BOARD OF REGISTRATION
FOR THE HEALING ARTS
DISCLAIMER
• Pursuant to section 324.023.2, RSMo, any opinions
contained in this presentation are for educational
purposes only, are in no way binding on the
licensees of the Missouri Board of Registration for the
Healing Arts, and cannot be used as the basis for
any discipline against any licensee of the Missouri
Board of Registration for the Healing Arts.
BOARD MEMBERSHIP
• Benjamin Lampert, MD
• James DiRenna, DO
• Bradley Freeman, MD
• David Poggemeier, MD
• Jeffrey Carter, MD
• John Lyskowski, MD
• David Tannehill, DO
• Jade James, MD
• Springfield
• Anesthesiology/Pain Medicine
• St. Louis
• General Surgery/Critical Care
• St. Louis
• Anesthesiology
• St. Louis
• Critical Care/Telemedicine
• Kansas City
• Family Practice
• St. Charles
• Emergency Medicine
• Jefferson City
• Psychiatry
• St. Louis
• Obstetric & Gynecology
• Public Member – Vacant
ABOUT THE BOARD
• Meets 4 times a year in person
• Holds at least 4 conference calls a year
• Mission: To protect the citizens of the state through
the licensing of physicians and other health
designated professionals, assessing their
competence to practice and their moral character.
It is also the board’s duty to investigate all
complaints against its licensees in a fair and
equitable manner.
ADVISORY COMMISSIONS
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Physical Therapists
Speech Language Pathologists/Audiologists
Physician Assistants
Athletic Trainers
Clinical Perfusionist
Anesthesiology Assistants
PHYSICAL THERAPIST ADVISORY
COMMISSION
• The Advisory Commission for Physical Therapists was
created in 1989 and is responsible for advising the
Board on the licensure and regulations of the
physical therapist profession.
• Made up of five (5) members, four (4) of which shall
be licensed as physical therapists, and one (1) shall
be licensed as a physical therapist assistant.
• Members serve three (3) year terms.
• Meets on average once a month via conference
call to discuss pending discipline cases and
licensure matters.
ADVISORY COMMISSION MEMBERSHIP
• William P. Hopfinger, PT, AT, Chair
• St. Louis, MO
• Judith E. Pastorino, PTA, Secretary
• Columbia, MO
• Tamara L. Burlis, DPT
• St. Louis, MO
• James A. Dronberger, DPT
• Kansas City, MO
STAFF ORGANIZATION
Connie Clarkston (ED)
Jimmy Leggett
(Executive I)
Kim Brester
(Administrative
Coordinator)
Bill Smittle
Kim Beffa
(Chief Medical
Officer)
(Supervisor
Enforcement)
Information
Coordinator
Licensure
Supervisor
3 Med Staff in
Office (part time)
4 Staff
6 Licensure Techs
3 Med Staff (work
from Home)
Frank Meyers
(General Counsel)
Vacant
(Associate
General Counsel)
Paralegal and
Clerical
Vacant
(Chief
Investigator)
2 Probation
Supervisors
14 Investigators
LICENSED PHYSICAL THERAPISTS
PROFESSION
# OF ACTIVE LICENSES
Physical Therapist
5,938
Physical Therapist Assistant
2,699
THE PRACTICE ACT
WHAT IS THE PRACTICE ACT?
• The “Practice Act” is the title commonly used when
referring to the statutes and rules governing the
practice of physical therapy in Missouri.
• Chapter 334 of the Revised Statutes of Missouri.
• Sections 334.500 to 334.687, RSMo.
• Regulations 20 CSR 2150-3.010 to 20 CSR 2150-3.210.
• Available online at: http://pr.mo.gov/healingartsrules-statutes.asp
WHY DO I CARE ABOUT THE PRACTICE
ACT?
• Rules for How to Practice in Missouri
• Scope of practice
• Medical record requirements
• Supervision requirements
• Unintended Consequences
• Board investigation
• Complaint
• Discipline
INVESTIGATIONS
AVENUES FOR COMPLAINTS
Complaint Received
Complaint Review
Committee
(“CRC”)
Malpractice Review
Investigative
Discipline
Medical Staff Review
Board Direction
Paralegal
Close
COMPLAINT REVIEW
• All complaints and reports (other than malpractice)
are reviewed by CRC (20 CSR 2150-1.011)
• First level of the screening process
• CRC determines how complaints are handled
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Quality of care
Routine Investigation
Paralegal Gathers Information
Letter to Doctor
Closed agenda
WHAT IS A COMPLAINT?
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Uniform Complaint Form
Letter from Program stating non-compliance
Information from Licensee (self-report)
“Yes” question on renewal
Newspaper Article about Court Conviction
Staff concern
Misc.
INVESTIGATIVE TOOLS
• Letter to Licensee
• Gather documents
• Routine Investigation
• Quality of Care
• Records Review
APPEARANCES
• Appear before the Board
• Gives the Board a chance to meet licensee and
evaluate the case and the licensee
• Gives the licensee a chance to provide his/her side
of the story directly to the Board
BOARD DECISIONS
BOARD DECISIONS
• Close
• Order Further Investigation
• Order Appearance
• Order MSI
• Propose ILOD (§324.043, RSMo)
• Propose Settlement Agreement (§621.045.4, RSMo)
• File a Case
• AHC (§334.100.2, RSMo)
• Emergency Suspension (§334.102, RSMo)
• Board (§§324.042, 334.102.7, and 334.103, RSMo)
COMPLAINTS
NUMBERS OF COMPLAINTS
2012
2013
1,067
954
Unprofessional
Conduct
361
249
Negligence
245
188
Inappropriate
Prescribing
189
187
Cases Resulting in
Discipline
69
59
Total Complaints
TYPES OF DISCIPLINE
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Reprimand
Probation
Suspension
Revocation
Restriction
Can be used in combination
HOT TOPICS
PTA SUPERVISION
• Section 334.506.7, RSMo states:
• 7. A physical therapist shall only delegate physical therapy
treatment to a physical therapist assistant or to a person in
an entry level of a professional education program
approved by the Commission for Accreditation of Physical
Therapists and Physical Therapist Assistant Education
(CAPTE) who satisfies supervised clinical education
requirements related to the person's physical therapist or
physical therapist assistant education. The entry-level
person shall be under on-site supervision of a physical
therapist.
• On-site supervision…
• See also 334.610, RSMo
PT TECHS
• Related to issue of proper supervision/unlicensed
practice
• Section 334.506, 334.510, and 334.610, RSMo
• PT Techs are NOT licensed
• Amount of supervision is irrelevant
• Don’t fudge on your resume/application
DRY NEEDLING
• Not addressed in statute or rule
• Beware of overlapping practice
• Acupuncturists ARE licensed in Missouri (see chapter 324,
RSMo)
• Federal requirements?
• Type of needle being used?
• Requirement to purchase and use?
LICENSURE ISSUES
• Most issues are licensure related
• Reciprocity and “substantially equivalent” (see section
334.611, RSMo)
• FCCPT (see 20 CSR 2150-3.010)
• TOEFL (see 20 CSR 2150-3.010)
• FSBPT Scaled Score (see 20 CSR 2150-3.030)
• Returning to active practice
• Temporary License (see section 334.665, RSMo)
RENEWALS/APPLICATIONS
• Lying on your renewal/application is cause
to discipline
• § 334.100.2(15) states that “knowingly
making a false statement, orally or in writing
to the board” is cause to discipline
POSITIVE ANSWERS ON RENEWALS
• If you answer a question on a renewal “yes” you
should submit an explanation with your renewal
• Board may take no further action
• Board may request more information
• Board may investigate
NAME CHANGES
• Written request (licensure@pr.mo.gov)
• Send the document showing the name change
• Marriage certificate
• Divorce decree
• Court order
• Tell us how you want your name to appear
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Jane Smith
Jane Smith-Doe
Jane Smith Doe
Jane Doe
THINGS TO KNOW
• Update your addresses with the Board
• Know the law
• Attorneys and the Board
QUESTIONS
• Email questions to: legal@pr.mo.gov