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


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.


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

PUBLIC HEALTH CODE
ARTICLE 15 OCCUPATIONS














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

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

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


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


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


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


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


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

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


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

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


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


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


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


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


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

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)

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


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


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


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

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

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


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

• 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

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

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

Freedom of Information Coordinator
Dept. of Community Health
Bureau of Health Services
P.O. Box 30670
Lansing, Mi 48909
Fax: (517) 241-0191


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

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


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


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


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

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

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

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


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