225D.1 Definitions.

As used in this chapter unless the context otherwise requires:

1. “Applied behavioral analysis” means the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior or to prevent loss of attained skill or function, including the use of direct observation, measurement, and functional analysis of the relations between environment and behavior.

2. “Autism” means autism spectrum disorders as defined in section 514C.28.

3. “Autism service provider” means a person providing applied behavioral analysis, who meets all of the following criteria:

a. Is any of the following:

(1) Is certified as a behavior analyst by the behavior analyst certification board, is a psychologist licensed under chapter 154B, or is a psychiatrist licensed under chapter 148.

(2) Is a board-certified assistant behavior analyst who performs duties, identified by and based on the standards of the behavior analyst certification board, under the supervision of a board-certified behavior analyst.

b. Is approved as a member of the provider network by the department.

4. “Autism support fund” or “fund” means the autism support fund created in section 225D.2.

5. “Clinically relevant” means medically necessary and resulting in the development, maintenance, or restoration, to the maximum extent practicable, of the functioning of an individual.

6. “Department” means the department of human services.

7. “Diagnostic assessment of autism” means medically necessary assessment, evaluations, or tests performed by a licensed child psychiatrist, developmental pediatrician, or clinical psychologist.

8. “Eligible individual” means a child less than fourteen years of age who has been diagnosed with autism based on a diagnostic assessment of autism, is not otherwise eligible for coverage for applied behavioral analysis treatment or applied behavior analysis treatment under the medical assistance program, section 514C.28, section 514C.31, or other private insurance coverage, and whose household income does not exceed five hundred percent of the federal poverty level.

9. “Federal poverty level” means the most recently revised poverty income guidelines published by the United States department of health and human services.

10. “Household income” means household income as determined using the modified adjusted gross income methodology pursuant to section 2002 of the federal Patient Protection and Affordable Care Act, Pub. L. No. 111-148.

11. “Medical assistance” or “Medicaid” means assistance provided under the medical assistance program pursuant to chapter 249A.

12. “Regional autism assistance program” means the regional autism assistance program created in section 256.35.

13. “Treatment plan” means a plan for the treatment of autism developed by a licensed physician or licensed psychologist pursuant to a comprehensive evaluation or reevaluation performed in consultation with the patient and the patient’s representative.

2013 Acts, ch 138, §82, 85; 2015 Acts, ch 137, §69, 162, 163; 2016 Acts, ch 1139, §59; 2017 Acts, ch 18, §1, 5; 2017 Acts, ch 170, §35, 44