COOPERATION AND TEAMWORK - The Federation of State Boards of

Transcription

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forum
federation
Volume 21, Number 3
A M A G A Z I N E O F T H E F E D E R AT I O N O F S TAT E B O A R D S O F P H Y S I C A L T H E R A P Y
fa l l 2 0 0 6
Mark Your Calendar
2
President’s Perspective
3
Administrative Staff Corner
4
Legal Notes
5
Measurement Matters
6
Improving Services to PT and
PTA Programs
8
Ten Easy Ways to Lose Your
License
COOPERATION
AND TEAMWORK
Among Board Staff, Board Members and Board Attorneys: PART II
Kevin Heupel
10
The Fourth Edition of the Model
Practice Act
12
Security Watch
13
Academy of Advanced Item
Writers
14
General Education in the
Coursework Evaluation Tool
15
APTA Litigation Resolved
15
Cheating in the News
16
It’s in the Mail
16
2006 FSBPT Annual Meeting
18
Call For Nominations
27
This is the second article taken from a presentation made by Barbara Safriet and Kevin Heupel to the
Citizen Advocacy Center’s 2005 annual meeting. This article provides Kevin Heupel’s presentation with
questions at the end that were responded to by both Safriet and Heupel.
The Role of the Board Attorney
Whether it is the Attorney General’s Office or a hired attorney, the role of board counsel is the
same: legal counsel and advisor to the board. It sounds simple, but I can remember preparing
for my first meeting: I needed to know the practice act, other professions’ practice acts, open
records and open meeting laws, board member conduct and ethics, contract principles, general
administrative law, concept, rules and case law. I remember going into my first meeting
intimidated and not knowing what to expect. As the board’s attorney, I wanted to prevent
the board from going beyond its scope and getting into dangerous areas.
The Goal of the Board’s Attorney
One of the things the attorney is most concerned about is that the board does not appear
biased—that the proceedings and discussions are impartial—that the board is making decisions
based on the facts before them and not hearsay, speculation or rumor. It is not uncommon
that attorneys get aggressive and start interjecting their opinions and beliefs. It may feel as
if the attorney is trying to constrain board members and bring them in, but he or she is
really trying to maintain impartiality through the process. Unfortunately, some attorneys go
too far and warn the board it will lose its immunity.
Board Immunity
There are two types of immunity: absolute and qualified. Absolute immunity applies because
board members serve in a quasi-judicial capacity, meaning their role is similar to that of
a judge, hearing testimony, issuing subpoenas, ruling on evidence, rendering a decision.
When boards are doing those things, they are immune from liability.
S e t t i n g t h e G o l d S ta n d a rd
f o r S e rv i c e a n d P rot e c t i o n
C O O P E R AT I O N A N D T E A M W O R K
continued on page 20
federation
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forum
www.fsbpt.org
ADMINISTRATIVE SERVICES
Page 2
mark your
calendar
Note: Committee and task force meetings are for members only.
2006
703.299.3100 phone • 703.299.3110 fax
DECEMBER
EXAM PROCESSING AND
SCORE TRANSFER SERVICE
703.739.9420 phone • 703.739.9421 fax
BOARD OF DIRECTORS
8–9
10–11
Finance Committee Meeting • Alexandria, VA
BOD meeting • Alexandria, VA
2007
E. Dargan Ervin, Jr., President
Chuck Meacci, Vice President
JANUARY
Senora Simpson, Secretary
4–7
Kathy Fleischaker, Treasurer
EDC PT/PTA Meeting • Alexandria, VA
18–21
IBRC/EDC PT • Alexandria, VA
Nina Hurter, Director
19–21
Membership Survey Task Force
Tom Mohr, Director
27–28
Education Committee • Memphis, TN
Maggie Donohue, Director
Barbara Safriet, JD, Public Member
FEBRUARY
COMMITTEE CHAIRS
2–4
Stephanie Lunning, Education
Peg Hiller, Ethics and Legislation
Diane Hansmeyer, Exam Administration
Douglas White, Exam Development PTA
Pam Leerar, Exam Development PT
Dargan Ervin, Investment
Kathy Fleischaker, Finance
FARB Forum • San Antonio, TX
14–18
APTA CSM • Boston, MA
22–25
IBRC/EDC PTA • Alexandria, VA
MARCH
9–11
Item Writing Workshop • Alexandria, VA
Ron Seymour, Nominating
22–25
Martha Clendenin, Resolutions
22–26
BOD Five Year Strategic Planning Meeting • Santa Fe, NM
CHIEF EXECUTIVE OFFICER
APRIL
William A. Hatherill
ABOUT THE FEDERATION’S LOGO
12–15
IBRC/EDC PTA • Alexandria, VA
26–29
A beautifully simple yet intricately complex drawing by
Leonardo da Vinci is the focal point of the FSBPT logo.
Taken from the great master’s concept of separate but
MAY
17–19
EDC PT/PTA • Alexandria, VA
connected, each straight line is meant to represent an
20
individual state board, functioning
independently yet coming together for
26–27
ECCCM • Alexandria, VA
Advanced Item Writing Workshop • Alexandria, VA
support at the focal point—under the aegis
of the Federation. In addition to the aptness
JUNE
of this lovely metaphor, the Federation is proud to link its
1
name to Leonardo da Vinci because his pioneering work
paved the way for our modern understanding of the
human body.
Candidate Orientation • Alexandria, VA
2–3
BOD/Committee Chair Planning Meeting • Alexandria, VA
3–4
BOD meeting • Alexandria, VA
13
THE FEDERATION’S MISSION
Motions for 2007 Delegate Assembly must be submitted to Resolutions Committee
To protect the public by providing service and leadership
14–17
EDC PT / IBRC PTA • Alexandria, VA
to promote safe and competent physical therapy practice.
27–30
APTA Annual Conference • Denver, CO
Federation Forum is published three times a year.
Subscriptions may be obtained from Administrative
Services for US $35/year.
JULY
13–15
EDC PT/PTA • Alexandria, VA
20–22
© 2006 by the Federation of State Boards of Physical
27
Therapy. All rights reserved. Unauthorized reproduction or
use of the articles contained in this magazine are punishable under federal law. Permission to reproduce articles
may be obtained by writing to Federation Forum, FSBPT,
509 Wythe Street, Alexandria, VA 22314.
Motions/2006 Delegate Handbook must be received by membership
AUGUST
9–12
23–26
IBRC–Item Bank Clean Up • Alexandria, VA
IBRC PT/PTA • Alexandria, VA
SEPTEMBER
6–10
FSBPT Annual Meeting • Memphis, TN
7–9
NPTE Workshop for Faculty • Memphis, TN
21–23
2008
SEPTEMBER
11–15
2 • Volume 21, Number 3
FSBPT Annual Meeting • Minneapolis, MN
president’s
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perspective
The Assault on
Examination
Security
E. Dargan Ervin, PT
We have well chronicled
our own history with the
NPTE Internet cheating and
our efforts to identify and bring
appropriate consequences to
those that violated copyright
laws by posting recalled
test questions.
t is rare these days if you see a News Brief or a Forum publication that does not
have some issue related to examination security. It is an unfortunate, but very
necessary fact that we need to expend significant resources to protect the NPTE.
That being said, it is also understood that we will need to be ever watchful, diligent
and creative in security measures. We learn this from our own history and from the
security events that other testing organizations endure.
I
The Federation’s Experience with NPTE Cheating
We have well chronicled our own history with the NPTE Internet cheating and
our efforts to identify and bring appropriate consequences to those that violated
copyright laws by posting recalled test questions. In 2002, the Federation learned
of a widespread cheating effort by physical therapist students preparing to take the
NPTE. Students were illicitly sharing recalled or memorized exam questions over
the Internet by means of the student forum chat room of an exam preparation
vendor. One form of the exam that contained exposed items was retired from
further use. All candidates who had registered and been assigned the exposed
form were assigned different forms.
Four individuals were identified for investigation and civil or criminal
prosecution. By July 2003, the Federation had initiated four lawsuits. In each case,
a consent order and settlement agreement was signed admitting to copyright
violation of the NPTE. The individuals agreed to make a financial settlement,
to identify others involved in copyright violations, and finally, to post a curative
message warning other candidates and acknowledging their copyright violation
of the NPTE.
The assault continues. As of October 18, 2006, due to security concerns, NPTE
candidates were no longer able to schedule to test at Prometric locations in U.S.
territories and Canada. Candidates already scheduled to take an exam in the U.S.
territories or Canada will be able to sit for the exam as scheduled. Testing continues
as usual in the 50 states and the District of Columbia.
National Association of Boards of Pharmacy Had to Suspend
the FPGEE
In October 2002, the National Association of Boards of Pharmacy® (NABP®)
identified an extensive security breach in the Foreign Pharmacy Graduate
Equivalency Examination® (FPGEE®) that halted administration of the FPGEE®
on November 19, 2002. Computer-based FPGEE scores affected by the
compromise were invalidated and Foreign Pharmacy Graduate Examination
Committee (FPGEC) certificates awarded to candidates who passed the exam
affected by the compromise were invalidated. All existing appointments were
cancelled.
PRESIDENT
Dargan Ervin, Jr., PT currently works as Director of Administration and Client Services with Atlantic Physical Therapy & Rehab in Myrtle Beach, South Carolina. His
responsibilities require a great deal of operational and fiscal oversight. Dargan’s practice experience includes acute care, sports medicine, outpatient, and industrial
rehabilitation home health. He received the Distinguished Alumnus Award in 1999 from the Medical University of South Carolina College of Allied Health Sciences.
Dargan has been a member of the South Carolina Board of PT Examiners since 1992, and served as chair from 1995 to 2000. He headed the Federation’s Prescreening
Task Force, was a member of the Finance Committee and served as the Federation’s Treasurer before being elected to President. Dargan has also been active in the
South Carolina Physical Therapy Association, serving as its Treasurer from 1984 to 1987.
Dargan received the 2001 Emily Cate Award from the South Carolina Physical Therapy Association for his noteworthy contributions to physical therapy on a local and national level.
Federation Forum • 3
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corner
A Report on the CBA Forum in September
Jim Heider, Executive Director for the Oregon PT Licensing Board
n Thursday, September 7, 2006, the Council of Board
Administrators (CBA) held its annual CBA Forum in
Portland, Oregon. I acted as Moderator and Veronica
Reynolds, Administrator for the South Carolina Board of PT
Examiners, served as Recorder. The meeting was attended by
35 Administrators and other Board representatives. We spent
the afternoon gleaning information relevant to our Boards and
networking on various topics, concepts, ideologies and concerns.
The formal agenda included
■ An update on recent changes to the Healthcare Integrity
and Protection Data Bank (HIPDB), as presented by
Betsy Ranslow, HIPDB Senior Associate for External
Relations.
■ Presentations by Seif Mahmoud, FSBPT Managing
Director of Information Systems, on updating the FSBPT
Historical Exam Data Capture Project, followed by a
presentation on the proposed further development of the
FSBPT/CBA List Serve/Message Board tool.
■ A panel discussion titled “Board Responsibility for Public
Outreach and Protection.” The panel and topic was well
represented by Heidi Herbst Paakkkonen, Executive
Director for the Arizona State Board of Physical Therapy,
Kevin Heupel, Section Director of the Colorado Physical
Therapy Licensure Board and Jeff Rosa, Executive
Director of the Ohio OTPTAT Board.
■ Nina Hurter, PT Coordinator for the Texas Board of
Physical Therapy Examiners, and Administrative Director
on the Federations Board of Directors, summarized
Federation information and activities relevant to the CBA.
At the end of the informal program, the group convened
into their annual business meeting. The business meeting
began with a presentation on the history and development
of the CBA by Ann Tyminski, Executive Director for the
Maryland Board of PT Examiners. Ann, who has been a
member of the Federation for 16 years, adeptly described
the evolution of Administrator involvement in all Federation
affairs. During the meeting, the CBA recognized Ann’s unstinting efforts on behalf of the Federation and Administrators,
O
from her mentoring of new Administrators to her service on the
Board of Directors.
The Moderator and Recorder for 2007’s meeting were
elected at this meeting. Heidi Herbst Paakkonen was elected
the 2007 Moderator and Jeff Rosa was elected the 2007
Recorder.
As a result of this year’s meeting, the CBA will form two
committees: one will focus on the CBA Message Board
project, while the other investigates other possible methods
for the selection of the nominees for the Administrative Staff
Director position on the Federation Board of Directors. As
a note, during the business meeting, the group discussed the
possibility of changing the way the CBA Board member is
elected to the FSBPT Board. After discussion, the group
determined the current process is effective but decided to take
a look at how the CBA selects the nominees.
From the results of the program evaluations, it is evident that
Administrators truly value this unique opportunity to gather
once a year as a group; many would like to see the meeting
scheduled as a full day. This is my fourth CBA annual meeting
and every year I see the group grows more interdependent,
interacting as colleagues. What this meeting conveys goes way
beyond just the sharing of concepts and ideas, it is a venue
by which relationships are built, and, it is through those
relationships Administrators feel comfortable and confident
to contact one another to solicit information and help with
issues not unique to any one jurisdiction.
Veronica and I want to publicly acknowledge all those who
helped to make this year’s CBA meeting a success. Our thanks
and gratitude to all the speakers and presenters mentioned
above, to Amanda Atkinson for her role in handling the meeting
logistics, and a special note of thanks to the FSBPT Board of
Directors for their continued support, wisdom and insight, and
the acknowledgment of the vital role the Board Administrator
plays in the structure, continued development, and operations
of each jurisdiction.
■
Jim Heider is the Executive Director for the Oregon Physical Therapist Licensing Board. Jim started working for the Oregon Board in March 2003. Jim is a graduate of
Central Washington University with a BS degree in Business and Finance. His work credentials include: 25 years experience in the field of management and operations,
specializing in human resources and training, and, he is nationally certified with the Society for Human Resource Management as a Senior Professional in Human Resources.
Jim currently serves as a member of the FSBPT Exam Administration Committee.
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Legal Notes
Dale Atkinson
Extra-Territorial Jurisdiction
The Authority to Discipline
he authority of a regulatory board to administratively
discipline an individual will be governed by the language of the practice act enacted by the legislature
and related rules/regulations promulgated by the board.
Many complex legal issues exist that provide a basis to
contest the authority of a regulatory board to “sanction” an
individual. One issue includes whether the physical therapy
board has “jurisdiction” to administratively sanction
someone who is not licensed nor is applying for licensure.
Another issue includes whether a licensed physical therapist
accused of violating the laws of another profession (i.e. occupational therapy) is subject to administrative action by the
physical therapy board.
T
Conduct Outside the Practice of the Profession
In particular, interesting legal and moral debate is generated
over whether conduct outside the practice of a profession
gives rise to administrative sanctions against the professional
license. In theory, this question may appear to be elementary
because the practice acts may, for example, provide a basis
for discipline based upon a criminal conviction, irrespective
of the crime. That is, and dependent upon the applicable
laws, crimes committed within the practice and those
unrelated to the practice may both result in subsequent
administrative action against a professional license.
Overlapping Scope of Practice
Outside the criminal arena, a difficult question arises as to
whether conduct, theoretically unrelated to practice, triggers
the authority of the regulatory board to sanction a particular
licensee. This question may present itself in the area of
overlapping scopes of practice. Overlapping scopes of
practice in related professions are often difficult for the
public to sort out and, at times, can present interesting legal
issues for regulatory boards themselves.
Many complex legal issues exist that
provide a basis to contest the authority
of a regulatory board to “sanction” an
individual.
Practice acts are generally drafted to respect the fact that an
ancillary profession (or professions) may also infringe upon
the identified scope of practice. Ultimately, the question arises
as to which board has “jurisdiction” over such practitioners
and the extent of and authority to administratively discipline
those accused of violating the law.
Accusations of Unlicensed Practice
Generally, these issues arise under such circumstances involving
accusations of the unlicensed practice of a profession. That is,
an individual licensed in one profession, but practicing outside
the scope of the license and within the scope of another
profession, may be accused of wrongdoing by either or both
boards. However, issues may arise regarding the authority or
jurisdiction of one board to discipline an individual who is
licensed by multiple boards. The issues become especially
complex where there are overlapping scopes of practice and
differing standards imposed upon practitioners from each
respective profession.
CONSIDER THE FOLLOWING CASE. An individual was licensed
both by the Psychology Board as a psychological associate
(LPA) and by the Board of Licensed Professional Counselors
as a professional counselor (LPC). He maintained separate
practices providing group therapy to adult sexual offenders
as an LPC, while also performing contract work as an LPA
for Medicaid clients through a county mental health center.
In fact, the licensee undertook comprehensive measures to
keep his two practices distinct and separate, including
maintaining two separate offices, maintaining separate
LEGAL NOTES
Dale J. Atkinson is an attorney in private practice in Evanston, Illinois. His area of concentration includes representing associations of regulatory boards and the legal
aspects of developing and administering programs within the entities. Representative clients include the Association of Regulatory Boards of Optometry, the National
Association of Boards of Pharmacy, American Association of Veterinary State Boards, and the Association of Social Work Boards. Mr. Atkinson is also Executive Director
of the Federation of Associations of Regulatory Boards (FARB) an association of associations of which FSBPT is a member.
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Measurement
Matters
David Wilson
High Risk for a Heart Attack?
he year is 1981. I was a new partner in a company called
Arthur Young & Companies (now Ernst & Young LLP),
and when you become partner you have to have a physical. I was not yet 40. I was running between 25 to 40 miles
a week, weighed 170 pounds and had just a couple of vices.
I was not worried about the physical.
When I went back about a week later to meet the doctor he
had just two things on his 97-foot-long desk—my report and
a silver-bound bible. Now I was worried. He opened up the
conversation with marvelous bedside manner; he said, “You
are a high-risk candidate for a heart attack. You have 68 points
on our scale—anything over 40 makes you high risk.”
That’s the last thing I heard. I did not pay any more
attention at that point, but that evening I decided to drive
my triglycerides up and have a stiff drink.
I read his report, and discovered that to get those 68
points, I had to come up with four different matrixes. The
first measurement was a scale of 1 to 4. How stressful is your
job? I put down a 3. Bam! Eight points. The second was a
measure of fat folds and as it turns out I had an extremely
large fat fold on my quadriceps. Bam! Eleven points. The
third measurement was age. Age cost me 39 points—just
one less than the high risk limit. A big bam. My cholesterol
was elevated and that cost me, bam, 10 more points.
I went back to see the doctor and I said, “You know, I am
little concerned because this stress test was an uninformed
measure—it was not normed against anything.”
I also said that the measurement of fat folds was a little strange
because of my running. So they went back and re-measured;
it turned out there was a brand new nurse who had taken the
original measurements, and she had done it incorrectly.
Then we got to my age and I said, “Look, you told me if the
total number goes over 40 I am in trouble. How the hell am I
going to survive with 39 points for age alone?” And the doctor
said, “No, no, no. Thirty nine is your actual years—but it’s
only 12 points on the scale.”
As for the cholesterol thing—it was at 240 and the joy of the
American Heart Association is that every year when you finally
take enough pills and you stop eating anything and you get your
cholesterol down to their level, the levels are lowered again. A
240 was a bit elevated back then—now it is astronomical.
So I had an arbitrary measure, an incompetent assessor, a scale
conversion error and no quality control over the cholesterol
T
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process. I would argue that confident objective measurement is
an imperative in this world—and I did not get it.
Nine Tenths of a Second
Last New Year’s Eve, we added a leap second to the coordinated
universal time, and it was not actually a full second, but rather
only 9/10 of a second. Why is that important? The leap second
is important because it is what keeps a number of digital devices
functioning—clocks, computers, cell phones, pacemakers.
Someone determined that measuring 9/10 of a second every
whatever number of years is an imperative, careful objective
measure.
Pounds Instead of Metric Tons
In 1999, we lost the Mars climate observer or Orbiter—
it was a spacecraft that was supposed to go to Mars and make
observations about the atmosphere from a distance of 65
miles—it cost nine months of time and $125 million. In the end,
all the hardware and software were lost. Why? Because in trying to
determine the thrust that was necessary to keep the Orbiter in
orbit and stop it from crashing into the surface of Mars, we used
pounds instead of metric tons. When it came time to deploy the
thrusters, we had only 25% of the thrust we needed.
What Gets Measured Gets Done
Measurement matters—it matters a lot. And poor measurements
are incredibly costly. Furthermore, what gets measured gets done.
People will modify their behavior to meet the performance
metric if they believe there is a risk or a reward attached to it.
Behavior modification will be met to maximize the beneficial
outcome of the individual. When you think about the stuff that
we look at everyday—whether it is miles per hour, sales quarter,
yards to the green or earnings per share—if it is measured, it is
going to influence behavior.
The exam items that you create influence behavior. Certainly
the comfort with which people live their lives depends on your
examinations and how well you assess their performance. It is
incredibly important. Yet we seem to be under assault on all
kinds of fronts today.
You Only Get One Chance to Educate a Child
Former New York City Mayor Rudy Giuliani was a very
outspoken proponent of education and a critic of the current
educational system. He said, “You only get one chance to
educate a child and if you screw it up then it is very hard to
Measurement matters—it matters a
lot. And poor measurements are
incredibly costly. Furthermore, what
gets measured gets done.
correct it later. We should be ashamed of ourselves that we do
not have the political courage to take on the unions, the special
interests, and anything else that is holding our children back.”
We do only have one chance to educate a child, and if we
lack the courage and the will to give a child objective and
honest feedback on his or her performance, we have failed that
child. It takes a lot of courage and will to take on those special
interests, those who will argue against standards and against
measurement in education and those who want to lower all
the barriers.
Strong Objective Predictors of Performance
Standardized tests have always been strong objective predictors
of performance, not the only predictor, but they have been
strong objective predictors. Yet I do not think a day goes by
that you do not hear one more story of a university that has
dropped the SAT. I just do not understand that. Why are those
tests so important? They are objective, they are valid, and they
are secure.
Admissions directors realize that they control the destiny
of young people—they really can control people’s lives. They
can let you into the school or not in—it is a very profound
decision that they hold in their hand.
Essays
One thing they look at is essays. If you Google “college essays,”
you get thousands. If you refine your search to people who will
ghostwrite a college essay for you for about $400, you get about
600. These essays, by the way, are referred to as “inspirational.”
What a crock. These are not inspirational essays at all and they
are useless in determining whether or not a candidate ought to
be in a university. In fact they are worse than useless; a school
might be keeping someone out of the classroom that really
deserves to be there, but that person’s seat is taken by a lazy
person with too much money and not enough energy.
Extracurricular Activities
Admission directors also look at extracurricular activities.
MEASUREMENTS
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Improving Services to PT
and PTA Programs
n the last few years, the Board of Directors has sought to
improve communications and services to an important
stakeholder, the academic community. A continuing goal
has been to strengthen collaborative relationships with the
academic community and a more specific goal in 2004
focused on identifying this community’s needs. Another
goal has been to develop and disseminate information about
the exam program.
I
2005 Survey of Academic Program Directors and
Faculty
In order to identify potential improvements in communications, delivery of services and opportunities for
new services to the academic community, the Federation
surveyed U.S. PT and PTA program directors and faculty
in 2005. Three hundred and eighteen people responded
to the survey. The feedback was useful, providing general
information about communications and more specific
feedback about the faculty newsletter; Federation websites,
the Practice Exam and Assessment Tool (PEAT), school
pass rate reports and the NPTE Workshop for Faculty
(originally called the Item Writing Workshop for Faculty).
Current Services
Although faculty consortiums
are not a direct result of the survey recommendations, they
do come under the heading of improved communications.
With questions from the North Carolina Board as our
starting point, Federation Board and staff developed a halfday program to discuss current exam issues with ten PT and
PTA programs in North Carolina. This format allowed for
lots of two-way discussion between participants. The Ohio
Board was next to request a similar meeting with programs
in its state.
The advantage of a Faculty Consortium is the ability to bring
a small group of educators face-to-face with jurisdiction staff
and Federation board and staff to discuss an agenda specifically
tailored to meet the group’s needs. We hope that more boards
will invite us to host a Faculty Consortium in the future.
FACULTY NEWSLETTER . FSBPT has been emailing
newsletters to PT and PTA program directors and faculty on
a quarterly basis since 2004. The newsletter was first sent to
FACULTY CONSORTIUMS.
program directors only, but its distribution was expanded in
2006 to include faculty members who would like to receive it.
FEDERATION WEBSITES. All faculty members have access
to the public website, www.fsbpt.org. Two sections of interest
to many faculty members are the section that lists up-todate contact information for physical therapy licensing
boards called Licensing Authorities, and another section
dedicated to Examination Information.
A second website for physical therapy program directors
can be linked to by clicking on Schools Home in the upper
right hand corner of the public website. Schools Home
requires a username and password to log on. This site is
where program directors can order pass rate reports for their
school. The website also includes copies of the Faculty
Newsletter and articles on exam development, exam security
and cheating issues.
NPTE WORKSHOP FOR FACULTY. The Federation has
been offering item writing workshops for physical therapist
and physical therapists assistant faculty for the last few
years. In 2004, we offered it at the Federation’s Annual
Meeting in Philadelphia, Pennsylvania and received positive
feedback from participants. The workshop focused on
improving item writing skills and understanding the exam
development process. Survey respondents also said they
would find this workshop valuable, so it was offered again
in 2005 and in 2006, the workshop was offered three times.
In 2007, the NPTE Workshop for Faculty will again be
offered at the same time as the Federation’s Annual Meeting
in Memphis, Tennessee at the Peabody Hotel. A second
workshop is planned for spring 2007. We will use monthly
Newsbriefs, the Federation Website and Faculty Newsletters
to provide more specific dates and registration information.
PRACTICE EXAM AND ASSESSMENT TOOL ( PEAT ).
The Federation offers exam candidates a preparation tool
called the Practice Exam and Assessment Tool or PEAT.
Information about PEAT can be found on the public
website under Examination Information.
SCHOOL REPORTS. School reports, which provide pass
rate reports for an individual school, are ordered through
the Schools Home website. At this time, there are three types
of reports: the basic subscription, the enhanced subscription
and the content area subscription.
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Basic Subscription
The basic subscription can be sent via mail or downloaded
via the website. It provides program pass rate information
for the past three years required by the Commission on
Accreditation in Physical Therapy Education (CAPTE). It
includes a list of names of students whose scores were used
to determine each year’s pass rate.
Enhanced Subscription
The enhanced subscription includes the same information
found in the basic subscription. In addition to student
names, though, it provides actual test scores for each
student, including scores on any retake if the student did
not pass the first time. Each student whose score is reported
has authorized the Federation to release their scores to the
school.
Content Area Subscription
The content area subscription allows a school to compare
how its program is doing in each content area of the exam
compared to all U.S. programs in aggregate. This can assist
program faculty in identifying strengths and weaknesses of
their program.
Current content areas for the physical therapist exam are:
■ Examination;
■ Evaluation, Diagnosis, Prognosis and Outcomes;
■ Interventions;
■ Standards of Care; and
■ System Specifications: Musculoskeletal, Neuromuscular,
Cardiovascular/Pulmonary, Integumentary and Other
(non-system specific).
Current content areas for the physical therapist assistant
exam are:
■ Test and Measures (Data Collection);
■ Intervention; and
■ Standards of Care; and
■ System Specifications: Musculoskeletal, Neuromuscular,
Cardiovascular/Pulmonary, Integumentary and Other
(non-system specific).
Faculty Advisory Task Force Convened
In order to gain additional insight into the survey results and
prioritize the suggestions for improvement, the Federation’s
Board of Directors appointed a Faculty Advisory Task Force
that met in February 2006 to review survey results in an
intense two-day session.
Task force members included Jim Carey, PT, Ph.D.
(University of Minnesota); Barbara Connolly, PT, Ed.D.
(University of Tennessee Health Science Center); Janice Haas,
PTA, B.A. (MercyHurst NE); Jim Kelley, PT, EMMDS (Villa
Maria College); Carol Patnode, PTA, M.A. (North Iowa Area
Community College); and Richard Segal, PT, Ph.D. (University
of North Carolina) along with two members of the FSBPT
Board of Directors and six staff members.
The task force provided some very specific recommendations
to improve the content and understandability of the school
reports, and clarify the purchasing process for the school
reports. They provided suggestions for improving the Schools
Home website, the candidate authorization to release scores,
the faculty newsletter and general communications.
Status of Task Force Recommendations
We have not completed the implementation of all of these
recommendations, but wanted to provide you with some of the
accomplishments so far. We’ll continue to update you in future
editions of the Federation Forum.
FACULTY NEWSLETTER . Based on feedback from survey and
task force participants, the purpose of the newsletter has been
expanded to include information about regulatory and security
issues. There are now regular sections—What Your Student
Needs to Know, This Quarter’s Question, which solicits and
answers questions from readers, Becoming Involved and
Contact Information.
The Faculty Newsletter and Newsflashes have been used to
solicit feedback on replacing candidates’ authorization to
release test scores to schools from a paper format (bubble
sheets) to an electronic format and eliminating the ”all” pass
rate from school reports. In addition, they have been used to
alert program directors that pass rate information has been
updated and that changes were made in PEAT’s performance
feedback report.
SCHOOLS HOME ( FACULTY ) WEBSITE AND SCHOOL PASS
RATE REPORTS. So far this year, we have been able to
improve the accuracy of pass rate reports through the ”My
Students” link on the Schools Home website and by preventing
students from erroneously changing their school codes when
registering for subsequent examinations, purchasing PEAT or
requesting score transfers.
IMPROVING SERVICES
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Page 10
am a member of the Board of Allied Health Professions in
Massachusetts. For the past eight years, we have been
offering the “Ten Easy Ways to Lose Your License”
program in Massachusetts. For the last four years, we have
been a standing program at the Massachusetts chapter level.
We get invited to the smaller district meetings as well and
lately, hospitals and facilities have been inviting us out to do
this as an educational program for them as part of their in
service education.
It continues to surprise me that there is such a need and
a call for the presentation. We simply offer the rules and
regulations, give an anecdotal story of why this is important
or why one should not do particular behaviors and explain
how not following the regulations could potentially cause
someone to lose a license or come before the board for
discipline.
I am going to walk you through what we have been doing
and offer it to you as a template if you want to go back to
your jurisdictions and adapt this to meet your needs. Once
or twice a year our board holds its meetings offsite; usually
one of the PT or PTA programs in the state will invite us to
come for the day. Students, faculty and staff can come and
go to the open portion of our board meetings. It is a nice
way for them to get to see the work of the board. We travel
with our full board, our legal counsel, our administrators and
our investigators. Somewhere in the middle of the day we
will put on an hour or hour and half program on the “Ten
Easy Ways to Lose Your License.”
This is a program that can be done by one person or the
whole board. If it is done by the whole board, everyone will
take a segment. We start with an overview of our division of
professional licensure, going through all the different offices
within our division. The board staff introduces themselves
and explains their roles.
These are the 10 things we cover in the “Ten Easy Ways to
Lose Your License.”
■ Sexual misconduct
■ Substance abuse
■ Professional discipline like criminal convictions or
unethical conduct
■ Fraud and misrepresentation
■ Patient abuse
■ Medication violations
■ Unethical behavior
■ Poor documentation or record keeping
■ Unlicensed practice
■ Boundary violations
I
Ten Easy Ways
to Lose Your
License
Kathleen Barnes
11/20/06
1:19 PM
Page 11
It continues to surprise me that there is such a need and a call for the presentation.
SEXUAL MISCONDUCT. It is important to send the message
that, “No, you may not have a sexual relationship with your
patient, especially a minor,” and to emphasize that this could
mean any sexual relationship such as inappropriate speech or
touching, gestures, etc. Keep in mind that the regulations are
going to vary from jurisdiction to jurisdiction. Therapists
also need to be reminded of patient misperceptions of
treatment; there are cultural, age or gender differences where
it is inappropriate to touch. These may be common-sense
things, but I am always amazed at the therapist who forgets
to obtain an informed consent.
SUBSTANCE ABUSE . Massachusetts has a professional
recovery system in place to work with therapists who have
an alcohol or drug dependency. We go through entrance
requirements for them to qualify for this program and tell
anecdotal stories about drinking that is not appropriate on
the job.
PROFESSIONAL DISCIPLINE . Lately there has been an
increase in creating false records for patients who do not exist
as well as creating false billing. We explain why it is wrong to
forge a patient’s signature on an informed consent or to falsify
staff signatures on insurance forms or checks. I also remind
therapists not to default on student loans because they will
lose their license. Be aware that a common response is “No
one ever told me that!”
Also, I had a student who had graduated six months ago,
and was practicing but had not yet applied for licensure in
the state. I told her supervisor, “You are in trouble with your
billing and anything that the student has done.” My colleague
just looked at me. Then I found out there were 20 others in
her class that had done the same thing. We now are trying to
wrestle with graduate practice. (We do not want to open up
temporary licensure again in our jurisdiction.) We are trying
to figure out how to work with the schools as well.
FRAUD AND MISREPRESENTATION. This involves
charging different fees for private payers versus insurance.
I am just amazed at this one. People will brazenly show us
that they have printed two different fee schedules. Also, if
they do have an insurance fees schedule, we will find them
coding for a different reimbursement. We have also found some
changing of treatment dates. We explain why that is a dumb
move. Someone may call for medical records and see that
there is a different handwriting or a different color pen or
something is squeezed in between the lines.
Some therapists claim ignorance on codes. They were using
the wrong codes for the wrong things and said things such as
“What do you mean I cannot do a hot pack and cold pack
and electric modality?” and “Why can I not go for all of those
because they are unbundling?”
We have also seen students come before us with false
college degrees. I guess you can go on the Internet and just
create your own transcripts and your own degrees. It just
amazes me that you cannot take degrees at face value; today
you really have to verify them.
PATIENT ABUSE . We talk about this in terms of responsibility.
If a person suspects abuse of patients, whether it is a child or a
spouse, he should look for signs and symptoms and know how
to report it. We reiterate that when working with the elderly,
there are a lot of potential malpractice cases where fractures have
occurred by therapists because they were not doing standard
practices of care while taking a proper course with that patient
and a fracture resulted.
MEDICATION VIOLATION. This is different in every state.
In Massachusetts, we cannot dispense or administer or provide
advice about medications beyond our scope. There are many
cases where a therapist has prescribed or told a patient to take
Advil or other medications that contradicted medications that
they were also taking.
UNETHICAL BEHAVIOR . We cannot discriminate against
age, race, religion or sex. I had a young lady from India who
was fine on Friday when she left school and somewhere over
the weekend had this epiphany that she was going to get her
tongue, nose, belly and ears pierced. This was part of her
culture, but she was working with cultures that did not accept
all of this. The debate was, do we tell her to remove all of the
body piercings or tell her not to work with those patients. I
got a call from her the next day and she asked if it was alright
if she took out all of the piercings before she went to work
and then put them back in at the end of the day. I said that
was probably in her best interest. Usually, however, the therapist
will say, “That was just discriminating against me. If I want to
have my tongue pierced that is my right and if you tell me
to take it out that is discrimination.” Of all the serious cases
concerning age, race, religion and sex, we still have to deal
with the question of tattoos! In Massachusetts, we suggest
to our facilities that they create their own dress codes and work
with their legal counsel to make sure that it is within the legal
parameters of the jurisdiction.
TEN
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The Fourth Edition
of the Model Practice Act
Peg Hiller and Christine Larson
There are more changes in this edition
than any of the three preceding editions.
Purpose of the Model Practice Act
In 1997 when the first edition of the Model Practice Act
(MPA) was published by the Federation of State Boards of
Physical Therapy, the preface stated the following:
The Model Practice Act for Physical Therapy: A Tool for
Public Protection and Legislative Change is the preeminent
standard and most effective tool available for revising and
modernizing physical therapy practice acts.
Since the initial edition, we have seen wide sweeping changes
in our environment, society, medicine and physical therapy.
The MPA has always been referred to as a work in progress and
the Fourth Edition speaks to that. There are more changes in
this edition than any of the three preceding editions.
Legislative Intent
There is a continuous movement within the states to update
physical therapy practice acts. Multiple states have added sections
from Article 1.01, Legislative Intent of the Model Practice Act,
which addresses the explicit desire of state legislatures to place
public interest first and foremost in the laws that regulate
physical therapy. Other jurisdictions have added language on
consumer rights and protection, while others have incorporated
provisions for licensees with substance abuse problems that need
immediate treatment, not immediate discipline. The MPA
supports jurisdictions as they work to ensure that they have the
legal authority to fully protect the public while allowing for the
effective regulation of the profession.
Simple Changes for Ease of Use
Some of the MPA changes are simple. Since examination
comes prior to licensure, the title of Article 3 put examination
first so that it reads Examination and Licensure instead of
Licensure and Examination. The language on cheating from the
Third Edition did not change, but the discipline options for
cheating were moved to the section on discipline, Article 4.04.
Denial of a License
Additionally, Article 4.04 was changed to include grounds for
denial of a license to applicants as well as disciplinary action
for applicants and licensees who violate the law and it was
renamed Grounds for Denial of a License [and Certificate];
Disciplinary Action from Grounds for Disciplinary Action.
Qualifications versus Requirements for Licensure
Just as there are 53 jurisdictions in the Federation, there are
53 different physical therapy practice acts. One of the changes
in the Fourth Edition is the creation of language that
distinguishes between the qualifications for licensure and
requirements for licensure. Qualifications, which are the
same in all 53 jurisdictions, are listed in Article 3.02,
Qualifications for Licensure [and Certification]:
■ Complete the application process including payment of
fees.
■ Submit proof of graduation from a professional physical
therapy education program accredited by a national
accreditation agency approved by the board.
■ Pass an examination approved by the board.
■ Meet the requirements established by board rule if
applicable.
Once the qualifications have been met, the requirements,
which should be written into each state’s rules, can address
more specific information about the applicant’s fitness to
practice such as good morale character, a required criminal
background check and other conduct that may constitute
grounds for the denial of a license.
New Exemptions from Licensure
Once the First Edition of the MPA was published, the Model
Practice Act Task Force was dissolved and the Ethics and
Legislation Committee began working to refine the language
of the MPA to meet the needs of the public related to
physical therapy practice. Although the committee has
worked to be proactive and anticipate the need for language
changes, many of those changes came about in response to
specific events. The Second Edition developed language
(sojourner laws) in Article 3.04, Exemptions from Licensure [or
Certification], to respond to physical therapists working at the
FOURTH EDITION
F C C P T U P D AT E
on page 18
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Security
1:19 PM
Page 13
Watch
Crime Doesn’t Pay
John M. Silverstein, Attorney, North Carolina Board of Physical Therapy Examiners
license to engage in the practice of a regulated
profession is a privilege available only to those who
have met specific statutory standards. In North
Carolina, the practice of physical therapy has been regulated
since 1951. The Physical Therapy Practice Act specifies the
qualifications that applicants for licensure must possess, and
the Board spends a considerable amount of time reviewing
applications for compliance with those requirements.
To a large degree, the Board must rely on the honesty and
integrity of the applicant to furnish truthful answers to the
questions on the application that determine eligibility for
licensure. Unfortunately, from time to time applicants
will furnish false or misleading responses to application
questions. Fortunately, the Board has mechanisms for
confirming whether responses are accurate for some
questions, such as requesting the number of times an
applicant has taken the examination, whether disciplinary
action has been imposed against the applicant in another
jurisdiction, or whether past criminal conduct has occurred.
Additionally, NCGS §90-270.29 (1) requires every
applicant for licensure to possess “good moral character.”
Furnishing false information or failing to furnish relevant
information is evidence of the absence of good moral
character. The Board is more likely to approve applicants
who disclose prior conduct with complete explanations of
how their character has been rehabilitated since the conduct
occurred than applicants who fail to disclose relevant
information that is requested on the application. Whenever
there is doubt as to whether particular information is
relevant, it is always better for the applicant to provide full
disclosure and let the Board make that determination than
for the applicant to determine the information is not
germane and then suffer the consequences when the Board
determines otherwise.
In rare instances, an applicant will submit fraudulent
documents in order to induce the Board to issue a license.
When discovered, such conduct not only ensures that the
application will be denied, but the Board will proceed with
criminal prosecution if that is warranted. For example, on
July 16, 2004, the Board received an Application for Physical
Therapist Licensure from a resident of North Carolina. The
application indicated that she had received her MPT in May
A
Unfortunately, from time to time
applicants will furnish false or
misleading responses to application
questions.
2004. The Board also received a Certification of Physical
Therapist Education that contained the seal and signature
of the director of the program. Based on the information
contained in the application, the Applicant was authorized to
sit for the examination, which she took on October 6, 2004,
but she did not receive a passing grade. The exam was repeated
on November 2, 2004, but the results still did not warrant
licensure.
In order to assist educational programs to monitor the
performance of their graduates on the examination, the
programs are furnished with examination scores for their
graduates. The Applicant’s scores were furnished to the
program from which she had allegedly graduated. On
December 14, 2004, the Board was advised by the Managing
Director of Examinations for the Federation of State Boards
of Physical Therapy (“FSBPT”) that the Applicant was not a
graduate of a physical therapy program, and that the program
director’s signature and embossed seal on the Certification
had been forged. On that same date, the Board advised the
Applicant that her eligibility to sit for the National Physical
Therapy Examination had been revoked.
This matter was referred to the Board’s Investigative
Committee which reviewed the application and conduct
more thoroughly, including documents from the test site and
interviews with the program director and the Applicant. In
April 2005, the information that the Investigative Committee
had compiled was forwarded to the District Attorney’s Fraud
Unit in the Applicant’s home county. After an additional
investigation by that unit, including an interview of the
Applicant, that agency declined to proceed with prosecution,
advising that the case should be prosecuted in Durham
County, which is where the application was received.
In October 2005, the Board’s Executive Director, Ben
Massey, met personally with the Durham County District
Attorney who reviewed the Board’s materials with Mr. Massey.
S E C U R I T Y WAT C H
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Academy of Advanced Item Writers
N AT I O N A L P H Y S I C A L T H E R A P Y E X A M I N AT I O N
n 2005, the Federation of State Boards
of Physical Therapy established the
Academy of Advanced Item Writers.
The purpose of the Academy is to provide
recognition to those item writers that have
gone well above and beyond the task asked
of them and have made significant contributions to the National Physical Therapy
Examination (NPTE) item bank. These
people have volunteered their time, energy
and resources to contribute to the enhancement of the NPTE program. As Academy
members, they automatically become
associate members of the Federation.
I
The criteria for membership into the
Academy is
1. Develop at least 60 items that are
approved by the Item Bank Review
Committee and are entered into the
item bank (and this is no easy task)
2. Attend at least one FSBPT beginning
item writing workshop
3. Fulfill content area assignments during
the item writing workshops
4. Be recommended by an item writer
coordinator
We were very fortunate to have twelve of the
2005/2006 inductees into the Academy at
the annual meeting in Portland, Oregon
on September 10, 2006. Please be sure to
congratulate all of these fine folks for the
work that they have done for the licensure
■
exam.
Eileen Bach, NY
Janet Crosier, DC
DJ Mattson, NY
James Scarpaci, IL
Ronald Barredo, TN
Carol Dionne, OK
Thomas Mohr, ND
Christopher Scott, WV
Peggy Block, KY
Phyllis GuarreraBowlby, NJ
Joan Morse, FL
Vicki Stemmons
Mercer, NC
Carol Brooks, VA
Nancy Henderson, WA
Sara Piva, PA
Kay Tasso, FL
Karen Cascardi, FL
Michael Jensen, MT
Janice Pollock, FL
Richard Woolf, AZ
Not pictured:
Nushka Remec, AZ
Jennifer Collins, NY
Pamela Leerar, WA
Rebecca Porter, IN
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Page 15
General Education in the
Coursework Evaluation Tool
he Federation developed the Coursework Evaluation
Tool for use by credentialing agencies to compare
foreign educated physical therapists’ academic courses
to courses taken by graduates of programs accredited by the
Commission on Accreditation in Physical Therapy Education
(CAPTE). The Tool provides credentialing agencies and
licensing authorities with a reliable, valid measure of a
foreign-educated physical therapist’s educational equivalence
to a CAPTE-accredited education.
In 2004, the Coursework Evaluation Tool was adjusted to
reflect current minimum credits in General Education to 54
semester credits. This number was based upon the minimum
credits of any U.S. accredited program reported in the APTA
Fact Sheet produced by the CAPTE Annual Report. The
report used to be published in May but beginning this year,
the report will be published in early 2007.
The CAPTE evaluative criteria which were set in place for
incoming classes after January 2006 require a minimum of six
terms of general education and six terms of professional
education. This is expected to result in a gradual increase in
General Education minimum requirements to 75-90 semester
credits, with a similar increase in the minimum requirements
for Professional Education credits.
The definition of General Education was clarified to be
“all non-physical therapy education completed, provided
these courses were taken at the college level from a recognized
T
educational program. These courses, both pre-professional
and post-professional education, may be used to fulfill the 54
credit requirements after the core courses have been met.”
The core course content areas remain the same as in prior
forms;
■ One course in humanities,
■ Two semesters in chemistry with lab,
■ Two semesters in physics with lab,
■ One course in biological sciences
■ One course in social sciences,
■ One course in psychology,
■ One course in mathematics.
The remaining courses are electives within any of these
categories.
General Education is required in the first professional
degree in physical therapy education in the United States to
demonstrate depth and breadth and a well-rounded basis of
educational knowledge. The acquisition of this knowledge
and demonstration of this educational basis can be obtained
in a number of ways. The candidate may attend classes at
any recognized or accredited college or university, they may
complete online coursework from a recognized college or
university or they may complete CLEP (College Level Exam
Program) examinations to demonstrate college level knowledge in
an area. For coursework to be considered, an official transcript
of record must be provided by the original source institution. ■
APTA Litigation Resolved
he American Physical Therapy Association and the Federation of State Boards of Physical Therapy are pleased to
announce that they have resolved their dispute over the fees for the National Physical Therapy Examination that
had been the subject of litigation. Under the terms of the settlement, the Examination fee will remain $350 through
2009, with set limits on any increases in the fee that may be instituted thereafter, through the expiration of the contract
between the Association and the Federation in 2014. The new terms ensure that the price to take the Examination remains
affordable for licensure candidates starting their careers in the profession, while providing appropriate revenue to support
the Federation’s continued development and administration of the Examination. “We think this is a fair resolution, and
we are confident that this agreement on Examination fees is in the best interests of our members and the physical therapy
profession,” said Federation President E. Dargan Ervin and Association President R. Scott Ward, adding that “we are glad
to put this dispute behind us, and plan to return the focus of our relationship to continued collaboration between our
organizations.”
T
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Page 16
Cheating in the News
NATIONAL PHYSICAL THERAPY EXAM NO
LONGER AVAILABLE OUTSIDE OF 50 STATES
AND DISTRICT OF COLUMBIA
Due to security concerns, candidates are no longer able to
take the NPTE at Prometric locations in U.S. territories
and Canada effective October 18, 2006. Candidates
already scheduled to take an exam in the U.S. territories
or Canada will be able to sit for the exam as scheduled.
All future examinations may be scheduled at any of the
approximately 300 testing centers in the United States,
including the District of Columbia.
LANGUAGE EXAMINATION CERTIFICATES
FAKED
On September 04, 2006, The Budapest Times reported
a flourishing trade in faked language exam certificates.
This is because Hungarian universities require students
to present a language certificate in order to graduate, but
do not independently test language skills of graduates.
How do students cheat on the language exam? As
one student wrote on an online forum: “Other types of
cheating are outdated, now you pay somebody to take
the exam for you.” Tiny earphones and micro-cameras
are used to dictate answers to students, costing around
$450 for an intermediate level exam and $588 for an
advanced level exam. In Hungary, this counts only as
a simple form of cheating, an “ethical offense,” so the
only risk for the candidate is that of being excluded
from the exam if they are discovered.
The oral exams cost around $680 and involve using a
double. According to Hungary’s Criminal Code, counterfeiting public documents could incur a three-year prison
sentence. This applies if someone uses a double for an
exam and submits the document as if it were theirs, as
well as to those selling this service, he said.
Examination centers in Budapest, however, were
skeptical. They receive incredibly detailed instructions
as to how the exams should be conducted: how many
invigilators (proctors) are needed, how far apart the
tables should be, what students can take into the exam
room with them. They are warned about what kind of
gadgets to look out for.
People at exam centers thought that using a double
would be virtually impossible. “Students have to prove
their identity on two occasions; if we are in doubt over
whether the person in the photo is the same as the
person wishing to take the exam, then we require that
they produce another form of identification with a more
recent photo.”
■
It’s In the Mail
The following items were sent to members since the summer 2006 issue of the Federation was published.
Please contact Maribeth Decker at 800-881-1430, ext. 227 or mdecker@fsbpt.org for a copy.
Monthly Newsbriefs—If you’re a jurisdiction board member or administrator, you should be receiving these every
month via email or fax.
Members:
Membership Survey—A huge thank you to all who participated! We exceeded all previous survey responses.
Delegates:
Link for the 2006 Delegate Assembly Minutes can be found in the October News Briefs.
PT and PTA Program Faculty:
Fall Faculty Newsletter
PT and PTA Program Directors:
Eliminating bubble sheets
PEAT Performance Review report
TEN
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Page 17
continued from page 11
Advertising can also constitute unethical behavior. I cannot
even read the newspaper for pleasure anymore because I see
ads where clinics are giving free treatment and free Game Boys
if people go to their clinic. This is not unfair, deceptive,
fraudulent or misleading advertisements if the services are
actually free. But you can not advertise “free” and then say,
“Oh, by the way we need your co-pay,” or “Oh, by the way,
that was just for this free screening; your real treatment is really
$100.” We even had people advertising for free services when
those services did not even exist.
POOR DOCUMENTATION. There is no excuse for not documenting properly. You can download guides for documentation
and reimbursement and there are several books and handbooks as
well, along with reference lists. Yet sometimes we find (1) if you
can read it, you are lucky (2) that there are just key elements—
there is no way you could reproduce or figure out what happened
and (3) there is no actual evidence/information to be found in the
documentation.
UNLICENSED PRACTICE . Ignorance is not acceptable.
Evidently, people think they can get away with not getting a
license and that insurance companies aren’t going to alert us
that there is billing activity under their name and number. I
often feel like I am in a reality comedy show about unethical
behavior. I’ll hear, “I moved into our neighboring states and so
I got a license there and I only travel back every now and then,
so I did not think I had to renew my Massachusetts’ license.”
Or, “I just forgot for ten years.” Massachusetts just went to a
birthday rule—you renew on your birthday. That may help.
BOUNDARY VIOLATIONS. We have an issue with aides
coming from other jurisdictions where they are permitted to do
more than they are allowed to do in Massachusetts and doing
basically what a PTA would do. We have a lot of PTAs that
cross borders, too, but what the PTA can do in each of the
New England states is very different.
These ten things, the Ten Easy Ways to Lose Your License, are
really ten common-sense things. You’d think everyone would know
them but we have been doing this for eight years on a regular basis
and I am often just shocked by the excuses, misinformation and
failure to accept responsibility. For eight years, the ten items have
remained the same, but you will probably see us altering this
top-ten list soon. Violation of HIPAA requirements is going to
■
probably bump something out.
S E C U R I T Y WAT C H
Security
Watch
Crime Doesn’t Pay
In January 2006, the matter was assigned to an Assistant
District Attorney, who contacted Mr. Massey to arrange an
interview with an investigator with the Fraud Department
of the Durham Police Department. After an additional
investigation, the Applicant was eventually served with
a summons charging her with (1) a violation of NCGS
§14-122.1, a misdemeanor that prohibits the furnishing of
fraudulent or forged materials to procure a license, and
(2) common law forgery, a felony. The Applicant recently
entered a plea that will defer prosecution so long as she
satisfies the requirements of her plea, which include 100
hours of community service and supervised probation for
12 months.
Although the Board has learned from this case that the
wheels of justice often turn very slowly, the Board feels that
its commitment toward prosecution has been justified. The
Board has communicated with other licensing boards to
advise them of the Applicant’s conduct in North Carolina,
and the FSBPT has been kept advised of the Board’s
proceedings against the Applicant.
The Board believes that a competent application process
is an integral element of preserving the integrity of the
practice of physical therapy in North Carolina. Applicants
who do not possess good moral character will be denied the
opportunity to sit for examination. Applicants who engage
in criminal conduct will be referred to the appropriate
authorities for criminal prosecution. To do anything less
would compromise the Board’s responsibility to protect the
■
public health, safety, and welfare.
Reprinted with permission from the North Carolina Board of
Physical Therapy Examiners Issue 36, Summer 2006.
Kathleen has thirty years of clinical experience in pediatrics and fourteen in
John M. Silverstein, Attorney, graduated from UNC-CH School of Law
higher education which allows her to integrate theory and practice. She is
in 1971 and has served as legal counsel for the North Carolina Board
a member of the Massachusetts Board of Allied Health Professions and
of Physical Therapy Examiners since 1977. He has participated in
has served as an alternate delegate or delegate since 2002. She is a
numerous lectures at PT Conferences and Seminars over the past 28
member of two task forces: The PTA licensure task force and the Referral
years.
for Financial Gain Task force. She also is a credentials reviewer for FCCPT.
Her interests are in ethical practice and regulation building upon her doctoral thesis and
professional activities.
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Page 18
2006 FSBPT Annual Meeting
September 7–11, 2006 • Portland, Oregon
“Bridges to the Future of Public Protection”
The use of the image of “bridges” for the 2006 annual meeting
theme illustrated our focus on the importance of licensing
boards staying connected to consumers and legislatures in order
to improve regulation.
This was the first year we funded alternate delegates to the annual
meeting in addition to our regularly funded voting delegates and
administrators. We were pleased to see how many jurisdictions took
advantage of this opportunity and sent an alternate delegate to the
annual meeting. We had 50 voting delegates registered, 40 alternate
delegates registered and 38 administrators registered. Thirty three
of our attendees were first timers!
Council of Board Administrators
The Council of Board Administrators met on Thursday
afternoon to discuss topics of interest and elected a new
Moderator and Recorder for 2007. You can read about their
meeting in the Admin Staff Corner.
National Physical Therapy Examination (NPTE)
Workshop for Faculty
For the third year in a row, we conducted an NPTE Workshop
for Faculty concurrently with the annual meeting. This workshop
gives faculty members a chance to improve item writing skills
and provides them with an overview of the NPTE exam development process. The workshop ran for two and a half days.
Pre-Meeting Workshops
There were four Pre-Meeting Workshops held on Friday. As
usual, all sessions were full. We will continue to offer these
full-day Pre-Meeting Workshops, although the topics may
change to meet future membership needs and interests.
1. Putting the Model Practice Act to Good Use
2. Foreign Education Credentialing for Regulation
3. Jurisdiction Boards, FSBPT and ADA: Who does what
and why?
4. Communication and Coaching for Managers
Saturday and Sunday’s Educational Sessions
Throughout Saturday and Sunday, we offered twenty educational
sessions, discussing various issues related to licensure and regulation.
One presentation was about a program that the state board of
Massachusetts presents to its licensees called “Ten Easy Ways to
Lose Your License.” You can read the article based on Kathleen
Barnes’ presentation in this Forum. Federation members can
find copies of many of the presentation on the Members Home
website. Once you’ve logged on, go to References/Meeting
Materials/Presentations.
You can order audio CDs of individual sessions or the whole
conference by going to http://www.softconference.com/260908.
Or download the order form by going to the FSBPT website,
www.fsbpt.org and clicking on “Publications.”
Awards
This year, we recognized a new category of award recipient—the
Academy of Advanced Item Writers. You can find a description
of this award plus the awardees’ names and faces in this Forum.
RICHARD MCDOUGALL LONG TERM SERVICE AWARD —
RONALD J. SEYMOUR , NEW YORK
This award was given to Ronald J. Seymour of New York for his
active involvement in Federation activities during the past ten
years, making a significant contribution of volunteer time,
talents, and service to the mission of the organization. Below is
a partial list of contributions he has made.
■ Physical Therapist Item Bank Review Committee from
1995–1998
■ Board Assessment Task Force from 1999–2001
■ Chair and member of the Education Committee from
2002–2004
■ NPTE Commission in 2003
■ Nominating Committee from 2005–2007
■ Chaired the Board Self Assessment Task Force in 2006
PRESIDENT ’ S AWARDS — GREGORY J. CIZEK , NORTH
CAROLINA
The President’s Award recognizes and honors those individuals
who, in the President’s opinion, have made significant, outstanding contributions to the Federation in the past year. Here’s
a review of some Gregory Cizek’s contributions during the past
few years.
■ Member of the 2003 NPTE Commission; Spoke about the
Commission’s Report at the Federation’s 2003 Annual
Meeting
■ Member of the NPTE Technical Advisory Panel from 2004
to present
11/20/06
“Mac” McDougall presents
Ronald J. Seymour with the
Richard McDougall Long
Term Service Award.
■
■
■
1:19 PM
Page 19
Pamela Robinson, Beverly Gordon and
Senora Simpson from the District of Columbia.
Spoke on the NPTE passing standard review at the 2005
APTA Combined Sections Meeting and 2005 FSBPT annual
meeting
Spoke at the 2005 North Carolina Faculty Consortium
Presented at the NPTE Workshop for Faculty in 2004,
2005 & 2006
Outstanding Service Awards
This award recognizes individuals what have made a significant
contribution to the Federation through their current volunteer
work. This year, the following people received Outstanding
Service Awards.
■ James D. Heider, Oregon
■ Peg Hiller, Arizona
■ Stephanie Lunning, Minnesota
■ Scott Romanowski, Georgia
■ Jeffrey M. Rosa, Ohio
■ Douglas White, Massachusetts
Motions
Three motions were passed by the Delegate Assembly this year.
■ Reaffirmed the Federation’s six Areas of Focus: Examinations;
Membership; States’ Rights, States’ Responsibilities and Professional Standards; Education; Leadership; and Organizational
and Financial Stability.
■ Corrected the recommended passing scores for reading comprehension (21) and Listening Comprehension (18) on the Test
of English as a Foreign Language (TOEFL iBT).
■ Supported a call for proposals and funding research to
investigate professional and business ownership issues
identified by the Referral for Financial Gain Task Force.
Mark Brown, attendee from
Louisiana and Mary Thompson,
delegate from Texas.
The 2006 Delegate Assembly
was held on Monday,
September 11th in
Portland, Oregon.
Election Results
This year, Kathy Fleischaker from Minnesota was re-elected
Treasurer; Tom Mohr from North Dakota was re-elected
Director; and Senora Simpson, from the District of Columbia
was re-elected Secretary on the Board of Directors. Stephanie
Lunning from Minnesota was elected as the newest member
of the Nominating Committee.
We would like to extend a big thank you to the members
who were also slated in this election. We salute their willingness
to take on a leadership role in the Federation: Don Chu from
California; Seth Coulter from Arkansas; and Judy White from
■
Wisconsin.
Next Year’s Meeting:
“Whole lotta
regulation goin’ on”
September 2007 • Memphis, Tennessee
It’s not too early to start planning for next year’s
meeting in Memphis at the famous Peabody Hotel from
September 6–10, 2007. We will continue to fund a voting
delegate, alternate delegate and administrator from each
member jurisdiction to the 2007 annual meeting.
We’d love to see more board members and administrators attend this meeting—those who attend regularly
will tell you that the reason they do is because it’s a
unique training and networking opportunity that you
just won’t find anywhere else.
11/20/06
C O O P E R AT I O N A N D T E A M W O R K
1:19 PM
Page 20
they listen? Do they try to understand the issue? Do they try
to help the board achieve the goal it intends? Do they move
cases in a timely manner? Do they respond to questions in a
timely manner? Are they willing to acknowledge when they
don’t know the answer and need to research an issue? Would
you hire this individual if you were paying the bill? Do you
trust this person?
If there are conflicts, talk about them. If there is an
irresolvable conflict, talk to the attorney’s supervisor. Some
statutes permit boards to hire outside counsel if there is a
disagreement between a board and its attorney.
Qualified Immunity
However, this immunity does not cover discovery or investigations. In those situations, qualified immunity applies.
This protects government officials from damage liability
unless their discretionary acts violate clearly established
statutory or constitutional rights. Qualified immunity exists
to curb the threat of damages and tort liability so government
officials are not deterred from performing with the decisiveness
and judgment the public requires. A good example is rulemaking,
which would never occur if officials did not have some type of
immunity in the process.
A Nebraska court recently ruled that qualified immunity
protects all but the plainly incompetent and those willing to
violate the law. In another state, the secretary for the racing
commission lost the board’s qualified immunity. A racetrack
veterinarian was doing a poor job and overcharging, so when
he came to renew his license, the commission held a hearing
and denied the renewal. The vet reapplied the following year
and, after a hearing, was denied again. He reapplied yet again
and was denied again—this time without a hearing. He sued,
alleging discrimination and bias because he was denied a
hearing. The court held the board secretary accountable and
said qualified immunity no longer existed due to incompetence
for not granting a hearing.
Attorney-Client Privileges
Remember, discussions between boards and attorneys are
attorney-client privileged. So, board members can use candor,
and depending on the open meetings law, can go into an
executive session to talk about matters that are attorney-client
privileged.
Determining the Quality of an Attorney
Questions to ask in determining attorney quality include: Do
Consent Orders
Consent orders are becoming more common. In the past, a
disciplinary action would go to an Administrative Law Judge
(ALJ) or be heard by the board. As states see the number
of complaints increase without commensurate increases in
resources, they are turning to consent orders where they are
able to sit down with the respondent and resolve the case
without having to go through the formal adjudicatory process.
Punishment or Remediation
Before relying on consent orders, a board really needs to clarify
its philosophy on sanctions. Do they want to punish, or
are they looking for remediation? If the goal is punishment,
consent orders are hard to craft. Few respondents are going
to willingly agree to be punished. If the goal is remediation,
a licensee will be more willing to sign a consent order.
A consent order is a contract to which both parties must
agree. So the board is not necessarily bound by the statute’s list
of disciplinary sanctions. Clarity is important to consent orders
so that the board staff person responsible for tracking or
monitoring the order can understand it.
In some states such as Colorado, boards are using such
sanctions as permanent revocation in which an individual agrees
never to seek re-licensure, or permanent denial in which an
applicant cannot reapply. Given that creativity is permitted,
perhaps it would be more appropriate in any given case to write
a consent order for a five-year suspension with remediation
rather than a revocation. Then the burden is on the licensee
to show he or she is fit to return to practice. Also, under a
suspension, the board maintains jurisdiction over the individual.
Admission
One tricky area with consent orders is the admission. Often,
a board complaint is accompanied by a malpractice suit, meaning
respondents are reluctant to sign a stipulation including admissions of fault. Boards want admissions to at least some of the
charges both to resolve the case and to establish a formal record
in case the licensee moves to another state.
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Questions
1. I have been legal counsel for my board for seven
years and if it were not for me, there would be no
continuity. Board members change, chairs change
and executive directors change. This highlights the
need for evaluation and strategic planning. Also,
with some boards, whenever the chair changes,
there are numerous investigations in the geographic
area where the new chair practices. Where do you
draw the line, not so much with discipline as with
policy, rulemaking, and declaratory judgments?
Continuity is important, especially at the
state level. That is one of the reasons I emphasized
trying to write things down, not just to have more
records, but to have tools such as a matrix for consent
orders—to give some continuity and guidance. On the
subject of influence or preferences that do not rise to
the level of legally-recognized bias, the first principle
is that the chair has only so much authority. To
reinforce group decision making, particularly when
there is a change in leadership of the board, any
proposals for new initiatives in rulemaking or declaratory judgments should be preceded by board
discussion preceded by a written statement of why
the initiative is important.
SAFRIET.
Continuity is always a problem. Staff and
attorneys can serve as a resource to point out what the
board has done in the past in similar situations. I am
concerned about the ideas of a chair wanting to issue
declaratory orders because the appearance of bias is
just as detrimental as actual bias because it destroys the
public trust.
HEUPEL .
2. My experience confirms that boards spend most of their
time on sex, drugs, rock and roll and lies. Data shows a high
correlation between hospital reporting and board disciplinary actions. How do you get hospitals to report when
they take restrictions?
SAFRIET. Once again, the question is balance. You have
institutions acting in self-interest and for altruistic motives
by wanting to help a practitioner improve. Unless there is
a mandatory reporting system which competes with peer
assessment and continuous quality improvement, the statutory
state v. federal conflict is quite difficult. The only thing I
know of is to keep informing the relevant actors of this
frustration. That is not only professional associations and the
hospitals, but also consumers. Consumers probably think
hospitals have an obligation to report—if they ever think
about licensing boards. If I were talking to a reporter, I would
explain that ultimately, our board’s job as monitor is impaired
by the hospitals’ refusal to provide information. Don’t blame
us, we don’t have the needed information.
I think this is the biggest struggle in regulatory law.
If you look at the percentage of complaints compared to licensees,
it is less than one percent. You know there is a lot more going on
out there. We have some mandatory reporting requirements, but
that does not generate more reports. Hospitals are reluctant to
report because it exposes them to liability. Their fear is that
lawyers will file class action suits because the hospital has some
rogue respiratory or physical therapist out of control. Try to
educate the profession and the public and try to convince people
in the profession to file complaints because there is a self-policing
■
component to professional licensing.
HEUPEL .
Kevin D. Heupel is a Program Director with the Colorado Department of Regulatory Agencies (DORA). He manages six licensing programs within DORA: Acupuncture,
Audiology/Hearing Aid Providers, Barbering and Cosmetology, Midwifery, Physical Therapy, and Respiratory Therapy. Prior to joining DORA in November 1991, Kevin
was an Assistant Attorney General for five years with the Colorado Office of the Attorney General. He prosecuted disciplinary actions against a variety of healthcare
licensees and served as general counsel to several licensing boards. Before going to law school, Kevin was a corporate accountant with NCR Corporation.
MEASUREMENTS
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Page 22
But the simple fact that your examination
—your licensure examination—is not the
philosopher’s stone does not diminish in
any way the value that it brings to the table.
There was a great Doonesbury article recently that showed a
young lady working on her college application and her dad is
looking over her shoulder.
She’s writing down soccer captain, student government
president, editor of a newspaper, and daddy is just proud as
can be. He pauses and looks down and says, “Founder and
president of the String Theory Appreciation Club?” She looks
up and says, “Oh, no, Daddy, that’s just one of my imaginary
clubs.” When it is okay to have imaginary clubs on resumes
and college applications? What kind of role model are we
playing? When does it not really have to be true; or does it
just have to resonate?
Grade Point Average
The third element of the application process is the GPA—the
grade point average. Grade inflation is the academy’s greatest
single retreat in years from responsibility to measure. On many
campuses, more than one-third of the student body is on the
dean’s list. How can that mean anything?
An Age of Entitlement
We are moving towards an age of entitlement and that scares
me. The College Board recently did a survey of 829,000
people, all high school seniors, and asked them to rate
themselves. Less than 1% thought they were below average.
Less than 1% thought they were below average in getting along
with people. And 60% saw themselves in the top 10% of
students! Even more amazing is that 25% percent of them
thought they were in the top 1%.
The harsh reality is that in this age of entitlement, teachers,
politicians and unions have found it is a whole lot more
expedient just to cave in rather than fight when it comes to
giving tough and honest assessments. This age of entitlement
is not going to end until each of us everywhere decides that
we are going to make it stop and take a stand against it.
Critics are often awarded celebrity status. I like to think of
them as actors without borders, and to my mind, critics are
a bit like eunuchs. They know there is a lot of exciting stuff
going on but they are unequipped by nature to participate.
I am really concerned about the critics of state and national
testing schemes. They argue that since many students are
faring poorly on these tests we should throw the tests out. It is
about the same as one weighing himself on January 3—he does
not like the measurement. Maybe we have to fix the body and
not the scale.
The State of Our Students
The latest national data are absolutely consistent on this.
Too many fourth graders at the national level have trouble
distinguishing even numbers from odd numbers. Too many
eighth-grade students cannot convert a fraction to a decimal.
The United States used to be the preeminent educational
center in the world. We are dramatically losing that edge
because as we lower standards, it becomes harder to compete
in a global space. Technology has made it very easy for people
from all over the world to compete. We have witnessed what
that did to the workforce and to our families and our friends
who lost positions to Ireland or China or India. In part, it is
because these people are getting better educated.
We are losing our scientific and mathematical and technological edges. One-third of American college degrees are
awarded in science and engineering and yet two-thirds of the
Chinese and Japanese degrees are awarded in science and
engineering. The trend is not a new one. The reality is that
today fewer and fewer foreigners are coming to this country
to study—and stay—in America and that is not a good thing.
If you go back and look at the Nobel prizes that have been
awarded in medicine and physiology to Americans since 1949,
40% went to scientists who were Americans but were born in
other lands. At the same period of time, 50% to 60% of
university degrees in science, engineering and computer science
were awarded to international students. Where will we be in
2025? That is what scares me.
The literacy of college graduates is falling apart. Only 31%
of college graduates are able to read a complex book and
extrapolate from it. It is stunning to me that more are applying
to school, fewer are graduating, and even those that do are
often leaving without sufficient skills such as reading a table
that explains the relationship between blood pressure and
physical activity. These are college grads. I do not know how
we are going to compete as we go forward.
Something that stunned me when I visited the Federation’s
website, www.fsbpt.org, was that you actually have a question,
“Why is it unethical to ask someone else for recalled questions?”
Why would you ever have to ask that question? Is that the
kind of candidate you want?
I read that some nurses in the Philippines were hiring
imposters to take the English test—the IELTS—International
11/20/06
1:19 PM
Page 23
English Language Testing System. We came across some
imposters ourselves two or three years ago. These imposters
would charge $5,000 to take our test for GMAT and get a very
high score. With the help of the FBI, the U.S. Postal Service,
the U.S. Attorney General and New York State District
Attorney, we were able to arrest five of the six; the other one is
still a fugitive. All of the schools that had received these scores
and these candidates were told exactly why we were canceling
the score. One candidate at a very well-known private school
had actually finished his first year of a two-year program and
he was working that summer for the dean preparing a curriculum on ethics. When the dean informed him that he was
going to be expelled, he said he was going to switch to another
program that did not require the test. He just assumed that he
could move into a program that did not require the test; he
thought it was only within the test that he was actually doing
anything wrong.
Miami University in Ohio is now taking action against 39
of its engineering graduates who paid someone to write their
thesis. Thirty nine. How long can we in the professions
continue to hold that bar up there?
Licensure Exams
I do not want to suggest for a moment that our tests can
adequately assess all the things that we want to measure
whether it is intellectual creativity and curiosity or compassion
or bedside manner or aesthetic value or all of those things.
I do not think for a minute that anyone should make a lifealtering decision in terms of a single number alone. But the
simple fact that your examination—your licensure examination
—is not the philosopher’s stone does not diminish in any way
the value that it brings to the table.
What you do every day matters. Everything adds a critical
piece of accurate, objective and valuable information to a
complex decision process to relate to a profession and to the
lives of patients. We have two choices. We can choose to be
the critic who points out how those who seek to improve our
professions and our licensure programs have failed by not
going far enough. Or we can live a life that matters. We can
bring our training, our intellect, our energy and our passion to
our discipline every single day and to every challenge that we
confront. We can strive valiantly and we can spend our lives
on a worthy cause, because I believe that measurement and
assessment is a truly worthy cause.
I go to work every morning believing that what I am doing
is contributing value to society and it is important for me to
feel that every morning. If at the end of our course, we do
come up a bit short and we have not enjoyed the triumphs of
high achievement, we will know that we dared greatly and we
will also know that what we did mattered, it mattered greatly.
It matters today, it matters tomorrow, and it matters most of
■
all to our kids.
David Wilson has been President and CEO of the Graduate Management Admission Council (GMAC®) since 1995. Prior to joining the Council, he was Managing Partner and National Director
of Professional Development for Ernst and Young LLP and has also served as faculty in a number of universities. Dr. Wilson received his BCom degree from Queen’s University, MBA from
the University of California-Berkeley, and Ph.D. from the University of Illinois. He has been published extensively, including four textbooks and numerous articles and cases. He is a frequent
speaker to business, professional, and academic groups and has received numerous awards.
IMPROVING SERVICES
However, so many good ideas were given to improve the
Schools Home website and pass rate reports that a general
renovation of both the website and pass rate reports is being
planned for implementation throughout 2007 and 2008. One
goal of this overhaul is to make purchasing and using pass rate
reports easier, along with providing more useful information in
the reports themselves. Another goal is to make more of the
Schools Home website accessible without having to log in,
although confidential information such as specific school pass
rate reports will kept in a password-protected section of the
Schools Home website.
More to Follow
We hope that this report has given you a better understanding
of the work the Federation has done and will be doing to
improve services to academic programs. The Board of Directors
pledges to provide members and stakeholders with updates as
these recommendations are implemented. Feel free to contact
the board or staff members about any of the information in
this article.
■
LEGAL NOTES
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Page 24
letterhead without cross references to his dual licensure,
never holding himself out as an LPA to his LPC clients, and
separate listings in the telephone books.
The licensee confirmed that at all times he was engaged
as an LPA, he worked under the supervision as required
by the law regulating psychology assistants. But, the licensee
admitted that when practicing as a LPC, he was not
supervised in such practice for a period of approximately
four years.
Eventually, the licensee informed the psychology board
that he wished to discontinue his LPA practice which
triggered an investigation by that board. The psychology
board found probable cause that the licensee had engaged
in activities in the scope of his LPC practice that required
supervision for an LPA. After an investigation and hearing,
the psychology board determined that
“if the activities [performed] meet the definition of those activities
requiring supervision under [the Psychology Practice Act,
licensee] is required to receive such supervision no matter under
which license he purports to be performing such activities.”
Based upon its findings, the board rejected the arguments
of the licensee that he “parsed out” his activities between his
LPA and LPC licenses. The board found wrongdoing and
placed the practitioner’s LPA license on probation for two
years. On appeal, the Superior Court affirmed the psychology
board and upheld the sanction. The licensee appealed the
matter to the Court of Appeals.
The appellate court identified the issue as whether
the Psychology Board can require an LPA licensee to be
supervised in his LPC practice by virtue of his LPA license,
despite the fact that such activities need not be supervised
under his LPC license. In its assessment, the appellate court
first examined the language of the Psychology Practice Act
which, in pertinent part, provides that the act precludes the
Psychology Board from preventing:
“qualified members of other professional groups from rendering
services consistent with their professional training and code of
ethics, provided they do not hold themselves out to the public by
any title or description stating or implying that they are psychologists or are licensed, certified, or registered to practice
psychology.”
Under the clear language of the statute, the court
questioned whether the Psychology Board was authorized by
the legislation to sanction its licensees for activities permitted
by another applicable practice act. The Psychology Board
argued that the Psychology Practice Act allows it to regulate
an LPC practice because the licensee opted to obtain licensure
as an LPA. Disagreeing, the court held that the statutory
language did not support empowering the Psychology Board in
such a manner.
The court also addressed the practical application of the
Psychology Board’s arguments stating that following such
logic would create harsh results. That is, licensees who held
dual licensure would be forced to adhere to the most
onerous requirements, even if the practice fell squarely
within the practice act of the additional license.
The court also opined that a licensee under the Psychology Board’s arguments would unfairly be forced to
surrender his license if he wished to engage in an LPC
practice or face disciplinary action by the Psychology Board.
Finally, the court held that the Psychology Board’s
interpretation would be in conflict with the plain language
of the statute. It stated that the licensee’s activities fell
within both practices and the court could not state that his
activities are “principally psychology any more than [the
court] could say his activities are principally counseling.”
Based upon it findings, the appellate court held that the
Psychology Board did not have the authority to discipline
an LPA for activities of an LPC permitted under the
counseling statutes. Thus it reversed the lower court and
board and remanded the matter to vacate the disciplinary
action.
Boards of physical therapy must understand their powers
and responsibilities and identify under what circumstances
they may discipline individuals for acts or omissions that
may fall outside the physical therapy practice, but within
the scope of another act. An issue likely on the horizon
includes the authority of the physical therapy board to
discipline a licensee for the unlicensed practice of another
■
profession. Stay tuned.
Trayford v. North Carolina Psychology Board, 619 S.E. 2d 862
(App. Ct. NC 2005)
FOURTH EDITION
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summer Olympics in Atlanta. The Fourth
Edition has added more exemption language,
respectfully referred to as the 9/11 and the
Katrina exemptions. The 9/11 exemption (3.04.6)
allows licensed physical therapists to go into a state to provide
physical therapy following a declared disaster; the Katrina
exemption (3.04.7) allows licensed physical therapists to leave
their home state where a disaster has been declared and seek
work in another state.
Lawful and Ethical Practice
‘Lawful practice’ is addressed in two sections of the MPA:
Patient Care Management (Article 4.03) and Grounds for Denial
of a License [and Certificate]; Disciplinary Action (Article 4.04).
The authority to practice is stated multiple times within the
MPA but the language developed in Article 4.01 is the only
section that addresses Ethical Practice. The ‘recognized
standards or ethics’ establishes ethical conduct as the minimum
standard of practice. As stated in the MPA commentary:
“This language establishes that ethical conduct in the state is
legally mandated as the minimum standard of lawful practice.
Inclusion of this language empowers a board to be more than the
“gatekeepers” or “hand-slappers” some feel is the historical and
only duty of licensing boards.”
Use of Titles and Terms
One of the places where it is evident that the MPA continues
to respond to the professional environment is in the edits to
Article 4.02, Use of Titles and Terms; Restrictions; Classification
of Violation. The language requires that a licensed physical
therapist “shall use the letters ‘PT’ immediately following his
or her name to designate licensure under this [act].” ‘PT’ is the
professional and regulatory designation required by practice
acts and used by physical therapists in this country. Although
the initials ‘DPT’ are protected, the legal
designator remains ‘PT.’ The MPA prohibits
the substitution of any letters following the name
of the physical therapist but does not restrict the
addition of academic degrees, professional degrees, certifications or honorary status.
Treatment Intervention
In Article 4.03, Patient Care Management as well as Article
1.02, Definitions, Paragraph D, “Practice of physical therapy,”
the term ‘therapeutic treatment’ was changed to ‘treatment
intervention.’ This language was changed to strengthen the
notion that physical therapists are professionally and legally
responsible for all the treatment interventions they personally
render as well as all those components of intervention rendered
by those under the supervision of the physical therapist. This
supports the concept that the physical therapist is responsible
for all of the treatment interventions, not just the ones
considered to be ‘therapeutic’ interventions.
Rights of Consumers
There were some minor changes to Article 4.12, Rights of
Consumers, which is the final section in the Model Practice
Act. The language has always had a provision where a licensee
had to “display a copy of their license in a location accessible
to the public.” The Fourth Edition added language that the
licensee “produce a copy immediately upon request,” which
addresses licensees who work in a private setting such as the
home health physical therapist. Further changes to strengthen
the language on consumer rights are seen in the addition of
language which provides a requirement that “Each licensee [and
certificate holder] shall provide the public with information on
how to file a complaint with the board against a licensee [or
■
certificate holder].”
You can find the Fourth Edition of the Model Practice Act on our public website, www.fsbpt.org, under Professional Standards/MPA.
Peg Hiller, PT, received her bachelor?s degree and certificate in physical therapy from the University of Michigan in 1972. In 1974 she moved to Arizona and began her 30year career in clinical practice and Association leadership. She has worked in a variety of in-patient and outpatient settings developing her skills in manual physical therapy
practice. For the past four years Peg has worked as the investigator and compliance officer for the Arizona State Board of Physical Therapy. In addition to her roles in
complaint investigations and compliance monitoring, Peg has developed educational programs for students and physical therapy practitioners about lawful practice in
Arizona. She has served on the FSBPT’s 2002 Membership Survey Task Force, and last year authored an article for the Federation Forum about collaboration between
regulatory boards and professional associations.
Peg has served in a variety of APTA and Arizona Chapter leadership positions since 1976, culminating in her term as Arizona Chapter President in 1998-1999. She has served on the APTA
Committee on Chapters, and was appointed to the APTA Vision 2020 Task Force and the APTA Direct Access Task Force. Peg currently is a member of the APTA Ethics and Judicial Committee
and chairs the FSBPT Ethics and Legislation Committee.
Christine A. Larson, PT, was the Federation’s Director of Professional Standards. She has more than ten years of experience as a Washington State Board of Physical Therapy
member, and an equal amount of experience in the Federation, as Washington’s delegate to the Delegate Assembly and as member of the Model Practice Act Task Force,
Ethics and Standards of Practice Committee and Legislative Committee. She also served as secretary on the FSBPT Board of Directors.
PRESIDENT
11/20/06
1:19 PM
Page 26
Defendants’ willful and egregious copyright infringement harmed the public as well as plaintiffs.
Then NABP President John A. Fiacco stated, “Upon learning
of this serious breach of security, NABP, in keeping with its
responsibility of aiding the state boards in the protection of
public safety and welfare, initiated a large-scale investigation and
will pursue all workable remedies to the fullest extent as permitted
by law…”
The NABP® did not offer the FPGEE® again until June 21,
2003. At that time, it was offered as a pencil-and-paper exam in
four United States locations. NPBP® administered the second
successful paper-and-pencil exam on December 6, 2003 in three
United States locations. NABP® did not declare that they were
“fully recovered” from the initial breach of security until May
2004. It now offers the paper-and-pencil FPGEE® twice a year,
in June and December at two to three United States locations only.
Like our own NPTE, the NABP® sees the FPGEE® as a
critical component of public protection. Both organizations have
invested time and resources to bring the copyright violators to
justice and ensure ongoing security of the examination tool.
MBE Wins $11.9 Million from Test Prep Company for
Illegally Copied Questions
Just this past summer, a federal judge found that a test preparation
company for the Multistate Bar Examination (MBE) had illegally
copied questions from the test to use in its bar exam preparation
program. The test preparation company was ordered to pay $11.9
Million to the National Conference of Bar Examiners (NCBE).
In the suit, NCBE claimed that employees of Multistate Legal
Studies Inc. attended bar exams in several states for the sole
purpose of copying, or mining, questions to be used in its prep
courses. In one instance, a prep company employee had taken
the examination up to 20 times in a jurisdiction that did not
have a limit on the number of times that an applicant can take
the test. Testimonials from program attendees that were used
on company brochures included “dozens of nearly identical
questions appeared on the actual exam,” and one stated that
he “breezed through the exam because I recognized so many
of the questions…”
Eastern District of Pennsylvania Judge John P. Fullam concluded
that the test preparation company had compromised the integrity
of the examination and may have assisted unqualified lawyers pass
the bar. Judge Fullam wrote that the “Defendants’ willful and
egregious copyright infringement harmed the public as well
as plaintiffs. States have a compelling interest in regulating
admission to the bar both to maintain the integrity of the legal
system and to protect the safety of their citizens,” and that “by
exposing its students to questions likely to appear on the MBE,
[the defendants] undermined the integrity of the bar examination,
possibly causing the admission of unqualified applicants.” And
“that the victims of this harm are impossible to identify and the
injury impossible to quantify underscores the need to deter
would-be copyright infringers.”
It is too sad to see the lengths that test preparation companies
and test takers will go to pass a licensure examination. We have
seen it in the past with our own NPTE and continue to see
it happen with other testing organizations. Both the testing
company and the jurisdictions have a role in protecting licensure
examinations by bringing copyright violators to justice and
disciplining licensure applicants or licensees that collect, share
or utilize recalled copyrighted test questions.
In his address at our FSBPT Annual Meeting in Portland,
Oregon, David Wilson, President and CEO of the Graduate
Management Admission Council stated “one of the things that
stunned me when I visited your website was that you actually
have a question ‘why is it unethical to ask someone else for
recalled questions?’ Why would you ever have to ask that
question? Is that the kind of candidate we want?” The NPTE
is just a piece but a vital piece in determining competency and
plays a role in public protection. He points out that the “test
that you create … does matter. What you do every day matters…
everything that you do adds a critical piece of accurate, objective,
and valuable information to a complex decision process to relate
to a profession and relates to the lives of patients like me.”
Each of us must take steps to protect the licensure examination. That may mean taking on arduous and difficult tasks
related to disciplining licensees and seeking legal recourse against
individuals and companies that have violated copyright law. We
strive to be effective in protecting the examination and there is
good reason to do so. In closing, Mr. Wilson brought this home
by stating, “what all of us… each of you in this room and what
I do matters—it matters greatly, it matters today, it matters
tomorrow, and it matters most of all to our kids.”
The FSBPT will continue to stress examination security and
be ever watchful for those that would violate copyright law by
mining and sharing copyrighted examination items. Both the
Federation and the jurisdictions have a role in responding to
these security breaches and bringing appropriate consequences
■
to those that endanger public protection by doing so.
11/20/06
1:19 PM
Page 27
F S B P T D E L E G AT E A S S E M B LY E L E C T I O N S • S E P T E M B E R 2 0 0 7
CALL FOR NOMINATIONS
Positions available:
■
President
■
Vice President
■
Member of the Nominating Committee
The leadership of our Federation is a serious matter to all physical therapy licensing authorities. As a Federation, we have
been very fortunate to have leaders who not only are capable of dealing with priority matters, but also are willing to share
their talents, abilities, and a good amount of time to the future goals of the Federation.
We pledge to act in a responsible manner in selecting a slate of candidates for the 2007 elections. We encourage you to
send us the names of members who you believe would best serve the Federation. In thinking about the eligible members to
nominate, please look at the criteria we use in selecting candidates.
We encourage self-nomination; do not hesitate to put your own name on the list. The Federation deserves the very best
candidates, and we do not want to miss an opportunity to provide the best slate possible for the membership.
FSBPT Nominating Committee
Ron Seymour, Chair, Jeanne DeKrey, Stephanie Lunning
C R I T E R I A F O R S L AT E D C A N D I D AT E S
A.
Eligible and willing to serve, if elected.
B.
Able to attend Committee Chair Planning
Meeting: June 1–4, 2007 in Alexandria, Va.
C.
Experience related to the Federation:
■ Offices held, committee appointments
■ Demonstrated effectiveness in elected office or
appointed position
■
D.
Active or past member or administrator of
a licensure board
Personal characteristics:
■ Leadership skills
■ Decision-making skills
■ Consensus-building skills; team player
■ Ability to think and express self clearly
■ Ability to meet deadlines/goals/objectives
■ Parliamentary procedure/knowledge/experience
■
I suggest the following individuals
be considered for nomination:
Position
Name
Email address
Daytime phone
Present understanding of critical licensure issues
E.
Geographical location of recommended
nominee
F.
Professional experience of recommended
nominee:
■ Past as well as present experience
■ Current positions held
■ Area of primary work
Member making nomination
Email address
Daytime phone
G. Specific offices for 2007 election:
■
President and Vice President: Member or former
member of a Member Board.
■
Nominating Committee: Widespread knowledge
of the membership; identification of leadership
capabilities; and knowledge of Federation bylaws,
functions, and responsibilities.
Directions: Email nominations to the Nominating Committee
at nominating@fsbpt.org or fax to the Nominating Committee’s
attention at 800-981-3031.
11/20/06
1:19 PM
Page b
Federation of State Boards of Physical Therapy
509 Wythe Street
Alexandria, VA 22314
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COOPERATION AND TEAMWORK - The Federation of State Boards of

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