Transcript Document

ABA AND THE VIRGINIA GENERAL
ASSEMBLY: LEGISLATIVE UPDATES
FOR BEHAVIOR ANALYSTS
Christy Evanko, BCBA, LBA
March 12, 2015
AGENDA
Brief Introduction on ABA and Autism (only if necessary)
The History of ABA in the Virginia Legislature
Regulations Governing the Practice of Behavior Analysis
Applying for your License
AUDIENCE CHECK
How many here are behavior analysts?
How many are behavioral technicians or providers who work with
children with special needs, but are not behavior analysts?
How many are related to someone with autism?
Others?
APPLIED BEHAVIOR ANALYSIS (ABA) IS A
SCIENCE BASED ON THE PRINCIPLES OF
BEHAVIOR
Evidence-based techniques based on these principles are used to
encourage meaningful and beneficial change in behavior – both
increases in pro-social behaviors and skill acquisition and decreases in
maladaptive behaviors
Often focuses on reinforcement of pro-social behavior and acquisition
of daily living and academic skills
Data are collected and analyzed to determine what has the most
effect on the behaviors
ABA is not only used in classrooms and therapy sessions, but also in the
home, workplace, and community
ABA in Virginia must be provided or supervised by a licensed
Behavior Analyst
THE SEVEN DIMENSIONS OF ABA
Applied – importance to society
Behavioral – focus on behavior: what a person does
Analytic – believable demonstration of the events responsible for the
behavior
Technological – techniques used are completely identified and
described so that others can understand and replicate
Conceptual Systems – relevant to the principles of BA
Effective – effects are large enough to have value
Generality – changes are durable over time
Source: Baer, Donald, Wolf, Montrose, and Risley, Todd. Some current dimensions of applied behavior analysis. Journal of
Applied Behavior Analysis. Spring 1968.
ABA IS OFTEN USED SUCCESSFULLY TO
TREAT PEOPLE WITH AUTISM
“Between 1985 and 2010, there were over 500 articles published
concerning Applied Behavior Analysis and autism.”1
In 1987 O. Ivar Lovaas
published a landmark study
showing the effects of
intensive intervention on
children with autism. “47%
of the autistic children
treated before the age of
three and a half attained
normal intellectual
functioning and passed first
grade in a normal school by
the age of seven” 2
A 2000 report from the
Surgeon General
“Acknowledges the efficacy
of applied behavioral
methods in the treatment of
children with autism and
cites the ‘well-designed
study carried out by Lovaas
and colleagues’” 1
A 2001 book published by
the National Research
Council states that “forty
years of single-subjectdesign research testifies to
the efficacy of time-limited,
focused applied behavior
analysis methods in
reducing or eliminating
specific problem behaviors
in teaching new skills to
children and adults with
autism or other
developmental disorders.” 3
Sources: 1. www.lovaas.com, 2. Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic
Children, Journal of Consulting and Clinical Psychology, 1987, 3. Educating Children with Autism, National Research Council, 2001
BEHAVIOR ANALYSIS PROFESSIONALS
BCBA-D: Board Certified
Behavior Analyst
Doctoral Level
BCBA: Board Certified
Behavior Analyst
(Master’s Level Implied)
LBA: Licensed
Behavior
Analyst
BCaBA: Board Certified Assistant
Behavior Analyst
(Bachelor’s Level Implied)
LABA: Licensed
Assistant
Behavior Analyst
RBT: Registered Behavioral Technician
No Current
License
IDENTIFICATION
Note that you should not alter the identifying letters in any way (i.e.
BCBA/L)
The BCBA® credential is trademarked
The preferred listing is:
Augustine Castle, BCBA-D, LBA
Steve Jamnik, BCBA, LBA
Barbara Macklin, BCaBA, LABA
Rachel Meyerson, RBT
BEHAVIOR ANALYSTS ARE CERTIFIED BY A
NATIONAL CERTIFICATION ORGANIZATION
The Behavior Analysis Certification Board (BACB) was established in
1998 to meet professional credentialing needs (www.bacb.com)
Requirements for certification include
 Bachelors, Masters, or Doctoral Degree in a related
area
 BCaBA’s need to meet supervision requirements
 Education in Behavior Analysis by an accredited
school
 Supervised Experience (between 1000 and 1500
hours depending on certification)
 Passage of a board examination
 Strict adherence to ethical guidelines
 Continuing education required for renewal every two
years
Source: Behavior Analyst Certification Board www.bacb.com
Certification programs are
reviewed and standards are raised
on an ongoing basis
Provides Exam Content Task List
Holds certificants to Professional
Disciplinary and Ethical Standards
Presents Guidelines for Responsible
Conduct for Behavior Analysts
BEHAVIOR ANALYSTS HAVE VARIED
RESPONSIBILITIES
• Conducts
assessments of
behavior and
interprets results
• Designs and
supervises
behavior
analytic
interventions to
target reduction
of maladaptive
behaviors and
skill acquisition
• Trains others to
carry out ethical
and effective
behavior
analytic
interventions
based on
published
research
• Seeks
consultation of
more
experienced
practitioners
when necessary
LBA’s often do not work one-on-one with the client
except in assessment, training, and supervision situations
Source: Behavior Analyst Certification Board www.bacb.com
Licensed Behavior Analysts (LBA) and Licensed Assistant Behavior Analysts (LABA)
in the Commonwealth of Virginia as of January 30, 2015
Includes 533 LBAs and LABAs. Does not include those who list out of state residences or those who have not yet
received their licenses.
As of 1/30/15, there are 544 LBAs and 96 LABAs; there are 496 BCBAs (including Masters and Doctoral), and 89
BCaBAs in the Commonwealth of Virginia.
GROWTH IN THE
DIAGNOSIS OF AUTISM
16
14
12
10
8
6
4
2
0
2000
2002
2004
2006
Prevalance per 1000
Source: CDC
2008
2010
GROWTH IN BEHAVIOR ANALYSIS
PROFESSION IN VIRGINIA
700
600
500
400
300
200
100
0
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Base Added
Based on data from www.bacb.com pulled beginning in December 2014 and therefore may not be fully accurate.
THE HISTORY OF ABA IN
THE VIRGINIA LEGISLATURE
SHORT HISTORY OF THE LAWS REGARDING
APPLIED BEHAVIOR ANALYSIS
2011 Autism Insurance
Law
2012 Licensure Law
2014 Advisory Board/
Exemption Bill
2015 Autism Insurance
Law
Age Cap Increase
• HB2467/SB1062
• HB1106
• HB926
• HB1940
• Sponsored by Del. Tag
Greason, Sen. Janet
Howell
• Sponsored by Del. Tag
Greason
• Sponsored by Del. Tag
Greason
• Sponsored by Del. Tag
Greason
• Now law in the Code of
Virginia: § 38.2-4319;
38.2-3418.17
• Now law in the Code of
Virginia: § 54.12900; 54.1-2957.16;
54.1-2957.17
• Now law in the Code of
Virginia § 54.12957.17, 54.12957.18
• Passed legislature and
waiting for Governor’s
signature
THE AUTISM INSURANCE LAW:
§38.2-3418.17 IN THE
CODE OF VIRGINIA
Bill signed into law in 2011 after more than 10 years of effort
Virginia became the 26th state to enact Autism Legislation
Requires insurance companies to cover care for children with ASD
prescribed or ordered by a licensed physician or licensed psychologist
who says it’s medically necessary
Includes behavioral health treatment, pharmacy care, psychiatric care,
psychological care, Therapeutic Care (such as speech, OT, PT), and
Applied Behavior Analysis by a Licensed Behavior Analyst or Licensed
Assistant Behavior Analyst
Source: Virginia General Assembly Legislative Information System: leg1.state.va.us
Chapter 3: An Act to amend and reenact § 54.1-2900 of the Code of Virginia and to amend the Code of Virginia by adding in
Article 4 of Chapter 29 of Title 54.1 sections numbered 54.1-2957.16 and 54.1-2957.17, relating to licensure of behavior analysts
and assistant behavior analysts.
MORE DETAILS ON THE 2011 INSURANCE LAW
Persons cannot be denied insurance solely because they are
diagnosed with or receive treatment for ASD
Annual dollar cap - $35,000
Age cap – 2 to 6 years (one of the most restrictive in the US)
State employees are included
Companies with 50 or fewer employees are exempt
Self-funded plans are exempt, but many of them do cover autism,
often up to any age (e.g. Capital One, Bon Secours, etc.)
Source: Virginia General Assembly Legislative Information System: leg1.state.va.us
Chapter 876: An Act to amend and reenact § 38.2-4319 of the Code of Virginia and to amend the Code of Virginia by adding a section
numbered 38.2-3418.17, relating to health insurance coverage for autism spectrum disorder.
2015 UPDATES TO
THE 2011 INSURANCE LAW
In 2015 a new bill was introduced whose purpose was to delete the age cap.
In order to pass the bill it was necessary to compromise and have the new law
cover ages 2 to 10 (new coverage of children 7 to 10)
An additional amendment was made to match some changes to the federal law
that increased the size of what is considered a small company from 50 employees
to 100 employees.
The 2008 Wellstone-Domenici Act (which only applies to large group fully-funded
and self-funded policies) prohibits treatment limitations and financial requirements
on “mental health benefits” if not on physical health benefits (such as the $35K
cap in the 2011 law). 1
Nine states including Virginia explicitly list autism as a covered diagnosis in their
mental health parity laws. 1
Six states explicitly and 5 states implicitly include autism within their state
definition of mental illness, but Virginia is not one of these state. 1
1 Source:
Autism Speaks
THE BA LICENSURE LAW:
§54.1-2900 -2957.16/17 IN THE
CODE OF VIRGINIA
Governor sent amendments to the insurance bill in March 2011, one of
which included that necessity that Behavior Analysts be licensed by the
Board of Medicine. This provision did not come from the behavior
analysis community.
It shall be unlawful for any person to practice or to hold himself out as
practicing as a(n) (assistant) behavior analyst or to use the title
"Licensed (Assistant) Behavior Analyst" unless he holds a license as a(n)
(assistant) behavior analyst issued by the Board.
Emergency regulations took effect on 9/18/12 and were in effect
until 3/20/13, at which time the full regulations took over (with no
changes).
Source: Virginia General Assembly Legislative Information System: leg1.state.va.us
Chapter 3: An Act to amend and reenact § 54.1-2900 of the Code of Virginia and to amend the Code of Virginia by adding in
Article 4 of Chapter 29 of Title 54.1 sections numbered 54.1-2957.16 and 54.1-2957.17, relating to licensure of behavior analysts
and assistant behavior analysts.
THE BA ADVISORY BOARD BILL:
§54.1-2957.17, 18 IN THE
CODE OF VIRGINIA
The Board of Medicine asked Behavior Analysts to go back to the
legislature in 2014 to request an Advisory Board and a Student
Exemption; the Student exemption was rewritten to include both
intensive practicum and supervised fieldwork (post coursework)
The Department of Education asked to add an exemption so that their
employees could continue to perform their duties under IDEA
The bill passed and the first Advisory Board meeting was held
October 7, 2014. The board meets quarterly and advises the BOM
on disciplinary issues and other topics pertaining to behavior analysis.
Anyone can make public comment and the meetings are open to the
public.
Source: Virginia General Assembly Legislative Information System: leg1.state.va.us
Chapter 3: An Act to amend and reenact § 54.1-2900 of the Code of Virginia and to amend the Code of Virginia by adding in
Article 4 of Chapter 29 of Title 54.1 sections numbered 54.1-2957.16 and 54.1-2957.17, relating to licensure of behavior analysts
and assistant behavior analysts.
CHANGING THE LAW
From time to time it is necessary
to add new laws and change
existing ones. If you want to be
involved with those efforts, feel
free to join the following
advocacy organizations:
 Virginia Association for Behavior Analysts:
www.virginiaaba.org
 Virginia Autism Project:
www.virginiaautismproject.com
 Autism Speaks:
www.autismspeaks.org/advocacy/state/v
irginia
Photo credit: Virginia General Assembly
REGULATIONS GOVERNING THE
PRACTICE OF BEHAVIOR
ANALYSIS
LICENSURE UNDER
THE BOARD OF MEDICINE
It is the responsibility of every LBA and LABA to become familiar with
these regulations housed on the Board of Medicine Web site:
http://www.dhp.virginia.gov/medicine
It is the licensed person’s responsibility to update the BOM when
his/her name or address changes within 30 days
Initial fees are:
Renewal fees are:
 BCBA - $130
 BCaBA - $70
 BCBA - $135
 BCaBA - $70
 Renewals occur in the birth month of odd-numbered years
The main requirement for licensure is BACB certification, but BACB
certification is not needed for renewal.
Source: BOM Regulations
Note: In this slide and in all of the following, some of the information is pulled word-for-word from the sources, and some is
paraphrased.
PRACTICING
It is very important to note that BCBAs or BCaBAs without a current
license MUST NOT PRACTICE, regardless of their ability or status in
another state
From the BACB Professional and Ethical Compliance Code for Behavior
Analysts (Jan 2016 version):
 1.04 Integrity.
 (d) Behavior analysts’ behavior conforms to the legal and ethical codes of the social
and professional community of which they are members.
It is every behavior analyst’s responsibility to know the laws that
govern us
Source: BOM Regulations
SCOPE OF PRACTICE
18VAC85-150-110. Scope of practice.
The practice of a behavior analyst includes:
1. Design, implementation, and evaluation of environmental
modifications using the principles and methods of behavior analysis to
produce socially significant improvement in human behavior, including
the use of direct observation, measurement, and functional analysis of
the relationship between environment and behavior; and
2. Supervision of licensed assistant behavior analysts and unlicensed
personnel.
Source: BOM Regulations
CONTINUING EDUCATION
Continuing education requirements do not track with BACB requirements
that changed in January of 2015, however the Advisory Board is
looking into realignment.
BACB
VA License
BCBA/LBA
32/2 years
24/2 years
Plus 4 ethics credits (and No other requirements
supervision
requirements)
BCaBA/LBA
24/2 years
Plus 4 ethics credits
16/2 years
No other requirements
Note that the source of the CEUs are the same for the BACB and the
BOM (a BACB approved provider).
Source: BOM Regulations, BACB
SUPERVISORY RESPONSIBILITIES
Supervision in the BOM regulations refers only to supervision of LABAs
by LBAs and does not related to supervision of students
“The Licensed Behavior Analyst is ultimately responsible and
accountable for client care and outcomes under his clinical supervision
. . . Delegation shall only be made if, in the judgment of the licensed
behavior analyst, the task or procedures can be properly and safely
performed by an appropriately trained assistant behavior analyst or
other person, and the delegation does not jeopardize the health or
safety of the client.”
Source: BOM Regulations
LABA SUPERVISION COMPARISON WITH BACB
BACB Current
BACB 2017
VA License
Responsibility
Not addressed
BCBA supervisor will be responsible
for the work of the BCaBA(s) he/she is
supervising
LBA ultimately
responsible (see
previous slide)
Public
Identification
Not addressed
BCBA supervisor will be publicly
identified on the Certificant Registry
Reported to the BOM,
but not listed
publically
Qualifications
Not addressed
Same requirements as in the
Experience Standards policy (e.g., the
supervisor may not be related to or
subordinate to the BCaBA); Supervisor
must complete a supervision class and
module and maintain supervision CEUs
Not addressed
Caseload
Not addressed
Volume of supervisory activity must be
commensurate with ability to be
effective
Not addressed
Source: BACB Newsletter – 12/2014, BOM Regulations
Source: BACB Newsletter – 12/2014, BOM Regulations
LABA SUPERVISION COMPARISON WITH BACB
BACB Current
BACB 2017
VA License
Amount
1 hour per month
(regardless of
practice hours)
2% of hours of ABA services
provided per month; supervisors
may require more when
appropriate (adjusted based on
hours of practice)
Frequency
Every month
At least once per month, but the
supervisor must be available for
consultation during servicedelivery periods
The frequency and nature of
supervision interactions are
determined by the
individualized assessment or
treatment plans of the clients
served by the licensed
behavior analyst and the
assistant behavior analyst, but
shall occur not less than once
every four weeks with each
supervision session lasting no
less than one hour.
New BCaBAs
Not addressed
5% of hours of ABA services
provided per month for the first
1,000 hours of practice, with no
less than one hour of supervision
every two weeks (current BCaBAs
exempt)
Not addressed
LABA SUPERVISION COMPARISON WITH BACB
Interaction
Type
BACB Current
BACB 2017
VA License
Real-time, faceto-face
interactions only
Real-time, face-to-face
interactions not required; no
supervision via text or email;
incorporates Experience
Standards provisions on nature
of supervision
“Real-time" shall mean live and
person-to-person.
Source: BACB Newsletter – 12/2014, BOM Regulations
Source: BACB Newsletter – 12/2014, BOM Regulations
LABA SUPERVISION COMPARISON WITH BACB
Observation
BACB
Current
BACB 2017
VA License
Semiannually,
in person
Quarterly via •
any
appropriate
means (no inperson
requirement) •
•
Direct, real-time observation of the supervisee
implementing behavior analytic assessment and
intervention procedures with clients in natural
environments and/or training others to implement
them, with feedback from the supervisor.
One-to-one, real-time interactions between
supervisor and supervisee to review and discuss
assessment and treatment plans and procedures,
client assessment and progress data and reports,
published research, ethical and professional
standards and guidelines, professional development
needs and opportunities, and relevant laws,
regulations, and policies.
Informal interactions between supervisors and
supervisees via telephone, electronic mail, and other
written communication are encouraged but may not
be considered formal supervision.
LABA SUPERVISION COMPARISON WITH BACB
BACB Current
BACB 2017
VA License
Group
Supervision
Type
No stipulation
on group size or
activities
Small interactive
groups of 2-10
supervisees. If nonsupervisees are
present, their
participation should
be limited
Group
Supervision
Amount
Allowed
Max. 50% of
supervision
Max. 50% of
supervision
Includes real-time interactions between a
supervisor and a group of supervisees to
review and discuss assessment and treatment
plans and procedures, client assessment and
progress data and reports, published
research, ethical and professional standards
and guidelines, professional development
needs and opportunities, and relevant laws,
regulations, and policies.
Source: BACB Newsletter – 12/2014, BOM Regulations
LABA SUPERVISION COMPARISON WITH BACB
Reporting
BACB Current
BACB 2017
VA License
Once per year
Ongoing documentation of
supervision meetings using
meeting form that must be
provided if requested by the
BACB
A copy of the written supervisory
agreement shall be maintained
by the licensed behavior analyst
and the licensed assistant
behavior analyst and made
available to the board upon
request.
Source: BACB Newsletter – 12/2014, BOM Regulations
BCABA/LABA CONTRACT COMPARISON
BACB (Beginning in 2017)
Virginia License
A contract must be in place that specifies:
 Nature and frequency of supervision (including
grounds for increased supervision at the discretion
of the supervisor)
 Mechanism for reporting caseload to supervisor
 Methods of supervisory observation
 Mandatory third-party consent for supervisor
involvement
 Written feedback retained by both parties
 Supervisory responsibility over services and client
consent for supervisor’s involvement
 Provision terms for supervision (fee for service)
 Termination and verification criteria
There shall be a written supervisory
agreement between the licensed
behavior analyst and the licensed
assistant behavior analyst that shall
address:
 The domains of competency within which
services may be provided by the
licensed assistant behavior analyst; and
 The nature and frequency of the
supervision of the practice of the
licensed assistant behavior analyst by
the licensed behavior analyst.
Note that the current BACB guidelines do not address
the contract.
Source: BACB Newsletter – 12/2014, BOM Regulations
UNLICENSED PERSONNEL
18VAC85-150-130. Supervision of unlicensed personnel.
A. Unlicensed personnel may be supervised by a licensed behavior
analyst or a licensed assistant behavior analyst.
B. Unlicensed personnel may be utilized to perform:
1. Nonclient-related tasks including, but not limited to, clerical and
maintenance activities and the preparation of the work area and
equipment; and
2. Certain routine client-related tasks that, in the opinion of and under
the supervision of a licensed behavior analyst or a licensed assistant
behavior analyst, have no potential to adversely impact the client or
the client's treatment plan and do not constitute the practice of
behavior analysis.
Source: BOM Regulations
CONFIDENTIALITY
BACB
• Confidentiality is addressed in Ethics
Code 2.06. Disclosures are discussed in
2.08.
• BA’s have an obligation to take
reasonable precautions to protect the
confidentiality of clients.
• BA’s discuss confidentiality at the
beginning of the relationship and during
new circumstances.
Virginia License
A practitioner shall not willfully or
negligently breach the confidentiality
between a practitioner and a client. A
breach of confidentiality that is required
or permitted by applicable law or
beyond the control of the practitioner
shall not be considered negligent or
willful.
• BA’s minimize the amount of private
information they communicate
• Research is governed separately
• Sharing identifying info on social media is
prohibited
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
CLIENT RECORDS
BACB
• Maintaining Records is
addressed in Ethics Codes 2.07
and 2.11
• Behavior analysts maintain
appropriate confidentiality in
handling records, but this is not
specified.
• This code indicates that
behavior analysts follow the
law as well as corporate
policies with regard to records
• Behavior analysts must retain
records and data for at least 7
years and as otherwise
required by law.
Virginia License
• There is a separate code relating to health records privacy: § 32.1127.1:03.
• Practitioners need to provide records to other practitioners in a timely
manner (following the above code).
• Practitioners shall properly manage and keep timely, accurate, legible, and
complete client records.
• If a practitioner does not own the records (e.g. an agency does), then they
need to comply with the owner’s procedures.
• But those who are self-employed shall:
• Maintain records for a minimum of 6 years unless a minor or transferred to
another practitioner. Minor’s records should be maintained until the child is
18, is emancipated, or at least 6 years. There may be other laws that
extend the record-keeping time.
• Practitioners also need to post or otherwise inform clients of the recordkeeping time frame.
• When records are destroyed, they need to be completely destroyed so
the information can’t be stolen.
• There is another code that governs the closing or selling of a practice: §
54.1-2405.
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
CLIENT COMMUNICATION
BACB
Many of the Ethics Codes touch on this,
however, these are the closest related:
3.03 – written approval must be acquired
before the assessment
3.05 – consent must be gained prior to
reviewing records.
4.04 – written approval is required prior to
making significant modifications to plans
8.02 – behavior analysts avoid false and
deceptive statements about treatment
Virginia License
• Practitioners shall accurately present information in
understandable terms and encourage participation in
decisions regarding client care. There is another code that
governs this: § 32.1-127.1:03 F
• Practitioners should not make false or misleading statements
about their skills or the efficacy of treatment.
• Initial assessments require informed consent from client or
guardian. They need to be informed about the risks,
benefits, and alternatives of the recommended procedure
that a reasonably prudent practitioner would tell a client.
• Intervention changes (that are not routine and are more
restrictive) require informed consent.
• There is an exception to the consent requirement in an
emergency situation or when delay would cause harm.
• There is a code that covers informed consent for human
research (not including retrospective record reviews): §
32.1-162.18
CLIENT TERMINATION
BACB
• Interrupting or Discontinuing Services is
addressed in Ethics Code 2.15
• Behavior analysts act in the client’s best interest
to avoid interruption of services and make
reasonable and timely efforts to find other
services.
• Contracts should stipulate what happens when
the relationship ends with focus on the welfare
of the client.
• Relationships are discontinued when the client
doesn’t need the service any more, isn’t
benefiting from the service, is being harmed by
the service, or requests the end of the service.
• Behavior analysts do not abandon clients. All
attempts are made to facilitate transition.
Virginia License
• Either practitioner or client may terminate the
relationship.
• Client records need to be made available to
the client except where prohibited by law.
• The practitioner must give document notice that
allows for a reasonable time to find another
provider.
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
PRACTITIONER RESPONSIBILITY
BACB
Virginia License
Many of the Ethics Codes touch on this, however,
these are the closest related:
Practitioners are prohibited from
 working outside the scope of his/her practice
1.02 – behavior analysts stay within the
boundaries of their competence
 allowing a subordinate to jeopardize client
safety or provide client care outside of
his/her scope of practice
5.03 – behavior analysts delegate only
responsibilities that they think the subordinate
can perform safely and provide training for
skills the subordinate does not have
 delegating client care to someone who isn’t
properly trained and supervised
1.07 – behaviors analysts do not exploit the
people with whom and for whom they work
 exploiting the relationship for personal gain
 engaging in behavior that interferes with
treatment or adversely impacts client care
Advocating for client safety or improvement in
client care within a health care entity shall not
constitute disruptive behavior provided the
practitioner does not engage in prohibited
behavior.
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
REFERRALS
BACB
• Referrals and fees is addressed in Ethics Codes
2.07 and 2.11
• Behavior analysts must not receive or provide
money, gifts, or other enticements for any
professional referrals.
• Referrals should include multiple options and be
made based on objective determination of the
client need and subsequent alignment with the
repertoire of the referee.
• When providing or receiving a referral, the
extent of any relationship between the two
parties is disclosed to the client
Virginia License
• A practitioner shall receive cash or other
compensation for a referral to a facility,
institution, or hospital
• Payments, business arrangements, or payment
practices allowed by 42 USC § 1320 a-7b(b)
do not apply
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
SEXUAL CONTACT
BACB
• Sexual Contact is addressed in
Ethics Code 1.07
• Behavior analysts do not engage
in sexual relationships with clients,
students, or supervisees, because
such relationships easily impair
judgment or become exploitative.
• Behavior analysts refrain from
any sexual relationships with
clients, students, or supervisees,
for at least two years after the
date the professional relationship
has formally ended.
Virginia License
• Sexual behavior is defined as verbal or physical behavior that may be
interpreted as intended for sexual arousal of either party or may be
interpreted as romantic involvement with a client regardless of the
setting (professional or otherwise).
• This section states that the determination of when a person is a client is
made on a case-by-case basis. It does not limit the definition of client to
someone who is actively receiving treatment, but the person is only no
longer considered a client when the contract is terminated.
• Who initiated or consented does not change the prohibition.
• Sexual contact with a former client after termination of the relationship,
key third party (spouse or partner, parent or child, guardian, or legal
representative), or a subordinate may still be prohibited if the
relationship is found to exploit trust, knowledge, or influence of emotions
derived from the relationship or the relationship has an adverse effect
on client care.
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
REFUSAL TO PROVIDE INFO
BACB
• Disclosures are addressed in Ethics Code 2.08
• Behavior analysts never disclose confidential
information without the consent of the client,
except as mandated by law, or where
permitted by law for a valid purpose, such as
providing services to the client, professional
consultations, protecting the client or others from
harm, and obtaining payment for services.
• Behavior analysts need to obtain consent for
disclosure a the beginning of the relationship
and in an ongoing manner as necessary.
Virginia License
• A practitioner shall not willfully refuse to
provide information or records as requested or
required by the board or its representative
pursuant to an investigation or to the
enforcement of a statute or regulation.
Source: BACB 2016 Professional and Ethical Compliance Code for Behavior Analysts, BOM Regulations for Behavior Analysts
APPLYING FOR YOUR LICENSE
HOW TO APPLY
Go to the Board of Medicine Web site and click on the links. Here is
the direct link:
http://www.dhp.virginia.gov/medicine/medicine_forms.htm#ABA
VABA will be producing a toolkit to assist new applicants. Stay tuned!
The BOM suggests you apply prior to taking the test because it takes
so long to hear back from the BACB as well as to get a license. The
BACB supports this.
Feel free to contact me at [email protected] if you have
any questions when the time comes.
RESOURCES
RESOURCES
www.virginiaaba.org – The Virginia Association for Behavior Analysis
www.apbahome.net – The Association for Professional Behavior
Analysts
RESOURCES
leg1.state.va.us – The Virginia General Assembly Legislative
Information System. On this site you can look up laws that have been
passed and the Code of Virginia
www.dhp.virginia.gov/medicine - The Virginia Board
of Medicine
 On this site you can see the BA regulations and also look up licensed personnel
RESOURCES
www.BACB.com – the Website for the credentialing body for
Board Certified Behavior Analysts®
 Includes the document Guidelines for Health Plan Coverage of Applied Behavior
Analysis Treatment for Autism Spectrum Disorder
www.vcuautismcenter.org - VCU Autism Center for Excellence
 Technical assistance, professional development, and educational research center for
Autism Spectrum Disorders
RESOURCES
virginiaautismproject.org –
Virginia Autism Project
 A grassroots, statewide coalition of
families with children affected by ASD,
working to create positive change through
Autism Insurance Reform.
autismspeaks.org/advocacy/insurance Autism Speaks
 Including the Self-Funded Employer Tool Kit, a toolkit to help families approach their
self-funded ERISA employers about adding autism benefits to the company health
plan.
RESOURCES
www.uhccf.org - United Health Care Children’s Foundation (UHCCF)
 Provides a grant that can cover insurance co-pay for children up to 16
Virginia’s Bureau of Insurance
 If your provider is not following the law:
www.scc.virginia.gov/boi/complaint.aspx#A7
 Link to the Life and Health Insurance Complaint Form:
www.scc.virginia.gov/publicforms/262/Ihinquiry.pdf
 Or to discuss a complaint or receive assistance call 1-877-310-6560 or (804)3719691