BILL ANALYSIS Ó SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND ECONOMIC DEVELOPMENT Senator Jerry Hill, Chair 2015 - 2016 Regular Bill No: SB 479 Hearing Date: April 27, 2015 ----------------------------------------------------------------- |Author: |Bates | |----------+------------------------------------------------------| |Version: |April 6, 2015 | ----------------------------------------------------------------- ---------------------------------------------------------------- |Urgency: |No |Fiscal: |Yes | ---------------------------------------------------------------- ----------------------------------------------------------------- |Consultant|Sarah Huchel | |: | | ----------------------------------------------------------------- Subject: Healing arts: behavior analysis: licensing. SUMMARY:1) Establishes the Behavior Analyst Act to license behavioral analysts and assistant behavioral analysts, and establishes an advisory Behavior Analyst Committee to advise the Board of Psychology on administration of this Act. Existing law: 1)Establishes the Board of Psychology to enforce and administer the Psychology Licensing Law. (Business and Professions Code (BPC) §§ 2901 and 2920) 2)Defines the practice of psychology as rendering or offering to render for a fee to individuals, groups, organizations or the public any psychological service involving the application of psychological principles, methods, and procedures of understanding, predicting, and influencing behavior, such as the principles pertaining to learning, perception, motivation, emotions, and interpersonal relationships; and the methods and procedures of interviewing, counseling, psychotherapy, behavior modification, and hypnosis; and of constructing, administering, and interpreting tests of mental abilities, aptitudes, interests, attitudes, personality characteristics, emotions, and motivations. The application of these principles and methods includes, but is not restricted to: diagnosis, prevention, treatment, and amelioration of SB 479 (Bates) Page 2 of ? psychological problems and emotional and mental disorders of individuals and groups. (BPC § 2903) 3)Defines "professional clinical counseling" as the application of counseling interventions and psychotherapeutic techniques to identify and remediate cognitive, mental, and emotional issues, including personal growth, adjustment to disability, crisis intervention, and psychosocial and environmental problems, and the use, application, and integration of the coursework and training as specified. "Professional clinical counseling" includes conducting assessments for the purpose of establishing counseling goals and objectives to empower individuals to deal adequately with life situations, reduce stress, experience growth, change behavior, and make well-informed, rational decisions. (BPC § 4999.20) 4)Requires that every health care service plan or insurance policy that provides hospital, medical or surgical coverage must also provide coverage for behavioral health treatment for pervasive developmental disorder or autism (PDD/A). (Health and Safety Code (HSC) §1374.73(a), Insurance Code (IC) §10144.51(a)) 5)Requires these health care service plans and health insurers subject to this provision to maintain an adequate network of qualified autism service providers. (HSC §1374.73(b), IC §10144.51(b)) 6)Defines "behavioral health treatment" as professional services and treatment programs, including applied behavior analysis and evidence-based behavior intervention programs which develop or restore the functioning of an individual with pervasive developmental disorder or autism, and meets the following criteria: a) Is prescribed by a licensed physician and surgeon or is developed by a licensed psychologist. b) Is provided under a treatment plan prescribed by a qualified autism service provider and administered by such a provider or by a qualified autism service professional under supervision and employment of a qualified autism service provider. SB 479 (Bates) Page 3 of ? c) The treatment plan has measurable goals over a specific timeline and the plan is reviewed by the provider at least once every six months. d) Is not used for purposes of providing or for the reimbursement of respite, day care, or educational services. (HSC §1374.73(c), IC §10144.51(c)) 7)Defines a "qualified autism service provider" as either: a) A person, entity, or group that is certified by a national entity, such as the Behavior Analyst Certification Board (BACB), that is accredited and which designs, supervises, or provides treatment for pervasive developmental disorder or autism. b) A person who is licensed as a specified healing arts practitioner, including a psychologist, marriage and family therapist, educational psychologist, clinical social worker, or professional clinical counselor. The licensee must design, supervise, or provide treatment for pervasive developmental disorder or autism and be within his or her experience and competence. (HSC §1374.73(c), IC §10144.51(c)) 8)Defines a "qualified autism service professional" as someone who meets all of the following: a) Provides behavioral health treatment. b) Is employed and supervised by a qualified autism service provider. c) Provides treatment according to a treatment plan developed and approved by the qualified autism service provider. d) Is a behavioral service provider approved by a regional center to provide services as an Associate Behavior Analyst, Behavior Analyst, Behavior Management Assistant, Behavior Management Consultant, or Behavior Management Program as defined in Title 17 of the California Code of Regulations (CCR) § 54342. SB 479 (Bates) Page 4 of ? e) Has training and experience providing services for pervasive developmental disorder or autism pursuant to the Lanterman Developmental Disabilities Services Act. (HSC §1374.73(c), IC §10144.51(c)) 9)Defines a "qualified autism service paraprofessional" as an unlicensed and uncertified person who meets all of the following: a) Is employed and supervised by a qualified autism service provider. b) Provides treatment according to a treatment plan developed and approved by the qualified autism service provider. c) Meets criteria set forth in regulations regarding use of paraprofessionals in group practice providing behavioral intervention services. d) Is certified by a qualified autism service provider as having adequate education, training, and experience. (HSC §1374.73(c), IC §10144.51(c)) 10)Defines vendor service codes and sets requirements for regional center to classify the following professions: a) Associate Behavior Analysts. b) Behavior Analysts. c) Behavior Management Assistants. d) Behavior Management Consultants. e) Behavior Management Programs. (17 CCR §54342) This bill: 1)Adds behavior analysts (BAs) and assistant behavior analysts (ABAs) to the list of licensees about which the Board of Psychology (Board) is required to disclose information. 2)Requires the Board to enforce the licensure provisions of this SB 479 (Bates) Page 5 of ? bill. 3)Increases the size of the Board from nine to 11 by July 1, 2017, and states its composition as follows: a) Seven professional members appointed by the Governor, consisting of: i) Five licensed psychologists. ii) One licensed psychologist who is qualified to practice behavior analysis, as specified. (1) For the first appointment, the member shall be a certified BA. (2) For subsequent appointments, the member shall be a licensed BA. iii) One BA as follows: (1) For the first appointment, the member shall be a certified BA. (2) For subsequent appointments, the member shall be a licensed BA. b) Four public members, appointed as follows: i) Two appointed by the Governor. ii) One appointed each by the Senate Committee on Rules and the Speaker of the Assembly. 4)Requires six members of the Board to constitute a quorum. 5)Establishes the Behavior Analyst Act. 6)Makes Legislative findings and declaration as to the importance of licensing behavior analysts in California. 7)States the intent of the Legislature that the Board begin accepting applications for BA licensure and ABA licensure no later than January 1, 2018, provided that the funds necessary SB 479 (Bates) Page 6 of ? to implement this bill have been appropriated by the Legislature. 8)Defines the following terms: a) "Certifying entity" as the BACB or its successor, or a national organization with a behavior analyst certification program approved by the Board and accredited by the National Commission for Certifying Agencies. b) "Practice of behavior analysis" or "to practice behavior analysis" means the design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior and includes any of the following: i) The empirical identification of functional relations between behavior and environmental factors, known as functional assessment and analysis. ii) Interventions based on scientific research and the direct observation and measurement of behavior and the environment. iii) Utilization of contextual factors, motivating operations, antecedent stimuli, positive reinforcement, and other consequences to help people develop new behaviors, increase or decrease existing behaviors, and emit behaviors under specific environmental conditions. iv) The practice of behavior analysis does not include psychological testing, diagnosis of a mental or physical disorder, neuropsychology, psychotherapy, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, or counseling as treatment modalities. 9)Vests the Board with the power to administer the provisions and requirements of the Act, and authorizes it to make and enforce rules and regulations that are reasonably necessary. 10)Establishes a sunset date of January 1, 2021. 11)States that protection of the public shall be the highest priority for the Board in exercising its licensing, SB 479 (Bates) Page 7 of ? regulatory, and disciplinary functions pursuant to this bill. Whenever the protection of the public is inconsistent with other interests sought to be promoted, the protection of the public shall be paramount. 12)Requires the Board to adopt, amend, and repeal regulations to implement the requirements of this bill upon recommendation of the Behavior Analyst Committee ("Committee"). 13)Authorizes the Board to employ, subject to civil service and other laws, employees as may be necessary to carry out the provisions of this bill under the direction of the executive officer of the Board. 14)Requires the Board to maintain, and make available to the public, a list of all licensees and their statuses on its Internet Web site, as specified. 15)Establishes the Committee as of July 1, 2017 within the jurisdiction of the Board to protect the public from the unauthorized and unqualified practice of applied behavior analysis, and unprofessional, unethical, or harmful conduct by persons licensed to practice behavior analysis. 16)Establishes the Committee as having five members, as follows: a) Two members shall be licensed BAs. b) One member shall be a psychologist who is also a member of the Board and who is a licensed BA. c) One member shall be a licensed ABA. d) One member shall be a public member who is a consumer of behavior analysis services and who is not licensed under this bill or under any healing arts board under the Department of Consumer Affairs. 17)Requires the Governor to appoint one licensed BA member, the licensed psychologist member, and the licensed ABA member. The Senate Committee on Rules shall appoint the public member, and the Speaker of the Assembly shall appoint one licensed BA member. SB 479 (Bates) Page 8 of ? 18)Establishes the initial appointees as follows: a) The Governor's appointees: i) One member shall hold a certificate as a certified BA from a certifying entity and shall serve an initial term of one year. ii) One member shall hold a certificate as a certified ABA from a certifying entity and shall serve an initial term of two years. iii) One member shall be a licensed psychologist who holds a certificate as a certified BA from a certifying entity and shall serve an initial term of three years. b) The initial public member appointed by the Senate Committee on Rules shall serve a term of four years. c) The initial member appointed by the Speaker of the Assembly shall hold a certificate as a certified BA from a certifying entity and shall serve an initial term of four years. 19)States that each member of the Committee shall hold office for a term of four years, and shall serve until the appointment of his or her successor or until one year has elapsed since the expiration of the term for which he or she was appointed, whichever occurs first. Vacancies shall be filled by the appointing power for the unexpired portion of the terms in which they occur. A member shall not serve for more than two consecutive terms. 20)Requires Committee membership terms to begin on July 1 and expire on June 30. 21)Requires each member of the Committee to receive $100 per diem and actual expenses, as specified. 22) States that three members of the Committee shall at all times constitute a quorum. 23)Requires the Committee to do all of the following: SB 479 (Bates) Page 9 of ? a) Meet publicly at least once per quarter, called upon reasonable notice at the discretion of the chair, and may be called at any time upon reasonable notice by a written request to the chair by two Committee members. b) Elect a chair and a vice chair from among its members at the first meeting held in each fiscal year. The chair shall preside at all meetings of the Committee and shall work with the executive officer of the Board to coordinate the Committee's business. If the chair is unable to attend a meeting, the vice chair shall preside at the meeting. 24)Authorizes the Committee to make recommendations to the Board regarding licensing and practice standards and regarding the adoption, amendment, and repeal of regulations to implement the requirements of this bill including, but not limited to, the setting of fees and the establishment of disciplinary actions. 25)Requires, for any action taken by the Committee to be effective, adoption by majority vote of the members of the Committee and a majority vote of the Board. 26)Requires each applicant for licensure as a BA or ABA to meet the Board's regulatory requirements for BA or ABA licensure, as applicable, including all of the following: a) The applicant has not committed acts or crimes constituting grounds for denial, as specified. b) The applicant has not been convicted of a crime in this state, or another state, or in a territory of the United States that involves sexual abuse of a child, or who is required to register as a sex offender in the United States or other territory. c) The applicant has successfully passed a state and federal level criminal offender record information search conducted through the Department of Justice. 27)Requires an individual seeking a license as a BA to submit an application on a form approved by the Board accompanied by the appropriate fees. SB 479 (Bates) Page 10 of ? 28)Requires the Board to verify with the certifying entity that the applicant meets all of the following requirements: a) Has passed the Board Certified Behavior Analyst examination administered by the BACB. b) Maintains an active status as a certified BA with the certifying entity. c) Is in compliance with all ethical and disciplinary standards published by the certifying entity. 29)Requires each applicant to obtain a passing score on a California law and ethics examination administered by the Board. 30)Establishes the following requirements for BA licensure: a) Possession of a master's degree or higher level of education from a qualified institution, as specified, that was conferred in behavior analysis or other natural science, education, human services, engineering, medicine, or a field related to behavior analysis and approved by the certifying entity. b) Meet one of the following requirements: i) Completion of 270 hours of classroom graduate-level instruction in specified content areas and experience by any of the following: (1) Completed 1,500 hours of independent field work in behavior analysis supervised in accordance with the requirements of the certifying entity. (2) Completed, with a passing grade, 1,000 hours of supervised practicum in behavior analysis within a university practicum approved by the certifying entity and taken for graduate academic credit. (3) Completed, with a passing grade, 750 hours of supervised intensive practicum in behavior analysis within a university practicum approved by the certifying entity and taken for graduate academic SB 479 (Bates) Page 11 of ? credit. (4) Completed a combination of the supervised experience listed above. ii) Completed one academic year as a full-time faculty appointment at a college or university during which he or she taught classes on basic principles of behavior, single-subject research methods, applications of basic principles of behavior in applied settings, and ethical issues, and conducted and published research in behavior analysis. An applicant by this method shall also have obtained experience by any of the following: (1) Completed 1,500 hours of independent field work in behavior analysis supervised in accordance with the requirements of the certifying entity. (2) Completed, with a passing grade, 1,000 hours of supervised practicum in behavior analysis within a university practicum approved by the certifying entity and taken for graduate academic credit. (3) Completed, with a passing grade, 750 hours of supervised intensive practicum in behavior analysis within a university practicum approved by the certifying entity and taken for graduate academic credit. (4) Completed a combination of the supervised experience listed above. iii) Possession of a doctoral degree, conferred at least 10 years prior to the date of application, in the field of behavior analysis, psychology, education, or a related field approved by the certifying entity, and ten years of verified and documented postdoctoral experience practicing behavior analysis. 31)States that if an individual is certified by a certifying entity whose requirements for initial certification as a certified BA at the time of license application meets or surpasses the requirements listed in this bill, the applicant for licensure shall be deemed to have satisfied these SB 479 (Bates) Page 12 of ? requirements. 32)Requires an individual seeking licensure as an ABA to submit an application on a form approved by the Board accompanied by the appropriate fees. 33)Requires the Board to verify with the certifying entity that the applicant meets all of the following requirements: a) Has passed the Board Certified Assistant Behavior Analyst examination administered by the certifying entity. b) Maintains an active status as a board certified ABA with the certifying entity. c) Is in compliance with all ethical and disciplinary standards published by the certifying entity. 34)Requires each applicant to obtain a passing score on a California law and ethics examination administered by the Board. 35)Requires each applicant to provide proof of ongoing supervision by a licensed BA in a manner consistent with the certifying entity's requirements for supervision of ABAs. 36)Establishes the following requirements for ABA licensure: a) Possession of a baccalaureate degree or higher level of education from a qualifying institution, as specified. b) Completion of 180 classroom hours of undergraduate or graduate level instruction in specified content areas, and obtained experience by any of the following: i) Completed 1,000 hours of independent field work in behavior analysis supervised in accordance with the requirements of the certifying entity. ii) Completed, with a passing grade, 670 hours of supervised practicum in behavior analysis within a university practicum approved by the certifying entity and taken for academic credit. SB 479 (Bates) Page 13 of ? iii) Completed, with a passing grade, 500 hours of supervised intensive practicum in behavior analysis within a university practicum approved by the certifying entity and taken for academic credit. iv) Completed a combination of the supervised experience listed above. 37)States that if an individual is certified by a certifying entity whose requirements for initial certification as a certified ABA at the time of the license application meet or surpass the requirements in this bill, the applicant for licensure shall be deemed to have satisfied these requirements. 38)Requires the education required to obtain a BA or ABA license to be from any of the following: a) A United States institution of higher education listed by the Council for Higher Education Accreditation. b) A Canadian institution of higher education that is a member of the Association of Universities and Colleges of Canada or the Association of Canadian Community Colleges. c) An institution of higher education located outside the United States or Canada that, at the time the applicant was enrolled and at the time the applicant graduated, maintained a standard of training equivalent to the standards of training of those institutions accredited in the United States as demonstrated by a member of the National Association of Credential Evaluation Services. 39)Makes it unlawful on and after January 1, 2018, for any person to engage in any of the following acts: a) Engaging in the practice of behavior analysis without first having complied with the provisions of this bill and without holding a current, valid, and active license. b) Representing himself or herself by the title "licensed BA," or "licensed ABA" without being duly licensed according to the provisions of this bill. SB 479 (Bates) Page 14 of ? c) Make any use of any title, words, letters, or abbreviations that may reasonably be confused with a designation provided by this bill to denote a standard of professional or occupational competence without being duly licensed. d) Materially refuse to furnish to the Board information or records required or requested pursuant to this bill. 40)Specifies that this bill does not apply to any of the following: a) An individual licensed to practice psychology if the practice of behavior analysis engaged in by the licensed psychologist is within the licensed psychologist's training and competence. b) An occupational therapist, a physical therapist, a marriage and family therapist, or an educational psychologist acting within his or her licensed scope of practice and within the scope of his or her training and competence, provided that he or she does not represent himself or herself as a licensed BA or licensed ABA. c) An individual, including a paraprofessional technician, acting under the authority and direction of a licensed BA, a licensed ABA, or an individual described in paragraph (a) or (b). d) A family member of a recipient of behavior analysis services who acts under the extended authority and direction of a licensed BA or a licensed ABA. e) A matriculated college or university student who practices behavior analysis as a part of a defined program of study, course, practicum, internship, or postdoctoral fellowship, provided that the behavior analysis activities are directly supervised by a licensed BA, or by an instructor in a course sequence approved by the certifying entity. f) An unlicensed individual pursuing supervised experience in behavior analysis consistent with the experience requirements of the certifying entity provided such SB 479 (Bates) Page 15 of ? experience is supervised in accordance with the requirements of the certifying entity. g) An individual who teaches behavior analysis or conducts behavior analytic research provided that such teaching or research does not involve the direct delivery of behavior analysis services. h) A BA licensed in another state or certified by the certifying entity to practice independently, and who temporarily provides behavior analysis services in California during a period of not more than 90 days in a calendar year. i) An individual who is designated as a vendor by one or more regional centers of the California Department of Developmental Services while practicing behavior analysis services authorized pursuant to the conditions to under a vendor agreement. That individual shall not represent himself or herself as a licensed BA or licensed ABA unless he or she holds a license under this bill, and that individual shall not offer behavior analysis services to any person or entity other than the regional centers with which he or she is authorized, and the individual may not accept remuneration for providing behavior analysis services other than the remuneration received from those regional centers. j) An individual employed by a school board performing the duties of his or her position, provided that he or she shall only offer behavior analysis services within the scope of that employment by the school board. 41)Requires the Board to issue a license to a person who is licensed as a BA or an ABA in another state if that state currently imposes comparable licensure requirements as those required by this state and if that state offers reciprocity to individuals licensed under this chapter. 42)Requires applicants for a license under reciprocity to submit an application on a form approved by the Board accompanied by the appropriate fees and complete any other eligibility requirements established by the Board, including, but not limited to, a criminal background check. SB 479 (Bates) Page 16 of ? 43)Requires the Board to verify that the applicant: a) Holds an active license as a licensed BA or licensed ABA in another state. b) Is not subject to any disciplinary action by another state or certifying entity. c) Maintains an active status as board certified behavior analyst or board certified assistant behavior analyst with the certifying entity. d) Is in compliance with all ethical and disciplinary standards published by the certifying entity. e) Has obtained a passing score on a California law and ethics examination. 44)Requires a licensee to give written notice to the Board of a name change within 30 days after each change, giving both the old and new names. A copy of the legal document authorizing the name change, such as a court order or marriage certificate, shall be submitted with the notice. 45)Requires that a license expires and becomes invalid two years after it is issued at 12 midnight on the last day of the month in which it was issued, if it is not renewed. 46)Requires a licensee, to renew an unexpired license on or before the date on which it would otherwise expire, apply for renewal on a form provided by the Board, accompanied by the renewal fee set by the Board. The Board shall obtain verification from the certifying entity that the renewal applicant maintains an active certification status with the certifying entity. 47)Requires an individual renewing an ABA license to apply for renewal on a form provided by the Board, accompanied by the renewal fee set by the Board. The Board shall obtain verification from the certifying entity that the renewal applicant maintains an active certification status with the SB 479 (Bates) Page 17 of ? certifying entity. The licensee shall also submit proof of ongoing supervision by a licensed BA in a manner consistent with the certifying entity's requirements for supervision of ABAs. 48)Provides that a license that has expired may be renewed at any time within three years after its expiration by applying for renewal on a form provided by the Board, payment of all accrued and unpaid renewal fees, and the delinquency fee, as specified. The board shall obtain verification from the certifying entity of the licensee's active certification status with the certifying entity. 49)Provides that, except in cases of a suspended or revoked license, a license that is not renewed within three years of its expiration shall not be renewed, restored, or reinstated, and the license shall be canceled immediately upon expiration of the three year-period. 50)States that a suspended license is subject to expiration and shall be renewed as provided in this bill, but such renewal does not entitle the licensee, while the license remains suspended, and until it is reinstated, to engage in the licensed activity or in any other activity or conduct in violation of the order or judgment by which the license was suspended. 51)States that a license revoked on disciplinary grounds is subject to expiration as provided in this article, but it may not be renewed. If it is reinstated after its expiration, the licensee, as a condition of reinstatement, shall pay a reinstatement fee in an amount equal to the renewal fee, plus the delinquency fee and any fees accrued at the time of its revocation. 52)Authorizes the Board on its own volition and requires the Board, upon the receipt of a complaint from any person, to investigate the actions of any licensee. The Board shall review a licensee's alleged violation of statute, regulation, or any other law and any other complaint referred to it by the public, a public agency, or the department, and may upon a finding of a violation take disciplinary action under this article. SB 479 (Bates) Page 18 of ? 53)States that a license issued under this bill may be denied, revoked, or otherwise sanctioned upon demonstration of ineligibility for licensure, including, but not limited to, failure to maintain active certification by the certifying entity or falsification of documentation submitted to the board for licensure or submitted to the certifying authority for certification. 54)The board may deny a license application, may issue a license with terms and conditions, may suspend or revoke a license, or may place a license on probation if the applicant or licensee has been guilty of unprofessional conduct. Unprofessional conduct shall include, but not be limited to: a) Conviction of a crime substantially related to the qualifications, functions, or duties of a licensed BA or a licensed ABA. b) Use of any controlled substance, dangerous drug, or any alcoholic beverage to an extent or in a manner dangerous to himself or herself, any other person, or the public, or to an extent that this use impairs his or her ability to safely perform the practice of behavior analysis. c) Fraudulently or neglectfully misrepresenting the type or status of a license actually held. d) Impersonating another person holding a license or allowing another person to use his or her license. e) Use of fraud or deception in applying for a license or in passing any examination required by this bill. f) Paying, offering to pay, accepting, or soliciting any consideration, compensation, or remuneration, whether monetary or otherwise, for the referral of clients. g) Violating laws related to advertising. h) Willful, unauthorized communication of information received in professional confidence. i) Being grossly negligent in the practice of his or her profession. SB 479 (Bates) Page 19 of ? j) Violating any of the provisions of this bill or regulations duly adopted thereunder. aa) The aiding or abetting of any person to engage in the unlawful practice of behavior analysis. bb) The suspension, revocation, or imposition of probationary conditions or other disciplinary action by another state or country of a license, certificate, or registration to practice behavior analysis issued by that state or country to a person also holding a license issued under this Act if the act for which the disciplinary action was taken constitutes a violation of this section. A certified copy of the decision or judgment of the other state or country shall be conclusive evidence of that action. cc) The commission of any dishonest, corrupt, or fraudulent act. dd) Any act of sexual abuse or sexual relations with a patient or former patient within two years following termination of therapy, or sexual misconduct that is substantially related to the qualifications, functions, or duties of a licensed BA or a licensed ABA. ee) Functioning outside of his or her particular field or fields of competence as established by his or her education, training, and experience. ff) Willful failure to submit, on behalf of an applicant for licensure, verification of supervised experience to the Board. gg) Repeated acts of negligence. hh) Failure to comply with all ethical and disciplinary standards published by the certifying entity. 55)Requires accusations, subject to the exceptions below, to be filed against a licensee within three years from the date the Board discovers the alleged act or omission that is the basis for disciplinary action, or within seven years from the date SB 479 (Bates) Page 20 of ? the alleged act or omission that is the basis for disciplinary action occurred, whichever occurs first. The limitations period shall be tolled during any period if material evidence necessary for prosecuting or determining whether a disciplinary action would be appropriate is unavailable to the Board due to an ongoing criminal investigation. The following are exceptions: a) An accusation filed against a licensee alleging the procurement of a license by fraud or misrepresentation may be filed at any time. b) The three year limitation shall be tolled for the length of time required to obtain compliance when a report required to be filed by the licensee or registrant with the board is not filed in a timely fashion. c) If an alleged act or omission involves a minor, the seven and ten year limitation periods, as specified, shall be tolled until the minor reaches the age of majority. d) An accusation filed against a licensee alleging sexual misconduct shall be filed within three years after the board discovers the act or omission alleged as the ground for disciplinary action, or within 10 years after the act or omission alleged as the ground for disciplinary action occurs, whichever occurs first. 56)Requires that any proposed decision or decision that contains any finding of fact that the licensee engaged in any act of sexual contact with a patient or with a former patient within two years following termination of services to contain an order of revocation. The revocation shall not be stayed by the administrative law judge. 57)Authorizes the Board to deny an application for, or issue subject to terms and conditions, or suspend or revoke, or impose probationary conditions upon, a license or registration after a hearing, as specified. 58)States that a plea or verdict of guilty or a conviction following a plea of nolo contendere made to a charge which is substantially related to the qualifications, functions, and duties of a licensed BA or licensed ABA is deemed to be a SB 479 (Bates) Page 21 of ? conviction. Authorizes the Board to order the license suspended or revoked or decline to issue a license when: a) The time for appeal has elapsed, b) The judgment of conviction has been affirmed on appeal, c) An order granting probation is made suspending the imposition of sentence, irrespective of a subsequent order allowing the person to withdraw his or her plea of guilty and to enter a plea of not guilty. d) An order is made setting aside the verdict of guilty, or dismissing the accusation, information, or indictment. 59)States that any person required to register as a sex offender is not eligible for licensure. 60)Authorizes an administrative disciplinary decision that imposes terms of probation to include, among other things, a requirement that the licensee who is being placed on probation pay the monetary costs associated with monitoring the probation. 61)States that a person who violates any of the provisions of this bill is guilty of a misdemeanor punishable by imprisonment in a county jail not exceeding six months or by a fine not exceeding two thousand five hundred dollars ($2,500), or by both that fine and imprisonment. 62)States that, in addition to other proceedings provided in this bill, whenever any person has engaged, or is about to engage, in any acts or practices that constitute, or will constitute, an offense against this bill, the superior court in and for the county wherein the acts or practices take place, or are about to take place, may issue an injunction or other appropriate order restraining that conduct on application of the Board, the Attorney General, or the district attorney of the county. States that there shall be a presumption that there is no adequate remedy at law and that irreparable damage will occur if the continued violation is not restrained or enjoined. On the written request of the Board, or on its own motion, the Board may commence an action in the superior court. SB 479 (Bates) Page 22 of ? 63)Requires the Board to report each month to the Controller the amount and source of all revenue received pursuant to this bill and at the same time deposit the entire amount thereof in the State Treasury for credit to the Psychology Fund. 64)Requires that the money credited to the Psychology Fund be used for the purposes of carrying out and enforcing the provisions of this bill. 65)Requires the Board to keep records that will reasonably ensure that funds expended in the administration of each licensing category bear a reasonable relation to the revenue derived from each category, and notify the department no later than May 31 of each year. 66)Requires the Board to assess fees for the application for and the issuance and renewal of licenses to cover, but not exceed, administrative and operating expenses of the Board related to this chapter. The fees shall be fixed by the board in regulations that are duly adopted under this bill. 67)Does not establish fee parameters for the following: a) Application for licensure. b) Law and ethics examination. c) Issuance of a license. d) Biennial renewal of a license. 68)Establishes the following fees: a) The delinquency fee shall be 50 percent of the biennial renewal fee. b) The fee for rescoring an examination shall be twenty dollars ($20). c) The fee for issuance of a replacement license shall be twenty dollars ($20). d) The fee to change a name or address on the Board's SB 479 (Bates) Page 23 of ? records shall be twenty dollars ($20). e) The fee for issuance of a certificate or letter of good standing shall be twenty-five dollars ($25). 69)Exempts the following licensees from payment of renewal fees in any one of the following instances: a) While engaged in full-time active service in the Army, Navy, Air Force, or Marines. b) While in the United States Public Health Service. c) While a volunteer in the Peace Corps or Vista. 70)Prohibits a person exempted from the payment of the renewal from engaging in any private practice. Requires that the licensee is liable for the fee for the current renewal period upon the completion of his or her period of full-time active service and shall have a period of 60 days after becoming liable within which to pay the fee before the delinquency fee becomes applicable. Any person who completes his or her period of full-time active service within 60 days of the end of a renewal period is exempt from the payment of the renewal fee for that period. 71)States that the time spent in that full-time active service or full-time training and active service shall not be included in the computation of the three-year period for renewal of an expired license. 72)States that the renewal fee exemption is not applicable if the person engages in any practice for compensation other than full-time service in the Army, Navy, Air Force or Marines or in the United States Public Health Service or the Peace Corps or Vista. 73)States that the licensing and regulatory program under this chapter shall be supported from fees assessed to applicants and licensees. Startup funds to implement this program shall be derived, as a loan, from the reserve fund of the Board of Psychology, subject to an appropriation by the Legislature in the annual Budget Act. The Board shall not implement this Act until funds have been appropriated. SB 479 (Bates) Page 24 of ? FISCAL EFFECT: Unknown. This bill has been keyed "fiscal" by Legislative Counsel. COMMENTS: 1.Purpose. The California Association for Behavior Analysis is the sponsor of this bill. According to the Author's office, "This bill seeks to require licensure by the Board of Psychology for persons engaging in the practice of behavior analysis. The bill establishes educational and certification requirements for licensure. "California law does not provide for licensing of behavior analysts. However, for purposes of health care service plan and health insurance coverage, both the Knox-Keene Act and the Insurance Code recognize behavior analysts that are certified by a national entity, such as the nationally accredited Behavior Analysis Certification Board (BACB), as qualified health care providers. "While existing law recognizes nationally certified behavior analysts, it does not provide for their licensure. As a result, the state has no authority to regulate the practice of behavior analysis. Without licensing, the state does not have the authority to protect consumers from unqualified practitioners through direct regulation. In addition, because current law recognizes behavior analysts as health care providers, health plans must credential these providers for the purpose of including them in provider networks. Licensing these providers would improve and ease the credentialing process, and make that process consistent with credentialing of other health care providers." 2.Behavior Analysts. Behavior analysts focus on behaviors that can be readily observed and measured. As researchers, they conduct studies that measure specific influences, such as the environment on behavior, or look for new ways to solve behavior problems in specific audiences. Representative clients include individuals with autism and other developmental and intellectual disabilities, learning and SB 479 (Bates) Page 25 of ? communication difficulties, behavior disorders, brain injuries, physical disabilities, difficulties associated with aging, and typically developing individuals. Behavior analysts often work for government agencies, community centers, schools and hospitals where they help in the treatment of various mental health issues, particularly autism, brain injuries and developmental disabilities. They may assist individuals in identifying their needs and formulating treatment plans to manage problematic behaviors. Behavior analysts also monitor the progress of the individuals under their care and collaborate with family members or other care providers to determine how to best address long-term individual goals. The Author's office reports that there are 2,198 practitioners in California currently certified by the BACB. 3.Board of Psychology and the Behavior Analyst Certification Board (BACB). BA and ABA licensees will be regulated by the Board in conjunction with a certifying body, which for present purposes is the BACB (there is currently no other national certifying body). This bill requires the BACB to be responsible for many responsibilities that would otherwise be handled by a state regulatory body --this bill requires a potential licensee to take curriculum approved by the BACB, complete supervised experience approved by the BACB, adhere to disciplinary and ethical standards established by the BACB, and maintain an active status with the BACB, in addition to licensure by the Board. BACB is a nonprofit 501(c)(3) corporation established in 1998 and states that it adheres to international standards for boards that grant professional credentials. BACB reports that its certification procedures and content undergo regular psychometric review and validation pursuant to a job analysis survey of the profession and standards established by content experts in the field. The BACB has approved course sequences at over 240 universities. 4.Need for Regulation. According to the Author's office, there is significant research demonstrating that "early, intensive behavior analysis treatment can produce moderate to large improvements in the overall functioning of many young children SB 479 (Bates) Page 26 of ? with autism when that treatment is designed and supervised by qualified professional BAs." BACB certifications are currently recognized as qualifications for practicing behavior analysis in the California Department of Developmental Services regulations and in state special education law. At present, however, there are no laws clearly requiring that individuals document and demonstrate training and competence as an ABA in order to practice in this state. As of 2014, 17 other states have adopted licensing, certification, or registration requirements for practitioners of behavior analysis. a) Autism Advisory Task Force. SB 946 (Chapter 650, Statutes 2011) required the California Department of Managed Health Care (DMHC) to convene an Autism Advisory Task Force (Task Force) to develop recommendations regarding the education, training, and experience requirements that unlicensed individuals providing behavioral health treatment (BHT) must meet in order to obtain licensure from the state. The Task Force concluded that all top level BHT providers should be licensed by the state, and set forth recommendations for establishing a new professional license which are largely consistent with this bill. The task force also stated that any new license should be "intended to expand, not supplant, the existing professional licenses discussed in the report." The Task Force references the following current licensees who may design, supervise, or provide treatment for autism, provided the services are within the experience and competence of the licensee: physician and surgeon, physical therapist, occupational therapist, psychologist, marriage and family therapist, educational psychologist, clinical social worker, professional clinical counselor, speech language pathologist, or audiologist. b) Association of State and Provincial Psychology Boards. The Association of State and Provincial Psychology Boards' adopted position statements stating their assertion that behavior analysis services should be state regulated in order to ensure consumer protection and that such regulation should occur under the psychology boards with a defined scope of practice and title separate from that of SB 479 (Bates) Page 27 of ? psychologists. 5.Intersection with Other Current Licensees. This bill does not include a grandfather clause that would allow current practitioners to be fully licensed without meeting the bill's requirements. Because the bill also does not make the practice of behavioral analysis unlawful without a license until 2018, this provides some opportunity for individuals to acquire any necessary additional experience and/or education. This bill exempts the following licensees from the BA and ABA licensure requirements: a) Licensed psychologist. b) Occupational therapist. c) Physical therapist. d) Marriage and family therapist (MFT). e) Educational psychologist. There is potentially significant practice overlap with other professions not specified in this bill, however. The Author may wish to consider adding the professions referenced in the Task Force, as well, and clarifying any potential scope incursions. 6.Previous Legislation. AB 1205 (Berryhill) of 2011 would have created licensure for behavior analysts by the Board of Behavioral Sciences. ( Status . This bill was held in the Assembly Appropriations Committee.) SB 946 (Steinberg, Chapter 650, Statutes of 2011) requires health care service plans and health insurers to provide coverage for behavioral health treatment for pervasive developmental disorder and autism (PDD/A) from July 1, 2012, SB 479 (Bates) Page 28 of ? through July 1, 2014, or earlier, as specified. 7.Arguments in Support. The sponsor of this bill, California Association for Behavior Analysis writes in support, "SB 479's licensure requirement would provide both the state of California and its residents additional consumer protections and recourse when there are concerns with the services provided by behavior analysts and assistant behavior analysts. At the same time, the bill would not preclude other licensed professionals from providing behavior analysis services, if such services are within their scope of practice." Southern California Consortium for Behavior Analysis adds that "ABA services have traditionally been provided by BCBAs [Board Certified Behavior Analysts], however, many health plans including Medi-Cal require contracted providers of ABA to be licensed. Therefore, licensure for behavior analysts would allow for providers to more easily contract with health plans and provide medically necessary services for a vulnerable population." The Center for Learning and Autism Support Services, Inc. writes in support of this measure in part because "there are far too many licensed professionals in the State of California who are practicing in this realm who lack the necessary qualifications to provide appropriate services to individuals on the autism spectrum." The Center for Autism and Related Disorders writes in "support if amended," stating the following concerns: a) Board Membership - The stated goal of the Board is to represent as widely as possible, the varied professional interests of psychologists and behavior analysts in California. However, the make-up of the board includes five psychologists, one psychologist who is also a certified behavior analyst, one behavior analyst, and two members of the public. Unfortunately, very few people in the state are both a licensed psychologist and certified behavior analyst. Requiring one board member to be both significantly limits the pool of candidates. It would be more appropriate to delete that position and require two certified behavior analysts. SB 479 (Bates) Page 29 of ? b) Certifying Entity - SB 479 defines a certifying entity as a "Behavior Analyst Certification Board or its successor, or a national organization with a behavior analyst certification program approved by the Board and accredited by the National Commission for Certifying Agencies." While the BACB is currently the only certifying board, this definition leaves room for future options if another entity meets the standards. However, in several areas the language of bill doesn't refer to the "certifying entity" but instead ties the certification directly to the BACB and uses terminology specific to the BACB. This language should be deleted and replaced with the language used in the definition of a certifying entity. c) Ethics and Standards -SB 479 requires applicants to be in compliance with all ethical and disciplinary standards published by the certifying entity. CARD has concerns with linking state licensure to an outside entity's disciplinary standards which often involve issues that don't affect treatment integrity and are proprietary concerns (such as logo use). We understand and support the need to include ethics and disciplinary standards and hope to work with your office to establish these requirements. The California Psychological Association expresses "concern," and requests amendments relating to collaboration, exemption from licensure and supervision, dual licensure, and Board requirements. 8.Arguments in Opposition. The California Speech-Language-Hearing Association opposes this bill unless amendments are taken to clarify that "a license to practice applied behavioral analysis is not a license to practice speech-language pathology, and vice versa" and to affirm that this bill "would neither limit nor infringe on the practice of any other profession, nor would it prohibit them from practicing ABA as long as it is within their scope of practice and the bounds of their competence and training." SUPPORT AND OPPOSITION: Support: SB 479 (Bates) Page 30 of ? California Association for Behavior Analysis (Sponsor) Behavior Frontiers California Association of Private Special Education Schools Center for Learning and Autism Support Services, Inc. Clinic 4 Kidz Southern California Consortium for Behavior Analysis Southwest California Legislative Council Numerous individuals Support if Amended: Center for Autism and Related Disorders Concerns : California Psychological Association Opposition: California Speech-Language-Hearing Association -- END --