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.