BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                    AB 1715


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          Date of Hearing:   April 20, 2016


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                               Lorena Gonzalez, Chair


          AB  
          1715 (Holden) - As Amended April 12, 2016


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          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:










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          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.









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          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,  








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            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  








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            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.













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          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. 









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          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