W.Va. lawmakers advised on autism care oversight

CHARLESTON, W.Va. (AP) — West Virginia does not appear to need its own regulatory board to oversee specialists who treat children with autism, given current national standards, a Tuesday report presented to lawmakers concluded.

The legislative audit found that the national Behavior Analyst Certification Board "provides adequate and sufficient protection to the public."

The findings arrive after the West Virginia Board of Examiners of Psychologists sought to claim jurisdiction over behavior analysts last year. The board dropped that attempt following a lawsuit and an outcry among parents of children diagnosed with these neurological conditions.

These specialists provide applied behavioral analysis, a treatment considered crucial by experts for many children with an autism spectrum disorder. These conditions are marked by problems with communication, behavior and social skills. The range includes a severe form called autistic disorder and the much milder Asperger's syndrome. Tuesday's report said the number of West Virginia schoolchildren diagnosed within the spectrum increased to 1,474 during the just-completed school year from 372 during 2001-2002.

"It is a distinct profession with distinct training that pulls from many difference degree programs in order for a certification to be specialized," Susannah Poe, the state's only behavior analysts who is also a licensed psychologist, told the House-Senate committees that received the report.

West Virginia is among 35 states that require insurers to cover this treatment. The auditors found that 27 of those coverage states don't directly oversee behavior analysts, including neighboring Maryland. Those that do include border states Kentucky, Pennsylvania and Virginia. The latter two assign this duty to their boards that license physicians, while Kentucky has a board specifically for these specialists.

West Virginia is also among 21 states where insurance coverage hinges on a nationally certified analyst developing the child's treatment plan. Tuesday's report cited how the national board requires basic qualifications, certification exams and continuing education, and also has both professional standards and a complaint process for the public.

Welcoming the audit's conclusion, Poe blasted the psychology board for trying to force behavior analysis to work under the paid supervision of licensed psychologists.

"This current board of examiners filed an unprecedented and unnecessary emergency order that immediately restricted our professionals from engaging in the work that they had performed without complaint, without oversight or without any interest from the board," Poe said.

Poe noted to lawmakers that analysts have worked in the state for more than a decade. What changed was the 2011 legislation requiring insurers to reimburse for these services, she said. But board Executive Director Jeffrey Harlow told the committees that a financial incentive did not spur his agency's action.

"The sole motivation of the board was to protect the public, which is its main mission," Harlow said.

Harlow also noted that the audit said that if lawmakers wish to pursue state oversight of behavior analysts, they should consider his board for that task. Poe had told lawmakers that while analysts draw from psychology, she cautioned against enlisting the present board members given their action last year.

"In the future, as our numbers increase, we would be glad to re-assess the need for establishing a statewide regulatory entity," Poe said.

Legislation passed and enacted this year makes clear that benefit caps set by the 2011 insurance mandate only govern applied behavioral analysis.

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