65G-4.001: Definitions for Behavior Analysis Certification and Services Rules.
65G-4.0011: Recognized Certification Organizations for Behavior Analysts and Assistant Behavior Analysts
65G-4.002: Service Delivery.
65G-4.003: Certification as a Behavior Analyst.
65G-4.004: Certification as an Associate Behavior Analyst.
65G-4.005: Renewal of Behavior Analysis Certification.
65G-4.006: Approved Continuing Education.
65G-4.007: Behavior Analysis Certification Fees.
65G-4.008: Behavior Analysis Services Oversight System Organization.
65G-4.009: Design, Implementation and Monitoring of Behavior Analysis Services.
65G-4.010: Behavior Analysis Services Approval.
65G-4.011: Determination of Mental Retardation in Capital Felony Cases: Intelligence; Tests to be Administered.
65G-4.012: Determination of Mental Retardation: Intelligence Tests to Be Administered.
PURPOSE AND EFFECT: The purpose of the proposed rulemaking is to clarify existing language, to ensure effective program administration and reflect changes in provider practice.
SUMMARY: The purpose of the proposed rulemaking is to clarify and amend certain provisions regarding the provisions of behavior analysis services provided under Rules 65G-4.001, 65G-4.008, 65G-4.009, 65G-4.010, and 65G-4.012 F.A.C., create new Rules 65G-4.0011 and 65G-4.0012, F.A.C. This amendment includes the repeal of Rules 65G-4.003, 65G-4.004, 65G-4.005, 65G-4.006, 65G-4.007, F.A.C.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: Statement of Regulatory Cost was prepared. The Agency determined the proposed rule will not have an impact on small business.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 393.063, 393.125, 393.13(4)(g)3., 393.17, 393.501, 916.106 FS.
LAW IMPLEMENTED: 393.0651, 393.066, 393.067, 393.068, 393.125, 393.13, 393.17(2) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN FAW.
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 7 days before the workshop/meeting by contacting: Steve Coloman, PhD., Senior Behavior Analyst, Agency for Persons with Disabilities, Residential and Clinical Support, 4030 Esplanade Way, Suite 380, Tallahassee, Florida 32399. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Steve Coloman, PhD., Senior Behavior Analyst, Agency for Persons with Disabilities, Residential and Clinical Support, 4030 Esplanade Way, Suite 380, Tallahassee, Florida 32399
THE FULL TEXT OF THE PROPOSED RULE IS:
BEHAVIORAL SERVICES: PRACTICE AND PROCEDURE SERVICE DELIVERY PRACTICE AND PROCEDURE
65G-4.001 Definitions for Behavioral Services: Practice and Procedure Behavior Analysis Certification and Services Rules.
(1) Behavior analysis refers to the use of scientific methods to produce socially significant improvements in behavior. This process entails gathering information to analyze or describe the link between behavior and environment. It includes assessment of the environment and consequences that are maintaining the behavior targeted for change. It also encompasses changing the situations in the environment that trigger problem behavior and arranging situations that will provide the opportunity for desirable behaviors to occur. Behavior Analysis interventions teach or increase occurrence of skills to replace the behavior targeted for change and arrange delivery of consequences for desirable and undesirable behavior. A behavior analytic intervention also includes strategies and approaches to maintain the gains of the intervention over time and in varied settings. Behavior change interventions are based on the principles and laws of behavior. Behavior analytic interventions require monitoring and evaluation for effectiveness through direct observation and quantification of the behavior targeted for change. Caregivers and family members are actively involved in the behavior analysis process and are taught how to implement specific techniques or changes in the environment. The design, implementation and evaluation of systematic environmental modifications for the purposes of producing socially significant improvements in and understanding of human behavior based on the principles of behavior identified through the experimental analysis of behavior. It includes the identification of functional relationships between behavior and environment. It uses direct observation and measurement of behavior and environment. Contextual factors, establishing operations, antecedent stimuli, positive reinforcers and other consequences are used, based on identified functional relationships between behavior and environment, in order to produce practical behavior change. Behavior analysis does not rely on cognitive therapies and expressly excludes psychological testing, neuropsychology, psychotherapy, sex therapy, psychoanalysis, hypnotherapy and long term counseling as treatment modalities.
(2) Behavior analysis services The use of behavior analysis to assist a person or persons to learn new behavior, to increase existing behavior, to reduce existing behavior, and to emit behavior under precise environmental conditions. The term behavior analysis services includes the terms behavior analysis service plan, behavioral programming, behavioral supports, behavior modification programs, behavior intervention plans, behavior plans and behavioral programs. as well as those interventions designed to ameliorate dangerous behavior as described in paragraphs 65G-4.010(2)(a) through (h), F.A.C., below. These services are supported in documentation showing that they are applied, behavioral, analytic, technological, conceptually systematic, and effective relative to the definitions of these terms found in Some Current Dimensions of Applied Behavior Analysis by D. M. Baer, M. M. Wolf, and T. R. Risley and available in the Journal of Applied Behavior Analysis, Volume 1, 1968. This article is incorporated by reference and may be found online at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1310980/pdf/jaba00083-0089.pdf.
(3) Certification Body A nonprofit corporation whose standards for certification of behavior analysts and assistant behavior analysts adheres to the national standards of boards that determine professional credentials to meet the needs of behavior analysts, state governments and consumers of behavior analysis services. The certification procedure of the nonprofit corporation must undergo regular psychometric review and validation pursuant to a job analysis survey of the profession and standards established by content experts in the field.
(4)(3) Consultation Monthly contacts between an Board Certified Assistant Behavior Analyst (BCaBA) applicant for certification and a consulting Board Certified Behavior Analyst (BCBA) certified behavior analyst or a person with the education and experience required for certification as a behavior analyst, during which the behavior analysis services provided by the BCaBA applicant are evaluated. At the time consultation is provided, the consulting BCBA behavior analyst shall not be the BCaBAs applicants subordinate, employee, spouse or family member. The consulting BCBA behavior analyst shall not be considered an employee of the BCaBA applicant if the only compensation received by the consulting BCBA behavior analyst consists of payment for consultation. Monthly contacts may include the BCaBAs applicants presentation of behavior analysis services designed by the BCaBA applicant, with a focus on graphic displays of data, at local review committee meetings, established in Rule 65G-4.008, F.A.C.
(4) Supervision Face-to-face meetings for at least two hours every two weeks or two hours per 40 hours of the applicants contact with clients, between the applicant and a certified behavior analyst or a person with the education and experience required for certification as a behavior analyst, during which the supervising behavior analyst directs and evaluates the behavior analysis services provided by the applicant. The supervising behavior analyst shall not be, at the time supervision is provided, the applicants subordinate or employee. The supervising behavior analyst shall not be considered an employee of the applicant if the only compensation received by the supervising behavior analyst consists of payment for supervision. The applicants presentation of behavior analysis services designed and implemented by the applicant, with a focus on graphic displays of data, at local review committee meetings, established in Rule 65G-4.008, F.A.C., may be substituted for up to 25 percent of the total supervision time needed to be eligible to take the behavior analyst certification examination.
(5) Facility Can be a publicly or privately established residential operation serving individuals with behavioral service needs.
(6) Provider An enrolled professional authorized to provide behavior analysis services. Only individuals who are board certified behavior analysts doctoral level, board certified behavior analysts (BCBA), board certified assistant behavior analysts (BCaBA), Florida certified behavior analysts or persons licensed in accordance with Chapter 490 or 491, F.S., on active status, and demonstrating supervision as required, may be providers of behavior analysis services. Only those providers holding a certificate on active status from a recognized certification organization for behavior analysis shall use the title, certified behavior analyst. Individuals performing behavior analysis services shall limit their practice to areas of documented expertise and in accordance with their education, training, and certification or licensure, unless otherwise demonstrating evidence of supervision by an individual meeting the requisite education, training, and certification.
(7) Regular psychometric review and validation A certification process which complies with recognized national standards in the testing and certification industry to ensure the certification examinations are fair, valid and reliable and in conformance with recognized standards such as those of the International Organization for Standardization (ISO) or the National Commission for Certifying Agencies (NCCA).
Rulemaking Specific Authority 393.13(4)(g)3., 393.17 FS. Law Implemented 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.023, 65B-4.023, Amended________.
65G-4.0011 Recognized Certification Organizations for Behavior Analysts and Assistant Behavior Analysts.
All providers of behavior analysis services must either be licensed to practice under Florida Statutes, or certified under a nonprofit corporation meeting the qualifications under Section 393.17(2), F.S. All providers of behavior analysis services must submit to the Agency for Persons With Disabilities proof of their active licensure or certification in order to provide behavior analysis services. Pursuant to Rule 65G-4.001, F.A.C., and as required by Section 393.17(2), F.S., recognizes the certification for behavior analysts awarded by the following organizations: Behavior Analyst Certification Board, Inc., 2888 Remington Green Lane, Suite C, Tallahassee, FL 32308.
Rulemaking Authority 393.17(2) FS, Law Implemented 393.17(2) FS. HistoryNew________.
65G-4.002 Service Delivery.
(1) The Agency shall provide all clients with appropriate supports and services in accordance with their support habilitation plan. Implementation of this policy, however, is subject to availability of funds.
(2) Clients of the Agency shall be integrated within local communities the their general population to the greatest extent possible extent. To this end, generic and specialized community services rather than Agency services shall be used whenever this will serve the best interest of the client. For referral purposes, each area office shall have a current descriptive directory of community resources.
(3) Programs and services provided by or for the Agency shall adhere to the policies, standards and procedures specified and made reference to in this chapter. The Agency shall make every effort to ensure that services provided are of good quality and at least comparable to those provided without disabilities to persons in the community non-retarded.
(4) All contracts for programs and services provided to the Agency shall include any appropriate guidelines.
Rulemaking Specific Authority 393.501(1) FS. Law Implemented 393.062, 393.066 FS. HistoryNew 1-1-77, Formerly 10F-4.08, 10F-4.008, 65B-4.008.-.654, Amended________.
65G-4.003 Certification as a Behavior Analyst.
(1) Applicants for certification as a behavior analyst who meet the eligibility requirements specified in paragraph (a), [(b) or (c)] and (d), below, and pay the certification fees prescribed by the Agency are eligible to take the behavior analyst examination administered by the Agency:
(a) Possession of a minimum of a masters degree from an institution of higher education fully accredited by a regional accrediting body; an institution that is accredited as a member in good standing of the Association of Universities and Colleges of Canada; an institution of higher education located outside the United States or Canada, which at the time the applicant was enrolled and at the time the applicant graduated maintained a standard of training equivalent to the standards of training of those institutions in the United States.
(b) Completion of graduate level instruction in the content areas and for the number of hours specified in subparagraphs 1.-5., below. Experience from one of the categories specified in paragraph (c) below shall be substituted for this requirement. One semester credit is equivalent to 15 hours of instruction and one quarter hour of credit is equivalent to 10 hours of instruction.
1. Basic behavior analytic principles 45 hours.
2. The application of behavior analytic principles and methods in applied settings 45 hours.
3. Single-subject research methods 20 hours.
4. Any other behavior analysis content area 70 hours.
5. Ethical and professional standards issues relevant to the practice of behavior analysis 10 hours.
(c) Experience in one of the following categories may be substituted for the required graduate level instruction. Experience substituted for course work under this rule shall not be used to meet the requirements specified in paragraph (d), below.
1. Completion of at least a one-year, full-time appointment in a tenure tract position on a college or university faculty during which the applicant taught classes on basic principles of behavior, single-subject methodology, applications of basic principles of behavior in applied settings and ethical issues and conducted and published research in behavior analysis.
2. Completion of no less than 35 hours of employment per week, for at least 24 months within a 30-month period, with consultation in an educational, health or human services setting during which the applicant was responsible for the following:
a. The design, implementation and monitoring of behavior analysis services.
b. Oversight of behavior analysis services designed, implemented and monitored by others.
c. Instruction of classes or college or university courses in basic principles of behavior and applications of basic principles in applied settings.
d. The applicant shall document that the services provided were applied, behavioral, analytic, technological, conceptually systematic, and effective relative to the definitions of these terms found in Some Current Dimensions of Applied Behavior Analysis by D. M. Baer, M. M. Wolf, and T. R. Risley and available in the Journal of Applied Behavior Analysis, Volume 1, 1968. Such documentation shall include a portfolio of the behavioral assessments, plans of service based on these assessments, data displays related to these plans, and service plan monitoring reports produced during the term of employment applied to this experience requirement. The applicant shall also submit a description of the organizational and personnel management systems used at the place of employment.
e. Teaching experience shall be documented by the submission of a letter, signed by the applicant, certifying the dates, locations and content of classes and courses taught by the applicant.
(d) Completion of the experience requirements specified in either subparagraph 1. or 2., below, in an educational, health or human services setting.
1. Completion of no less than 20 hours of employment per week, for 6 months, with supervision; followed by the completion of no less than 35 hours of employment per week, for 6 months, with consultation. The applicants primary duties during both employment periods must have been the design, implementation and monitoring of behavior analysis services and overseeing the implementation of behavior analysis services implemented by others. The employment with supervision requirement may be satisfied by completion of a practicum or field experience, with supervision, that included the design, implementation and monitoring of behavior analysis services, as part of a university or college degree program. Possession of a doctorate degree from an institution that meets the requirements specified in paragraph (a), above, with a dissertation that had behavior analysis as its central focus shall be substituted for the required hours of employment with consultation.
2. Completion of no less than 35 hours of employment per week for 18 months within a 21-month period, with consultation. The applicants primary duties during the employment period must have been the design, implementation and monitoring of behavior analysis services and overseeing the implementation of behavior analysis services by others. Possession of a doctorate degree from an institution that meets the requirements specified in paragraph (a), above, with a dissertation that had behavior analysis as its central focus shall be substituted for 6 months of the required 18 months of employment.
(2) Applicants for examination for certification as a behavior analyst shall submit to the Agency a completed application form entitled Application for Certification as a Behavior Analyst, which is incorporated by reference, and pay the certification fees prescribed by the Agency no less than 45 days in advance of the date of the examination for which they are applying.
(3) Applicants who pass the behavior analyst examination and pay the certification fees shall be certified as behavior analysts. Only persons who are certified pursuant to this rule shall use the title of certified behavior analyst.
(4) Notwithstanding the above provisions, persons certified as behavior analysts prior to the effective date of this rule will retain their certification.
(a) These persons may continue to approve the implementation of behavior analysis services that includes one or more of the following restricted behavior analysis procedures, regardless of the behavior or behaviors being addressed.
1. Time-out from reinforcement of 20 minutes or less.
2. Contingent removal or restriction of potential reinforcers.
3. Contingent effort of 10 minutes or less.
4. Contingent manual restraint of five (5) minutes or less.
(b) However, these persons may not approve the implementation of other restricted procedures unless they apply to the Agency to have their implementation approval privileges expanded to those established in Rule 65G-4.010, F.A.C., by submitting to the Agency a completed application form entitled Expansion of Approval Privileges, incorporated by reference. Expansion of privileges requires that the applicant meet the education and experience requirements established above for eligibility to take the behavior analyst examination. Application for expansion of privileges may be submitted at any time after the effective date of these rules.
Rulemaking Specific Authority 393.13(4)(g)3., 393.17 FS. Law Implemented 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.024, 65B-4.024, Repealed________.
65G-4.004 Certification as an Associate Behavior Analyst.
(1) Applicants for certification as an associate behavior analyst who meet the requirements specified in paragraphs (a)-(c), below, and pay the certification fees prescribed by the Agency are eligible to take the associate behavior analyst examination administered by the Agency:
(a) Possession of a minimum of a bachelors degree from an institution that meets the requirements specified in Rule 65G-4.003, F.A.C.
(b) Completion of 90 hours of classroom instruction covering, at a minimum, basic principles of behavior analysis, the application of these basic principles, and ethical issues related to the delivery of behavior analysis services. Instruction shall be obtained through one of the following methods:
1. College or university courses in behavior analysis, that are taken from an institution that meets the requirements specified in Rule 65G-4.003, F.A.C. No more than three courses may be combined to meet the 90 hour requirement. One semester credit is equivalent to 15 hours of instruction and one quarter hour of credit is equivalent to 10 hours of instruction.
2. Non-college or university classes approved for this purpose by the Agency in accordance with Rule 65G-4.004, F.A.C.
3. A combination of college or university courses and approved classes.
4. However, credit shall be given only once for a course or class.
(c) Employment in one of the following categories in an educational, health or human services setting:
1. Completion, with consultation, of no less than 35 hours of employment per week, that included the design, implementation and monitoring of behavior analysis services, for 12 months within a 15-month period.
2. Completion, with supervision, of no less than 20 hours of employment per week, during which the applicants primary duties were the design, implementation and monitoring of behavior analysis services, for six consecutive months. However, the employment requirement may be satisfied by completion of a practicum or field experience, with supervision, that included the design, implementation and monitoring of behavior analysis services, as part of a university or college degree program.
(2) Applicants for examination for certification as an associate behavior analyst shall submit a completed application form entitled Application for Certification as an Associate Behavior Analyst, which is incorporated by reference, and pay the certification fees prescribed by the Agency no less than 45 days in advance of the date of the examination for which they are applying.
(3) Applicants who pass the associate behavior analyst examination and pay the certification fees shall be certified as associate behavior analysts. Only persons who are certified pursuant to this rule shall use the title of certified associate behavior analyst.
(4) Approved Classes Application for class approval shall be made by submitting a completed application form, entitled Approval of Behavior Analysis Classes, incorporated by reference, 45 days in advance of the teaching of the class. Classes that meet the following criteria shall be approved by the Agency for a maximum of two years beginning on the approval date:
(a) The content of the class covers only behavior analysis and ethical issues related to the practice of behavior analysis.
(b) There are written learning objectives for the class.
(c) Student progress on each content area is evaluated during the class.
(d) The class is taught by a certified behavior analyst. The certified behavior analyst may be assisted by a certified associate behavior analyst.
Rulemaking Specific Authority 393.13(4)(g)3., 393.17 FS. Law Implemented 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.025, 65B-4.025, Repealed________.
65G-4.005 Renewal of Behavior Analysis Certification.
(1) Certification in behavior analysis shall be renewed every two years from the date of certification under these rules, if the applicant for renewal meets the following requirements:
(a) Completion of 16 hours of continuing education for renewal of certification as an associate behavior analyst and 24 hours of continuing education for renewal of certification as a behavior analyst within the applicants two year certification period. However, to be accepted, one hour of continuing education must be no less than 50 minutes of instruction in one hour.
(b) Submittal of a completed renewal application form, entitled Behavior Analysis Certification Renewal, incorporated by reference, and payment of the certification renewal fee prescribed by the Agency at least 45 days in advance of the expiration of the applicants two year certification period.
(2) The following shall be accepted toward fulfillment of the continuing education requirements:
(a) Completion of college or university courses, the content of which is entirely behavior analytic, taken from an institution that meets the requirements specified in Rule 65G-4.003, F.A.C.
(b) Completion of programs approved by the Agency under Rule 65G-4.007, F.A.C.
(c) Completion of programs not approved by the Agency provided such programs relate directly to the practice of behavior analysis or other topics pertinent to developmental disabilities.
(d) Attendance at local review committee meetings, established in Rule 65G-4.008, F.A.C., provided that the work of the applicant is discussed at the meeting with a focus on graphic displays of data.
(e) The combined total number of hours of continuing education from the categories defined in paragraphs (c) and (d), above, shall not exceed 25 percent of the total required hours of continuing education.
(f) Presentation or moderation by the applicant of approved continuing education programs on a one-time basis for each program. A maximum of 25 percent of the total required hours of continuing education may come from this category.
(g) Authorship or co-authorship of a research or review article on the application of behavior analysis that is published, during the two year certification period to which credit is to be applied, in a journal that requires that authors meet the American Psychological Associations ethical guidelines for authorship. A publication shall count towards a maximum of 25 percent of the total required hours of continuing education.
(3) Prior to the end of the two-year certification period, an associate behavior analyst or behavior analyst may request in writing that the Agency place his or her certification on inactive status for a maximum period of four years. At the time of the request, the certificate holder shall pay the fee prescribed by the Agency for placing certification on inactive status. While certification is on inactive status, the person shall not exercise any privileges associated with certification.
(4) Inactive certification may be reactivated if the applicant:
(a) Submits the reactivation form entitled Reactivation of Certification, which is incorporated by reference, and pays the certification renewal fee prescribed by the Agency. The applicants two year certification period will begin on the date the Agency reactivates the applicants certification.
(b) Completes the number of hours of continuing education required for the period beginning with the last renewal of certification and ending with the date of reactivation of certification.
(5) Once an inactive certificate expires, in order to be recertified, the person must meet the eligibility and examination requirements and pay the certification fees prescribed by these rules.
Rulemaking Specific Authority 393.13(4)(g)3., 393.17 FS. Law Implemented 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.026, 65B-4.026, Repealed________.
65G-4.006 Approved Continuing Education.
An individual or agency may apply to the Agency to have a course, class, seminar, workshop or institute approved for continuing education by submitting a completed application, entitled Application for Continuing Education (CE) Program Approval, incorporated by reference. An approved continuing education program shall:
(1) Cover behavior analysis practice, theory or methods.
(2) Have stated learning objectives.
(3) Be for the purposes of furthering and maintaining the skills or knowledge of behavior analysis.
(4) Be of sufficient duration to accomplish the stated learning objectives.
(5) Be instructed by a person who meets the following criteria:
(a) Is a certified behavior analyst or is a certified associate behavior analyst under the direction of a certified behavior analyst and
(b) Has received training in the subject taught in the program or
(c) Has experience of not less than one year of practical application or research in the subject taught in the program.
Rulemaking Specific Authority 393.13(4)(g)3., 393.17 FS. Law Implemented 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.027, 65B-4.028, Repealed________.
65G-4.007 Behavior Analysis Certification Fees.
The following fees are prescribed by the Agency for associate behavior analyst and behavior analyst certification and certification renewal:
(1) The certification fee for an associate behavior analyst is $125.00.
(2) The certification fee for a behavior analyst is $175.00.
(3) The certification renewal fee for associate behavior analysts is $75.00.
(4) The certification renewal fee for behavior analysts is $100.00.
(5) The fee for placing a certificate on inactive status shall be $50.00 for both categories of certification.
Rulemaking Specific Authority 393.13(4)(g)3., 393.17 FS. Law Implemented 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.028, 65B-4.027, Repealed________.
65G-4.008 Behavior Analysis Services Oversight System Organization.
(1) The Agency will establish and maintain a behavioral services program including a senior clinician, or Agency Senior Behavior Analyst (ASBA) to assume direction for standards of behavioral practice, develop and manage systems of quality, utilization and cost containment for statewide behavioral practice. The ASBA holds a doctorate from an accredited university program with behavior analysis as a primary focus, is a board certified behavior analyst, has completed a dissertation that had behavior analysis as its central focus and has at least one year of experience in the provision of behavior analysis services for persons with developmental disabilities. However, if no one with these qualifications is available, then the ASBA must be a certified behavior analyst with at least the education and experience established by the designated certification board. The behavioral services program will also include the support of at least one masters level board certified behavior analyst. The ASBA will direct:
(a) Standards of practice.
1. Area Behavior Analysts will be recruited, appointed, given clinical supervision and direction and annually evaluated in conjunction with their functional supervisor in the area to which they are assigned.
2. Committees.
a. The Local Review Committees working in conjunction with the ASBA will establish guidelines for committee function, including the establishment of time frames for scheduling, reviewing, and approving, as well as tracking for efficient program review and approval, charter content, committee membership, meeting participants, confidentiality requirements and development of a process to resolve provider and LRC disputes.
b. The Peer Review Committee working in conjunction with the ASBA will establish a committee charter and membership, as well as annual projects including, at minimum, review of behavioral practices in at least one Developmental Disability Center, at least one state operated forensic facility, at least one area community residential behavioral provider, at least one Local Review Committee, and other services as identified by the Agency.
3. Standards for Behavior Analysis Provider Practices will be established in conjunction with Area Behavior Analysts, and providers of behavior analysis and behavior assistant services to assure that common operational requirements are implemented statewide, including but not limited to designating individuals as local service providers, standards for time frames and process for behavioral program reviews and approvals, standards for behavioral assessment content and behavioral program content, standards for graphic display of data, documentation, billing, and LRC presentation.
4. Residential Behavioral Provider Standards will be established to determine eligibility requirements, and a common process created for Area approval and designation for providers of behavioral residential services, consistent with programs provided by the Agency.
5. Quality management and utilization standards for behavior analysis services and behavioral residential habilitation will be coordinated and implemented in coordination with:
a. Agency Quality Management;
b. Contracted Quality Management;
c. Area Licensing Coordinators;
d. LRC and PRC Committees;
e. Prior Service Authorization agency; and
f. Agency for Health Care Administration.
(2)(1) A statewide peer review committee (PRC) and local review committees (LRCs) shall be appointed by the Agency to provide oversight of behavior analysis services.
(a) The Agency will establish the composition, function and procedures to be followed by the committees. Each committee shall operate in accordance with by-laws written by the committee and approved by the Agency prior to their implementation by the committee.
(b) Each committee shall be chaired by a person who holds a doctorate from an accredited university program with behavior analysis as a primary focus, is a board certified behavior analyst, has completed a dissertation that had behavior analysis as its central focus and has at least one year of experience in the provision of behavior analysis services for persons with developmental disabilities. However, if no one with these qualifications is available, then the chairperson must be a certified behavior analyst with at least the education and experience requirements for taking the boards behavior analyst examination.
(c) Local review committees may establish subcommittees within varied locations outside the area office or within large facilities, upon mutual agreement between an area office and a provider, or between a primary facility campus and remote locations, and operate under the rules governing local review committees. Subcommittees shall ensure that at least two participating members are certified behavior analysts who are not employed or contracted by the facility, and who have no interest in the behavior programs produced by it. The LRC shall remain responsible for the decisions of the subcommittees.
1. A sufficient number of LRCs shall be established to allow for the timely review of behavior analysis services as required by law and rule. Subcommittees shall operate under the rules governing local review committees, however, the local review committees shall remain responsible for the decisions of the subcommittee.
2. Each LRC will be chaired by an individual meeting the qualifications above who is either an employee of the Agency or under contract to provide this service. Under no circumstances may the chair participate in the LRC review of his or her own services, services provided by or to a family member, or related services. Each subcommittee that oversees behavior analysis services of a single provider of a statewide program must be approved by the Agency in advance of the committee making decisions authorized by these rules.
(3)(2) The PRC statewide committee shall conduct on-site reviews of behavior analysis services including the operations of local review committees; provide training and technical assistance related to client and systemic behavior analysis services issues; monitor the development of the behavior analysis certification examinations to ensure that they are consistent with practice and testing standards; and provide recommendations regarding laws and regulations that affect behavior analysis services.
(4)(3) Each area office, and each developmental disabilities center institution, hereafter referred to as facility, institution shall have a local review committee that shall oversee behavior analysis services provided to clients in their area or facility institution as specified in paragraphs (a)-(c), below:
(a) The committee shall review all behavior analysis services requiring review and use of reactive strategies, when necessary, to ensure that behavioral programs are implemented as required and with the intended improvement in target behaviors these services are designed and approved in accordance with Florida Statutes and Agency Rules.
1. The person who designed the services or a designee, who has sufficient knowledge of the plan and its implementation, shall be present during the initial committee review. A person with primary responsibility for the ongoing implementation and monitoring of the services shall be present at all future meetings at which the services are reviewed by the committee.
2. The LRC chairperson Any person can request that bring a behavior analysis services plan be brought before the committee for its review.
(b) The committee shall monitor behavior analysis services in accordance with a monitoring schedule reviewed by the committee plan developed and approved by the committee to ensure that behavior analysis services are in compliance with Florida Statutes and the Agency rules. Approval of services includes the determination by the LRC chairperson that the individual designing and implementing the behavior analysis services is in compliance with subsection 65G-4.002(5), F.A.C., above, or is appropriately supervised.
(c) If reactive strategies continue without the implementation of required behavioral programs or behavior analysis services requiring review are not presented to the LRC or are not found not to be in accordance with Florida law, the committee chairperson shall request that the Agency notify the behavior analyst, and when appropriate, the residential provider and behavior analysts supervisor, of the services, in writing and orally at the time of review and in writing within ten days of review in the language of the provider or supervisor, and in English, of each area of non-compliance.
1. Absent emergency circumstances that threaten public health, safety or welfare, the provider shall have twenty (20) days within which to demonstrate compliance or present to the committee chairperson in writing evidence showing that the services being provided are in compliance with Florida Statutes and the Agency rules. The provider may present whatever evidence the provider deems appropriate to demonstrate that the provider is in compliance with Florida Statutes and the Agency rules.
2. If, however, the committee determines that the behavior analyst, and when appropriate, the residential provider, is not in compliance with Florida Statutes or the Agency rules, the committee chairperson shall report all facts and circumstances to the Agency in writing within five (5) days of the providers response and request a final decision be made by the Agency.
3. Within twenty (20) days of such report, the Agency shall notify the committee, in writing, and the provider, in writing and orally in the language of the provider and in English, of its decision. In the event the Agency finds the provider is not in compliance with Florida Statutes or the Agency rules, the Agency shall allow the provider an additional ten (10) days to modify services to meet requirements. If modifications are not made within the time alotted, the Agency shall take appropriate action against the provider up to and including withdrawal of status as an authorized provider, notification of the designated certification or licensing board, and revoke the providers behavior analysis certification require that the services being provided be discontinued and notify the provider of the providers rights in accordance with Chapter 120, F.S.
4. Following a committee report set forth above, the Agency may require additional supervision of the providers services. The requirement for additional supervision may be a prerequisite for allowing the provider to continue to serve as an authorized behavior analysis services provider. Such required supervision may include the following conditions:
a. Supervision must be provided by a Board Certified Behavior Analyst Doctoral level, Board Certified Behavior Analyst; or a person licensed under Chapter 490 or 491, F.S., (Psychologist, School Psychologist, Clinical Social Worker, Marriage and Family Therapist or Mental Health Counselor), with evidence (e.g. work samples) of at least three years of experience in the application of Applied Behavior Analysis procedures approved by a local review committee, to persons with exceptional needs post certification or licensure.
b. Face-to-face meetings for up to two hours every two weeks or two hours per 40 hours of the providers contact with clients. These meetings shall be between the provider and a board certified behavior analyst or a person licensed under Chapter 490 or 491, F.S., during which the supervisor directs and evaluates the behavior analysis services provided by the provider.
c. The supervisor shall not be, at the time supervision is provided, the providers subordinate or employee. The supervisor shall not be considered an employee of the provider if the only compensation received by the supervising behavior analyst consists of payment for supervision.
d. The providers presentation of behavior analysis services designed and implemented by the provider, with a focus on graphic displays of data, at local review committee meetings, established in Rule 65G-4.008, F.A.C., may be substituted for up to 25 percent of the total supervision time required.
Rulemaking Specific Authority 393.125, 393.13(4)(g)3., 393.17 FS. Law Implemented 393.066, 393.067, 393.125, 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.029, 65B-4.029, Amended________.
65G-4.009 Design, Implementation and Monitoring of Behavior Analysis Services.
(1) Providers of behavior analysis services shall provide services only as certified and as provided by law.
(2) All aspects of behavior analysis services shall be integrated by the provider with other relevant services and supports being provided to the client by the provider within the scope of authorized behavioral services.
(3) The selection of behavior analysis procedures and decisions by the provider to make environmental changes that obviate the need for the use of behavior change procedures shall be based upon information obtained through direct and indirect functional assessment or functional analysis descriptive analysis or systematic environmental manipulations designed to identify patterns of behavior and the functional relationships between the behavior or behaviors targeted for change and the environment. Consistent with established Agency operating procedure, the assessment will contain at minimum:
(a) Operational definitions of all behaviors targeted for change.
(b) Description of conditions under which the behavior is most likely and least likely to occur.
(c) Measures of current level of behavior targeted for change.
(d) Other relevant personal, social, medical, pharmacological or historical information that may impact on behavior targeted for change, if any.
(e) Putative functional relationships between targeted behavior and environment.
(f) Recommendations for procedures to decrease maladaptive behavior and increase relevant appropriate alternative behavior.
(4) Behavior analysis services designed by the provider to decrease behavior shall include procedures for increasing functional replacement behavior, or acquisition of adaptive skills to serve as a functional alternative to the behaviors targeted for change.
(5) Behavior analysis procedures that are the least intrusive to the client and the most likely to be effective shall be used by the provider.
(6) Medical treatment to address purely medical etiologies or physical or occupational therapies to address behaviors that are related are due to physical limitations shall be provided concurrent with, or prior to, the implementation of behavior analysis services by the provider.
(7) Behavior analysis services shall not be provided continuously without appropriate considerations for mMaintenance and generalization of behavior change in relevant settings or a designation of criteria for termination of the interventions or services shall be addressed by the provider whenever behavior analysis services are provided.
(8) The provider shall ensure that persons responsible for implementing, monitoring and providing behavior analysis services receive performance-based training that prepares them to properly implement the behavior analysis procedures involved, within the circumstances under which the services will be provided.
(9) The provider shall take reasonable steps to ensure appropriate data collection that measurement for of behaviors targeted for increase change and decrease replacement behavior during the entire period services are in effect. Graphic displays of data on behaviors targeted for change shall be kept maintained and up-dated by the provider at least weekly, unless the local review committee determines that a less stringent requirement is acceptable for individual cases.
(10) The LRC local review committee shall approve the providers behavior analysis services monitoring plan and specify the requirements for reporting of findings and data to the committee for behavior analysis services approved by the committee.
(a) Behavior analysis services plans are to be written as succinctly as is possible to effectively serve as a guide to those who will be implementing the plan.
(b)(a) Consistent Monitoring with established Agency operating procedure, the behavior analysis services plan shall include, either in text or by reference to appropriate documents:
1. Identifying information for the individual affected by the plan.
2. The name, signature and certification or licensure information of the individual who developed, supervises or approves the implementation of the procedures described in the plan.
3. Objective statements of goals relative to behavior reduction and behavior acquisition resulting in program termination.
4. Rationale for intervention being warranted, and selection of proposed interventions, consistent with assessment results.
5. Medical, social and historical information including previous treatment programs relevant to the current problems being addressed.
6. How and where behavioral services will be integrated with daily routines and other relevant services.
7. Identification of behaviors targeted for reduction.
8. Identification of behaviors targeted for acquisition or as replacement.
9. Data collection methods for behaviors targeted for reduction and acquisition.
10. Intervention procedures for behaviors targeted for reduction and acquisition.
11. Description of performance-based training for persons implementing procedures.
12. Techniques for maintaining and generalizing behavioral improvements, which could include the reduction and fading of behavioral services.
13. When employed, rationale for use of ancillary support staff, such as behavior assistants; a description of training, their routine or duties, performance monitoring and fading of services.
14. Methods and schedule of monitoring for programmatic fidelity, including data analysis and direct observation.
15. Signatures of informed participants as may be required by law and individuals authorized to approve the procedures.
1. Documentation of when and by whom monitoring was done.
2. Examination and interpretation of data.
3. Direct observations in the setting(s) where the plan is implemented, including the observation of the implementation of procedures or simulated implementation.
4. Discussions with and observations of individuals who implement the behavior analysis procedures involved.
5. Determination that the services are in accordance with Florida Statutes and the Agency rules.
(c)(b) Modifications to the behavior analysis service plan which includes procedures listed in Rule 65G-4.010, F.A.C., approved by the LRC committee shall be documented and submitted by the provider to the committee chairperson within one week after the changes are made, for determination of need for committee review. A summary of the effects of and modifications to behavior analysis services plan shall be created written by the provider at least annually. This summary may be a graphical display of data collected over the year with appropriate annotation of program modifications.
Rulemaking Specific Authority 393.13(4) FS. Law Implemented 393.0651, 393.066, 393.067, 393.068, 393.13, 393.17 FS. History New 9-23-96, Formerly 10F-4.030, 65B-4.030, Amended________.
65G-4.010 Behavior Analysis Services Approval.
(1) All written plans describing behavior analysis services approved for implementation pursuant to these rules shall be submitted to the local review committee chairperson within five working days following implementation. Behavior analysis services plans shall be consistent with the requirements of subsection 65G-4.009(10), F.A.C.
(2) The local review committee must review:
(a)(1) Behavior analysis services that include behavior analysis procedures that are designed to decrease the probability of the occurrence of a behavior by presenting, attenuating or removing a stimulus following each occurrence of the behavior to be reduced, behavioral contingencies designed to increase the probability of a behavior by removing or attenuating a stimulus following each occurrence of the behavior to be increased, and the use of satiation and deprivation procedures, hereafter referred to as restricted procedures, and shall require the approval of one of the following practitioners prior to implementation. :
1.(a) A board certified behavior analyst as defined in subsection 65G-4.0011(5), F.A.C., who meets the education and experience requirements established in these rules for taking the behavior analyst certification examination.
2.(b) A person licensed pursuant to Chapter 490 or 491, F.S.
(b)(2) Approval by a certified behavior analyst who meets the education and experience requirements specified in these rules for taking the behavior analyst certification examination or a person licensed pursuant to Chapter 490 or 491, F.S., shall also be required prior to implementation for Bbehavior analysis services that are designed to address those actions of the individual which, without behavioral, physical, or chemical intervention can be expected to result in subparagraphs 1. through 8. below and will be provided or supervised by a Certified Behavior Analyst as defined in subsection 65G-4.001(5), F.A.C., or a person licensed pursuant to Chapter 490 or 491, F.S.:
1.(a) Have resulted in self-inflicted, detectable damage, or resulted in external or internal damage requiring medical attention or are expected to increase in frequency, duration, or intensity resulting in self-inflicted, external or internal damage requiring medical attention.
2.(b) Have occurred or are expected to occur with sufficient frequency, duration or magnitude that a life-threatening situation might result, including excessive eating or drinking, vomiting, ruminating, eating non-nutritive substances, refusing to eat, holding ones breath, or swallowing excessive amounts of air.
3.(c) Have resulted in detectable damage, or external or internal damage to other persons that requires medical attention or are expected to increase in frequency, duration or intensity resulting in external or internal damage to other persons that requires medical attention.
4.(d) Have resulted or are expected to result in major property damage or destruction.
5.(e) Have resulted or are expected to result in arrest and confinement by law enforcement personnel.
6. Have resulted in the need for behavioral services in a Behavior Focused or Intensive Behavioral Residential Habilitation program.
7. Have resulted in the need for additional staffing or Behavior Assistant Services.
8. Have resulted in the repeated use of reactive strategies without a formal approved plan.
(3) Behavioral programs or manuals implemented as group contingencies or behavior change systems, including behavioral program manuals, level systems and token economies, require local review committee review and approval. A written plans describing behavior analysis services approved for implementation pursuant to these rules shall be sent to the local review committee chairperson within five working days following implementation.
Rulemaking Specific Authority 393.13(4)(g)3. FS. Law Implemented 393.066, 393.067(14), 393.068, 393.13, 393.17 FS. HistoryNew 9-23-96, Formerly 10F-4.031, 65B-4.030, Amended________.
65G-4.011 Determination of Mental Retardation in Capital Felony Cases: Intellectual Intelligent and Adaptive Functioning; Tests to be Administered.
(1) When a defendant convicted of a capital felony is suspected of having or determined to have mental retardation, the standard criteria for determining mental retardation must be met. This means the defendant has significantly subaverage general intellectual functioning as determined by performance which is two or more standard deviations from the mean score on a standardized intelligence test, existing concurrently with deficits in at least two areas of adaptive behavior and manifested during the period from conception to age 18. Iintelligence tests as well as tests of adaptive functioning to determine intellectual functioning as specified below shall be administered by a qualified professional who is authorized in accordance with Florida Statutes to perform evaluations in Florida. The test shall consist of an individually administered evaluation, which is valid and reliable for the purpose of determining intelligence and adaptive functioning. In all cases, the test(s) used must be current at the time of assessment.
(a) The tests specified below shall be used for determining intelligence:
1.(a) The Stanford-Binet Intelligence Scale.
2.(b) Wechsler Intelligence Scale.
3. If, given the condition of the individual to be tested, the Stanford-Binet Intelligence Scale or the Wechsler Intelligence Scales are not valid and reliable as determined by the person authorized to administer such tests as specified in subsection (1), an alternative test or evaluation procedure, administered and interpreted in conformance with instructions provided by the producer of the tests or evaluation materials, may be used. The results of the testing or evaluation must include reference to published validity and reliability data for the specified test or evaluation procedure. Alternative tests may include current versions of the:
a. Universal Nonverbal Intelligence Test;
b. Comprehensive Test of Nonverbal Intelligence;
c. Wechsler Non-Verbal Test of Intelligence.
(b) Accepted tests for adaptive functioning include current versions of the following tests:
1. Vineland Adaptive Behavior Scales;
2. Adaptive Behavior Scale;
3. Adaptive Behavior Assessment System;
4. Adaptive Behavior Evaluation Scale;
5. Scales of Independent Behavior.
(c) The psychologist completing the assessments should also:
1. Look for Evidence of hospitalizations or treatments after age 18 based on conditions or injuries known to decrease cognitive and adaptive functioning.
2. Look for existence of a significant psychiatric diagnosis, history of psychiatric treatment, or the use of medicines or substances that decrease cognitive and adaptive function. Existence of such precludes a determination of eligibility unless it predates the applicants 18th birthday.
3. Show validation of findings and make a recommendation to confirm diagnosis of retardation with onset prior to the age of 18.
4. Look for academic and intellectual test results and records prior to the persons 18th birthday.
(2) Notwithstanding this rule, the court, pursuant to Section 921.137, F.S., is authorized to consider the findings of the court appointed experts or any other expert utilizing individually administered evaluation procedures which provide for the use of valid tests and evaluation materials, administered and interpreted by trained personnel, in conformance with instructions provided by the producer of the tests or evaluation materials. The results of the evaluations submitted to the court shall be accompanied by the published validity and reliability data for the examination, and demonstrate whether the defendant meets all three criteria identified above for determining mental retardation.
Rulemaking Specific Authority 921.137(1) FS. Law Implemented 921.137(1) FS. HistoryNew 1-13-04, Formerly 65B-4.032, Amended________.
65G-4.012 Determination of Mental Retardation: Intelligence: Tests to be Administered.
(1) For the purposes of Chapters 393 and 916, F.S., the Stanford-Binet Intelligence Scale or the Wechsler Adult & Infant Intelligence Scales, administered by or under the direct supervision of a psychologist or school psychologist licensed under Chapter 490, F.S., shall be used to establish determine mental retardation and the level of intellectual functioning, as one of the three criteria required for determining mental retardation. Significantly subaverage general intellectual functioning existing as determined by performance which is two or more standard deviations from the mean score on a standardized intelligence test, existing concurrently with deficits in adaptive behavior must also be present and both must be manifested during the period from conception to age 18. In all cases, the test(s) used must be current at the time of assessment.
(2) Notwithstanding subsection (1), if, given the condition of the individual to be tested, the Stanford-Binet Intelligence Scale or the Wechsler Adult & Infant Intelligence Scales are not valid and reliable as determined by the person authorized to administer such tests as specified in subsection (1), a current version of an alternative test or evaluation procedure, administered and interpreted in conformance with instructions provided by the producer of the tests or evaluation materials, may be used. The results of the testing or evaluation must include reference to published validity and reliability data for the specified test or evaluation procedure. Tests that might be used in situations where the Stanford-Binet or Wechsler scales are invalid or unreliable include:
(a) Differential Abilities Scales;
(b) Bayley Scales of Infant and Toddler Development;
(c) Leiter International Performance Scale;
(d) Universal Nonverbal Intelligence Test;
(e) Test of Nonverbal Intelligence;
(f) Comprehensive Test of Nonverbal Intelligence;
(g) Wechsler Nonverbal Scale of Ability.
(3) Deficits in adaptive behavior are defined as either an overall score or scores in two or more areas of a standardized measure of adaptive behavior that fall more than two standard deviations below the mean of the test. In all cases, the test(s) used must be current at the time of assessment. Accepted tests for adaptive functioning include:
(a) Vineland Adaptive Behavior Scales;
(b) Adaptive Behavior Scale;
(c) Adaptive Behavior Assessment System;
(d) Adaptive Behavior Evaluation Scale;
(e) Scales of Independent Behavior.
(4) In cases where there is a statistically significant difference between scores on an intelligence test, variability in subtest scores, or variability in scores obtained in different assessments, individual scores may not indicate mental retardation and should not be relied upon as a valid score. In these cases the following factors should also be considered:
(a) The overall pattern of scores;
(b) School records;
(c) School placement;
(d) Achievement scores;
(e) Behavior during testing;
(f) The psychosocial situation at the time of testing.
(5) In cases where there are no test scores available prior to the age of 18, determination may be based on test scores after the age of 18 combined with the following:
(a) A social history obtained from a family member or someone who has known the applicant since childhood indicating:
1. Developmental milestones and age of onset of problems of concern.
2. Reason why services were not previously requested.
3. Schools or training facilities person attended and types of placement and services received.
(b) The psychologist or other Agency for Persons with Disabilities staff should:
1. Look for evidence of hospitalizations or treatments after age 18 based on conditions or injuries known to decrease cognitive and adaptive functioning.
2. Look for existence of a significant psychiatric diagnosis, history of psychiatric treatment, or the use of medicines or substances that decrease cognitive and adaptive function. Existence of such precludes a determination of eligibility unless it predates the applicants 18th birthday.
3. Show validation of findings and make a recommendation to confirm diagnosis of retardation with onset prior to the age of 18.
Rulemaking Specific Authority 393.063(38), 916.106, 393.501(1) FS. Law Implemented 393.063(38), 916.106 FS. HistoryNew 6-13-06, Amended________.
