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Physical Therapy Advisory Committee

Minutes The Physical Therapy Committee of the Board of Medical Licensure and Supervision met on July 28, 2017 in accordance with the Open Meeting Act. The meeting was held at the office of the Board, 101 NE 51st Street, Oklahoma City, Oklahoma. Advance notice of this regularly scheduled meeting was transmitted to the Oklahoma Secretary of State on November 1, 2016, and posted on the Board's website on July 26, 2017. The notice and agenda were posted in prominent public view on the front doors of the Oklahoma Board of Medical Licensure and Supervision building located at 101 NE 51st Street, Oklahoma City, Oklahoma on July 26, 2017 at 3:15 p.m. Members Present:

David Haynes, PT, AT, Chair Jennifer Ball, PT/ATC, MHR Andrew Ward, PT, COMT Carla Hinkle, MS, PTA

Members absent: Joe Jekel, Public Member Others present: Lyle Kelsey, Executive Director Barbara J. Smith, Executive Secretary Teresa Mitchell, Licensing Director Kenna Shaw, Administrative Technician (Licensing) Lisa Cullen, Administrative Technician (Licensing) Wendy Howell, Administrative Technician (Licensing) Tiffany Wythe, Assistant Attorney General, Committee Advisor Having noted a quorum, Mr. Haynes called the meeting to order at 9:00 a.m. New

committee members, Mr. Ward and Ms. Hinkle, were introduced and welcomed.

Following Committee discussion, Ms. Ball nominated David Haynes, PT, AT, to serve as Chair of the Committee. Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative. Ms. Hinkle nominated Jennifer Ball, PT/ATC, MHR, to serve as Vice-Chair of the Committee. Mr. Ward seconded the motion and the vote was unanimous in the affirmative.

The Committee then reviewed the minutes of April 28, 2017, and Ms. Ball moved to approve the minutes with an amendment correcting the designation of Jaren Moorman to Physical Therapist Assistant ("PTA") rather than Physical Therapist ("PT"). Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative.

RHONDA HESTER appeared in support of her application for Physical Therapist Assistant licensure. Teresa Mitchell stated the application is incomplete and Ms. Hester is

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appearing before the Committee due to non-completion of an approved PTA program. The applicant passed the National Physical Therapy Exam ("NPTE") in 1980 and holds a current Arkansas license. Further, she is eligible for Oklahoma licensure by endorsement. Ms. Hester explained that when she went to school and graduated, there was not an approved PTA program at that time. Ms. Ball moved to recommend approval of the application for Physical Therapist Assistant licensure by endorsement pending completion of the file. Mr. Ward seconded the motion and the vote was unanimous in the affirmative.

KUMARI LAKSHMI NIMMALAPALLI appeared in support of her application for Physical Therapist licensure. Teresa Mitchell stated this application was incomplete and the report from the Foreign Credentialing Commission on Physical Therapy ("FCCPT") indicates the applicant's education does not meet Oklahoma standards for licensure. She is licensed in Delaware and Kansas, but has not worked in Delaware and has only worked in Kansas for approximately 20 hours per week for four months. (Her lack of work experience in the states is due to issues with obtaining a legal work visa.) Prior, she practiced for two years in India. Ms. Nimmalapalli stated she completed 30 continuing education units ("CEUs") in the last year. The Committee asked to see those CEUs, but it was unclear as to whether those had been provided to our licensing department. Following Committee discussion, Ms. Hinkle moved to recommend approval of the application for Physical Therapist licensure pending completion of the file to include 800 hours of direct on-site supervision with a progress report to be provided to Staff for review and approval upon completion of the required supervised hours. Ms. Ball seconded the motion and the vote was unanimous in the affirmative.

JOSEPH TERRY, Physical Therapist, appeared in support of his request to waive/reduce the 800 required clinical hours for a foreign graduate which were assigned at the April 2017 committee meeting. His application for licensure was previously approved pending completion of the file. Mr. Terry has completed 260 of the 800 hours and is requesting a reduction of required hours to the 260 already completed. He is requesting this reduction based on the new circumstances that he recently passed the licensing exam and began working for a physical therapist in May under a temporary license. Prior, he worked full-time for a full year as a physical therapist technician. Teresa Mitchell indicated she would obtain proof of the 260 supervised hours from his supervising PT in writing. Mr. Terry stated the clinic where he is employed is looking at expanding in the future and he would like to be able to work without supervision. Mr. Terry brought a letter of recommendation with him, but the Committee found it lacking in regard to specific skills he might possess. He told the Committee he has worked extremely hard and is ready to work without supervision. There was discussion regarding drafting a specific evaluation form for matters such as these, which Ms. Mitchell agreed to do, but ultimately the Committee decided a form was unnecessary at this time.

Following further Committee discussion, Ms. Ball moved to recommend granting the request of JOSEPH TERRY, Physical Therapist, to reduce the number of required clinical hours for a foreign graduate from 800 hours to 400 hours with a written evaluation to be provided for review and approval by Staff from his direct supervisor setting forth Mr. Terry's skill level and ability to set appropriate goals. Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative. After the vote, the Committee advised they would be looking for information from his supervisor regarding Mr. Terry's specific skills, i.e., the type of patient care and comfort he provides to patients, as well as his ability to evaluate any patient that comes through the door.

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JEANNE RAPPSILBER appeared in support of her application for re-entry of Physical

Therapist Assistant licensure. Her application is incomplete. As requested previously by the Committee, Ms. Rappsilber provided her Practice Exam and Assessment Tool ("PEAT") scores, which were all over 600, as well as additional continuing education units ("CEUs") for review. Following Committee discussion, Ms. Ball moved to recommend approval of the application of JEANNE RAPPSILBER for re-entry of Physical Therapist Assistant licensure pending completion of twelve months of direct on-site supervision with an evaluation provided to Staff for review and approval from her direct supervisor setting forth her skill level. Mr. Ward seconded the motion and the vote was unanimous in the affirmative.

Next, the Committee reviewed applications for licensure. Ms. Ball moved to recommend approval of the following incomplete applications of Physical Therapist licensure pending completion of the files. Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative.

FOX, KENNA CLARK, JAY BRADFORD MOORE, LINDSY RENAE NAYLOR, KESHA KARLYN ANDERSON, LYDIA DIXIE ANN O'MARA, PAMELA SMITH THOMPSON, REBEKAH ELIZABETH DESLATTE, KYRIE ALESIAN CURTIS, JAKOB

SARAVANE, JACQUELYNN M DRIVER, PAIGE ALICIA PETERSON, LAUREN COLLIER MCSHANE, JENNIFER JEANNE WONG, PATRICIA BAKER, KRISTINA JOHNSON SEILER, KERRI LEIGH GOAD, MELISSA LAVONNE

Ms. Ball moved to recommend approval of the incomplete application of TERI LEE

TAYLOR for re-entry of Physical Therapist licensure pending completion of the file. Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative.

Ms. Ball moved to recommend approval of the following complete applications for

Physical Therapist licensure. Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative.

GELVEZON, NINETTE CROW, ALLIE JARVIS, JENNA MARIE BARNES, MACKENZIE LYNN PRATER, DAVID ELIJAH

GREEN, PAIGE LEANN BILAL, REEMA URGELLO, ANTON DOMINIC MULVIHILL, SHAWNA FIGURACION

Ms. Hinkle moved to recommend approval of the following incomplete applications for

Physical Therapist Assistant licensure pending completion of the files. Ms. Ball seconded the motion and the vote was unanimous in the affirmative. KUSZAK, COURTNEY ELIZABETH MOORE, LAWANDA GAY

SMITH, JARROD PERSSON, JOAKIM

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RICHARDSON, RHETT DUANE WOODY, TERESA PARRETT, DAWN HUSTON, BRYCEE TAYLOR TOMASI, MIKAYLA N ALLS, JONATHAN WALTAS CUSICK, TANNER SHAUN COOK, BRYSON LANE SANDERS, PERNILLE DRAMSTAD FRAZIER, KRYSTAL

DIGGS, CHEYENNE MCCOY WEBER, MATTISON MARY NICOLE POULIN, ASHLEY BLACKIM, JODIE NICOLE REEDY, MEGAN NICOLE DUPREE, JACOB DANIEL BROWN, JOHN WESLEY WELLS, ALISON GRACE COLE, SANDRA MAE BREVIESCAS PITTMAN, JAMES RICHARD

Ms. Ball moved to recommend approval of the incomplete application of PATRICIA

ANA ROJAS for re-entry of Physical Therapist Assistant licensure pending completion of the file. Mr. Ward seconded the motion and the vote was unanimous in the affirmative.

Ms. Hinkle moved to recommend approval of the following complete applications for Physical Therapist Assistant licensure. Ms. Ball seconded the motion and the vote was unanimous in the affirmative. SERMAN, REGAN ELIZABETH TIEDEMAN, AMBER LYNN BLAND, AUTUMN

CROSS, ERICA CREAGER, STEPHANIE ANN

Next, Teresa Mitchell stated there are two boxes of previously reviewed continuing

education units ("CEUs") that were just received by licensing so they are not logged into the database or put into a list form, but are ready for Committee approval. Ms. Mitchell stated she would put the approved CEUs into list form and provide that list as an attachment to these minutes. Mr. Ward moved to approve the two boxes of loose paper continuing education unit submittals. Ms. Hinkle seconded the motion and the vote was unanimous in the affirmative. (See Attachment #1)

Teresa Mitchell then led a discussion regarding the newly revised Form 5 which was

approved at the April 2017 committee meeting. She indicated it is not yet available online, but will be converted into a "fillable" form and placed on the website. The licensees will be notified of the revised Form 5 once it is online. The Committee was very appreciative of Staff's efforts. No action was required on the form and, therefore, none was taken. (See Attachment #2)

The Committee then discussed the Federation of State Boards of Physical Therapy Annual

Meeting scheduled for November 2-4, 2017, in Albuquerque, New Mexico. Ms. Ball stated that if she was not able to attend this year, she would like to attend in 2018. Mr. Haynes stated he would recommend the new committee members attend the new board member orientation which is scheduled for June of 2018. Ms. Ball moved to send David Haynes, as the Committee Delegate, and Carla Hinkle, as the Alternate Delegate, to the annual meeting in November of 2017. Mr. Ward seconded the motion and the vote was unanimous in the affirmative. Ms. Smith will process the registration forms and state travel request forms for Mr. Haynes and Ms. Hinkle.

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Next, Teresa Mitchell provided a presentation regarding the current continuing education ("CEU") approval procedure and process including any anticipated updates/changes.

Ms. Mitchell explained that the CEUs are currently submitted electronically on the submission portal and from there the courses are logged into an Excel spreadsheet. One of the problems is the licensees enter course titles differently which causes duplicates. Ms. Mitchell told the Committee that a better-quality product could be provided to the reviewers than what has previously been submitted, and she is diligent working to confirm there are no duplicate submissions of courses for the reviewers in the future.

Ms. Hinkle is concerned with the reviewer approval form because it indicates the number of hours requested for a course. She requested that the autopopulate feature be deleted so the reviewer will be required to become more diligent. Following Committee discussion, the autopopulate feature will remain as is with the reviewer to mark through and correct the amount of hours approved.

Ms. Mitchell walked the Committee through the timeline from receipt of CEU courses requesting approval to approval. She stated that courses which have been submitted but not yet approved are now available online. Also, a reviewer's recommendation before committee recommendation will also be provided which will help cut down on confusion for the community as well. Ms. Hinkle thinks this will be very helpful to the community, but this information needs to be communicated to vendors and licensees.

Mr. Kelsey stated this is a laborious process and we need to look at better ways to resolve the current issues with the CEU approval process. He discussed with the Committee the option of moving to an audit process, which is what many of the other medical professionials utilize. Under an audit system, random files would be audited to determine if the CEU requirements have been met. Ms. Ball stated she is on the continuing competency subcommittee and they have some things in place which, if ultimately approved, will drastically change the way CEUs are processed and, ultimately, approved. Mr. Kelsey was pleased with that news.

Mr. Kelsey went on to advise that the reviewer portal has run into problems because the web developer is no longer available. The estimated completion date is not until June of 2018. Ms. Hinkle discussed approving vendors versus approving each course. The Committee expressed concern that if a vendor submitted a course for approval in 2016, but the references used were from 2010 or 2011, then they are out of date. Ms. Hinkle suggested a vendor update could be provided.

Ms. Ball stated that in the proposed law changes, all courses approved by the American Physical Therapy Association and the colleges will be automatically approved for CEU credit. There was also discussion about CEU courses going through PROCert (Federation of State Board of Physical Therapy) for approval. This will most likely require a rule change. Ms. Wythe advised that, at this point, vendors cannot be charged a fee to be allowed to present their courses. Ms. Hinkle suggested the Oklahoma Physical Therapy Association could review/approve the courses, but that is not allowable at this time under the current rules.

Ms. Mitchell stated another problem was that the Committee only met five times a year and that was contributing to the lag/backlog in the approval process. Ms. Mitchell stated she believed one additional meeting scheduled for some time in October of 2017 would be very helpful. The Committee stated its willingness to hold a special meeting in October for the purpose of CEU review/approval only. Ms. Smith will be in contact with the Committee to schedule a special meeting for that time. (See Attachment #3)

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Regarding the current communication method(s) with licensees, Mr. Kelsey provided a brief presentation on the new Gov.delivery service and advised that this is one way licensees will receive new information. Also, Mr. Kelsey told the Committee that a blast e-mail will be sent regarding the revised Form 5 and the request to receive all continuing education units which need approval no later than November 1, 2017. (See Attachment #4)

There being no further business, David Haynes adjourned the meeting at 11:15 a.m.

PT CEUs Approved July 28, 2017

PT CEUs (two boxes) approved in the July 28, 2017 PT Committee meeting which were not put into list form prior to approval. Attachment #1 hereto will be provided by Licensing. If you have any questions in the meantime, please contact Licensing at licensing@okmedicalboard.org or (405) 962-1400 Ext. 113.

Attachment #1

Attachment #2

Attachment #2

PT Committee 7/ 28/ 2017 - Agenda Item talking points:

9. Discussion - Current continuing education approval procedures and process including anticipated updates/changes (Carla Hinkle)

Current Process and Timeline

• Courses are submitted electronically online using CE Submission portal

• Log courses to Excel spreadsheet (show the spreadsheet on screen- take them thru columns)

• Check for duplicate entries and incomplete submissions

• Print attachment/coversheet

• Ready for reviewer- call for reviewer- schedule delivery

After 3 to 4 weeks:

• Receive reviewed materials back

• Update Excel spreadsheet with approved hours and notify submitter of disapproved/denials, etc.

• Prepare for next PT Committee review/action

• Update file and upload approved courses to website report.

Current Bug fixes in the works:

Measures to prevent multiple submission of same course:

Committee meets 5 times a Year­

Adding anywhere from 1 to 2.5

months for a course to fi nally get

approved. Or potentia lly 2.5 to 4

months of total lead time.

• List all approved and " Pending Approval" list of courses on the website * Courses Pending Approval are listed at the end, highlighted in Yellow

Status: Done see at: CEUs Approved and Pending _li] • Try to prevent duplicates. Essentially this involves taking whatever value the user enters

in the Course Title field and doing a fuzzy search against the database for existing courses with a similar Course Title . This searches courses that have been entered via the provider portal; this does not search courses that were submitted prior to I outside of this portal. Can't make any promises about how effective it's going to be in finding duplicates because doing fuzzy searches is difficult in general, but hopefully it'll work at least somewhat reasonably well. If one or more duplicates are found a warning is presented to the user.

Estimated completion date: 10/1/2017.

Attachment #3

PT Committee 7/ 28/ 2017- Agenda Item talking points:

Future Upgrades assigned to Web developer:

Reviewer Portal: Estimated completion date: 6/1/2018. (This date assumes we are not able to find a developer to help our current contractor to implement this. Actively looking for a developer so hopefully we'll get this done much sooner, but we are trying to be conservative with this date and plan for a worst­case scenario) .

Board is switching to a new communicat ion platform ca lled "GovDelivery" - see agenda item 12.

Any communication for PTs/PTAs will be distributed via GovDelivery platform.

Attachment #3

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