BIRMINGHAM, Ala. – Parents whose children receive behavior therapy services and the professionals who deliver that care say they were caught off guard this week when lawmakers advanced a bill that would remove regulatory authority from Alabama’s Behavior Analyst Licensing Board.
Supporters of the bill call it overdue reform and critics warn it could weaken professional oversight and make behavior therapy services harder to get.
Senate Bill 113, sponsored by Sen. Chris Elliott, R-Josephine, would shift the Behavior Analyst Licensing Board into an advisory role and move regulatory authority to the Alabama Department of Mental Health and its commissioner. The bill is expected on the House floor Thursday morning.
Lawmakers are charged with extending dozens of occupational and licensing boards’ authority each year. Elliott’s originally filed bill would have extended the behavior analyst board’s for one year. A significant rewrite of the original bill passed the Senate on Feb. 5.
At the center of the dispute is who should control licensing and rulemaking for behavior analysts – professionals who provide intensive therapy services, often for children with autism and other developmental disorders. There are about 800 licensed behavior analysts in Alabama.
Lawmakers say the change is needed after years of administrative problems cited in state audits, while parents and practitioners argue that licensing and rulemaking should remain in the hands of licensed professionals.
Elliott said the issue has been moving through the Sunset Committee, which reviews boards’ performances and can recommend changes, process for years, even if many stakeholders only recently became aware of the proposal.
The Department of Examiners of Public Accounts issued its Sunset Report in September, and the committee gave the board until the end of November to work with ADMH, where the board technically exists, to correct administrative issues.
The Sunset Report, covering 2022 through 2024, catalogued problems including noncompliance with the Open Meetings Act and failure to notify the Secretary of State when board positions opened. Similar problems existed during the prior audit period from 2018 through 2022.
“This board has had problems since its inception,” Elliot said. “The board’s leadership has had problems since its inception. The board members have not done a good enough job making sure that the significant issues found by the Examiner of Public Accounts were corrected.”
Elliott, a member of the Sunset Committee, said ADMH has assured him they are “going to dedicate the time, energy, effort and resources to this, to make this work.”
Sunset Committee Co-Chair Rep. Margie Wilcox, R-Mobile, said the board had multiple opportunities to address administrative concerns but failed to do so. Rep. Kerry Underwood, R-Tuscumbia, said he views the shift as a fix to longstanding problems.
Parents and practitioners began pushing back after learning details of the proposal earlier this week.
Catey Hall, whose son received behavior analysis services as a young child, posted a call to action on social media Sunday, urging parents to contact lawmakers to slow down and consult stakeholders. Hall was active in the grassroots effort that helped secure passage of a 2017 law requiring insurance coverage for applied behavior analysis therapy.
“This actually sets up the entire professional field to fail,” Hall said. “I don’t know any other profession that has a licensing board that is not peer-regulated.”
Erich Grommet, a psychologist and current board member, said shifting authority away from professionals is a step backward.
“Having representatives from a profession regulate that profession – that’s the gold standard,” he said. “That’s what you see in licensure boards across America.”
“One of the things that the Behavior Analyst Licensing Board has to do, and it’s true of other professions, is to make a determination on what should the qualifications be to be licensed behavior analysts in Alabama,” he added. How could a person who isn’t a member of the profession make that determination, he questioned.
Jennifer Bonney, a board certified behavior analyst in Dothan who operates a practice serving multiple communities, said losing board autonomy could hurt recruitment in a field that already struggles to attract providers to Alabama.
“It will certainly cost us,” Bonney said. “It’s hard enough to get people to work in Alabama as it is, and that’s just going to cost us having a workforce.”
Bonney said behavior analysts work intensively with children to reduce harmful behaviors and teach new skills critical to development, and she worries workforce shortages would ultimately hurt families needing services.
Both sides agree on at least one thing: Alabama needs licensed behavior analysts and stable oversight of the profession.
Alabama Department of Mental Health Commissioner Kim Boswell told Alabama Daily News Wednesday that she still will rely on the newly named council to have the final say on issues involving the practice of behavior analysis.
“We do value the input of those individuals, especially when it comes to things like complaints and disciplinary actions,” Boswell said. “They are the subject matter experts and we certainly recognize that.”
Boswell said the licensing requirements are a checklist making sure the behavior analyst has proper certification credentials and undergoes a background check along with other paperwork.
“My biggest concern was that the sunset committee was going to sunset the ABA (Applied Behavior Analysis) board,” a possibility that was “just absolutely unacceptable,” Boswell said.
“We have to have licensed ABA therapists in the state,” she added. “There is nothing more important for individuals with autism and other related issues than ABA therapy.”
Boswell said she hoped her department and the licensing board could work together to complete required changes by the Sunset Committee’s deadline, but the board disagreed with the department’s proposed policies and procedures, which the Examiners’ office said were necessary, and the work was not completed in time.
Grommet said the board disagreed because members believed the proposed policies shifted authority from the board to ADMH in ways that did not match the law. The board developed its own proposal, which ADMH viewed as inadequate to address concerns outlined in the review.
Grommet said after the policy disagreement, the board sought clarification about its legal status and relationship with ADMH, submitting a request for an attorney general’s opinion on the issue. He said the board planned to move forward with adopting policies after receiving guidance from the attorney general’s office, which acknowledged receipt of the request Jan. 27.
This is not the only board being put under the authority of a state agency this session. The bill pending a House vote would put the licensing and regulating of massage therapists and massage establishments in the state under the Alabama Department of Public Health. Another puts the Alabama Sickle Cell Oversight and Regulatory Commission under ADPH.
Wilcox said she plans to closely monitor what happens if the behavior analyst bill passes and that the matter could come back to the Sunset Committee in the future.
“At any time that they are able to resurrect themselves and come back to be a full board, we’ll be glad to do that,” she said.
Elliott said he sees the restructuring as the path toward stabilizing the licensing process moving forward.
“The result is going to be something much more positive for behavior analysts,” Elliott said. “That’s a competent, capable administrative organization handling the day-to-day operations of the board.”