News reports are that North Carolina families will be converging on the capitol on Monday to meet with legislators and weigh in to Committee on the need for helath care reform and financial relief.
HB 569-FN - As amended by the Senate: AN ACT clarifying insurance coverage for diagnosis and treatment of pervasive developmental disorder or autism.
passed in the New Hampshire Senate and is anticipated to receive Governor John Lynch's signature. The passage came after some delay from its passage in the New Hampshire House on January 6, 2010.
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2 New Section; Coverage for Treatment of Pervasive Developmental Disorder or Autism. Amend RSA 417-E by inserting after section 1 the following new section:
417-E:2 Coverage for Treatment of Pervasive Developmental Disorder or Autism
I. For the purposes of this chapter, treatment of pervasive developmental disorder or autism as required under RSA 417-E:1, III(h) shall include the following:
(a) Professional services and treatment programs, including applied behavioral analysis, necessary to produce socially significant improvements in human behavior or to prevent loss of attained skill or function. To be eligible for coverage, applied behavior analysis must be provided by a person professionally certified by the national Behavior Analyst Certification Board or performed under the supervision of a person professionally certified by the national Behavior Analyst Certification Board.
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(d) III. The policy, contract, or certificate may limit coverage for applied behavior analysis to $36,000 per year for children 0 to 12 years of age, and $27,000 from ages 13 to 21. An insurer may not apply payments for coverage unrelated to autism spectrum disorders to any maximum benefit established under this paragraph.
V. The commissioner shall adopt rules, pursuant to RSA 541-A, relative to the insurance coverage requirements established under this section.
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3 Applicability. This act shall apply to all group policies, contracts, and certificates issued or renewed on or after January 1, 2011.
4 Effective Date.
I. Sections 1 and 2 of this act shall take effect January 1, 2011.
On May 5, 2010 the Connecticut Senate unanimously passed in the final hour of the final day of the regular legislative session, the Substitute for Raised H.R. 5425: "An Act Concerning Special Education"
The measure had previously passed the Connecticut House on April 27, 2010.
"Starting July 1, 2012, the bill requires school districts to use only behavior analysts licensed or certified in accordance with its requirements to provide applied behavior analysis for students with autism spectrum disorders who require the services (1) according to a special education individualized education program (IEP) or (2) under an educational plan established under section 504 of the federal Rehabilitation Act of 1973. The bill also establishes standards for people who may provide applied behavioral analysis services if the education commissioner finds there are not enough licensed or certified personnel available...*House Amendment “A” (1) specifies that a teacher or paraprofessional may implement the behavior analysis services under the supervision of a licensed or certified person;..."
On May 3, 2010 the amended California SB 1282 was reported with a "do pass" recommendation from the Senate Business, Professions and Economic Development Committee by a vote of 5 to 3.
SUBJECT: Applied behavior analysis services: California Behavioral Certification Organization.
SUMMARY: Creates the California Behavioral Certification Organization (CBCO) and provides for the certification of applied behavior analysts and applied behavior analyst assistants by the CBCO.
The analysis for the Committee describes in lay-friendly language the current version of SB 1282 itself, current state regulation, relevant history, rationale for the legislation, prior legislation, and those who currently support and those in opposition to SB 1282.
Within the analysis, the distinction is made that SB 1282 would establish a title act; authorizing use of the title of "certified applied behavior analyst" or "certified applied behavior analyst assistant" by those who engage in the defined activities of applied behavior analysis, meet the stated education and other criteria, and are certified by the California Behavioral Certification Organization (CBCO), a non-profit corporation. It prohibits non-certified persons from use of those titles. (One area of potential conflict noted is the specific titles, which may conflict with those used by BACB certificants; potentially amendment may be required to prevent infringement on the BACB terms.) This is distinct and separate from a practice protection act, which would confer along with licensure the exclusive right to practice a given profession.
As noted, the CBCO would be a non-profit corporation with authority, composition and responsibilities as defined in SB 1282, and not a state-operated certification or program under a state agency. The CBCO would be prohibited from issuing certificates prior to September 11, 2011, and a "sunset review process" would be imposed for January 1, 2017. One means of granting of the certificate by the CBCO would be previous certification by the BACB as well as other requirements of fees and background checks.
For further reading Bill Analysis dated 29 April 2010
Bill No: SB 1282 Author:Steinberg As Amended:April 28, 2010
04/29/10 - Sen. Business, Professions And Economic Development
On April 29, 2010, Iowa Governor Chet Culver signed into law the Standing Appropriations Bill, HF 2531, which contains an amendment specifying insurance coverage for autism spectrum disorders - including applied behavior analysis and recognizing BCBAs as approved providers for that treatment modality. The coverage in the enacted law is restricted to certain state employee group health insurance plans; the purpose is to provide a pilot to inform real implementation costs and potential future expansion to other health care plans.
"...As used in this section, unless the context otherwise requires:
"Applied behavioral analysis" means the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior or to prevent loss of attained skill or function, including the use of direct observation, measurement, and functional analysis of the relations between environment and behavior.
"Autism service provider" means a person, or group providing treatment of autism spectrum disorders. An autism service provider that provides treatment of autism spectrum disorders that includes applied behavioral analysis shall be certified as a behavior analyst by the behavior analyst certification board or shall be a health professional licensed under chapter 147.
"Rehabilitative care" means professional services and treatment programs, including applied behavioral analysis, provided by an autism service provider to produce socially significant improvement in human behavior or to prevent loss of attained skill or function...."
On April 27, 2010, the Connecticut House passed Substitute for Raised H.B. No. 5425 by a 126 to 14 vote and transmitted it to the Senate, where it is listed on the Senate Calendar as ready for action by that chamber with favorable reports from the House Education and Appropriations Committees.
"Starting July 1, 2012, the bill requires school districts to use only behavior analysts licensed or certified in accordance with its requirements to provide applied behavior analysis for students with autism spectrum disorders who require the services (1) according to a special education individualized education program (IEP) or (2) under an educational plan established under section 504 of the federal Rehabilitation Act of 1973. The bill also establishes standards for people who may provide applied behavioral analysis services if the education commissioner finds there are not enough licensed or certified personnel available...*House Amendment “A” (1) specifies that a teacher or paraprofessional may implement the behavior analysis services under the supervision of a licensed or certified person;..."
Prefacing note: While this report is being shared as a "news item of interest" as a public event in progress, it seems relevant at this time to state that this report is not taking an editorial position on the legal aspects or allegations of this case nor the specific claimants, nor does this constitute legal interpretation. Please see the court documents for relevant specifics.
"...does Kaiser's health plan contract exclude from coverage Applied Behavior Analysis therapy or speech therapy for autism spectrum disorders on the grounds that such therapies are “non-health care services,” “academic or educational interventions,” or “custodial care”? Second, assuming that the therapies are excluded from coverage by the health plan contract, does the Mental Health Parity Act allow Kaiser to categorically apply such exclusions on the basis that the therapies are not health care services, or are provided by persons not licensed or certified by the state?..."
