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. 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 OSTEOPATHIC MEDICINE AND SURGERY PHARMACY PHYSICIAN’S ASSISTANTS PHYSICAL THERAPY PODIATRIC MEDICINE AND SURGERY PSYCHOLOGY RESPIRATORY THERAPISTS SANITARIANS SPEECH-LANGUAGE PATHOLOGY SOCIAL WORK VETERINARY MEDICINE Federal Legislation Mandates NURSE AIDE REGISTRY PUBLIC HEALTH CODE ARTICLE 15 OCCUPATIONS

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@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, doesn’t 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: (517) 241-0191

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.orgwww.ncsbn.org

37. QUESTIONS?

38. NEW LICENSEE INFORMATION

39. APPLICATION PROCESSING

40. APPLICATION PROCESS • Request Application • Download application from www.michigan.gov/healthlicense • Call 517-335-0918, follow prompts • Email application request to bhpinfo@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/appstatus - 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?