Showing posts with label legislation. Show all posts
Showing posts with label legislation. Show all posts

Thursday, February 18, 2010

LEG.NEWS: Missouri - SS/SB 618 autism insurance bill to Senate floor for 3rd reading on Thursday, February 18, 2010

Missouri SS/SB 618: Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions


Is shown on the Missouri Senate Calendar for Thursday, February 18, 2010, under
THIRD READING OF SENATE BILLS and is anticipated to be debated and voted on in that body.

The Missouri Senate is scheduled to convene at 10:00AM. CST

Past blog post
Feb 13, 2010
LEG. NEWS - Missouri : SS/SB 618 & HCS HB 1311 & 1341 poised for action the week of February 15, 2010; licensing added to the House bill


© 2010 Regina G. Claypool-Frey
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.

Tuesday, February 16, 2010

LEG NEWS: Committee Substitute for Virginia SB 464 autism insurance bill scheduled to come to Senate Floor on February 16, 2010

**Update 2/16/10 - 1:11PM PST - SB 464 Committee Substitute was passed without amendment by a vote of 27 to 13 in the Virginia Senate**

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Virginia SB 464: A BILL to amend and reenact § 38.2-4319 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 38.2-3418.16, relating to health insurance coverage for autism spectrum disorder has been favorably reported with substitute  from the Senate Committee on Commerce and Labor on February 15, 2010.

The Regular Senate Calendar for Tuesday, February 16, 2010 shows
SB 464 S1
  as coming to the Senate Floor for a vote.

The major change of the amendment/substitute was to reduce the age of coverage from up to age ten years to "from age two to age six".

Applied behavior analysis is defined in SB 464 S1, and coverage of applied behavior analysis is in the category of "Habilitative or rehabilitative care". Service provider of behavior analytic services not defined in SB 464 S1, nor are the competencies of the Behavior Analysis Certification Board specified.


FOR MORE INFORMATION

Virginia General Assembly

Autism Votes - Virginia

Bill mandates autism coverage
The state Senate votes today on legislation to require employers to cover autism treatments.
By Courtney Cutright
Tuesday, February 16, 2010


Past blog posts
Thursday, February 4, 2010
LEG. NEWS - Virginia autism insurance bills die or stall in committee

© 2010 Regina G. Claypool-Frey
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.

LEG NEWS: Iowa autism insurance bill SF1 replaced by Committee substitute SF 2349

Senate File (SF)1: A bill for an act requiring certain group health insurance policies, contracts, or plans to provide coverage for autism spectrum disorders for certain persons, requiring certification of behavior specialists, and providing an applicability date.
was passed out of the Senate Commerce Committee with amendment on February 11, 2010 but the nature of those amendments were not available at that time.

At the Iowa Legislature on February 15, 2010 it is reported that SF1 has been replaced by

Committee substitute Senate File 2349
Senate File 2349 - Introduced
SENATE FILE BY COMMITTEE ON COMMERCE
(SUCCESSOR TO SF 1)

A BILL FOR An Act requiring certain group health insurance established for employees of the state to provide coverage for autism spectrum disorders for certain persons, requiring certification of behavior specialists, and providing an applicability date.

The most recent actions are

FEB. 15 10 Introduced, placed on calendar. S.J. 405.
FEB. 15 10 Committee report, approving bill. S.J. 407.

Bill Title: *SENATE FILE 2349 (formerly SF 1), a bill for an act requiring certain group health insurance established for employees of the state to provide coverage for autism spectrum disorders for certain persons, requiring certification of behavior specialists, and providing an applicability date.
Recommendation: APPROVED COMMITTEE BILL.
Final Vote: Ayes, 11 Nays, 3 Absent, 1

Fiscal Note: NOT REQUIRED UNDER JOINT RULE 17.
*Pursuant to Senate Rule 40, the Legislative Services Agency reported nonsubstantive changes
to the members of the Commerce Committee on Senate File 2349, and they were attached to the committee report.

Brief review seems to indicate that the clauses in SF 1 related to the creation of a "behavior specialist" certification still apply, to wit:
a "'Behavior specialist' means an individual, certified by the commissioner, who designs, implements, or evaluates a behavior modification intervention component of a treatment plan, including those based on applied behavioral analysis, to produce socially significant improvements in human behavior or to prevent loss of attained skill or function, through skill acquisition and the reduction of problematic behavior,
and that,
"The commissioner, in consultation with the board of medicine, shall adopt rules providing for the certification of behavior specialists..."

See the full text of SF 2349 for specific language.


FOR MORE INFORMATION

To create an Iowa Legislature Bill and Code Watch

Iowa Legislature

Autism Votes Iowa

Past post
Friday, January 22, 2010
LEG. NEWS: Iowa - SF1 Autism Insurance bill and January 27, 2010 hearing


© 2010 Regina G. Claypool-Frey
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.

Monday, February 15, 2010

LEG. NEWS - West Virginia : HB 4410 autism insurance bill would defines competencies, requirements and scope of practice of state "Certified Behavior Analysts"

This blog previously reported on SB 145 and HB 2858 which would amend West Virginia code to require insurance coverage for autism spectrum disorder early detection, diagnosis and treatment.  HB 2858 references "behavioral therapy" but does not explicitly address providers and competencies.

Since that post two more bills have been added to the slate of legislation currently in the West Virginia Legislature.

A bill introduced on Tuesday February 9, 2010 explicitly references applied behavior analysis, the competencies and qualifications of the stated service providers, and qualifications of "Certified Behavior Analyst"s is
HB 4410
Introduced February 9, 2010 ; referred to the Committee on Banking and Insurance.
A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §5-16-7f; to amend said code by adding thereto a new section, designated §9-5-21; and to amend said code by adding thereto a new section, designated §33-16-3v, all relating to requiring health insurance coverage for autism spectrum disorders; setting forth the types of coverage required; requiring medical services to be provided on a nondiscriminatory basis; and defining terms.
Some definitions from HB 4410 that may be of interest to practicing behavior analysts,
  • "Autism services provider" means any person, entity or group that provides treatment of autism spectrum disorders.
  • "Certified behavior analyst" means a West Virginia licensed psychiatrist or psychologist who is also board certified as a behavior analyst by the Behavior Analyst Certification Board.
  • "Habilitative or rehabilitative care" means professional, counseling and guidance services and treatment programs, including applied behavior analysis, that are necessary to develop, maintain and restore, to the maximum extent practicable, the functioning of an individual.
  • "Therapeutic care" means services provided by licensed or certified speech therapists, occupational therapists or physical therapists under the direction of a certified behavioral analyst.
HB 4410 would apply to West Virginia Public Employees Insurance, Medicaid, Group Accident and Sickness Insurance,

Another bill introduced on January 28, 2010 is primarily related to prohibiting gender discrimination.
HB. 4215,
Introduced January 28, 2010; referred to the Committee on Banking and Insurance then the Judiciary.
A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §5-16-7f; that said code be amended by adding thereto a new section, designated §33-15-22; that said code be amended by adding thereto a new section, designated §33-16-18; and that said code be amended by adding thereto a new section, designated §33-16D-17, all relating to prohibiting gender discrimination in health care insurance plans.
FOR MORE INFORMATION

West Virginia Legislature Bill Status Search page

West Virginia Legislature

Autism Votes - West Virginia
(No content related to the bills as of 2/15/10)

© 2010 Regina G. Claypool-Frey
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.

Saturday, February 13, 2010

LEG. NEWS - Missouri : SS/SB 618 & HCS HB 1311 & 1341 poised for action the week of February 15, 2010; licensing added to the House bill

**Update February 16, 2010 - The Missouri House amended, perfected and passed HCS 1311 & 1341. The House Journal for February 16 notes a number of amendments, some of which affect the portions of the bill referring to the practice of behavior analysis; the bill as perfected and passed will be posted when available from the legislative website**

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The Missouri General Assembly is currently entertaining two bills previously reported on in this blog that would affect the practice and reimbursement of the practice of behavior analysis in Missouri, and the legislative website indicates that action on these could be happening as early as the beginning of this coming week,

Senate Substitute (SS)/SB.618 : Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions.
Bill History

SS/SB. 618 is scheduled for a third reading in the Missouri Senate on February 15, 2010. It is stated on the Senate main page that the Senate will convene at 4:00PM.

SS/SB. 618 provides coverage under the age of 21 for applied behavior analysis, with such payments or reimbursements shall be made to either an "autism provider", the person who is supervising an autism service provider, who is certified as a board certified behavior analyst by the Behavior Analyst Certification Board; or the entity or group for whom such supervising person works or is associated.

SS/SB. 618 defines applied behavior analysis, and includes applied behavior analysis in the coverage category of "habilitative or rehabilitative care". It specifies an "Autism service provider" as 'any person, entity, or group that provides diagnostic or treatment services for autism spectrum disorders who is licensed or certified by the state of Missouri; any person who is certified as a board certified behavior analyst by the behavior analyst certification board; or any person, if not licensed or certified, who is supervised by a person who is certified as a board certified behavioral analyst by the Behavioral Analyst Certification Board, whether such board certified behavioral analyst supervises as an individual or as an employee of or in association with an entity or group'..."

See full text of SS/SB, 618 for all definitions and conditions.

and

House Committee Substitute (HCS) HB 1311 & 1341 -- Insurance Coverage for Pervasive Developmental Disorders

The Missouri House of Representatives reports that HCS HB 1311 & 1341 was reported favorably out of the Rules Committee on February 8, 2010 with a "do pass" recommendation and is shown on the House Bill Calendar for February 15, 2010 for "Perfection".

HOUSE BILLS FOR PERFECTION
House Committee Substitute (HCS) for HB 1311 & 1341 Handler: Scharnhorst (093)
Title:PERVASIVE DEVELOPMENTAL DISORDERS

A significant inclusion in HCS HB 1311 & 1341 is creation of a "Behavior Analyst Advisory Board", the inclusion of a licensure provision for Licensed Behavior Analysts, Licensed Assistant Behavior Analyst, and definition of a "PDD Service Provider" as a Licensed Behavior Analyst, and "Line Therapist" as a person supervised by a Licensed Behavior Analyst.

HCS HB 1311 & 1341 defines applied behavior analysis and the practice of applied behavior analysis.
It would create a  "Behavior Analyst Advisory Board...under the state committee of psychologists within the division of professional registration. Appointments to this Advisory Board would be made by the Governor upon the recommendations of the director of the division, upon the advice and consent of the senate.

The division, prior to submitting nominations, shall solicit nominees from professional associations and licensed behavior analysts or licensed assistant behavior analysts in the state.

The Behavior Analyst Advisory Board shall consist of the following seven members:
  • three licensed behavior analysts, 
  • one licensed behavior analyst holding a doctoral degree, 
  • one licensed assistant behavior analyst, 
  • one professional member of the committee, and 
  • one public member."
The Behavior Analyst Certification Board (BACB) is stated explicitly as a certifying entity, although there is provision for an "equivalent nationally accredited nongovernmental agency approved by the committee [of psychologists] which certifies individuals who have completed academic, examination, training, and supervision requirements in applied behavior analysis;"

Authority, duties, term of service, scope of practice and other specifics are found within the full text of HCS HB 1311 & 1341.

HB 1311 & 1341 also addresses insurance coverage for diagnosis and treatment of autism spectrum disorders; defining applied behavior analysis, including it under the category of "habilitative or rehabilitative care", defines a "PDD service provider" as a licensed behavior analyst/LBA and would authorize payment for applied behavior analysis services to a "PDD service provider".
Coverage would extend through age 21 with differential coverage for children through age 9 and a lower amount through 21.

See summary and full text of HCS HB 1311 &1341 for specifics of coverage, implementation and exclusions.

FULL SUMMARY with description of testimony and statements by opponents and proponents.

Among those testifying for the bill were Lorri Unumb, Autism Speaks; Representative Dennis O'Brien, Pennsylvania House of Representatives; Colin Peeler, Ph.D., BCBA, Ronald Ekstrand, Jr.,John M. Guercio, Ph.D., BCBA, CBIST, Missouri Association for Behavior Analysis.

FOR MORE INFORMATION

Missouri General Assembly

Missouri Association for Behavior Analysis/MOABA

Autism Votes - Missouri

Show Me Autism Coverage Now

Possible Insurance Coverage for Autism Treatment
KOMO
Published: Friday, February 12, 2010 at 4:29 PM
Last Updated: Friday, February 12, 2010 at 8:05 PM


Previous Blog Posts
Wednesday, February 3, 2010
LEG. NEWS: Missouri autism insurance bills progress in General Assembly with amendments

Friday, January 29, 2010
LEG. NEWS: Missouri SB 618 autism insurance bill goes to Senate floor on February 1, 2010 for "Perfection"

Wednesday, January 27, 2010
LEG NEWS: Missouri SB 618 unanimously passed in Senate Committee, HB 1311 under scrutiny in House Committee

Tuesday, January 19, 2010
LEG NEWS: Missouri Autism Insurance bills heard in committee on Tuesday, January 19, 2010

Friday, December 4, 2009
STATES: Missouri Prefiles Two Autism Insurance Reform Bills

© 2010 Regina G. Claypool-Frey
Disclaimer: This blog publishes news and announcements only as a service to interested persons, the posts are the responsibility of the individual author, and unless otherwise noted do not constitute nor claim to represent the official position of ABA International, its officers or associated entities. This blog makes no representation as to the accuracy of the report and readers are strongly encouraged to consult and reference the primary sources noted.

Thursday, February 11, 2010

LEG. NEWS: Maine SP 446/LD 1198 Scheduled for a committee worksession on February 17, 2010

This blog previously reported on Maine SP 446/LD 1198: An Act To Reform Insurance Coverage To Include Diagnosis for Autism Spectrum Disorders, which was carried over from 2009 to the 2010 legislative season. SP 446/LD 1198 defines applied behavior analysis, and includes applied behavior analysis under "habilitative and rehabilitative services"; it does not explicitly state provider, nor does it specify the BACB certification or competencies for delivery of applied behavior analysis service.

The hearing calendar for the Committee on Insurance and Financial Services shows SP 446/LD 1198 as scheduled for another work session on February 17, 2010 at 2PM in Room 427, State House.

The bill has been in committee for some months and since the commencement of the 2010 legislative session but not yet voted out, although work sessions were scheduled on January 12, 19, and February 9, 2010.

For further information & Previous blog post(s)

Maine Legislature Tracking SP 446/LD 1198


Autism Votes - Maine


Friday, January 8, 2010
LEG. NEWS: January 12 hearing on Maine LD 1198: "An Act To Reform Insurance Coverage To Include Diagnosis for Autism Spectrum Disorders"

Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Wednesday, February 10, 2010

LEG. NEWS - Kentucky HB 159 moves forward with substitute bill to create separate licensing board for behavior analysts

This blog previously reported on Kentucky HB 159, which specified a licensing condition for behavior analysts practicing in the state, depending on the conditions specified in the bill, as Licensed Behavior Analyst or Licensed Assistant Behavior Analyst; however at the time of that post, the proposal was that  regulation and licensure would be under the purview of Kentucky Board of Examiners of Psychology.

HB 159 also contains a section defining health insurance coverage for autism with differentials from ages 1-6 years and 7-21 years with applied behavior analysis and practice defined, included under the category of "habilitative and rehabilitative care". The competencies of the Behavior Analyst Certification Board are specified in HB 159 under the definitions and in meeting the licensure requirements.

Today, the Kentucky Legislative website reports that a substitute bill for HB 159 (HCS) passed favorably from the  House Standing Committee on Local Government now specifies establishment of a separate licensing board - the "Kentucky Applied Behavior Analysis Licensing Board".
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HB 159 - AMENDMENTS

     HCS/HM - Delete the provisions relating to regulation and licensure of applied behavior analysis for behavior disorders by the Board of Examiners of Psychology and in lieu thereof establish a new KRS Chapter 319B to create the Kentucky Applied Behavior Analysis Licensing Board including the definitions, membership, terms, per diem and authority of the board, the requirements for licensure, and the exemptions from licensure; retain the provisions containing the health mandate, but clarify that the large group mandate for individuals is for individuals through age six by providing that individuals between the ages of one and their seventh birthday shall receive the mandated benefits.

"(...)SECTION 20.   A NEW SECTION OF KRS CHAPTER 319B IS CREATED TO READ AS FOLLOWS:
(1)    (a)    There is hereby created the Kentucky Applied Behavior Analysis Licensing Board. The board shall consist of seven (7) members appointed by the Governor.

(b)    The initial board members shall be appointed as follows:
1.    Four (4) members shall be credentialed behavior analysts nominated by a credentialed behavior analyst practicing in the state;
2.    One (1) member shall be a psychologist licensed in the state, the majority of whose practice is related to the treatment of behavior disorders, including but not limited to autism spectrum disorders. The psychologist member shall be nominated by a credentialed behavior analyst practicing in the state; and
3.    Two (2) members shall be the parent of a child diagnosed with and treated for a behavior disorder, including but not limited to an autism spectrum disorder, selected from the state at large.

(c)    Subsequent board members shall be appointed by the Governor as follows:
1.    Four (4) members shall be licensed behavior analysts nominated by a licensed behavior analyst practicing in the state;
2.    One (1) member shall be a psychologist licensed in the state, the majority of whose practice is related to the treatment of behavior disorders, including but not limited to autism spectrum disorders. The psychologist member shall be nominated by a licensed behavior analyst practicing in the state; and
3.    Two (2) members shall be the parent of a child diagnosed with and treated for a behavior` disorder, including but not limited to an autism spectrum disorder, selected from the state at large.
(...)"
Other specifications and conditions stated in full text of the amendment
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Should HB 159 proceed in the legislative season into enacted statute, Kentucky would join Arizona, Pennsylvania [behavior specialists], Nevada and Oklahoma in specifying a licensure condition for the practice of applied behavior analysis.

FOR FURTHER READING
Record of HB 159 at Kentucky Legislature

Autism Votes Kentucky

Model licensing Act ABA International

BACB Model Licensing Act
Association of Professional Behavior Analysts members only

Past blog posts

Thursday, January 14, 2010
LEG. NEWS: Kentucky - Bill Introduced to Establish Licensure of Behavior Analysts

Monday, January 11, 2010
ABAI NEWSFLASH: ABA International Announces Model Licensing Act for Behavior Analysts

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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Thursday, February 4, 2010

LEG NEWS: U.S. House Bill - H.R. 4247 on changing restraint and seclusion policy in U.S. schools passes House Committee

Thursday, February 4, 2010, the U.S. House Committee on Education and Labor passed by a bipartisan vote of 34 to 10,
H.R. 4247: The Preventing Harmful Restraint and Seclusion in Schools Act -
"To prevent and reduce the use of physical restraint and seclusion in schools, and for other purposes".

This bill, which would regulate the use of restraint, seclusion and other practices in all U.S. public schools, has been the subject of considerable public attention since its introduction on December 9, 2009.

The impetus for H.R. 4247's introduction by Representatives George Miller, 7th-D, CA & Cathy McMorris Rodgers, 5th-D. WA, was a May 19, 2009 hearing before the House Committee on Education and Labor examining the abusive and deadly use of seclusion and restraint in schools, in addition to an investigative report by the GAO, and the report: School is Not Supposed to Hurt: Investigative Report on Abusive Restraint and Seclusion in Schools by the National Disability Rights Network.

A related bill is S.2860 (Dodd) "A bill to protect students from inappropriate seclusion and physical restraint, and for other purposes"

The next step for H.R. 4247 is the floor of the U.S. House of Representatives.


For further reading

H.R. 4247 at Thomas.gov

Seclusions and Restraints: Selected Cases of Death and Abuse at Public and Private Schools and Treatment Centers.  GAO-09-719T, May 19, 2009


School is Not Supposed to Hurt: Investigative Report on Abusive Restraint and Seclusion in Schools
National Disability Rights Network, January 2009

Bipartisan Legislation to Prevent Abuse in Schools Clears House Committee
February 4, 2010 12:30 PM

MYTH VS. FACT: Preventing Harmful Restraint and Seclusion in the Schools Act
By Kittredge, Betsy Miller on February 3, 2010 11:05 AM
EdLabor Journal. Committee on Education & Labor
 

H.R. 4247 - Preventing Harmful Restraint and Seclusion in Schools Act
U.S. House Committee on Education & Labor
Full Committee Markup 11:00 AM, February 4, 2010 2175 Rayburn H.O.B
Washington, DC


News of the Day: The Story Behind The Bill
By Kruger, Mike on February 4, 2010 10:30 AM |
School Restraint, Seclusion Bill Clears House Committee
By Michelle Diament, Disability Scoop
February 4, 2010


Past Blog Posts
All past blog posts on the topic and introduction of H.R. 4247 & S.2860

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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

LEG. NEWS - Virginia autism insurance bills die or stall in committee

**Update February 8, 2010 4:00PM PST - Autism Votes Virginia reports that due to the weather conditions in the East, that the Senate Labor & Commerce Committee Hearing on SB 464 has been rescheduled for February 15, 2010 at 1:30pm **

**Update February 4, 2010 5:57PM PST - There is some ambiguity on HB 303 since earlier news reports were that this bill had been defeated in committee, but Autism Votes Virginia reports that in addition to the abstention there was a non-physically present "yes" vote, which would not kill HB 303 but also not move it from committee. The legislative website note is that the vote was 4-yea, 4-nay, 1 abstention and 1 not voting, 02/02/10  House: Subcommittee failed to recommend reporting (4-Y 4-N).

On a related note, Autism Votes Virginia also reports that SB 464 has been granted a hearing on Monday February 8, 2010 in the Senate Committee on Commerce and Labor. Currently the Committee docket for February 8 is not showing SB 464 this for that date, but the agendas and dockets are subject to change.**

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On February 1 and 2, 2010 three autism insurance bills in the Virginia Legislature were defeated in committee, and one was deferred to the 2011 legislative session. Two bills remain in committee at this time.

H 303 and H 34 died in the House Committee on Commerce and Labor Subcommittee#1. The bills were combined and the proposed annual coverage reduced below the original proposal, and age range for coverage was restricted to ages 2 to 6. Even with these amendments, the vote on H 303 was a 4Y-4 NY tie with one abstention. In Virginia a tie constitutes a defeat; a majority is required for passage.

SB 649 which, besides the insurance clause, would have established a tuition assistance grant program, was defeated in the Senate Commerce and Labor Committee by a 8-N to 7-Y vote.

H 730, also in the House Committee on Commerce and Labor Subcommittee#1, and was restricted to coverage of early intervention was voted by the Committee to defer to 2011.

The remaining bills as noted in the Virgina Legislative tracking system,are H 1367 and S 464 (which is identical to the original H 303) - however at this time neither bill shows progress in their respective committees.
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Past posts
Sunday, January 31, 2010
LEG NEWS: Virginia autism insurance bills up for hearing week of Feb 1, 2010

Media reports
Va. House panel kills autism therapy bill
BusinessWeek
The Associated Press  February 3, 2010, 11:23AM ET


Autism coverage bill killed in Va. House
February 3, 7:24 AMNorfolk Health Care ExaminerEd Lamb

Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

LEG. NEWS: All Mississippi bills addressing behavior analysis and autism insurance die in committee

On Tuesday, February 2, 2010 all of the bills under consideration in the Mississippi Legislature,
the six autism insurance bills [SB 2055, SB 2129, SB 2175, SB 2363, SB2607, HB1496] died in the Senate and House Insurance Committees and are no longer under consideration in the 2010 Mississippi State Legislature.

SB 2457, which would have phased in training of personnel and routine school use of "applied behavior science" for the state's students with ASD, also died without a vote in the  Education; Appropriations Committees.
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Past blog posts:
Thursday, January 28, 2010
LEG. NEWS: Mississippi - Six autism insurance bills in the legislature 

Friday, January 29, 2010
LEG. NEWS: Mississippi - SB2457 would phase in training of personnel and routine school use of "applied behavior science" for students with ASD


Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Wednesday, February 3, 2010

LEG. NEWS: Missouri autism insurance bills progress in General Assembly with amendments

On Wednesday, February 3, 2010 two autism insurance bills moved another step forward within the Missouri General Assembly, although both were subject to amendment reducing the amount of annual coverage, with the Senate bill allowing "foreign" health insurance carriers of certain named states to provide health insurance within Missouri with exemption from the mandate. Both bills retained previously included clauses on provision of applied behavior analysis within specified policies, and that BACB certified Board Certified Behavior Analysts were appropriate to supervise delivery of applied behavior analysis, and would meet approval as a provider under the bills. Some concern was voiced on the inability to include Mo Healthnet-Medicaid in the autism insurance legislation.

S.B. 618: Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions.
Deliberation on the Senate floor took two days. A Senate Substitute was offered, amended several times and passed, adopted and perfected as SS/SB 618. The most significant change is that the cap amount has been reduced.

H.B. 1311: Requires health carriers issuing or renewing a health benefit plan to provide coverage for the diagnosis and treatment of autism spectrum disorders
 The progress of HB 1311 was delayed relative to SB 618 SS/SB 618.  It has been reported that H.1311 passed with amendment in an Executive Session of the Special Standing Committee on Insurance today. The legislative website shows that H.B 1311 and H.B. 1341, another autism insurance bill, were referred to Rules - Pursuant to Rule 25(32)(f) (H) , with H.B. 1311 accepted as a substitute for H.B 1341.
At the time of this post no summary copy of the amended H.B. 1311 is available, but media reports state that amendments to H.B. 1311 have substantially reduced the annual coverage requested in the original bill and use a tiered diffential coverage for children <10 years, and 10-21 years. No report was made of whether the BCBA supervisor clause has been changed. H.B. 1311 may come to the floor of the Missouri House for debate as early as next week.

For specfic details and most accurate information on the content of this legislation as it progresses through the Missouri Assembly, the reader is referred to the Missouri General Assembly.

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For more information/Media reports

Autism Votes - Missouri

Missouri General Assembly

Legislators narrow gap on autism bills
Virginia Young
ST. LOUIS POST-DISPATCH
02/04/2010


This story has .mp3 files of the Senate deliberation
Senate near passage of autism bill
by Bob Priddy on February 3, 2010


Mo. Senate passes child autism coverage bill
By: The Associated Press | 03 Feb 2010 | 04:46 PM ET

House committee passes autism insurance bill
By Chad Livengood • clivengood@news-leader.com
Inside Missouri Politics Blog
February 3, 2010


Previous post:
Friday, January 29, 2010
LEG. NEWS: Missouri SB 618 autism insurance bill goes to Senate floor on February 1, 2010 for "Perfection"
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Sunday, January 31, 2010

FED. LEG - Bills in Congress under topic of Positive Behavior Supports, and regulation of physical restraint and seclusion in schools

While attention is focused on the states, with numerous bills and, in many cases, short legislative calendars, it seems prudent to review the status of Federal legislation currently before the U.S. Congress. This post is a brief round-up and reminder of those under the topic of Positive Behavior Supports, and the regulation of physical restraint and seclusion in U.S. Schools.

The bills below may be of interest to practicing behavior analysts, those who work in schools, and those who are interested in regulation and training in the matter of physical restraint and seclusion.  HR 4247 and S. 2680 are bills that have the attention of the public and the active interest of a large number of advocacy organizations.
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Resources and Related past posts

Thursday, December 17, 2009
S. 2860 bill on restraint and seclusion joins HR 4247 & Wrightslaw sums up this legislation

Autism Votes

Thomas.gov 
legislative information from the Library of Congress

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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

LEG NEWS: Virginia autism insurance bills up for hearing week of Feb 1, 2010

Three Virginia bills dealing with insurance coverage of autism spectrum disorders that make reference to applied behavior analysis, are listed on the Virginia General Assembly Legislative Information System as receiving committee consideration on Monday, February 1, and Tuesday, February 2, 2010.

A 1/21/10 blogpost on the Virginia measures has been updated to reflect the current slate of autism insurance bills : HB 34HB 303SB 434 and SB 649

The bills stated to be receiving committee consideration this week are

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Past posts on Virginia's autism insurance bills

Thursday, January 21, 2010
LEG NEWS: Updated list of Virginia autism insurance bills - Virginia HB 34, HB 303, SB 464 , and SB 649
Virginia HB 303 & SB 464 Insurance Coverage for ASD

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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website
 

Friday, January 29, 2010

LEG. NEWS: Missouri SB 618 autism insurance bill goes to Senate floor on February 1, 2010 for "Perfection"

**Update - Before Perfection of S.618, there was a Senate substitute offered and amendments to the substitute debated before Perfection and ordered printing of the Senate Substitute SS/S618 on Wednesday, February 3, 2010. Please see the post of February 3, 2010 for report on SS/618 and HB1311**
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Missouri SB 618, the Senate autism insurance bill (a similar bill is House bill HB 1311) has a scheduled date of Monday, February 1, 2010 on the Missouri Senate Calendar for "Perfection".

Missouri Senate Calendar
THIRTEENTH DAY--MONDAY, FEBRUARY 1, 2010
FORMAL CALENDAR
(After SECOND READING OF SENATE BILLS)

SENATE BILLS FOR PERFECTION
1. SB 618-Rupp, et al
    Requires health carriers to provide coverage for the diagnosis and treatment of autism spectrum disorders under certain conditions

(In considering the "Perfection" process, bear in mind that SB 618 was unanimously voted out of committee with a do-pass as is recommendation.)

Perfection of a bill
"If a bill is reported favorably out of committee or a substitute is recommended, it is placed on the "perfection calendar" and when its turn comes up for consideration it is debated on the floor of the originating house. If a substitute is recommended by the committee or if committee amendments are attached to the bill, they are first presented, debated and voted upon. Further amendments can then be proposed by other members with their changes designated as House or Senate amendments to differentiate from the committee amendments. When all amendments have been considered, a motion is made to declare the bill perfected. Perfection is usually voted on a voice vote but on the request of five members, a roll call shall be taken. If a majority of members vote to perfect, the bill is reprinted in its original or amended form."

For further information on the legislative progression in Missouri, see
How a Bill Becomes a Law

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Past blog posts on Missouri SB 618

Wednesday, January 27, 2010
LEG NEWS: Missouri SB 618 unanimously passed in Senate Committee, HB 1311 under scrutiny in House Committee
Practitioner Issues in Behavior Analysis SIG blog

Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

LEG. NEWS: Mississippi - SB2457 would phase in training of personnel and routine school use of "applied behavior science" for students with ASD

Besides the autism insurance bills in the Mississippi Legislature, another bill that might have impact on the practice of applied behavior analysis in that state is an education bill, SB2457, establishing specialized autism classrooms with special emphasis in behavioral supports, including "applied behavior science and techniques", each taught by an "educational expert". That students with ASD would be entitled to at least 30 hours of intervention a week, and that all district personnel working with students with ASD would have training in "behavioral supports, including applied behavior science and techniques". Other clauses describe phase in time to implementation and nature of in-service training, parent training, and establishment of an expert on behavioral intervention treatment and autism initially within each school district and transitioning to each school site. Many of the statements in SB2457 bear strong resemblance to the recommendations of a 2007 report, Caring for Mississippi Children and Families with Autism, Task Force Report , December 2007.
Please see the bill text and the Task Force Report for the respective exact language of each.
  • SB2457
    Referred to Senate Committees Education; Appropriations1/11/2010
    Title:
    AN ACT TO AUTHORIZE AND DIRECT THE MISSISSIPPI DEPARTMENT OF EDUCATION TO DEVELOP STANDARDS AND IMPLEMENT AUTISM SPECTRUM DISORDER (ASD) CLASSROOMS IN THE SCHOOL DISTRICTS STATEWIDE TO MORE FULLY MEET THE NEEDS OF STUDENTS WITH AUTISM IN THE PUBLIC SCHOOL SETTING; AND FOR RELATED PURPOSES.
From SB 2457,
"...The ASD classroom will be taught by an educational expert who is trained in behavioral supports, including applied behavior science and techniques.
(d) The Autism Spectrum Disorder (ASD) classroom will not replace the self-contained/resource classroom, the Attention Deficit Disorder classroom, or the general inclusion program. The ASD classroom will serve as an additional service that meets the  specialized needs of children with autism. All students with ASD shall have access to appropriate services for a minimum of thirty  (30) hours per week unless otherwise justified on the individualized Education Plan of the child.
(e) All school district personnel instructing children with ASD shall be trained in behavioral supports, including applied behavior science and techniques. This training should include elementary, junior high and high school personnel.
(f) Professional training will include in-service training for current regular and special educators, establishing an expert within each school district on autism and behavioral intervention treatment for the 2010-2011 school year and establishing within the next two (2) years an expert within each school site. Continuing education for parents and supporters of children with autism shall be included in this training. All training for professional educators and parents shall be an ongoing process.
(g) The programs shall include transitional services to include high school and post-high school vocational and job training programs that meet the individual needs of teens and 70 adults with Autism Spectrum Disorders.

SECTION 2. This act shall take effect and be in force from and after January 1, 2010."
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Related posts and information
Thursday, January 28, 2010
Practitioner Issues in Behavior Analysis SIG blog
LEG. NEWS: Mississippi - Six autism insurance bills in the legislature

The Mississippi State Legislature

Caring for Mississippi Children and Families with Autism, Task Force Report , December 2007
Comments and recommendations of that document.

"...p. 19, "Therefore our state must increase the numbers of healthcare providers, allied health professionals, psychologists and behavioral therapists who are well-versed in the diagnosis and treatment of ASD. To ensure that comprehensive and continuous health services are given to those with ASD, the legislature must also ensure that these providers can be compensated through private insurance and Medicaid assistance
programs..."

p. 20, "...Essential components of early intervention programs include:
1. Comprehensive curriculum, addressing core domains of imitation, language, toy play, and social interaction;
2. Sensitivity to normal developmental sequences,
3. Highly supportive teaching strategies based on applied behavioral procedures,
4. Behavioral strategies for reducing interfering behaviors,
5. Involvement and training of parents,
6. Gradual, careful transition from a highly supportive environment (usually one on one) to a less structured environment (small group),
7. A staff trained in autism spectrum disorders,
8. Supervisory and review mechanisms,
9. Intensive intervention, i.e., at least 25 hours per week of structured intervention for at least two years (per National Research Council recommendations),
10. Parental and caregiver training; and
11. Intervention by two years of age whenever possible..."

p. 22: Educational Recommendations for 3-21
"E-3: All school district personnel instructing children with ASD be trained in behavioral supports, including applied behavioral science and techniques."

p.23,
"Programming...Only half of the school districts surveyed reported using any form of Applied Behavior Analysis (ABA) one of the most effective therapies for individuals with ASD. Again, programming methods were varied and only half the districts reported using any form of Applied Behavior Analysis (ABA) programming techniques. Not only will the behavioral techniques learned through training in ABA benefit children with ASD, but those techniques can be used for children with other disorders including ADHD, Emotional Disturbance, Mental Retardation, and has even proven effective in neuro-typical children. For children with ASD, ABA methods and/or programming should be utilized in all educational settings with an emphasis placed on moving away from a clinical setting to an inclusive setting while maintaining independence, social development, and learning..."

p. 23, Teacher Support in Schools
School districts at a minimum should employ or contract the following professionals to meet the educational requirements of these children: a behavioral specialist in ASD treatment, a speech/language pathologist, an occupational therapist and a school psychologist.

E-6: A priority in education be to increase the number of trained professionals educating children with ASD. These activities should include
1) in-service training for current regular and special educators,
2) establishing an expert within each school district for 2009-2010 the next year on autism and behavioral intervention treatment, and
3) establishing within the next 2 years an expert within each school site.

p. 24,
E-7: School districts at a minimum should employ/ obtain contractual services with the following professionals to appropriately treat ASD children OT, Speech, PT, Behavioral Analysts or similar professional, Behavioral Techs or other professional who will implement ABA and social skills programming that is data driven and periodically monitored for each individual student

Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Wednesday, January 27, 2010

LEG NEWS: Missouri SB 618 unanimously passed in Senate Committee, HB 1311 under scrutiny in House Committee

On Tuesday,  January 26, 2010 Missouri Senate Bill,
passed unanimously by bipartisan vote without amendment and with a do-pass recommendation  in the Senate Small Business, Insurance and Industry Committee. The positions SB 618 to come to the Missouri Senate floor.

SB 618 [full text] defines applied behavior analysis, specifies applied behavior analysis as a covered treatment, and includes Board Certified Behavior Analysts as "Autism service providers", and  specifies Board Certified Behavior Analysts, either in independent practice or as an employee of an agency, as appropriate supervisor for those who are neither certified nor licensed by the state of Missouri.

The similar House bill,
was studied on January 26 in a work session (no public testimony) of the House Special Standing Committee on Health Insurance and proposals for amendment to this bill, including reducing the annual coverage for applied behavior analytic services and an exemption for small businesses with fewer than 25 employees were discussed. The Missouri legislative website shows that another work session (no public testimony) on HB 1311 is scheduled for Wednesday, January 27, 2010, 4:00pm, Hearing Room 5.

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For more info, news stories and past blog posts
Autism Votes Missouri



Missouri edges closer to autism insurance reform
L Mae Wilkinson
January 26, 9:37 PMSt. Louis Autism & Parenting Examiner


Autism bill advances in Senate, studied in House
01.26.2010 3:19 pm
By Virginia Young
Post-Dispatch Jefferson City Bureau
Political Fix, stltoday.com


Autism coverage bill clears Missouri Senate commitee
Tuesday, January 26, 2010 | 8:09 p.m. CST
BY Brian Krebs, Missourian


Legislative links page for the Missouri Association for Behavior Analysis (MOABA)
Note: the current legislation listed is the mandate bills from the previous 2009 session, but shows that MOABA has tracked these events in the past. This page also has a 2007 powerpoint of MOABA testimony about applied behavior analysis before Missouri's Blue Ribbon Panel on autism.

Missouri General Assemby


Tuesday, January 19, 2010
LEG NEWS: Missouri Autism Insurance bills heard in committee on Tuesday, January 19, 2010
Practitioner Issues in Behavior Analysis SIG blog
 
Friday, December 4, 2009
STATES: Missouri Prefiles Two Autism Insurance Reform Bills
Practitioner Issues in Behavior Analysis SIG blog


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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or SIG members and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website, http://www.abainternational.org

Tuesday, January 26, 2010

FYI: The Autism Votes Facebook page and Twitter feed

While the main Autism Votes website is a great comprehensive site for what's going on at both state and Federal level with autism-related legislation and developments, autism insurance bills in particular - for fast-breaking announcements, such as committee hearings or other action alerts, two useful options are
the Autism Votes twitter feed , for those who enjoy "tweeting",  and for slightly more detailed announcements of fast-breaking developments with autism-insurance related bill introductions and legislative meetings or hearings the Autism Votes Facebook page.



This blog will also track a variety of news items, events and legislation of interest to practicing behavior analysts, including autism legislation as it pertains to professional practice of behavior analysis, (and this site also carries the feeds from the Autism Votes Facebook page and Twitter in the right sidebar) but if you as practitioner or consumer are particularly interested in keeping up to date and getting hearing alerts on an autism-related bill in your state that is being tracked by Autism Votes - a friendly recommendation would be to stay in touch with the above resources.

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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website,

LEG. NEWS: Georgia - SB 161 Autism Insurance bill recommitted by Georgia Senate

In the 2009 Georgia legislative session, two autism insurance bills named "Ava's Law", aka SB 161 and HB 426 stalled and failed to progress to votes on the floor. At this time is unclear whether HB 426 will be recommitted in the 2010 session but,

SB 161 (Ava's Law): A BILL to be entitled an Act to amend Code Section 33-24-59.10 of the Official Code of Georgia Annotated, relating to insurance coverage for autism, so as to require certain insurance coverage of autism spectrum disorders; to provide for definitions; to provide for related matters; to repeal conflicting laws; and for other purposes.
which was introduced in 2009 and Tabled in March of 2009 has been removed from the Table and recommitted by the Georgia Senate on 1/11/10

Brief History
Introduced in 2009
03/12/2009    Senate Tabled
01/11/2010    Senate Taken from Table
01/11/2010    Senate Recommitted
In Senate Committee on Insurance and Labor (I&L)

SB 161 [As introduced LC 37 0853]
has been subject to committee substitute and considerable amendment, but it seems that the bill still retains reference to applied behavior analysis, in re:

Committee sub LC 33 3069S
Retains definition of applied behavior analysis, and definition of "habilitative and rehabilitative care" to mean behavioral interventions and related services...and treatment programs including applied behavior analysis and other structured behavioral programs provided by a licensed psychiatrist, licensed psychologist, licensed clinical social worker, licensed behavioral therapist, certified behavioral analyst, or other qualified professional as prescribed by a licensed physician, licensed physician's assistant, or certified nurse practitioner.

Floor amend 1 AM 37 0067 which appears to have substantially amended the bill by striking lines and making subbstitutions in lieu of that language,
(3) 'Behavioral therapy' means discrete trial training, pivotal response training, verbal behavior intervention, and early intensive behavioral intervention.
...Coverage shall be provided for behavioral therapy, speech therapy, occupational therapy, and physical therapy when such therapies are prescribed in accordance with the treatment plan...
For purposes of this Code section, behavioral therapy shall be considered to be a medical benefit as opposed to a mental health benefit.
Floor amend 1a

Amend amendment #1 (AM 37 0067) to SB 161 by adding on line 27 after "behavioral" the following: "or developmental"
Most recent floor amendment,
Floor amend 2 AM 33 0774
is related to type of policy.

Please see legislative website and the specific amendments and substitutes for exact language.
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For further info
Autism Votes - Georgia

Ava's Law - Georgia Autism Insurance Mandate Facebook page

Georgia General Assembly

ABAI Chapters in/serving Georgia
Georgia Association for Behavior Analysis (GABA)

Related - in GABA newsletter -
"Georgia Improves Options for Individuals with Developmental Disabilities"
Clint Trusty, MS, BCBA
GABA Newsletter, Volume 3 Number 1
Summer 2009
&
Georgia Department of Behavioral health and Developmental Disabilities


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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website


LEG. NEWS: New York - A full roster of autism insurance coverage legislation

The New York State Assembly has a VERY full roster of legislation proposing coverages for, and related to, autism diagnosis and treatment. This is in addition to the previously reported on NY S.3676 for establishing qualification standards for autism service providers for those 21 years or younger, including state recognition of the BACB Certifications and conditions of reimbursement and other clauses.

The insurance bills are (reported in approximate numerical order),


S 385 and A 2759
"Requires health insurers to provide full coverage for the prevention, early detection, diagnosis and treatment of autism spectrum disorder, establishes an advisory panel on health insurance coverage for autism spectrum disorder to annually compile a list of treatments and therapy options for which health insurers will be required to provide coverage, establishes a toll-free, 24 hour a day, autism and health insurance coverage hotline."
S 385 and A 2759 do not specify or define applied behavior analysis nor providers nor competencies. Creates an advisory panel to determine on an annual basis a list of "successful treatment and therapy options" that will be required to be covered under the conditions of the bill.
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Although it is stated that there is no "same as" bill, this is very similar, if not identical to,
Applied behavior analysis is not defined in S.1175 or A 3332, but is categorized explicitly under "therapeutic care, including behavioral, speech, occupational and physical therapies that provide treatment in the following areas..4. Applied behavior analysis, intervention and modification,..."

Provider or competencies of provider of applied behavior analysis unspecified, although there is reference to "a provider of treatment for autism spectrum disorders".
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"Relates to autism spectrum disorders in individuals twenty-one years or less; directs the department of health to promulgate rules and regulations establishing standards for qualified autism services providers and upon such promulgation, payment for treatment of autism spectrum disorders covered shall only be made available to autism services providers who meet such standards; further directs the department of health shall further establish standards to be utilized by managed care plans for the credentialing of autism service providers and authorizes that the department of insurance may require that a managed care plan grant credentials to any autism service provider whom the department determines meets or exceeds the department's credentialing standards."
S 2366-A and A6001-A define Applied behavior analysis, and coverage is specified under "habilitative or rehabilitative care". Provider of applied behavior analysis services not specified nor the competencies of the Behavior Analyst Certification Board (BACB). An "Autism Services Provider" is identified as "any person, entity, or group that provides treatment of autism spectrum disorders". These bills have been endorsed by Autism Speaks.
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Applied behavior analysis is not defined in S. 6123 or A. 6888-B; it is included under "therapeutic care" as "applied behavior analysis, intervention and modification". Providers of behavior analytic intervention not defined, nor are the competencies of the BACB specified. There is reference to a "provider of treatment" and a mechanism for a coverage provider to refer to a specialist or nonparticipating provider with appropriate training and experience.

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For more information:
Autism Votes - New York
Currently specific to S2366 and A6001/Endorsed by Autism Speaks

New York State Assembly

Related: ABAI chapters in/that serve New York
New York State Association for Behavior Analysis (NYSABA)

Past related blog post:
Monday, January 25, 2010
Practitioner Issues in Behavior Analysis SIG blog
LEG. NEWS: New York S. 3676 Defines the practice of behavior analysis and recognizes the Behavior Analysis Certification Board competencies

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Practitioner Issues in Behavior Analysis SIG
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Views and news expressed in this blog or by the PIBA SIG are those of the SIG or individual SIG member authors and do not represent official policy of ABA International or other official body. For official policy of the Association of Behavior Analysis International, the reader is directed to their website