Broad View: July

Michael_RBy: Michael Ranney, MPA, OPA Executive Director

When I first started at OPA, there were occasionally some calm moments when the workload was less stressful. That is certainly not true anymore. We are always at a very high level of activity.

In her Advocacy Alert article this month,  Bobbie Celeste outlines some of the work we are doing on insurance issues. This has become a constant for us. The problems and issues just keep coming and we take them all seriously. APA Practice Organization staff are very helpful, since so many of these issues are national.

But there are other things that also need our attention. For example, in January 2011, the Ohio Board of Psychology established an Applied Behavior Analysis Work Group, involving stakeholders involved with ABA services. Thus, began a dialogue about the board’s role in regulating ABA providers other than psychologists. OPA was very involved in these meetings. Who knew that in June 2013, we would still be significantly involved in work on this issue?

During the course of the board’s thorough process, an opinion letter from Attorney General Mike DeWine (October 3, 2012) concluded that applied behavior analysis involves “the practice of psychology” and is appropriately regulated by the board. As the board’s work group was finishing up its work, legislation mandating insurance coverage for the treatment of autism was introduced.

The Psychology Board’s White Paper, authored by Dr. Suzanne LeSure, was extremely well done and very helpful to the legislative process. It summarized the dialogue of the work group participants and analyzed how other states had approached the regulation of ABA. As questions came up we found that many were answered in this white paper. OPA, the board, Autism Speaks and several legislators worked on this bill and the regulatory issues that needed to be addressed. While the bill failed to get through the process before the end of the legislative session, Governor Kasich issued an Executive Order, making the coverage of autism treatment/ABA services an essential health benefit.

Implementation of this Executive Order, particularly the required regulation and certification, needed authorizing legislation. Because of the need to have everything in place by January 1, 2014, this had to be on a fast track. The Psychology Board would need many months to complete the rule making process to be ready by January 1.

Senator Bill Seitz (R-08) led this effort. OPA, the Psychology Board and Autism Speaks did much of the work of the initial work. We had great input from many others (Behavior Analysis Certification Board, Autism Society of Ohio, Ohio Counselors Association, National Association of Social Workers-Ohio Chapter, the Counselor, Social Worker, Marriage and Family Therapist Board, Ohio Council of Behavioral Health and Family Service Providers and others). Several legislators were involved in the process (Representative Cheryl Grossman R-23 and Representative Louis Terhar R-30 were particularly interested.) Because of the need to get the legislation approved quickly, the language was amended into the budget bill, passed the Senate, approved in conference committee and signed by Governor Kasich. Not everyone was happy about the need for speed on this or inserting it in the budget bill, but if there was to be the slightest hope of being ready for January 2014, this was the most expeditious route.

I realize that in summarizing this in just a few sentences it sounds like it was so easy and just breezed through, not so. I have over 300 emails dealing with the language for this legislation from just the past two months. There were countless phone calls and a number of meetings to get language that was agreeable to everyone. The concerns that everyone focused on throughout this process were to take care not to disrupt services or to create barriers that would prevent people, who are qualified to provide services from doing the work. It is also very important to assure that there are adequate protections for consumers of these services. It is important that ABA fall under the Psychology Board’s regulatory authority.

So all of this work is a mere prelude to what lies ahead. The Psychology Board will soon be convening another work group to begin drafting rules to implement the language in the budget bill. The work group will make recommendations to the Psychology Board and once the rules are accepted by the board there is a public hearing process that must be followed.

With all the attention on the state budget bill, the bill updating the Psychology Law (which passed the Ohio House) is waiting for hearings in the Senate. Hearings should go quickly once they begin.

I am busy getting ready for the APA Convention too. State association directors meet beginning July 29 with many association management topics on the agenda. I also plan on attending convention programs on ethics, colleague assistance programming and important public policy issues.