BILL ANALYSIS                                                                                                                                                                                                    



                                                                       



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                                 THIRD READING


          Bill No:  SB 1282
          Author:   Steinberg (D)
          Amended:  5/26/10
          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

           SOURCE  :     Author


           DIGEST  :    This bill makes, until January 1, 2017, it an  
          unfair business practice for a person to use certain titles  
          or terms implying that he/she is certified as an applied  
          behavior analyst unless he/she holds a current  
          certification from a specified organization, or to state,  
          advertise, or represent that he/she is certified or  
          licensed by a governmental agency as an applied behavior  
          analyst, and subjects the bills provisions to the sunset  
          review process.

           Senate Floor Amendments  of 5/26/10 narrow the bill's  
          provisions to provide that it is an unfair business  
          practice for a person to use the title of "certified  
          applied behavior analyst" or any similar term without  
          holding a current certification from a specified national  
          certifying organization.
                                                           CONTINUED





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           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  
             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" 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.








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             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  
                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. 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.

          3. 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 any other  
             term, such as "licensed," "registered," "CABA" or any  
             term that implies or suggests that the person is  
             certified as an applied behavior analyst without holding  
             a current certification from a national organization  
             that certifies applied behavior analyst and is  
             accredited by the National Commission on Certifying  
             Agencies.

          4. Provides that nothing under this law shall be construed  
             to:

             A.    Prevent applied behavior analysis providers who  
                are vendorized by one of the California Regional  
                Centers or hold state accredited nonpublic agency  
                status from developing, providing, or supervising  







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                applied behavior analysis consistent with the  
                requirements of their Regional Center vendorization  
                or nonpublic agency certification or accreditation,  
                provided their practice of applied 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 applied 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 nor to add to or increase requirements for  
                providing applied behavior analysis.

          5. Specifies that this bill shall not be construed to  
             prevent specified licensed professional from providing  
             applied behavior analysis when acting within the scope  
             of his/her license, formal training, experience, and  
             accepted standards of his/her profession.

          6. Subjects the bills provisions 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.

           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  







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          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.

           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.








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           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  
          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  5/27/10)







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          Alliance of California Autism Organizations (if amended)
          Behavioral Intervention Association (if amended)
          California for Applied Behavior Analysis (if amended)
          Center for Autism and Related Disorders (if amended)
          Sacramento Based ABC Schools (if amended)

           OPPOSITION  :    (Verified  5/27/10)

          American Assoc. of Marriage and Family Therapy, CA Div.  
          (prior version)
          California Association of Health Plans (prior version)
          California Psychological Association (prior version)
          California Association of Marriage and Family Therapist  
          (prior version)

           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  
          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."

          JJA:do  5/27/10   Senate Floor Analyses 








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                         SUPPORT/OPPOSITION:  SEE ABOVE

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