BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1282|
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THIRD READING
Bill No: SB 1282
Author: Steinberg (D)
Amended: 4/28/10
Vote: 21
SENATE BUS., PROF. & ECON. DEVEL. COMMITTEE : 5-3, 5/3/10
AYES: Negrete McLeod, Correa, Florez, Oropeza, Yee
NOES: Wyland, Aanestad, Walters
NO VOTE RECORDED: Calderon
SUBJECT : Applied behavior analysis services: California
Behavioral
Certification Organization
SOURCE : Author
DIGEST : This bill creates the California Behavioral
Certification Organization (CBCO) and provides for the
certification of applied behavior analysts and applied
behavior analyst assistants by the CBCO.
ANALYSIS :
Existing law
1. Licenses and regulates the practice of psychotherapy
preformed by marriage and family therapists (MFTs),
licensed educational psychologists (LEPs), and licensed
clinical social workers (LCSWs) by the Board of
Behavioral Sciences (BBS) within the Department of
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Consumer Affairs (DCA). Beginning January 1, 2012, the
BBS will additionally license professional clinical
counselors (LPCCs).
2. Licenses and regulates various health care professions
including physicians and surgeons, psychologists,
speech-language pathologists, occupational therapists,
physical therapists by the various healing arts boards
within the DCA.
3. California law does not license, certify or specifically
regulate applied behavioral analysis services.
This bill:
1. Provides that "applied behavior analysis services"
includes the following functions:
A. Designing, implementing, and evaluating
systematic instructional and environmental
modifications to produce social improvements in
the behavior of individuals or groups.
B. Applying the principles, methods, and
procedures of behavior analysis.
C. Utilizing contextual factors and establishing
operations, antecedent stimuli, positive
reinforcement, other consequences, and other
behavior analysis procedures to help people
develop new behaviors, increase or decrease
existing behaviors, and emit behaviors under
specific environmental conditions.
D. Assessing functional relations between behavior
and environmental factors.
E. Using procedures based on scientific research
and the direct observation and measurement of
behavior and environment.
F. Determining whether a nonlicensed or
noncertified individual shall be deemed as
qualified to perform all of the functions under
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this subdivision subject to his or her
supervision.
G. Excludes from the specified functions:
psychological testing, neuropsychology,
psychotherapy, sex therapy, psychoanalysis,
hypnotherapy, and long-term counseling.
H. Applies the definition regardless of the source
of payment or reimbursement.
2. Establishes the CBCO and specifies that the CBCO shall
be a nonprofit corporation exempt from taxation under
Section 501(c)(3) of Title 26 of the United States Code.
Provides that the CBCO may commence authorized
activities once it has submitted a request to the
Internal Revenue Service and the Franchise Tax Board
seeking the exemption. Authorizes the CBCO to take any
reasonable actions to carry out the responsibilities and
duties in the chapter, including, but not limited to,
hiring staff and entering into contracts.
3. Provides that the CBCO shall include the following
members:
A. Two representatives from each professional
society, association, or other entity whose
membership is comprised of applied behavior
analysts and that has a membership in California or
on a national basis of at least 1,000 individuals
for the last three years and that requires its
members to abide by a code of ethics.
B. Additional persons shall be included on the
board of directors as established by the CBCO
bylaws.
C. Additional members of the board of directors may
include certified behavior analysts and at least
two consumer or public members.
4. Provides that the CBCO shall establish certification
fees that are reasonably related to the cost of
providing services and carrying out its ongoing
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responsibilities and duties.
5. Provides that the meetings of the CBCO shall be subject
to the Bagley-Keene Open Meetings Act.
6. Requires the CBCO to issue an "applied behavior analyst"
certificate to an applicant who submits a written
application, pays the required fees, and provides
satisfactory evidence that he or she meets either of the
following requirements:
A. Holds a current, valid certification in applied
behavior analysis from the Behavior Analyst
Certification Board (BACB) or another organization
accredited by the National Commission for
Certifying Agencies (NCCA) or American National
Standards Institute (ANSI) whose mission is to meet
professional credentialing needs identified by
behavior analysts, governments, and consumers of
behavior analysis services.
B. Possesses a master's or doctorate degree in
applied behavior analysis or a related field, and
demonstrates three years of experience in the last
five years of providing those functions specified
in Item #1) above, to individuals, either as an
independent professional or as an employee of an
organization.
7. Requires the CBCO to issue an "applied behavior analyst
assistant" certificate to an applicant who submits a
written application, pays the required fees, and
provides satisfactory evidence that he or she meets
either of the following requirements:
A. Holds a current, valid certification as an
assistant behavior analysis from the BACB or
another organization accredited by the NCCA or ANSI
whose mission is to meet professional credentialing
needs identified by behavior analysts, governments,
and consumers of behavior analysis services.
B. Possesses a bachelor's degree in applied
behavior analysis or a related field, and
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demonstrates three years of experience in the
last five years of providing those functions
specified in Item #2) above, to individuals,
either as an independent professional or as an
employee of an organization.
8. Provides that a certificate shall be subject to renewal
in a manner prescribed by the CBCO and shall expire
unless renewed every two years. Further, authorizes the
CBCO to provide for the late renewal of a certification.
9. Authorizes the CBCO to receive factual information as a
condition of taking any action, and to conduct oral
interviews or make any investigation deemed necessary to
establish the accuracy of any information.
10.Provides that an applied behavior analyst shall maintain
that certification only by meeting the CBCO requirements
for continuing education and ethical standards.
11.Prohibits the CBCO from issuing certificates prior to
September 1, 2011.
12.Provides for the CBCO to require an applicant to submit
fingerprints, and establish a procedure consistent with
state law to obtain background information on
applicants.
13.Authorizes the CBCO to discipline a certificate holder,
as specified, and establishes various grounds for
discipline against a certificate holder or for denial of
a certificate to an applicant.
14.Provides that discipline or denial of a certificate or
registration by CBCO must be in keeping with specific
procedures, and that denial or discipline not in keeping
with the procedures is void and without effect.
15.Provides that it is an unfair business practice for any
person to advertise or represent to the public, that he
or she is certified, registered, or licensed by a
governmental agency as an applied behavior analyst or
applied behavior analyst assistant.
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16.Provides that it is an unfair business practice for any
person to hold himself or herself out or use the title
of "certified applied behavior analyst" or "certified
applied behavior analyst assistant" or any other term,
such as "licensed," "registered," "CABA" or "CABAA" or
any term that implies or suggests that the person is
certified as an applied behavior analyst or applied
behavior analyst assistant without meeting the
certification requirements.
17.Requires the CBCO to make available to the public the
current status certificate holders; requires the CBCO to
maintain on its Internet Website information updated
annually related to implementation of the chapter.
18.Provides that nothing under this law shall be construed
to:
A. Prevent behavior analysis service providers who
are vendorized by one of the California Regional
Centers or hold state accredited nonpublic agency
status from developing, providing, or supervising
applied behavior analysis consistent with the
requirements of their Regional Center vendorization
or nonpublic agency certification or accreditation,
provided their practice of behavior analysis is
commensurate with their level of training and
experience, and they do not hold themselves out to
the public by any title or description stating or
implying that they are Certified Behavior Analysts,
that they are "certified" to practice behavior
analysis if they are not in fact certified, or that
they are recognized or certified by the state to
practice applied behavior analysis.
B. Require certification, licensure, recognition,
or authorization to provide applied behavior
analysis services nor to add to or increase
requirements for providing those services.
19.Subjects the CBCO to the "sunset review process"
conducted by the Joint Committee on Boards, Commissions,
and Consumer Protection (Joint Committee), and
accordingly sunsets these provisions on January 1, 2017.
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Background
Autism and Autism Spectrum Disorder (ASD) . Autism and ASDs
are neurodevelopment disorders that typically last
throughout a person's lifetime and may cause significant
impairments in language, communications, play and social
interactions, abnormalities in behaviors, and other
physical manifestations. ASDs represent the spectrum of
these disabilities and include Autistic Disorder (or
classic autism), Asperger Syndrome, Pervasive Developmental
Syndrome and others. ASD manifests itself in various ways,
including difficulty in using and understanding language;
poorly developed social skills; over- and-under sensitivity
to sound, sight, taste, touch or smell; repetitive
behaviors; difficulty with changes in surroundings or
routines; and uneven skill development.
Increase of ASDs . According to the Centers for Disease
Control and Prevention (CDC), more children than ever
before are being classified as having ASDs. It is unclear,
however, how much of this increase may be attributed to
changes in identifying and classifying ASDs. The CDC
states, that by current standards ASDs are the second most
common serious developmental disability after mental
retardation/intellectual impairment, but still less common
than other conditions that affect children's development,
such as speech and language impairments, learning
disabilities, and attention deficit/hyperactivity disorder
(ADHD). According to data from the California Health
Interview Survey, it is estimated that more than 36,000
children age 3-11 had autism in 2005. The State Department
of Developmental Services (DDS) indicates that the
population of persons with autism in California's
developmental services system rose by 634 percent from 1987
and 2002, and nearly doubled in the four years from 1998 to
2002.
ASDs is the fastest growing serious developmental
disability and now impacts one out of every 150 children in
the United States; also, most school districts in
California have seen a doubling of students with ASDs in
the past five years.
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Resources for Families with Autistic Children . Children
with autism are served by a number of government and
private entities: regional centers and the Department of
Developmental Services; schools, school districts, and the
Department of Education. Health care service plans and
insurers are required under mental health parity laws to
provide benefits on a par with physical illness, although
coverage of specific benefits and treatments has been
unclear. In addition, the California Center for Autism and
Developmental Disabilities Research and Epidemiology
(CADDRE), a government-provider partnership, conducts
surveillance and research on ASD, as well as creates
information on autism in multiple languages.
Lanterman Act and Regional Centers . In the late 1960s and
'70s, the Lanterman Act established California's system of
care for persons with developmental disabilities, including
ASD, which consists of 21 regional centers and five state
developmental centers where people are assessed for
developmental disabilities and, if they qualify, are served
for life by a regional center. Children age three and
older may be served through this system.
A Senate Human Services Committee analysis of AB 1478 of
2006 (an autism-related measure) notes that, over the last
decade, overall regional center caseload has grown by 68.9
percent, as compared to the state's overall growth rate of
17.2 percent for a comparable period. The Department of
Developmental Service's Fact Book for 2005, indicates that
currently 15.1 percent of the regional center caseload is
described as autistic while only 5.3 percent were so
described a decade ago.
Early Start . Implemented by DDS and regional centers, in
collaboration with the Department of Education, local
education agencies, and other state agencies, the Early
Start program serves children under the age of three, who
may receive early intervention services if they have a
developmental delay in either cognitive, communication,
social or emotional, adaptive, or physical and motor
development, including vision and hearing, or have certain
risk conditions for these delays.
Under Early Start, eligible individuals may receive
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screening and assessment; case management; family training,
counseling, and home visits; health, nutrition, nursing,
physical therapy, psychological, speech and language, and
transportation services, among other services.
Local Education Agencies . Children age three to 21 may
receive specialized instruction and related services
through local education agencies, through the development
of an individualized education program.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 5/5/10)
Alliance of California Autism Organizations (if amended)
Behavioral intervention Association (if amended)
Center for Autism and Related Disorders (if amended)
Sacramento based ABC Schools (if amended)
OPPOSITION : (Verified 5/5/10)
California Association of Health Plans
California Psychological Association
ARGUMENTS IN SUPPORT : According to the author's office,
"Currently there are no standards, criteria, or
professional requirements that indicate the level of
education, training, experience and other professional
factors that reflect on the background and qualifications
of individuals who currently provide ABA services.
Furthermore, the ABA profession lacks any form of
recognition or standing within the California Business and
Professions Code. During the past decade, there has been
increasing evidence that ABA therapy is an important and
valuable therapeutic intervention in the treatment of
medical conditions such as ASD. Consequently, there has
been an extensive increase in the practices of this
profession throughout California. However, consumers may
face significant difficulties and challenges in making an
informed decision with regard to these programs and
services. Specifically, some consumers may lack adequate
information by which they can choose an ABA provider and/or
ABA services in an informed manner. Consequently, in some
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cases, these ABA programs may be designed, supervised,
and/or implemented by individuals who lack the appropriate
training and educational background. SB 1282 is an initial
step in providing professional standards and guidelines for
ABA services that will assist consumers in making more
informed decisions."
ARGUMENTS IN OPPOSITION : This bill is opposed by the
California Association of Health Plans (CAHP), who states
that those dealing with developmental disabilities and
mental health conditions often need additional supportive
services to help them with housing, everyday living skills
and education. Unfortunately, the state lacks clear
guidelines for who is responsible for providing many of
these services, creating great confusion for families and
those living with developmental disabilities and mental
illness. CAHP opposes the bill because it appears to
require health plans to pay for educational services in
addition to the health care and mental health care that
health plans already provide. Shifting responsibility for
educational and other non-medical services to health plans
would create a costly new mandate that would cause already
increasing health insurance costs to skyrocket, according
to CAHP.
CAHP is concerned that while the bill focuses on the
certification of providers of ABA, the bill links those
providers to payments by health plans and insurers. CAHP
states that because ABA helps children learn everyday life
and social skills, most health plans do not consider
educational services like ABA to be a covered service under
the terms and conditions of their contracts, and notes that
the American Academy of Pediatrics lists ABA as an
educational service
JJA:do 5/5/10 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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