The Effective Representation Of Parties In State Professional Licensing Board Proceedings By Raymond P. Pepe +1.717.231.5988 raymond.pepe@klgates.com October 2007 Revised from original version presented in November 2006 to the Pharmacy Law XII Seminar of the National Association of Pharmacy Law and the National Association of Chain Drug Stores Proceedings before state professional licensing boards may involve disciplinary proceedings; disputes regarding the issuance of licenses, certifications or approvals to individuals or facilities; and proceedings pertaining to the development of licensing board policies and regulations. The effective representation of professionals and professional corporations and partnerships in these proceedings depends in substantial measure upon the understanding and proper application of principles of state administrative practice and procedure unique to each of these types of proceedings as applied in the context of occupational licensing law. Critical Issues in Disciplinary Proceedings Identifying and Protecting the Interests of Diverse Parties Because disciplinary board proceedings may involve multiple parties, including licensed or registered professionals, facilities and business associations authorized to offer professional services, facility owners and other persons, it is essential at the outset of any proceeding to identify how the interests of various parties will potentially be affected and to explore the benefits and costs of using separate counsel for all parties versus common counsel for all or some subset of the affected parties. The ethical issues regarding when the representation of two or more parties is permissible; the types of notifications and cautions necessary regarding any use of common counsel; and the need for joint-defense agreements to protect attorney-client privilege are generally well understood. What is less well recognized is the need to forge constructive working relationships among counsel for multiple parties and the strategic advantages that may be obtained through the use of separate counsel even when separate representation does not appear to otherwise be required or warranted. One of the greatest risks of using separate counsel for parties whose interests diverge is that the zeal of counsel for individual parties to protect their specific interests will generate a suboptimal outcome for all parties to a proceeding. While inevitably in some circumstances the representation of individual interests is of necessity a zero-sum game, in far too many other instances the failure of counsel to work together cooperatively to promote the common interest of all parties forfeits opportunities to resolve controversies in a more desirable manner. Unfortunately, there is no general formula or specific approach to follow to avoid these problems. Instead, it is imperative for parties to proceedings to select mature representatives with sound judgment who can work together well and effectively pursue opportunities to promote the common interests of all parties to proceedings, while at the same time being realistic and honest in recognizing the pragmatic imperatives essential to protecting the interests of their individual clients. Counsel should also be selected with experience in dealing with licensing board proceedings in the jurisdiction involved, because the customs and practices of boards are often unique and not well documented. Even where the interests of multiple parties to proceedings do not materially diverge, it is also worthwhile at the outset of any engagement to consider whether the use of separate counsel will be strategically beneficial. For example, where the outcome of proceedings turns on the credibility of parties not themselves the target of disciplinary complaints and who face little realistic risk of sanctions, but whose interests technically diverge from those of other parties, the perceived independence and reliability of testimony offered by such parties may be enhanced by separate representation. In addition, during the investigatory stages of proceedings and in the course of the consideration of settlement options, the use of separate counsel for such parties may open up avenues of access to information and create alternative channels for communication that may not be equally available to counsel for the primary target of disciplinary proceedings. Identifying Sources for Third-Party Recovery Various forms of insurance coverage may be available to parties to disciplinary proceedings and for other persons affected by the outcome of such proceedings. Coverage that may be available includes not only professional liability insurance, but may also involve errors and omissions policies, officers and directors coverage, business interruption insurance and fidelity policies which may provide coverage for losses incurred due to unlawful conduct or a breach of fiduciary duty. Far too often, however, parties either fail to recognize that coverage may be available either to cover losses incurred or the cost of representation, or conclude that coverage is not available based upon a cursory review of policy provisions and discussions with the representatives of agents or representatives of insurers who may be either ill-informed or less than candid in discussions of policy provisions. The failure to promptly evaluate and identify sources of coverage also often leads to the loss of otherwise available coverage when notice is not provided in a timely manner to insurers regarding claims. To evaluate the availability of insurance coverage, at the outset of any significant controversies, a careful assessment should be conducted of current and prior insurance policies and guidance sought regarding any ambiguous policy provisions. Where the consequences of adverse outcomes in disciplinary proceedings are substantial, it may be worthwhile to have a review of available insurance coverage reviewed by specialized counsel experienced in the protection of policyholder interests. To the extent coverage may be available, care should be taken to ensure that written instructions are provided to insurance brokers directing them to provide written notifications to affected carriers. In this regard, it is important to recognize that many brokers may not operate as agents of various insurers and only as sales representatives, and therefore notice to a broker may not constitute notice to the insurer. Accordingly, it is important to follow up any initial discussions with brokers regarding the provision of notice to carriers to ensure that notice is actually provided and to ensure that brokers do not make independent judgments in questionable cases regarding the availability of insurance benefits. In addition to evaluating potential sources of insurance coverage, parties to disciplinary proceedings should also determine whether proceedings trigger any relevant hold harmless or indemnity agreements. Depending upon the facts and circumstances, indemnities may be available for violations of professional standards that occurred prior to the purchase of a licensed business or its assets. Likewise, when help supply services are utilized to provide professional personnel, technicians or other employees, the agreement with the help supply agency may provide indemnities for misconduct of the personnel supplied by the agency. Developing Strategies Based Upon a Risk Assessment While some professional licensing boards have adopted schedules of fines and sanctions associated with various types of violations, more typically, no formal guidelines or standards exist to guide a board in imposing sanctions for misconduct. Instead, often the only guidance provided consists of the maximum permissible sanctions authorized by law. As a result, in many jurisdictions even minor violations result in the issuance of a rule to show cause why licenses or permits should not be suspended or revoked for alleged violations and why the maximum permissible fines and monetary penalties authorized by law should not be imposed. In these circumstances, it is critical at the outset of any engagement to initiate research regarding the types of sanctions historically levied by the board for the type of conduct alleged. Even where boards maintain formal penalty guidelines, such research is warranted to determine whether and to what extent actual board practices deviate from published standards. Unfortunately, this research may need to be performed “on site” since frequently these types of administrative decisions are not published or reported electronically. Such research should never be discounted, however, since it often reveals information remarkably inconsistent with demands made by prosecuting counsel. Research regarding the likely range of sanctions that may be imposed by boards will provide guidance helpful in October 2007 | determining whether and to what extent to vigorously contest allegations of professional misconduct or to initiate settlement discussions with board counsel. In addition, such research typically provides valuable insight critical to the successful negotiation of settlement agreements and may provide a basis to contest the imposition of sanctions inconsistent with board precedents. Under the law of most states, it is arbitrary and capricious for boards to deviate substantially from its precedents and established practices without good cause. In addition to reviewing the pattern of sanctions imposed by licensing boards, it is also important to evaluate the potential collateral consequences of adverse board actions. For example, under CMS Medicare Provider Agreements and State Medicaid Provider Agreements, changes in information regarding “adverse legal actions” previously reported must typically be updated within 30 to 90 days of the changes occurring. Once this information is reported, CMS or State Medicaid agencies may initiate proceedings to revoke provider agreements. If this occurs, federal and state law typically prevent the transfer of a licensed business or its assets to certain related parties to avoid the impact of any debarment. Comparable provisions are also often included in other public and private healthcare participating provider agreements. Mortgages, franchise agreements and loan documents may also require the prompt reporting of disciplinary actions taken against licensed professionals, entities offering professional services, and their personnel. Once reported, lenders may enjoy broad discretion to declare defaults and accelerate loan payment obligations. Fortunately, the prompt reporting of disciplinary proceedings and the full disclosure of the outcome of proceedings often enable parties to avoid the revocation of provider agreements or debarment from participation in public healthcare benefit plans. Conversely, the failure to promptly report such information and incorrect characterization of the outcome of proceedings may in themselves provide a basis for suspension or revocation of provider agreements or debarment, even for violations which in themselves may be comparatively minor. Clearly Defining Administrative Procedures State administrative procedures acts and rules of procedure may vary substantially from jurisdiction to jurisdiction and many licensing boards may not have clearly established rules of procedure to govern disciplinary proceedings. Board rules of procedure may also provide certain options to parties to disciplinary proceedings, such as allowing matters to proceed before hearing examiners who will issue reports and recommendations for review by boards or alternatively allowing contested proceedings to be conducted directly before boards. Options may also exist to seek informal conferences with designated board members or third parties to seek the informal resolution of proceedings in a manner similar to mediation. Developing the most effective approach to the representation of parties to board proceedings requires understanding the options available and selecting alternatives best suited to the needs of any particular case. At the outset of proceedings, a thorough review should be conducted regarding applicable rules of procedure and administrative practices with a focus on identifying service requirements, deadlines, discovery mechanisms (if any), requirements for pre-hearing reports and conferences, the availability of various types of procedural and dispositive motions, opportunities for briefing and argument, and posthearing remedies, including requests for reconsideration of adverse determinations. Because board practices are often highly informal and subject to change, in order to clearly understand and best take advantage of available procedural options, there is no substitute for a pre-hearing conference in which a full discussion of procedural requirements occurs. In pre-hearing conferences, it is essential to obtain not only a clear understanding of the applicable rules of procedure, but also to identify the expectations and particular requirements of individual hearing officers or boards. Care should be taken, however, not to make premature commitments regarding the management of a case that may limit available procedural options. Instead, the goal should be to clearly understand the applicable administrative rules and requirements, while preserving as much flexibility as possible to change strategies and procedural approaches to a case as proceedings unfold. One important goal to pursue in evaluating relevant administrative procedures is to ensure a fair and level playing field upon which to mount a defense of disciplinary charges. While due process requires a separation of functions between prosecutorial and adjudicative officers, the disqualification of board members or hearing officers October 2007 | subject to potential bias prohibits ex parte communications and limits the use of administrative notice of facts and information outside the official record; the extent to which these protections exist in practice may deviate substantially. Understanding the extent to which such protections are actually provided in any particular jurisdiction is helpful in developing strategies for the presentation of a defense, but may also provide potential grounds for a successful appeal of any adverse adjudications. Careful attention to due process requirements and a frank discussion of the mutual expectations of adverse parties may also make participants in disciplinary proceedings more attune to the necessity to conduct fair and impartial hearings. An additional goal that should be pursued in discussions regarding rules of administrative procedure is to take appropriate measures to protect the confidentiality of information. These measures, where appropriate, should not only insure that potentially damaging information is submitted under seal, but also that appropriate orders and authorizations are obtained for the disclosure of protected health care information subject to HIPPA protections. Taking Full Advantage of Available Discovery In many types of disciplinary proceedings, nothing approaching discovery available under the applicable rules of civil procedure exists. Instead, evidence likely to be presented at a hearing by prosecuting counsel can sometimes only be identified by allegations included in disciplinary complaints or rules to show cause, pre-hearing reports and through the filing of freedom of information requests.1 Assertions of privileges to preserve the confidentiality of investigative reports and the attorney work product of board counsel may also severely limit access to information in advance of hearings. The absence of traditional discovery mechanisms in professional licensing proceedings may or may not pose problems depending upon the facts or circumstances of particular cases. The inability of counsel defending parties to disciplinary proceedings to obtain access to evidence likely to be presented in a hearing is typically mirrored by the inability of prosecuting counsel to similarly obtain information from parties subject to disciplinary complaints and from prospective witnesses. How the risks and benefits associated with the limited access to pre-hearing information affect a particular case requires a careful exercise of judgment by counsel. To the extent access to evidence likely to be presented by board counsel in advance of a hearing is determined to be important to the presentation of an effective defense, several options should be considered to obtain the required information. Requests should be routinely made to conduct file reviews of all public information available regarding parties to proceedings in the possession of licensing boards. Motions can be filed with hearing officers or boards requesting the issuance of pre-hearing orders requiring the disclosure of witnesses, exhibits, expert reports and any and all exculpatory evidence in the possession of prosecuting counsel and investigators. In conferences with hearing officers or boards, requests can be made that pre-hearing reports disclose the scope, extent and anticipated content of testimony likely to be presented. While hearing officers and boards may refuse to grant such requests, even in the absence of established board practice to the contrary, it should not be assumed that such requests will not be fruitful. In addition, denials of requests for information essential to a fair and impartial hearing may provide a basis for the pursuit of subsequent appeals. Exploring Settlement Options Except in unusual circumstances, it is rare for licensing boards to pursue disciplinary action against licensed professionals or facilities without substantial justification for doing so. While extenuating and mitigating factors may exist, and disputes may exist regarding the appropriate interpretation of relevant laws and regulations or the scope and extent of appropriate sanctions, it is rare to be called upon to defend parties to disciplinary proceedings who are without substantial responsibility for activity the licensing boards characterize as professional misconduct. Accordingly, in many circumstances, the negotiation of consent orders terminating proceedings represents a preferable alternative Some jurisdictions take the position that the only discoverable information consists of documents the disclosure of which can be compelled through freedom of information requests. Because exceptions from compelled disclosure typically exist for investigatory reports, pursuing this option may appear fruitless. Nonetheless, surprising amounts of useful information can often be learned from public file reviews, both due to the less than thorough cleansing of files for privileged information or through the discovery of references to information which then may be subject to disclosure pursuant to motions filed with hearing examiners and boards. 1 October 2007 | to proceeding with contested hearings, especially when the costs and potential collateral consequences of participating in contested proceedings are taken into consideration. decision regarding the best venue may depend upon the personal characteristics and experience of hearing officers and board members. The principal difficulties sometimes encountered in negotiating reasonable settlements to disciplinary complaints involve how to deal with overly aggressive prosecuting attorneys unwilling to reasonably compromise; requirements that parties agree to standard terms and conditions in consent orders that appear unreasonable; or with the possibility that the manner in which a settlement is structured may trigger more serious consequences for pharmacies and pharmacists in the form of the termination of provider agreements or potential criminal prosecution. Generally, proceeding before hearing officers typically represents the best option if (1) complex factual evidence will be presented subject to conflicting interpretations; (2) threshold legal questions exist that fall outside the expertise of board members to effectively resolve; (3) multiple witnesses and exhibits are likely to be presented; or (4) emotionally charged and adversarial confrontations with complaining witnesses are likely to occur. In these circumstances, the availability of a detailed written record and proposed report to the licensing board from which parties may take exceptions provides a better opportunity for effective advocacy and careful reconsideration of relevant facts and circumstances. Proceedings before hearing officers, however, are also likely to be much more protracted and expensive, a factor that may be very important to affected parties. Some options to consider to increase the likelihood of a favorable consent agreement are to request an informal conference before an individual member of the board authorized to conduct such proceedings and make recommendations for settlement (and who is then typically recused from participation in any subsequent contested hearing if settlement negotiations are unsuccessful), to request mediation before a neutral party familiar with pharmacy operations, or to recommend the preparation of investigatory reports to be used exclusively for purposes of settlement discussions prepared by independent experts. The latter approach may be particularly useful when disputes arise regarding contested standards of industry practice in specialized areas in which board members may not have significant experience. In drafting settlement agreements, care should also be taken to limit the admissibility of any admissions contained in settlement agreements only to proceedings to enforce the agreements and to include where possible within the text of agreements or in supporting documentation authorized for disclosure any mitigating circumstances pertinent to violations for later potential use in response to inquiries that may be generated by public and private benefit plans and certification agencies. Determining the Role of Hearing Examiners In jurisdictions in which the option to proceed before a hearing examiner or directly before a licensing board exists, electing the best option for a particular case may represent one of the most difficult challenges faced in the defense of disciplinary proceedings, especially because a In contrast, proceeding directly before licensing boards may represent the best option where (1) the primary issue presented involves the scope and extent of sanctions to be imposed and witnesses are likely to persuasively present evidence of mitigating circumstances; (2) an understanding of the practical problems faced in day-to-day operations will be helpful in obtaining a favorable resolution; or (3) giving board members an opportunity to personally evaluate the demeanor and credibility of witnesses is important. In deciding to proceed directly before a licensing board, however, counsel must consider the potential that board members (who typically are only nominally compensated) will react unfavorably to the need to participate in a hearing and the possibility that their clients may not present sympathetic figures when presented for direct scrutiny. Making Effective Use of Stipulations Notwithstanding how thoroughly a case is prepared, witnesses are always likely to make unanticipated statements and admissions when presented for direct and crossexamination. While sometimes such unanticipated testimony can be very beneficial to the outcome of proceedings, often the opposite occurs. The demeanor of witnesses (especially defendants who feel they are being unjustly subject to disciplinary proceedings) may also detract from the effectiveness of a defense. Accordingly, it is usually October 2007 | desirable to narrow the scope of contested facts as much as possible through the effective use of stipulations. Narrowing the scope of contested issues may also reduce the cost of proceedings and better focus adjudicators on the resolution of critical factual questions without getting lost in irrelevant and extraneous details. In jurisdictions subject to the legal residuum rule, it is obviously critical to properly object to hearsay evidence. In other jurisdictions, however, the principles that underlie the rule should be articulated as a basis for giving hearsay evidence less probative value than other evidence and to disregard such evidence unless independently corroborated. Unfortunately, it can sometimes prove to be difficult to persuade state board counsel to agree to any extensive set of stipulated facts. This may occur because board counsel face crowded dockets and lack the time and resources to work on stipulations or due to their fears (which are often justified) that stipulations (often prepared by more seasoned adversaries) may prejudice their ability to obtain favorable rulings and stiff penalties. Some alternatives to increase the likelihood that useful stipulations will be generated are recommendations made to hearing examiners or board representatives in pre-hearing conferences that scheduling orders be issued mandating the exchange of agreed upon and contested findings of facts and that parties meet and confer, beginning at dates substantially in advance of the scheduled hearing, to discuss stipulations and settlement options. Similar issues arise with respect to other rules of evidence. For example, in some jurisdictions rules limiting the use of judicial notice are not applicable in administrative proceedings. This represents a particularly thorny problem in pharmacy board proceedings where board members may be tempted to use their independent knowledge and expertise as a basis upon which to make determinations. To reduce the possibility of the misuse of administrative notice, and to discourage boards from relying upon evidence outside of the record, pre-hearing orders can be used to establish comparable requirements prior to the taking of administrative notice by a hearing officer or board. For example, in the same manner as required for the judicial notice of facts not within the record of proceedings, prior notice and an opportunity to rebut any administrative noticed facts can be required. Understanding the Relevance of the Rules of Evidence Presenting Exculpatory and Mitigating Evidence In virtually all jurisdictions, the rules of evidence do not apply in administrative hearings and hearsay evidence is admissible. Care should be taken, however, to not lose sight of the role played by the rules of evidence in ensuring the reliability of evidence and in using instances of noncompliance with the usual rules of evidence to suggest that certain types of testimony should be given reduced probative value or disregarded. Unlike criminal trials which typically have bifurcated proceedings to determine guilt and to impose sanctions, in most circumstances state licensing boards use the same record for the purpose of determining whether unprofessional conduct has occurred and to determine the appropriate sanctions. This clearly poses a challenge to counsel defending pharmacies and pharmacists because an effort to directly present character witnesses may create a presumption, even if unstated, that the unprofessional conduct has occurred and that parties are pleading for lenience. In several jurisdictions, the so-called “legal residuum” rule provides that although admissible in administrative proceedings, hearsay evidence if properly objected to is not competent to support a finding of fact based solely upon such evidence, and if admitted without objection may support a finding of fact only if it is corroborated by other competent evidence in the record. Often the legal residuum rule is articulated as a requirement for constitutional due process, especially in proceedings involving property rights such as those that occur in licensing board proceedings. In some states, such as California, New Jersey and Florida, various permutations of the rule are embodied into state statutory law. Clearly the best way to avoid this dilemma is to ask a hearing officer or board to conduct bifurcated proceedings. If such requests are rejected or are not practical in the circumstances, it may be necessary to find creative ways to present character testimony and make the hearing officer or board aware of mitigating factors without clearly acknowledging or suggesting that the evidence is being presented for such a purpose. This can be accomplished by background testimony regarding the long history of operations of a facility or the conduct of an individual October 2007 | without disciplinary complaints or by presenting evidence regarding the location or services provided by a facility suggesting that its continued operation is critical to the continued provision of professional services to certain communities. It may also be useful in disciplinary proceedings to describe actions taken by a facility after complaints have occurred to avoid future complaints in the same area. If presented skillfully, such testimony rather than appearing to provide an admission of guilt may instead illustrate the commitment of a facility to establishing good business practices and suggest to a hearing officer or licensing board the type of order to issue in lieu (in whole or in part of civil penalties), i.e., a mandate to prepare and submit for review a facility compliance plan. Licensing Controversies Licensing board proceedings concerning the issuance of licenses, approvals and certifications unrelated to disciplinary matters, but instead relating to the actual physical requirements for the operation of a facility, the granting of reciprocal licensing privileges or other regulatory matters, pose at least one important set of issues that may be less relevant in disciplinary proceedings, namely, the applicability and validity of non-regulatory “statements of policy” or “guidance documents,” or of board practices imposed uniformly but not reduced to written directives. Licensees often protest the application of such requirements and question their legal validity. State precedent has emerged in three primary directions with respect to administrative requirements not imposed by regulations. Recognizing how to handle controversies regarding such administrative requirements requires an appreciation of the relevant state law. In some jurisdictions, policies that are treated as “binding norms” which are not properly incorporated into published administrative rules are treated as void and unlawful and may not be properly relied upon as a basis for refusing to issue a license or for imposing conditions upon a license. In such jurisdictions, the relevant documents or policies should be identified and documented and appropriate motions objecting to their use filed. Upon appeal, unless the reliance upon the documents or policies constituted harmless error, adjudications relying on such documents or policies may generally be vacated. Other jurisdictions recognize the practical need for policies and guidance documents not incorporated into regulations, and afford these documents two substantially different degrees of recognition. In most jurisdictions, if an agency adopts statements of policies or guidance documents not intended to have the force and effect of administrative regulations, such documents may be treated as valid “statements of policy” or “interpretative rules,” but may not be binding upon a hearing examiner or board and are never binding upon a court considering an appeal. Instead, in many circumstances a hearing examiner or board enjoys the discretion to apply or not apply such policies or documents to the extent appropriate. Even where a hearing officer or board determines its actions are bound by such documents or policies, however, upon appeal a court may decide whether or not the application of the policy is reasonable and appropriate without affording the document or policy any significant degree of deference. In such jurisdictions, practitioners must stress the non-binding nature of the documents or policies and suggest reasons that the documents or policies do not provide the most reasonable and appropriate interpretation of statutory requirements in a particular setting. One final set of state practices is highly problematic. Some states treat policies not incorporated into valid administrative regulations as mere interpretations of validly adopted rules and hold that an agency’s interpretation of its own rules must be upheld unless clearly contrary to law, unconstitutional or arbitrary and capricious. In such jurisdictions, the best approach is to illustrate that the challenged policies are not in fact mere interpretations of existing rules, but instead represent new rules that have been invalidly adopted. Rulemaking and Policy Setting Proceedings Rulemaking typically poses significant challenges for professional licensing boards because in most jurisdictions boards are not provided the staff and resources necessary to develop any significant regulatory initiatives and board members are nominally compensated appointees who lack the expertise, time and background necessary to function as their own regulatory staff. These problems may pose particularly acute challenges for licensing boards in jurisdictions in which tradition or practice prevents boards or their staff members from issuing advisory opinions regarding various issues without the adoption of formal administrative rules. October 2007 | At least two alternatives are available for individuals and organizations promoting the adoption of new regulatory standards in jurisdictions in which boards lack the capacity or willingness to initiate rulemaking proceedings. It may be possible either to take advantage of formal or informal options for “negotiated rulemaking” or to petition pharmacy boards to consider and adopt specific proposed rules. In recent years, many jurisdictions have adopted formal negotiated rulemaking laws. Unfortunately, many of these laws have remained largely unutilized because of fear of their often highly detailed prescriptive procedural requirements. Upon closer examination, however, the procedures mandated by these laws are often less burdensome in practice than seems apparent, especially when agencies are engaged in adopting technical rules sometimes typical in pharmacy board practice that do not involve controversial public policy issues. Accordingly, for major regulatory initiatives of significant importance, consideration should be given to utilizing formal negotiated rulemaking requirements. An alternative to formal negotiated rulemaking that may be considered in many jurisdictions is the use of informal advisory committees to develop proposed rules for consideration by pharmacy boards. Fortunately, most regulatory negotiation statutes provide optional, not mandatory, procedures for boards to work cooperatively with stakeholder groups to develop proposed rules, and in most jurisdictions, there are no formal restrictions or limitations upon the development and use of advisory committees to develop regulatory proposals for consideration by pharmacy boards. Finally, the option of formally proposing rules for consideration by agencies by way of petition should also be considered. Many states authorize rulemaking petitions whereby parties may draft detailed rules and present the rules to boards for consideration by way of petition. Typically, a board will then study the rules and make a determination about whether to publish the rules for notice and comment either as submitted or with modifications adopted by the board. This option may be attractive because it allows proposed rules to be quickly promulgated for notice and comment without the necessity of a licensing board formally endorsing the recommendations. Instead, all that is required is for a board to conclude that the topic and recommendations have sufficient merit to be promulgated for notice and comment. 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