COOPERATION AND TEAMWORK - The Federation of State Boards of
Transcription
COOPERATION AND TEAMWORK - The Federation of State Boards of
FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 1 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 FORUMFinal_fall2006.qxd federation 11/20/06 1:19 PM 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 IBRC/EDC PT • Alexandria, VA 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 IBRC/EDC PT • Alexandria, VA 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 Item Writing Workshop • Alexandria, VA © 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 Item Writing Workshop • Alexandria, VA 2008 SEPTEMBER 11–15 2 • Volume 21, Number 3 FSBPT Annual Meeting • Minneapolis, MN FORUMFinal_fall2006.qxd president’s 11/20/06 1:19 PM Page 3 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 continued on page 26 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 FORUMFinal_fall2006.qxd 11/20/06 administrative staff 1:19 PM Page 4 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. 4 • Volume 21, Number 3 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 5 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 continued on page 24 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. Federation Forum • 5 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 6 Measurement Matters David Wilson 6 • Volume 21, Number 3 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 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 7 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 continued on page 22 Federation Forum • 7 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 8 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. 8 • Volume 21, Number 3 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. FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 9 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 continued on page 23 Federation Forum • 9 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM 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 10 • Volume 21, Number 3 FORUMFinal_fall2006.qxd 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 continued on page 17 Federation Forum • 11 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 12 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 continued on page 25 12 • Volume 21, Number 3 F C C P T U P D AT E on page 18 FORUMFinal_fall2006.qxd 11/20/06 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 continued on page 17 Federation Forum • 13 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 14 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. 14 • Volume 21, Number 3 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 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM 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 Federation Forum • 15 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM 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 [email protected] 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 16 • Volume 21, Number 3 FORUMFinal_fall2006.qxd TEN 11/20/06 1:19 PM 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 continued from page 13 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. Federation Forum • 17 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM 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 18 • Volume 21, Number 3 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 FORUMFinal_fall2006.qxd 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. Federation Forum • 19 FORUMFinal_fall2006.qxd 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 continued from page 1 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 20 • Volume 21, Number 3 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. FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page 21 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. Federation Forum • 21 FORUMFinal_fall2006.qxd MEASUREMENTS 11/20/06 1:19 PM Page 22 continued from page 7 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 22 • Volume 20, Number 3 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 FORUMFinal_fall2006.qxd 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 continued from page 9 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. ■ Federation Forum • 23 FORUMFinal_fall2006.qxd LEGAL NOTES 11/20/06 1:19 PM Page 24 continued from page 5 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.” 24 • Volume 21, Number 3 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) FORUMFinal_fall2006.qxd FOURTH EDITION 11/20/06 1:19 PM Page 25 continued from page 12 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. Federation Forum • 25 FORUMFinal_fall2006.qxd PRESIDENT 11/20/06 1:19 PM Page 26 continued from page 3 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 26 • Volume 20, Number 3 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. FORUMFinal_fall2006.qxd 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 [email protected] or fax to the Nominating Committee’s attention at 800-981-3031. Federation Forum • 27 FORUMFinal_fall2006.qxd 11/20/06 1:19 PM Page b Federation of State Boards of Physical Therapy 509 Wythe Street Alexandria, VA 22314 PRESORTED FIRST-CLASS MAIL U.S. POSTAGE PAID 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 FIRST CLASS PERMIT NO. 4705 SUBURBAN, MD f