John R.

Kasich, Governor
Dr. Richard A. Ross, Superintendent of Public Instruction

June 5, 2015

70140150000101899837

Spectrum Behavioral Consulting

Attn: Rebecca Eslinger (016863)
800 Park Ave W, Suite 100
Mansfield, OH 44906
Dear Ms. Eslinger,
The purpose of this letter is to inform you of the results of the complaint investigation and records
review conducted by the Ohio Department of Education.
In October of 2014, our office received a letter alleging that the operating practices of Spectrum
Behavioral Consulting (Spectrum) were not compliant with state regulation governing the autism
scholarship program (ASP). Billing and attendance records were requested for one family on
October 27, 2014. As no information was received, a second request for information was made
on December 4, 2014.
Additional inquiry into Spectrums billing processes raised added questions and on January 16,
2015 a certified letter was mailed to Spectrum informing you that all payments would be held
pending receipt of the records originally requested in October along with copies of all student
attendance and billing records for the months of November and December of 2014. On February
6, 2015 Spectrum delivered the requested records and, as an act of good faith, payments were
reinstated pending review of the materials. A review of records led us to determine that Spectrum
has failed to maintain adequate staffing and has been erroneously billing for services. The details
of these findings are listed below.

Summary of Findings
Staffing
The Spectrum web site and information provided to our office indicates that they provide a center
based program either half-day with a 1:2 staff to student ratio or full-day with a 1:4 ratio. They
also provide a home based program and a mainstreaming program including behavioral
consultation. Their program materials describe their program as rooted in Applied Behavior
Analysis (ABA) and offering center and in-home ABA programming. Spectrum served 39 Autism
scholarship students, and an unknown number of non-scholarship students, in the 2014-2015
program year. Spectrum currently employs a staff of 34. That staff includes 3 licensed
professionals. Donna Morris has a social work license, and Terri Keckler and Angela Lavery have
intervention specialist licenses. The Marion City school district has reported that Angela Lavery
is a FT employee in a public middle school. The owner and the remaining staff are unlicensed.
No one on the Spectrum staff is licensed to provide ABA either through the Behavior Analyst
Certification Board or the Ohio Board of Psychology.

25 South Front St, Mail Stop 309

Columbus, Ohio 43215
Education.ohio.gov

Requirement
Ohio Revised Code (ORC) 4783.02 (A) States that Except as otherwise provided in division (B) of
this section, no person shall do either of the following: (1) Engage in the practice of applied
behavior analysis in this state without holding a certificate issued under section 4783.04 of the
revised code; (2) Hold the persons self out to be a certified Ohio behavior analyst unless the
person holds a certificate issued under section 4783.04 of the Revised Code.
OAC 3301-103-06(A)(3) Requires the private provider meets the minimum standards of the
applicable professional organization for individual or non-school providers. The private provider
holds, and any employees hold, and any volunteers hold, appropriate credentials from the state
board of education or appropriate credentials from a national or state board for their specific
professions, and these credentials are related to the individualized education program (IEP)
services they will be providing. If the private provider contracts with another provider who will be
providing special education and related services to children in the autism scholarship program,
the contracted provider and any subcontractors and employees or volunteers of both the
contracted and subcontracted providers shall also hold appropriate credentials from the Ohio
department of education or credentials from a national or state board for their specific professions.
OAC 3301-103-06 (A) (5) Requires the private provider has on file, prior to providing any special
education and related services to children participating in the autism scholarship program, a
current criminal records check from the superintendent of the Ohio bureau of criminal
identification and investigation pursuant to rule 109:5-1-01 of the Administrative Code.
Billing
Complaint
Billing history from the 2013-2014 program year was reviewed for three children based on
concerns raised by their parent. According to the parent, Student 1 was seen daily in the home
for 4hrs per day by an unlicensed aide, Jade Acker. The billing history presented by Spectrum for
September 2013 June 2014 reflected a mix of billed services listed as staff, Holly/Kami Time
Intervention Specialists, Becca Executive Director, and some smaller charges ($125 - $250
range) listed as Work Shop Expense. The invoices submitted to our office for payment during
that period reflected a single service, Intervention or Education, each month in amounts ranging
between $1515 and $4000 per month. The invoices indicated that those services were provided
entirely in any given month either by Kambrianna Thornton or Holly Cleland, licensed intervention
specialists. The parent has reported that neither person worked with their son. Nowhere in the
billing history are the services of Jade Acker reflected.
The fee information provided by Spectrum indicates that fees will be based the qualifications of
the individual providing the services as defined on their billing hierarchy. The regular staff rate is
$25 per hour. Consultant fees are $125 per hour.
Fee policies for 2013-2014 also indicate that outside services such as Speech and Occupational
Therapy can be purchased by families from non-Spectrum employees and billed to the students
scholarship. Then, payment would be made to the family minus a 2% service fee. In addition,
policies state that iPads and other equipment can be purchased by families and billed to the
scholarship for reimbursement to the family minus a 5% service charge or Spectrum can
purchase the items directly, bill the students scholarship and charge the parent a 10% service
charge. All of these policies are violations of scholarship regulations and policies.

The chart below shows the billing breakdown for Student 1 based on the documents that you
provided for Student 1 along with the amount you invoiced to the department. The home-based
fee schedule sets an hourly rate of $25 per hour. The days of attendance and fees could not be
calculated because you did not provide attendance records for this student.
Student 1
Month
September
October
November
December
January
February
March
April
May
June

Billing Breakdown
$1635
$1960
$2635
$2215
$2475
$2250
$4125
$1675
$2607.50
$1195

Invoiced
$1635
$1515
$2635
$2215
$2350
$2125
$4000
$1675
$2125

For Student 2, Spectrum provided a billing history, monthly attendance rosters for the year and
representative daily sign in/out logs for weeks in January and February. The majority of the billing
was recorded under Center Classroom 1:2 placement with smaller amounts billed to
Intervention Specialist and Home Support Additional. The attendance logs were signed by
Michelle B. This would indicate that the student was working with Michelle Bing, an unlicensed
aide. Two separate sets of logs for 2/3/14 2/14/14 and 2/17/14 - 2/28/14 were submitted. The
logs reflected different days of attendance for this student in the same time period. The first
month of services provided according to Spectrums records was August. The first month of
services invoiced to ODE was July. Spectrum invoiced and was paid for $2000 of Intervention
Services provided by Kambrianna Thornton for the month of July. Attendance for August reflects
the student was expected for 1 day during the month but had an excused absence. Spectrum
invoiced $1200 of Aide and Intervention services for August.
The Center based fee schedule indicates a set usage allotment of 3hrs per day for 5 days per
week for students requiring a 1:2 ratio. The fee schedule is also set based on the number of
weeks of service in each month. Generally the center bills $500 per week of service. The dollar
amount invoiced to ODE monthly for Student 2 is not reflective of this schedule nor is it reflective
of the students attendance patterns.
Billing for Student 3 also showed inconsistencies. An attendance calendar was presented that
reflected 21 days of attendance in October and an invoice was submitted for the amount of
$2650. The next month, November, the attendance calendar showed 14 days of attendance and
an invoice was submitted for $2625. In January the student attended for 10 days and the provider
invoiced our agency for $2900. All services billed in these months were for a center based
program and were provided by non-credentialed aides.

The charts below show the days of attendance, fee for services and billing breakdown based on
the documents that you provided for students 2 and 3 along with the amount you invoiced to the
department.
Student 2
Month
July
August
September
October
November
December
January
February
March
April
May
June

Days
0
0
11
15
12
12
9
9
14
13
18
2

Fee
$0
$0
$2000
$2000
$1500
$1000
$2000
$2000
$2000
$2000
$2000
$500

Days
0
6
15
21
14
13
10
16
19
16
19
4

Fee
$0
$1000
$2000
$2000
$1500
$1000
$2000
$2000
$2000
$2000
$2000
$500

Billing Breakdown
$0
$1200
$2250
$2578.75
$3200
$1235
$2245
$2635
$1840
$2011.25
$1840
$535

Invoice
$2000
$1200
$2250
$2578.75
$3200
$1100
$2245
$2635
$1840
$2011.25
$1840
$535

Student 3
Month
July
August
September
October
November
December
January
February
March
April
May
June

Billing Breakdown
$1625
$2875
$2650
$2625
$1025
$2900
$1800
$1595
$2030
$2030
$1080

Invoice
$1625
$2625
$2650
$2625
$1025
$2650
$2374
$2030
$2030
$2030
$1080

Records Review
Other issues of a similar nature were found when reviewing a sampling of the attendance and
billing of multiple Spectrum students for November and December 2014.
Nearly all student invoices indicated they received Intervention services from Angela Lavery.
Angela works as a FT intervention specialist in a public school district that is more than 30
minutes away. These students were served in the center during school hours.
In November, Spectrum invoiced ODE for FT intervention services delivered by Angela Lavery to
22 students and PT intervention services for another 8. In December, Spectrum invoiced for FT
intervention serviced delivered by Angela to 21 students and PT services for another 5.

Spectrum, as of the end of April 2015 billing, has billed $333,271 for services provided by Angela.
Based on the low staff to student ratios indicated on the Spectrum website which are required by
this high needs population, the fact that Angela was working full time in a public school, and the
centers own reporting of 10 different student classes, Spectrum has not provided evidence that
Angela provided the services that were invoiced to the Department.
Requirement
OAC 3301-103-02(C) Each scholarship shall be used only to pay tuition for the child on whose
behalf the scholarship is awarded to attend a special education program that implements the
childs individualized education program (IEP) and that is operated by an alternative public
provider or by a registered private provider.
OAC 3301-103-07 (A) and (B) Requires each scholarship is to be used for payment to a school
district other than the school district in which the child is entitled to attend school or to another
eligible public entity, or to a registered private provider who is providing special education and
related services as identified on the child's current individualized education program (IEP). Each
scholarship is payable to the parent. The parent and the provider must endorse each check
issued under this program.
Each scholarship shall be used only as payment for the child, on whose behalf the scholarship is
awarded, to receive special education and related services that implement the child's current IEP
and that is operated by a school district other than the school district in which the child is entitled to
attend school or by another eligible public entity or by a registered private provider.
System User Guide - billing instructions
9. Select the service your organization has provided for the student.
10. Enter the service start date.
11. Enter the service end date.
12. Select the staff member that provided this service.
13. Enter the dollar amount being billed for this service.
14. Select the Save Service button to save the information entered (Illustrated above with the
arrow).
15. To add additional services to the invoice, repeat steps 6-14.
16. After all services have been added to the invoice, select the Save button.
Conclusions
In order to participate in the Autism Scholarship Program, all providers must have licensed staff that
can oversee the implementation of a students IEP and provide related services. Oversight of an
IEP would require an intervention specialist license. A licensed psychologist or certified Ohio
behavior analyst can be approved to serve in that capacity if the program is primarily providing
Applied Behavior Analysis (ABA). Currently there are two intervention specialists employed at
Spectrum with credentials to implement the students IEP or provide special education services.
One of them cannot be in the building serving students because she is employed at a public school.
Spectrum does not have an adequate number of licensed staff to implement the IEPs of their
students.

Invoices submitted to the department were not reflective of the services provided to the children or
the staff that provided them. Given the small group size and staffing arrangement at Spectrum,
there would not be an opportunity for a single staff person to serve 20 or more students on a full
time basis in a single month, particularly if that person were also serving a public school district on
a full time basis.
The billing submitted to ODE was not an accurate representation of the services delivered.
Invoices were submitted for students in months that they did not receive services. Invoices were
submitted for services provided by staff that parents report never worked with their children.
Aide services were represented as intervention services. Amounts billed do not align with the
providers own fee schedule or the attendance history of the students.
In addition to the billing complaints received and addressed here, we have received numerous
calls and e-mails from prior Spectrum staff members, parents and public school district staff
concerning your professional conduct including inappropriate posts to Facebook and other web
sites, inappropriate e-mail messages and unprofessional comments or behavior in meetings.
Recommendations
The issues above were addressed during a previous complaint investigation and subsequent
corrective action process in the summer of 2013. Since that time, the issues have been ongoing.
Spectrum Behavioral is out of compliance with the requirements for participation in the Autism
Scholarship Program specified under sections 3301-103-01 to 3301-103-07 of the Ohio
Administrative Code. Your repeated violations of the autism program regulations regarding
staffing and billing require that the office move to revoke your participation in the autism
scholarship program per OAC 3301-103-06 (E). A refund notification will be sent by separate
letter to Spectrum to reconcile in full the charges for intervention and education services provided
by Angela Lavery between September 2014 and June 2015.
You are hereby notified that you have the opportunity to request a hearing on the revocation of
your registration. At the hearing, in accordance with Chapter 119 of the Ohio Revised Code, you
may present your position in writing. You may also present evidence and examine witnesses
appearing for and against you. Your request for a hearing must be mailed to my attention, at the
address listed below, within thirty (30) days from the date of the mailing of this notice.

Attn: Sue Cosmo, Director

Office of Quality School Choice
Ohio Department of Education
25 South Front St, Mail Stop 310
Columbus, OH 43215-4183

Questions concerning the appeal process should be addressed to the Ohio Department of
Education, Office of Legal Counsel at 614-466-4605.

Sincerely,

Susan L. Cosmo
Director
Office of Nonpublic Educational Options
CC:
Lisa Huckins, Education Program Specialist, Office of Quality School Choice
Sharon Jennings, Attorney, Office of Legal Council