Building Better Care: Public Policy and Staff Empowerment in ABA
The ABA field is no stranger to challenges—from maintaining compliance and negotiating rates to empowering staff and ensuring high-quality services. Yet, as Alexandra Tomei, BCBA, highlights in this episode of ABA Business Leaders presented by 3 Pie Squared, these challenges are also opportunities to foster meaningful change. As the Director of Clinical Standards at BlueSprig, Alexandra brings her extensive expertise to the forefront, discussing the vital role of public policy and staff empowerment in building better care.
Balancing Standards with Individualized Care
One of the most critical aspects of ABA is balancing clinical standards with the need for individualized care. Alexandra shares her experience creating standard operating procedures that align with generally accepted standards of care while allowing flexibility to meet each client’s unique needs. She emphasizes that creating efficiencies—from treatment planning to documentation—not only streamlines operations but also enables clinicians to focus on what truly matters: delivering impactful, personalized care.
Empowering RBTs and BCBAs
Alexandra underscores the importance of empowering both Registered Behavior Technicians (RBTs) and BCBAs. Frontline staff, she notes, are often the experts on the clients they serve. Organizations must ensure these team members feel heard, valued, and supported. From providing pathways for leadership to creating safe spaces for open communication, Alexandra explains how fostering a culture of collaboration leads to better outcomes for clients and greater retention of skilled staff.
She also advocates for training and professional development opportunities tailored to the diverse career goals of RBTs and BCBAs. Not everyone aspires to advance to higher certifications, and that’s okay. Offering growth opportunities within their roles ensures that every team member feels appreciated and has a clear path forward.
Public Policy: A Call to Action
Public policy plays a pivotal role in the sustainability of ABA services. Alexandra shares her experience advocating for fair reimbursement rates and ethical practices, particularly in Colorado, where Medicaid rate challenges have forced many providers to close their doors. Her involvement with the Public Policy Posse and efforts to engage state organizations underscore the importance of collective advocacy.
“Public policy is like walking uphill through cold molasses,” Alexandra says, highlighting the persistence required to enact change. Yet, even small victories can have profound impacts on the accessibility and quality of care.
Lessons for ABA Business Owners
For ABA business owners, Alexandra’s insights are invaluable. She advises prioritizing long-term investments in staff training and retention, even when short-term costs seem daunting. High-quality training, open communication, and a culture of appreciation not only reduce turnover but also improve client outcomes.
Additionally, she stresses the importance of rate negotiations and partnering with state organizations to advocate for fair reimbursement policies. While the process can be frustrating, collective efforts can lead to systemic improvements that benefit providers and clients alike.
Building a Better Future
Alexandra’s vision for the ABA field is clear: a community where quality care and staff empowerment are not mutually exclusive. By fostering collaboration, advocating for fair policies, and valuing every team member’s contribution, ABA businesses can create sustainable, impactful practices.
