BILL ANALYSIS                                                                                                                                                                                                    �






                                  SENATE HUMAN
                               SERVICES COMMITTEE
                            Senator Jim Beall, Chair


          BILL NO:       AB 2041                                      
          A
          AUTHOR:        Jones                                        
          B
          VERSION:       June 9, 2014
          HEARING DATE:  June 24, 2014                                
          2
          FISCAL:        Yes                                          
          0
                                                                      
          4
          CONSULTANT:    Mareva Brown                                 
          1

                                        

                                     SUBJECT
                                         
          Developmental services: regional centers: behavioral health  
                                   treatment.

                                     SUMMARY  

          This bill defines for the purposes of regional center  
          vendorization a behavior management consultant or behavior  
          management assistant, including the amount and nature of  
          experience and education required. The bill would require  
          the department to amend its regulations as necessary to  
          implement the provisions of the bill.

                                     ABSTRACT 

           Existing law:
           
             1)   Establishes the Lanterman Developmental  
               Disabilities Services Act, which states   that  
               California is responsible for providing an array of  
               services and supports sufficiently complete to meet  
               the needs and choices of each person with  
               developmental disabilities, regardless of age or  

                                                         Continued---




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               degree of disability, and at each stage of life and to  
               support their integration into the mainstream life of  
               the community. (WIC 4500, et al)  

              2)   Establishes a system of nonprofit Regional Centers,  
               overseen by the Department of Developmental Services  
               (DDS), to provide fixed points of contact in the  
               community for all persons with developmental  
               disabilities and their families, to coordinate  
               services and supports best suited to them throughout  
               their lifetime. (WIC 4620)  

              3)   Establishes an Individual Program Plan (IPP) and  
               defines that planning process as the vehicle to ensure  
               that services and supports are customized to meet the  
               needs of consumers who are served by regional centers.  
               (WIC 4512)  
                 
              4)   Requires a regional center shall secure services  
               and supports that meet the needs of the consumer, as  
               determined in the IPP, and to give highest preference  
               to those which would allow minors with developmental  
               disabilities to live with their families, adult  
               persons with developmental disabilities to live as  
               independently as possible in the community, and that  
               allow all consumers to interact with persons without  
               disabilities in positive, meaningful ways. (WIC 4648)

             5)   Establishes a process for regional centers to  
               "vendorize" or contract with service providers to  
               serve consumers IPP-identified service needs based on  
               the vendor's qualifications and other requirements  
               necessary in order to provide the service, and  
               specifies the process and requirements for becoming a  
               regional center vendor. (WIC 4648 (3) (a))

             6)   Defines behavioral health treatment, for purposes  
               of payment under a health care service plan contract  
               or a health insurance policy, as professional services  
               and treatment programs, including Applied Behavior  
               Analysis (ABA) and evidence-based behavior  
               intervention programs, which develop or restore, to  
               the maximum extent practicable, the functioning of an  
               individual with pervasive developmental disorder (PDD)  
               or autism, and sets requirements for the treatment  





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               plan, prescription of the treatment, and the providers  
               authorized to provide such treatment, including  
               qualified autism service professionals, as specified.  
               (HSC 1374.73(c)(1), INS 10144.51(c)(1))

             7)   Includes in the definition of a "qualified autism  
               service professional" a behavioral service provider  
               approved as a vendor by a California regional center  
               to provide services as an Associate Behavior Analyst,  
               Behavior Analyst, Behavior Management Assistant,  
               Behavior Management Consultant, or Behavior Management  
               Program as defined in Title 17 CCR �54342. (HSC  
               1374.73 (c)(4)(D), INS 10144.51(c)(4)(D))

             8)   Defines in state regulations, for purposes of  
               regional center vendorization, Behavior Management  
               Assistant and Behavior Management Consultant and  
               requires education or experience in ABA for both  
               professionals, as specified. (17 CCR �54342)

           This bill:
           
             1)   Establishes in the Lanterman Act under a new  
               section, WIC 4648.32, the same definition of  
               "behavioral health treatment" for vendors as is  
               defined in health and insurance codes for purposes of  
               payment under a health care service plan contract or  
               health insurance policy.

             2)   Requires that a regional center vendor classified  
               as a Behavior Management Consultant must do both of  
               the following: 

                  a.        Design or implement behavioral health  
                    treatments under the direct supervision of a  
                    Behavior Management Consultant, as defined, or  
                    assess the function of a behavior of a consumer  
                    and design, implement, and evaluate instructional  
                    and environmental modifications to produce  
                    socially significant improvements in the  
                    consumer's behavior through skill acquisition and  
                    the reduction of behavior, under direct  
                    supervision of a Behavior Analyst, as defined in  
                    Title 17 of the California Code of Regulations,  
                    or a Behavior Management Consultant, as defined  





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                    in statute.

                  b.        Meet specified education and professional  
                    requirements.

             3)   Defines the education and professional requirements  
               of a Behavior Management Consultant to be either:

                  a.        Possesses a bachelor of arts or science  
                    degree and has either of the following:

                        i.             Twelve semester units of  
                         applied behavior analysis or behavioral  
                         health treatment and one year of experience  
                         in designing or implementing behavioral  
                         health treatment.
                        ii.            Two years of experience in  
                         designing or implementing behavioral health  
                         treatment.

                  b.        Or is one of the following:

                        i.             A registered psychological  
                         assistant or licensed psychologist, as  
                         defined in Business and Professions Code.
                        ii.            An associate clinical social  
                         worker registered with the Board of  
                         Behavioral Sciences.

             4)   Requires regional centers classify a vendor as a  
               Behavior Management Consultant if the vendor has two  
               years of experience designing and implementing  
               behavioral health treatments and is a licensed  
               psychologist, licensed clinical social worker,  
               licensed marriage and family therapist, as defined, or  
               other licensed professional in California whose  
               license permits the design or implementation of  
               behavioral health treatments.

             5)   Requires that individuals vendored as a behavior  
               management consultant as of December 31, 2006, must  
               have completed 12 semester units in ABA by December  
               31, 2008; or, for individuals vendored after that  
               date, 12 units of either ABA or behavioral health  
               treatment.





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             6)   Requires that a regional center classify a vendor  
               as a Behavior Management Consultant only if the vendor  
               designs or implements behavioral health treatments  
               that are consistent with the vendor's experience and  
               education.

             7)   Requires DDS to amend its regulations as necessary  
               to implement to this section.
                                         
                                 FISCAL IMPACT  

          This bill has not been heard by a fiscal committee.


                            BACKGROUND AND DISCUSSION  

           Purpose of the bill: 
           
          The author writes that despite the intent of the  
          Legislature in passing SB 946, which mandated insurance  
          companies cover ABA therapy for regional consumers with  
          autism, many Californians are still being denied coverage  
          for the specific type of treatment they need, if the  
          treatment is an evidence-based treatment prescribed by  
          their physician or psychologist that is not ABA. The author  
          states that while ABA has proven essential to the  
          development of many children, not all children respond to  
          it.  

          The author states that some Californians with Autism are  
          being denied the treatment prescribed by their physician or  
          psychologist because SB 946, in specifying which providers'  
          services were to be covered, referenced existing  
          definitions in Title 17 that refer only to ABA as the  
          frontline providers and their supervisors.  This bill will  
          expand those definitions to include other forms of  
          evidence-based behavioral health treatment, ensuring that  
          all Californians with autism can receive the evidence-based  
          treatment their physician has prescribed, the author  
          states. 

           Regional Centers
           
          California's 21 regional centers are non-profit  





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          organizations that provide local services and supports to  
          approximately 270,000 individuals through contracts with  
          DDS. Regional centers provide diagnosis and assessment of  
          eligibility and help plan, access, coordinate and monitor  
          the services and supports that are needed because of an  
          individual's developmental disability. Services for  
          consumers are determined through an individual program plan  
          (IPP). Additionally, regional centers share primary  
          responsibility with local education agencies for provision  
          of early intervention services under the California Early  
          Intervention Services Act.  

          A developmental disability is defined as a disability that  
          originates before an individual attains 18 years of age, is  
          expected to continue indefinitely, and constitutes a  
          substantial disability for that individual.  It includes  
          intellectual disabilities, cerebral palsy, epilepsy, and  
          autism spectrum disorders (ASD).  

           Autism 
           
          Autism is a neurodevelopmental disorder characterized by  
          impairments in social relating, language, and by the  
          presence of repetitive and stereotyped behaviors. The  
          National Institutes of Health describes autism as the most  
          severe form of a range of conditions that together make up  
          ASD. Other conditions along the spectrum include a milder  
          form known as Asperger syndrome, and childhood  
          disintegrative disorder and pervasive developmental  
          disorder not otherwise specified (usually referred to as  
          PDD-NOS).  Although ASD varies significantly in character  
          and severity, it occurs in all ethnic and socioeconomic  
          groups and affects every age group.  Experts estimate that  
          1 in 88 children age 8 will have an ASD.<1>  Males are four  
          times as likely to have an ASD than females. 

          The hallmark feature of ASD is impaired social interaction,  
          according to the National Institutes of Health.  An infant  
          with ASD may not respond to people or may focus intently on  
          one item to the exclusion of others for long periods of  
          time.  Children with an ASD may fail to respond to their  
          names and often avoid eye contact with other people.  They  
          may have difficulty interpreting what others are thinking  
          -------------------------
          <1> Centers for Disease Control and Prevention: Morbidity  
          and Mortality Weekly Report, March 30, 2012




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          or feeling because they can't understand social cues, such  
          as tone of voice or facial expressions.  Although symptoms  
          and severity vary broadly among individuals with autism,  
          all individuals affected by the disorder have difficulties  
          beginning and maintaining social interactions, impaired  
          communication skills, and repetitive patterns of behavior  
          or interests.

          Data from DDS in March 2014 indicates approximately 70,000  
          regional center consumers had a diagnosis of autism or  
          PDD-NOS, more than twice as many as had the same diagnosis  
          in 2006. Overall, 3 in 10 regional center consumers have a  
          diagnosis of autism or PDD, although many consumers have  
          multiple conditions. 

          Behavioral treatments for autism 

          Over the past several years, there have been a number of  
          medical entities that have concluded that intensive  
          behavioral treatments are effective in treating children  
          and adults with autism. There are a several different types  
          of behavioral health treatment; however one of the  
          best-known and most commonly accepted as being an  
          evidence-based practice is ABA. 

          While the term ABA encompasses several different treatment  
          modalities, there are also other interventions that have  
          been scientifically studied and found to be effective. One  
          of those is the Early Start Denver Model, which is a  
          relationship-based intervention provided in the home by  
          trained therapists and parents during natural play and  
          daily routines. Researchers at the UC Davis MIND Institute  
          have been studying the ESDM's effectiveness. Additionally,  
          there are a number of behavioral treatments in practice  
          that have not yet met other criteria to be considered  
          "evidence-based."

           Related legislation: 
           
          SB 946 (Steinberg) Chapter 650, statutes of 2011 required  
          health plans and insurers to pay for behavioral health  
          treatment when a consumer's IPP identified the need. 

          AB 171 (Beall) 2011, would have required health plans and  
          insurers to cover the screening, diagnosis and treatment of  





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          ASD. This bill died in the Senate Health committee. 
          
           AB 1205 (Bill Berryhill) 2011, would have required  
          behavioral analysts and assistant behavioral analysts to be  
          licensed by the state Board of Behavioral Sciences. It was  
          held on suspense in the Assembly Appropriations committee. 

                                     COMMENTS

           This bill codifies current Title 17 regulations that define  
          the criteria for vendorization as Behavior Management  
          Assistant and Behavior Management Consultant, and adds  
          reference to language in health and insurance codes that  
          also includes broader categories of behavioral treatment  
          therapists. These definitions pre-date passage of SB 946  
          and are centered around ABA treatment as the identified  
          therapy for autism treatment. 

          Although "behavioral health treatment" was defined in  
          statute through SB 946 to include evidence-based, behavior  
          intervention programs that are not categorized as applied  
          behavior analysis (ABA), the author and supporters of this  
          bill say that some health plans and insurance companies are  
          strictly adhering to regulations, which define  
          professionals classifications to include the need for  
          education and experience in ABA.  

          Opponents of this bill, including the Association of  
          Regional Center Agencies, which was a co-sponsor of SB 946,  
          express concern that the bill diminishes requirements for  
          regional center vendors by eliminating the requirement  
          providers be trained in ABA. "It would adversely affect the  
          quality of services for a wide range of individuals," ARCA  
          writes in its letter of opposition. 

          In order to clarify the intent of this bill and of SB 946,  
          which is to provide evidence-based behavioral treatment to  
          regional center consumers through their health plans, staff  
          recommends the following clarifying amendment on page 12 of  
          this bill: 

          4648.32 (c)(5) For purposes of this section, a regional  
          center shall only classify as a vendor a Behavior  
          Management Consultant who designs or implements  
           evidence-based  behavioral health treatments that are  





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          consistent with the vendor's experience and education.
                                         
                                  PRIOR VOTES  

          Assembly Floor                71 - 3
          Assembly Human Services         6 - 0 

                                    POSITIONS  

          Support:       Autism Speaks
                         California Association for Behavior Analysis
                         Child Development Institute 
                         Disability Rights California
                         Professional Child Development Associates
                         Southern California Consortium for Behavior  
          Analysis
                         WAPADH
                         3 individuals

          Oppose:   ACT Today 
                         Association of Regional Center Agencies
                         Autism Research Group
                         Center for Autism and Related Disorders
                         

                                   -- END --