BILL ANALYSIS Ó SB 479 Page 1 Date of Hearing: August 19, 2015 ASSEMBLY COMMITTEE ON APPROPRIATIONS Jimmy Gomez, Chair SB 479 (Bates) - As Amended August 17, 2015 ----------------------------------------------------------------- |Policy |Business and Professions |Vote:|13 - 0 | |Committee: | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | |-------------+-------------------------------+-----+-------------| | | | | | | | | | | | | | | | ----------------------------------------------------------------- Urgency: No State Mandated Local Program: YesReimbursable: No SUMMARY: This bill establishes the Behavior Analyst Act (Act), which provides for the licensure, registration, and regulation of behavior analysts and assistant behavior analysts, and requires SB 479 Page 2 the California Board of Psychology (BOP), until January 1, 2021, to administer and enforce the Act. Specifically, this bill: 1)States intent that BOP begin accepting applications for behavior analyst licensure and assistant behavior analyst licensure no later than January 1, 2018, provided necessary funds have been appropriated. 2)Defines "practice of behavior analysis" or "to practice behavior analysis" as the design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior, as specified, 3)Defines "licensed behavior analyst" (LBA) as a person licensed under the Act to practice behavior analysis, and "licensed assistant behavior analyst" (LABA) as a person licensed under the Act to practice behavior analysis under the supervision of an LBA. 4)Requires paraprofessional technicians practicing under the supervision of an individual licensed under the Act to satisfy specific requirements, including background checks, being at least 18 years of age, and paying an application fee in an amount not to exceed a reasonable regulatory cost, to be determined by the board. 5)Vests the BOP, until January 1, 2021, with the power to enforce the Act. Creates, until January 1, 2021, the Behavior Analyst Committee within the jurisdiction of the BOP to make recommendations to the BOP regarding the regulation of the practice of behavior analysis. SB 479 Page 3 6)Establishes licensing provisions for LBAs and LABAs, including licensure, renewal, enforcement, background checks, continuing education, and related provisions. 7)Establishes revenue provisions: a) Requires the board to establish fees in regulation for the application for and the issuance and renewal of licenses to cover, but not exceed, the reasonable regulatory costs of the board. b) Specifies fee revenues collected for this purpose are credited to the Psychology Fund and such funds are available upon appropriation, for the purposes of the Act. c) Sets fee amounts for several smaller fee categories. However, it does not specify licensure or renewal fees and exempts certain categories of public service personnel from renewal fees during active service. d) Requires the licensing and regulatory program under this chapter to be supported from fees assessed to applicants and licensees. Requires startup funds to implement the Act be derived, as a loan, from the Psychology Fund, subject to a budget appropriation. e) Specifies the board shall not implement licensure until funds have been appropriated. FISCAL EFFECT: SB 479 Page 4 1)Approximate fiscal impact to BOP of $1.6 million in 2016-17, the first year of implementation, and about $1 million ongoing (Psychology Fund). Higher initial costs relate to promulgation of regulations, development of materials, build-out of office space, and information technology changes to add a licensure category. 2)Based on an assumption of 3,000 licensees and annual population growth of 12%, initial application fees and exam fees will likely be set around $550, and renewals will be set around $650 per 2-year renewal cycle. 3)Unknown, likely minor if any, potential GF revenue, if penalty authority contained in the bill is used to enforce the bill's provisions. COMMENTS: 1)Purpose. According to the author, a state mandate for health plans and insurers to cover behavioral health treatment for autism have substantially increased demand for applied behavioral analysis (ABA) services. With the increased demand, there is a greater need to regulate the BA profession, and to protect autistic children and others who can benefit from ABA treatment from people who falsely claim that they are qualified to practice behavior analysis. This bill will ensure BA professionals are qualified and overseen by the Board of Psychology, for whom consumer protection will be paramount. 2)BA. According to the American Psychological Association, behavior analysis is the study of behavior. The clinical practice of behavior analysis, called ABA, applies SB 479 Page 5 interventions based upon the principles of learning theory to improve socially significant behaviors to a meaningful degree. Socially significant behaviors include reading, academics, social skills, communication, and adaptive living skills like motor skills, eating and food preparation, personal self-care, domestic skills, home and community orientation, and work skills. ABA often requires intensive treatments of more than 25 hours each week and costs about $50,000 each year. 3)BA practitioners. The Behavior Analyst Certification Board (BACB) is a private non-profit that provides four types of credentials: (1) board certified behavior analyst, (2) board certified assistant behavior analyst, registered behavior technicians (RBTs), and (3) doctoral-level BCBA. The BACB requirements for the initial certification and renewal of analysts and assistant analyst certifications are nearly identical to the requirements for LBAs and LABAs under this bill. 19 other states either license or certify ABA practitioners. State law recognizes "qualified autism service providers" (QASPs) who are authorized to provide ABA services. QASPs must be a specified licensed health care provider or a person, entity, or group that is certified by a national entity such as the BACB. "Qualified autism service professionals" can be employed by QASPs and must be approved as a regional center vendor by the Department of Developmental Services (DDS) system, among other requirements. 4)Related Legislation. AB 796 (Nazarian), pending in the Assembly Business and Professions Committee, expands the SB 479 Page 6 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. 5)Previous Legislation. a) SB 946 (Steinberg), Chapter 650, Statutes of 2011, among other things, mandated health care service plan contracts and health insurance policies, except as specified, to provide coverage for behavioral health treatment (BHT), as defined, for pervasive developmental disability or autism spectrum disorders. b) SB 126 (Steinberg), Chapter 680, Statutes of 2013, extended the operation of the BHT mandate until January 1, 2017. 1)Concern. The Association of Regional Center Agencies (ARCA) supports this bill in concept, but expresses concern that this bill will further reduce access to ABA services by constraining the professionals available to provide these services. ARCA notes there is already a shortage of providers. 2)Comments. Many fee types for other professional licensure categories have caps in statute. Since it is a new licensure SB 479 Page 7 program, it is appropriate not to set a fee cap at this time. However, the first sunset review in 2020 should critically examine whether fees are set commensurate with workload. Analysis Prepared by:Lisa Murawski / APPR. / (916) 319-2081