BILL NUMBER: SB 1282AMENDED BILL TEXT AMENDED IN SENATE MARCH 23, 2010 INTRODUCED BY Senator Steinberg FEBRUARY 19, 2010 An act to add Chapter 5.2 (commencing with Section 2529.50) to Division 2 of the Business and Professions Code, relating to healing arts. LEGISLATIVE COUNSEL'S DIGEST SB 1282, as amended, Steinberg. Applied behavioral behavior analysis therapists services: California Behavioral Certification Organization . Existing law provides for the licensure and regulation of various healing arts practitioners, including, but not limited to, marriage and family therapists, clinical social workers, educational psychologists, and professional clinical counselors, by the Board of Behavioral Sciences in the Department of Consumer Affairs. This bill would state the intent of the Legislature to enact legislation that would provide for the certification of applied behavioral analysis therapists provide for the certification or registration of specified applied behavior analysis practitioners by a California Behavioral Certification Organization, which would be a nonprofit organization meeting specified requirements, and would impose certain duties on the organization. The bill would specify which individuals would be considered as qualified to practice applied behavior analysis services, and would prohibit an individual from holding himself or herself out as a practitioner unless he or she has complied with the act or another applicable licensing provision or is otherwise certified by certain nationally recognized entities. The bill would authorize the organization to establish specified curriculum and continuing education standards, and establish a certification and registration process, in conjunction with the California Association for Behavior Analysis (CalABA). The bill would require CalABA to implement the certi fication or registration process until the organization is established. The bill would set forth other disciplinary standards and hearing requirements . Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. It is the intent of the Legislature in enacting this act to provide state recognition of educated, trained, and experienced individuals that provide applied behavior analysis services to individuals with medical conditions such as autism spectrum disorder and other conditions that are responsive to behavior analysis. This act recognizes those professionals practicing with existing licenses issued by the state and those certified by nationally accredited organizations, and is intended to create an additional pathway for certification through the establishment of a private nonprofit organization that will enable consumers to identify qualified providers of applied behavior analysis services. These pathways for recognition of qualified providers will ensure that providers have completed sufficient training at approved institutions of higher education and follow nationally recognized standards for recognition of these professionals upon which consumers and those who pay for applied behavior analysis services, including private entities, governmental entities, nonprofit organizations, health care service plans, or insurers, may rely. SEC. 2. Chapter 5.2 (commencing with Section 2529.50) is added to Division 2 of the Business and Professions Code , to read: CHAPTER 5.2. APPLIED BEHAVIOR ANALYSIS SERVICES 2529.50. For purposes of this chapter, the following terms have the following meanings: (a) "ANSI" means the American National Standards Institute. (b) "BACB" means the Behavior Analyst Certification Board. (c) "CalABA" means the California Association for Behavior Analysis. (d) "CBCO" or "organization" means the California Behavioral Certification Organization established by this chapter. (e) "NCCA" means the National Commission for Certifying Agencies. 2529.55. (a) A person who is qualified to provide applied behavior analysis services, as enumerated in Section 2529.6, may do all of the following: (1) Design, implement, and evaluate systematic instructional and environmental modifications to produce social improvements in the behavior of individuals or groups. (2) Apply the principles, methods, and procedures of behavior analysis. (3) Utilize contextual factors and establish 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. (4) Assess functional relations between behavior and environmental factors, known as functional assessment and functional analysis. (5) Use procedures based on scientific research and the direct observation and measurement of behavior and environment. (6) Determine whether a nonlicensed or noncertified individual shall be deemed as qualified to provide applied behavior analysis services, exclusive of paragraph (7), subject to his or her supervision and solely for the purpose of implementing the services of applied behavior analysis developed by a person described in subdivision (a) of Section 2529.6. (7) Supervise the delivery of applied behavior analysis services by nonlicensed or noncertified individuals as described in paragraph (6). (b) The practice of applied behavior analysis excludes psychological testing, neuropsychology, psychotherapy, sex therapy, psychoanalysis, hypnotherapy, and long-term counseling. 2529.6. (a) The following persons shall be recognized as qualified to provide applied behavior analysis services as described in Section 2529.55: (1) Licensed professionals, including, but not limited to, physicians and surgeons, psychologists, social workers, marriage and family therapists, speech-language pathologists, occupational therapists, physical therapists, or counselors, when acting within the scope of their license, formal training, experience, and accepted standards of their profession. (2) An individual with certification in applied behavior analysis from the BACB or another organization that is 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. (3) An individual specializing in the treatment of autism spectrum disorder who meets all of the following requirements if verified on or before December 31, 2014, by one of the organizations specified in Section 2529.8: (A) Possesses a master's or doctorate degree in applied behavior analysis or a related field. (B) Demonstrates three years of experience in the last five years of providing, on a consistent rather than an episodic basis, applied behavior analysis services to individuals with autism spectrum disorder, either as an independent professional or as an employee of an organization providing services to those with autism spectrum disorder. (C) Submits references from at least two individuals who meet the requirements of paragraph (1) or (2). (4) An individual certified by the CBCO pursuant to subdivision (f) of Section 2529.7. (5) An individual who holds a bachelor's degree and meets the requirements of subparagraphs (B) and (C) of paragraph (3), subject to registration by one of the organizations specified in Section 2529.8. (b) The following persons shall be recognized as qualified to provide applied behavior analysis services as described in Section 2529.55, so long as supervised by a person described in paragraph (1), (2), (3), or (4) of subdivision (a): (1) A person who is certified as an Assistant Behavior Analyst by the BACB. (2) A person who is certified as a California certified assistant services professional by the CBCO pursuant to subdivision (g) of Section 2529.7. (c) (1) Pursuant to subdivisions (a) and (b), all of the following shall apply: (A) Persons meeting the requirements of paragraph (1) of subdivision (a) may hold themselves out as licensed professionals according to the conditions of their professional license and shall be deemed by the state as qualified to provide the services set forth in Section 2529.55. These persons may also hold themselves out as certified behavior analysis professionals if they meet any of the criteria specified in paragraph (2), (3), or (4) of subdivision (a). (B) Persons meeting the requirements of paragraph (2), (3), or (4) of subdivision (a) may hold themselves out as certified behavior analysis professionals and shall be deemed by the state as qualified to provide the services set forth in Section 2529.55. (C) Persons meeting the requirements of paragraph (5) of subdivision (a) may hold themselves out as registered behavior analysis professionals and shall be deemed by the state as qualified to provide the services set forth in Section 2529.55. (D) Persons meeting the requirements of subdivision (b) may hold themselves out as certified assistant behavior analysis professionals and shall be deemed by the state as qualified to provide the services set forth in Section 2529.55. (E) Persons meeting the requirements of paragraph (6) of Section 2529.55 may hold themselves out as qualified by the state solely for the purpose of implementing the services of applied behavior analysis, as set forth in Section 2529.55. (2) Paragraph (1) shall apply regardless of whether the services provided by those persons are paid for by private entities, governmental entities, nonprofit organizations, health care service plans, or insurers. 2529.7. (a) There is a hereby established a California Behavioral Certification Organization, which shall be a nonprofit corporation exempt from taxation under Section 501(c)(3) of the Internal Revenue Code and subdivision (d) of Section 23701 of the Revenue and Taxation Code. (b) The organization may commence activities as authorized by this chapter once it has submitted a request to the Internal Revenue Service and the Franchise Tax Board seeking tax exemption. The tax exempt application shall include information necessary to illustrate that the organization will operate in a manner consistent with the requirements imposed upon, and authority given to, the organization pursuant to this chapter. (c) The organization shall have until January 1, 2016, to receive accreditation from either ANSI or NCCA. (d) If the organization does not obtain national accreditation by January 1, 2016, it may not certify any additional individuals. However, any individuals certified during the five-year period commencing with the enactment of this section may retain their certification indefinitely provided they continue to meet any requirements established by the organization for certification maintenance and ethical compliance. (e) The CBCO board of directors shall be comprised of 12 members who shall be residents of the state. (f) The CBCO board of directors shall determine through a process involving public input the specific standards necessary to receive certification as a certified behavior analysis professional, as described in paragraph (4) of subdivision (a) of Section 2529.6. However, in the interest of consumer protection, the specific standards shall include one of the following: (1) Option one, which minimum requirements shall include all of the following: (A) A doctoral or master's degree in applied behavior analysis or a related field from a nationally accredited institution of higher learning and a course sequence in applied behavior analysis that is approved by the CBCO. The course sequence shall be at least equivalent to or more rigorous than an approved course sequence of the BACB. (B) The successful completion of an approved practicum or supervised experience in the practice of applied behavior analysis, totaling at least 1,500 hours over a period of not less than one calendar year, of which at least 75 hours are in direct one-to-one contact with the supervisor, or which is equivalent to or more rigorous than the approved practicum requirements of the BACB. (C) To ensure mastery of the material, successful completion of an examination administered by the BACB or the CBCO, which is at least as rigorous or equivalent to the examination administered by the BACB. (2) Option two, which minimum requirements shall include all of the following: (A) A doctoral or master's degree from a recognized educational program accredited by the Association for Behavior Analysis International, or from a program at a recognized educational institution that is approved by the third organization and that substantially meets the educational standards of the accreditation board of the Association for Behavior Analysis International. The program shall also include an approved course sequence of the BACB. (B) The successful completion of an approved practicum or supervised experience in the practice of applied behavior analysis, totaling at least 1,500 hours over a period of not less than one calendar year, of which at least 75 hours are in direct one-to-one contact with the supervisor. (C) To ensure mastery of the material, successful completion of an examination administered by the BACB or the CBCO, which is at least as rigorous or equivalent to the examination administered by the BACB. (g) The CBCO board of directors shall determine through a process involving public input the specific standards necessary to receive certification as a California certified assistant services professional, as described in paragraph (2) of subdivision (b) of Section 2529.6. However, in the interest of consumer protection, the specific standards shall meet all the following minimum requirements: (1) A bachelor's degree from a nationally accredited institution of higher learning and a course sequence in applied behavior analysis that is approved by the CBCO. The course sequence shall be at least equivalent to or more rigorous than an approved course sequence for an Assistant Behavior Analyst from the BACB. (2) The successful completion of an approved practicum or supervised experience in the practice of applied behavior analysis, totaling at least 1,000 hours over a period of not less than six months, of which at least 50 hours are in direct one-to-one contact with the supervisor, or which is equivalent to or more rigorous than the approved practicum requirements for an Assistant Behavior Analyst from the BACB. (3) To ensure mastery of the material, successful completion of an examination administered by the CBCO, which is equivalent to or more rigorous than the examination for an Assistant Behavior Analyst administered by the BACB. (h) The CBCO may charge applicants a fee not to exceed the costs of implementation of the chapter. 2529.8. (a) (1) Until December 31, 2014, the CBCO shall have the primary responsibility for verifying the qualifications of persons submitting the information set forth in paragraph (3) of subdivision (a) of Section 2529.6. (2) The CBCO shall have the primary responsibility for verifying the qualifications of persons submitting the information set forth in paragraph (5) of subdivision (a) of Section 2529.6. (b) (1) Prior to the establishment and operation of the CBCO or through December 31, 2014, whichever is earlier, CalABA or its designee shall be authorized to verify the qualifications of persons submitting the information set forth in paragraph (3) of subdivision (a) of Section 2529.6. (2) Prior to the establishment and operation of the CBCO, CalABA or its designee shall be authorized to verify the qualifications of persons submitting the information set forth in paragraph (5) of subdivision (a) of Section 2529.6. (c) (1) Prior to December 31, 2014, an individual meeting the requirements of paragraph (3) of subdivision (a) of Section 2529.6 may submit to the CBCO, or to CalABA, if the latter is accepting submissions, information necessary to establish that the individual meets the requirements set forth in paragraph (3) of subdivision (a) of Section 2529.6. (2) If submitted to CalABA under subdivision (b), CalABA shall issue to an individual that meets the qualifications a certificate of temporary certification as a California Certified Behavior Services Professional, which shall be valid for one year or until the CBCO is accepting submissions from those seeking certification pursuant to paragraph (3) of subdivision (a) of Section 2529.6, whichever is later. Once the CBCO commences accepting applications, CalABA shall finish processing all the submissions it has received and shall notify the CBCO of all individuals previously receiving certification from CalABA. Those individuals shall automatically receive CBCO certification. (3) If an individual submits information to the CBCO, the CBCO shall issue to an individual that meets the qualifications, certification as a California Certified Behavior Services Professional. (d) (1) An individual meeting the requirements of paragraph (5) of subdivision (a) of Section 2529.6 may submit to the CBCO, or to CalABA, if the latter is accepting submissions, information necessary to establish that the individual meets the requirements set forth in paragraph (5) of subdivision (a) of Section 2529.6. (2) If submitted to CalABA under subdivision (b), CalABA shall issue to an individual that meets the qualifications a certificate of temporary registration as a California Applied behavior analysis professional, which shall be valid for one year or until the CBCO is accepting submissions from those seeking registration pursuant to paragraph (5) of subdivision (a) of Section 2529.6, whichever is later. Once the CBCO commences accepting applications, CalABA shall finish processing all the submissions it has received and shall notify the CBCO of all individuals previously receiving registration from CalABA. Those individuals shall automatically receive CBCO registration, which shall be valid for five years from the original date of issuance by CalABA. (3) If an individual submits information to the CBCO, the CBCO shall issue to an individual who meets the qualifications, registration as a California Applied behavior analysis professional, which shall be valid for five years. (e) No later than January 1, 2016, individuals who have received certification pursuant to subdivision (c), shall maintain that certification only if they meet the requirements established by the CBCO for compliance with continuing education and ethical standards. If the CBCO is not in operation, those previously certified by the CBCO shall no longer be able to represent themselves as California Certified Behavior Services Professionals, but may represent that they are recognized by the state as qualified to provide applied behavior analysis services. 2529.9. (a) It shall be unlawful for any person to hold himself or herself out as a Board Certified Behavior Analyst (BCBA) unless the person is currently certified as a Board Certified Behavior Analyst by the BACB. (b) It shall be unlawful for any person to hold himself or herself out as a Board Certified Assistant Behavior Analyst (BCaBA) unless the person is currently certified as a Board Certified Assistant Behavior Analyst by the BACB. (c) It shall be unlawful to claim to have state recognition, certification, or registration as a California Certified Behavior Services Professional, California Applied behavior analysis professional, or California certified assistant services professional by CalABA, the CBCO, or the BACB, unless the person is otherwise recognized, certified, or registered by that entity. 2529.10. The CBCO shall implement this chapter in conformity with accepted standards for professional credentialing programs, including, but not limited to, doing all of the following: (a) Conducting certification activities in a manner that upholds standards for the competent practice of the profession of behavior analysis. (b) Structuring and governing the certification program in ways that are appropriate for the profession of behavior analysis and ensure autonomy in decision making over certification activities. (c) Including certified behavior analysts and at least one consumer or public member on the CBCO board of directors. (d) Having adequate financial and human resources to conduct effective and thorough certification, registration, recertification, and reregistration activities. (e) Establishing, publishing, applying, and reviewing policies and procedures for key certification or registration activities, such as determining eligibility criteria, applying for certification or registration, administering assessment instruments, establishing performance domains, appeals confidentiality, certification and registration statistics, and discipline, and complying with applicable laws. (f) Publishing a description of the assessment instruments used to make certification and registration decisions and the research methods used to ensure that the assessment instruments are valid. (g) Awarding certification or registration only after the applicant's knowledge and skill have been evaluated and found to be acceptable. (h) Maintaining a publicly available list of certified behavior analysts and verifying their certification. (i) Analyzing, defining, and publishing performance domains and tasks and associated knowledge and skills for the practice of behavior analysis, and using them to develop the assessment instruments. (j) Using assessment instruments that are derived from the job or practice analysis and are consistent with accepted psychometric principles and procedures, such as for setting passing scores, scoring and interpreting assessment results, ensuring reliability of scores, or establishing that different forms of the assessment instruments are equivalent. (k) Developing, adhering to, and publishing appropriate, standardized, and secure procedures for developing and administering the assessment instruments and for retaining all evidence of the validity and reliability of the assessment instruments, assessment results, and scores of all candidates. (l) Requiring periodic recertification and establishing, publishing, applying, and periodically reviewing policies and procedures for recertification or reregistration. (m) Requiring adequate continuing education. (n) Monitoring the practicing of applied behavioral analysis services consistent with the accepted standards of their respective professions and that the practice of applied behavior analysis is commensurate with their level of formal training and experience. (o) Maintaining accreditation by demonstrating continued compliance with accreditation standards. (p) Demonstrating that recertification or reregistration requirements measure or enhance the competence of those certified or registered. (q) Developing appropriate supervision guidelines for the provision of applied behavior analysis services. (r) (1) Establishing and maintaining a process to receive, review, and take corrective action, when necessary, with regard to complaints by consumers of applied behavior analysis or other interested parties against certificate holders or registrants and to make available to the public current status of those persons, such as whether they are in good standing or their certificate or registration has been suspended or revoked and details of any complaints or corrective action taken. (2) Maintaining on the organization's Internet Web site information updated annually related to implementation of this chapter. (s) Establishing a disciplinary and hearing process pursuant to Sections 2529.11 and 2529.12. (t) Requiring an applicant for certification or registration to submit fingerprint images to the CBCO, and establishing a procedure consistent with state law to obtain background information on the applicant. 2529.11. (a) The CBCO may discipline a certificate holder or registrant by any, or a combination, of the following methods: (1) Placing the certificate holder or registrant on probation. (2) Suspending the certificate or registration and the rights conferred by this chapter on a certificate holder or registrant for a period not to exceed one year. (3) Revoking the certificate or registration. (4) Suspending or staying the disciplinary order, or portions of it, with or without conditions. (5) Taking other action as the organization, as authorized by this chapter or its bylaws, deems proper. (b) The CBCO may issue an initial certificate or registration on probation, with specific terms and conditions, to any applicant. 2529.12. (a) No certificate holder, registrant, or applicant may be disciplined or denied a certificate or registration pursuant to Section 2529.11 except according to procedures satisfying the requirements of this section. A denial or discipline not in accord with this section shall be void and without effect. (b) Any applicant denial or discipline shall be done in good faith and in a fair and reasonable manner. Any procedure that conforms to the requirements of subdivision (c) is fair and reasonable, but a court may also find other procedures to be fair and reasonable when the full circumstances of the denial or discipline are considered. (c) A procedure is fair and reasonable if all of the following apply: (1) The provisions of the procedure have been set forth in the CBCO articles or bylaws, or copies of those provisions are sent annually to certificate holders or registrants if required by the articles or bylaws. (2) It provides the giving of 15 days prior notice of the denial or discipline and the reasons therefor. (3) It provides an opportunity for the applicant or certificate holder or registrant to be heard, orally or in writing, not less than five days before the effective date of the denial or discipline by a person or body authorized to decide that the proposed denial or discipline not take place. (d) Any notice required under this section may be given by any method reasonably calculated to provide actual notice. Any notice given by mail must be given by first-class or certified mail sent to the last address of the applicant or certificate holder or registrant shown on the organization's records. (e) Any action challenging a denial or discipline, including any claim alleging defective notice, shall be commenced within one year after the date of the denial or discipline. If the action is successful, the court may order any relief, including reinstatement, that it finds equitable under the circumstances. (f) This section governs only the procedures for denial or discipline and not the substantive grounds therefor. A denial or discipline based upon substantive grounds that violates contractual or other rights or is otherwise unlawful is not made valid by compliance with this section. (g) An applicant or certificate holder or registrant who is denied or disciplined shall be liable for any charges incurred, services or benefits actually rendered, dues, assessments, or fees incurred before the denial or discipline or arising from contract or otherwise. 2529.13. (a) Nothing in this chapter shall be interpreted to prohibit individuals not recognized in Section 2529.6 from providing the services defined as applied behavior analysis services, as set forth in Section 2529.55, provided those individuals do not hold themselves out to be Certified Behavior Analysts or claim to have state recognition or certification by the CBCO or CalABA pursuant to this chapter. (b) Nothing in this chapter shall be construed to 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. (c) Nothing in this chapter shall be construed to require certification, licensure, recognition, or authorization to provide applied behavior analysis services nor to add to or increase requirements for providing those services. SEC. 3. Nothing in this act shall be construed as interpreting an existing statutory or regulatory requirement. SECTION 1. It is the intent of the Legislature to enact legislation that would provide for the certification of applied behavioral analysis therapists.