The Berkshire Association for Behavior Analysis and Therapy

Issues Related to Professional Practice

Behavior Analyst Licensing Hearing Well Attended By Behavior Analysts and Parent Advocates


            BABAT would like to thank the many practitioners and parent advocates that turned out for the Sept. 20th hearing before the Joint Committee on Consumer Protection and Professional Licensing.  We packed the room (so much so they had to move the hearing to a larger room to accommodate the crowd) and showed our enthusiastic support for a responsible licensing process for behavior analysts. 

 

 Rep. Balser's bill was heard first.  A panel of three Psychologists from the Mass. Psychological Association testified in favor of Rep. Balser's bill.  Then, three licensed Psychologists (including two, Dennis Kolodzieski and BABAT President Joe Ricciardi, that BABAT requested to attend the hearing) testified in opposition to the MPA-supported bill. 

 

Following this, Rep. Scibak's bill was heard.  Over 20 persons signed up to testify in favor of this bill including Chair of Professional Practice Bill Ahearn (for a copy of his testimony, click HERE), Nan Leonard, Judith Ursitti, and Cathy Boyle.  We are incredibly fortunate to have such strong parent advocates for behavior analytic services and we thank them all for their support.  Testimony in favor of Rep. Scibak's bill was enthusiastic and thorough.  There was no testimony in opposition to Rep. Scibak's bill.  It should also be noted that in addition to behavior analysts and parent advocates, the Mass. Association of Health Plans also supports Rep. Scibak's bill (see HERE).

          We likely will not hear about the Joint Committee's decision for a while but as soon as we do, we will pass along our recommendations for action. 

 

BABAT would also like to thank APBA for their summary of the two bills and the BACB for alerting certificants in MA about the pending legislation that would affect our right to practice.

[Posted Prior to the September 20th Hearing]

The right to practice of BACB-credentialed behavior analysts in Massachusetts hangs in the balance. 

Legislative Update: Protecting Your Right to Practice as a Behavior Analyst  

The hearing on the bills relative to the licensure of behavior analysts is scheduled for Tuesday September 20th at 1:00 PM in the State House in Room B1. The Massachusetts Psychological Association wants to regulate Behavior Analysts while BABAT believes an independent Board of Behavior Analysts is necessary if licensure of Behavior Analysts is enacted in MA. We want to thank BABAT members for their support of Rep. Scibak's bill (click here to see H01901) on licensing.  Your efforts have been an important contribution.  By contacting your state legislators and expressing your support of this bill and opposition to Rep. Balser's bill (click here to see H01002), you have helped significantly.   

There are 38 co-sponsors to Rep. Scibak's bill (see below) and now we need to redouble those efforts as the bills are being reviewed by the Joint Committee on Consumer Protection and Professional Licensure. We need behavior analysts to educate themselves and their legislators on these bills. A brief synopsis of each bill and bulleted points are provided on this handout. To view an extremely informative interview with Rep. Scibak on the licensing bills, click here.  We thank MassABA for putting this video together and giving us permission to share the video with our members.  BABAT is very thankful for the strong commitment of MassABA in advocating for the BCBAs right to practice - our groups are strongly united in this effort!


Phone calls, personal letters, and emails to your senator and representative are very helpful.  Though it will be most helpful for you to craft your own message, BABAT Board member Amanda Karsten has drafted her testimony (see a copy here) that she will submit to the joint committee at the upcoming hearing.  It is an excellent example of a clear, concise and personal message about the licensing bills.  We urge you to contact your legislators (email or letter) and invite their support of the licensure bill that best meets your needs. BABAT President, Joseph Ricciardi, sent an email to his representative and a copy can be found here. Information related to contacting your representative and senator can be found here. 
For those interested in also contacting the members of the Joint Committee, the committee is made up of: Senate Chair Thomas P. Kennedy, Senate Vice Chair Anthony Petruccelli, House Chair Theodore C. Speliotis, House Vice Chair Robert F. Fennell, Senators Sal N. DiDomenico, James E. Timilty, Kenneth J. Donnelly, Michael R. Knapik, Representatives Geraldine Creedon, Thomas M. Stanley, Joyce A. Spiliotis, Angelo J. Puppolo, Jr., Paul A. Brodeur, Tackey Chan, Rhonda L. Nyman, Steven S. Howitt, Donald F. Humason, Jr.  The address and phone number listed for the committee are Joint Committee on Consumer Protection and Professional Licensure; Room 43; State House Boston, MA 02133; (617) 722-2030.   

Lastly, the following legislators have co-sponsored Rep. Scibak's bill: Linda Dean Campbell, Gale D. Candaras, Michael O. Moore, Frank I. Smizik, Jennifer E. Benson, Michael F. Kane, James E. Timilty, Elizabeth Poirier, Cory Atkins, Randy Hunt, David P. Linsky, Carolyn C. Dykema, John V. Fernandes, Todd M. Smola, Gailanne Cariddi, David M. Torrisi, William N. Brownsberger, Thomas P. Conroy, James J. O'Day, James Arciero, Sal N. DiDomenico, John D. Keenan, Louis L. Kafka, Karen E. Spilka, F. J. Barrows, Michael R. Knapik, Chris Walsh, Kimberly Ferguson, Anthony W. Petruccelli, Kay Khan, Anne M. Gobi, Barry R. Finegold, Bradford Hill, Edward Coppinger, Thomas A. Golden, Katherine M. Clark.  If you are contacting them, make sure to thank them for their support and then provide to them your message.


Thank you again for your time and efforts during this crucial time for our field.  


This update was submitted by William Ahearn, Ph.D., BCBA-D, BABAT Chair of Professional Practice.  BABAT welcomes questions or input - please contact Dr. Ahearn at bahearn@necc.org. 

 

 
 

MEMO FROM APBA

The Association of Professional Behavior Analysts
 

6977 Navajo Rd. #176 · San Diego, CA 92119 · info@apbahome.net
MEMO
DATE:            September 14, 2011

TO:                  William Ahearn, PhD, BCBA-D
                        Chair of Professional Practice
                        Berkshire Association for Behavior Analysis and Therapy (BABAT)

FROM:            Gina Green, PhD, BCBA-D
                        Executive Director, APBA
RE:                  Request for opinion on proposed bills to license behavior analysts in MA

Thank you for asking for APBA’s analysis of two bills to establish licensure of behavior analysts that will be heard by the legislature of the Commonwealth of Massachusetts on September 20. Comments on the general provisions of each bill, its likely effect on practitioners and consumers of applied behavior analysis (ABA) services, and our recommendations follow.

H01901  (Scibak)

This bill has a number of strengths:

·         It proposes to establish a board to license and oversee the practice of behavior analysts that consists of qualified professional behavior analysts, along with two members of the public. In doing so, the bill recognizes that behavior analysis has long been established as a distinct discipline, and that the practice of ABA is a distinct profession. It also respects and recognizes the importance of having the practice of behavior analysis regulated by members of that profession, as we believe is the case for other professions that are licensed in MA.

·         In making certification by the Behavior Analyst Certification Board, Inc. (BACB) the foundational requirement for licensure, the bill (if adopted) will enable the Commonwealth and its citizens to benefit from several facts about the BACB:

o   Its programs are accredited by the well-respected National Commission on Certifying Agencies (NCCA) of the National Organization for Competency Assurance. The NCCA standards are grounded in case law and best practices regarding professional credentialing. The NCCA accredits certifications in a number of professions, many of which are written into laws and regulations. Indeed, the NCCA-accredited BACB credentials are now recognized in many laws and regulations around the U.S.

o   Over the past 13 years, the BACB has developed standards for certifying practitioners of ABA based on extensive job analyses involving thousands of professional behavior analysts. Those standards include degrees, coursework, supervised experiential training, and passage of a psychometrically valid and reliable objective examination to obtain certification, and continuing education to maintain certification. Thus MA citizens can be confident that individuals who are licensed to practice ABA have met requirements established by knowledgeable members of that profession.

o   The BACB certification programs have built-in, empirical mechanisms for evaluating the certification standards periodically and upgrading them as needed. Those mechanisms ensure that the certification requirements – and therefore the MA licensure requirements -- reflect new developments in research, professional practice, laws and regulations, social and cultural norms, and other factors affecting the delivery of ABA services to consumers.

o   The BACB has also established Guidelines for Responsible Conduct for Behavior Analysts and Professional Disciplinary and Ethical Standards, both of which are designed to protect consumers as well as BACB-certified practitioners. The latter are enforced by the BACB. By making BACB certification the main requirement for licensure, H01901 affords MA consumers of ABA services more protection than many other licensure laws, because the practice of Licensed Behavior Analysts and Licensed Assistant Behavior Analysts will be overseen by both the BACB and the state behavior analyst licensure board.

o   Basing licensure of behavior analysts on BACB certification is likely to save money for the Commonwealth. For instance, the state will not have to undertake the very arduous and expensive task of developing a psychometrically and legally validated behavior analyst licensure exam, because applicants will be required to have passed the BACB exam. Additionally, since all licensure applicants’ degrees, coursework, and experiential training will be vetted by the BACB, that will save the behavior analyst licensure board a great deal of time and labor. 

·         Basing licensure on BACB certification is consistent with the recently adopted MA autism insurance law, which recognizes Board Certified Behavior Analysts as qualified providers of ABA services for people with autism spectrum disorders. Adoption of H01901 will help ensure that there is a cadre of properly credentialed ABA providers in the state, thereby fostering smooth implementation of the autism insurance law.

Our recommendation is to support H01901.

H01002 (Balser)

APBA respects the right of qualified psychologists to practice psychology within the bounds of relevant laws and the American Psychological Association (APA) Code of Ethics, and to have the licensure and practice of clinical psychologists overseen by members of that profession.  With respect to licensing and overseeing the practice of behavior analysts, however, this bill is problematic for many reasons:

·         It defines ABA incorrectly as a “subset of psychological treatment methodologies” and the practice of ABA as a “technical set of skills” that are useful only with a few client populations. That definition ignores several decades of published work on the conceptual and methodological underpinnings of the discipline of behavior analysis as distinct from psychology and the efficacy of ABA interventions for a wide array of socially important behaviors in a variety of populations.

·         The bill does not reflect an accurate understanding of the BACB, which is accredited to issue professional credentials to those who have met requirements for practicing ABA that have been set by the profession of behavior analysis, distinct from psychology and other professions. In fact, the APA’s Council of Specialties in Professional Psychology states explicitly that “The BACB certifies behavior analysts. The BACB certification is not psychological certification; instead, the BACB’s certification reflects the practice of applied behavior analysis in a variety of professional fields.” (http://cospp.org/specialties/behavioral-and-cognitive-psychology).

·         Although some behavior analysts have degrees in psychology, many have earned degrees from a variety of other academic departments. It is not clear that the APA Code of Ethics, which is included in this bill, could be enforced with behavior analysts who do not have degrees or licenses in psychology.

·         This bill would have the practice of ABA overseen not by members of that profession, but by psychologists. With due respect to that field, relatively few psychologists have the training that the profession of behavior analysis has determined to be necessary to practice ABA at even a basic level. Just as it would be inappropriate for the practice of psychology to be overseen by professionals who do not hold credentials in psychology, it is inappropriate for psychologists who are not credentialed in ABA to oversee the practice of ABA.

·         Adoption of this bill would likely have several effects:

o   Relatively few people with bona fide training and credentials in ABA would be eligible for licensure, and relatively few people who are truly qualified to do so would be available to supervise the delivery of ABA services. That would make it difficult for consumers to access those services, which would impede implementation of the autism insurance law and possibly other extant laws and regulations. It would also increase the cost of ABA services unnecessarily.

o   Conscientious licensed psychologists would be put in the difficult position of having to decide whether to practice outside of the bounds of their competence and training by overseeing the delivery of ABA services. If they decline, some MA consumers (such as children with autism) might not receive mandated medically necessary treatment. If they accept, those consumers may not receive ABA treatment, or that treatment might be compromised. Further, those psychologists might risk having complaints of unethical practice filed with their licensing board.

o   The Commonwealth would be forced to develop a licensure program for behavior analysts “from scratch.” That would likely be very costly, especially if it included development of a new licensure exam as provided in this bill, and other functions that would have to be carried out by a committee on behavior analysis within the Board of Registration of Psychologists. It would also likely take a substantial amount of time, again limiting consumers’ access to ABA services and driving up their costs. Those costs and delays are unnecessary. The legislature can avoid them by adopting H01901 instead of this bill.

Our recommendation is to strongly oppose H01002.

Please don’t hesitate to contact me if you have questions or if APBA can provide any additional information.
 

Eureka ARICA!
Autism Insurance Reform (ARICA; HB3809/4935) has passed in Massachusetts and was signed into law by Governor Patrick. The law provides insurance reimbursement for services provided to persons with autism. Board Certified Behavior Analysts, as certified by the BACB, are now formally recognized in MA state law. There are many people to credit for this effort but Rep. Barbara L’Italien, Judith Ursitti (Autism Speaks), Amy Weinstock (Advocates for Autism of Massachusetts), and Nan Leonard deserve special thanks.

In summary, the law requires health insurers in Massachusetts to provide coverage for the diagnosis and treatment of ASDs.  Private insurers, employees and retirees under the state plan, hospital service plans and HMOs are all required to comply with this law. Self-funded plans are regulated by federal law and are not subject to state laws and, therefore, are not required to provide coverage under ARICA. The law covers applied behavior analysis when prescribed or ordered for an individual diagnosed with one of the Autism Spectrum Disorders by a licensed physician or a licensed psychologist. Such treatment is considered “Habilitative or Rehabilitative Care.” Treatment is not limited to applied behavior analysis and any empirically-supported intervention for autism should be covered. Applied behavior analysis, as stated in the law, must be supervised by a board certified behavior analyst. Treatment will not be subject to any annual or lifetime dollar or unit of service limitation on coverage which is less than any annual or lifetime dollar or unit of service limitation imposed on coverage for the diagnosis and treatment of physical conditions.

The Massachusetts Division of Insurance has held special sessions to discuss the implementation of the autism insurance legislation. Representatives from BABAT attended and participated in these meetings. These hearings were focused on providing guidance to all on how the regulations will be implemented and bringing to light special circumstances that come with this new law. BABAT is grateful for assistance that has been provided to us by APBA and Autism Speaks. As ARICA is implemented, we anticipate requiring further input from these organizations and we will continue to advocate for the rights of behavior analysts to practice. We also anticipate that BABAT members who are interested in learning more about insurance reimbursement for behavior analytic services will benefit greatly from the events to be hosted by APBA and Autism Speaks early next year. BABAT welcomes questions about ARICA from BABAT members. Contact us at bahearn@necc.org.

For information on how to code ABA services under the new law, click here.
 
Over the past year (and more), BABAT has been advocating for the right to practice of BCBAs in Massachusetts.  Currently the Massachusetts Division of Insurance is holding special sessions relative to "Coverage of Services to Treat Autism" following the passage of Chapter 207 (autism insurance reform).  BCBAs are explicitly described in this law as reimbursable providers of habilitative/rehabilitative services for persons with autism.  The Massachusetts Psychological Association has argued that many licensed psychologists are qualified as providers of applied behavior analysis.  BABAT has suggested that the BCBA credential should be the minimal requirement for the provision of ABA services.

To read more about BABAT's position on this issue, click here.

The BABAT Board of Directors has been working with the Massachusetts Legislature to create a means for licensing applied behavior analysts.  We support licensure as a protection for consumers and applied behavior analysts. We would oppose any licensure bill that created unnecessary hardships for qualified behavior analysts to practice their profession.

Similar to the Lovass Institue's position on this issue, the BABAT Board of Directors would support any licensure bill with the endorsement of the Behavior Analyst Certification Board.

We are indebted to the leadership of Rep. John Scibak for his work on this issue.