Legislature(2013 - 2014)CAPITOL 106
03/18/2014 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation: Pediatric Partnership | |
| Presentation: Alaska Health Workforce Coalition & Vacancy Study | |
| HB324 | |
| HB361 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 324 | TELECONFERENCED | |
| *+ | HB 361 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 361-LICENSING OF BEHAVIOR ANALYSTS
4:39:07 PM
VICE CHAIR KELLER announced that the final order of business
would be HOUSE BILL NO. 361, "An Act relating to licensing of
behavior analysts."
4:39:21 PM
REPRESENTATIVE DAN SADDLER, Alaska State Legislature,
paraphrased from the sponsor statement:
Autism is a significant and growing problem in Alaska.
Statistics show that one in 110 Alaska children -
about 1 percent - are born with this developmental
disability, characterized by a diminished ability to
communicate, social isolation, and other symptoms.
While not curable, autism is treatable. Scientific,
peer-reviewed studies have shown that early intensive
treatment in the form of Applied Behavioral Analysis
offers the best opportunity to help people with autism
improve their ability to function productively in
society.
Applied Behavior Analysis is recognized as the basis
for the most effective form of treatment for autism by
the U.S. Surgeon General, The National Institute of
Child Health, and the American Academy of Pediatrics.
You can best understand ABA as behavior modification
therapy: It seeks to encourage appropriate behavior
by assessing and managing the relationship between the
environment and the desired behavior.
Forty years of research shows that nearly half of
people with autism who receive intensive early
intervention and treatment do not require lifelong
services and support - and half can achieve normal
functioning after two to three years. This can mean
lifetime savings of $200,000 to $1.1 million for a
person through the age of 55.
One of the most important elements in successful
autism treatment is having it provided by well-trained
behavioral therapists - those who hold the nationally
recognized credential of Board-Certified Behavioral
Analyst, or BCBA.
To qualify as a BCBA, applicants must have a minimum
of a master's degree, plus extensive training and
experience requirements of up to 1,500 hours of
supervised practice in the field, 225 hours of
graduate-level classroom work, or a year's experience
teaching ABA at the university level. They must also
pass the challenging BCBA certification examination.
The Board-Certified Assistant Behavioral Analyst, or
BCaBA credential, requires slightly lower standards.
The state already supports the training of BCBAs
through a grant to the Center for Human Development,
at the University of Alaska Anchorage. There are
about 20 to 30 BCBAs and BCaBAs in Alaska today,
although not all of them are currently working in the
field.
Under current state law, Alaskans with BCBAs cannot
bill health insurance companies or Medicaid for their
services at a rate that reflects their high degree of
training and professional skill because they are not
formally licensed.
HB 361 addresses this situation by providing for those
holding the BCBA or BCaBA credentials in Alaska to be
licensed by the Division of Professional Licensing, in
the Alaska Department of Commerce, Community and
Economic Development. Fourteen other states currently
provide licensing and regulate behavior analysts.
This approach has the strong support of Alaska BCBAs
and of national autism advocacy groups.
By ensuring licensing and higher standards of practice
for BCBAs and BCaBAs, HB 361 will:
· encourage more people to provide autism services in
Alaska
· offer higher reimbursement rates for professional
providers
· provide better outcomes for Alaska children with
autism
· save the state money by avoiding the need for costly
institutional care, and
· improve the quality of life for hundreds of Alaskans
and their families.
4:43:17 PM
VICE CHAIR KELLER opened public testimony.
4:43:46 PM
LORRI UNUMB, Vice President, State Government Affairs, Autism
Speaks, reported that she worked on autism insurance reform
legislation, she founded an applied behavior analysis treatment
center, and she taught law classes, including autism and the
law. She declared that, most importantly, she was the mother of
a severely affected 13 year-old autistic son. She stated her
strong support of HB 361. She reported that she had worked on
many of the 34 insurance laws nationwide, as well as many of the
professional licensure bills in 14 states. She offered her
belief that HB 361 was well written and "strikes an appropriate
balance; it recognizes the appropriate levels of professional,
the board certified behavior analyst, as well as the associate
level for those with lesser education experience." She noted
that the proposed bill allowed for a temporary license for those
licensed in another state, a disciplinary mechanism to sanction
those who violate the ethical and professional standards,
appropriate exemptions for those who did not need to be
licensed, and a two year transition for those already certified
elsewhere, but now practicing in Alaska. She noted that the
proposed bill reflected on the trend in creating professional
licensing.
4:47:06 PM
RICHARD KIEFER O'DONNELL, MD, Associate Director, Center for
Human Development, University of Alaska, shared that he had
started his work with the Center for Human Development in 2008
as part of a partnership with many other agencies and parents.
This partnership was tied to the core question for what type of
training and workforce development was necessary in Alaska to
serve the population of children with autism. He relayed that
this was a partnership with two other universities to offer the
program, and that there were now 20 certified analysts, with 17
others working toward the degree. He noted that many of the
graduates were now actively involved with the complex behavior
collaborative.
4:50:41 PM
RACHEL WHITE, Behavior Analyst, Good Behavior Beginnings, said
that she worked with children with autism, and that she provided
in-home services in the Anchorage and Mat-Su areas. She
declared her support for the proposed bill, as it would provide
access to services for clients with insurance that required
state licensing, as opposed to national certifications. She
expressed support for the regulation of services so clients
would receive quality and ethical behavior analytic services.
4:52:44 PM
ANNETTE BLANAS, Capacity Building and Autism Interventions
Project Director, Center for Human Development, University of
Alaska, reported that she was on the autism task force, and that
she was a board certified behavior analyst, as well as the
mother of a son with autism. She declared her support for the
proposed bill. She added that licensure brought a protection
for families in rural communities, as they were more vulnerable
to practices "that are not necessarily good." She pointed out
that, as many families were desperate for early intervention,
the licensure would add a component of protection for consumers.
4:54:20 PM
SUZANNE LETSO, Alaska Center for Autism, reported that she
operated a school, was a board certified behavior analyst, and
was the mother of a child with autism. She directed attention
to her previously submitted testimony [Included in members'
packets]. She stated that the proposed bill was well written
and would protect consumers, ensure appropriate interventions,
and safeguard the funding for education of children with autism.
She stated that the BCBA (Board-Certified Behavioral Analyst)
was the international organization recognized for setting the
standard for behavior analytics and qualifications worldwide.
She offered her belief that it was important to tie into this
standard, as it would allow recruitment into Alaska and would
reduce the cost for implementing licensure. She declared the
need for a funding stream to support the UAA graduates in
certified behavior analysis.
REPRESENTATIVE REINBOLD asked if teachers were getting enough
support with autistic children in the public classroom.
MS. LETSO offered her belief that they were not, and that it was
necessary for more training and more experts.
5:00:19 PM
REBEKA EDGE, Behavior Matters, reported that she was a board
certified behavior analyst, and had two children with autism.
She said that, although her business billed multiple insurance
companies, Tri-Care was the only reliable payer. She said that
most insurance companies required licensure.
5:02:32 PM
REPRESENTATIVE SADDLER asked if the proposed bill would inhibit
the ability of not licensed staffers to do their work.
MS. EDGE said that it would not as there were also behavioral
technicians.
5:03:21 PM
VICE CHAIR KELLER asked about the acceptance of national
certification by the insurance companies, and noted that Premera
Blue Cross did support the proposed bill. He asked if the
proposed bill would set up a self-regulating board.
REPRESENTATIVE SADDLER replied that private insurers were making
intermittent payments for claims, although the coding for
services was often questioned. He pointed out that Premera Blue
Cross supported the "approach of this bill" and they did see the
benefit of licensure, although they interpreted the need for an
independent professional licensing board. He reported that the
proposed bill envisioned departmental licensing, which he opined
would meet the licensure requirements for insurance billing and
Medicaid.
VICE CHAIR KELLER suggested allowing the indeterminate fiscal
note be passed on to the House Finance Committee.
5:05:07 PM
REPRESENTATIVE TARR commented that a recent article had linked
autism to environmental causes.
REPRESENTATIVE REINBOLD offered her belief that the increasing
rates of autism should be researched, especially if there was a
link to environmental causes. She suggested that early
intervention could cut the associated long term cost.
5:06:40 PM
REPRESENTATIVE PRUITT moved to report HB 361, labeled 28-
LS1474\A, out of committee with individual recommendations and
the accompanying fiscal notes.
VICE CHAIR KELLER objected. He then removed his objection.
There being no further objections, HB 361 was moved from the
House Health and Social Services Standing Committee.