Bill Text: OR SB365 | 2013 | Regular Session | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Relating to treatment for autism spectrum disorders; and declaring an emergency.

Spectrum: Slight Partisan Bill (Democrat 5-3)

Status: (Passed) 2013-08-21 - Effective date, August 14, 2013. [SB365 Detail]

Download: Oregon-2013-SB365-Introduced.html

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     77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session

NOTE:  Matter within  { +  braces and plus signs + } in an
amended section is new. Matter within  { -  braces and minus
signs - } is existing law to be omitted. New sections are within
 { +  braces and plus signs + } .

LC 1598

                         Senate Bill 365

Sponsored by Senator BATES (Presession filed.)

                             SUMMARY

The following summary is not prepared by the sponsors of the
measure and is not a part of the body thereof subject to
consideration by the Legislative Assembly. It is an editor's
brief statement of the essential features of the measure as
introduced.

  Establishes requirements for coverage of autism spectrum
disorders by health benefit plans, Public Employees' Benefit
Board and Oregon Educators Benefit Board. Requires Oregon Health
Licensing Agency to establish licensing procedures for providers
of applied behavior analysis. Requires individual seeking
reimbursement for applied behavior analysis from health benefit
plan, Public Employees' Benefit Board or Oregon Educators Benefit
Board to be licensed by agency. Grandfathers applied behavior
analysis practitioners until January 1, 2016.
  Declares emergency, effective on passage.

                        A BILL FOR AN ACT
Relating to treatment for autism spectrum disorders; creating new
  provisions; amending ORS 676.610, 676.612, 676.613, 676.622,
  676.625, 676.992 and 743A.190; and declaring an emergency.
Be It Enacted by the People of the State of Oregon:
  SECTION 1.  { + Section 2 of this 2013 Act is added to and made
a part of the Insurance Code. + }
  SECTION 2.  { + (1) As used in this section:
  (a) 'Applied behavior analysis' means the design,
implementation and evaluation of environmental modifications,
using behavioral stimuli and consequences, to produce significant
improvement in human social behavior, including the use of direct
observation, measurement and functional analysis of the
relationship between environment and behavior. The practice of
applied behavior analysis expressly excludes psychological
testing, neuropsychology, psychotherapy, cognitive therapy, sex
therapy, psychoanalysis, hypnotherapy and long-term counseling as
treatment modalities.
  (b) 'Autism spectrum disorder' means a neurobiological
condition that includes autistic disorder, Asperger's disorder,
childhood disintegrative disorder and pervasive developmental
disorder not otherwise specified, all as defined in the
Diagnostic and Statistical Manual of Mental Disorders published
by the American Psychiatric Association.
  (c) 'Behavioral health treatment' means counseling and
treatment programs, including applied behavior analysis and other
evidence-based behavioral interventions, that are necessary to
develop, improve, maintain or restore the functioning of an
individual to the maximum extent possible and that are provided
by:
  (A) A licensed health care professional, as long as the
services performed are within the licensed health care
professional's scope of practice and are commensurate with the
licensed health care professional's post-secondary education,
training and supervised experience;
  (B) A behavior analyst licensed under section 3 of this 2013
Act;
  (C) An assistant behavior analyst licensed under section 3 of
this 2013 Act who is supervised by a licensed behavior analyst;
or
  (D) An autism technician, licensed under section 3 of this 2013
Act, who is supervised by a licensed behavior analyst or by
another licensed health care professional, as long as the
services performed under supervision are within the licensed
health care professional's scope of practice and are commensurate
with the licensed health care professional's post-secondary
education, training and supervised experience.
  (d) 'Diagnosis' means medically necessary assessment,
evaluation or testing.
  (e) 'Health benefit plan' has the meaning given that term in
ORS 743.730.
  (f) 'Medically necessary' means in accordance with the
definition of medical necessity that is specified in the policy
or certificate for the health benefit plan and that applies
uniformly to all covered services under the plan.
  (g) 'Pharmacy care' means medications prescribed by a licensed
physician or another health care professional licensed to
prescribe medications, and any health-related services deemed
medically necessary to determine the need or effectiveness of the
medications.
  (h) 'Rehabilitation and habilitative services' means physical
therapy, occupational therapy or speech therapy services to
restore or improve function.
  (i) 'Treatment for autism spectrum disorder' includes, but is
not limited to, the following care prescribed, provided or
ordered for an individual diagnosed with autism spectrum disorder
by a licensed physician or licensed psychologist who determines
the care to be medically necessary:
  (A) Behavioral health treatment;
  (B) Pharmacy care, to the same extent that pharmacy care is
covered by the health benefit plan for other medical conditions;
  (C) Rehabilitative and habilitative services, to the same
extent that other mental health services are covered by the
health benefit plan; and
  (D) Any other medical services and mental health services that
are medically necessary and are otherwise covered by the health
benefit plan.
  (2) A health benefit plan shall provide coverage for the
screening for, diagnosis of and treatment for autism spectrum
disorders. An insurer may not terminate coverage or refuse to
issue or renew coverage for an individual solely because the
individual is diagnosed with autism spectrum disorder or has
received treatment for autism spectrum disorder.
  (3) An insurer may require, as a condition of coverage for
applied behavior analysis, that an insured be diagnosed with
autism spectrum disorder through a process meeting standards
established by the Oregon Commission on Autism Spectrum Disorder,
provided that the requirement does not delay the provision of
applied behavior analysis services by more than 60 days.
  (4) Coverage under this section may be subject to utilization
controls that are reasonable in the context of individual
determinations of medical necessity. An insurer may not require
prior authorization for coverage of up to 25 hours per week of
applied behavior analysis for children under eight years of age.
  (5) When an enrollee in a health benefit plan requests an
external review of an adverse benefit determination as defined in
ORS 743.801 regarding services described in this section, the
insurer or the Director of the Department of Consumer and
Business Services must expedite the enrollee's case pursuant to
ORS 743.857 (5).
  (6) Coverage under this section may not be subject to dollar
limits, deductibles, copayments or coinsurance provisions that
are less favorable to an insured than the dollar limits,
deductibles, copayments or coinsurance provisions that apply to
physical illness generally under the policy or certificate.
Coverage under this section may be subject to requirements and
limitations concerning participating or in-network providers that
apply to physical illness generally under the health benefit
plan.
  (7) This section does not limit coverage that is otherwise
available to an individual under the health benefit plan or
reduce benefits required under ORS 743A.168.
  (8) A claim for services described in this section may not be
denied on the basis that the service is habilitative or
rehabilitative and does not fully restore function.
  (9) Coverage under this section includes medically necessary
treatment provided in the home and in the community. This section
may not be construed as affecting any obligation to provide
services to an individual under an individualized family service
plan or an individualized education program. Nothing in this
section requires coverage for:
  (a) Services provided by a family or household member;
  (b) Services that are custodial in nature or that constitute
marital, family, educational or training services; or
  (c) Services or supplies that are not medically necessary.
  (10) Except for inpatient services, if an individual is
receiving treatment for autism spectrum disorder, an insurer may
require submission of a treatment plan, which shall include all
elements necessary for the health benefit plan to appropriately
determine coverage under the health benefit plan. The treatment
plan must be based on evidence-based screening criteria. An
insurer may require an updated treatment plan, not more than once
every six months and at the expense of the insurer, for the
purpose of performing utilization review and medical management.
The insurer may require the treatment plan to include the:
  (a) Diagnosis;
  (b) Proposed treatment by type;
  (c) Frequency and anticipated duration of treatment;
  (d) Anticipated outcomes stated as goals, including specific
cognitive, social, communicative, self-care and behavioral goals
that are clearly stated, directly observed and continually
measured and that address the characteristics of the autism
spectrum disorder;
  (e) Frequency with which the plan will be updated; and
  (f) Signature of the treating provider.
  (11) Subsections (1) to (10) of this section apply to health
benefit plans and to self-insured health plans offered by the
Public Employees' Benefit Board and the Oregon Educators Benefit
Board.
  (12) ORS 743A.001 does not apply to this section. + }
  SECTION 3.  { + (1) The Oregon Health Licensing Agency shall
establish by rule criteria for the licensing of:
  (a) Behavior analysts;
  (b) Assistant behavior analysts; and
  (c) Autism technicians.
  (2) The criteria for the licensing of a behavior analyst must
include, but are not limited to, the requirement that the
applicant has:
  (a) Been certified by the Behavior Analyst Certification Board
as a 'Board Certified Behavior Analyst'; and
  (b) Successfully completed a criminal records check.

  (3) The criteria for the licensing of an assistant behavior
analyst must include, but are not limited to, the requirement
that the applicant has:
  (a) Been certified by the Behavior Analyst Certification Board
as a 'Board Certified Assistant Behavior Analyst'; and
  (b) Successfully completed a criminal records check.
  (4) The criteria for the licensing of an autism technician must
include, but are not limited to, the requirement that the
applicant:
  (a) Has completed:
  (A) A minimum of 12 semester hours, or the equivalent of 12
semester hours, of college coursework and is currently enrolled
in a course of study leading to an associate's or bachelor's
degree in behavior analysis, psychology, education, social work,
behavioral science, human development or a related field; or
  (B) A minimum of 48 semester hours, or the equivalent of 48
semester hours, of college coursework in any field;
  (b) Has completed 40 hours of training with a licensed behavior
analyst or a licensed assistant behavior analyst, or 40 hours of
training with another licensed health care professional during
which the services performed are within the licensed health care
professional's scope of practice and are commensurate with the
licensed health care professional's post-secondary education,
training and supervised experience, and the training covers the
following topics:
  (A) Introduction to autism spectrum disorder, applied behavior
analysis, behavioral interventions and child development;
  (B) Principles and performance of applied behavior analysis or
other behavioral interventions;
  (C) Legal, ethical and safety issues related to working with
families and vulnerable populations; and
  (D) Professional standards and ethics;
  (c) During a period of not more than 12 weeks, has completed 40
hours of work in applied behavior analysis supervised by a
licensed behavior analyst or a licensed assistant behavior
analyst, or 40 hours of work in applied behavior analysis
supervised by another licensed health care professional during
which the services performed are within the licensed health care
professional's scope of practice and are commensurate with the
licensed health care professional's post-secondary education,
training and supervised experience;
  (d) Has successfully completed a criminal records check; and
  (e) Receives ongoing oversight by a licensed behavior analyst
or a licensed assistant behavior analyst, or by another licensed
health care professional, as long as the services performed under
supervision are within the licensed health care professional's
scope of practice and are commensurate with the licensed health
care professional's post-secondary education, training and
supervised experience.
  (5) In accordance with applicable provisions of ORS chapter
183, the agency shall adopt rules:
  (a) Establishing standards for the licensing of behavior
analysts, assistant behavior analysts and autism technicians in
accordance with this section;
  (b) Establishing guidelines for the professional methods and
procedures to be used by persons licensed under this section;
  (c) Governing the examination of applicants for licenses issued
under this section and the renewal, suspension and revocation of
the licenses; and
  (d) Establishing fees sufficient to cover the costs of
administering the licensing program under this section.
  (6) The agency shall issue a license to an applicant who:
  (a) Files an application in the form prescribed by the agency;
  (b) Pays fees established by the agency; and
  (c) Demonstrates to the satisfaction of the agency that the
applicant meets the criteria adopted under this section.
  (7) All moneys received by the agency under subsection (6) of
this section shall be paid into the General Fund of the State
Treasury and credited to the Oregon Health Licensing Agency
Account.
  (8) An individual who has not been licensed by the agency in
accordance with criteria and standards adopted under this section
may not claim reimbursement for services described in section 2
of this 2013 Act under a health benefit plan or under a
self-insured health plan offered by the Public Employees' Benefit
Board or the Oregon Educators Benefit Board. + }
  SECTION 4.  { + Notwithstanding section 3 (8) of this 2013 Act,
an individual actively practicing applied behavior analysis on
the effective date of this 2013 Act may continue to claim
reimbursement from a health benefit plan, the Public Employees'
Benefit Board or the Oregon Educators Board for services provided
without a license before January 1, 2016. + }
  SECTION 5.  { + The Oregon Health Licensing Agency make take
any action before January 1, 2014, that is necessary for the
agency to implement the provisions of section 3 of this 2013 Act
on and after January 1, 2014. + }
  SECTION 6. ORS 743A.190 is amended to read:
  743A.190. (1) A health benefit plan, as defined in ORS 743.730,
must cover for a child enrolled in the plan who is under 18 years
of age and who has been diagnosed with a   { - pervasive - }
developmental disorder all medical services, including
rehabilitation services, that are medically necessary and are
otherwise covered under the plan.
  (2) The coverage required under subsection (1) of this section,
including rehabilitation services, may be made subject to other
provisions of the health benefit plan that apply to covered
services, including but not limited to:
  (a) Deductibles, copayments or coinsurance;
  (b) Prior authorization or utilization review requirements; or
  (c) Treatment limitations regarding the number of visits or the
duration of treatment.
  (3) As used in this section:
  (a) 'Medically necessary' means in accordance with the
definition of medical necessity that is specified in the policy,
certificate or contract for the health benefit plan and that
applies uniformly to all covered services under the health
benefit plan.
  (b)   { -  ' Pervasive - }   { +  ' + } Developmental disorder'
means a neurological condition that includes Asperger's syndrome,
autism, developmental delay, developmental disability
 { - or - }  { +  and + } mental retardation.
  (c) 'Rehabilitation services' means physical therapy,
occupational therapy or speech therapy services to restore or
improve function.
  (4) The provisions of ORS 743A.001 do not apply to this
section.
  (5) The definition of   { -  ' pervasive - }  { +  ' + }
developmental disorder' is not intended to apply to coverage
required under ORS 743A.168 { +  or section 2 of this 2013
Act + }.
  SECTION 7.  { + Section 8 of this 2013 Act is added to and made
a part of ORS chapter 343. + }
  SECTION 8.  { + (1) Section 3 of this 2013 Act does not limit,
replace or affect any obligation of a school district to provide
services under an individualized education program to a child
with a disability in accordance with the Individuals with
Disabilities Education Act, 20 U.S.C. 1400 et seq., or other
publicly funded programs to assist individuals with autism
spectrum disorder.
  (2) Any governmental or educational entity providing services
as required under the Individuals with Disabilities Education
Act, 20 U.S.C. 1400 et seq., as amended, or other state or
federal law requiring the provision of services to individuals
with disabilities, is prohibited from reducing, eliminating or
shifting required services to coverage provided under section 2
of this 2013 Act. + }
  SECTION 9. { +  In the manner prescribed in ORS chapter 183 for
contested cases, the Oregon Health Licensing Agency may impose a
form of discipline listed in ORS 676.612 against any person
licensed under section 3 of this 2013 Act for any of the
prohibited acts listed in ORS 676.612 and for any violation of a
rule adopted under section 3 of this 2013 Act. + }
  SECTION 10. ORS 676.610 is amended to read:
  676.610. (1)(a) The Oregon Health Licensing Agency is under the
supervision and control of a director, who is responsible for the
performance of the duties, functions and powers and for the
organization of the agency.
  (b) The Director of the Oregon Department of Administrative
Services shall establish the qualifications for and appoint the
Director of the Oregon Health Licensing Agency, who holds office
at the pleasure of the Director of the Oregon Department of
Administrative Services.
  (c) The Director of the Oregon Health Licensing Agency shall
receive a salary as provided by law or, if not so provided, as
prescribed by the Director of the Oregon Department of
Administrative Services.
  (d) The Director of the Oregon Health Licensing Agency is in
the unclassified service.
  (2) The Director of the Oregon Health Licensing Agency shall
provide the boards, councils and programs administered by the
agency with such services and employees as the agency requires to
carry out the agency's duties. Subject to any applicable
provisions of the State Personnel Relations Law, the Director of
the Oregon Health Licensing Agency shall appoint all subordinate
officers and employees of the agency, prescribe their duties and
fix their compensation.
  (3) The Director of the Oregon Health Licensing Agency is
responsible for carrying out the duties, functions and powers
under ORS 675.360 to 675.410, 676.605 to 676.625, 676.992,
678.710 to 678.820, 680.500 to 680.565, 687.405 to 687.495,
687.895, 688.701 to 688.734, 688.800 to 688.840, 690.005 to
690.235, 690.350 to 690.415, 691.405 to 691.485 and 694.015 to
694.185 { +  and sections 3 and 9 of this 2013 Act + } and ORS
chapter 700.
  (4) The enumeration of duties, functions and powers in
subsection (3) of this section is not intended to be exclusive or
to limit the duties, functions and powers imposed on or vested in
the Oregon Health Licensing Agency by other statutes.
  SECTION 11. ORS 676.612 is amended to read:
  676.612. (1) In the manner prescribed in ORS chapter 183 for
contested cases and as specified in ORS 675.385, 678.780,
680.535, 687.445, 688.734, 688.836, 690.167, 690.407, 691.477,
694.147 and 700.111 { +  and section 9 of this 2013 Act + }, the
Oregon Health Licensing Agency may refuse to issue or renew, may
suspend or revoke or may otherwise condition or limit a
certificate, license, permit or registration to practice issued
by the agency or may discipline or place on probation a holder of
a certificate, license, permit or registration for commission of
the prohibited acts listed in subsection (2) of this section.
  (2) A person subject to the authority of a board, council or
program listed in ORS 676.606 commits a prohibited act if the
person engages in:
  (a) Fraud, misrepresentation, concealment of material facts or
deception in applying for or obtaining an authorization to
practice in this state, or in any written or oral communication
to the agency concerning the issuance or retention of the
authorization.

  (b) Using, causing or promoting the use of any advertising
matter, promotional literature, testimonial, guarantee, warranty,
label, insignia or any other representation, however disseminated
or published, that is false, misleading or deceptive.
  (c) Making a representation that the certificate, license,
permit or registration holder knew or should have known is false
or misleading regarding skill or the efficacy or value of
treatment or remedy administered by the holder.
  (d) Practicing under a false, misleading or deceptive name, or
impersonating another certificate, license, permit or
registration holder.
  (e) Permitting a person other than the certificate, license,
permit or registration holder to use the certificate, license,
permit or registration.
  (f) Practicing with a physical or mental condition that
presents an unreasonable risk of harm to the holder of a
certificate, license, permit or registration or to the person or
property of others in the course of performing the holder's
duties.
  (g) Practicing while under the influence of alcohol, controlled
substances or other skill-impairing substances, or engaging in
the illegal use of controlled substances or other skill-impairing
substances so as to create a risk of harm to the person or
property of others in the course of performing the duties of a
holder of a certificate, license, permit or registration.
  (h) Failing to properly and reasonably accept responsibility
for the actions of employees.
  (i) Employing, directly or indirectly, any suspended,
uncertified, unlicensed or unregistered person to practice a
regulated occupation or profession subject to the authority of
the boards, councils and programs listed in ORS 676.606.
  (j) Unprofessional conduct, negligence, incompetence, repeated
violations or any departure from or failure to conform to
standards of practice in performing services or practicing in a
regulated occupation or profession subject to the authority of
the boards, councils and programs listed under ORS 676.606.
  (k) Conviction of any criminal offense, subject to ORS 670.280.
A copy of the record of conviction, certified by the clerk of the
court entering the conviction, is conclusive evidence of the
conviction. A plea of no contest or an admission of guilt shall
be considered a conviction for purposes of this paragraph.
  (L) Failing to report any adverse action, as required by
statute or rule, taken against the certificate, license, permit
or registration holder by another regulatory jurisdiction or any
peer review body, health care institution, professional
association, governmental agency, law enforcement agency or court
for acts or conduct similar to acts or conduct that would
constitute grounds for disciplinary action as described in this
section.
  (m) Violation of a statute regulating an occupation or
profession subject to the authority of the boards, councils and
programs listed in ORS 676.606.
  (n) Violation of any rule regulating an occupation or
profession subject to the authority of the boards, councils and
programs listed in ORS 676.606.
  (o) Failing to cooperate with the agency in any investigation,
inspection or request for information.
  (p) Selling or fraudulently obtaining or furnishing any
certificate, license, permit or registration to practice in a
regulated occupation or profession subject to the authority of
the boards, councils and programs listed in ORS 676.606, or
aiding or abetting such an act.
  (q) Selling or fraudulently obtaining or furnishing any record
related to practice in a regulated occupation or profession
subject to the authority of the boards, councils and programs
listed in ORS 676.606, or aiding or abetting such an act.
  (r) Failing to pay an outstanding civil penalty or fee that is
due or failing to meet the terms of any order issued by the
agency that has become final.
  (3) For the purpose of requesting a state or nationwide
criminal records check under ORS 181.534, the agency may require
the fingerprints of a person who is:
  (a) Applying for a certificate, license, permit or registration
that is issued by the agency;
  (b) Applying for renewal of a certificate, license, permit or
registration that is issued by the agency; or
  (c) Under investigation by the agency.
  (4) If the agency places a holder of a certificate, license,
permit or registration on probation under subsection (1) of this
section, the agency, in consultation with the appropriate board,
council or program, may determine and at any time modify the
conditions of the probation.
  (5) If a certificate, license, permit or registration is
suspended, the holder may not practice during the term of
suspension. Upon the expiration of the term of suspension, the
certificate, license, permit or registration may be reinstated by
the agency if the conditions of suspension no longer exist and
the holder has satisfied all requirements in the relevant
statutes or administrative rules for issuance, renewal or
reinstatement.
  SECTION 12. ORS 676.613 is amended to read:
  676.613. (1) In addition to all other remedies, when it appears
to the Oregon Health Licensing Agency that a person is engaged
in, has engaged in or is about to engage in any act, practice or
transaction that violates any provision of ORS 675.360 to
675.410, 676.617, 678.710 to 678.820, 680.500 to 680.565, 687.405
to 687.495, 688.701 to 688.734, 688.800 to 688.840, 690.005 to
690.235, 690.350 to 690.415, 691.405 to 691.485 or 694.015 to
694.185 { +  or section 3 of this 2013 Act + } or ORS chapter
700, the agency may, through the Attorney General or the district
attorney of the county in which the act, practice or transaction
occurs or will occur, apply to the court for an injunction
restraining the person from the act, practice or transaction.
  (2) A court may issue an injunction under this section without
proof of actual damages. An injunction issued under this section
does not relieve a person from any other prosecution or
enforcement action taken for violation of statutes listed in
subsection (1) of this section.
  SECTION 13. ORS 676.622 is amended to read:
  676.622. (1) A transaction conducted through a state or local
system or network that provides electronic access to the Oregon
Health Licensing Agency information and services is exempt from
any requirement under ORS 675.360 to 675.410, 676.605 to 676.625,
676.992, 680.500 to 680.565, 687.405 to 687.495, 688.701 to
688.734, 688.800 to 688.840, 690.005 to 690.235, 690.350 to
690.415, 691.405 to 691.485 and 694.015 to 694.185 { +  and
section 3 of this 2013 Act + } and ORS chapter 700, and rules
adopted thereunder, requiring an original signature or the
submission of handwritten materials.
  (2) Electronic signatures subject to ORS 84.001 to 84.061 and
facsimile signatures are acceptable and have the same force as
original signatures.
  SECTION 14. ORS 676.625 is amended to read:
  676.625. (1) The Oregon Health Licensing Agency shall establish
by rule and shall collect fees and charges to carry out the
agency's responsibilities under ORS 676.605 to 676.625 and
676.992 and any responsibility imposed on the agency pertaining
to the boards, councils and programs administered and regulated
by the agency pursuant to ORS 676.606.
  (2) The Oregon Health Licensing Agency Account is established
in the General Fund of the State Treasury. The account shall
consist of the moneys credited to the account by the Legislative
Assembly. All moneys in the account are appropriated continuously
to and shall be used by the Oregon Health Licensing Agency for
payment of expenses of the agency in carrying out the duties,
functions and obligations of the agency, and for payment of the
expenses of the boards, councils and programs administered and
regulated by the agency pursuant to ORS 676.606. The agency shall
keep a record of all moneys credited to the account and report
the source from which the moneys are derived and the activity of
each board, council or program that generated the moneys.
  (3) Subject to prior approval of the Oregon Department of
Administrative Services and a report to the Emergency Board prior
to adopting fees and charges credited to the account, the fees
and charges may not exceed the cost of administering the agency
and the boards, councils and programs within the agency, as
authorized by the Legislative Assembly within the agency's
budget, as the budget may be modified by the Emergency Board.
  (4) All moneys credited to the account pursuant to ORS 675.405,
676.617, 680.525, 687.435, 688.728, 688.834, 690.235, 690.415,
691.479, 694.185 and 700.080 { +  and section 3 of this 2013
Act + }, and moneys credited to the account from other agency and
program fees established by the agency by rule, are continuously
appropriated to the agency for carrying out the duties, functions
and powers of the agency under ORS 676.605 to 676.625 and 676.992
 { +  and section 3 of this 2013 Act + }.
  (5) The moneys received from civil penalties assessed under ORS
676.992 shall be deposited and accounted for as are other moneys
received by the agency and shall be for the administration and
enforcement of the statutes governing the boards, councils and
programs administered by the agency.
  SECTION 15. ORS 676.992 is amended to read:
  676.992. (1) Except as provided in subsection (3) of this
section, and in addition to any other penalty or remedy provided
by law, the Oregon Health Licensing Agency may impose a civil
penalty not to exceed $5,000 for each violation of the following
statutes and any rule adopted thereunder:
  (a) ORS 688.701 to 688.734 (athletic training);
  (b) ORS 690.005 to 690.235 (cosmetology);
  (c) ORS 680.500 to 680.565 (denture technology);
  (d) ORS 687.405 to 687.495 (direct entry midwifery);
  (e) ORS 690.350 to 690.415 (tattooing, electrolysis, body
piercing, dermal implanting and scarification);
  (f) ORS 694.015 to 694.185 (dealing in hearing aids);
  (g) ORS 688.800 to 688.840 (respiratory therapy and
polysomnography);
  (h) ORS chapter 700 (environmental sanitation);
  (i) ORS 676.617 (single facility licensure);
  (j) ORS 675.360 to 675.410 (sex offender treatment);
  (k) ORS 678.710 to 678.820 (nursing home administrators);
  (L) ORS 691.405 to 691.485 (dietitians);   { - and - }
  (m) ORS 676.612 (prohibited acts) { + ; and
  (n) Section 3 of this 2013 Act (applied behavior analysis) + }.
  (2) The agency may take any other disciplinary action that it
finds proper, including but not limited to assessment of costs of
disciplinary proceedings, not to exceed $5,000, for violation of
any statute listed in subsection (1) of this section or any rule
adopted under any statute listed in subsection (1) of this
section.
  (3) Subsection (1) of this section does not limit the amount of
the civil penalty resulting from a violation of ORS 694.042.
  (4) In imposing a civil penalty pursuant to this section, the
agency shall consider the following factors:
  (a) The immediacy and extent to which the violation threatens
the public health or safety;
  (b) Any prior violations of statutes, rules or orders;
  (c) The history of the person incurring a penalty in taking all
feasible steps to correct any violation; and
  (d) Any other aggravating or mitigating factors.
  (5) Civil penalties under this section shall be imposed as
provided in ORS 183.745.
  (6) The moneys received by the agency from civil penalties
under this section shall be paid into the General Fund of the
State Treasury and credited to the Oregon Health Licensing Agency
Account established under ORS 676.625. Such moneys are
continuously appropriated to the agency for the administration
and enforcement of the laws the agency is charged with
administering and enforcing that govern the person against whom
the penalty was imposed.
  SECTION 16.  { + Section 3 of this 2013 Act and the amendments
to ORS 676.610, 676.612, 676.613, 676.622, 676.625 and 676.992 by
sections 10 to 15 of this 2013 Act become operative November 1,
2013. + }
  SECTION 17.  { + (1) Sections 2, 4 and 8 of this 2013 Act and
the amendments to ORS 743A.190 by section 6 of this 2013 Act
become operative January 1, 2014.
  (2) Sections 2 and 4 of this 2013 Act and the amendments to ORS
743A.190 by section 6 of this 2013 Act apply to policies or
certificates issued or renewed on or after January 1, 2014. + }
  SECTION 18.  { + This 2013 Act being necessary for the
immediate preservation of the public peace, health and safety, an
emergency is declared to exist, and this 2013 Act takes effect on
its passage. + }
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