04/14/2014 01:30 PM Senate HEALTH & SOCIAL SERVICES

             HB 361-LICENSING OF BEHAVIOR ANALYSTS                                                                          
                                                                                                                                
1:52:04 PM                                                                                                                    
CHAIR STEVENS announced  the consideration of HB 361.  He said it                                                               
was the  first hearing  on the  bill. The intent  is to  have the                                                               
sponsor introduce  the bill, take  public testimony, and  look to                                                               
the will of the committee.                                                                                                      
                                                                                                                                
1:52:41 PM                                                                                                                    
REPRESTENTATIVE  DAN SADDLER,  Alaska State  Legislature, Juneau,                                                               
Alaska, sponsor  of HB  361. He read  from the  following sponsor                                                               
statement:                                                                                                                      
                                                                                                                                
     Autism is a significant  and growing problem in Alaska.                                                                    
     Statistics  show   that  about  2  percent   of  Alaska                                                                    
     children 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                                                                                                         
                                                                                                                                
1:56:15 PM                                                                                                                    
CHAIR  STEDMAN noted  two fiscal  notes;  one indeterminate  note                                                               
from Department  of Health  and Social  Services (DHSS),  and one                                                               
fiscal   note  for   $46,600   receipt-supported  services   from                                                               
Department  of  Commerce,   Community  and  Economic  Development                                                               
(DCCED).                                                                                                                        
                                                                                                                                
SENATOR MICCICHE asked about the fiscal note from DCCED.                                                                        
                                                                                                                                
REPRESENTATIVE SADDLER explained that  it covers the initial cost                                                               
of  setting  up  the  database  and  arranging  for  professional                                                               
licensing. The  subsequent $1,700 is  a minimal cost  that covers                                                               
the cost of fingerprinting for  new applicants, potential hearing                                                               
mediation  costs,  legal support,  and  paperwork.  He noted  the                                                               
advantage of professional licensing  by a department, rather than                                                               
by  a  professional licensing  board;  lower  need for  meetings,                                                               
travel, and administrative staff support.                                                                                       
                                                                                                                                
CHAIR STEDMAN opened public testimony.                                                                                          
                                                                                                                                
1:57:54 PM                                                                                                                    
ANNETTE   BLANAS,   Director,   Capacity  Building   and   Autism                                                               
Interventions Project,  Center for Human  Development, Anchorage,                                                               
Alaska, testified  in support of HB  361. She said she  is also a                                                               
licensed board certified Behavioral Analyst  and the mother of an                                                               
autistic  child.  She  described  how  desperate  people  are  to                                                               
receive  services  for autism.  She  related  that some  services                                                               
provide inadequate and  unsafe programs and there  is very little                                                               
parents  can  do  to address  problems.  Rural  communities  have                                                               
little  access to  professionals  and are  at  risk of  receiving                                                               
services  from practitioners  who  are not  providing quality  or                                                               
safe services. She  spoke of the importance of  licensure and the                                                               
advantage of allowing practitioners to bill insurance companies.                                                                
                                                                                                                                
SUZANNE LETSO, CEO, Alaska Center  for Autism, Anchorage, Alaska,                                                               
testified  in support  of HB  361. She  said she  is also  on the                                                               
Behavioral  Analyst  Certification  Board.  She  stated  that  in                                                               
addition  to helping  families in  rural areas,  there is  also a                                                               
need to  protect large  schools like  Anchorage who  are spending                                                               
well over $1 million a year  on ABA services. She opined that the                                                               
state would  save money if even  one person is able  to come home                                                               
from an out-of-state  placement or prevented from  needing such a                                                               
placement.  She referred  to documents  in members'  packets that                                                               
depict cost savings in this area.                                                                                               
                                                                                                                                
She  maintained that  this legislation  will save  money, protect                                                               
consumers,  and  enhance the  quality  of  life for  people  with                                                               
autism and their  families. She noted that  this legislation also                                                               
has  applicability  for  other  populations  like  fetal  alcohol                                                               
syndrome and traumatic brain injury sufferers.  .                                                                               
                                                                                                                                
2:02:37 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
CHAIR STEDMAN closed public testimony.                                                                                          
                                                                                                                                
2:03:03 PM                                                                                                                    
SARA CHAMBERS,  Director, Division of Corporation,  Business, and                                                               
Professional  Licensing, Department  of  Commerce, Community  and                                                               
Economic Development (DCCED),  Juneau, Alaska, answered questions                                                               
related to  HB 361. She  said bill  would create a  new licensing                                                               
program  governed by  the division  instead  of by  a board.  The                                                               
division would deliver administrative  services to make sure that                                                               
the statutes and ensuing regulations  are complied with. She said                                                               
the department  does not  take a  position on  the bill,  but has                                                               
been  working with  the  sponsor  to analyze  the  impact to  the                                                               
division.  The  department is  prepared  to  implement the  bill,                                                               
should it become law.                                                                                                           
                                                                                                                                
2:04:28 PM                                                                                                                    
SENATOR  ELLIS noted  he served  on the  Autism Task  Force along                                                               
with the sponsor. He stated  that HB 361 is important legislation                                                               
and gets more professionals into  the field to help families that                                                               
face major challenges.                                                                                                          
                                                                                                                                
SENATOR  ELLIS  moved  to  report  HB  361  from  committee  with                                                               
individual recommendations and attached fiscal notes.                                                                           
                                                                                                                                
CHAIR  STEDMAN  announced  that  without  objection,  HB  361  is                                                               
reported  from the  Senate Health  and  Social Services  Standing                                                               
Committee.