Massachusetts ABA Requirements Are Changing: What’s New, and How Safety-Care Helps
Massachusetts is moving ABA organizations toward independent accreditation and stronger safeguards around crisis prevention and restraint. Two dates matter most:
• January 1, 2027: Center-based ABA providers must be accredited.
• January 1, 2028: All other ABA providers must be accredited. (autismcommission.org)
These timelines come in response to oversight findings in the state’s 2024 Office of the Inspector General (OIG) review of ABA services for children on MassHealth. Expect payer contracts (starting with MassHealth MCEs) to require accreditation by a nationally recognized ABA accreditor.
What about programs that don’t bill MassHealth?
The public mandate explicitly targets MassHealth-contracted ABA providers. However, many commercial payers adopt state standards over time; planning for accreditation by 2028 is a prudent, market-ready posture.
What accreditation expects (in plain English)
Two leading accrediting bodies, ACQ and BHCOE, spell out what surveyors will look for:
Crisis prevention & restraint:
- ACQ Standard 7.04 emphasizes least restrictive practice, use of restraint/seclusion only for imminent danger and only by formally trained staff, plus approval/monitoring and documentation & debrief within 24 hours.
- BHCOE standards (Section D) require organizations to provide safety/crisis management training to staff and maintain related policies, competency checks, and ongoing education.
Clinical governance & supervision:
Licensure and supervision rules still apply (e.g., LABA and A-LABA under 262 CMR 10.00), and surveyors will seek evidence that supervision, documentation, and treatment integrity meet state and accreditation requirements.
How Safety-Care maps to the new expectations
Safety-Care is a crisis prevention and behavioral safety training system widely used by ABA providers. Here’s how it supports accreditation readiness:
- Least-restrictive first: Core curriculum instruction focuses on prevention, environmental antecedent strategies, and de-escalation—directly aligning with ACQ’s “principle of least restrictiveness.”
- Formal training for any restrictive procedures: If a restrictive intervention is permitted by your policies, Safety-Care’s structured skills training and competency checks help you meet the “formally trained staff” requirement and BHCOE’s call for safety/crisis training.
- Post-incident processes: Safety-Care programs include incident review, debriefing with individuals and staff, and documentation practices you can standardize to meet ACQ’s “document and debrief within 24 hours” language.
- Policy & practice integration: Safety-Care gives a common framework for your written policies (required by BHCOE) and your day-to-day staff behavior (competency, skill maintenance refreshers).
Why this is happening now
The Massachusetts OIG’s 2024 report flagged quality and oversight issues in ABA delivery to children with autism, catalyzing the accreditation push. Accreditation is meant to standardize quality, tighten supervision, and reduce risk, especially around crisis events.
What to do now (5-step checklist)
- Choose your accreditor (ACQ or BHCOE) and download standards. Start a gap analysis against your current policies, supervision, and training.
- Make Safety-Care your system of record for crisis prevention. Ensure all direct-care and supervisory staff complete initial training and refreshers; track competencies.
- Tighten incident workflows. Build a 24-hour documentation and debrief rule into policy and your electronic health record (EHR) / incident system.
- Align supervision & licensure. Verify 262 CMR 10.00 compliance for LABA/A-LABA supervision, and reflect this clearly in your procedures.
- Set your timeline. Center-based organizations should target Q3 2026 for survey readiness. Home and community based organizations should target Q3 2027 to comfortably meet the Jan 1, 2028 deadline.