidelines for recommending treatment intensity of telehealth services.

(T)D.06 Organization has procedures to allow for acceptable environment arrangements to ensure patient and direct care staff are visible to supervisory staff.

(T)D.07 Organization develops procedures defining contingency plans for loss of internet connection prior to initiation of services.

(T)E. Technology, Privacy, & Security

(T)E.01 Organizations define procedures for mobile device setup, data removal, and external monitoring.

(T)E.02 Organization ensures staff sign an acknowledgment of receipt of company property.

(T)E.03 Organizations have policies in place that address acceptable use of equipment and security policies for company-issued equipment.

(T)E.04 Organization has systems in place to address maintaining, repairing, deactivating, disposing of, and replacing defective equipment.

(T)E.05 The Organization provides emergency management policies and procedures for software, hardware and other system resources that can be implemented during telehealth consultations.

(T)E.06 Organization has data loss or theft policy.

(T)E.07 Organization maintains written agreements with participating vendors/subcontractors and includes a signed Business Associate Agreement (BAA).

(T)E.08 Organization’s electronic medical records and telehealth data encryption, storage, and transmission are HIPAA compliant.

(T)E.09 Organization delivers telehealth services through a secure internet connection and has backup networks to reduce connectivity problems.

(T)E.10 Organization has a patient privacy policy.

(T)E.11 Organization ensures data are encrypted and transmitted securely. 

2021 Practica Accreditation Standards

P-A. Ethics, Integrity, & Professionalism

P-A.01 The organization acts in the best interest of the patients it serves at all times.

P-A.02* The organization acts honestly and responsibly to promote ethical practices of its trainees and experience supervisors and supports certified trainees and experience supervisors in complying with ethical and professional requirements of their certifying or licensing body. The organization never directs trainees or experience supervisors to act in violation of those requirements, instead resolving any conflicts between the company policy and those requirements.

P-A.03 The organization ensures trainees and experience supervisors avoid dual relationships that might impair their ability to make objective and fair decisions.

P-A.04 The organization protects the privacy of its personnel.

P-A.05 The organization has a designated ethics officer or ethics committee to address ethical issues such as patient programming and organizational, personnel, and patient concerns.

P-A.06 The organization has policies in place regarding trainees’ use of patient and caregiver images in educational practices, social media platforms, and livestreaming services. These policies first and foremost protect the privacy of the patients, parents or guardians, and caregivers.

P-B. Diversity, Equity, & Inclusion

P-B.01 The organization has a diversity statement that clearly expresses its ongoing commitment to an iterative process of developing an inclusive and equitable organizational culture, protecting and supporting staff, protecting and supporting patients, and devising steps the organization will take to ensure diversity, equity, and inclusion.

P-B.02 The organization is committed to and has a process for evaluating marketing, training, and therapeutic materials that ensure representation of diverse individuals, including (at a minimum) individuals with diverse age, gender, race and ethnicity, and disability.

P-B.03 The organization provides cultural humility training and competency checks to all trainees and experience supervisors upon acceptance, annually, and as required by state and federal guidelines.

P-B.04 The organization ensures that leadership and supervisory staff have completed conflict resolution training that provides an objective, neutral process for responding to bias incidents.

P-C. General Requirements & Liability

P-C.01 The organization sufficiently protects against claims resulting from injuries or damages by maintaining general, property, and liability insurance.

P-D. Recruiting, Acceptance, & Retention

P-D.01 The organization uses qualifying questions to screen candidates, standard interview questions, and acceptance criterion for each position.

P-D.02 The organization has administrative and clinical onboarding checklists for new trainees and experience supervisors.

P-D.03 The organization conducts state and federal background checks on all trainees and experience supervisors before they provide work or services on the organization’s behalf.

P-D.04 The organization provides training in clinical and administrative tasks for each trainee and experience supervisor upon acceptance.

P-D.05 The organization evaluates and assures the competence of trainees and experience supervisors prior to allowing them to provide treatment to patients.

P-D.06 The organization ensures experience supervisors at every level receive continuing education, training, and oversight in line with their certification and specific areas of need.

P-D.07 The organization provides trainees and behavior technicians with enhanced training opportunities, outside of overlaps.

P-D.08 The organization obtains and analyzes ongoing performance feedback using fidelity checklists and provides appropriate consequences as needed.

P-D.09 The organization utilizes formal feedback processes for performance review, which includes appropriate consequences for each personnel level.

P-D.10 The organization regularly measures personnel satisfaction and makes reasonable efforts to resolve personnel concerns and grievances.

P-D.11 The organization has a plan to ensure it is prepared for continuity of supervision if an experience supervisor leaves the organization or their position.

P-D.12 The organization accepts trainees who havebegun behavior analysis courses from an accredited program and/or those who have begun behavior analytic coursework from an approved and reputable but unverified or unaccredited university behavioranalysis program.

P-D.13 The organization verifies trainees’ certification or license status using a national certification or licensing registry, if applicable.

P-D.14 The organization provides at least the minimal required hours for behavior technician training to the trainee as part of the onboarding process and ensures that the trainee becomes certified or licensed at the technician or paraprofessional level.

P-D.15 The organization reviews all required certification and licensure documents with trainees and provides training on how to adhere to the experience hours.

P-E. Service Delivery

P-E.01 The organization uses evidenced-based and developmentally appropriate assessments to evaluate patient needs prior to implementing recommendations.

P-E.02* The organization has a process for prescribing data collection procedures (including the types of data to be collected, the method of data collection, the frequency of data collection, and the procedures for ensuring reliability of data collection) and data analysis procedures (including the frequency of data analysis) so that patients’ outcome data is effectively monitored.

P-E.03* The organization has a process that guides clinical practices that (1) is conceptually systematic with applied behavior analysis, (2) is informed by the best available contemporary research, (3) is selected and adapted to reflect patient values, (4) is commensurate with the clinical expertise of the professionals responsible for overseeing and implementing those practices, and (5) incorporate evidence-based decision-making in evaluating and revising clinical practices.

P-E.04 The organization provides treatment recommendations by relying on best practices such as decision models, research, and professional judgment. Treatment recommendations may include hours, amount of supervision, setting, approach, or frequency of treatment.

P-E.05 The organization provides patients of all abilities with a collaborative process to enable them to provide meaningful input in the selection of treatment goals and interventions.

P-E.06 The organization utilizes preference assessment procedures to generate a supportive environment and accommodate patient motivation.

P-E.07 The organization has a policy regarding the use of punishment procedures to address patient needs when reinforcement has been demonstrated to be ineffective or when necessary for safety. The policy should rely on best practices, research, and professional judgment.

P-E.08 The organization ensures intervention is delivered with treatment fidelity as written in the treatment plan. The organization ensures that implementation of services adheres to prescribed protocols.

P-E.09 The organization has a policy that outlines discharge plans and processes to ensure an equitable process for discharging patients, including written notice to relevant parties, a clear timeline for transition from the current level of care, and a plan to address any urgent patient needs. The organization makes patients aware of the policy at the onset of services.

P-F. Clinical Documentation

P-F.01 The organization has a standard clinical assessment report template.

P-F.02 The organization has a standard progress report or treatment plan template.

P-F.03 The organization has a standard template for documenting the session activities of qualified healthcare professionals (e.g., direct therapy, assessment activity, progress reporting, case supervision) that meets BHCOE Standard 101: Documentation of Clinical Records for Applied Behavior Analysis Services.

P-F.04 The organization has a standard template for documenting the activities of those delivering direct ABA services to patients that meets BHCOE Standard 101: Documentation of Clinical Records for Applied Behavior Analysis Services.

P-F.05 The organization has a standard discharge summary template.

P-G. Collaboration & Coordination of Care

P-G.01 The organization educates parents and guardians of patients on the therapeutic impact of their involvement and shares information about evidence-based decision-making.

P-G.02 The organization conducts an assessment for each patient to determine if parent, guardian, or caregiver involvement is appropriate and documents the results of that assessment. If potential barriers to parent, guardian, or caregiver involvement are identified, the organization documents such barriers and proposes solutions that would best support the patient’s treatment.

P-G.03 The organization makes reasonable efforts to collaborate with other professionals on a treatment team, such as occupational therapists, school personnel, speech-language pathologists, and physicians, to maximize the patient’s progress.

P-H. Health, Safety, & Emergency Preparedness

P-H.01 The organization provides safety and crisis management training for trainees and experience supervisors.

P-H.02 The organization has documented policies and procedures on mandated reporting requirements and conducts training on these requirements annually or more frequently as stipulated by state requirements.

P-I. Media, Communication, & Representation

P-I.01 The organization provides annual opportunities for trainees to renew video or photo releases and provides clear instructions regarding how to revoke consent, if requested, for the organization to use their image in training or marketing materials.

P-I.02 The organization has policies and procedures for communicating with stakeholders (e.g., university personnel and supervisors) who interact with the trainee.

P-J. Supervisor Qualifications & Competence

P-J.01* The organization retains experience supervisors who (1) hold a master’s or doctoral-level certification or license in behavior analysis or a related field from a nationally accredited certifying body, (2) meet the certifying body’s current standards for supervision, and (3) have at least one year of supervising cases or equivalent experience in accordance with certification or licensing standards. When applicable, supervisors should also be licensed in their state.

P-J.02 The organization outlines the nature and characteristics of supervision as required by certification and licensing bodies to potential experience supervisors.

P- J.03* The organization ensures experience supervisors carry a caseload that enables them to facilitate effective supervision and treatment of patients.

P-J.04 The organization provides training to experience supervisors in the use of evidence-based practices for providing supervision and feedback to trainees.

P-J.05 The organization ensures the experience supervisor establishes a plan for structured fieldwork experience.

P- J.06* The organization develops methods for evaluating supervisory effectiveness.

P- J.07 The organization reviews course syllabi and program expectations following acceptance of trainees to determine and reinforce relevant topic and skill areas.

P-K. Trainee Experience Documentation

P-K.01 The organization provides the trainee with a handbook outlining the supervision process, type of supervision (concentrated or independent fieldwork), supervision amount and structure, conditions for termination, responsibilities, and performance expectations.

P-K.02 The organization creates a secure record system to document the relationship between the experience supervisor and trainee.

P-K.03 The organization provides the trainee with the required supervision contract set forth by credentialing and licensing guidelines.

P-K.04 The organization provides the trainee with verification of hours forms as dictated by certification and licensing bodies.

P-K.05 The organization provides the trainee with documentation regarding terms of payment for supervision, if applicable.

P-L. Trainee Competence & Breadth of Experience

P-L.01 The organization conducts a baseline assessment of the trainee’s behavior analytic skills through formal and informal processes.

P-L.02 The organization ensures that the required fieldwork experience skills are targeted and met in accordance with certification and licensure rules and guidelines.

P-L.03 The organization involves trainees in the treatment implementation process including patient, parent or guardian, caregiver, and professional collaborations or education, in accordance with certification and licensure rules and guidelines and experience expectations.

P-L.04 The organization provides the trainee with opportunities to advance to more complex behavior analytic skills.

P-L.05 The organization provides the trainee with opportunities to meet the correct ratio of direct-to-advanced and supervisory behavior analytic hours per certification and licensure guidelines.

P-L.06 The organization provides the trainee with opportunities to demonstrate ethical and professional conduct.

P-L.07 The organization provides the trainee with opportunities to develop supervision and management skills necessary for their level of certification or licensure.

P-L.08 The organization tracks the trainee’s overall skill development.

P-L.09 The organization provides opportunities to develop clinical care skills and interaction style, including, but not limited to, rapport building and pairing, interview techniques, problem solving, case coordination, interprofessional collaboration, conflict resolution, ethical dilemmas, professionalism, time management skills, and organizational skills.

P-L.10 The organization utilizes competency-based training strategies throughout trainees’ fieldwork experience to teach behavior analytic skills consistent with best practices in the literature.

P-L.11 The organization ensures trainees carry a caseload that enables them to provide effective treatment for their patients.

* Note: Asterisk items indicate Must Pass Standards. Evidence of having met these standards must be demonstrated during the evaluation in order to earn accreditation.

2019 Preliminary Accreditation Standards

A. General Requirements

A.01 Organization is registered or incorporated.

A.02 Organization has general, property, and liability insurance.

A.03 Organization has a valid business license.

A.04 Organization has a payroll, accounting and record-keeping system and/or software.

A.05 Organization has workman’s compensation insurance.

A.06 Organization has a staff handbook.

A.07 Organization has a current working budget and proposed next year budget.

A.08 Organization has a defined organizational structure and hierarchy.

A.09 Organization has job descriptions and expectations for all current positions.

A.10 Organization has minimum qualifications and requirements for each job position.

B. Hiring

B.01 Organization has an organization-specific employment application.

B.02 Organization has a templated offer letter.

B.03 Organization has a checklist for new hires.

B.04 Organization conducts state and federal background checks.

B.05 Organization has staff performance and evaluation guidelines.

B.06 Organization provides safety/crisis management training to staff who may encounter dangerous behavior.

B.07 Organization trains staff on mandated reporting requirements.

B.08 Organization checks all staff Motor Vehicle records.

C. HIPAA

C.01 Organization has determined where PHI will be located.

C.02 Organization has an appointed HIPAA privacy/security official.

C.03 Organization has determined how or why PHI will be used or disclosed (e.g. treatment, payment, health care operations, public health reasons, etc.).

C.04 Organization’s email and other electronic communication are HIPAA-compliant.

C.05 Organization’s cloud or server-based storage is HIPAA-compliant.

C.06 Organization has a HIPAA breach policy.

C.07 Organization has a data backup plan.

C.08 Organization has HIPAA compliance training.

D. Intake

D.01 Organization has a patient intake form & questionnaire.

D.02 Organization has a patients’ rights agreement.

D.03 Organization provides a financial responsibility agreement to patients.

D.04 Organization has a confidential exchange of information policy.

D.05 Organization has a new patient welcome letter.

D.06 Organization has a written standard treatment/operating procedure for ABA services that is provided to new patients.

D.07 Organization has a patient home safety checklist.

D.08 Organization has an ABA treatment contract.

D.09 Organization has a parent/guardian participation and parent/guardian interaction policy.

D.10 Organization has a patient illness policy.

D.11 Organization has a new patient form and checklist.

D.12 Organization has a Notice of Privacy Practices for patients.

E. Clinical

E.01 Organization has an assessment report template.

E.02 Organization has a progress report template.

E.03 Organization has a supervisor case note template.

E.04 Organization has a technician case note template.

E.05 Organization has a preference assessment system for patients.

E.06 Organization has a data collection system.

E.07 Organization has a caregiver training protocol.

E.08 Organization utilizes a standardized assessment when evaluating patients.

E.09 Organization has a plan for how often they will conduct assessments.

E.10 Organization has a curriculum for developing patient programming.

E.11 Organization has a quality assurance officer.

E.12 Organization has guidelines for recommending treatment intensity of services.

E.13 Organization has a fade-out policy.

F. Consumer Protection

F.01 Organization has a conflict of interest policy.

F.02 Organization has guidelines regarding the exchange of gifts, money, or personal fundraising.

F.03 Organization has guidelines for how the organization is represented via social media.

F.04 Organization protects patient privacy by refraining from posting patient information or photos on social media.

F.05 Organization refrains from soliciting and posting testimonials.

F.06 Organization has written ethical codes of conduct.

F.07 Organization has legal representation.

F.08 Organization has a policy regarding non-evidence-based practices that includes refraining from participating in such practices, resolving conflicts when such practices interfere with ABA services, and educating patient or parent/guardian about how to choose effective services.

G. Liability

G.01 Organization has cyber or data privacy insurance.

G.02 Organization has a fidelity bond in place.

G.03 Organization has abuse prevention policies and procedures.

G.04 Organization has a policy in place to avoid one-to-one situations with patients.

2019 Full Accreditation Standards

Organizations who are fully accredited must meet the preliminary accreditation standards in addition to the full accreditation standards.

1.0 Staff Qualifications, Training & Oversight

1.01 Organization employs clinical director-level staff who hold adequate education and qualifications.

1.02 Organization employs supervisory staff who hold adequate education and qualifications.

1.03 Organization employs direct staff who hold adequate education and qualifications.

1.04 Organization tests for clinical competence prior to staff providing treatment to patients.

1.05 Organization provides training to ensure competency in clinical tasks (e.g., assessment processes, goal creation, intervention design, progress reporting, etc.) and administrative tasks (e.g., staff training, feedback delivery, BACB supervision standards, ethical billing practices, etc.).

1.06 Organization provides staff with continuing education in line with their areas of need.

1.07 Organization ensures consistency of treatment across staff members through staff overlap, data collection, and/or team meetings.

1.08 Organization will utilize staff performance evaluation processes such as goal-setting, performance measurement, regular performance feedback, and self-evaluation, as evidenced by documentation of staff progress.

1.09 Organization defines organizational structure and hierarchy.

1.10 Organization provides job descriptions and expectations for all current positions.

2.0 Treatment Program & Planning

2.01 Organization utilizes standardized assessments to evaluate patient outcome annually, or more frequently if needed.

2.02 Organization collects and monitors individual outcome data.

2.03 Organization collects and monitors organizational outcome data.

2.04 Organization utilizes evidence-based curricula when developing patient goals.

2.05 Organization utilizes research-based skill-acquisition procedures.

2.06 Organization utilizes research-based behavior-reduction procedures.

2.07 Organization trains for and measures generalization throughout treatment.

2.08 Organization ensures skills are age-appropriate based on the developmental order in which skills are acquired in individuals with typical development.

2.09 Organization has resources available to service non-verbal/non-vocal patients.

2.10 Organization collaborates with appropriately qualified professionals to facilitate language acquisition.

2.11 Organization determines treatment dosage based on professional judgment, research, and standard of care.

3.0 Collaboration & Coordination of Care

3.01 Organization notifies parents/guardians of expectations for involvement in programming.

3.02 Organization educates parents/guardians on clinical outcomes of parent involvement in their child’s progress.

3.03 Organization has standard requirements for parents/guardians participation and training independent of the patient’s funding source.

3.04 Organization makes reasonable efforts to involve parents/guardians in training, participation and treatment planning.

3.05 Organization appropriately documents parent/guardian participation or lack of participation in treatment sessions and planning.

3.06 Organization ensures eLearning opportunities are easily accessible to parents/guardians.

3.07 Organization makes reasonable efforts to collaborate with other professionals (e.g., speech-language pathologists, occupational therapists, school staff, physicians, etc.) to maximize a patient’s progress.

3.08 Organization provides a clear policy to patients or parents/guardians on collaboration with non-evidence-based practices.

4.0 Ethics & Consumer Protection

Waitlist

4.01 If the organization holds a waitlist, they clearly communicate expectations of waitlist time to patient or parent/guardian.

4.02 Organization offers resources to potential patient or parent/guardian if unable to initiate services within 45 days of contact.

4.03 Organization offers patient or parent/guardian with peer-referral options to potential patients if unable to provide services within 1 month of contact.

4.04 Organization maintains close supervision over wait list times and patient or parent/guardian needs.

Marketing & Representation

4.05 Organization accurately represents the services they provide.

4.06 Organization does not engage in misleading, false, or deceptive statements.

4.07 Organization does not exploit consumers of their services for marketing purposes.

4.08 Organization uses testimonials in compliance with BACB® Professional and Ethical Compliance Code for Behavior Analysts.

Promoting Ethical Behavior

4.09 Organization supports any workers who come forward with any claim of undue pressure to violate the BHCOE® Code of Effective Behavior Organizations or BACB® Professional and Ethical Compliance Code for Behavior Analysts.

4.10 Organization appoints an internal Ethics Officer and/or Ethics Committee to address internal ethical issues.

4.11 Organization obtains any relevant consent from patient or parent/guardian of their services.

4.12 Prior to the commencement of service delivery, the organization informs patient or parent/guardian where they can file complaints about any service provided by their organization.

4.13 Prior to implementation of services, the organization provides in writing the terms of consultation, requirements for providing services, financial agreements, treatment expectations, duration of treatment, the likelihood of success and responsibilities of all parties. If terms change, behavioral organizations will notify patient or parent/guardian.

5.0 HIPAA Compliance

Patient confidentiality and privacy should be consistent with applicable federal regulations including the Health Insurance Portability and Accountability Act of 1996 and Title 42 of the Code of Federal Regulations, state laws, code(s) of conduct, and professional guidelines;

5.01 Organization has determined where PHI will be located.

5.02 Organization has appointed a HIPAA privacy/security official.

5.03 Organization has determined how or why PHI will be disclosed.

5.04 Organization uses HIPAA-compliant electronic communication.

5.05 Organization uses HIPAA-compliant cloud or server-based storage.

5.06 Organization has HIPAA breach policy.

5.07 Organization has a data backup plan.

5.08 Organization provides HIPAA compliance training to staff.

6.0 Patient Satisfaction

The organization operates in a manner that indicates patient or parent/guardian satisfaction at 80% or higher.

7.0 Employee Satisfaction

The organization operates in a manner that indicates staff satisfaction at 80% or higher.

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