HOUSE OF REPRESENTATIVES	H.B. NO.	663
THIRTIETH LEGISLATURE, 2019
STATE OF HAWAII

A BILL FOR AN ACT

relating to health.

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

SECTION 1. In 2018, the legislature adopted Act 205, Session Laws of Hawaii 2018, to clarify and standardize the terminology used to refer to behavior analysis and the practice of applied behavior analysis, broaden the number of professional fields exempt from the behavior analysts law, and require the department of education to create an implementation plan to seek reimbursement of any applied behavior analysis that the department of education may provide to students diagnosed with autism spectrum disorder that is eligible for coverage by medicaid.

In December 2018, the department of education reported its plan to the legislature in response to Act 205. Among other things, the report indicated that the department needs thirty-four qualified applied behavior analyst professionals for assessment, program development, and supervision of qualified applied behavior analyst paraprofessionals plus training, mentoring, quality control, and program oversight. Additionally, the department requires four hundred sixty-five qualified behavior analyst paraprofessionals to implement the plan.

The legislature expresses concern that funding for all of the positions required by the department of education may not be available because, according to some reports, applied behavior analysts charge approximately $130 per hour for their services. The legislature also expresses concern that there may be an insufficient number of qualified applied behavior analysts available in Hawaii to meet the needs of the department of education students. Accordingly, the legislature finds the most sensible approach to meeting the needs of each student diagnosed with autism spectrum disorder is to allow the department of education to use other licensed professionals where appropriate.

The purpose of this Act is to provide the department of education with the flexibility to use licensed professionals in fields related to applied behavior analysis to control costs, meet paraprofessional staffing needs, and provide the necessary services to students diagnosed with autism spectrum disorder.

SECTION 2. 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) A licensed psychologist and any supervisee of the licensed psychologist; provided that applied behavior analysis services performed are within the boundaries of the licensed psychologist's education, training, and competence; provided further that neither the licensed psychologist nor any supervisee of the licensed psychologist purports to be a licensed behavior analyst; and provided further that master's level practitioners and postdoctoral fellows may provide training and supervision to direct support workers, paraprofessionals, caregivers, parents and guardians in a manner and to the extent determined by the supervising licensed psychologist.

For purposes of this paragraph, "supervisee" means a master's level practitioner, postdoctoral fellow, direct support worker, paraprofessional, caregiver, parent or guardian who provides applied behavior analysis services;

(2) A licensed classroom teacher or an individual who is working as a classroom teacher and is enrolled in a teacher preparation program working towards licensure who implements but does not design applied behavior analysis services in a school setting in direct collaboration with a licensed behavior analyst or a licensed psychologist on or before July 1, 2019;

(3) An individual licensed by a board, commission, or other regulatory body of the department of health, department of commerce and consumer affairs, or department of education, acting within the scope of their licensure, approved by the superintendent of education, and who implements but does not design applied behavior analysis services for students in a department of education school setting;

[(3)] (4) 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 licensed behavior analyst;

[(4)] (5) An individual who directly implements applied 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 licensed behavior analyst; or

(B) Is a direct support worker who directly implements an applied behavior analysis program under the supervision of a licensed behavior analyst or licensed psychologist on or before January 1, 2020;

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

[(5)] (6) A family member, legal guardian, or caregiver implementing an applied behavior analysis plan and who acts under the direction of a licensed behavior analyst or Hawaii-licensed psychologist; provided that for the purposes of this paragraph, "caregiver" means an individual who provides habilitative 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 services waiver program authorized by section 1915(c) of the Social Security Act;

[(6)] (7) An individual who designs or implements applied 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;

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

[(8)] (9) A matriculated graduate student or postdoctoral fellow whose activities are part of a defined applied 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 licensed behavior analyst, licensed psychologist, or an instructor from a nationally recognized training organization or in a Behavior Analyst Certification Board-approved course sequence; or

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

SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 4. This Act shall take effect upon its approval.

INTRODUCED BY:

_____________________________

Report Title:

DOE; Applied Behavior Analysts; Autism Spectrum Disorder: Special Education

Description:

Authorizes the Department of Education to use licensed professionals other than applied behavior analysts, where appropriate, to meet the department's needs for students diagnosed with autism spectrum disorder.

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