BILL ANALYSIS                                                                                                                                                                                                    Ó






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          |SENATE RULES COMMITTEE            |                        SB 479|
          |Office of Senate Floor Analyses   |                              |
          |(916) 651-1520    Fax: (916)      |                              |
          |327-4478                          |                              |
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                                   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)









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          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:








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               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  







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                 "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  







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          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:







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           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."








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          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


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