BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 479  


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          Date of Hearing:  August 19, 2015


                        ASSEMBLY COMMITTEE ON APPROPRIATIONS


                                 Jimmy Gomez, Chair


          SB 479  
          (Bates) - As Amended August 17, 2015


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          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  








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          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.










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          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:










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          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  








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            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  








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            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  








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            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