Category: Oversight in Practice

In November 2024, I began warning Nebraska lawmakers about emerging problems in the state’s applied behavior analysis (ABA) system. Those warnings included blanket forty-hour treatment plans, increasing reliance on remote supervision, and programs beginning to resemble full-day childcare rather than medical therapy. The messages received little response. Only later, when Medicaid spending on ABA began… Read more »

Conviction is easy when it costs nothing. It becomes real when it begins to cost comfort, relationships, or reputation. The past several posts in this series have addressed specific issues: workforce distribution, rural access, dosing standards, and the boundary between therapy and childcare. Each post focused on structure, incentives, and evidence. This final piece is… Read more »