THE SENATE	S.B. NO.	2925
TWENTY-NINTH LEGISLATURE, 2018		S.D. 1
STATE OF HAWAII

A BILL FOR AN ACT

 

 

RELATING TO THE PRACTICE OF BEHAVIOR ANALYSIS.

 

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 

     SECTION 1.  The legislature finds that behavior analysis means the design, implementation, and evaluation of instructional and environmental modifications to produce socially significant improvements in human behavior.  The practice of behavior analysis includes the empirical identification of functional relations between behavior and environmental factors, known as functional assessment and analysis, as well as the use of contextual factors, motivating operations, antecedent stimuli, positive reinforcement, and other consequences to help individuals develop new behaviors, increase or decrease existing behaviors, and display behaviors under specific environmental conditions.

     Act 199, Session Laws of Hawaii 2015, established the behavior analyst program within the department of commerce and consumer affairs and established licensing requirements for behavior analysts.  Licensing of behavior analysis services was made concurrent with mandated insurance coverage for diagnosis and treatment related to autism disorders.

     Act 107, Session Laws of Hawaii 2016, temporarily exempted some practitioners from licensing requirements of the practice of behavior analysis, in particular, direct support workers who provide autism treatment services pursuant to an individualized education plan.

     Many students enrolled in department of education schools would benefit from the expansion of behavior analysis services throughout Hawaii's public school system, including but not limited to students with autism disorders.

     Accordingly, the purpose of this Act is to:

     (1)  Clarify the licensing exemptions for certain individuals under certain conditions who provide behavior analysis services; and

     (2)  Require the department of education to create and implement a plan to provide medicaid billable applied behavior analysis services to all students diagnosed with autism spectrum disorder within the department.

     SECTION 2.  Section 465-3, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  This chapter shall not apply to:

     (1)  Any person teaching, lecturing, consulting, or engaging in research in psychology insofar as the activities are performed as part of or are dependent upon employment in a college or university; provided that the person shall not engage in the practice of psychology outside the responsibilities of the person's employment;

     (2)  Any person who performs any, or any combination of the professional services defined as the practice of psychology under the direction of a licensed psychologist in accordance with rules adopted by the board; provided that the person may use the term "psychological assistant", but shall not identify the person's self as a psychologist or imply that the person is licensed to practice psychology;

     (3)  Any person employed by a local, state, or federal government agency in a school psychologist or psychological examiner position, or a position that does not involve diagnostic or treatment services, but only at those times when that person is carrying out the functions of such government employment;

     (4)  Any person who is a student of psychology, a psychological intern, or a resident in psychology preparing for the profession of psychology under supervision in a training institution or facility and who is designated by a title as "psychology trainee", "psychology student", "psychology intern", or "psychology resident", that indicates the person's training status; provided that the person shall not identify the person's self as a psychologist or imply that the person is licensed to practice psychology;

     (5)  Any person who is a member of another profession licensed under the laws of this jurisdiction to render or advertise services, including psychotherapy, within the scope of practice as defined in the statutes or rules regulating the person's professional practice; provided that, notwithstanding section 465-1, the person does not represent the person's self to be a psychologist or does not represent that the person is licensed to practice psychology;

     (6)  Any person who is a member of a mental health profession not requiring licensure; provided that the person functions only within the person's professional capacities; and provided further that the person does not represent the person to be a psychologist, or the person's services as psychological;

     (7)  Any person who is a duly recognized member of the clergy; provided that the person functions only within the person's capacities as a member of the clergy; and provided further that the person does not represent the person to be a psychologist, or the person's services as psychological; [or]

     (8)  Any psychologist employed by the United States Department of Defense, while engaged in the discharge of the psychologist's official duty and providing direct telehealth support or services, as defined in section 431:10A-116.3, to neighbor island beneficiaries within a Hawaii National Guard armory on the island of Kauai, Hawaii, Molokai, or Maui; provided that the psychologist employed by the United States Department of Defense is credentialed by Tripler Army Medical Center[.]; or

     (9)  Any direct support worker as defined in section 465D‑7, who provides autism treatment services pursuant to an individualized education plan and is under the direction of a psychologist licensed in the State."

     SECTION 3.  Section 465D-7, Hawaii Revised Statutes, is amended by amending subsection (a) to read as follows:

     "(a)  This chapter is not intended to restrict the practice of other licensed or credentialed practitioners practicing within their own recognized scopes of practice and shall not apply to:

     (1)  [An individual working within the scope of practice or duties of another licensed profession that overlaps with the practice of behavior analysis; provided that the person does not purport to be a behavior analyst;] An individual licensed in the State who practices other professions and their supervisees; provided that behavior analysis is in the scope of practice of the profession's licensure law and the services provided are within the boundaries of the licensed professional's education, training, and competence; provided further that the individual does not purport to be a behavior analyst;

     (2)  An individual licensed in the State who practices psychology and their supervisees; provided that behavior analysis is in the scope of practice of the psychology licensure law and the behavior analysis services provided are within the boundaries of the licensed psychologist's education, training, and competence; provided further that the individual does not purport to be a behavior analyst;

    [(2)] (3)  An individual who implements or designs [applied] behavior analysis services and possesses board certification as an assistant behavior analyst by the Behavior Analyst Certification Board and who practices in accordance with the most recent supervisory and ethical requirements adopted by the Behavior Analyst Certification Board under the direction of a behavior analyst licensed in this State;

    [(3)] (4)  A licensed classroom teacher, or someone who is working as a classroom teacher and is enrolled in a teacher preparation program working toward licensure, in a school setting who implements and does not design behavior analysis services in direct collaboration with a professional licensed to practice behavior analysis in the State;

     (5)  An individual who directly implements [applied] and does not design behavior analysis services and:

          (A)  Is credentialed as a registered behavior technician by the Behavior Analyst Certification Board, and is under the direction of a behavior analyst licensed in this State;

          (B)  Is a direct support worker in a school setting who [provides autism treatment services pursuant to an individualized education plan] directly implements a behavior analysis program under the supervision of a professional licensed in this State to practice behavior analysis intervention or assessment plans on or before January 1, 2019; [[]or[]

      [](C)[]  Is a direct support worker who provides medicaid home and community-based services pursuant to section 1915(c) of the Social Security Act on or before January 1, 2019;] Is an individual who works within the scope of practice or duties of and is directly supervised by a licensed psychologist; provided that the supervised individual shall not use the title of "licensed behavior analyst";

          provided that for purposes of this paragraph, "direct support worker" means a [teacher or] paraprofessional [who directly implements intervention or assessment plans under supervision and does not design intervention or assessment plans];

     (6)  An individual who designs or implements behavior analysis services to participants in the medicaid home and community-based service waiver program pursuant to section 1915(c) of the Social Security Act on or before January 1, 2024;

    [(4)] (7)  A family member [or], legal guardian, or caregiver implementing [an applied] a behavior analysis plan and who acts under the direction of a licensed behavior analyst [licensed in this State]; provided that for the purposes of this paragraph, "caregiver" means an individual who provides rehabilitative services in an adult foster home, developmental disabilities domiciliary home, adult residential care home, expanded adult residential care home, special treatment facility, or therapeutic living program pursuant to the medicaid home and community-based service waiver program;

    [(5)] (8)  An individual who engages in the practice of behavior analysis with nonhuman or nonpatient clients or consumers including but not limited to applied animal behaviorists and practitioners of organizational behavior management;

    [(6)] (9)  A matriculated graduate student or postdoctoral fellow whose activities are part of a defined behavior analysis program of study, practicum, or intensive practicum; provided that the student's or fellow's activities or practice is directly supervised by a behavior analyst licensed in this State or an instructor in a Behavior Analyst Certification [Board-approved] Board-verified course sequence; or

    [(7)] (10)  An individual pursuing experience in behavior analysis consistent with the Behavior Analyst Certification Board's experience requirements; provided that the experience is supervised by a behavior analyst licensed in this State."

     SECTION 4.  (a)  The department of education shall create an implementation plan for the delivery of medicaid billable applied behavior analysis to all students diagnosed with autism spectrum disorder within the department.

     (b)  The department of education shall submit an initial report to the legislature and board of education within ninety days of the effective date of this Act; provided that the initial report shall include clear objectives on staffing, data collection and analysis, reporting and accountability, and any other necessary points to effectuate the implementation plan pursuant to subsection (a).

     (c)  After the submission of the initial report to the legislature and board of education pursuant to subsection (b), the department of education shall submit quarterly reports to the legislature and board of education; provided that the quarterly reports shall include the following:

     (1)  The number of students diagnosed with autism spectrum disorder;

     (2)  The number of students with autism spectrum disorder as part of their individualized education plan;

     (3)  The number of students requiring applied behavior analysis;

     (4)  Staffing updates and needs;

     (5)  Medicaid reimbursement schedules and amounts;

     (6)  Licensure updates; and

     (7)  Any other information pertinent to the implementation of this Act.

     SECTION 5.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 6.  This Act shall take effect upon its approval.

 

 

 

Report Title:

Practice of Behavior Analysis; Exemptions; Department of Education; Applied Behavior Analysis; Implementation Plan; Reporting

 

Description:

Clarifies the licensing exemptions for certain individuals under certain conditions who provide behavior analysis services.  Requires the Department of Education to create and implement a plan to provide Medicaid billable applied behavior analysis services to all students diagnosed with autism spectrum disorder within the Department.  Establishes reporting requirements.  (SD1)

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.