Legislature(2013 - 2014)SENATE FINANCE 532
04/16/2014 01:30 PM Senate FINANCE
| Audio | Topic |
|---|---|
| Start | |
| HB379 | |
| SB220 | |
| HB308 | |
| HB361 | |
| HB160 | |
| HB116 | |
| SB48 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 278 | TELECONFERENCED | |
| + | HB 385 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | HB 379 | ||
| = | SB 220 | ||
| = | HB 308 | ||
| = | HB 361 | ||
| = | HB 160 | ||
| = | SB 48 | ||
| = | HB 116 | ||
HOUSE BILL NO. 361
"An Act relating to licensing of behavior analysts."
2:40:00 PM
REPRESENTATIVE DAN SADDLER, explained the legislation. He
stated that Autism was 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 was treatable. Scientific, peer-
reviewed studies show that early intensive treatment in the
form of Applied Behavioral Analysis (ABA) offered the best
opportunity to help people with autism improve their
ability to function productively in society. He stated that
ABA was 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. One can best understand ABA as
behavior modification therapy: It sought to encourage
appropriate behavior by assessing and managing the
relationship between the environment and the desired
behavior. Forty years of research showed that nearly half
of people with autism who received intensive early
intervention and treatment did not require lifelong
services and support, and half could achieve normal
functioning after two to three years. This could mean a
lifetime savings of $200,000 to $1.1 million for a person
through the age of 55-years-old. One of the most important
elements in successful autism treatment is having it
provided by those who hold the nationally recognized
credential of Board-Certified Behavioral Analyst (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 1500 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, required slightly lower
standards. The state already supported the training of
BCBAs through a grant to eh Center for Human Development at
UAA. There were currently approximately 20 to 30 BCBAs and
BCABAs in Alaska, although not all of those were currently
working in the field. Under current state law, Alaskans
with BCBAs could not bill health insurance companies or
Medicaid for their services at a rate that reflected their
high degree of training and professional skill because
there were not formally licensed. He announced that BY 361
addressed that situation by providing for those holding the
BCBA or BCABA credentials in Alaska to be licensed by the
Division of Professional Licensing, in the DCCED. He
announced that 14 other states currently provided licensing
and regulated behavior analysts. The approach had the
strong support of Alaska BCBAs and the national autism
advocacy groups. By ensuring licensing and higher standards
of practice for BCBAs and BCABAs, HB 361 would do the
following: 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.
LORRI UNUMB, EXECUTIVE DIRECTOR, AUTISM SPEAKS, SOUTH
CAROLINA (via teleconference), spoke in support of the
legislation. She stated that she was involved in various
autism advocacy groups. She felt that the bill took in many
considerations including people who were moving from other
states to practice behavior analysis. She remarked that the
bill outlined some exemptions for people who need not have
a license, such as a family member of a person with autism.
She stated that the legislation relied on the existing
national board certification, which was the appropriate
structure for a licensing bill. She announced that she had
worked on various state's legislation that created
licensure for behavior analysts. She stated that there were
currently 15 state that licensed behavior analysts, and
Tennessee had just passed a behavior analyst licensing
bill, so there were almost 16 states that license behavior
analysts. She remarked that the legislation contained
disciplinary mechanisms to ensure adequate consumer
protection and created a temporary license for those who
had already been practicing within the state.
2:47:04 PM
REBEKA EDGE, DIRECTOR, BEHAVIOR MATTERS, EAGLE RIVER (via
teleconference), testified in support of the legislation.
She announced that she was a parent of two children with
autism. She stated that in her position as director of
Behavior Matters, she had a staff of 24 that served clients
Anchorage, Mat-Su, Talkeetna, Kenai, and Juneau. She felt
that the legislation would allow her business to continue
to work with their current families while provided a
professional weight that was consistent with their training
and expertise.
Co-Chair Meyer wondered if the bill would pertain to other
behavioral issues other than autism. Representative Saddler
replied that that the legislation would pertain to other
behavioral issues. He stated that the principles of applied
behavioral analysis have applicability to dealing with
various development disabilities like children with fetal
alcohol spectrum disorder (FASD).
Co-Chair Meyer wondered how many people would seek a
license in behavioral analysis. Representative Saddler
replied that there were approximately 25 people that would
seek a license, but agreed to provide further information.
Co-Chair Meyer asked if other states had a similar program.
Representative Saddler responded that 16 states had
instituted behavioral analysis licenses.
SARA CHAMBERS, DIRECTOR, CORPORATIONS, BUSINESSES, AND
PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE, COMMUNITY
AND ECONOMIC DEVELOPMENT, introduced herself.
Co-Chair Meyer wondered if she had drafted the attached
fiscal note. Ms. Chambers replied that she did not draft
the fiscal note, but she was familiar with it.
Co-Chair Meyer remarked that the fiscal note was
indeterminate. He looked at the third paragraph fiscal
analysis, and saw that the financial impact to health care
and Medicaid services could be significant. He asked for
further explanation regarding that statement. Ms. Chambers
responded that the fiscal note that he was referencing was
from the Department of Health and Social Services (DHSS).
She stated that DCCED supplied a fiscal impact note.
2:52:26 PM
Vice-Chair Fairclough stated that there was an issue of
recovering the fees for licensing in Alaska. She remarked
that the fiscal note was very low from DCCED. She queried
the fee estimate. Ms. Chambers responded that the fiscal
note reflected the additional appropriation that was needed
to implement the program, and it was not the total cost of
the program. She announced that she had been working with
the bill sponsor to provide additional information that
would be an estimate of anticipated additional costs based
on similarly situated programs. She stated that it was
determined that the additional cost plus the fiscal note
could result in a license that would cost around $500 to
$600 per license.
Vice-Chair Fairclough stressed that Alaska had faced issues
of investigation, as far as the boards to use the
information that DCCED provided to manage the funds.
Representative Saddler replied that the fee would be
significantly lower after the first year. He observed that
it would be small number of licensees, so the likelihood of
investigation would be substantially low.
Vice-Chair Fairclough stressed that there was a flat rate
of how the departments spread cost over licenses.
Representative Saddler agreed that he would not argue
statistics.
TERI KEKLAK, DIVISION OF BEHAVIORAL HEALTH, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES (via teleconference), stated
that the Division of Health Care Services created the DHSS
fiscal note. She stated that the fiscal note was
indeterminate because until licensure occurs, it was
difficult for the department to estimate the utilization
that might occur. She stated that DHSS required approval
that the coverage would be paid to the independent
practitioners under benefits. She stated that the licensees
were not currently listed in the Medicaid statute as
independent practitioners. She stated that there would be
some analysis of the medical necessity, utilization, and
determine services.
2:57:48 PM
Vice-Chair Fairclough looked at page 2 of the fiscal note,
and saw that it indicated 1838 under the age of 21 with a
diagnosis of autism. She queried an estimate of the cost of
one person receiving services. Ms. Keklak replied that DHSS
could not currently estimate that cost. She stated that
there needed to be a determination of the specific services
that would be covered.
Vice-Chair Fairclough understood that there was a wide
range of services, so she asked for an estimate range of
the cost of services. Ms. Keklak replied that she could not
address a range of costs.
DEB ETHERIDGE, MEDICAL ASSISTANT, DIVISION OF HEALTH CARE
SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES (via
teleconference), responded to a question from Vice-Chair
Fairclough. She stated that the persons who were diagnosed
with autism would undergo an initial assessment that would
be eligible for and need service. She remarked that, in
comparison to other states, the assessment cost would be
around $175. If it was estimated that 100 percent of
persons under the age of 21 with a diagnosis of autism, the
total health assessment cost would be around $320,000. She
stated that the service cost estimate would require some
eligibility determinations.
HB 361 was HEARD and HELD in committee for further
consideration.
3:02:12 PM
AT EASE
3:09:24 PM
RECONVENED