The Florida Senate
BILL ANALYSIS AND FISCAL IMPACT STATEMENT
(This document is based on the provisions contained in the legislation as of the latest date listed below.)
Prepared By: The Professional Staff of the Committee on Rules
BILL: CS/SB 538
INTRODUCER: Rules Committee and Senator Hooper
SUBJECT: Private Instructional Personnel Providing Applied Behavior Analysis Services
DATE: March 2, 2022 REVISED:
ANALYST STAFF DIRECTOR REFERENCE ACTION
1. Palazesi Bouck ED Favorable
2. Smith Brown HP Favorable
3. Palazesi Phelps RC Fav/CS
Please see Section IX. for Additional Information:
COMMITTEE SUBSTITUTE - Substantial Changes
I. Summary:
CS/SB 538 expands the definition of “private instruction personnel,” for purposes of allowing
such personnel to provide services in public schools, to include a registered behavior technician
who holds a nationally recognized paraprofessional certification in behavior analysis. The bill
authorizes the registered behavior technician to practice in a public school under the supervision
of a Board Certified Behavior Analyst or an individual licensed under ch. 490 or 491, F.S., and
who is employed by an enrolled Medicaid provider ., for applied behavior analysis services, by
assisting and supporting such an individual in the provision of those services.
The bill provides an effective date of July 1, 2022.
II. Present Situation:
Applied Behavior Analysis Services
Behavior Analysis measures outcomes through data collection and the direct observation of
behavior.1 Applied Behavior Analysis (ABA) is the use of principled methods of behavior
1
Florida Association for Behavior Analysis, What is Behavior Analysis?, https://www.fabaworld.org/what-is-behavior-
analysis (last visited Jan. 10, 2022).
BILL: CS/SB 538 Page 2
analysis to bring about meaningful changes in socially important behaviors.2 ABA is best known
for its success in treating individuals with autism spectrum disorder and other developmental
disabilities.3 Florida law defines ABA as “the design, implementation, and evaluation of
environmental modifications, using behavioral stimuli and consequences, to produce socially
significant improvement in human behavior, including but not limited to, the use of direct
observation, measurement, and functional analysis of the relations between environment and
behavior.”4
ABA Service Providers and Certification
Florida’s Agency for Persons with Disabilities (APD) is required to recognize a non-profit
corporation for the certification of behavior analysts. The non-profit corporation is required to:5
Adhere to the national standards of boards that determine professional credentials; and
Have a mission to meet professional credentialing needs identified by behavior analysts, state
governments, and consumers of behavior analysis services.
Further, the certification procedure recognized by the APD 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.6 The APD recognizes the certification awarded by the
Behavior Analyst Certification Board, Inc.,7 which certifies the three provider types: Board
Certified Behavior Analysts, Board Certified Assistant Behavior Analysts, and Registered
Behavior Technicians.
The Behavior Analyst Certification Board’s requirements for certification are outlined below:
Board Certified Behavior Analyst (BCBAs):8
o At least a master’s degree in applied behavior analysis or a closely-related field;
o Completion of 270 hours of graduate-level instruction in specified behavior analysis
topics;
o Completion of specified hours of supervised experiential training in ABA; and,
o Passage of the BCBA examination.
Board Certified Assistant Behavior Analyst (BCaBAs):9
o At least a bachelor’s degree;
o Completion of 180 classroom hours of instruction in specified behavior analysis topics;
o Completion of specified hours of supervised experiential training in ABA; and,
2
Association of Professional Behavior Analysts, Identifying Applied Behavior Analysis Interventions white paper, (2017),
available at https://cdn.ymaws.com/www.apbahome.net/resource/collection/1FDDBDD2-5CAF-4B2A-AB3F-
DAE5E72111BF/APBAwhitepaperABAinterventions.pdf, at 16 (last visited Jan. 10, 2022).
3
Behavior Analyst Certification Board, Autism & Intellectual/Development Disabilities, https://www.bacb.com/wp-
content/uploads/2020/05/Behavioral-Treatment-of-Autism-and-Other-Developmental-Disabilities-Fact-Sheet_210108.pdf
(last visited Jan. 10, 2022).
4
Sections 627.6686(2)(a), F.S. and 641.31098(2)(a), F.S.
5
Section 393.17(2), F.S.
6
Id.
7
Rule 65G-4.0011, F.A.C.
8
Behavior Analyst Certification Board, Board Certified Behavior Analyst Handbook, https://www.bacb.com/wp-
content/uploads/2021/09/BCBAHandbook_210915-2.pdf (last visited Jan. 10, 2022).
9
Behavior Analyst Certification Board, Board Certified Assistant Behavior Analyst Handbook, https://www.bacb.com/wp-
content/uploads/2021/09/BCaBAHandbook_210915-2.pdf (last visited Jan. 10, 2022).
BILL: CS/SB 538 Page 3
o Passage of the BCaBA examination.
Registered Behavior Technician (RBTs):10
o At least a high school diploma;
o Be at least 18 years old;
o Completion of 40 hours of training in specified behavior analysis topics;
o Completion of the RBT competency assessment; and
o Passage of the RBT examination.
The RBT is a paraprofessional certified in behavior analysis. RBTs may assist in delivering ABA
services under the direction and supervision of a BCBA or a BCaBA.11
Medicaid Coverage of ABA Services
Florida Medicaid has covered ABA services since 2012.12 In 2017, the Agency for Health Care
Administration (AHCA) adopted a provider reimbursement rule, setting a formal classification
for ABA providers that closely follows the certification hierarchy of the BCBA. The rule
established “lead analysts” as those professionals either holding a BCBA certification or
professionals licensed by the state under chapters 490 or 491. The rule also recognizes other
personnel who are permitted to provide ABA services, such as those holding BCaBA credentials
and RBT credentials.13
To enroll as a behavior analysis provider in Florida’s Medicaid Program, a provider must submit
an enrollment application along with documentation of proof of certification, which is then
evaluated and verified by AHCA.14 Depending on the type of BCBA certification, a provider
may apply as a sole proprietor or a sole proprietor enrolling as a member of a group.15 An RBT
may only apply as a sole proprietor enrolling as a member of a Medicaid-enrolled behavior
analysis group and AHCA requires a behavior analysis group to have at least one lead analyst as
a group member.16
Florida’s Agency for Persons with Disabilities (APD) requires all providers of behavior analysis
services in the Medicaid home and community based waiver program to be licensed to practice
10
Behavior Analyst Certification Board, Registered Behavior Technician Handbook, https://www.bacb.com/wp-
content/uploads/2021/09/RBTHandbook_210915-3.pdf (last visited Jan. 10, 2022).
11
Id.
12
See The Florida Bar Foundation, Federal judge orders state of Florida to cover applied behavioral analysis therapy for
autism, (July 1, 2012), https://thefloridabarfoundation.org/federal-judge-orders-state-of-florida-to-cover-applied-behavioral-
analysis-therapy-for-autism/ (last visited Feb. 21, 2022).
13
Rule 59G-4.125, F.A.C.
14
Agency for Health Care Administration, Enrolling as a Florida Medicaid Behavior Analysis Provider (April 25, 2019), at
9, available at
https://ahca.myflorida.com/medicaid/Policy_and_Quality/Policy/behavioral_health_coverage/bhfu/pdf/Enrolling_as_a_Florid
a_Medicaid_Behavior_Analysis_Provider.pdf.; A Medicaid Provider Enrollment Level 2 background screening is also
required.
15
Id. at 13.
16
Id. at 12-21.
BILL: CS/SB 538 Page 4
under chapters 49017 or 491,18 or be certified by a nonprofit corporation that adheres to the
national standards of boards that determine professional credentials and whose mission is to meet
professional credentialing needs identified by behavior analysts, state governments, and
consumers of behavior analysis services.19 The APD recognizes the certification for behavior
analysts awarded by the BACB.20
ABA Services in Florida’s Public Schools
In an educational setting, behavior analysis provides a scientific approach to designing,
implementing, and evaluating instruction based on analyzing interactions between what the
teacher does and student learning.21
Section 1003.572, F.S., was created in 2013,22 to encourage cooperation and coordination of
services for students with disabilities through public and private instructional collaboration.
Private instructional personnel who are hired by or contracted by parents to collaborate with
public instructional personnel must be permitted to observe the student in the educational setting,
act as a team with instructional personnel in the educational setting, and provide services in the
educational setting.23 Private instructional personnel must undergo a background screening, and
the student’s public instructional personnel and principal must consent to the time and place.24
Section 1003.572, F.S., defines term “private instructional personnel” to include:25
Individuals certified under s. 393.17, F.S., (a Board Certified Behavior Analyst) or
individuals licensed under ch. 490, F.S.,26 or ch. 491, F.S.,27 for applied behavior analysis
services.
Speech-language pathologists licensed under s. 468.1185, F.S.
Occupational therapists licensed under part III of ch. 468, F.S.
Physical therapists licensed under ch. 486, F.S.
Psychologists licensed under ch. 490, F.S.
17
Chapter 490, “Psychological Services Act” regulates psychological services in the state of Florida, including but not
limited to, the process and requirements to become a Florida Department of Health licensed psychologist, defining the scope
of practice of psychology, and the continuing education requirements of a licensed psychologist.
18
Chapter 491, regulates mental health counseling, clinical social work, and marriage and family therapy, including but not
limited to the process and requirements to become a Florida Department of Health licensed marriage and family therapist,
clinical social worker,
and mental health counselor.
19
Section 393.17(2), F.S. and rule 65G-4.0011, F.A.C.
20
Rule 65G-4.0011, F.A.C.
21
Behavior Analyst Certification Board, Behavior Analysis in Education, https://www.bacb.com/wp-
content/uploads/2020/05/Behavior-Analysis-in-Education-Fact-Sheet_210108.pdf (last visited Jan. 10, 2022).
22
Section 5, ch. 2013-236, L.O.F.
23
Section 1003.572(3), F.S.
24
Id.
25
Section 1003.572(1), F.S.
26
Chapter 490, “Psychological Services Act” regulates psychological services in the state of Florida, including but not
limited to, the process and requirements to become a Florida Department of Health licensed psychologist, defining the scope
of practice of psychology, and the continuing education requirements of a licensed psychologist.
27
Chapter 491, regulates mental health counseling, clinical social work, and marriage and family therapy, including but not
limited to the process and requirements to become a Florida Department of Health licensed marriage and family therapist,
clinical social worker, and mental health counselor.
BILL: CS/SB 538 Page 5
Clinical social workers licensed under ch. 491, F.S.
The statute does not expressly address other behavior analysis professionals, such as BCaBAs or
RBTs.
III. Effect of Proposed Changes:
CS/SB 538 expands the definition of “private instruction personnel” for purposes of allowing
such personnel to provide services in public schools. The definition is expanded to include a
registered behavior technician who holds a nationally recognized paraprofessional certification in
behavior analysis.
The bill adds an Registered Behavior Technician (RBT) who holds a nationally recognized
paraprofessional certification in behavior analysis, who practices under the supervision of either
certified behavior analysts or professionals licensed under chapter 490 or chapter 491, F.S., and
who is employed by an enrolled Medicaid provider, to the list of private instructional personnel
who must be allowed to provide ABA services in a K-12 public school.
The bill provides an effective date of July 1, 2022.
IV. Constitutional Issues:
A. Municipality/County Mandates Restrictions:
None.
B. Public Records/Open Meetings Issues:
None.
C. Trust Funds Restrictions:
None.
D. State Tax or Fee Increases:
None.
E. Other Constitutional Issues:
None.
V. Fiscal Impact Statement:
A. Tax/Fee Issues:
None.
BILL: CS/SB 538 Page 6
B. Private Sector Impact:
None.
C. Government Sector Impact:
None.
VI. Technical Deficiencies:
None.
VII. Related Issues:
None.
VIII. Statutes Affected:
This bill substantially amends section 1003.572 of the Florida Statutes.
IX. Additional Information:
A. Committee Substitute – Statement of Substantial Changes:
(Summarizing differences between the Committee Substitute and the prior version of the bill.)
CS by Rules on March 1, 2022:
The committee substitute requires that registered behavior technicians utilized for applied
behavior services in the classroom be employed by an enrolled Medicaid provider.
B. Amendments:
None.
This Senate Bill Analysis does not reflect the intent or official position of the bill’s introducer or the Florida Senate.