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Welcome. Professional Leadership Forum. October 30, 2013. New Laws Impacting The Office of the Professions. An Overview from 2010 to Present Sarah Benson. New Professions & Office of the Professions Responsibilities.

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  1. Welcome ProfessionalLeadership Forum October 30, 2013

  2. New Laws Impacting The Office of the Professions An Overview from 2010 to Present Sarah Benson

  3. New Professions & Office of the Professions Responsibilities • Polysomnographic Technologist Authorization – Ch.262/2011 • Perfusionist Licensure – Ch. 479/2012; Ch.409/2013 • Clinical Nurse Specialist (CNS) Certification – Ch.364/2013 • Social Work, Mental Health, Psychology Corporate Practice Waiver – Ch.130,132/2010; Ch.187/2011 • 4410/Early Intervention Corporate Practice Waiver – Ch.581/2011 • Required Reporting of Sexual Offenses to Law Enforcement – Ch.365/2012 New Laws

  4. Changes to Scope of Practice • Eliminated Midwifery Collaborative Practice requirement – Ch. 238/2010 • Pharmacists permitted to engage in CDTM (Collaborative Drug Therapy Management) – Ch.21/2011 • Expand podiatry to below the knee – Ch.438/2012; Ch.23/2013 • Qualified Pharmacists authorized to administer immunizations – Ch.316/2011; Ch.116/2012; Ch. 274/2013 • Allows Dental Hygienists to work with a Collaborative Practice Agreement in an Article 28 facility – Ch.239/2013 New Laws

  5. Changes to Existing Laws • Requires Masters Degree for Physical Therapy licensure – Ch.410/2011 • Defines and sets requirements for Occupational Therapy Assistants – Ch.460/2011 • Authorizes Design Professional Corporations – Ch. 550/2011 Ch.467/2012; Ch.9/2013 • Permits Accountancy mobility – Ch. 456/2011 • Requires Pharmacy interpretation services – Ch.56/2012 • Extends Clinical Laboratory Technology Limited License to 2016 – Ch. 336/2013 • Includes optometrists within provisions relating to clinical laboratories – Ch.444/2013 New Laws

  6. New Continuing Education Requirements • Veterinary Medicine/Vet Med Tech – Ch.328/2010 • Massage Therapy – Ch. 463/2010 • Occupational Therapy/OTA – Ch.444/2012; Ch.18/2013 • Social Work (LMSW/LCSW)– Ch.443/2013 New Laws

  7. Growth and Change Statistical Highlights in Professional Licensing Susan Naccarato

  8. New Licenses Issued Steady Increase in Licensed Professionals in NYS

  9. Operational Responsibility - 2012 NYSED and its Partners support the important role of Licensed Professionals in New York State

  10. OPERATIONAL RESPONSIBILITY - 2012 Serve the Public

  11. Number of Licensed Professionals that are Registered to Practice in NYS, by Year Serve the Public

  12. Growth and Change Technology Updates • e-Licensing Mary Beth Nelligan • Web Site Re-Design David Hamilton

  13. Growth and Change 6 State Agencies are part of the e-Licensing Project • Agriculture and Markets (AGM) • Dept. of State (DOS) – individual licenses only • Dept. of Environmental Conservation (DEC) • Dept. of Tax & Finance (DTF) • State Education Dept. (SED) • State Liquor Authority (SLA) e-Licensing

  14. TODAY’S NYSED WEBSITE IS TEXT-HEAVY AND CUMBERSOME Web Site Re-Design

  15. Commissioner King has set goals for improving NYSED.GOV • High-Demand Information & Services • User-Friendly Platform (Desk, Tablet, Mobile) • Enhanced Customer Service • Communication • Useful, Timely, Accurate, Appropriate • Technology Platform • Effective, Streamlined, Robust • Targeted Implementation on 1/4/2014 Web Site Re-Design

  16. A cleaner presence with enhanced features using new technology Web Site Re-Design

  17. Making the Office for the Professions website more responsive to our customers • Protect the public • Up-to-date information about disciplinary actions • Integrate e-Licensing and other SED databases • Maintain a responsive website • Provide customers access to laws, rules, regulations that define professional practice • Organize information so customers can quickly find answers to more than 1,000,000 inquiries each year • Transfer current information and test new website format in December 2013 for a “go-live” in January 2014 Web Site Re-Design

  18. Horizon Issues Then and Now Doug Lentivech

  19. Horizon Issues • Managed Care • Corporate Practice • Unlicensed Practice • Expansion of the Licensed Professions • Expanding Scopes of Practice • Continuing Competence • Technology and • Tele-practice • Cross-jurisdictional Practice • Effective Professional Regulation • Rising Consumer Demands

  20. Horizon Issues Technology and Telepractice Kathleen Doyle

  21. An Elusive Goal – Ever changing 1950 – Challenge of telephone, facsimile, research re: speech & hearing, NASA studies of vital signs and physiological parameters transmitted from space with primates; videoconferencing 1970 – Transmission of medical records and images and hotlines, e.g. ask-a-nurse 1990 – Explosion of telepractice. Major advances and cost savings for technology and health care; means to provide care over wide geographic areas and to many without other access to health care Telepractice

  22. An Elusive Goal – Ever changing 2000 – Focus on all professions, creation of a multitude of organizations, committees, laws and regulations and associations of state licensing boards, including the Council of Licensure, Enforcement and Regulation. Geographical distance was discarded as a core purpose. 2013 – Historical issues remain – licensure requirements for health, design and accountancy professions; competence; confidentiality; medical records; safety, appropriateness and accuracy of technology; changes in social communication Telepractice

  23. THE DEFINITION HAS EVOLVED 1950 – 2000: Telepractice is the provision of professional service over geographical distances by means of modern telecommunications technology. 2013: Telepractice includes the use of telecommunication and web based applications to provide education, information, and services, as part of the practice of health care and the design professions Telepractice

  24. An SED History • 1995 – A Regents presentation addressing telemedicine and a demonstration of diagnosing a tumor during surgery by a pathologist at a distant hospital • 1997 – A Regents presentation on telemedicine and NYS requirements, including licensure for providers of NY residents Telepractice

  25. Requirements for Telepractice Services to New York State Residents - 1999 • In accordance with Education Law, anyone practicing in NYS must be fully licensed and registered, or otherwise authorized. • All professionals must adhere to the same laws, rules & regulations and uphold the same standards of practice that they must follow without the use of technology over a distance to ensure the highest degree of public protection. • Each profession has its unique provisions for practice, so exemptions would also apply to telepractice. Telepractice

  26. RECENT SED ACTIVITIES • Practice Alerts and Guidelines posted on the webpages for several professions • Participation in many workshops, conferences on telepractice • Technical assistance to the Legislature Telepractice

  27. Practice Alerts Evolve • The Boards for Psychology, Social Work and the Mental Health Practitioners develop joint guidance as the explosion of technology coupled with social changes evolve in the 2000’s • Guidance expands from issues of privacy and confidentiality, access, provisions for emergencies, and technology proficiency to a universe of technology and communication changes Telepractice

  28. Specific Additions are Made to the Practice Alert to Meet Current Needs - 2013 • Becoming familiar with legal requirements across state lines • Understanding technology, encryption and limits of software and hardware • Expansion of concern to digital storage devices, copiers that retain images, disposal of equipment • Videoconferencing, security, and assuring identity of participants • Ability of patients and clients to adequately participate and understand the risks and benefits Telepractice

  29. Seeing the Next Horizon • Awareness that social media has significantly affected concepts of appropriate communication • Social media opens vast opportunities and challenging interactions by professionals, including setting boundaries • Avatars and Virtual Environments are creating new opportunities and challenges and the need for much more research to support initial positive findings Telepractice

  30. Horizon Issues Continuing Competency James Hinds

  31. Continuing Competency

  32. Horizon Issues Cross-jurisdictionalPractice Lawrence Mokhiber

  33. Pharmacy Oversight Individuals and Entities Such As: Pharmacists Pharmacies Manufacturers Cross-jurisdictional Practice

  34. Dispensing/Manufacturing/Compounding • Pharmacies dispense pharmaceuticals upon the authority of a patient specific prescription. • Manufacturers distribute bulk, non-patient specific pharmaceuticals. • “Compounders” are a hybrid that currently has no specific authority under either NY or federal law. • Pharmaceuticals, by their very nature, may be distributed across state borders, and may even be distributed internationally. Cross-jurisdictional Practice

  35. COMPOUNDING OF STERILE PRODUCTS • Over the past year, the United States has dealt with the latest – but not the first—series of infections and fatalities related to contaminated products • The NECC contamination has been the worst: • 751 Infected • 64 Deaths Cross-jurisdictional Practice

  36. Cross-jurisdictional Practice

  37. COMPOUNDING OF STERILE PRODUCTS • New York Law clearly distinguishes between manufacturing and compounding for prescriptions • New York Law makes no provision for “COMPOUNDING FOR OFFICE USE” Cross-jurisdictional Practice

  38. COMPOUNDING OF STERILE PRODUCTS • NYSED collaborated with many states and the Federal government to review legislation. Some amendment of NYS laws may be needed. • The Board of Pharmacy has developed draft regulations regarding the training & procedures ALL personnel engaged in preparing Compounded Sterile Products (CSPs) must follow. Cross-jurisdictional Practice

  39. Lets Take a 15 Minute Break

  40. Professional Oversight and Discipline The Disciplinary Process Louis Catone

  41. Professional Oversight and Discipline • Hundreds of practice interpretations and clarifications • Investigations and prosecutions across the state • Implementation of Illegal Practice enforcement: • 2012 Illegal Practice Cases Opened:  226 • 2012 Compliance Agreements:             55 • 2012 Cease & Desist Orders:               15 • Pending Criminal Cases:                        99 Public Protection through Professional Oversight and Discipline

  42. Source of Case Referrals • Total Number of Cases TAKEN in 2012 Protect the Public

  43. 2012 Highlights • 4,514 Investigations Completed • 1,032 Pharmacy inspections conducted • 47 Moral Character Final Actions • 18 License Restoration Final Actions Protect andServethe Public

  44. 2012 Highlights • Disciplinary Actions: • 412 Regents Actions • 377 Suspensions/Revocations • $420,750 in Regents fines • 474 Corrective Actions Required letters • 15 Cease and Desist Orders Issued • 34 Administrative Warnings Issued • 224 Violations Committee Resolutions • 110 Illegal Practice Referrals to AG and Compliance Agreements Protect and Servethe Public

  45. Professional Corporations and Corporate Practice Recent Changes Doug Lentivech

  46. Overview • Authority to regulate professional business organizations is generally found in Title VIII of the Education Law • Other authority exists in other areas of NY law including the Business Corporation Law, Partnership Law, Limited Liability Company Law in addition to Public Health Law, Insurance Law and Labor Law. Corporations and Corporate Practice

  47. Who can offer and provide professional services? • Individuals/sole proprietorships---simple but with minimal statutory guidance • Professional partnerships---simple and with only minimal statutory guidance • Professional Corporations---formally established and authorized within the Business Corporation Law Corporations and Corporate Practice

  48. Who can offer and provide professional services? • Registered Limited Liability Partnerships---formally established and authorized within the Partnership Law • Professional Limited Liability Companies---formally established and authorized within the Limited Liability Company Law • Anyone else who is exempted or otherwise authorized by law Corporations and Corporate Practice

  49. The Interface of Professional and Non-Professional Business Structures • Management companies - non-professional business enterprises that have a formal or informal relationship to a professional business enterprise • Management companies cannot practice or hold out to practice any restricted professional practice • Management companies cannot share profits or split fees with professional business enterprises (8 NYCRR 29.1 (b) (3) and (4)) Corporations and Corporate Practice

  50. Title Protection vs Scope Protection • All Title VIII professions restrict the title of their profession to only those individuals licensed by NYSED • Most, but not all, Title VIII professions also restrict the provision of services defined within their practice to only those licensed by NYSED and other individuals authorized or exempted by law Corporations and Corporate Practice

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