How to Raise a Concern or File a Complaint About an ABA Provider in Florida

Most concerns about ABA are solved with one honest conversation. Some are not. And a few, such as suspected abuse, should never wait for a conversation at all. This guide lays out the escalation ladder for Florida families: who to talk to first, when to go to the insurer, what the Behavior Analyst Certification Board (BACB) and the Florida Department of Health can and cannot do, and when to call the Florida Abuse Hotline or 911.

Is my child in danger right now?

If you believe your child or another child is in immediate danger, call 911 first. Then report to the Florida Abuse Hotline:

• Phone: 1-800-96-ABUSE (1-800-962-2873)
• TTY: 711 or 1-800-955-8771
• Online: the Department of Children and Families' online reporting form at reportabuse.myflfamilies.com. DCF says web reporting "should not be used for situations requiring immediate attention."

Under s. 39.201, Florida Statutes, every person who knows or suspects that a child is being abused, abandoned or neglected must report it immediately to the central abuse hotline. You do not need proof, and you do not need to talk to the provider first. Our guide to child abuse reporting in Florida explains what happens after a report.

Step 1: Can I raise it with my child's BCBA?

For most concerns, start with the BCBA who writes your child's plan. That includes worries about goals, hours, a specific procedure, a schedule problem, an RBT's punctuality or a mismatch between what you see at home and what the reports say. The BACB itself encourages this: "If you could potentially solve the issue by speaking with this individual, we encourage you to try that first."

Tips that make the conversation work:

• Be specific. "On Tuesday and Thursday last week the session started 40 minutes late" works better than "the RBT is never on time."
• Say what you want. A new RBT, a team meeting, a change to the behavior plan, more parent training, a copy of the data.
• Follow up in writing. A short email after the call: "Thanks for talking today. To confirm, you will..." gives you a record.

Step 2: How do I take it to the provider's leadership?

If the BCBA cannot or will not fix it, or the concern is about the BCBA, go to the next level: the clinical director, executive director or owner. Ask for the provider's written complaint or grievance process; many include one in the intake packet. Put your concern in writing, attach your notes, and ask for a response by a specific date.

If the concern is about records, you can also make a formal written records request at this stage. See your right to your child's ABA records.

Step 3: When should I contact my insurance plan?

Your insurer is the right place for concerns about coverage, authorization, billing or a provider's network status. Call the member services number on your card and ask to file a grievance or complaint. If the issue is a denied or reduced authorization, use the plan's appeal process; see how to appeal an ABA denial in Florida.

If the insurer does not resolve it, who regulates your plan decides where to go next:

• Fully insured plans issued in Florida: the Florida Department of Financial Services (DFS), Division of Consumer Services, through its online Consumer Assistance Portal at MyFloridaCFO.com. DFS asks you to first "contact the insurance company and allow them the opportunity to resolve your issue."
• Self-funded employer plans: the U.S. Department of Labor's Employee Benefits Security Administration (EBSA), toll-free 1-866-444-3272. DFS does not have authority over these plans.
• Florida Medicaid managed care plans: the Agency for Health Care Administration, 1-877-254-1055, or its online complaint form at flmedicaidmanagedcare.com.

Not sure which kind of plan you have? See fully insured vs self-funded plans and filing an insurance complaint in Florida.

Step 4: When should I report to the BACB?

The BACB handles alleged violations of its ethics requirements by the people it certifies. Key points from its reporting pages and Code-Enforcement Procedures:

• It covers people, not companies. "Because the BACB certifies people, not companies, you cannot report a company to us." It has no jurisdiction over noncertified individuals or organizations.
• Timing. A notice should be submitted within 6 months of the alleged violation or of when you became aware of it. Staff can extend this in exceptional circumstances.
• Documentation matters. The BACB "is not an investigatory body," so it relies on what you send: emails, texts, session notes, behavior plans, photos or videos. An eyewitness account should include a notarized affidavit. Redact personal identifying information before submitting.
• RBT concerns. The BACB says that in some cases an RBT's alleged violation should be reported to the RBT's supervisor or Requirements Coordinator.
• What it can do. Outcomes range from corrective actions, which are not published, to sanctions such as suspension or revocation of certification, which are published on the certificant's registry record or the BACB's disciplinary actions page.
• What it cannot do. It does not give legal advice, award money or resolve billing disputes. It will generally not take a notice that arises from a commercial dispute that is still in litigation.

Florida does not license behavior analysts, so there is no separate Florida behavior analyst board. You can look up a certificant's status and any published sanctions on the BACB registry. See verifying BCBA and RBT credentials.

Step 5: When does the Florida Department of Health get involved?

Some people on an ABA team also hold a Florida license, for example a licensed clinical social worker (LCSW), psychologist, speech-language pathologist or occupational therapist. Concerns about their professional conduct can go to the Department of Health (DOH):

• File through the Florida Health Care Complaint Portal. DOH says complaints against licensed practitioners "cannot be filed over the phone," and Florida law requires the complaint to be signed.
• DOH generally does not investigate fee disputes, billing disputes, personality conflicts or rudeness.
• Complaints "remain confidential until 10 days after probable cause is found," and patient identity and records always remain confidential.
• The statute of limitations is "generally" six years from the last date of treatment.
• If a licensed practitioner has not provided requested records after 30 business days, DOH says you may file a complaint with a copy of your request letter and the signed certified-mail receipt.

You can check a practitioner's license and any public discipline through the DOH license verification search.

Who handles what? A quick reference

How do I document a concern?

• Keep a simple log: date, time, who was involved, what happened, what you did.
• Save emails, texts, session notes and parent-portal messages.
• Write down the names and roles of everyone you talk to.
• Note any injuries with photos and a doctor's visit if needed.
• Keep copies of everything you send to an agency.

If you are thinking of switching providers while a concern is open, plan the transition so your child's services are not interrupted; see switching providers without losing your authorization. For legal questions, talk to a Florida attorney.

How does Hope Center handle concerns?

At Hope Center, start with your child's BCBA. If that does not resolve it, the concern goes to the assistant clinical director, then to the executive director. You can text or call your RBT, BCBA or the front desk at any time. Read more in sharing feedback or a concern at Hope Center, or contact us at 561-337-8865 or office@hopecenteraba.com.