board of registration for the healing arts. disclaimer pursuant to section 324.023.2, rsmo, any...
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BOARD OF REGISTRATION FOR THE HEALING ARTS
DISCLAIMER
• Pursuant to section 324.023.2, RSMo, any opinions contained in this presentation are for educational purposes only, are in no way binding on the licensees of the Missouri Board of Registration for the Healing Arts, and cannot be used as the basis for any discipline against any licensee of the Missouri Board of Registration for the Healing Arts.
BOARD MEMBERSHIP
• Benjamin Lampert, MD• Springfield• Anesthesiology/Pain Medicine
• Bradley Freeman, MD• St. Louis• General Surgery/Critical Care
• Jeffrey Carter, MD• St. Louis• Anesthesiology
• David Tannehill, DO• St. Louis• Critical Care/Telemedicine
• James DiRenna, DO• Kansas City• Family Practice
• David Poggemeier, MD• St. Charles• Emergency Medicine
• John Lyskowski, MD• Jefferson City• Psychiatry
• Jade James, MD• St. Louis• Obstetric & Gynecology
• Public Member – Vacant
ABOUT THE BOARD
• Meets 4 times a year in person• Holds at least 4 conference calls a year• Mission: To protect the citizens of the state
through the licensing of physicians and other health designated professionals, assessing their competence to practice and their moral character. It is also the board’s duty to investigate all complaints against its licensees in a fair and equitable manner.
ADVISORY COMMISSIONS
• Physical Therapists• Speech Language Pathologists/Audiologists• Physician Assistants• Athletic Trainers• Clinical Perfusionist• Anesthesiology Assistants
PHYSICAL THERAPIST ADVISORY COMMISSION
• The Advisory Commission for Physical Therapists was created in 1989 and is responsible for advising the Board on the licensure and regulations of the physical therapist profession.• Made up of five (5) members, four (4) of which
shall be licensed as physical therapists, and one (1) shall be licensed as a physical therapist assistant.• Members serve three (3) year terms.• Meets on average once a month via conference
call to discuss pending discipline cases and licensure matters.
ADVISORY COMMISSION MEMBERSHIP
• William P. Hopfinger, PT, AT, Chair• St. Louis, MO
• Judith E. Pastorino, PTA, Secretary• Columbia, MO
• Tamara L. Burlis, DPT• St. Louis, MO
• James A. Dronberger, DPT• Kansas City, MO
STAFF ORGANIZATION
Connie Clarkston (ED)
Jimmy Leggett (Executive I)
Information Coordinator
Kim Brester (Administrative
Coordinator)
Licensure Supervisor
6 Licensure Techs
Bill Smittle (Chief Medical
Officer)
3 Med Staff in Office (part
time)
3 Med Staff (work from
Home)
Kim Beffa(Supervisor
Enforcement)
4 Staff
Frank Meyers(General Counsel)
Vacant(Associate
General Counsel)
Paralegal and Clerical
Vacant(Chief
Investigator)
2 Probation Supervisors
14 Investigators
LICENSED PHYSICAL THERAPISTS
PROFESSION # OF ACTIVE LICENSES
Physical Therapist 5,938
Physical Therapist Assistant 2,699
THE PRACTICE ACT
WHAT IS THE PRACTICE ACT?
• The “Practice Act” is the title commonly used when referring to the statutes and rules governing the practice of physical therapy in Missouri.• Chapter 334 of the Revised Statutes of Missouri.• Sections 334.500 to 334.687, RSMo.• Regulations 20 CSR 2150-3.010 to 20 CSR 2150-3.210.
• Available online at: http://pr.mo.gov/healingarts-rules-statutes.asp
WHY DO I CARE ABOUT THE PRACTICE ACT?
• Rules for How to Practice in Missouri• Scope of practice• Medical record requirements• Supervision requirements
• Unintended Consequences• Board investigation• Complaint• Discipline
INVESTIGATIONS
AVENUES FOR COMPLAINTS
Complaint Received
Complaint Review Committee
(“CRC”)
Malpractice Review Investigative Discipline Medical Staff Review Board Direction Paralegal Close
COMPLAINT REVIEW
• All complaints and reports (other than malpractice) are reviewed by CRC (20 CSR 2150-1.011)• First level of the screening process• CRC determines how complaints are handled• Quality of care• Routine Investigation• Paralegal Gathers Information• Letter to Doctor• Closed agenda
WHAT IS A COMPLAINT?
• Uniform Complaint Form• Letter from Program stating non-compliance• Information from Licensee (self-report)• “Yes” question on renewal• Newspaper Article about Court Conviction• Staff concern• Misc.
INVESTIGATIVE TOOLS
• Letter to Licensee• Gather documents• Routine Investigation• Quality of Care• Records Review
APPEARANCES
• Appear before the Board• Gives the Board a chance to meet licensee and
evaluate the case and the licensee• Gives the licensee a chance to provide his/her
side of the story directly to the Board
BOARD DECISIONS
BOARD DECISIONS
• Close• Order Further Investigation• Order Appearance• Order MSI
• Propose ILOD (§324.043, RSMo)• Propose Settlement Agreement (§621.045.4,
RSMo)• File a Case• AHC (§334.100.2, RSMo)• Emergency Suspension (§334.102, RSMo)
• Board (§§324.042, 334.102.7, and 334.103, RSMo)
COMPLAINTS
NUMBERS OF COMPLAINTS
2012 2013
Total Complaints 1,067 954
Unprofessional Conduct
361 249
Negligence 245 188
Inappropriate Prescribing
189 187
Cases Resulting in Discipline
69 59
TYPES OF DISCIPLINE
• Reprimand• Probation• Suspension• Revocation• Restriction• Can be used in combination
HOT TOPICS
PTA SUPERVISION
• Section 334.506.7, RSMo states:• 7. A physical therapist shall only delegate physical
therapy treatment to a physical therapist assistant or to a person in an entry level of a professional education program approved by the Commission for Accreditation of Physical Therapists and Physical Therapist Assistant Education (CAPTE) who satisfies supervised clinical education requirements related to the person's physical therapist or physical therapist assistant education. The entry-level person shall be under on-site supervision of a physical therapist.
• On-site supervision…• See also 334.610, RSMo
PT TECHS
• Related to issue of proper supervision/unlicensed practice• Section 334.506, 334.510, and 334.610, RSMo
• PT Techs are NOT licensed• Amount of supervision is irrelevant• Don’t fudge on your resume/application
DRY NEEDLING
• Not addressed in statute or rule• Beware of overlapping practice• Acupuncturists ARE licensed in Missouri (see chapter 324,
RSMo)
• Federal requirements?• Type of needle being used?• Requirement to purchase and use?
LICENSURE ISSUES
• Most issues are licensure related• Reciprocity and “substantially equivalent” (see section
334.611, RSMo)• FCCPT (see 20 CSR 2150-3.010)• TOEFL (see 20 CSR 2150-3.010)• FSBPT Scaled Score (see 20 CSR 2150-3.030)
• Returning to active practice• Temporary License (see section 334.665, RSMo)
RENEWALS/APPLICATIONS
• Lying on your renewal/application is cause to discipline• § 334.100.2(15) states that “knowingly
making a false statement, orally or in writing to the board” is cause to discipline
POSITIVE ANSWERS ON RENEWALS
• If you answer a question on a renewal “yes” you should submit an explanation with your renewal• Board may take no further action• Board may request more information• Board may investigate
NAME CHANGES
• Written request ([email protected]) • Send the document showing the name change• Marriage certificate• Divorce decree• Court order
• Tell us how you want your name to appear• Jane Smith• Jane Smith-Doe• Jane Smith Doe• Jane Doe
THINGS TO KNOW
• Update your addresses with the Board• Know the law• Attorneys and the Board
