UNDERSTANDING THE MICHIGAN BOARD OF NURSING

1
UNDERSTANDING THE MICHIGAN BOARD OF NURSING

• Kathleen Lavery, MS, CNM
• Chair, Michigan Board of Nursing
• (appreciation to Margie Clark, initial author)

2
LEARNING OBJECTIVES

• Describe the role, function and governance of the
  Michigan Board of Nursing.
• To identify nurses individual responsibilities
  regarding regulation of nurses in Michigan
• To inform nurses about opportunities and
  resources.

3
BUREAU OF HEALTH PROFESSIONS

• Department of Licensing and Regulatory Affairs
• 25 Health Boards
• 36 Health Professions
• Approximately 390,000 Licensees
• 138,035 RNs, 7,277 Nurse Specialists and 28,222
  LPNs

4
PUBLIC HEALTH CODE ARTICLE 15 OCCUPATIONS

• OSTEOPATHIC MEDICINE AND SURGERY
• PHARMACY
• PHYSICIANS ASSISTANTS
• PHYSICAL THERAPY
• PODIATRIC MEDICINE AND SURGERY
• PSYCHOLOGY
• RESPIRATORY THERAPISTS
• SANITARIANS
• SPEECH-LANGUAGE PATHOLOGY
• SOCIAL WORK
• VETERINARY MEDICINE
• Federal Legislation Mandates
• NURSE AIDE REGISTRY

• ACUPUNCTURE
• ATHLETIC TRAINERS (New 12/06)
• AUDIOLOGY
• CHIROPRACTIC
• COUNSELING
• DENTISTRY
• DIETETICS NUTRITION (New7/07)
• MARRIAGE AND FAMILY THERAPY
• MASSAGE THERAPY
• MEDICINE
• NURSING
• NURSING HOME ADMINISTRATORS
• OCCUPATIONAL THERAPY
• OPTOMETRY

5
BOARD ROLE

• Licensing
• Rule Promulgation
• Regulatory Role
• Health Policy and Legislation

6
BOARD OF NURSING

• 23 voting members
• 9 registered professional nurses
• 1 nurse midwife
• 1 nurse anesthetist
• 1 nurse practitioner
• 3 licensed practical nurses
• 8 public members

7
BOARD MEMBERS

• Board members are appointed by the Governor
• Required to complete oath of office
• Must meet one of the defined categories specified
  by law
• Reimbursed for travel expenses only
• Meet for 1-2 days six times per year with a
  possible additional day each month
• Have disciplinary case materials to review before
  each board meeting

8
DISCIPLINARY SUBCOMMITTEE (DSC)

• Composed of 2 Public Members and 3 Professional
  Members
• Chaired by Public Member Appointed by Board
  Chairperson
• Responsible for Final Determination of Violations
  of the Public Health Code and Imposition of
  Sanctions

9
Licensing information
10
LICENSE PERIOD

• Nursing license for any level expires on March
  31, even or odd years
• Initial license valid for up to 1 year
• Subsequent licenses for 2 years

11
RENEWAL NOTICES

• Sent 45 days prior to the expiration date
• Mailed to last address on our database
• Responsibility for renewal lies with licensee
  also address updates
• CE completed before renewal fee submitted
  renewal form is a legal certification that the CE
  has been completed

12
RETURNED RENEWAL NOTICES

• If returned, staff check database to verify
  address
• If new address is available, renewal application
  is forwarded
• If new address is not available, wait for contact
  from the licensee YOU must pay attention to your
  renewal cycle and maintain current address with
  the department

13
GRACE PERIOD

• PHC 333.16201 (2) 60 day grace period after
  expiration date
• Can continue to practice in grace period
• If fail to renew, license officially lapses after
  5 pm on May 30 but website shows March 31 as
  expiration date
• Once license expires, have to apply for
  relicensure

14
RENEWAL VS RELICENSURE

• RENEWAL - continuation of a license for a person
  based on completion of requirements for renewal
  within the time limits set by law
• RELICENSURE - granting of a license to a person
  whose license has lapsed for failure to renew the
  license within 60 days after the expiration date

15
RELICENSURE PROCESS

• Application and fee
• Submit proof of 25 hours of CE within 2 years of
  application submission
• Verification of licensure and disciplinary status
  in other states
• Will issue license until next expiration date only

16
CONTINUING EDUCATION REQUIREMENTS- RN or LPN

• 25 hours in board approved activities in 2 year
  license cycle
• At least 1 hour in pain and symptom management
• Submission of renewal is statement that
  continuing education is completed
• Check website for more information
• Michigan.gov/LARA

17
OTHER STATE REQUIREMENTS

• 23 Boards currently require CE
• 10 require 30 hours in 2 years
• 2 require 25 hours in 2 years
• 3 require 24 hours in 2 years
• 1 requires 36 hours in 3 years
• 4 require 20 hours in 2 years
• 3 require 15 in 2 years
• Additional information can be found at
  www.learningext.com/resources/cerequirements.asp

18
Advanced Practice Renewal

• Must either renew or maintain national
  certification during the two year cycle
• This can include 25-40 hours of Continuing
  Education and other activities/exams
• Two year renewal versus five year cycles for
  Certification
• You verify that you are currently Certified and
  meeting their requirements

19
CE AUDIT

• Randomly Select Renewed Licensees
• Require Copies Of Approved CE
• Failure To Meet CE Requirement Results in
  Complaint
• Possible Sanction Fine, CE, Probation
• Permanent Complaint Record

20
DISCLOSURES REQUIRED

• Felony conviction of any kind
• Misdemeanor conviction resulting in imprisonment
• Misdemeanor conviction involving illegal
  delivery, possession, use of alcohol or
  controlled substances
• Loss of privileges to practice
• Loss of license (including other states)
• Conviction regarding vulnerable populations,
  criminal sexual conduct

21
WHAT HAPPENS?

• Positive responses reviewed
• Documentation may be requested, such as court
  documents.
• Decisions
• Approved
• Denied not eligible for licensure
• Notice of Intent to Deny (NOID)
• hearing to determine fitness for licensure
• Board makes final decision and can impose
  limitations
• Failure to report is a violation of the PHC

22
HPRP

• Health Professional Recovery Program
• Assist Health Professionals With Substance Abuse
  and Mental Health Problems
• Voluntary Admission to Program (self or employer
  referral) (confidential if successful)
• Required Involvement Through Disciplinary Process
  (requires reporting)

23
LICENSING DIVISION CONTACTS
24
www. michigan.gov/healthlicense

• Applications
• Public Health Code and Administrative Rules
• Questions and Answers
• Board members and meeting dates
• CE information
• Health Alert/HeathLink
• Disciplinary Action Reports
• How to file a complaint

25
GENERAL QUESTIONS

• Check website for information
• bhpinfo_at_michigan.gov
• Call 517-335-0918 with questions
• General application process
• Application status of individual (need social
  security number)
• How to get copy of applications, laws and rules,
  board meeting schedule, complaint form, FOIA
  request
• Scope of practice issues

26
SCOPE OF PRACTICE ISSUES

• Bureau staff will refer to Public Health Code and
  Administrative Rules
• Michigan does not have Practice Act that
  defines each task that can be done
• Suggest contact employer or attorney for
  assistance
• Consider what is standard of practice
• Consider your own skill level, what is safe for
  your patients in your circumstance just because
  someone tells you to, doesnt mean you can

27
Delegation Of Duties

• May Delegate Some Duties To Person Qualified By
  Experience, Training or Education
• Consider Prevailing Standard of Care
• If Others Trained To Perform Task Routinely, Must
  Use Trained Professional
• Supervisor Ultimately Responsible For Actions
  Performed By Self Or Staff YOU are responsible
  for what you delegate to others

28
COMPLAINTS DISCIPLINE
29
PROCESS

• Allegation report of possible violation of
  Public Health Code
• Investigation collect information and records
• Administrative
• Consent order and stipulation (informal agreement
  between board and licensee with department
  assistance)
• Administrative hearing (formal quasi court
  setting)
• Review and disposition final action by
  Disciplinary SubCommittee or Board
• Appeal ability of licensee to ask for second
  review

30
SOURCE OF ALLEGATIONS

• Citizens
• Complaint Allegation Division
• Licensing Division
• Colleague/peer
• Sister states
• Hospitals/employer reporting (ALL terminations
  plus other concerns)
• Attorney General
• Other sources

31
COMPLIANCE CONFERENCE

• Case Facts Reviewed by Parties with AG or Bureau
  Staff and Board Conferee
• Settle with Consent Order and Stipulation
• Board Conferee will Participate in Formulating
  the Proposed Consent Order and Stipulation
• If No Agreement is Reached, an Administrative
  Hearing is Scheduled

32
HEARING

• Licensee vs State with Attorney General Serving
  as Prosecutor
• You May Hire an Attorney to Represent You
• Case Facts Presented By Both Parties for
  Consideration by Administrative Law Judge (ALJ)
• ALJ Writes Proposal for Decision
• Proposal Then Goes to DSC or Full Board for
  Consideration and Action

33
ROLE OF THE DISCIPLINARY SUBCOMMITTEE (DSC)

• Determination of Sanctions
• Reclassification of Disciplined Licenses
• Reconsideration of DSC Decisions
• Dismissal of Complaints

34
ACCESS TO DISCIPLINARY INFORMATION

• Disciplinary Action Report (DAR) available on
  website
• Administrative documents can be obtained under
  the Freedom of Information Act

35
FREEDOM OF INFORMATION REQUEST

• Freedom of Information Coordinator
• Dept. of Community Health
• Bureau of Health Services
• P.O. Box 30670
• Lansing, Mi 48909
• Fax [phone]

36
National Council of State Boards of Nursing
(NCSBN)

• National resources regarding nursing practice and
  regulation
• Campaign for Consensus regarding Advanced
  Practice Regulation
• Social Media, Boundaries, Continuing Education,
  Disciplinary actions, national registry (nursys)
• www.learningext.org www.ncsbn.org

37
QUESTIONS?
38
NEW LICENSEE INFORMATION
39
APPLICATION PROCESSING
40
APPLICATION PROCESS

• Request Application
• Download application from www.michigan.gov/healthl
  icense
• Call 517-335-0918, follow prompts
• Email application request to bhpinfo_at_michigan.gov
  
• Must submit original application and document on
  paper
• Cannot accept faxed documents for original file
• Must pay by check or money order

41
FILE SET-UP

• Supporting documents are filed alphabetically
• Application and fee start physical file folder
• Supporting documents are placed in folder
• Review by processor
• Identify missing elements
• Second review upon receipt of new material
• Periodic check on file status as time permits

42
CHECKING STATUS OF APPLICATION

• Upon entry of application in database, letter is
  sent to applicant with customer number
• Check application status at www.michigan.gov/appst
  atus - need customer number to check

43
PROCESSING TIME APPLICATION

• Weeks 1 2 application and fee received
• Weeks 3 4 application entered in database and
  reviewed letter may be sent to applicant
• Weeks 5 6 final approval and paper license
  processed and mailed

44
FACTORS AFFECTING PROCESSING TIME

• Time of the year higher number of new
  applications, slower process
• Timeliness of supporting documentation
• Certification of completion of education
• Licensing jurisdictions
• NCLEX scores

45
COMMON PROBLEMS

• Wrong fee submitted
• Application not signed or incomplete
• Incorrect application submitted
• No social security number
• License verifications not submitted

46
HOW DO WE VERIFY CREDENTIALS?

• Documents must be submitted directly to us from
• Educational institution
• Other state licensing boards
• CGFNS
• PearsonVue (testing agency)

47
APPLICABLE TO ALL NEW LICENSEES

• Verification of licensure on website within 48
  hours at www.michigan.gov/verifylicense
• if license number appears, license valid
• if says pending, not completed
• Physical copy of license should arrive in about 3
  weeks

48
QUESTIONS?