Provides for the licensure of behavior analysts

Summary of provisions

Section 1 would add a new Section 8405-a to the education law to define the practice of behavior analysis, and to establish licensure require- ments and the fee for initial licensure and a triennial registration process for licensed behavior analysts. Section 2 adds an effective date of six months after the bill is signed into law with authority for the Department of Education to promulgate necessary rules and regulations prior to that time. Section 2 would make conforming changes to Article 163, the Mental Health Practitioners Act.

Existing law

Does not provide for licensure of behavior analysts.

Justification

The field of behavior analysis grew out of the scientific study of learning and behavior. It is a separate and distinct scientific disci- pline and professional practice. Behavior analysis has three main branches: conceptual or theoretical, experimental ("EAB"), and applied behavior analysis ("ABA"). EAB is the basic science of this field and has, over many decades, produced a substantial and well-respected research literature. That literature provides the scientific foundation for ABA, which is both an applied science with its own research litera- ture on methods for understanding and changing behavior, and application of behavior analytic principles and methods in the provision of services to meet the needs of diverse populations in a wide range of settings. Examples include: building the skills of children and youths in school settings; conducting functional behavioral assessments and analyses that guide the creation of behavior intervention programs as part of Individ- ual Educational Plans and Individual Family Support Plans; enhancing the functioning of children and adults with various diagnoses; and augment- ing the performance and satisfaction of employees in organizations and businesses.

This bill would make the credential of Board Certified Behavior Analyst ("BCBA") as granted by the Behavior Analyst Certification Board, Inc. ("BACB") the principal requirement for licensing behavior analysts in New York. The BACB was established in 1998 to meet needs identified by governments, consumers, funding sources, and behavior analysts. The BACB has degree, coursework, supervised practical training, examination, and continuing education requirements for credentialing practitioners of ABA that have been determined by the profession. It also has rigorous stan-

dards and systematic procedures for determining eligibility require- ments, developing and administering exams, and establishing and enforc- ing disciplinary standards. The BACB credentialing program therefore provides valuable protections for practitioners, consumers, and govern- ments. The BACB is accredited by the National Commission for Certifying Agencies of the Institute for Credentialing Excellence. NCCA-accredited credentials, including the credentials issued by the BACB, are accepted by many public and private funding sources.

Although state laws regulating the practice of psychology and social work include some exemptions for individuals who practice ABA in a particular setting, such as a school, existing site-based exemptions simply do not go far enough to ensure that individuals who will benefit from ABA services can attain access to such services from credentialed behavior analysts. The education and treatment of individuals with autism spectrum disorder ("ASD") is an area that is particularly affected by the need for well-trained professional behavior analysts. As of December 1, 2006, according to the New York State Education Depart- ment ("Department"), there were 15,459 children between the ages of four and 21 that were identified with autism in New York; 11,569 (or over 70%) were between the ages of four and 13.

These numbers, according to the Department, have been increasing signif- icantly since 2001 when only 7,918 children were so identified. (Educa- tion programs and services for students with autism, including Asperger's Syndrome, EMSC-VESID Committee Report, October 10, 2007, p. 3). In 2006 there were 15,459 children between the ages of four and 21 that were identified with autism in New York, and 11,569 (or over 70%) were between the ages of four and 13 individuals have been identified with ASD in New York. The New York State Department of Health has specifically recognized applied behavior analysis as "an important element of any intervention program for young children with autism." (New York State Department of Health, Division of Family Health, Bureau of Early Intervention, Clinical Practice Guideline, Quick Ref. Guide, p. 33).

Last year, Chapters 595 and 596 of the Laws of 2011 authorized health insurance coverage for the treatment of ASD. Chapters 595 and 596 authorized payment for behavioral health treatments for individuals with autism, including ABA services provided by a licensed provider or an individual certified as a Board Certified Behavior Analyst by the BACB. It is now important for New York to ensure that beneficiaries of health plans covered by those laws and other consumers will be able to access ABA services provided by qualified professionals. This bill will help accomplish that.

This change is long overdue. ABA intervention provided by a qualified behavior analyst has been recognized as an effective, evidence-based intervention for autism by the U.S. Surgeon General, New York State Department of Health, U.S. Department of Defense, American Academy of Pediatrics, Association for Science in Autism Treatment, and Autism Speaks. There are hundreds of published studies documenting the effec-

tiveness of many specific, focused ABA techniques for building a wide range of important skills and reducing problem behaviors in people with ASD of all ages, in a variety of settings. At least 11 controlled between-groups studies show that multiple ABA techniques combined into early, comprehensive, intensive treatment programs can produce large improvements in symptoms and skill deficits in many young children with ASD when treatment is directed by qualified professional behavior analysts Careful meta-analyses showed that early intensive ABA produced larger, more reliable improvements than "eclectic" (mixed-method) treat- ment or standard services.

Research has shown that without effective treatment, each person with autism will incur lifetime costs of specialized services and care of at least $3.2 million (Ganz, 2006). several studies have shown that with early, comprehensive, intensive ABA treatment, a large number of chil- dren with autism need few or no specialized, intensive services from early elementary school age onward, reducing those costs by at least $1 million per person, on average (e.g., Jacobson, Mulick, & Green, 1998; Motiwala et al., 2006). Focused ABA interventions can also reduce healthcare utilization and costs for people with autism by increasing personal safety and self-help skills, increasing cooperation with medical and dental care routines, and decreasing behaviors that often result in costly (and largely ineffective) medication and hospitaliza- tions (e.g., eating problems. sleeping problems, self-injury, elope- ment, aggression, and pica).

Today, there are over 10,000 BACB-certified behavior analysts around the world, but only 600 in New York. Licensure will clearly change that dynamic and keep qualified professionals in New York to meet the need for ABA services. programs to train ABA practitioners are already in place in 12 colleges and universities here in New York. These programs are geo graphically dispersed throughout the state and are located at both public and private universities. For instance, SUNY Stony Brook and Binghamton as well as Columbia, Russell Sage, University of Rochester, and Queens College of the City University of New York each have programs with BACB approved course sequences. Other such programs are located at hundreds of colleges and universities around the world.

Eight other states have enacted legislation to license behavior analysts. Many other states recognize the BACB credentials in other types of laws and regulations that permit holders of those credentials to practice and to be reimbursed for their services. In situations where there has been a need for separation in the professions, especially those who serve people with disabilities, the New York Legislature has not hesitated to act. For instance, in the areas of Occupational Therapy (Article 156), Speech Therapy (Article 159), and physical Therapy (Arti- cle 156), the education law has been amended to separate those professions from others and provide for their expansion and growth. The proposed bill would do the same for behavior analysis.

Legislative history

New bill.

Fiscal implications

Minimal.

Effective date

Six months after the act is signed into law, but the State Education Department would be authorized to promulgate any necessary regulations prior to that date.