BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | SB 479| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: SB 479 Author: Bates (R) Amended: 6/2/15 Vote: 21 SENATE BUS, PROF. & ECON. DEV. COMMITTEE: 8-0, 4/27/15 AYES: Hill, Bates, Block, Galgiani, Hernandez, Jackson, Mendoza, Wieckowski NO VOTE RECORDED: Berryhill SENATE APPROPRIATIONS COMMITTEE: 7-0, 5/28/15 AYES: Lara, Bates, Beall, Hill, Leyva, Mendoza, Nielsen SUBJECT: Healing arts: behavior analysis: licensing SOURCE: California Association for Behavior Analysis DIGEST: This bill establishes the Behavior Analyst Act, to be administered and enforced by an expanded Board of Psychology (Board), with recommendations from the Behavior Analyst Committee ("Committee"). ANALYSIS: Existing law: 1)Establishes the Board to enforce and administer the Psychology Licensing Law. (Business and Professions Code (BPC) §§ 2901 and 2920) SB 479 Page 2 2)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)) 3)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. 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)) This bill: 1) Requires the Board to enforce the provisions of this bill. 2) Increases the size of the Board from nine to 11, consisting of six professional members and five public members. 3) Establishes the Behavior Analyst Act. 4) Defines the following terms: SB 479 Page 3 a) "Certifying entity" as the Behavior Analyst Certification Board, Inc. (BACB) or its successor, or another national credentialing organization with behavior analyst certification programs 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. 5) States that protection of the public shall be the highest priority for the Board in exercising its licensing, regulatory, and disciplinary functions pursuant to this bill. 6) Establishes the Committee to make recommendations to the Board regarding the regulation of the practice of behavior analysis. 7) 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 standards. 8) Establishes the requirements for behavior analysts (BA) and assistant behavior analyst (ABA) licensure until July 1, 2018, and establishes further qualifications for licensure after that date, which includes supervised experiential training. 9) Makes it unlawful on and after July 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 SB 479 Page 4 "licensed BA," or "licensed ABA" without being duly licensed according to the provisions of this bill. 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. 10) Specifies that this bill does not apply to a psychologist, a speech-language pathologist or an audiologist, an occupational therapist, a physical therapist, a marriage and family therapist, or an educational psychologist, a clinical social worker, or a professional clinical counselor if the behavior analysis engaged in by those licensees is 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. 11) 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. 12) 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. 13) 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, subject to an appropriation by the Legislature in the annual Budget Act. The Board shall not implement this Act until funds have been appropriated. Background 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 SB 479 Page 5 problems in specific audiences. Representative clients include individuals with autism and other developmental and intellectual disabilities, learning and communication difficulties, behavior disorders, brain injuries, physical disabilities, difficulties associated with aging, and typically developing individuals. The Author's office reports that there are 2,198 practitioners in California currently certified by the BACB. Board of Psychology and the Behavior Analyst Certification Board (BACB). BA and ABA licensees will be regulated by the Board in conjunction with a national certifying body, which for present purposes is the BACB (there is currently no other national certifying body). BACB is a nonprofit 501(c)(3) corporation established in 1998 and reports that its certification procedures and content undergo regular psychometric review and validation. The BACB has approved course sequences at over 240 universities. 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 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. State licensure for individuals providing behavioral health treatment is supported by the California Department of Managed Health Care's Autism Advisory Task Force, and the Association of State and Provincial Psychology Boards. FISCAL EFFECT: Appropriation: No Fiscal Com.:YesLocal: Yes According to the Senate Appropriations Committee: SB 479 Page 6 One-time costs of about $1.7 million and ongoing costs of about $1 million per year to license and regulate behavior analysts and assistant behavior analysts (Psychology Fund). Those costs would ultimately be offset by licensing fees. No significant increase in costs to provide applied behavior analysis services under the Medi-Cal program or through the Department of Developmental Services are anticipated. SUPPORT: (Verified6/2/15) California Association for Behavior Analysis 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 OPPOSITION: (Verified6/2/15) California Speech-Language-Hearing Association ARGUMENTS IN SUPPORT: The source of this bill, California Association for Behavior Analysis, states that "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." SB 479 Page 7 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." Prepared by:Sarah Huchel / B., P. & E.D. / (916) 651-4104 6/2/15 15:37:38 **** END ****