BILL ANALYSIS Ó
SB 479
Page 1
Date of Hearing: July 7, 2015
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Susan Bonilla, Chair
SB 479(Bates) - As Amended June 30, 2015
SENATE VOTE: 40-0
SUBJECT: Healing arts: behavior analysis: licensing
SUMMARY: Establishes the Behavior Analyst Act, which provides
for the licensure, registration, and regulation of behavior
analysts and assistant behavior analysts, and requires the
California Board of Psychology (BOP), until January 1, 2021, to
administer and enforce the act.
EXISTING LAW:
1)Provides for the licensure, registration, and regulation of
psychologists and psychological assistants under the
Psychology Licensing Law. (Business and Professions Code
(BPC) §§ 2900-2999)
2)Establishes the BOP, which consists of nine members, five
professional and four public, requires the BOP to enforce and
administer the Psychology Licensing Law, repeals those
sections by January 1, 2017, and subjects the BOP to review by
the appropriate policy committees of the Legislature. (BPC §§
2902, 2920)
SB 479
Page 2
3)Requires the professional board members to be a licensed
psychologist, prohibits the public members from being
licensees under any healing arts board, and requires each
member be a resident of the state. (BPC § 2923)
4)Requires the BOP to disclose information on the status of
every license issued its licensees, including psychologists,
psychological assistants, and registered psychologists. (BPC
§ 27)
5)Requires every private health care service plan contract that
provides hospital, medical, or surgical coverage and every
private health insurance policy to provide coverage for
behavioral health treatment for pervasive developmental
disorder or autism, including applied behavior analysis (ABA).
(Health and Safety Code (HSC) § 1374.73, Insurance Code (IC)
§ 10144.51)
THIS BILL:
6)Increases, on and after July 1, 2017, the number of members on
the BOP to 11, and increases the number of members for a
quorum to six members. The members must meet the following
requirements:
a) Be a resident of the state;
b) Five members must be licensed psychologists;
c) One member must be qualified to practice behavior
analysis, as follows:
SB 479
Page 3
i) For the first appointment after the operative date
of the section, the member must hold a certificate as a
certified behavior analyst from a certifying entity, as
defined.
ii)For subsequent appointments, the member must be licensed
as a behavior analyst under the Act.
iii)The public members must not be licensees of any healing
arts board.
7)Establishes general provisions of the Behavior Analyst Act
(Act):
a) States that the Legislature finds and declares that the
practice of behavior analysis in California affects the
public health, safety, and welfare, and is subject to
regulation to protect the public from the unauthorized and
unqualified practice of behavior analysis, and
unprofessional, unethical, or harmful conduct by persons
licensed to practice behavior analysis.
b) States that it is also the intent of the Legislature
that the BOP begin accepting applications for behavior
analyst licensure and assistant behavior analyst licensure
no later than January 1, 2018, provided that the funds
necessary to implement this chapter have been appropriated
by the Legislature.
c) Defines "board" as the BOP.
d) Defines "certifying entity" as the Behavior Analyst
Certification Board (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 (NCCA).
SB 479
Page 4
e) Defines "committee" as the Behavior Analyst Committee.
f) Defines "department" as the Department of Consumer
Affairs (DCA).
g) Defines "licensed assistant behavior analyst" (LABA) as
a person licensed under the Act to practice behavior
analysis under the supervision of a licensed behavior
analyst.
h) Defines "licensed behavior analyst" (LBA) as a person
licensed under the Act to practice behavior analysis.
i) Defines "paraprofessional technician" as an individual
who works directly with a client to implement applied
behavior analysis services under the direction and
supervision of a LBA or a LABA and has successfully
completed the application requirements under the Act.
j) 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 and includes:
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; and
SB 479
Page 5
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.
aa)Provides that the practice of behavior analysis does not
include psychological testing and assessment, diagnosis of
a mental or physical disorder, neuropsychology,
psychotherapy, cognitive therapy, sex therapy,
psychoanalysis, hypnotherapy, counseling, prescribing
drugs, performing surgery, or administering
electroconvulsive therapy.
bb)States that the Legislature recognizes that the scopes of
practice of healing arts licensees regulated under this
division sometimes contain similar practices. However, the
Act shall not be construed to allow a LBA or a LABA to
engage in those practices other than specific to their
scope of practice within behavior analysis as described
under the Act. Any person practicing behavior analysis
under the Act who violates the prohibition is subject to
disciplinary action by both the BOP and the board
overseeing the relevant practice.
8)Establishes the administration provisions of the Act:
a) Vests the BOP, until January 1, 2021, with the power to
enforce the Act.
b) Provides that protection of the public shall be the
highest priority for the BOP in exercising its licensing,
regulatory, and disciplinary functions pursuant to the Act.
Whenever the protection of the public is inconsistent with
other interests sought to be promoted, the protection of
the public shall be paramount.
c) Requires the BOP to adopt, amend, and repeal regulations
to implement the requirements of the Act. All regulations
SB 479
Page 6
adopted by the BOP shall comply with the provisions of
Chapter 3.5 (commencing with Section 11340) of Part 1 of
Division 3 of Title 2 of the Government Code.
d) Requires the BOP to adopt a program of consumer and
professional education in matters relevant to the ethical
practice of behavior analysis. The BOP must establish as
its standards of ethical conduct relating to the practice
of behavior analysis, the "Professional and Ethical
Compliance Code for Behavior Analysts" published by the
Behavior Analyst Certification Board (BACB). The standards
must be applied by the BOP as the accepted standard of care
in all licensing examination development and in all board
enforcement policies and disciplinary case evaluations.
e) Authorizes the BOP to employ, subject to civil service
and other laws, employees as may be necessary to carry out
the provisions of this chapter under the direction of the
executive officer of the BOP.
f) Requires the BOP to post information in its website
regarding licensed behavior analysts and licensed assistant
behavior analysts, as specified.
g) Requires the BOP to conduct disciplinary hearings, as
specified.
h) Makes it unlawful, on and after July 1, 2018, to
practice behavior analysis without being licensed by the
BOP, except as specified.
i) Creates, until January 1, 2021, the Behavior Analyst
Committee within the jurisdiction of the BOP to make
SB 479
Page 7
recommendations to the BOP regarding the regulation of the
practice of behavior analysis in the state in order to
protect the public from the unauthorized and unqualified
practice of ABA, and unprofessional, unethical, or harmful
conduct by persons licensed to practice behavior analysis.
j) The committee must consist of five members. Two members
must LBAs, one of which must also be a member of the BOP.
One member must be a psychologist licensed under BPC
Chapter 6.6 (commencing with § 2900) and who holds a
current certification from a certifying entity as a
behavior analyst. One member must be a licensed assistant
behavior analyst. One member must be a public member who
is a consumer of behavior analysis services and who is not
licensed under a healing arts board.
aa)The Governor must appoint one LBA member, the licensed
psychologist member, and the LABA member. The Senate
Committee on Rules must appoint the public member, and the
Speaker of the Assembly must appoint one LBA member.
bb)The initially appointed members of the committee shall be
appointed as follows:
i) The initial members appointed by the Governor shall
be as follows:
(1)One member must be currently certified by a
certifying entity as a certified behavior analyst and
shall serve an initial term of one year.
(2)One member must be currently certified by a
certifying entity as a certified assistant behavior
analyst and shall serve an initial term of two years.
(3)One member must be a licensed psychologist who is
SB 479
Page 8
currently certified by a certifying entity as a
certified behavior analyst and shall serve an initial
term of three years.
ii)The initial member appointed by the Senate Committee on
Rules shall serve a term of four years.
iii)The initial member appointed by the Speaker of the
Assembly shall be currently certified by a certifying
entity as a certified behavior analyst and shall serve an
initial term of four years.
cc)Except as provided, each member of the committee will hold
office for a term of four years, and will serve until the
appointment of his or her successor or until one year has
elapsed since the expiration of the term for which the
member was appointed, whichever occurs first. Vacancies
must be filled by the appointing power for the unexpired
portion of the terms in which they occur. A member may not
serve for more than two consecutive terms.
dd)Provides that all committee member terms begin on July 1
and expire on June 30.
ee)Provides that each member of the committee will receive
per diem and expenses as provided in BPC §§ 103 and 113.
ff)States that three members of the committee shall at all
times constitute a quorum.
gg)Requires the committee to do all of the following:
i) Meet at least once per quarter. All meetings of the
committee shall be public meetings. Notice of each
regular meeting of the committee shall be given in
SB 479
Page 9
accordance with the Bagley-Keene Open Meeting Act
(Article 9 (commencing with § 11120) of Chapter 1 of Part
1 of Division 3 of Title 2 of the Government Code).
ii)Call committee meetings at any time upon reasonable
notice by a written request of two committee members to
the chair. Committee meetings may also be called upon
reasonable notice at the discretion of the chair.
iii)Elect a chair and a vice chair from among its members
at the first meeting held in each fiscal year. The chair
must preside at all meetings of the committee and must
work with the executive officer of the BOP to coordinate
the committee's business. If the chair is unable to
attend a meeting, the vice chair shall preside at the
meeting.
hh)Authorizes the committee may make recommendations to the
BOP regarding licensing and practice standards and the
adoption, amendment, and repeal of regulations to implement
the requirements of the Act including the setting of fees
and the establishment of disciplinary guidelines.
9)Establishes the licensing provisions of the Act:
a) Requires each applicant for a license must meet the
BOP's regulatory requirements, including all of the
following:
i) The applicant has not committed acts or crimes
constituting grounds for denial of licensure under BPC §
480.
ii)The BOP shall not issue a license or registration to any
person who has 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 pursuant to § 290 of the Penal Code or the
equivalent in another state or territory.
iii)The applicant has successfully passed a state and
SB 479
Page 10
federal level criminal offender record information search
conducted through the Department of Justice, as follows:
iv)The BOP shall request from the Department of Justice
subsequent arrest notification service, pursuant to §
11105.2 of the Penal Code, for each person who submitted
information pursuant to this subdivision.
v) The Department of Justice shall charge a fee
sufficient to cover the cost of processing the request
described in this section.
b) Requires, until July 1, 2018, in order to receive a
license as a behavior analyst, the following:
i) An individual must submit an application on a form
approved by the BOP accompanied by the fees required by
the BOP as specified in BPC § 2999.93.
ii)The BOP must verify with the certifying entity that the
applicant meets both of the following requirements:
(1)Has passed the Board Certified Behavior Analyst
examination or an equivalent examination administered
by the certifying entity.
(2)Maintains an active status as a certified behavior
analyst with the certifying entity.
iii)Each applicant must obtain a passing score on a
California law and ethics examination administered by the
BOP.
iv)This requirement will remain in effect until January 1,
2019, and as of that date is repealed.
c) Requires, after July 1, 2018, in order to obtain a
SB 479
Page 11
license as a behavior analyst:
i) An individual must submit an application on a form
approved by the BOP accompanied by the fees required by
the BOP as specified in BPC § 2999.93.
ii)An applicant must maintain active status as a certified
behavior analyst in good standing with a certifying
entity.
iii)The BOP must verify with the certifying entity that the
applicant has passed the Board Certified Behavior Analyst
Examination or an equivalent examination administered by
the certifying entity.
iv)Each applicant must obtain a passing score on a
California law and ethics examination administered by the
BOP.
v) The applicant must possess a master's degree or
higher level of education from an institution, which
meets the requirements described in BPC § 2999.35, that
was conferred in behavior analysis, psychology, or
education, or conferred in a degree program in which the
applicant completed a behavior-analytic course sequence
approved by the certifying entity.
vi)The applicant must meet one of the following three
requirements in order to be licensed under the Act:
(1)Complete both of the following degree requirements:
(a)Two hundred seventy hours of classroom
graduate-level instruction in all of the following
content areas:
(i)Ethical and professional conduct coursework
consisting of 45 hours. The content must be
SB 479
Page 12
taught in one or more freestanding courses
devoted to ethical and professional conduct of
behavior analysts.
(ii)Concepts and principles of behavior analysis
consisting of 45 hours.
(iii)Research methods in behavior analysis,
consisting of 25 hours of measurement, including
data analysis, and 20 hours of experimental
design.
(iv)ABA, consisting of 45 hours of fundamental
elements of behavior change and specific behavior
change procedures, 30 hours of identification of
the problem and assessment, 10 hours of
intervention and behavior change considerations,
10 hours of behavior change systems, and 10 hours
of implementation, management, and supervision.
(v)Elective coursework in behavior analysis
consisting of 30 hours.
(b)Supervised experiential training by any of the
following:
(i)One thousand five hundred hours of independent
field work in behavior analysis supervised in
accordance with the requirements of the
certifying entity.
(ii)One thousand hours of supervised practicum in
behavior analysis within a university practicum
approved by the certifying entity, taken for
graduate academic credit, and completed with a
passing grade.
SB 479
Page 13
(iii)Seven hundred fifty hours of supervised
intensive practicum in behavior analysis within a
university practicum approved by the certifying
entity, taken for graduate academic credit, and
completed with a passing grade.
(iv)A combination of the supervised experience in
clause (i), (ii), or (iii). Hours may be
completed in any combination of the categories of
supervised experience. Hours accrued through a
combination of supervised experience shall be
proportionately calculated.
(2)Meet all of the following teaching requirements:
(a)Have a faculty appointment of at least three years,
cumulatively, of full-time work as a faculty member
at a fully accredited higher education institution
within a five-year period.
(b)Taught at least five sections or iterations of
behavior analytic coursework. An applicant must
have taught at least two behavior analytic content
areas, which are concepts and principles of
behavior, single-subject research methods, applied
behavior analysis, and ethics in behavior analysis,
in separate courses. Each course taught shall have
been exclusively or primarily devoted to behavior
analytic content, and shall have been taught at the
graduate level. An applicant shall submit proof of
completion of the faculty appointment and teaching
requirements from a department head, including the
syllabus for each course taught, to the board.
(c)Published one article with all of the following
characteristics:
SB 479
Page 14
(i)Behavior analytic in nature.
(ii)Includes at least one experimental evaluation.
(iii)Published in a high-quality, peer reviewed
journal.
(iv)The applicant is the first, second, or
corresponding author.
(v)The article may have been published at any time
during the applicant's career.
(d)Obtained supervised experiential training by any of
the following:
(i)One thousand five hundred hours of independent
field work in behavior analysis supervised in
accordance with the requirements of the
certifying entity.
(ii)One thousand hours of supervised practicum in
behavior analysis within a university practicum
approved by the certifying entity, taken for
graduate academic credit, and completed with a
passing grade.
(iii)Seven hundred fifty hours of supervised
intensive practicum in behavior analysis within a
university practicum approved by the certifying
entity, taken for graduate credit, and completed
with a passing grade.
(iv)A combination of the supervised experience in
clause (i), (ii), or (iii). Hours may be
completed in any combination of the categories of
SB 479
Page 15
supervised experience. Hours accrued through a
combination of supervised experience shall be
proportionately calculated.
(3)Completed all of the following doctoral requirements:
(a)A doctoral degree in behavior analysis, psychology,
or education from an accredited higher education
institution.
(b)Ten years of postdoctoral experience practicing
behavior analysis. The duration of practice shall be
at least 10 years, cumulatively, of full-time
practice. An applicant's practice shall have
occurred under a relevant state professional
credential or license.
(c) At least 500 hours of supplemental supervised
experiential training that meets current experience
standards of the certifying entity, commencing after
the 10 years of postdoctoral experience required
above.
d) Requires, until July 1, 2018, to obtain a license as an
assistant behavior analyst:
i) An individual must submit an application on a form
approved by the BOP accompanied by the fees required by
the BOP as specified in BPC § 2999.93.
ii)The BOP must verify with the certifying entity that the
applicant meets all of the following requirements:
(1)Has passed the Board Certified Assistant Behavior
Analyst examination or equivalent examination
administered by the certifying entity.
(2) Maintains an active status as a certified assistant
behavior analyst with the certifying entity.
SB 479
Page 16
iii) Each applicant must obtain a passing score on a
California law and ethics examination administered by the
BOP.
iv)Each applicant must provide proof to the BOP of ongoing
supervision by a LBA in a manner consistent with the
certifying entity's requirements for supervision of
assistant behavior analysts.
v) This requirement will remain in effect only until
January 1, 2019, and as of that date is repealed.
e) Requires, after July 1, 2018, in order for an individual
to be licensed as an assistant behavior analyst:
i) The applicant must possess a baccalaureate degree or
higher level of education from an institution that meets
the requirements described in BPC § 2999.35.
ii)The applicant must maintain active status as a certified
behavior analyst in good standing with a certifying
entity. The BOP must verify with the certifying entity
that the applicant has passed the Board Certified
Behavior Analyst Examination or an equivalent examination
administered by the certifying entity.
iii)The applicant must obtain a passing score on a
California law and ethics examination administered by the
BOP.
iv)The applicant shall provide proof to the BOP of ongoing
supervision by a LBA in a manner consistent with the
certifying entity's requirements for supervision of
assistant behavior analysts.
v) The applicant must meet all of the following
SB 479
Page 17
requirements:
(1)Completed a baccalaureate degree or higher level of
education from an institution that meets the
requirements in Section 2999.35.
(2)An applicant shall meet both of the following:
(a)Completed 180 classroom hours of undergraduate or
graduate level instruction in all of the following
content areas:
(i)Ethical and professional conduct coursework of
behavior analysis consisting of 15 hours.
(ii)Concepts and principles of behavior analysis
consisting of 45 hours.
(iii)Research methods in behavior analysis,
consisting of 10 hours of measurement, including
data analysis, and five hours of experimental
design.
(iv)ABA, consisting of 45 hours of fundamental
elements of behavior change and specific behavior
change procedures, 30 hours of identification of
the problem and assessment, five hours of
intervention and behavior change considerations,
five hours of behavior change systems, and five
hours of implementation, management, and
supervision.
(v)Elective coursework in behavior analysis
consisting of 15 hours.
(b)Obtained supervised experiential training by any of
SB 479
Page 18
the following:
(i)One thousand hours of independent field work in
behavior analysis supervised in accordance with
the requirements of the certifying entity, taken
for academic credit, and completed with a passing
grade.
(ii)Six hundred seventy hours of supervised
practicum in behavior analysis within a
university practicum approved by the certifying
entity, taken for academic credit, and completed
with a passing grade.
(iii)Five hundred hours of supervised intensive
practicum in behavior analysis within a
university practicum approved by the certifying
entity, taken for academic credit, and completed
with a passing grade.
(iv)A combination of the supervised experience in
clause (i), (ii), or (iii). Hours may be
completed in any combination of the categories of
supervised experience. Hours accrued through a
combination of supervised experience shall be
proportionately calculated.
f) Provides that the education to obtain a behavior analyst
license or an assistant behavior analyst license be from
any of the following:
i) A United States institution of higher education
listed by the Council for Higher Education Accreditation.
ii)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.
iii)An applicant for licensure trained in an educational
SB 479
Page 19
institution outside the United States or Canada shall
demonstrate to the satisfaction of the BOP that the
applicant possesses a degree in a relevant subject that
is equivalent to a degree earned from a regionally
accredited university in the United States or Canada. The
applicant must provide to the BOP a comprehensive
evaluation of the degree performed by a foreign
credential service that is a member of the National
Association of Credential Evaluation Services (NACES),
and any other documentation that the BOP deems necessary.
g) Requires paraprofessional technicians practicing in this
state under the supervision of an individual licensed under
the Act to satisfy all of the following requirements:
i) Be at least eighteen years of age and possess a
minimum of a high school diploma or its equivalent.
ii)Submit an application on a form approved by the BOP.
iii)Submit fingerprint images to the California Department
of Justice for a state and federal criminal background
report within fourteen days from the date of application.
iv)Annually pay an application fee, in an amount not to
exceed a reasonable regulatory cost, to be determined by
the board.
v) The BOP may deny or revoke an application if it is
determined to be in the best interest of public safety
and welfare, as described in § 2999.21.
h) Makes it unlawful, on and after July 1, 2018, for any
person to engage in any of the following acts:
i) Engage in the practice of behavior analysis, as
defined, without first having complied with the
SB 479
Page 20
provisions of this chapter and without holding a current,
valid, and active license as required by the Act.
ii)Use the title "licensed behavior analyst," or "licensed
assistant behavior analyst" without being duly licensed
according to the Act.
iii)Use any title, words, letters, or abbreviations that
may reasonably be confused with a designation provided by
the Act to denote a standard of professional or
occupational competence without being duly licensed.
iv)Materially refuse to furnish the BOP information or
records required or requested pursuant to the Act.
i) Excludes the following from the licensure requirements:
i) An individual licensed to practice psychology in
this state under BPC Chapter 6.6 (commencing with Section
2900), if the practice of behavior analysis engaged in by
the licensed psychologist is within the licensed
psychologist's training and competence.
ii)A speech-language pathologist or an audiologist licensed
under Chapter 5.3 (commencing with Section 2530), an
occupational therapist licensed under Chapter 5.6
(commencing with Section 2570), a physical therapist
licensed under Chapter 5.7 (commencing with Section
2600), a marriage and family therapist licensed under
Chapter 13 (commencing with Section 4980), an educational
psychologist licensed under Chapter 13.5 (commencing with
Section 4989.10), a clinical social worker licensed under
Chapter 14 (commencing with Section 4991), or a
professional clinical counselor licensed under Chapter 16
(commencing with Section 4999.10), if the services
provided by any of those licensees are 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 behavior
SB 479
Page 21
analyst or licensed assistant behavior analyst.
iii)A student or other individual pursuing supervised
experiential training toward a license described in the
Act, provided such training is conducted in accordance
with the requirements of the Act.
iv)A student, or post-graduate individual, pursuing
supervised experience in behavior analysis toward a
license. The experience must be gained in accordance
with the experience and supervision requirements of the
respective healing arts licensure act for the license.
v) A parent or guardian of a recipient of behavior
analysis services who acts under the extended authority
and direction of a licensed behavior analyst or licensed
assistant behavior analyst.
vi)A matriculated college or university student who
practices behavior analysis as a part of a defined
program of study, course, practicum, internship, or
postdoctoral trainee, provided that the behavior analysis
activities are directly supervised by a licensed behavior
analyst, a licensed psychologist, or by an instructor in
a course sequence approved by the certifying entity.
vii)An individual who teaches behavior analysis or conducts
behavior analytic research, provided that the teaching or
research does not involve the direct delivery of behavior
analysis services.
viii)A behavior analyst 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
SB 479
Page 22
more than 90 days in a calendar year.
ix)An individual who is vendorized by one or more regional
centers of the State Department of Developmental Services
while practicing behavior analysis services authorized
under that vendorization. The individual may not
represent himself or herself as a LBA or LABA unless he
or she holds a license under this chapter, and shall not
offer behavior analysis services to any person or entity
other than the regional centers with which he or she is
vendorized or accept remuneration for providing behavior
analysis services other than the remuneration received
from those regional centers unless he or she holds a
license under this chapter.
x) An individual employed by a local educational agency
for the purpose of assisting students with behavioral and
developmental issues when in classroom and other school
settings.
j) Requires a licensee to give written notice to the BOP 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, must be submitted with the notice.
aa)Establishes the following regarding license renewals:
i) A license will expire and become invalid two years
after it is issued at 12 midnight on the last day of the
month in which it was issued, if not renewed.
ii)To renew an unexpired license, the licensee must, on or
before the date on which it would otherwise expire, apply
for renewal on a form provided by the BOP, accompanied by
the renewal fee set by the BOP. The licensee must
include verification from the certifying entity that he
or she maintains an active certification status with the
renewal form.
SB 479
Page 23
iii)To renew an assistant behavior analyst license, in
addition to the above requirements, the licensee must
submit proof of ongoing supervision by a LBA or a
licensed psychologist who is qualified to practice
behavior analysis in a manner consistent with the CBA's
requirements for supervision of assistant behavior
analysts. A LABA must be supervised by a LBA for at
least 2 percent of the hours of behavior analysis
services the LABA provides per month.
iv)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 BOP, payment of all
accrued and unpaid renewal fees, and the delinquency fee
specified in BPC § 2999.93. The licensee must include
verification from the certifying entity that the licensee
maintains an active certification status with the renewal
form.
v) Except as provided in BPC § 2999.46.5, 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.
vi)A suspended license is subject to expiration and must be
renewed as provided, but the 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.
vii)A license revoked on disciplinary grounds is subject to
expiration as provided, but it may not be renewed. If it
is reinstated after its expiration, the licensee, as a
SB 479
Page 24
condition of reinstatement, must 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.
bb)Establishes the following regarding continuing education
(CE):
i) The BOP may not issue any renewal license, a new
license after expiration of an expired license, or a
reinstatement license unless the applicant submits proof
that the applicant has completed not less than 32 hours
of approved CE in the preceding two-year licensure cycle
for LBAs and 20 hours of approved CE in the preceding
two-year licensure cycle for LABAs.
ii)Each person renewing or reinstating his or her license
or obtaining a new license after expiration of a prior
license issued pursuant to the act must submit proof of
compliance with the CE requirements to the BOP.
iii)A person applying for renewal, a new license after
expiration of a prior license, or reinstatement to an
active license status must certify under penalty of
perjury that the person is in compliance with the CE
requirements.
iv)The BOP may recognize CE courses that have been approved
by one or more private nonprofit organizations that have
at least 10 years' experience managing continuing
education programs for behavior analysts.
v) The BOP may adopt regulations as necessary for
implementation of this requirement.
10) Establishes the enforcement
SB 479
Page 25
provisions of the Act:
a) Provides that the BOP may on its own, and shall, upon
the receipt of a complaint from any person, investigate the
actions of any licensee. The BOP must 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.
b) Provides that a license issued under the Act 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.
c) Authorizes the BOP to deny a license application, issue
a license with terms and conditions, suspend or revoke a
license, or place a license on probation if the applicant
or licensee has been guilty of unprofessional conduct.
d) Defines unprofessional conduct to include:
i) Conviction of a crime substantially related to the
qualifications, functions, or duties of a LBA or a LABA.
ii)Use of any controlled substance as defined in Division
10 (commencing with Section 11000) of the Health and
Safety Code, 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.
iii)Fraudulently or neglectfully misrepresenting the type
or status of a license actually held.
SB 479
Page 26
iv)Impersonating another person holding a license or
allowing another person to use his or her license.
v) Use of fraud or deception in applying for a license
or in passing any examination required by this chapter.
vi)Paying, offering to pay, accepting, or soliciting any
consideration, compensation, or remuneration, whether
monetary or otherwise, for the referral of clients.
vii)Violating Section 17500.
viii)Willful, unauthorized communication of information
received in professional confidence.
ix)Violating any rule of professional conduct promulgated
by the board and set forth in regulations duly adopted
under this chapter.
x) Being grossly negligent in the practice of his or
her profession.
xi)Violating any of the provisions of the Act or
regulations adopted by the BOP.
xii)The aiding or abetting of any person to engage in the
unlawful practice of behavior analysis.
xiii)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
SB 479
Page 27
that state or country to a person also holding a license
issued under the Act if the act for which the
disciplinary action was taken constitutes unprofessional
conduct. A certified copy of the decision or judgment of
the other state or country must be conclusive evidence
of that action.
xiv)The commission of any dishonest, corrupt, or fraudulent
act.
xv)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
related to the qualifications, functions, or duties of a
LBA or a LABA.
xvi)Functioning outside of his or her particular field or
fields of competence as established by his or her
education, training, and experience.
xvii)Willful failure to submit, on behalf of an applicant
for licensure, verification of supervised experience to
the board.
xviii) Repeated acts of negligence.
xix)Failure to comply with all ethical and disciplinary
standards published by the certifying entity.
e) Establishes the following enforcement procedures:
i) Defines "health care facility," for purposes of the
enforcement rules, as a clinic or health facility
licensed or exempt from licensure pursuant to Division 2
(commencing with § 1200) of the Health and Safety Code.
ii)Any accusation filed against a licensee pursuant to §
11503 of the Government Code shall be filed within three
years from the date the BOP discovers the alleged act or
omission that is the basis for disciplinary action, or
within seven years from the date the alleged act or
omission that is the basis for disciplinary action
occurred, whichever occurs first.
iii)An accusation filed against a licensee pursuant to §
SB 479
Page 28
11503 of the Government Code alleging the procurement of
a license by fraud or misrepresentation is not subject to
the limitations above.
iv)The limitation provided for will 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 BOP pursuant to BPC Article 11 (commencing with
§ 800) of Chapter 1 is not filed in a timely fashion.
v) If an alleged act or omission involves a minor, the
seven-year limitations period and the 10-year limitations
period will be tolled until the minor reaches the age of
majority.
vi)An accusation filed against a licensee pursuant to §
11503 of the Government Code alleging sexual misconduct
shall be filed within three years after the BOP 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.
vii)The limitations period provided above will be tolled
during any period if material evidence necessary for
prosecuting or determining whether a disciplinary action
would be appropriate is unavailable to the BOP due to an
ongoing criminal investigation.
viii)Any proposed decision or decisions issued under the
Act in accordance with the procedures set forth in
Chapter 5 (commencing with § 11500) of Part 1 of Division
3 of Title 2 of the Government Code that contains any
finding of fact that the licensee engaged in any act of
SB 479
Page 29
sexual contact, as defined in BPC § 728, when that act is
with a patient, or with a former patient, within two
years following termination of services, shall contain an
order of revocation. The revocation shall not be stayed
by the administrative law judge.
f) Authorizes the BOP 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 provided in BPC § 2999.
g) Provides 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 LBA or LABA is
deemed to be a conviction. The BOP may order the license
suspended or revoked, or may decline to issue a license
when the time for appeal has elapsed, the judgment of
conviction has been affirmed on appeal, or when an order
granting probation is made suspending the imposition of
sentence, irrespective of a subsequent order under § 1203.4
of the Penal Code allowing the person to withdraw his or
her plea of guilty and to enter a plea of not guilty, or
setting aside the verdict of guilty, or dismissing the
accusation, information, or indictment.
h) Provides that any person required to register as a sex
offender pursuant to § 290 of the Penal Code, is not
eligible for licensure by the BOP.
i) Defines 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.
j) Requires that the proceedings under the Act must be
conducted by the BOP in accordance with Chapter 5
SB 479
Page 30
(commencing with § 11500) of Part 1 of Division 3 of Title
2 of the Government Code.
aa)Provides that a person who violates any of the provisions
of this chapter 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.
bb)Provides that whenever any person has engaged, or is about
to engage, in any acts or practices that constitute, or
will constitute, an offense under the Act, 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 BOP, the Attorney General, or
the district attorney of the county. The proceedings will
be governed by Chapter 3 (commencing with § 525) of Title 7
of Part 2 of the Code of Civil Procedure, except that it
will be presumed 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 BOP, or on its own motion, the BOP may
commence an action in the superior court.
cc)Provides that a licensee who fails or refuses to comply
with a request for the medical records of a client, that is
accompanied by that client's written authorization for
release of those records to the BOP, within 15 days of
receiving the request and authorization, must pay to the
board a civil penalty of one thousand dollars ($1,000) per
day for each day that the documents have not been produced
after the 15th day, unless the licensee is unable to
provide the documents within this time period for good
cause.
SB 479
Page 31
dd)Requires a health care facility to comply with a request
for the medical records of a client that is accompanied by
that client's written authorization for release of records
to the board together with a notice citing this section and
describing the penalties for failure to comply with this
section. Failure to provide the authorizing client's
medical records to the CBA within 30 days of receiving the
request, authorization, and notice will subject the health
care facility to a civil penalty, payable to the BOP, of up
to one thousand dollars ($1,000) per day for each day that
the documents have not been produced after the 30th day, up
to ten thousand dollars ($10,000), unless the health care
facility is unable to provide the documents within this
time period for good cause. This paragraph does not
require health care facilities to assist the BOP in
obtaining the client's authorization. The BOP shall pay
the reasonable costs of copying the medical records.
ee)A licensee who fails or refuses to comply with a court
order, issued in the enforcement of a subpoena, mandating
the release of records to the BOP shall:
i) Pay to the BOP a civil penalty of one thousand
dollars ($1,000) per day for each day that the documents
have not been produced after the date by which the court
order requires the documents to be produced, unless it is
determined that the order is unlawful or invalid. Any
statute of limitations applicable to the filing of an
accusation by the board shall be tolled during the period
the licensee is out of compliance with the court order
and during any related appeals; and,
ii)Be subject to a civil penalty, payable to the CBB, of
not to exceed five thousand dollars ($5,000). The amount
of the penalty shall be added to the licensee's renewal
fee if it is not paid by the next succeeding renewal
date. Any statute of limitations applicable to the
SB 479
Page 32
filing of an accusation by the board shall be tolled
during the period the licensee is out of compliance with
the court order and during any related appeals.
iii)Shall be a misdemeanor, if there are multiple
violations, punishable by a fine not to exceed five
thousand dollars ($5,000) or by imprisonment in a county
jail not exceeding six months, or by both that fine and
imprisonment.
ff)A health care facility that fails or refuses to comply
with a court order, issued in the enforcement of a
subpoena, mandating the release of client records to the
BOP:
i) Shall pay to the BOP, if accompanied by a notice
citing this requirement and describing the penalties for
failure to comply with this section, a civil penalty of
up to one thousand dollars ($1,000) per day for each day
that the documents have not been produced, up to ten
thousand dollars ($10,000), after the date by which the
court order requires the documents to be produced, unless
it is determined that the order is unlawful or invalid.
Any statute of limitations applicable to the filing of an
accusation by the BOP against a licensee shall be tolled
during the period the health care facility is out of
compliance with the court order and during any related
appeals.
ii)Be subject to a civil penalty, payable to the board, of
not to exceed five thousand dollars ($5,000). Any
statute of limitations applicable to the filing of an
accusation by the BOP against a licensee shall be tolled
during the period the health care facility is out of
compliance with the court order and during any related
appeals.
iii)Shall be a misdemeanor, if there are multiple
SB 479
Page 33
violations, punishable by a fine not to exceed five
thousand dollars ($5,000) and will be reported to the
State Department of Health Care Services and will be
considered as grounds for disciplinary action with
respect to licensure, including suspension or revocation
of the license or certificate.
gg)Provides that a failure or refusal of a licensee to comply
with a court order, issued in the enforcement of a
subpoena, mandating the release of records to the BOP
constitutes unprofessional conduct and is grounds for
license suspension or revocation.
hh)Requires the imposition of the civil penalties be in
accordance with the Administrative Procedure Act (Chapter 5
(commencing with § 11500) of Part 1 of Division 3 of Title
2 of the Government Code).
11) Establishes the revenue provisions of
the Act:
a) Requires the BOP to report each month to the Controller
the amount and source of all revenue received pursuant to
this chapter and at the same time deposit the entire amount
thereof in the State Treasury for credit to the Psychology
Fund established by BPC § 2980.
b) Requires the moneys credited to the Psychology Fund
under BPC § 2999.90, upon appropriation by the Legislature,
be used for the purposes of carrying out and enforcing the
provisions of this chapter.
c) Requires the BOP 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 shall so notify the
DCA no later than May 31 of each year.
SB 479
Page 34
d) Requires the BOP to establish fees for the application
for and the issuance and renewal of licenses to cover, but
not exceed, the reasonable regulatory costs of the BOP
related to administering the Act. The fees shall be fixed
by the BOP in regulations that are duly adopted under the
Act. Fees assessed may not exceed the following:
i) The delinquency fee shall be 50 percent of the
biennial renewal fee.
ii)The fee for rescoring an examination shall be twenty
dollars ($20).
iii)The fee for issuance of a replacement license shall be
twenty dollars ($20).
iv)The fee for issuance of a certificate or letter of good
standing shall be twenty-five dollars ($25).
e) Provides that a person licensed under the Act is exempt
from the payment of the renewal fee in any of the following
instances:
i) While engaged in full-time active service in the
United States Army, Navy, Air Force, or Marine Corps.
ii)While in the United States Public Health Service.
iii)While a volunteer in the Peace Corps or AmeriCorps
VISTA.
f) Provides that every person exempted from the payment of
the renewal fee may not engage in any private practice and
will become liable for the fee for the current renewal
period upon the completion of his or her period of
full-time active service and will have a period of 60 days
SB 479
Page 35
after becoming liable within which to pay the fee before
the delinquency fee becomes applicable. Any person who
completes the 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.
g) Provides 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 specified in BPC § 2999.45.
h) Provides that the exemption provided are not applicable
if the person engages in any practice for compensation
other than full-time service in the United States Army,
Navy, Air Force, or Marine Corps, in the United States
Public Health Service, or the Peace Corps or AmeriCorps
VISTA.
i) Requires the licensing and regulatory program under the
Act to be supported from fees assessed to applicants and
licensees. Startup funds to implement this program must be
derived, as a loan, from the Psychology Fund, subject to an
appropriation by the Legislature in the annual Budget Act.
The BOP may not implement the Act until funds have been
appropriated.
12) States that no reimbursement is
required by this bill pursuant to § 6 of Article XIII B
of the California Constitution because the only costs that may
be incurred by a local agency or school district will be
incurred because this act creates a new crime or infraction,
eliminates a crime or infraction, or changes the penalty for a
crime or infraction, within the meaning of § 17556 of the
Government Code, or changes the definition of a crime within
the meaning of § 6 of Article XIIIB of the California
Constitution.
FISCAL EFFECT: According to the Senate Appropriations
SB 479
Page 36
Committee, this bill will result in 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. The costs would ultimately be offset by licensing
fees. There will also be no significant increase in costs to
provide applied behavior analysis services under the Medi-Cal
program or through the Department of Developmental Services.
COMMENTS:
Purpose. This bill is sponsored by the California Association
for Behavior Analysis . According to the author, "California law
mandates that health plans and health insurance policies cover
behavioral health treatment for autism. This mandate has
substantially increased demand for [ABA] services. With the
increased demand, there is a greater need to regulate the
behavior analysis 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. To protect the public from the unauthorized and
unqualified practice of behavior analysis, and from
unprofessional, unethical or harmful conduct by licensees, [this
bill] will create licensure for behavior analysts, with
regulation under the [BOP].
While [ABA] can help various populations achieve improvements to
socially significant behaviors, it is most commonly recognized
for helping autistic children foster basic skills, such as
looking, listening and imitating, as well as develop and improve
complex skills, such as reading, conversing, and understanding
another person's perspective. Research shows that early,
intensive [ABA] treatment can produce significant improvements
in the overall functioning of young children with autism, when
that treatment is designed and supervised by qualified
professional behavior analysts. By contrast, studies have shown
that early 'behavioral' interventions by unqualified individuals
SB 479
Page 37
produced no improvements in young children with autism. This
reinforces why it is important for qualified behavior analysts
to be distinguished from unqualified practitioners through
licensing and regulation."
Background. According to the American Psychological
Association, behavior analysis is the study of behavior. The
clinical practice of behavior analysis, called ABA, applies
basic psychological principles of learning and association to
change the behavior of an individual. For example, a behavior
analyst may train a child (conditioning) to respond to things in
the environment (stimuli) in a desirable way by offering praise
when the desirable behavior occurs (positive reinforcement).
In early psychology, behaviorism was an approach that sought to
find connections between environment and behavior. Because
behaviorism was a bottom-up approach, it focused on observable
behaviors rather than the internal state of mind.
Behaviorism-driven research produced principles and behavioral
techniques that could be used to manage and modify behavior in
humans without addressing inner thoughts. The application of
the research to the clinical setting led to the practice of
behavioral management and modification, or behavior therapy.
Modern psychology departed from the behavior-only model with the
social learning theory (social cognitive theory). Social
learning theory combines behavior principles with principles of
cognitive psychology (the science of mental thoughts). As a
result, many modern psychological behavioral therapies often
incorporate a cognitive component. For instance, one popular
form of psychotherapy is cognitive behavioral therapy (CBT), in
which a therapist attempts to solve a client's problem by
addressing both thought patterns and behaviors. ABA, however,
remains focused on the behavior-only model and has become a
standalone profession.
SB 479
Page 38
Board Certification of Behavior Analysts. ABA is a relatively
new profession, and there is only one certification board for
behavior analysts, the Behavior Analyst Certification Board
(BACB). The BACB is a nonprofit 501(c)(3) corporation
established in 1998 that is accredited by the National
Commission for Certifying Agencies Accreditation (NCCA). The
BACB provides certifications for professional behavior analysts
and approves school programs for behavior analysis. Because the
BACB is currently the only NCCA accredited program that provides
behavior analysis certifications, this bill was crafted to
closely match the BACB's requirements.
The BACB provides four types of credentials: (1) board certified
behavior analyst (BCBA); (2) board certified assistant behavior
analyst (BCaBA); (3) registered behavior technicians (RBTs); and
(4) the doctoral-level BCBA ( BCBA-D). The BACB requirements
for the initial certification and renewal of BCBA and BCaBA
certifications are nearly identical to the requirements for LBAs
and LABAs under this bill.
The BACB requirements for RBTs are similar to the
paraprofessional technician, except that the BACB requires a
40-hour training program and a competency assessment, while this
bill does not. The BCBA-D designation requires specific
requirements above the regular BCBA and would qualify for
licensure under this bill.
ABA and PDD/ASD. As noted above, ABA is a relatively new
profession and its specific therapies have only recently gained
popularity. Prior to SB 946 (Steinberg), Chapter 650, Statutes
of 2011, health plans in California were not required to provide
behavioral health treatments (BHTs) for pervasive developmental
disorders (PDD) or autism spectrum disorder (ASD).
SB 479
Page 39
While behavioral health therapies were popular, they were often
not covered for PDD and ASD because they were considered
habilitative. In contrast to rehabilitative services,
habilitative services aim to bring an individual's functioning
above what the individual's normal development provides. As a
result, many plans did not consider them medically necessary.
This is salient because medical necessity is often required for
reimbursement. Further, the efficacy of many BHTs for PDD and
ASD is difficult to prove, given the wide range of diagnoses,
settings, and therapies (See California Health Benefits Review
Program Analyses (CHBRP) for SB 126, SB 796, AB 2041).
However, after SB 946 and the subsequent behavioral health
mandate bills passed, the use of BHTs such as ABA increased. In
addition, last year the federal Centers for Medicare and
Medicaid Services (CMS) wrote that BHTs such as ABA-based
therapies are now covered under the Medicaid benefit for
children, Early and Periodic, Screening, Diagnosis, and
Treatment.
Consequently, health plans and providers were required to begin
implementing BHT providers, including low-level providers, to
provide coverage for the benefit. Because some of the most
popular behavioral health treatments specific to PDD and ASD are
ABA-based, the utilization of BHT providers like BCBAs has
increased. However, while ABA is often referred to as a
specific form of treatment, it is actually a discipline that
includes many behavioral therapies, such as:
13)Discrete Trial Training-a style of teaching that uses a
series of trials to teach each step of a desired behavior or
response. Lessons are broken down into their simplest parts
and positive reinforcement is used to reward correct answers
and behaviors. Incorrect answers are ignored.
14)Verbal Behavior-focuses on teaching language using a
sequenced curriculum that guides children from simple verbal
SB 479
Page 40
behaviors (echoing) to more functional communication skills
through techniques such as errorless teaching and prompting.
15)Pivotal Response Training-aims at identifying pivotal skills,
such as initiation and self-management, that affect a broad
range of behavioral responses. This intervention incorporates
parent and family education aimed at providing skills that
enable the child to function in inclusive settings.
Still, not all behavioral therapies are based on ABA, such as
DIR/Floortime. Further, ABA's practice is not confined to the
treatment of PDD and ASD.
Scope of Practice of Behavior Analysts. While ABA is most
popular for PDD and ASD treatments, it is much broader.
According to the BACB, the application of ABA can be used in
"building the skills and achievements of children in school
settings; enhancing the development, abilities, and choices of
children and adults with different kinds of disabilities; and
augmenting the performance and satisfaction of employees in
organizations and businesses."
However, because ABA principles are basic principles of learning
that can be utilized in many other fields and therapies, there
is significant overlap in other fields. For instance, because
ABA sticks to the behavior-only model, it is often seen as a
field that is distinguishable from psychology. Still, its basic
principles are built into many psychological approaches, such as
industrial-organizational (I/O) psychology and behavioral and
cognitive psychology-industrial organizational psychologists
specialize in behavior in the work place, and behavioral and
cognitive psychologists specialize in ABA, behavior therapy, and
cognitive therapy.
SB 479
Page 41
As a result, in California, it is the unlicensed practice of
psychology to perform behavioral therapies without meeting the
requirements of the Psychology Licensing Law. While many
providers that currently provide ABA-based behavioral
interventions are licensed psychologists, a BCBA that is not
licensed in psychology risks falling within the scope of
practice of psychology. Therefore, this bill places the
regulation of behavior analysts under the BOP.
Still, because there are many other types of behavior therapies,
there may be overlap in many other professions as well.
Therefore, this bill also provides a list of exemptions for
other professions, including:
16)Speech-language pathologists or audiologists;
17)Occupational therapists;
18)Physical therapists;
19)Marriage and family therapists;
20)Educational psychologists;
21)Clinical social workers; and,
22)Professional clinical counselors.
However, as noted above, there are other types of BHTs that are
not considered ABA. Therefore, this bill may also
unintentionally impact other providers that provide BHTs, which
may not be licensed.
SB 479
Page 42
Need for Licensure. The sponsors also note that as of March 18,
2014, there were 2,198 practitioners in California certified by
the [BACB], including 1779 BCBAs, 269 BCBA-Ds, and 150 BCaBAs.
It is unclear how many other uncertified providers there may be.
The U.S. Bureau of Labor Statistics does not currently track
behavior analysts or behavioral therapists as their own
profession. They are currently tracked under the psychologist
categorization.
According to the sponsor's sunrise report, "The availability of
additional funding for ABA services through SB 946, together
with increasing numbers of people receiving diagnoses of ASD and
other conditions for which ABA services have proved effective,
will further increase consumer demand for those services going
forward. Without a statute and regulations formalizing minimum
standards for practicing ABA competently and establishing a body
within the state to oversee that practice, consumers will be at
increasing risk of harm from individuals making false claims to
be qualified to provide ABA services." Further, ABA is a
practice rather than a specific treatment, the other aspects of
ABA-practice may be overlooked.
However, under existing law, the BOP has the authority to
require ABA practitioners to become licensed as psychologists.
In the past, the BOP has pursued cases of unlicensed behavior
therapy. In addition, because of the recent rise in the
practice of ABA services for PDD and ASD, the health industry
regulates many ABA practitioners through reimbursement rates and
plan-provider contracts.
Other States. Currently 19 other states either license or
certify ABA practitioners. In six states, they are regulated by
a psychology board (AZ, MO, ND, NV, OH, TN). In seven states,
they are regulated under a behavior analysis board (AL, KY, LA,
SB 479
Page 43
NY, OK, OR, RI). In the remainder of the states, they are either
issued direct licenses (AK, WI) or licensed under the behavioral
sciences board (KS), the allied mental health board (MA), or the
medical board (VA).
Current Related Legislation. AB 796 (Nazarian), of this
legislative session, expands the eligibility for a person to be
a qualified autism service professional to include a person who
possesses a bachelor of arts or science degree and meets other
specified requirements, a registered psychological assistant, a
registered psychologist, or an associate clinical social worker.
The bill also expands the eligibility for a person to be a
qualified autism service paraprofessional to include a person
with a high school diploma or equivalent and, among other
things, 6 months experience working with persons with
developmental disabilities. STATUS: This bill was held in the
Assembly Business and Professions Committee.
Prior Related Legislation. SB 126 (Steinberg), Chapter 680,
Statutes of 2013, extended the operation of the BHT mandate
until January 1, 2017.
AB 1205 (Berryhill) of 2011 would have provided for the
licensure and regulation of behavior analysts under the Board of
Behavioral Sciences. NOTE: This bill was held in the Assembly
Appropriations Committee.
AB 2041(Jones) of 2011 would have required that a regional
center classify a vendor as a behavior management consultant or
behavior management assistant if the vendor designs or
implements evidence-based behavioral health treatment, has a
specified amount of experience in designing or implementing that
treatment, and meets other licensure and education requirements.
NOTE: This bill was held in the Senate Appropriations
Committee.
SB 479
Page 44
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, as defined, for PDD or ASD.
ARGUMENTS IN SUPPORT:
The California Association for Behavior Analysis (sponsor)
writes in support, "Behavior analysts and assistant behavior
analysts who are certified by the national [BACB] provide the
vast majority of ABA services. Though accredited and certified,
these professionals are not licensed or regulated by the state.
[This bill's] licensure requirement would provide both the state
of California and its resident's additional consumer protections
and recourse when there are concerns with the services provided
by behavior analysts and assistant behavior analysts. At the
same time, this bill would not preclude other licensed
professionals from providing behavior analysis services."
ARGUMENTS IN OPPOSITION:
None on file.
POLICY ISSUES FOR CONSIDERATION:
Regional Center Exemption. This bill exempts individuals
vendorized through the regional centers from the licensure
requirements. However, it is not clear that the regional
centers need to be excluded. Therefore, the BOP requests that
SB 479
Page 45
the exemption be deleted.
According to the BOP, "A key component of the consumer
protection mandate of the [BOP] is the jurisdiction the [BOP]
has over an individual's license to ensure minimal competency.
Exempting an entire category from licensure because of their
relationship to the regional centers potentially places a large
number of ABA practitioners beyond the [BOP's] jurisdiction and
does not ensure minimal competency of these individuals. The
BOP is aware of concerns regarding access to care. However, if
the legislature believes minimum standards of competency must be
obtained by an individual to provide ABA services to the public,
the threshold for such services should not be determined by
one's financial status or insurance. Californians should be
confident that applied behavior analysis services are being
given by a trained, ethical individual free of criminal history.
Additionally, financially disadvantaged individuals should not
be deprived of the ability to pursue administrative action if
there is a deviation from the standard of care."
While there may be concerns surrounding the continuity of care
for regional center clients, even if many providers vendorized
with the regional centers do not meet the requirements for
licensure, they can still register as a paraprofessional and
continue to practice under supervision of a licensed
professional. According to the BOP, registration should not be
a financial burden. The BOP has calculated that the
registration fees will come out to about fifty (50) dollars.
Providers that cannot meet license requirements or are not being
supervised may not be qualified to provide for the regional
center clients. Therefore, the Committee may wish to consider
whether, if behavior analysts should be licensed, vendorized
regional center providers should be exempted.
SB 479
Page 46
Therapist/Client Privilege. While many other counselors and
therapists have a professional/client privilege, this bill does
not include a privilege clause for LBAs and LABAs (like
psychologists have in BPC § 2918). Therefore, the BOP has
requested that a privilege clause is added.
The purpose of privilege is to protect client records and ensure
that patients are not deterred from being candid with their
therapist. However, this is a new licensure scheme and a
relatively new profession. Further, the nature of the
information disclosed to a licensee of this bill is different
from that disclosed to a mental health therapist as the
treatment is purely behavioral in nature. In addition, client
records, which include confidential information such as
diagnoses, will still be protected by the privilege that
licensed psychologists are psychiatrists may exercise.
As a result, it is not clear that the nature of the information
shared between a licensee under this bill and a client merits a
privilege clause. However, the Committee may wish consider
whether there should be a privilege clause for this new category
of licensure.
Unintended Effect on Other BHT Providers. Due to the fact that
so many licensed providers have asked for specific exclusions
from the licensure requirements for a LBA and LABA, this bill
may have an unintended consequence of negatively impacting other
types of BHT providers that may fall under the ABA scope of
practice, such as DIR/Floortime providers. For example, the
legitimacy that licensure provides ABA providers may result in
unintentional discrimination against other BHT modalities as lay
persons may assume that ABA is a more effective treatment for
autism or other developmental disabilities versus other BHTs.
AMENDMENTS:
SB 479
Page 47
LABA License Renewal Supervision. Under BPC § 2999.44(c), this
bill allows a LABA to submit proof of ongoing supervision a LBA
or a licensed psychologist who is qualified to practice behavior
analysis when renewing a license. However, it also requires
that a LABA be supervised by a LBA for at least two percent of
the hours of behavior-analytic services they provide per month.
As written, this bill provides no clear distinction between a
LBA and a licensed psychologist that is qualified to practice
behavior analysis. Under the current scheme, the psychology
scope of practice is much more broad. Additionally,
psychologists are the provider that will make the initial
diagnosis. Therefore, there is no reason to require a LABA to
be supervised by a LBA if they are already being supervised by a
qualified psychologist.
While the two percent requirement may be consistent with the
BACB's requirements, it does not leave the door open for other
certifying entities in the future. Further, LABAs are already
required to maintain active status with the certifying entity
(which also includes the BACB), so the requirement is redundant.
Therefore, the author should amend the bill to strike the
requirement:
On page 22, lines 33-36, strike out " A licensed assistant
behavior analyst shall be supervised by a licensed behavior
analyst for at least 2 percent of the hours of behavior-analytic
services they provide per month. "
Technical Amendments. The author should make the following
conforming and clarifying technical amendments:
SB 479
Page 48
23)The author should correct a typographical error:
On page 17, line 30 insert:
assistant
24)The author should amend the term "paraprofessional
technician" to "behavior analysis technician" for clarity:
On page 9, line 1, strike out " Paraprofessional technician " and
insert:
behavior analysis technician
On page 19, line 23, strike out " Paraprofessional technician "
and insert:
behavior analysis technician
25)The author should amend the bill to replace the term
"behavior analytic" with "behavior analysis" when possible:
On page 14, line 24, strike out " behavior-analytic " and insert:
behavior analysis
On page 15, line 30, strike out " analytic " and insert:
SB 479
Page 49
analysis
On page 15, line 32, strike out " analytic " and insert:
analysis
On page 15, line 36, strike out " analytic " and insert:
analysis
On page 21, line 29, strike out " analytic " and insert:
analysis
26)The author should amend the bill to conform to recent
amendments regarding the supervision of LABAs and
paraprofessionals:
On page 17, line 15, after "analyst" insert:
or a licensed psychologist who is qualified to practice behavior
analysis
On page 17, line 21, after "analyst" insert:
or a licensed psychologist who is qualified to practice behavior
analysis
SB 479
Page 50
On page 19, line 25, after "chapter" insert:
or a licensed psychologist who is qualified to practice behavior
analysis
27)The author should amend the committee requirements to conform
to the amendments striking, for privacy reasons, the
requirement that a public member of the board be a consumer of
ABA services:
On page 11, lines 14-15, strike out " who is a consumer of
behavior analysis services and "
28)The author should amend the bill to conform to recent
amendments regarding BOP
confirmation of licensure requirements:
On page 13, line 34, strike out " The board shall verify with the
certifying entity that the " and insert:
An applicant shall include, with the application, verification
from the certifying entity that the
On page 14, strike out lines 13-17 and insert:
(b) An applicant shall include, with the application,
verification from the certifying entity that the applicant
SB 479
Page 51
meets both of the following requirements:
(1) Has passed the Board Certified Behavior Analyst examination
or an equivalent examination administered by the certifying
entity.
(2) Maintains an active status as a certified behavior analyst
with the certifying entity.
On page 17, line 5, strike out " The board shall verify with the
certifying entity that the " and insert:
An applicant shall include, with the application, verification
from the certifying entity that the
On page 17, strike out lines 29-33 and insert:
(b) An applicant shall include, with the application,
verification from the certifying entity that the applicant
meets both of the following requirements:
(1) Has passed the Board Certified Behavior Analyst examination
or an equivalent examination administered by the certifying
entity.
(2) Maintains an active status as a certified assistant behavior
analyst with the certifying entity.
29)The author should amend and consolidate the duplicative
student exemptions:
SB 479
Page 52
On page 21, strike out lines 1-13 and insert:
(c) A student or other individual pursuing supervised experience
for any of the following:
(1) Experiential training toward a license described in this
chapter in accordance with the requirements of this chapter.
(2) Experience in behavior analysis toward a license described
in subdivision (a) or (b) in accordance with the requirements
of the respective licensure act in this division.
(3) As a part of a defined program of study, course, practicum,
internship, or postdoctoral program, provided that the
behavior analysis activities are directly supervised by a
licensed behavior analyst, a licensed psychologist, or by an
instructor in a course sequence approved by a certifying
entity.
On page 21, strike out lines 18-23
30)Because "extended authority" is not clear, the author strike
it out and leave "direction":
On page 21, line 15, strike out " extended authority and "
31)To clarify that SLP assessments are not included in the LBA's
scope of practice, the author should make the following
amendment:
SB 479
Page 53
On page 9, line 34, after "practices" insert:
including, but not limited to, assessments,
REGISTERED SUPPORT:
California Association for Behavior Analysis (sponsor)
Behavior Intervention Association
California Association of Private School Education Schools
Center for Autism and Related Disorders
Southern California Consortium for Behavior Analysis
Seven individuals
REGISTERED OPPOSITION:
None on file.
Analysis Prepared by:Vince Chee, and Le Ondra Clark Harvey,
Ph.D. / B. & P. / (916) 319-3301
SB 479
Page 54