Supporting the Adult Population as a Board-Certified Behavior Analyst (BCBA)
Tip #114: When Funding Shifts: Will Your Organization Pivot or Panic?
As behavior analysts, we spend considerable time developing individualized crisis plans to support adults experiencing high-intensity vulnerable distress behaviors. These plans often include proactive strategies, environmental supports, staff guidance, and safety procedures designed to reduce risk and improve quality of life. However, an important Organizational Behavior Management (OBM) question remains: Have we developed an organizational crisis plan for our own agency?
Recent changes in federal Medicaid funding have raised concerns across disability and behavioral health services. Medicaid serves as a primary funding source for many Home- and Community-Based Services (HCBS), and reductions in funding may create significant challenges for providers, including workforce shortages, reimbursement pressures, increased caregiver burden, and reduced access to services (American Psychological Association Services, 2026). Because many adult service organizations rely heavily on Medicaid reimbursement, financial changes at the federal or state level can quickly impact staffing, service delivery, and organizational stability.
From an ethical standpoint, our response to these challenges cannot be driven solely by financial considerations. The BACB's Ethics Code recommends an 11-step ethical decision-making process that includes identifying stakeholders, assessing potential risks of harm, gathering supporting documentation, considering personal biases, consulting available resources, evaluating potential solutions, implementing a plan, and monitoring outcomes (Behavior Analyst Certification Board, 2024). When organizations face restructuring, budget constraints, or service disruptions, these decisions should be guided by both ethical principles and the best interests of the individuals we support.
Monica Oss's Three Recommendations for Building an Organizational Crisis Plan (Oss, 2026)
1. Develop a Contingency Plan
Plan before a crisis occurs rather than reacting after the fact.
Establish objective operational "triggers" that require action.
Identify predetermined financial benchmarks, staffing thresholds, and policy changes that activate specific organizational responses.
Review data regularly and adjust plans based on emerging trends and legislative updates.
2. Strengthen Crisis Communication
Create a clear organizational communication strategy before a crisis occurs.
Define how information will flow from executive leadership to supervisors and direct support professionals.
Increase transparency to reduce uncertainty and staff anxiety.
Maintain workforce engagement and retention through consistent communication.
3. Diversify Revenue Streams
Reduce reliance on a single funding source such as Medicaid.
Explore alternative service lines aligned with the organization's mission.
Consider private-pay services, consultation, professional development workshops, host home models, or other innovative supports.
Strengthen long-term financial sustainability while expanding opportunities to support individuals and families.
Just as we encourage flexibility, resilience, and proactive problem-solving among the individuals we support, our organizations must demonstrate those same qualities. The question is not whether the service landscape will continue to change. The question is whether we are prepared to respond ethically, strategically, and effectively when it does.
From the one and only... Shanda J Your BCBA
Author Credit: Meme and article modified and enhanced with support from my AI tool ChatGpt aka Gem.
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