STATEMENT OF FACT AND RECORD OF CONTRADICTION

*Please note this is not about my employers, my client(s) or their families. In my personal experience, I've been blessed with amazing employers who put their love for their children first and are dedicated to God, family and compassion for humans as a whole. This is a structural problem, not client and family.*

Regarding the Misclassification, Improper Delegation, and Ethical Breach in the Use of Attendants and Behavioral Technicians in the State of Texas

I. STATEMENT OF PURPOSE

This document exists to formally document a systemic contradiction in the classification, compensation, and utilization of direct-care workers in Texas-funded behavioral services.

Specifically, it addresses the practice of classifying workers as Attendants while assigning them the responsibilities, expectations, and liabilities of Behavioral Technicians (BTs)—a practice that violates the state’s own role definitions, undermines ethical care, and exposes clients, families, and workers to preventable harm.

This is not speculation.

This is not grievance.

This is a factual analysis based on role definitions, assigned duties, and lived operational practice.

II. ROLE DEFINITIONS UNDER TEXAS POLICY (FOUNDATION)

A. Attendant (Personal / Community Attendant Services). Under Texas Medicaid and HHSC frameworks, an Attendant provides non-clinical support, including but not limited to:

• Assistance with activities of daily living (ADLs)
• Personal care
• Supervision for safety
• Non-medical support tasks

Key limitations of the Attendant role:

• No clinical decision-making authority
• No implementation of behavioral treatment plans
• No responsibility for therapeutic outcomes
• No requirement to analyze behavior or manage escalation beyond basic supervision

The Attendant role is explicitly non-clinical.

B. Behavioral Technician (BT) Under Texas Medicaid’s ABA benefit and associated manuals, a Behavioral Technician:

• Implements behavior intervention plans
• Delivers Applied Behavior Analysis (ABA) services
• Operates under clinical supervision (e.g., BCBA)
• Manages behavioral escalation
• Collects and reports behavioral data
• Is accountable for treatment fidelity and outcomes

Key characteristics of the BT role:

• Clinical responsibility
• Real-time decision-making
• Direct impact on safety, learning, and regression
• Accountability for progress and failure

The BT role is clinical in function, regardless of credential tier.

III. STATEMENT OF FACT: ACTUAL EXPECTATIONS ASSIGNED

Despite being classified and paid as an Attendant, I am expected to:

• Implement behavioral strategies and interventions
• Regulate nervous systems during escalation
• Prevent harm to the client and others
• Make immediate decisions that affect safety and learning
• Collect and communicate behavioral observations and outcomes
• Maintain consistency and continuity essential to therapeutic progress
• Be held accountable for unmet goals or regression

These are Behavioral Technician duties, not Attendant duties.

This is not occasional overlap.

This is the core of the role I am expected to perform and have been doing so since February 13, 2024 with this current client.

IV. THE CREDENTIAL CONTRADICTION (CRITICAL)

I do not currently hold formal BT certifications (RBT, BCAT, ABAT).

I do not hold a degree in behavioral science.

This is not due to lack of competence, experience, or effort.

My expertise comes from:

• Raising my own autistic child into adulthood
• Years of hands-on work with autistic individuals
• Direct training by occupational therapists, speech therapists, educators, and specialists
• Continuous application of that knowledge in real-world, high-risk environments 

Despite the lack of formal credentials, the system:

• Assigns me clinical responsibilities
• Holds me accountable for clinical outcomes
• Relies on my judgment during crisis and escalation

This creates a fatal contradiction:

Either:

1. The duties assigned do not require certification, in which case the system is misrepresenting credential necessity
   OR
2. The duties do require certification, in which case assigning them to an uncertified, misclassified worker is an ethical and regulatory breach

There is no third compliant option.

V. STRUCTURAL BARRIERS TO CERTIFICATION (NOT NEGLIGENCE)

I have actively attempted to pursue certification.

However, Texas certification pathways require:

• BCBA sponsorship
• Employment under the sponsoring BCBA
• Often, reassignment away from existing clients

In practice, this means:

• Advancement requires abandoning stable clients
• Loyalty and continuity are penalized
• Ethical care conflicts with professional mobility

Despite these barriers, the system continues to extract certified-level labor without certified-level recognition or protection.

This is not an accident.

It is a structural choke point that benefits agencies financially.

VI. FINANCIAL INCENTIVE AND AGENCY BENEFIT

By classifying a worker as an Attendant while assigning BT duties, agencies can:

• Pay lower wages
• Avoid benefits
• Reduce liability exposure
• Retain a larger portion of state reimbursement

At the same time:

• The client’s care becomes dependent on underprotected labor
• The family becomes vulnerable to sudden worker loss
• The worker absorbs physical, emotional, and professional risk

This arrangement benefits systems, not people.

VII. RESULTING HARMS

This practice:

• Undermines ethical care
• Drives burnout and turnover
• Punishes progress (reduced hours when outcomes improve)
• Discourages transparency and advocacy
• Places workers in impossible positions

It is unsustainable and unjustifiable.

VIII. CONCLUSION (PROSECUTORIAL FINDING)

Based on the above, the following conclusion is unavoidable:

If I am an Attendant, I must only be assigned Attendant duties.

If I am assigned Behavioral Technician duties, I must be classified and compensated as such.

Continuing to do both is a violation of the system’s OWN rules.

This is not a request for special treatment.

It is a demand for internal consistency, ethical compliance, and basic integrity.

The system cannot continue to rely on misclassification while claiming legitimacy.

IX. STATEMENT FOR RECORD

I am not overstating my role.

I am naming what I am already required to do.

I am not rejecting accountability.

I am rejecting exploitation disguised as policy.

This record is entered not in anger,

but in refusal to remain complicit in a structure

that survives by silencing the people it depends on.

Amy Lee Murr

Feral Faith Studio

amyleemurr@gmail.com

PO Box 111

Godley, Tx 76044