Qualifications: Professional with a Bachelor's degree who has completed at least 1,500 hours of training or supervised experience consistent with best practice and research on individuals with Autism Spectrum Disorder as documented by a Board Certified Behavior Analyst or Licensed Clinical Psychologist. Behavior therapists must have the above credentials approved by the DHS Division of Developmental Disabilities to provide behavior-based therapy under the Illinois Adult, Children's Support and Children's Residential Medicaid Waivers.
How do I apply for approval from the Illinois Department of Humans Services, Division of Development Services to submit an IMPACT Provider Enrollment application?
- You must complete the Behavior Therapy (Autism Spectrum Disorder) - Behavior Intervention & Treatment - Level 2 Course Work & Experience Requirements: Checklist C Form (IL462-0955) (pdf). Please scroll down to the bottom of this page for detailed information on required documentation of 1,500 hours of supervised training and experience.
- Send completed Checklist C and the required documents as specified on Checklist C to the address provided on the form or via email to DHS.BehavioralTherapy@illinois.gov.
- When your application has been reviewed and approved by the Division of Developmental Disabilities, the Division will send an approval letter. NOTE: This letter will be viewed as your credentials to provide behavior therapy services. Behavior therapy services can not be provided until the application has been reviewed and an approval letter has been issued by DHS/DDD
I have received the IDHS, DDD approval letter, how do I submit an IMPACT Provider Enrollment application?
AFTER you have received an approval letter from IDHS, DDD to enroll as a behavior therapist:
- Obtain a National Provider Identifier from the National Plan and Provider Enumeration System.
- The NPI must be a Type 1- Individual.
- The taxonomy code should align with your credentials and services that you be providing.
- Send a copy of your approval letter to: DHS.DDDMedProv@illinois.gov .
- Create an IMPACT account on the IMPACT login page. Please use the Single Sign-On ID PowerPoint Presentation found on the IMPACT Presentations and Materials page on the HFS website to complete this step.
- When the Single Sign-On ID has been approved, return to the IMPACT login page and log into your account. On the IMPACT home page there will be a blue IMPACT hyperlink located under the 4 green boxes. Click on the IMPACT hyperlink.
- Click on NEW ENROLLMENT.
- On the next screen, select the Enrollment Type:
- Individual/Sole Proprietor
- Regular Individual/Sole Proprietor or Rendering/Servicing Provider
- On the Basic Information page, select the applicant type Rendering/Servicing Only.
- Please use the Individual Sole Proprietor PowerPoint Presentation found on the IMPACT Presentations and Materials page to complete the application as a Rendering/Servicing Only applicant type. step. IMPACT application must includes the following information:
- Add Specialty: Behavior Health; Behavior Therapist; Autism Spectrum Disorder
- Associate Provider:
- DDD Billing Provide ID number 7094718
- Employer's NPI or IMPACT Provider ID.
- Associate MCO Plan: DDD MCO Plan ID number 3000006.
- Send an email to DHS.DDDMedProv@illinois.gov to notify DHS, Division of Developmental Disabilities that your application has been submitted for state review
- Complete a Payee Designation/Authorization form (IL462-1180) to authorize the company that you are working for to submit the billing and receive the payment for the services you provide.
- You will receive an email notification from the IMPACT system when your provider enrollment application has been approved. You may begin providing services at that time.
Documentation of eligible supervised experience
Applicants that are applying for approval to enroll as a Behavior Therapist must provide documentation to verify completion of at least 1,500 hours of training or supervised experience consistent with best practice and research on individuals with Autism Spectrum Disorder as documented by a Board Certified Behavior Analyst or Licensed Clinical Psychologist.
A person under the "organizational" supervision of a BCBA or Licensed Clinical Psychologist (LCP) would not necessarily have all their work experience hours considered supervised by a BCBA or LCP and countable as such by the Division of Developmental Disabilities in making a decision about their behavior therapist credential. To be considered countable hours, a qualified supervisor (BCBA or LCP) must be very directly involved in supervising the person's "behavior-related" work experience. See the examples of eligible and ineligible supervised experience below.
- Examples of eligible supervised experience include:
- Conducting assessment activities related to the need for behavioral interventions,
- Designing, implementing and monitoring behavior analysis programs for clients,
- Overseeing the implementation of behavior analysis programs by others,
- Training, designing behavioral systems and performance management,
- Other activities normally performed by a behavior analyst directly related to behavior analysis such as:
- attending planning meetings regarding the behavior analysis program,
- researching the literature related to the program,
- talking to individuals about the program;
- any additional activities related to oversight of behavioral programming such as behavior analyst supervision issues, or evaluation of behavior analysts' performance.
- Examples of activities that are not eligible as supervised experience include:
- attending meetings with little or no behavior analytic content,
- providing interventions that are not based in behavior analysis,
- doing non-behavior analytic administrative activities,
- other activities not directly related to behavior analyst