LICENSED BEHAVIOR ANALYST (LBA)

Position Summary

The Licensed Behavior Analyst (LBA) provides clinical leadership for PPBHA’s Applied Behavior Analysis services delivered under North Carolina Medicaid Research-Based Behavioral Health Treatment (RB-BHT). When all applicable enrollment, scope, and competency requirements are met, the LBA functions as a Licensed Qualified Autism Service Provider (LQASP) and is responsible for assessment, treatment-plan development and modification, direct clinical services, observation and direction of paraprofessional service delivery, caregiver training, data-based decision-making, and quality oversight.

The LBA is accountable for ensuring that treatment is person-centered, individualized, developmentally appropriate, medically necessary, evidence-based, data driven, delivered within scope of practice, and designed to improve adaptive functioning, independence, communication, social functioning, safety, and quality of life while protecting beneficiary rights, dignity, autonomy, and choice.

CURRENT CCP 8F SUPERVISION STANDARD: At least 10% of all CCP 8F services provided by a paraprofessional must involve observation and direction of that paraprofessional by an LQASP. PPBHA tracks this requirement at the beneficiary and authorization-period level and uses the separate LBA Supervision/Audit Tool for monitoring.

Essential Clinical Responsibilities

2.1 Assessment and Case Conceptualization

• Complete behavioral, functional, adaptive, and other ABA-related assessments that are within the LBA’s lawful scope, training, and demonstrated competence.
• Review relevant diagnostic, medical, developmental, psychological, educational, speech/OT/PT, caregiver, and prior treatment information necessary to understand the beneficiary’s needs.
• Use clinically appropriate and scientifically validated assessment methods and instruments and document the basis for clinical conclusions.
• Identify strengths, interests, communication abilities, adaptive functioning, functional impairments, target behaviors, skill deficits, environmental variables, safety risks, treatment barriers, and generalization needs.
• Reassess when the beneficiary’s condition, environment, risk, treatment response, or authorization requirements indicate a clinically meaningful need.
  
  

2.2 Individualized Treatment Planning

• Develop and modify the RB-BHT/ABA Treatment Plan based on a qualifying assessment and documented medical necessity.
• Ensure goals and interventions are individualized to the beneficiary’s developmental profile, strengths, adaptive skill levels, functional impairments, priorities, and treatment context.
• Write operationally defined targets, baseline information, measurable objectives, mastery criteria, data-collection methods, treatment procedures, generalization/maintenance strategies, service schedule, staffing plan, caregiver involvement, titration strategy, and transition/discharge criteria as applicable.
• Specify and clinically justify treatment intensity, service location(s), and any telehealth use; treatment intensity must not exceed the beneficiary’s needs.
• For Treatment Plans involving more than 16 hours of services per week, support review/modification and reauthorization at least every 90 calendar days; for plans involving 16 hours or fewer per week, support review/modification and reauthorization at least every 180 calendar days, subject to current payer requirements.
• For beneficiaries receiving more than 200 paraprofessional RB-BHT hours in a 180-calendar-day authorization period, ensure the Treatment Plan documents the targeted LQASP-to-paraprofessional service-hour ratio and includes written clinical justification if outside the 10%-20% range.

2.3 Direct Treatment, Protocol Modification, and Clinical Direction

• Provide direct LQASP services when clinically indicated and authorized.
• Observe behavior, troubleshoot treatment protocols, analyze data, and modify protocols when clinically necessary.
• When directing a paraprofessional during treatment, provide beneficiary-specific clinical direction regarding developmental and behavioral techniques, progress measurement, data collection, behavioral function, generalization, and treatment-protocol implementation.
• Ensure observation and direction are for the benefit of the beneficiary and are clinically meaningful rather than administrative supervision.
• Differentiate billable beneficiary-specific observation/direction from non-billable administrative or employment supervision.

2.4 Paraprofessional Supervision and 10% CCP 8F Oversight

• Ensure at least 10% of paraprofessional-delivered CCP 8F services involve LQASP observation and direction, tracked by beneficiary and authorization period.
• Directly observe technicians at a clinically appropriate frequency while they are providing direct treatment to verify fidelity to the authorized treatment plan.
• Evaluate implementation of prompting, reinforcement, skill-acquisition procedures, behavior-reduction protocols, measurement systems, generalization, and safety procedures.
• Provide immediate corrective clinical direction when treatment is implemented incorrectly or when beneficiary response indicates protocol modification is needed.
• Document observation/direction, treatment-protocol changes, clinical rationale, and follow-up actions in accordance with payer documentation requirements.
• Coordinate with HR/Compliance to verify assigned behavior technicians meet current certification requirements. A technician operating within an authorized certification grace period must receive the enhanced/direct oversight required by current NC Medicaid guidance.

2.5 Caregiver Training and Generalization

• Engage parents, guardians, and caregivers in assessment, treatment planning, and treatment delivery unless clinically contraindicated and documented.
• Develop measurable caregiver-training objectives and teach beneficiary-specific strategies through instruction, modeling, guided practice, feedback, and competency checks.
• Identify barriers to caregiver participation and implement reasonable strategies to improve participation.
• Plan for generalization and maintenance across natural settings, people, materials, and routines.

2.6 Data Analysis and Clinical Decision-Making

• Establish data-collection systems that are reliable, clinically meaningful, and feasible for staff and caregivers.
• Review and analyze data routinely, including trends, treatment response, treatment integrity, and potential barriers to progress.
• Use data to determine whether procedures should be continued, modified, intensified, faded, generalized, or discontinued.
• Ensure overall assessment of progress toward treatment goals remains under appropriate LQASP clinical responsibility.

3. Documentation and Medical Record Responsibilities

• Complete accurate, objective, timely clinical documentation that reflects the actual service provided and supports medical necessity, authorization, duration billed, clinical intervention, beneficiary response, and progress.
• Ensure each service note is written and signed by the person(s) who provided the service and contains all elements required by current CCP 8F and payer requirements.
• For protocol-modification services, clearly document the treatment-plan or protocol modification and clinical rationale when required.
• Ensure beneficiary-specific data and clinical interpretation are sufficient to support continued treatment, titration, transition, reauthorization, and discharge decisions.
• Do not falsify, backdate, clone, improperly alter, inflate, or direct another person to misrepresent clinical records or billing information.
• Immediately report suspected fraud, waste, abuse, documentation falsification, credential lapses, or improper billing through PPBHA’s compliance process.

4. Quality, Safety, Rights, and Interdisciplinary Coordination

• Participate in quality assurance, utilization review, record audits, corrective action, performance improvement, and survey/readiness activities.
• Protect beneficiary dignity, privacy, confidentiality, autonomy, cultural identity, communication preferences, informed choice, and the right to receive services in the least restrictive clinically appropriate manner.
• Use positive, function-based, evidence-based interventions and avoid punitive, retaliatory, coercive, convenience-based, or unnecessarily restrictive procedures.
• Recognize and respond to safety concerns, abuse/neglect/exploitation allegations, self-harm or suicide risk, elopement, aggression, injury, medical emergencies, rights concerns, and other reportable incidents according to PPBHA policy and applicable law.
• Coordinate, with appropriate authorization, with physicians, psychologists, therapists, schools, care managers, residential providers, and other treatment-team members to reduce duplication and improve continuity and generalization.
• Ensure RB-BHT does not duplicate or supplant educational, custodial, respite, personal-care, or other non-covered services.

Qualifications

North Carolina LBA License

Current, unrestricted license as a Licensed Behavior Analyst through the North Carolina Behavior Analysis Board or successor authority.

BCBA Status

Active Board Certified Behavior Analyst status consistent with N.C.G.S. § 90-737 and current licensing requirements.

Education

Graduate degree or graduate-level qualification meeting current BCBA and NC LBA eligibility requirements.

Experience

Demonstrated competency in assessment, treatment planning, data analysis, ABA intervention, technician supervision, caregiver training, and ASD services.

NPI / Medicaid Enrollment

Active NPI and NC Medicaid/NCTracks enrollment or eligibility when assigned to bill/render Medicaid services; in-state enrollment as required by current policy.

Professional Standing

No active exclusion, debarment, or restriction that prohibits participation in Medicaid or assigned clinical duties.

Competency

Successful completion of PPBHA initial job-specific competency assessment before independent assignment and annual reassessment thereafter.

Core Competencies/Expected Capability

Clinical ABA

Functional assessment; measurement; behavior-change procedures; skill acquisition; prompting/fading; reinforcement; generalization; maintenance; data analysis; protocol modification; treatment integrity.

Clinical Judgment

Medical necessity; individualized treatment intensity; risk recognition; referral when needs exceed scope; transition and discharge planning.