BILL ANALYSIS Ó AB 1715 Page 1 Date of Hearing: April 20, 2016 ASSEMBLY COMMITTEE ON APPROPRIATIONS Lorena Gonzalez, Chair AB 1715 (Holden) - As Amended April 12, 2016 ----------------------------------------------------------------- |Policy |Business and Professions |Vote:|14 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: YesReimbursable: No SUMMARY: This bill establishes the Behavior Analyst Act (Act), which provides for the licensure, registration, and regulation of behavior analysts and related providers, and requires the California Board of Psychology (BOP), until January 1, 2022, to administer and enforce the Act. Specifically, this bill: AB 1715 Page 2 1)States intent that BOP begin accepting applications for behavior analyst licensure and assistant behavior analyst licensure no later than January 1, 2018, provided necessary funds have been appropriated. 2)Defines "practice of behavior analysis" or "to practice behavior analysis" as the design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior, as specified, 3)Defines licensed and registered personnel under the act, including "licensed behavior analysts," assistants, technicians, and interns; and establishes educational and other criteria as well as supervision standards. 4)Establishes licensing and registration provisions, including licensure, renewal, enforcement, discipline, ethical standards, background checks, continuing education, and related provisions. Establishes civil penalty authority for violations. 5)Makes it unlawful, on and after July 1, 2019, to practice behavior analysis without being licensed by BOP, except as specified. Exempts other healing arts licensees, parents, researchers, and individuals employed or contracted by a school from licensure. 6)Vests the BOP, until January 1, 2022, with the power to enforce the Act. Creates, until January 1, 2022, the Behavior Analyst Committee within the jurisdiction of the BOP to make recommendations to the BOP regarding the regulation of the practice of behavior analysis. AB 1715 Page 3 7)Establishes revenue provisions: a) Requires the board to establish fees in regulation for the application for and the issuance and renewal of licenses to cover, but not exceed, the reasonable regulatory costs of the board. b) Specifies fee revenues collected for this purpose are credited to the Psychology Fund and such funds are available upon appropriation, for the purposes of the Act. c) Sets fee amounts for several smaller fee categories. However, it does not specify licensure or renewal fees. Exempts certain categories of public service personnel from renewal fees during active service. d) Requires the licensing and regulatory program under this chapter to be supported from fees assessed to applicants and licensees. Requires startup funds to implement the Act be derived, as a loan, from the Psychology Fund, subject to a budget appropriation. e) Specifies the board shall not implement the Act until funds have been appropriated. FISCAL EFFECT: 1)Approximate fiscal impact to BOP of $1.9 million in 2017-18, the first year of implementation, and about $2.6 million ongoing (loan from the Psychology Fund, to be reimbursed by fees). Initial costs relate to promulgation of regulations, AB 1715 Page 4 development of materials, build-out of office space, and information technology changes to add a licensure category. This is based on an assumption of 3,850 licensees and 45,000 technicians and interns. The Psychology Fund has a projected balance of $9.4 million at the end of $2016-17 based on GF loan repayments of $6.3 million in 2016-17. 2)Unknown, likely minor if any, potential GF revenue, if penalty authority contained in the bill is used to enforce the bill's provisions. 3)Significant costs over the first year of licensure and minor ongoing costs to DOJ for additional background checks, reimbursed by the individuals being screened (Fingerprint Fees Account). COMMENTS: 1)Purpose. According to the author, a state mandate for health plans and insurers to cover behavioral health treatment for autism have substantially increased demand for applied behavioral analysis (ABA) services. With the increased demand, there is a greater need to regulate the BA profession, and to protect autistic children and others who can benefit from ABA treatment from people who falsely claim that they are qualified to practice behavior analysis. This bill will ensure BA professionals are qualified and overseen by the Board of Psychology, for whom consumer protection will be paramount. 2)BA. According to the American Psychological Association, behavior analysis is the study of behavior. The clinical practice of behavior analysis, called ABA, applies AB 1715 Page 5 interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree. Socially significant behaviors include reading, academics, social skills, communication, and adaptive living skills like motor skills, eating and food preparation, personal self-care, domestic skills, home and community orientation, and work skills. ABA often requires intensive treatments of more than 25 hours each week. 3)BA practitioners. The Behavior Analyst Certification Board (BACB) is a private non-profit that provides four types of credentials: (1) board certified behavior analyst, (2) board certified assistant behavior analyst, registered behavior technicians (RBTs), and (3) doctoral-level BCBA. The BACB requirements for the initial certification and renewal of analysts and assistant analyst certifications are nearly identical to the requirements for LBAs and LABAs under this bill. Nineteen other states either license or certify ABA practitioners. State law currently recognizes "qualified autism service providers" (QASPs) who are authorized to provide ABA services under the state's mandate for health insurers to provide behavioral health treatment. QASPs must be a specified licensed health care provider or a person, entity, or group that is certified by a national entity such as the BACB. "Qualified autism service professionals" can be employed by QASPs and must be approved as a regional center vendor by the Department of Developmental Services (DDS) system, among other requirements. AB 1715 Page 6 4)Related Legislation. AB 796 (Nazarian), pending in the Senate Health Committee, requires the BOP, no later than December 31, 2017, and thereafter as necessary, upon appropriation of the Legislature, to convene a committee to create a list of evidence-based treatment modalities for purposes of behavioral health treatment (BHT) for pervasive developmental disorder or autism. It also extends the sunset on the existing behavioral health treatment mandate for an additional five years, from January 1, 2017 to January 1, 2022. 5)Previous Legislation. a) SB 946 (Steinberg), Chapter 650, Statutes of 2011, among other things, mandated health care service plan contracts and health insurance policies, except as specified, to provide coverage for BHT. b) SB 126 (Steinberg), Chapter 680, Statutes of 2013, extended the operation of the BHT mandate until January 1, 2017. c) SB 479 (Bates) was substantially similar to this bill, and is pending on the Suspense File of this committee. 1)Support and Opposition. The DIR/Floortime Coalition of California has expressed opposition, citing concerns that licensing for one treatment technique may inadvertently suggest other treatment modalities such as DIR/Floortime are less legitimate. The California Association for Behavior Analysis (sponsor) and a number of treatment service providers write in support. AB 1715 Page 7 2)Staff Comments. Many fee types for other professional licensure categories have caps in statute. Since it is a new licensure program, it is appropriate not to set a fee cap at this time. However, the first sunset review in 2021 should critically examine whether fees are set commensurate with workload. It appears given expected costs and number of regulated individuals, that fees could be set at reasonable levels. Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081