To amend Article 1 of Chapter 1 of Title 20 of the Official Code of Georgia Annotated, relating to ensuring access to prescribed ABA therapy for special needs children at public schools, to amend Article 3 of Chapter 9 of Title 19 of the Official Code of Georgia Annotated, relating to consideration of a child's educational needs, to amend Article 70 Chapter 5 of Title 16 of the Official Code of Georgia Annotated, relating to obstruction of prescribed ABA therapy for special needs children, so as to provide for certain insurance coverage of autism spectrum disorders; to provide for definitions; to provide for limitations; to provide for related matters; and for other purposes.

Article 1 of Chapter 1 of Title 20 of the Official Code of Georgia Annotated, relating to ensuring access to prescribed ABA therapy for special needs children at public schools, is amended by adding a new Code section to read as follows:

“20-1-1.11

A.(1) A public school governing authority shall not prohibit a behavioral health provider from providing behavioral health services to a student at school during school hours if the student's parent or legal guardian requests such services from the provider.

(2) Each public school governing authority shall adopt and make available to the public a policy to implement the provisions of this Section and such policy, at a minimum, shall provide that:

(a) A behavioral health provider who provides services pursuant to this Section shall maintain general liability insurance coverage in an amount not less than one million dollars per occurrence and one million dollars per aggregate and provide a certificate of insurance naming the public school as the certificate holder.

(b) A behavioral health provider shall complete a criminal background check and shall pay all related costs.

(c) Behavioral health services shall be permitted during school hours if the student's parent or legal guardian presents a behavioral health evaluation performed by an evaluator chosen by the parent or legal guardian and the evaluation indicates that the services are necessary during school hours to assist the student with behavioral health impairments that the evaluator determines are interfering with the student's ability to thrive in the educational setting. A behavioral health evaluation presented by the parent or legal guardian of a student shall not be construed as an independent educational evaluation for purposes of determining if a student meets the criteria established for eligibility for special education and related services.

(d) Behavioral health services may be provided during instructional time in various topics, including English, reading, mathematics, and science if the public school governing authority and the behavioral health provider agree that it is in the best interest of the student.

(e) A public school governing authority shall not enter into a contract or an exclusive agreement with a behavioral health provider that prohibits the parent or legal guardian from choosing the behavioral health provider for the student. However the provisions of this Subparagraph shall not impair any extant contract on the effective date of this Section, or the renewal thereof.

(f) The cost of all behavioral health services provided to a student shall be the sole responsibility of the parent or legal guardian, individually or through an applicable health insurance policy, Medicaid, or other third-party payor, other than the public school governing authority, that has made funds available for the payment for the services provided.

(g) While on a school campus, a behavioral service provider shall comply with, and abide by, the terms of any Individualized Education Plan, Individualized Accommodation Plan, Section 504 Plan, Behavior Management Plan, or Individualized Health Plan applicable to a student who is a patient of the provider. The services furnished by a provider shall be incorporated into a written treatment plan applicable to a student.

(h) The parent or legal guardian of a student receiving services from a behavioral service provider shall be required to execute a "consent to release information form" between the provider and the public school governing authority.

(i) A public school governing authority shall establish reporting requirements for a behavioral health provider related to the student's progress and student and school safety concerns as related to the student's educational program.

(j) A public school governing authority may establish sanctions, including termination of a provider's authorization to provide services on any school campus, against a behavioral health provider for failure to comply with the governing authority's policy.

(3) The failure of a public school governing authority to adopt a policy shall not be cause to prohibit the provision of behavioral health services to a student as provided in this Section.

B. For purposes of this Section, the following terms shall have the following meanings:

(1) "Applied behavior analysis provider" shall mean a provider who is licensed, certified, or registered by a relevant licensing board and is in good standing to provide applied behavior analysis services.

(2) "Applied behavior analysis services" shall include the design, implementation, and evaluation of systematic instructional and environmental modifications by an applied behavior analysis provider to produce significant improvements in behavior
(3) "Behavioral health evaluation" shall include but not be limited to the following criteria:

(e) Identification of impact of student behavior on a student's educational program.

(4) "Behavioral health provider" shall mean a provider who is licensed by the Georgia Department of Health or a health profession licensing board and is in good standing to provide behavioral health services in Georgia including but not limited to a psychiatrist, psychologist, medical psychologist, licensed specialist in school psychology, marriage and family therapist, professional counselor, clinical social worker, applied behavior analysis provider, or a behavioral health provider organization licensed to provide behavioral health services in Georgia.

(5) "Behavioral health services" shall include but not be limited to individual psychotherapy, family psychotherapy, psychotropic medication management, community psychiatric support and treatment, crisis intervention, and medically necessary applied behavior analysis services.

(6) "Evaluator" shall mean a licensed psychiatrist, psychologist, medical psychologist, licensed specialist in school psychology, professional counselor, marriage and family therapist, clinical social worker, or applied behavior analysis provider who is certified by the respective board of examiners in Georgia to provide necessary evaluations and who is not an employee of the public school governing authority or the state Department of Education.

C. Nothing in this Section shall be construed to supersede any of the following:

(1) The authority of a student's Individualized Education Program team or Section 504 committee to determine appropriate services for a student pursuant to applicable federal and state law.

Article 3 of Chapter 9 of Title 19 of the Official Code of Georgia Annotated, relating to consideration of a child's educational needs, is amended by adding a new Code section to read as follows:

(i) Due to the extreme developmental importance of ABA therapy for special needs children and its extreme importance in helping them to not be institutionalized by the state, and due to parental implementation of the ABA techniques in day-to-day interactions with such a child being considered a critical component of a child's ABA therapy program, if a parent or guardian of a special needs child has knowingly obstructed or tried to obstruct the special needs child from receiving a doctor-prescribed ABA therapy program, or taken the position that modern ABA therapy is abusive, primary custody of the child and final decision making on matters affecting the child's education, health, extracurricular activities, religion, and any other important matter shall be assigned by order to a fit parent or fit guardian of the child who has not done such, if the child has such a parent or guardian.

Article 70 Chapter 5 of Title 16 of the Official Code of Georgia Annotated, relating to consideration of a child's educational needs, is amended by adding a new Code section to read as follows:

(e) A parent or guardian having charge or custody of a child under the age of 18 commits the offense of cruelty to children in the third degree when such person knowingly and willfully obstructs a special needs child from receiving a doctor-prescribed ABA therapy program against the will of another parent or guardian having charge or custody of the child under the age of 18.

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Good reasons for this act (which is primarily a copy of Louisiana's unanimously-passed law):

My name is Ben Fremer, and I have a severely autistic 7-year-old daughter in Cherokee county.

I believe I have important insights, testimony, and legislative suggestions that can help the legislature to achieve its objectives and to further help special needs people to overcome obstacles in ways which should significantly reduce the amount who end up institutionalized and costing the state millions of dollars. The two main obstacles I have noticed are around allowing ABA therapists into public schools like Louisiana recently unanimously legislated (https://legis.la.gov/legis/BillInfo.aspx?s=18RS&b=HB766&sbi=y ), and around parental blocking of prescribed ABA therapy to special needs children despite it being deemed medically necessary and it being extremely important for the child to avoid institutionalization (there is a well-documented small but significant community of parents who go to extremes, even divorcing, to block their children from the prescribed ABA treatment that the GA legislature near-unanimously voted for, and there is not a law mechanism to ensure it can’t be blocked by such a parent). My daughter is at risk of institutionalization.

Per representative advice, I have put together suggested draft legislation to remedy these issues, which I have attached. It is very primarily a copy of the Louisiana law which passed unanimously.

Though most don’t know what ABA therapy is, ABA therapy and early intervention with it is *extremely* important for dramatically improving the outcomes of special needs children so they don’t otherwise end up institutionalized (you can see an explanation of that and a cameo by Senator Albers in the first few minutes of this WSB piece – https://www.youtube.com/watch?v=CfU8-kJZR70 – studies show about half of autistic kids being practically cured by ABA therapy). An autistic child who doesn’t get ABA therapy is expected to cost the state millions of dollars over their lifetime as they otherwise largely end up institutionalized, and that along with a greatly lowered life expectancy are both tragically sad for such children.

A bit about me – I recently passed a federal public trust background investigation for my job where I [redacted] for the United States' Department of State, and I am also certified as an autism treatment professional ABA therapy provider (RBT certification). I'm also a Georgia state witness in a recent case where I went out of my way to bodyguard a stranger from a sex offender in Cherokee county (the Donald Harris case). My dad is a former elected village trustee, and I am a bit of a budding political activist in trying to help regular people resolve their local government challenges through networking, routing, investigating, hyperlocal polling and distributed voter guides, and am trying to scale out a bipartisan organization to help do that nationally.

Now to detail, the first obstacle for special needs children which I have noticed is that ABA therapists are not allowed into public schools, even when 30-40 hours per week of ABA therapy is prescribed by doctors and deemed medically necessary by the state and insurance companies, which makes scheduling the full therapy program difficult – especially for working parents as much / most of ABA therapy is delivered in at-home programs to help the children learn practical skills. This also contributes to the current shortage of ABA therapists to treat children with autism. For instance, there is an 8-month wait list for ABA programs locally. If ABA therapists could also deliver aid during school hours, that would also enable an increased supply of ABA services. I unofficially spoke with a lawyer and was advised that schools like across the state aren’t going to allow the therapists in unless a law is passed due to the liability issue. I’d guess that is why the Louisiana law addressed the liability issue with background check and liability insurance carrying requirements.

The other issue I have noticed is that there is a significant community of parents who go to extremes to try to keep their children from receiving ABA therapy, despite its extreme importance for the child. Here is an example of such a parent, even writing in a fairly mainstream publication: “I threw the doctor's recommendation for ABA therapy in the garbage, along with the prescriptions for the genetic testing.” https://www.insider.com/my-child-is-autistic-autistic-adults-changed-my-perspective-2022-12

Local doctor Robert Montgomery has testified that divorces to keep children away from ABA therapy are an ongoing issue. His contact info is listed here - https://www.psychologytoday.com/us/therapists/robert-w-montgomery-woodstock-ga/132194

Unfortunately, due to ABA therapist BACB ethical guidelines, a parent wanting to block a child from ABA therapy can drastically limit the effectiveness of the program the child receives to like a small fraction of what it should be, for instance, by barring the core table-time component, or by simply not doing the parental component.

In my daughter’s situation, as the experts teach happens when they are not in an environment where their ABA program is supported, she has been losing her ability to speak, as is logged in her IEP charts which I have attached here - https://www.dropbox.com/sh/2uquad7934vqn9g/AAAPfvkw1-s-BAh4WGeA3E5Ja?dl=0. My daughter’s situation is especially disturbing, as many people can testify to. I would be happy to testify to the Georgia congress on these issues. Without legislation, there is a significant chance my daughter will otherwise be institutionalized and become a very large expense to the people of Cherokee county and the people of Georgia.

In closing, most people don’t know what ABA therapy is, but I think it is clear common sense to those who understand ABA therapy and its extreme importance to both autistic children and the state’s budget that autistic children should not be blocked from receiving ABA therapy. To that end, per advice I received from my GA congressperson, I have drafted an act to remedy the issue. It is modeled almost ver-batim off the Louisiana law which passed unanimously, with additions for the other obstacles I have detailed. I would like to see as many of these issues as feasible addressed by legislation this session. I plan to be actively lobbying for legislation like this over the next couple sessions. I further believe that the legislature would do good to reconvene again to look into making prescribed ABA therapy treatment closer to compulsory. Compared to a K-12 education, the therapy is perhaps even more important given the drastically reduced life expectancy of autistic children who don’t get the therapy.

Please let me know your thoughts on this. It seems like whoever has an ABA-eligible child would like them to be able to be aided at school, which would also help the schools. People I talk to, like Anthony and his wife at the First Baptist of Woodstock special needs ministry, similarly think opening up the schools to ABA therapy is like needed. I also have a bit of a relationship with arguably the foremost autism education expert on earth whose course has apparently trained more RBTs than any other -- Rhonda Davin. I believe she would be happy to confirm what I have detailed. We have a good base of supporters, and I hope this is simply common-sense legislation. Please feel free to reach out to me any time by text, call or email.

Thanks,

Ben Fremer

404-936-0550

benfremer@hotmail.com

Georgia STAR Act (Georgia Special-Needs Treatment Access Reassurance Act)