Oregon State Board of Nursing Memorandum

Transcription

1 1 Oregon State Board of Nursing Memorandum TO: FROM: Interested Parties Ruby R. Jason, MSN, RN, NEA-BC Executive Director DATE: May 2016 SUBJECT: NOTICE OF BOARD MEETING The Oregon State Board of Nursing will meet Tuesday, Wednesday and Thursday, June 14-16, 2016, in the conference room of the Oregon State Board of Nursing, S.W. Upper Boones Ferry Road, Portland, Oregon. On June 14 th, the Board will meet at 6:30 p.m. and continue until 8:00 p.m., or to the end of business, to discuss and schedule topics related to nursing regulation policy. On June 15 th the Board will meet at 8:30 a.m. and continue until 4:00 p.m., or to the end of business. Portions of the meeting will be held in Executive Session for disciplinary proceedings, as authorized by ORS , ORS , and ORS The Board will meet for the purpose of discussing and taking action on disciplinary cases including Defaults, Stipulations, requests for Board Direction, Dismissals, and Consent Agenda of Cases Closed with No Violations of the Nurse Practice Act. The Board will go into Public Session periodically for the sole purpose of taking formal action on cases that have been reviewed in Executive Session. Board action may include but is not limited to, ratification of interim consent orders, motions for discipline, and approval or denial of licensure. On June 16 th the Board will convene in Executive Session from 8:30-9:00 a.m. to consider any additional disciplinary or legal matters from the previous day. The Board will then meet in Public Session at 9:00 a.m. to discuss rule changes to the Nurse Practice Act and other nursing practice, licensure, and education-related issues. The meeting timeline is tentative and the order of agenda items may be changed at the Board s discretion. If you have a disability that requires any special materials, services, or assistance please contact Peggy Lightfoot via phone ( ) or (peggy.lightfoot@state.or.us), so appropriate accommodations may be arranged. Current Board Members: Bonnie Kostelecky, RN (President) Barbara Gibbs, LPN ( Secretary) Colin Hunter, Public Member (President-Elect) Kathleen Chinn, RN, FNP Adrienne Enghouse, RN Beverly Epeneter, RN Barbara Turnipseed, RN Ryan Wayman, Public Member William Youngren, CNA

2 2 TENTATIVE TIMEFRAME FOR JUNE 2016 BOARD MEETING Tuesday, June 14, 2016 Agenda Items 6:30 p.m. 8:00 p.m. PUBLIC SESSION: Telehealth Nursing and Cross Jurisdictional Licensure Wednesday, June 15, 2016 Agenda Items 8:30 a.m. End of business EXECUTIVE SESSION: Defaults Stipulations Board Direction Dismissals Consent Agenda of Cases for Recommended Closure 12:00 p.m. 1:00 p.m. PUBLIC SESSION Lunch and Learn Presentation: State Budgeting Process John Etherington, Licensing and Fiscal Manager Thursday, June 16, 2016 Agenda Items 8:30 a.m. 9:00 a.m. EXECUTIVE SESSION 9:00 a.m. 9:30 a.m. RULEMAKING HEARING 9:30 a.m. 10:00 a.m. TRAINING AND ASSESSMENT 10:00 a.m. 10:30 a.m. PRACTICE AND EVALUATION 10:30 a.m. 12:00 p.m. ADVANCED PRACTICE 12:00 p.m. 12:15 p.m. BREAK 12:15 p.m. 1:00 p.m. LUNCH PRESENTATION 1:00 p.m. 1:30 p.m. OPEN FORUM 1:30 p.m. 2:30 p.m. EDUCATION 2:30 p.m. 3:30 p.m. ADMINISTRATION Please note: The above timeframe is tentative except for the open forum at 1:00 p.m. on June 16, The time for individual agenda items may vary. Agenda items may also be rescheduled at the discretion of the Board president. Portions of the meeting will be held in Executive Session for disciplinary proceedings, as authorized by ORS , ORS and ORS

3 Oregon State Board of Nursing Board Meeting June 14-16, 2016 Agenda - Page 1 3 MEETING June 14-16, 2016 A G E N D A TUESDAY, JUNE 14, :30 p.m. 8:00 p.m. OR END OF BUSINESS PUBLIC SESSION: Telehealth Nursing and Cross Jurisdictional Licensure WEDNESDAY, JUNE 15, :30 a.m. END OF BUSINESS EXECUTIVE SESSION: Defaults Stipulations Board Direction Dismissals Consent Agenda of Cases for Recommended Closure THURSDAY, JUNE 16, :30 a.m. EXECUTIVE SESSION 9:00 a.m. PUBLIC SESSION 1. CALL TO ORDER 2. PUBLIC MEETING NOTICE 3. ROLL CALL 4. DECLARATION OF QUORUM 5. INTRODUCTION OF BOARD MEMBERS, STAFF AND AUDIENCE REVIEW OF MEETING AGENDA 1. Additions, Modification, Reordering of Agenda 2. Approval of Consent Agenda* M.S.C., that the Consent Agenda items (be/not be) approved as (presented/corrected) Page Consent Agenda Items: Number C-M1 Approval of Minutes from the March 23, 2016 Teleconference 9 Board Meeting C-M2 Approval of Minutes from the April 12-14, 2016 Board Meeting 17 C-M3 Approval of Minutes from the May 11, 2016 Teleconference Board Meeting 37 C-A1 Fiscal Status Report 42 C-A2 Communications and IT Report 45 C-A3 RBH HPSP Satisfaction Report 46 C-L1 Licensing and Fiscal Report 75 C-L2 Ratification of CNA/CMA Training Program Approvals and Withdrawals 76 *Any Consent Agenda item may be removed from the Consent Agenda by a Board member asking the President to consider it separately.

4 Oregon State Board of Nursing Board Meeting June 14-16, 2016 Agenda - Page 2 4 9:00 a.m. 9:30 a.m. ADMINISTRATIVE RULEMAKING HEARING H1. Adoption of Amendments to Discussion and Action 79 Division 2 Administrative Rules (Exhibit H1) Regarding Agency Fees M.S.C., that the proposed amendments to OAR (be/not be) adopted as (presented/modified) 9:30 a.m. 10:00 a.m. TRAINING AND ASSESSMENT Debra Buck, Policy Analyst - Training & Assessment CNA1. Appointment Request- Discussion and Action 83 New CNA/CMA Advisory (Exhibit CNA1) Group Membership M.S.C., that the applicants presented (be/not be) approved for the newly formed Oregon State Board of Nursing CNA/CMA Advisory Group positions CNA2. Environmental Scan Board Review and Questions Discussion 10:00 a.m. 10:30 a.m. PRACTICE AND EVALUATION Gretchen Koch, Policy Analyst - Nursing Practice & Evaluation PR1. Environmental Scan Discussion Board Review and Questions 10:30 a.m. 12:00 p.m. ADVANCED PRACTICE Christina Cowgill, Policy Analyst - APRN Education & Assessment AP1. Advanced Practice Registered Discussion and Action 85 Nurse & Non-Surgical Aesthetic (Exhibit AP1) Procedures Interpretive Statement M.S.C., that the Advanced Practice Registered Nurse and Non-Surgical Aesthetic Procedures Interpretive Statement (be/not be) approved as (presented/modified) AP2. OHSU Family Nurse Practitioner Discussion and Action 90 Program Quarterly Updates (Exhibit AP2)

5 Oregon State Board of Nursing Board Meeting June 14-16, 2016 Agenda - Page 3 5 M.S.C., that the OHSU FNP Program quarterly improvement reporting to the Board (be/not be) discontinued AP3. Division 50 Review of Draft Discussion and Action 91 Revisions Prior to Rulemaking Process (Exhibit AP3) M.S.C., that based on the information presented, Board staff continue with rulemaking related to Division 50 AP4. Environmental Scan Discussion 109 Board Review and Questions (Exhibit AP4 and Exhibit AP4.1) 12:00 p.m. 12:15 p.m. BREAK 12:15 p.m. 1:00 p.m. LUNCH PRESENTATION Oregon s Nurse Faculty Workforce: Challenges to RN Supply Jana R. Bitton, MPA Executive Director, Oregon Center for Nursing 1:00 p.m. 1:30 p.m. OPEN FORUM The Board will not be able to act on any issues presented at the Open Forum because prior public notice has not been given, but the Board can take matters under consideration as agenda items at future Board meetings. If there are no presentations during the forum, the Board will proceed with the conduct of regular business. 1:30 p.m. 2:30 p.m. EDUCATION Joy Ingwerson, Policy Analyst - Nursing Education & Assessment E1. Blue Mountain Community College Discussion and Action 113 Survey Visit Report (Exhibit E1) M.S.C., that the Blue Mountain Community College Associate Degree Nursing Program (be/not be) Approved for up to eight (8) years to April, 2024 E2. Umpqua Community College Discussion and Action 137 Survey Visit Report (Exhibit E2)

6 Oregon State Board of Nursing Board Meeting June 14-16, 2016 Agenda - Page 4 6 M.S.C., that the Umpqua Community College Associate Degree Nursing Program (be/not be) approved for up to three (3) years to April 2019, with a report on actions to correct deficiencies to be submitted for review at the April 2017 Board meeting E3. Umpqua Community College Discussion and Action 163 Practical Nursing Program (Exhibit E3) Survey Planning M.S.C., that the survey visit to the Umpqua Community College Practical Nursing Program be moved to April 2017 with continued program approval until that time E4. Concordia University Discussion and Action 164 Curriculum Change (Exhibit E4) M.S.C., that the Concordia University Major Curriculum Changes (be/not be) approved as (presented/modified) E5. Environmental Scan Discussion Board Review and Questions 2:30 p.m. 3:30 p.m. ADMINISTRATION - Ruby Jason, Executive Director A1. Director s Report A2. Division 10 Review of Draft Discussion and Action 195 Revisions Prior to Rulemaking Process (Exhibit A2) M.S.C., that based on the information presented, Board staff continue with rulemaking related to Division 10

7 Oregon State Board of Nursing Board Meeting June 14-16, 2016 Agenda - Page 5 7 A3. Rule Advisory Committee for Discussion and Action for review of Division 54 Clinical Nurse Specialists M.S.C., that the OSBN staff assemble a Rule Advisory Committee for Review of Division 54 Regarding Clinical Nurse Specialists A4. Approval of Probation Criteria for Discussion and Action CRNAs with Substance Use Disorders (Exhibit A4 - Handout) M.S.C., that the Probation Criteria for CRNAs with Substance Use Disorders (be/not be) adopted as (presented/modified) A5. Out of State Licensed Nurses Discussion and Direction 198 and Student Field Trips into Oregon (Exhibit A5) A6. Source Verification for National Discussion and Action 199 Certification for NPs, CRNAs and CNSs (Exhibit A6) M.S.C., that the Primary Source Verification of Advanced Practice Registered Nurse National Certification required by applicable rule(s) (is/is not) required A7. Rule Hearing Proposal Discussion and Direction 201 (Exhibit A7) NEXT BOARD MEETINGS The next scheduled Board Meetings via teleconference will be held in Executive Session on July 13, 2016 and August 10, 2016 at the Board offices, S.W. Upper Boones Ferry Road, Portland, Oregon. The next regularly scheduled in-person Board meeting will be at the Board offices on September 7-8, 2016, with a Board Work Session on September 9, ADJOURNMENT

8 8

9 9 OREGON STATE BOARD OF NURSING BOARD MEETING Minutes March 23, :30pm Board Members Present Bonnie Kostelecky Barbara Gibbs Beverly Epeneter Bobbie Turnipseed Colin Hunter Donna Cain Ryan Wayman Board Members Excused Kathleen Chinn Staff Members Present Ruby Jason Jacy Gamble Rick Sexton Rebecca Nyberg Suzanne Meadows Wendy Bigelow Maria Parish Shanon Rahimi Karen Russell Michelle Standridge Suzi Shults Leslie Kilborn Tanya Wade Nikki Blomquist Benita Ficarra Helen Turner Board Counsel Present Tom Cowan MSC Epeneter, Gibbs that based on the procedural record, Lisa Dix, RN Applicant be issued a Final Order by Default, denying the application as set forth in the Notice. Ayes 6, Excused 1 Chinn Page 1 of 8

10 10 MSC Epeneter, Gibbs that based on the procedural record, Cynthia Severin, RN be issued a Final Order by Default, suspending the license as set forth in the Notice. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the procedural record, the following: Rebecca Bichler, CNA John Clay, RN Curtis Hamilton, LPN Janet Ranney, CNA Preston Walker, CNA be issued Final Orders by Default, revoking the licenses or certificates as set forth in the Notice. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that the Interim Orders by Consent, signed by the following: Stephanie Callahan, RN Jana Nistler, RN Timothy Wheeler, LPN be ratified. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence provided, the Stipulation for Probation, signed by Amy Bray, LPN Reinstatement Applicant be adopted and reinstatement be granted. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, Mellisa Moore, CNA Renewal Applicant Page 2 of 8

11 11 be issued a Notice of Proposed Denial of CNA Certification. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by following: Alice Cain, RN Rebecca Forte, RN Sylvia Garcia, CAN Debra Hill, CAN Deborah Taylor, RN be adopted. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Reprimand, signed by the following: Natalie Blevins, CNA Rita Murphy, RN be adopted. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Withdrawal of Application, signed by Ashley Wiens, CNA Applicant be adopted. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Probation, signed by the following: Angielin Hill, CNA Lori Linton Nelson, NP Michelle Spangler, RN be adopted. Ayes 6, Excused 1 Chinn Page 3 of 8

12 12 MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Suspension followed by Probation, signed by Amanda Ciraulo, RN be adopted. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the following: Samuel Coleman, RN Endorsement Applicant Sante Van Meter, CAN Renewal Applicant be issued Notices of Proposed Denial. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, Jennifer Darrow, RN be issued a Notice of Proposed Civil Penalty. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the following: Barbara Jaques, RN Andrea Loveday, RN be issued Notices of Proposed Revocation. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the licensee in the case number: be issued an Order for Evaluation. Ayes 6, Excused 1 Chinn Page 4 of 8

13 13 MSC Epeneter, Gibbs that based on the evidence presented, case numbers: be dismissed. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, Lorian Ordonez, RN be issued an Amended Notice of Proposed Revocation. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, case number: be dismissed. Ayes 6, Excused 1 Chinn Investigations Status Reports were reviewed in the following case numbers: Board directed the investigations to continue. MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Probation, signed by Danielle Caldwell, RN be adopted. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs Page 5 of 8

14 14 that based on the evidence presented, the licensee in the following case number: be allowed entry into HPSP and the case be dismissed upon completion of full enrollment. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, the licensee in the following case number: be allowed entry into HPSP and the case be dismissed upon completion of full enrollment. Ayes 6, Nay 1, Excused 1 Chinn MSC Epeneter, Gibbs that based on the evidence presented, case numbers: be dismissed. Ayes 6, Excused 1 Chinn MSC Epeneter, Gibbs that the Board accept Staff recommendations that investigations outlined in summaries for cases between February 3, 2016 and March 10, 2016 be closed. Ayes 6, Excused 1 Chinn MSC Epeneter, Cain that based on the evidence presented, case numbers: Page 6 of 8

15 be dismissed. Ayes 5, Excused 2 Chinn, Gibbs MSC Epeneter, Cain that based on the evidence presented, case number: be closed as an inactive investigation. Ayes 5, Excused 2 Chinn, Gibbs MSC Epeneter, Cain the Board extends the licensee s program contract by one year as noted in the Compliance Advisory Committee Memo. Ayes 5, Excused 2 Chinn, Gibbs Page 7 of 8

16 16 MSC Cain, Turnipseed that the Interim Orders by Consent, signed by the following: Andrea Loveday, RN Lisa Miller, RN Alex Woolner, LPN be ratified. Ayes 5, Recused 1, Epeneter, Excused 2 Chinn, Gibbs MSC Epeneter, Cain that the Interim Order by Consent signed by Caitlin Lee, RN be ratified. Ayes 5, Excused 2 Chinn, Gibbs MSC Epeneter, Cain that based on the evidence presented, Caitlin Lee, RN be issued a Notice of Proposed Revocation. Ayes 5, Excused 2 Chinn, Gibbs Adjourned at 6:15 p.m. Page 8 of 8

17 17 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 1 of 20 MEETING April 12-14, 2016 M I N U T E S CALL TO ORDER Board President, Bonnie Kostelecky, called the regular meeting of the Oregon State Board of Nursing to order. This Board meeting was held in the conference room of the offices of the Oregon State Board of Nursing in Portland, Oregon. PUBLIC MEETING NOTICE A notice of this meeting was published on the Board of Nursing's website and sent out to the interested parties list by Ruby Jason, Executive Director, in accordance with the Open Meeting Law. The Board met in Executive Session during portions of the meeting as authorized by ORS and ROLL CALL Present/Absent Board Members Cain, Present Chinn, Present Epeneter, Present Gibbs, Present Hunter, Present Kostelecky, Present Turnipseed, Present Wayman, Excused QUORUM There being a quorum present, the Board President declared the Board eligible to conduct its business. Staff Members Present at Various Times Bigelow Blomquist Buck Cowgill Ficarra Gamble Holtry Ingwerson Jason Kilborn Koch Meadows Messina Parish Rahimi Sexton Shults Standridge Taube VanHorn Nyberg Lightfoot Cowan, Board Counsel

18 18 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 2 of 20 TUESDAY, APRIL 12, 2016 PUBLIC SESSION 6:30 p.m. Thomas Cowan, DOJ Assistant Attorney General and Board legal counsel, facilitated a discussion related to contested case hearing processes. Adjourned at 8:05 p.m. WEDNESDAY, APRIL 13, 2016 EXECUTIVE SESSION 8:30 a.m. MSC Gibbs, Epeneter that based on the procedural record, Lisa Jones, CNA be issued a Final Order by Default, suspending the certificate as set forth in the Notice. Ayes 6, Excused 1 Wayman MSC Gibbs, Epeneter that based on the procedural record, the following: Barbara Jaques, RN be issued a Final Order by Default, revoking the license as set forth in the Notice. Ayes 6, Excused 1 Wayman MSC Epeneter, Gibbs that based on the evidence presented, the Interim Order by Consent, signed by the following: Cami Butler, LPN Shawna Stanley, RN be ratified. Ayes 6, Excused 1 Wayman MSC Chinn, Cain that based on the evidence presented, the Stipulation for Probation, signed by Kay Kastrava, CNA Reactivation Applicant be adopted and reactivation be granted. Ayes 6, Excused 1 Wayman

19 19 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 3 of 20 MSC Epeneter, Chinn that based on the evidence presented, a Notice of Proposed Denial of Application be issued to the following: Julie Garner, RN Reinstatement Applicant Rebecca Johnson, RN Endorsement Applicant Tracy Miller, RN RN Endorsement Applicant Ayes 6, Excused 1 Wayman MSC Epeneter, Chinn that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by the following: John Elder, CNA Patty Holmes, RN Karma Sammy, CNA Tracy Wilkinson, LPN be adopted. Ayes 6, Excused 1 Wayman MSC Epeneter, Chinn that based on the evidence presented, the Stipulation for Reprimand, signed by the following: Cynthia Bowling, NP Julianne Hunter, RN Barbara Irving, LPN Heather Lorenz, RN Carol Oliver, NP be adopted. Ayes 6, Excused 1 Wayman MSC Epeneter, Chinn that based on the evidence presented, the Stipulation for Probation, signed by Charles Cole, CNA be adopted. Ayes 6, Excused 1 Wayman

20 20 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 4 of 20 MSC Chinn, Cain that based on the evidence presented, the Amended Stipulation for Probation, signed by the following: Amy Culley, LPN Jamie Grijalva, RN Lisa Holladay, RN Ruth Merrill, RN Kesa Nomiyama, RN be adopted. Ayes 6, Excused 1 Wayman MSC Chinn, Epenter that based on the evidence presented, the following: Jesse Misner, CNA Karen Moore, LPN Franklin Roles, RN be issued a Notice of Proposed Revocation. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented in case number: the licensee be allowed to complete the program and the case be dismissed. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented in case number: Probation be ended and the case be dismissed. Ayes 6, Excused 1 Wayman

21 21 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 5 of 20 MSC Chinn, Epeneter that based on the evidence presented in case number: a one year extension of licensees participation in the program be allowed and the case be dismissed. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented in case number: the licensee be allowed to inactivate licensure and the case be dismissed. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented, Tracy Koblinski, RN be issued a Notice of Proposed Revocation. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented, Patti Lanham Young, RN be issued a Notice of Proposed Suspension. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented, the Stipulation for Probation, signed by Anne Meeks, RN be adopted. Ayes 6, Excused 1 Wayman

22 22 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 6 of 20 MSC Chinn, Epeneter that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by Lauri Wallace, LPN be adopted. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter, that based on the evidence presented, the licensee in the following case number: be issued an Order for Evaluation. Ayes 6, Excused 1 Wayman Working Lunch: Footcare and Nursing Presenters: Michelle Standridge, RN Investigator and Wendy Bigelow, RN Investigator MSC Chinn, Epeneter that based on the evidence presented, case numbers: be dismissed. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented Jacalyn Dubay, NP be issued a Notice of Proposed Revocation. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by Benjamin Farlow, RN be adopted. Ayes 5, Recused 1 Cain, Excused 1 Wayman

23 23 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 7 of 20 Based on the status update in case number: The Board directed the investigator to continue the investigation. MSC Epeneter, Gibbs that based on the evidence presented, licensees in the following case numbers: be allowed entry into HPSP and the Interim Order by Consent be vacated upon compete enrollment. Ayes 6, Excused 1 Wayman MSC Epeneter, Cain that based on the evidence presented, licensee in the following case number: be allowed entry into HPSP. Ayes 5, Recused 1 Gibbs, Excused 1 Wayman MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Probation, signed by Kara Del Curto, NP be adopted. Ayes 6, Excused 1 Wayman MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by Terence Mitchell, RN be adopted. Ayes 6, Excused 1 Wayman

24 24 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 8 of 20 MSC Epeneter, Gibbs that the Board accept Staff recommendations that investigations outlined in summaries for cases between March 10, 2016 and March 30, 2016 be dismissed. Ayes 6, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented, case number: be dismissed. Ayes 5, Recused 1 Epeneter, Excused 1 Wayman MSC Chinn, Epeneter that based on the evidence presented in case numbers: be dismissed. Ayes 6, Excused 1 Wayman

25 25 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 9 of 20 MSC Chinn, Epeneter that based on the evidence presented, Kathy Truong, RN be issued a Notice of Proposed Suspension. Ayes 6, Excused 1 Wayman MSC Epeneter, Gibbs that based on the evidence presented, the Board adopts the ALJ s Proposed Order and Joseph Finel, CNA be issued an Final Order of Revocation. Ayes 6, Excused 1 Wayman MSC Epeneter, Gibbs that based on the evidence presented, the Board adopts the ALJ s Proposed Order and Gary Rogers, CNA be issued a Final Order of Suspension. Ayes 6, Excused 1 Wayman MSC Epeneter, Gibbs that based on evidence presented, the Board adopts the ALJ s Proposed Order and Tamara Dixon, NP be issued a Final Order of Revocation. Ayes 5, Recused 1 Cain, Excused 1 Wayman MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Reprimand, signed by Deborah Sanders, RN be adopted. Ayes 6, Excused 1 Wayman

26 26 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 10 of 20 MSC Epeneter, Gibbs that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by Joshua Shepherd, RN be adopted. Ayes 6, Excused 1 Wayman Adjourned at 2:10 p.m. THURSDAY, APRIL 14, 2016 EXECUTIVE SESSION 8:30 a.m. The Board met in Executive Session as authorized by ORS and ORS THURSDAY, APRIL 14, 2016 PUBLIC SESSION 9:00 a.m. Board President, Bonnie Kostelecky, called the meeting to order at 9:05 a.m. A quorum was present. Introductions: staff, Board members, audience REVIEW OF MEETING AGENDA ADDITIONS, MODIFICATIONS, REORDERING OF AGENDA There were no requests for additions, modifications, or reordering of the agenda. APPROVAL OF CONSENT AGENDA M.S.C. Epeneter, Cain that the Consent Agenda items be approved as presented Ayes 6, Excused 1 (Wayman) C-M1 C-A1 C-A2 C-A3 C-E1 C-L1 C-L2 C-PR1 Approval of Minutes from the February 16-18, 2016 Board Meeting Fiscal Status Report Communications and IT Report National Council of State Boards of Nursing (NCSBN) Programs and Services Pioneer Pacific College Extended Campus Request Licensing, Fiscal and Organization Development Report Ratification of CNA/CMA Training Program Approvals and Withdrawals Nurse Practice Committee New Member Applicant

27 27 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 11 of 20 TRAINING & ASSESSMENT CNA1. Environmental Scan Training and Assessment Policy Analyst Debra Buck provided information and updates. Ms. Buck is continuing her pursuit to increase the pass rate on the Nursing Assistant State Certification Exam. She recently completed the second annual Headmaster Testing Workshops; about 57 participants attended representing about 66% of the training programs. There were two workshops in Portland over the weekend, then she traveled to Springfield, Central Point, and Klamath Falls for additional workshops. During the workshops, one thing that came to light was the number of training program faculty retiring within the next five to ten years. The annual report from the training programs included in the February 2016 Board meeting materials reflected a high number of unfilled faculty positions and faculty planning to retire in the next three to five years. Two-thirds of all primary instructors for CNA level one, level two, and Medication Aide training programs are over the age of 55. As of October 1, 2015, 83% of the Nursing Assistant programs reported that there were 26 budgeted primary instructors, or clinical teaching associate positions, unfilled with current active recruitment. These programs also reported needing 67 full-time or part-time primary instructor clinical teaching associates in the next two years. There is a summit scheduled for October 14, 2016, for stakeholders to create a plan to address the faculty shortage issue. Another challenge that came to light during the workshops was from the community colleges. Originally, when the Board started regulating nursing assistant training programs, community colleges were some of the first on board and continue to be quality providers of nursing assistant training in the state. In the last few years nursing assistant training programs are being moved from under nursing departments, and into the community education non-credit side at community colleges. Due to the competition for clinical sites, there is talk that some community colleges are considering no longer being involved in nursing assistant training in this state. There are, however, other community colleges in the state that are thriving. Ms. Buck suggested that communication between the programs take place to assist the colleges facing challenges. There were recent revisions to DHS rules related to reimbursements for nursing assistant training. One of the changes in the rules is to clarify for students what expenses are reimbursable. The new rules also strengthen the facility requirements to inform CNAs of the reimbursement program upon hire. One of the most significant revisions to the rule is the change from 12 months to three months for students to receive reimbursements. The revisions will also enable DHS to better track the newly hired CNAs and the reimbursements. DHS also has the ability to sanction facilities that are not compliant; if they fail to report, fail to timely reimburse or report, or if there are discrepancies, they could be faced with a fine of up to $1,600 per CNA. Applications are being received for the CNA/CMA Advisory Group representing a wide variety of employers, educators, administrators, and CNAs. The deadline to submit the applications is April 15. Ms. Buck suggested that a board member be included in the group, and anticipates providing applicant information at the June Board meeting. Lastly, Ms. Buck reported that she continues to work on the Test Master University (TMU) implementation. This is a software program developed by Headmaster, the current CNA and CMA testing vendor. It serves both as a registration system for students in these types of training programs, and also as a vehicle for scheduling and transmitting tests.

28 28 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 12 of 20 PRACTICE AND EVALUATION PR1. Environmental Scan Practice and Evaluation Policy Analyst Gretchen Koch provided information and updates. Ms. Koch reported that the Oregon Center for Nursing (OCN) recently published a report on Oregon s newly licensed workforce pertaining to where licensees are seeking employment. The report indicated about 75% predominance for hospital employment with the Bachelor of Science in Nursing (BSN) prepared RN. The Associates Degree in Nursing (ADN) prepared new licensees are more often employed in the fields of longterm care, assisted living, community health, public health, and similar venues. There are implications for preparation of a workforce with the competency and skills to address the health needs of people that are receiving care in the community and outside of the hospital. This also ties in to the fact that there has been some pilot grants for Centers for Medicare and Medicaid Services (CMS) enhancing reimbursement for physicians to provide assessment within the nursing facility. Although Oregon is not one of the states that is currently doing this, there are about six other states whereby the nursing facility would receive more reimbursement for providing acute care interventions where typically that person would have received care in the hospital. There will be a Board learning session on the future health needs of Oregon in practicing community-based care. Ms. Koch stated she would contact the policy analysts at other state boards as to the data they are receiving related to this issue. Ms. Koch provided an update on the rule revisions to Division 45, stating that the work continues based on Board direction that was provided at the February 2016 Board meeting. This included looking at language related to a licensee s responsibilities when working with unlicensed assistive personnel, as well as finalizing language around professional boundaries and ethical practice. The goal is to present Division 45 revisions to the Board at the September Board meeting for Board direction on proceeding with rule revisions. ADVANCED PRACTICE AP1. Environmental Scan APRN Education and Assessment Policy Analyst Christy Cowgill provided information and updates. Ms. Cowgill referred to a report in the packet consisting of a list of the current Nurse Practitioner clinical placements in the state of Oregon for the last quarter of 2015 and the first quarter of There are 13 universities reporting, which has been fairly consistent over the past year. There was a question from the Board as to why people are pursing degrees from external universities; Ms. Cowgill responded that the Oregon universities cannot currently accommodate the volume of students, so they are having to look at out-of-state universities. OHSU and PSU, the only Oregon schools that currently have advance practice programs are at capacity. The APRN Rules Advisory Committee (RAC), continues to meet regularly regarding advanced practice rule revisions. Ms. Koch facilitated the March meeting; the focus was Division 45, with discussion as to how to incorporate APRN conduct derogatory language into Division 45. There was feedback, some of which will be incorporated in the regulations and some of which may be used to adopt interpretive statements. There was discussion pertaining to nurse fatigue, and how many hours can a practitioner work and be safe, which could be difficult to incorporate into regulation. Another discussion focused on the issue of fraudulent billing practices, which again goes back to the ethical standards that the advanced practice nurse would operate under and incorporating those into Division 45. The APRN RAC meeting minutes are posted on the agency website, including the March meeting minutes. The committee is leveraging technology, utilizing Adobe Connect which allows both audio and video recordings of these meetings. In the December and March meetings, roughly attended the meetings; about half of the attendees attended via distsance. The APRN RAC discussion surrounding Division 50 has been in progress since January The RAC will

29 29 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 13 of 20 continue discussion and propose language amendments related to Division 50. In addition, the RAC will be introduced to new topics including telehealth and licensing barriers at the May 5, 2016 meeting. Lastly, at the February Board meeting, the Board approved the amendments to Division 52, which is the division related to the Nurse Anesthetist. These rules will have an effective date of August 1, As an update to that, Board staff have been working with the Board of Medical Imaging and Oregon Health Authority (OHA), Public Health Division of Radiation Protection Services to interpret all applicable rules surrounding the practice and use of medical imaging technology by the Advanced Practice Nurse.. The Boards recognize that and intend to navigate the rules as such that these Boards can offer services to the public, but also do have to respect their Board make-up may influence how their regulations are interpreted and implemented. EDUCATION E1. NCLEX -PN Improvement Plan Concorde Career College Education and Assessment Policy Analyst Joy Ingwerson made opening comments related to statistics and trending of NCLEX -PN results prior to addressing the NCLEX -PN Improvement Plan for Concorde Career College. Ms. Ingwerson reminded the Board that NCLEX pass rate reports for five RN programs were presented to the Board at the February Board meeting. This Board meeting includes four PN programs, one of which is divided into two campuses. As a frame of reference, of the programs in Oregon, there are nine PN standalone programs, meaning that the program intends to graduate PNs. There are five PN-exit option programs, meaning most students really intend to complete the entire program, but have the option to exit after the first year. It is an oddity in terms of data because a lot of students in those programs take the NCLEX -PN even though they may have no intention of working as PNs. There are 17 associate degree programs, primarily based in community colleges and spread throughout the state, and six BSN programs. Nationally, first-time NCLEX -PN pass rates vary widely from state to state; 36% to 94%. In 2013, the national average pass rate for NCLEX -PN was 85%, Oregon was 92%. In 2014, the national pass rate was 83%, Oregon was 89%. In 2015, the national pass rate was 81%, Oregon was 85%. Oregon has always stayed above the national average for pass rates, even based on just the PN stand-alone programs. The Nursing Education Advisory group has had discussions regarding possibly looking at other measures, besides the first-time pass rate as a metric to track programs. The reports received on NCLEX pass rates to not allow for reviewing a cohort group very easily, but schools can compile data this way. Related to the NCLEX improvement plans, as the Board saw at the February Board meeting, there is a fair amount of variability as to how the reports are prepared. The reports are screened to assure that programs are focusing on the factors that can impact the pass rate, that faculty have been involved in the plan, and using data that makes sense for carrying out that analysis. There are themes seen, the first being the use of vendor computer-based testing. There is no requirement that any program uses testing of that type. Faculty shortage and faculty turnover, and issues filling faculty positions are apparent in almost every program in the state. Ms. Ingwerson introduced Tamra Samson, Director of Nursing, and Kary Weybrew, Regional Nursing Education Specialist, representing Concorde Career College. Ms. Ingwerson explained that Concorde Career College provided the required plan to address a two-year pass rate of 80.4% which does not meet the required 85% standard according to OAR The program provided an improvement plan to the Board in June 2015, because they fell below a one year pass rate requirement of 70%, and began to work on some of the issues that were going to influence the two-year report as well. The most recent pass rate for 2015 is 82.35%, which was up from the overall in 2014 of 80%. There was a correction noted to the cover memo, to indicate the all candidates who had graduation dates in 2015 passed on their first attempt. The program has been tracking the progress of students who graduated in the November 2015 graduate group; Ms. Samson stated that of the 15 graduates, 12 have tested, 10 passed. There were Board questions

30 30 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 14 of 20 and discussion related to the faculty vacancy rate and level of experience, the students meeting with faculty or the director of nursing education, who do not meet the expected benchmarks or scores. M.S.C. Epeneter, Gibbs that the NCLEX -PN Improvement Plan from Concorde Career College be accepted as presented Ayes 6, Excused 1 (Wayman) E2. NCLEX-PN Improvement Plan Pioneer Pacific College Springfield Ms. Ingwerson introduced Carmen Angel, Nursing Program Director Springfield and Barbara Lew, Nursing Program Director Wilsonville, representing Pioneer Pacific College. Ms. Ingwerson referred to the reports, pointing out that for the Springfield campus, it was noted that students failing the NCLEX had lower course grades, and more course repeats. There were some changes implemented in grading elements of those courses to ensure that students are meeting the academic achievement mentioned; closer monitoring of grades and advising to decrease the use of extra credit assignments that might have impacted grades. Both campuses have adopted changes to their admission standards, ensuring that the students admitted are capable of taking on the coursework required in the program and increasing structured advising for students. Ms. Ingwerson pointed out that the Wilsonville report contains more data than the report from Springfield. The Board asked questions related to the number of students in each program, and policies around course failures, and how many courses a student can fail and still be allowed to continue in the program and retake a course. Ms. Ingwerson pointed out that both programs are scheduled for program survey reviews in M.S.C. Epeneter, Chinn that the NCLEX -PN Improvement Plan from Pioneer Pacific College Springfield be accepted as presented Ayes 6, Excused 1 (Wayman) E3. NCLEX-PN Improvement Plan Pioneer Pacific College Wilsonville M.S.C. Epeneter, Chinn that the NCLEX -PN Improvement Plan from Pioneer Pacific College Wilsonville be accepted as presented Ayes 6, Excused 1 (Wayman) E4. NCLEX-PN Improvement Plan Sumner College Ms. Ingwerson introduced Linda Edwards-Davies, Nursing Program Director, Joanna Russell, President, and Bill Honeycutt, Director of Education, representing Sumner College. Sumner College provided the required plan to address a two-year pass rate of 83.2% which does not meet the required 85% standard rate in OAR The Board has had discussions with representatives from Sumner at past meetings related to survey processes, about students being able to move forward in the program with a D grade. There is a summary included in the report related to grade distribution; from the detailed information, there were no Ds in nursing courses in the last six cohorts. The program has shared previously that the students still need to maintain an overall GPA. The adoption of the Lippincott Williams & Wilkins Pass Point testing in preparation products is new, replacing ATI, and may provide data that the program previously has not had access to. There were questions form the Board and discussion pertaining to faculty. M.S.C. Epeneter, Chinn that the NCLEX -PN Improvement Plan from Sumner College Wilsonville be accepted as presented Ayes 6, Excused 1 (Wayman)

31 31 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 15 of 20 E5. Letter of Intent and Preliminary Application for Associate Degree Nursing Program Pioneer Pacific College Ms. Ingwerson stated that Pioneer Pacific submitted the first level of application, a Letter of Intent and Preliminary Application, to develop an associate of applied science in nursing program which would be offered on both the Springfield and Wilsonville campuses. An analysis of the specific standards from Division 21 were applied to the preliminary application level to assist in determining whether those standards had been met, not met, or partially met. The areas that were not met were the studies documenting the need for graduates of the program, and the analysis of potential impact on other nursing programs. Ms. Ingwerson stated she did seek clarification regarding the budget, and received a response, that the school would be able to add an allocation of $48,000 that would be linked to development of the Wilsonville simulation space that was not accounted for in the budget. The budget did not reflect the cost of added faculty time to develop curriculum and move forward with the application. There were Board questions pertaining to past approval of schools requesting new programs, and questions from the Board related to the NCLEX pass rates in the currently offered PN program. Representatives from the school stated that they are in the process of implementing interventions to address the PN program pass rates, are currently in the process of getting students through with those new interventions, and are confident of the results so far. There was concern from the Board pertaining to the two categories marked not met in the report, related to documenting the need for graduates, as well as concern related to clinical sites and the need for an analysis of the current usage of facilities for clinical placements. M.S.C. Epeneter, Gibbs that Pioneer Pacific College not be granted Preliminary Approval to develop an Associate Degree Nursing Program Ayes 6, Excused 1 (Wayman) LUNCH BREAK 12:00 12:15 P.M. LUNCH PRESENTATION 12:15 1:00 P.M. Christopher Hamilton, and Dr. Robbie Bahl, Reliant Behavioral Health (RBH) facilitated a presentation on the topic of Toxicology. OPEN FORUM The Board is not able to act on any issues presented at Open Forum because prior public notice had not been given, but the Board could designate matters presented as agenda items at future Board meetings. Jana Bitton, Executive Director, Oregon Center for Nursing (OCN), explained that OCN is the state s nursing workforce center, whose focus is to look at the data related to the nursing workforce. Ms. Bitton pointed out that she noticed previous discussions and conversations around nurse faculty. OCN recently released a report on the nurse faculty workforce and there was a report in 2014 by the Health Resources and Services Administration (HRSA), pertaining to what the predictions of shortages are going to be between now and Overall, it is expected that there will be a surplus of nurses nationally, however, on the West Coast there will be a shortage. To thwart that shortage, Oregon will need to increase the nursing programs in the state by five to eight percent, looking at the nurse faculty issue now to stabilize the programs. OCN has a workgroup in place to look at nurse faculty at the RN level. The reports that OCN is working on right now are really focused on the demand for nurses, to look at it from as an objective of a view as possible, to get the best information for Oregon. There is a demand study that will be coming out very shorty related to the demand for associate degree nurses in hospitals, as opposed to long-term care, home health, and public health. Also, the HRSA, as part of the 2014 report, put together a model whereby each state workforce center could enter data related to their state to get updated information and be able to compare it to other states. They received permission to take some of Oregon s data, input into the

32 32 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 16 of 20 national model; Oregon is only one of five states that have done this. What was found so far is that Oregon is one of the only states that is collecting data related to retirement plans and looking at how many people are planning to retire. There were questions from the Board related to the background of OCN and funding. The OCN Board consists of 15 positions, currently there are 12 members. Gretchen Koch is the OSBN representative on the Board and Carlton Brown, Assistant Executive Director, ONA, is the OCN Board President. Funding sources are the $9 surcharge to nursing licenses, which provided 50% of the funding for the OCN, directed mostly towards research. Other funding includes grants, donations, and an annual fundraiser. Besides research, the mission of OCN is to collaborate for Oregon s nursing workforce and work on issues such as nurse faculty shortages and other issues that arise as a result of their research. Currently, there is contract with OSBN, working with the Nursing Education Advisory Group, related to clinical placements. Ms. Bitton stated that OCN has also published articles in the OSBN Sentinel and will continue to keep the Board updated on the work of the OCN. EDUCATION (Continued) E6. Environmental Scan Ms. Ingwerson provided information and updates. At the November 2015 Board meeting, the Board provided direction for completion of the Umpqua Community College program survey. That survey visit was completed the first week of April, and the report will be brought before the Board at the June Board meeting. In the interim, things have stabilized as far as changes in personnel, and the program is moving in a positive direction. Joanne Noone, OHSU Ashland Campus Associate Dean, and Chris Lee, OHSU Ashland faculty, along with herself, are planning to submit for grant dollars from the National Council of State Boards of Nursing (NCSBN). The grant pertains to looking at a measure other than first-time pass rate on NCLEX as a way to analyze school-to-school comparisons; the application is due in October. Ms. Ingwerson stated additional details will be provided to the Board at a future Board meeting. Ms. Ingwerson recently met with the president of Chemeketa Community College, Julie Huckestein, regarding pursing legislation related to community colleges granting baccalaureate degrees. Across the nation, when the Institute of Medicine (IOM) recommendation came out to increase the number of BSN prepared nurses, some states took this approach. In Oregon, there are laws that are very specific, prohibiting community colleges from doing anything at a higher education level. Ms. Ingwerson stated that when she met with Ms. Huckestein she agreed to bring this information before the Board. As this process proceeds, Ms. Huckestein may come before the Board herself to explain to the Board what the Legislative Concept is. Ms. Ingwerson reported that she facilitated a presentation at the Oregon Student Nurses Association meeting. Marquis companies had a booth there; they have about 22 buildings in Oregon consisting of longterm care, skilled care, and some assisted living facilities. Marquis companies are not going to be hiring LPNs going forward. ADMINISTRATION A1. Director s Report Executive Director Ruby Jason reported on staffing changes. John Etherington has been promoted to the position of Fiscal and Licensing Manager, replacing Helen Bamford, who has retired but is staying on parttime, working on organizational development including the implementation of the electronic performance management system. Two additional staff were hired to fill vacancies in Licensing, one to fill a vacancy, the other is a Limited Duration position to assist with timely issuance of licenses during peak graduation times. At this time last year, there were concerns from schools pertaining to student frustration related to the pace

33 33 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 17 of 20 of issuing licenses. There is a significant increase in the amount of people coming into Oregon, not only new graduates, but endorsements. There are many manual processes that will always be a part of licensing, including criminal background checks and obtaining necessary paperwork for licensure. In addition, Roberta Poole, the CNA/CMA Licensing Technician, has recently received an internal promotion moving to the Intake Complaint Coordinator, replacing Molly Taube, who was promoted to an Investigator 3 position. Ms. Jason reported that she will be going before the Emergency Board in May to request an increase in the expenditure cap for the Limited Duration positions in the agency. In addition, there will be a request for permanent financing for a series of reclassifications. Ms. Jason reported that the agency financial status is solid. The NCSBN 2016 NCLEX conference is scheduled on September 12, in Philadelphia. Ms. Jason pointed out that the materials in the Board packet included a list of Programs and Services offered by NCSBN. All ten of the Legislative Concepts have been submitted; Communications Manager Barbara Holtry explained each of the concepts. Prior to June 3, DAS will review all of the concepts and pass them on the Governor s Office to review for approval. If approved, notice of approval will be received and the concepts will be sent to Legislative Counsel for drafting. Ms. Holtry stated that one of the ten concepts is a placeholder to possibly add two additional members to the Board, this is the only concept that has a fiscal impact. There was Board discussion regarding this concept; a decision will need to be made about the placeholder by June 24 th, which is the deadline, if the Governor approves it. This will be brought up at the June Board meeting, which is scheduled prior to the 24 th. A2. Policy Proposed Notices of Discipline on OSBN Website At the February Board meeting, there was Board direction for staff to rewrite the policy, to specifically include language that notices of proposed revocation or suspension of a license or certificate generated by the Board staff, or the staff of the Attorney General s Office, will be posted on the verification page of the OSBN website. The Board was reminded that in these cases, the license remains unencumbered; a license is not encumbered until a final order is issued. It was explained that the purpose of posting these notices would add an additional level of transparency and proactive approach related to public safety. M.S.C. Epeneter, Chinn that the disciplinary actions of suspension or revocation imposed by the Oregon Board of Nursing be made available on the OSBN website to promote transparency and public safety Ayes 6, Excused 1 (Wayman) A3. Delegation to Board Staff to Extent Probation Stipulations Ms. Jason reminded the Board that they heard several cases where Board staff requested the Board to extend the probation stipulations for several licensees who could not find jobs, lost their original job due to termination, or removed themselves from practice. All probation stipulations require a specified period of monitored practice within a specified timeframe. Some licensees have difficulty finding new employment. Many of the licensees are completely compliant with the probation requirements and are actively seeking employment. If the licensee will not meet the required period of monitored practice within the specified probation timeframe, the staff must bring the information to the Board for approval to extend the original probation period to allow for completion of the monitored practice requirements. The staff is requesting that the Board allow the compliance committee to authorize an extension only for allowing the licensee to adhere to the original stipulation of monitored practice. If approved, the Board would delegate to the Compliance Advisory Committee, consisting of Board staff, the authority to extend the monitored practice requirement under certain conditions. There was Board discussion to confirm that these would only be one-time extensions, for the purpose of completing their original probation.

34 34 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 18 of 20 M.S.C. Cain, Epeneter that the Board delegate authority to the Compliance Advisory Committee to extend probation stipulations as described Ayes 6, Excused 1 (Wayman) A4. Oregon Administrative Rule Hearing Process Ms. Jason reminded the Board that at a previous Board meeting, there was discussion regarding conducting administrative rule hearings outside of the Board meetings. At that time, Board Counsel explained that there are Boards that currently conduct hearings this way; a public hearing is held outside of the regular Board meeting, all testimony, also required to be provided in written format, is collected by the rule hearings officer and presented to the Board. The Board would review testimony between the time of the public hearing, and the time the Board votes at the following Board meeting. Board direction was to further look into this process; it was found that multiple Boards in this state have rule hearings separate from Board meetings. There was Board discussion to try this for a period of time to see how it works. There was concern from the Board that they would not actually hear verbal testimony, denying those who wish to testify in person before the Board. There was agreement that there would be no vote at this meeting, but to bring this back before the Board at a future Board meeting including a process flow as to what this would look like. A5. Definition of Delegation and Assignment & Supervision Ms. Jason stated that Board staff had a discussion about the definitions of Delegation and Assignment and Supervision after receiving reports about confusion regarding the nurse s responsibilities regarding these acts. In OAR , Delegation has a specific meaning and definition. The interpretive statement presented was developed to guide the licensee involved in either nursing activity. Ms. Koch explained that the document included FAQs, and stated that she would make a correction to the definition of the term assignment as found in Division 45, and clarify some of the language in the FAQs. When finalized, the interpretive statement will be posted on the agency website. M.S.C. Epeneter, Gibbs that the Board accept the Interpretive Statement regarding Delegation and Assignment & Supervision as modified Ayes 6, Abstain 1 (Cain), Excused 1 (Wayman) A6. Cosmetic Services Interpretive Statement Ms. Jason stated that the Interpretive Statement reiterates that cosmetic services are within the scope of practice for an RN, and for an LPN under the clinical supervision of the RN. However, if the individual nurse is going to perform these services, they must do so in accordance with OAR , in conjunction with other statutes. The interpretive statement was designed to fit the decision scope tree, related to the nurse s knowledge, skills, and ability, while working with an Licensed Independent Practitioner (LIP). There was a suggestion for minor language modifications. There was Board discussion regarding the intent of the interpretive statement not including cosmetic procedures for medical issues. When finalized, the interpretive statement will be posted on the agency website. M.S.C. Epeneter, Gibbs that the Board accept the Interpretive Statement regarding Cosmetic Services as modified Ayes 6, Excused 1 (Wayman)

35 35 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 19 of 20 A7. The Registered Nurse and Licensed Practical Nurse Who Performs Foot Care Ms. Jason stated that the proposed interpretive statement relates to entrepreneurial RNs and LPNs who have been practicing foot care for the benefit of the community. Similar to cosmetic services, there has been little evidence that individuals are following the nursing practice standards including a treatment plan for an LIP. Additionally, there are some licensees counting this practice as nursing practice in the license renewal process. An interpretive statement would interpret the Nurse Practice Act when there are situations of a public complaint about individuals doing this service, as well as standards that have to be followed. There was a suggestion to modified language, page 2, line 22, to mirror Division 45, which states that the LPN works under the clinical direction of the RN or LIP. Language will also be added to include that the RN must have the knowledge, skills and abilities in foot care in order to have the LPN work under the supervision of the RN. When finalized this interpretive statement will be posted on the agency website. M.S.C. Epeneter, Gibbs that the Board accept the Interpretive Statement regarding the RN/LPN Who Performs Foot Care as modified Ayes 6, Excused 1 (Wayman) BOARD B1. Establishment of Subcommittee to rewrite OSBN Administrative Procedures Board President Bonnie Kostelecky suggested that a subcommittee work on OAR , Administration, which are rules related to the workings of the Board, including language pertaining to Board officers, elections and duties of officers. The subcommittee will consist of two Board members, Beverly Epeneter and Ryan Wayman, and a member of the public. ONA Assistant Executive Director Carlton Brown volunteered to serve on the subcommittee. The committee will meet and report back to the Board at the June Board meeting. Ms. Jason explained the difference between Board policy and Administrative Rules, explaining that the subcommittee would determine whether to put language into policy, rule, or a combination of both. A meeting date will be determined soon, probably sometime in May. M.S.C. Chinn, Gibbs that the Board establish a subcommittee to review administrative procedures as defined in OAR and review of Board policies Ayes 6, Excused 1 (Wayman) B2. Proposal to Elect President-Elect Ms. Kostelecky stated there is language in statute that the OSBN consist of a nine-member Board, made up of specific certain representation, a quorum being five members. There is a stipulation in statute, ORS , that the Board shall elect annually from its number, a President, a President-Elect, and a Secretary, each of whom shall serve until the successor is elected and qualified. There was discussion regarding voting, conflicts and recusals. Board counsel agreed to provide materials to the Board regarding this topic. There was clarification that the President-Elect would not necessarily be the successor to the President, but a separate elected officer, and that the President-Elect would step into the role of President in the President s absence. Board member Colin Hunter was nominated as President-Elect and accepted the nomination. M.S.C. Epeneter, Chinn that Colin Hunter be ratified as the new President-Elect for the Oregon State Board of Nursing Ayes 5, Abstain 1 (Hunter), Excused 1 (Wayman)

36 36 Oregon State Board of Nursing Board Meeting April 12-14, 2016 Minutes - Page 20 of 20 NEXT BOARD MEETING The next scheduled teleconference Board meeting will be held in Executive Session on May 11, 2016, at the Board offices, S.W. Upper Boones Ferry Road, Portland, Oregon. The next regularly scheduled in-person Board meeting will be at the Board offices on June 14-16, ADJOURNMENT Adjourned at 4:28 p.m.

37 37 OREGON STATE BOARD OF NURSING BOARD MEETING Minutes May 11, :30 pm Board Members Present Bonnie Kostelecky Barbara Gibbs Beverly Epeneter Bobbie Turnipseed Colin Hunter Donna Cain Kathleen Chinn Ryan Wayman Staff Members Present Ruby Jason Jacy Gamble Rebecca Nyberg Dante Messina Suzanne Meadows Wendy Bigelow Maria Parish Shanon Rahimi Michelle Standridge Suzi Shults Leslie Kilborn Nikki Blomquist Benita Ficarra Barb Holtry Tanya Wade Lisa Traynor Board Counsel Present Tom Cowan MSC Hunter, Gibbs that based on the procedural record, Elizabeth Beal, CNA Reactivation Applicant be issued a Final Order by Default, denying the application as set forth in the Notice. Ayes 7 MSC Hunter, Gibbs that based on the procedural record, Page 1 of 5

38 38 Skyler Zynda, CNA be issued a Final Order by Default, suspending the certificate as set forth in the Notice. Ayes 7 MSC Hunter, Gibbs that based on the procedural record, the following: Caitlin Lee, RN Karen Moore, LPN be issued Final Orders by Default, revoking the licenses as set forth in the Notice. Ayes 7 MSC Hunter, Gibbs that the Interim Orders by Consent, signed by the following: James Ball, RN Rachel Carlton, NP Sonja Hendershott, RN Sharon Kent, RN Amy Mendez, RN Eileen Padilla, RN be ratified. Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, the Stipulation for Withdrawal of Application, signed by Christopher Carlson, RN Applicant be adopted. Ayes 5 MSC Hunter, Gibbs that based on the evidence presented, the Stipulation for Voluntary Surrender, signed by the following: Jenny Burns, LPN Gaylene Copley, RN be adopted. Page 2 of 5

39 39 Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, the Stipulation for Reprimand, signed by Jana Nistler, RN be adopted. Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, the Stipulation for Suspension followed by Probation, signed by the following: Lorian Ordonez, RN Julie Taylor, RN be adopted. Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, the Amended Stipulation for Probation, signed by Aaron Boyce, LPN be adopted. Hunter, Gibbs MSC Hunter, Gibbs that based on the evidence presented, Jeffery Ford, LPN be issued a Notice of Proposed Revocation. Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, the licensee in case number: be issued an Order for Evaluation. Ayes 7 Page 3 of 5

40 40 MSC Hunter, Gibbs that based on the evidence presented, case numbers: be dismissed. Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, case numbers: be dismissed. Ayes 7 The Board directed staff to continue investigations based on status reports for case numbers: Page 4 of 5

41 MSC Hunter, Gibbs that based on the evidence presented, case numbers: be dismissed. Ayes 7 MSC Hunter, Gibbs that the Board accept Staff recommendations that investigations outlined in summaries for cases between March 30, 2016 and April 27, 2016 be closed. Ayes 7 MSC Hunter, Gibbs that based on the evidence presented, the Interim Order by Consent, signed by the following: Eileen Padilla, RN be vacated. Ayes 7 Adjourned at 5:40 p.m. Page 5 of 5

42 Oregon State Board of Nursing Expenditures and Ending Balance Through End of April Biennial LAB Expenditures Projected Expenditures (with Steps & COLA) Total Est. Under/Over Budget Limitation Thru Apr 2016 May June 2017 Expenditures Expended Personal Services * 8,592,788 3,558,234 5,161,315 8,719,549 Pending Salary Pot Distribution 0 Total Personal Services 8,592,788 3,558,234 5,161,315 8,719,549 (126,761) Services & Supplies ** 3,400,970 1,342,861 2,113,600 3,456,461 Fingerprinting 1,054, , , ,437 Note: The pending salary pot distribution is the amount allocated for Oregon State Board of Nursing for COLA and salary steps added by the Governor after Legislatively Approved Budget was prepared. It will be added to the original LAB after legislative approval. Total Services & Supplies 4,455,417 1,660,204 2,728,694 4,388,898 66,519 Capital Outlay 74, , ,137 Total Capital Outlay 74, , ,137 (84,042) Impairment Professional - Special Payments 1,643, , ,728 1,600,350 43,103 Distribution to Non-Profit Organization 500, , ,000 0 Total Budget with Salary Pot 15,265,753 6,155,197 8,711,737 15,366,934 (101,181) Original Budget 15,265, Legislatively Adopted Budget Revised Beg Bal + Actuals Thru Apr Beg Bal 3,052,619 3,052,619 Total LAB Revenues* 16,457,211 16,266,498 Total Available 19,509,830 19,319,117 Total Est. Expenditures (15,265,753) (15,366,934) Additional limitations to be provided for step increases and COLA Est Ending Balance 4,244,077 3,952,183 5/24/2016 Board Report thru Apr 2016.xls Ending Balance

43 Oregon State Board of Nursing Expenditures and Ending Balance Through April Thru July 2015 Aug June 2017 Oregon State Board of Nursing Revenue Chart Adv Practice 4.9% CNA 12.4% CMA 0.3% Administration 3.5% Fingerprinting 6.5% RN/LPN 72.4% Administration: Collections to Date Projected Revenue Total Revenues LAB Revenue NPAs, Mailing Lists 20,270 52,500 72,770 NSF Fees ,323 Other 6,408-6,408 OCN Fee 166, , ,200 Fingerprinting 379, , ,958 Subtotal 573, ,083 1,533,659 RN/LPN Programs: Licenses 4,564,915 6,359,299 10,924,214 Civil Penalties 38, , ,633 Subtotal 4,603,215 6,487,633 11,090,848 Advanced Practice Programs: Licenses 338, , ,768 CNA Programs: Training Programs 2,740 3,243 5,983 Certifications 440, ,607 1,148,587 Testing Fees 300, , ,185 Subtotal 744,406 1,147,350 1,891,756 CMA Programs: Testing Fees 13,761 13,285 27,046 Certifications 5,780 10,456 16,236 Training Programs 500 2,132 2,632 CNA2 Registrations Subtotal 20,041 25,873 45,914 Total Collections 6,279,383 9,036,562 15,315,945 15,491,249 Due to (transfered to) SPD (464,566) (848,805) (1,313,371) Transfer to DHS - PP Monitoring (32,715) (97,072) (129,787) Transfer to DHS - WF Development (84,500) (352,234) (436,734) Due from (transfered from) SPD 1,002,924 1,827,522 2,830, ,962 Net Match Revenue Total Revenue 6,700,525 9,565,973 16,266,498 16,457,211 5/24/2016 Board Report thru Apr 2016.xls Revenues by Program

44 Oregon State Board of Nursing Expenditures and Ending Balance Through April Oregon State Board of Nursing Expenditure Chart Thru July 2015 Aug June 2017 Board 0% Administration/Fiscal 14% Monitoring 14% Fingerprinting 5% Consulting 11% Investigations 31% Communications 8% Licensing & LEDS 18% Board: Detail Personnel 35,688 Services & Supplies 74,980 Total 110,669 Administration/Fiscal: Fingerprinting: Consulting Group: Licensing & LEDS: Communication/IT: Investigations: Monitoring: Agency Total: DAFR 9230 (08) Personnel 798,410 Services & Supplies 4,385 Fingerprinting 317,343 Personnel 589,131 Services & Supplies 56,462 Personnel 467,015 Services & Supplies 625,241 Personnel 294,341 Services & Supplies 48,451 Capital Outlay 158,137 Personnel 1,337,124 Services & Supplies 533,342 Personnel 36,524 Special Payments 778,622 Services & Supplies 0 Personnel 3,558,234 Services & Supplies 1,342,861 Special Payments 778,622 Capital Outlay 158,137 Fingerprinting 317, , , ,593 1,092, ,929 1,870, ,146 6,155,197 5/24/2016 Board Report thru Apr 2016.xls Exp by Org Unit

45 45 Memorandum May 18, 2016 TO: FROM: RE: Oregon State Board of Nursing Barbara Holtry, Communications Manager Communication and IT activities The following is a brief summary of communication and IT activities: Communications & Legislative: The Sentinel newsletter continues on a quarterly basis. August issue is due to publish the week of RN/LPN booklet is on hold awaiting revisions. Draft of the revised CNA booklet being finalized. Continuing coordination of media requests and website communications. Discipline news releases issued following each Board meeting. (Each meeting s discipline list also is published on the agency s website.) Legislative concepts for 2017 submitted to DAS. Awaiting decision on placeholder to submit prior to June 24. Participating in the state s enterprise public records request and management task force. Other Projects: Working to review various internal policies and update as needed. Working to incorporate civil penalties and Notices for suspension and revocation into the online verification system. Active shooter training session scheduled for June 8 onsite for staff. Due to multiple issues on Headmaster s side, go-live for the new CNA testing interface has been delayed several times. IT stands ready to implement as soon as it s final. IT is ready to implement the $9 Oregon Center for Nursing surcharge to endorsement applications (both online and on paper). The surcharge goes into effect July 1. Continuing plans for a redesign of the online application systems. We are waiting to hear final cost estimate for the Elite system, which would allow us to upgrade our online renewal and endorsement system and add exam applications. Several other boards are implementing the Elite system for their entire database, and we re next in line. If costs are acceptable, work could begin July 1. Two staff members will attend the NCSBN IT conference May 24 & 25. OSBN staff plans to visit the Idaho Board of Nursing this summer to see the NCSBN s new ORBs system in action.

46 46 Reliant Behavioral Health, LLC Health Professionals Services Program (HPSP) Satisfaction Report Year 6, 1 st Period Report: July 1, 2015 December 31, 2015 RBH Health Professionals Services Program 1220 SW Morrison Street, Suite 600 Portland, Oregon Fax:

47 47 Executive Summary Health Professionals' Services Program Satisfaction Survey: Year Six, First Period Report Overview: This Health Professionals Services Program report reviews the satisfaction survey results for the first period of the sixth year of the program, covering July 1, 2015 through December 31, Surveys were sent to the following groups of stakeholders at the beginning of January 2016: Licensees, Employers (Workplace Monitors), Treatment Providers, Health Associations, and the Boards. Each of these stakeholder groups will be surveyed again in July An overview of the number of surveys sent, number of responses received, and the response rate is displayed below and broken down by stakeholder group: Table 1: Response Rate - Year 6, 1 st Period Licensees Employers (Workplace Monitors) Treatment Providers Health Associations # Sent # of Responses Boards Response Rate 36.3% 23.3% 8.7% 11.1% 28.6% Highlights Survey results show that each of the stakeholder groups is pleased with the overall services provided by HPSP. Each group except the health associations is asked to rate the overall experience working with HPSP. Results for each stakeholder group are strong with a mode response of excellent or above average. Combining the excellent, above average and average ratings the program achieved a rating of at least 82.1% (by the licensees) and above 90% for the other three groups. The licensee population indicated that the program treats them with dignity and respect (84% agreement) and that program requirements are clearly explained (78% agreement). Nearly 89% indicate that they understand the program s statutory monitoring requirements. The structure and accountability provided by the program were also recognized by respondents. HPSP responses to licensees were rated positively in terms of time frame (74% of respondents), quality (77% of respondents), and professionalism (78% of respondents). Agreement Monitors were viewed as knowledgeable about the licensees case (82% of respondents.) Those who had been reported non-compliant primarily indicated they understood the process (all but two respondents). Those who had been recently enrolled and provided feedback, typically were positive about the process and supportive of the benefits of the in-person intake option. Workplace Monitors provided strong ratings for HPSP s customer service, particularly in the case of timeliness of responses, knowledge of licensees when there is a concern in the workplace, ability to respond to questions regarding program administration, and frequency of feedback regarding licensee s compliance. Ninety-two and a half percent (92.5%) of respondents indicated that they were either very satisfied or satisfied with the support they receive when supervising licensees. Forty (40%) of respondents indicated that they rate RBH s ability to monitor the licensee to ensure safety in the workplace as excellent and an additional 55% rated it above average or average. All (100%) of the treatment provider respondents agreed or strongly agreed that their questions/concerns were responded to promptly and that information was communicated clearly and professionally. Efforts have been increasingly made to provide treatment providers with the necessary information when meeting with a licensee; 80% of respondents agreed or strongly agreed with this statement. A collaborative relationship with the treatment providers is beneficial to the support of the licensees in their recovery and improved monitoring. Only two Board representatives responded to the survey this period and both were from the Medical Board. Results however were positive: When reflecting on a recent licensee situation, question, or concern both responders agreed or strongly agreed that they knew who to speak with, that the time frame was within one business day, and that RBH had knowledge of the licensee or situation. When reflecting on a broader question or programmatic concern, responders again agreed or strongly agreed that they knew who to speak with, felt comfortable bringing concerns forward, felt RBH provided useful and insightful data and felt the time frame was within one business day. January 2016 Year Six, First Period Report 2

48 It is recommended that RBH continue to outreach to each of the Professional Associations so that their support can be garnered. The Oregon Nurses Association continued to be the only responder to the survey. This period the program was rated as valuable but feedback from members was reported as below average. All responses will be reviewed by the PAC and an action plan will be put into place to address in order to provide for continued improvement. 48 January 2016 Year Six, First Period Report 3

49 Reliant Behavioral Health Health Professionals Services Program (HPSP) Satisfaction of LICENSEES 49 Purpose The purpose of assessing participants (Licensees) of the Health Professionals Services Program (HPSP) is to obtain constructive feedback that can be used to improve and maintain the quality, effectiveness, and efficiency of the HPSP Program. In order to provide continuous quality services, RBH evaluates Licensees satisfaction with the HPSP Program twice yearly. Feedback is obtained from Licensees via a satisfaction survey that is mailed or ed to each Licensee. When mailed, Licensees are given the option of completing the enclosed survey and mailing it back to the RBH offices in the postage-paid envelope, or going through the link to the survey and completing it online. The survey is short and can be completed in 2-3 minutes. Feedback includes information about program administration, RBH customer service, communication, Agreement Monitors, the non-compliance process, the enrollment process, and overall services. One method of determining the value of HPSP is through the Satisfaction Survey. One of the roles of the RBH Policy Advisory Committee (PAC) is quality management. Following review of the survey results, the PAC will identify opportunities for improvement and develop interventions if necessary. The PAC will continue to monitor performance at specified intervals following the implementation of the intervention(s). Data Results Response Rate Table 1: Response Rate This Period Year 5 Year 4 Year 3 Year 2 Year 1 # Sent # of Responses Response Rate 36.3% 27.5% 38.7% 26.9% 27.6% 23% The HPSP Licensee Satisfaction Survey was issued to 100% of the licensees enrolled in the HPSP Program at the close of December The survey was ed to 195 licensees and mailed to twenty. A total of 78 responses were received, representing a response rate of 36.3%. This means that more than a third of the enrolled licensees responded to the survey, similar to year four. Typically, closer to a quarter of the enrolled licensees respond. January 2016 Year Six, First Period Report 4

50 50 Respondents Question 1: 51.3% of respondents this period were representatives of the Board of Nursing. The Medical Board follows with 34.6%, then the Board of Pharmacy with 7.7%, and the Board of Dentistry with 5.1%. These figures are similar to last year (See Data Table 2.) More importantly, the responses are representative of the enrolled licensee population with only a slight difference of about one percentage point (See Data Table 3.) Data Table 2: Table 2: Respondents by Board This Period (n=78) Year 5 (n=125) # % # % Medical Board % % Board of Nursing % % Board of Dentistry 4 5.1% 9 7.2% Board of Pharmacy 6 7.7% % No Response 1 1.3% 4 3.2% Data Table 3: Table 3: Comparison of Enrollees to Respondents Percent of Enrollees (1/1/16) Percent of Respondents (This Period) Medical Board 35.3% 34.6% Board of Nursing 50.2% 51.3% Board of Dentistry 5.6% 5.1% Board of Pharmacy 8.8% 7.7% January 2016 Year Six, First Period Report 5

51 51 Overall Program Question #2: This question asks respondents to respond to four statements regarding the overall program. The mode response to all four items was agree with 47% to 51% of responders. An additional 26% to 37% of responders strongly agreed with each item. The lowest ratings were in regards to the program requirements being clearly explained. To gain additional insight, it is helpful to combine the responses as follows: I understand the program s statutory monitoring requirements (regardless if I agree with it or not). Strongly Agree or Agree Disagree or Strongly Disagree 88.5% 10.3% The program treats me with dignity. 84.6% 14.1% The program treats me with respect. 84.6% 14.1% The program requirements are clearly explained. 78.2% 17.9% Generally, responders are in agreement with the statements. No more than 17.9% of responders disagreed or strongly disagreed to any one item. This survey question was not asked before last period, so comparison data is only displayed for one period (below). Overall, responses are not quite as positive as last period. Data Table 4a and b: The mode (most frequent) response is highlighted in red. Table 4a: This Period (n=78) I understand the program s statutory monitoring requirememtns (regardless if I agree with it or not). Strongly Strongly No Agree Disagree Agree Disagree Response # % # % # % # % # % % % 7 9.0% 1 1.3% 1 1.3% The program treats me with dignity % % 7 9.0% 4 5.1% 1 1.3% The program treats me with respect % % 6 7.7% 5 6.4% 1 1.3% The program requirements are clearly explained % % % 4 5.1% 3 3.9% Table 4b: Last Period (n=60) I understand the program s statutory monitoring requirememtns (regardless if I agree with it or not). Strongly Strongly No Agree Disagree Agree Disagree Response # % # % # % # % # % % % 1 1.7% 1 1.7% The program treats me with dignity % % % 5 8.3% The program treats me with respect % % % 5 8.3% The program requirements are clearly explained % % % 3 5.0% January 2016 Year Six, First Period Report 6

52 52 Question #3: Continuing to evaluate the overall program, the next question asks respodents to rate the amount of structure and the amount of accountability the program provides. The scale is 0 (none) to 4 (a significant amount) with 2 representing some. Notably, 61% of respondents indicated that the program provides a significant amount of accountability. An additional 23.1% rated this item with a 3 (more than some but less than a significant amount ). Looking at the amount of structure provided by the program, 42.3% rated it a significant amount and 25.6% rated it with a 3 (more than some but less than a signficiant amount ). This question was not asked before last period, so comparison data is only displayed for one period. The mode improved from 3 to 4 for the structure item and stayed at 4 for the accountability item. Data Table 5a and 5b and Figures 1 and 2: The mode (most frequent) response is highlighted in red. Table 5a: This Period (n=78) The amount of structure the program provides The amount of accountability the program provides 4 (significant amount) 3 2 (some) 1 0 (none) No Response # % # % # % # % # % # % % % % 2 2.6% 2 2.6% 1 1.3% % % % 2 2.6% 0 0.0% 1 1.3% Table 5b: Last Period (n=60) The amount of structure the program provides The amount of accountability the program provides 4 (significant amount) 3 2 (some) 1 0 (none) No Response # % # % # % # % # % # % % % % % 2 3.3% % % 5 8.3% 2 3.3% 1 1.7% January 2016 Year Six, First Period Report 7

53 53 Customer Service Question #4: This questions quieres response time frame, quality of response, communication style, and agreement monitor knowledge. The mode response to each item was agree and, like last period, a minimum of 70% of respondents indicated that they either agree or strongly agree with each item. This question was not asked before last period, so comparison data is only displayed for one period. Response Time Frame (My questions and/or concerns are responded to within one business day): The mode response was agree at 51.3% with an additional 23.1% strongly agreeing. Compared to last period, however the strongly agree responses went down by 17% points. Although this is discouraging, it was counter balanced by a 21% point increase in the agree responses. The net result of this change is a slight increase in positive responses (74% strongly agree and agree this period versus 70% last period.) Quality of Response (My questions and/or concerns are addressed fully within the structure of the program): The mode response was agree at 50%, with an additional 26.9% who strongly agree. The comparison to last period mirrors that of the prior item: The percentage of strongly agree responses decreased while the percentage of agree responses increased, resulting in a slight net increase in positive responses. Communication style (Information is communicated clearly and professionally): Responses were similar to those regarding the quality of the response. The mode response was agree at 44.9%, with an additional 33.3% who strongly agreed. Responses are nearly identical to last year except for a slight decrease (5% points) in strongly agree. Agreement Monitor (My Agreement Monitor is knowledgeable about my case): Again, the mode response is agree at 42.3% with an additional 39.7% strongly agreeing. Although the mode last period was strongly agree, the change is not due to a decrease in strongly agree responses; instead it is due to an increase in agree responses by 11% points. In summary, Agreement Monitor responses were more positive this period than last period. Data Table 6 a and b: The mode (most frequent) response is highlighted in red. Table 6a: This Period (n=78) My questions and/or concerns are responded to within one business day My questions and/or concerns are addressed fully within the structure of the program Information is communicated clearly and professionally My Agreement Monitor is knowledgeable about my case Strongly Strongly N/A or No Agree Disagree Agree Disagree Response # % # % # % # % # % % % % 7 9.0% 2 2.6% % % % 5 6.4% 4 5.1% % % % 6 7.7% 1 1.3% % % % 3 3.8% 2 2.6% Table 6a: Last Period (n=60) My questions and/or concerns are responded to within one business day My questions and/or concerns are addressed fully within the structure of the program Information is communicated clearly and professionally My Agreement Monitor is knowledgeable about my case Strongly Strongly N/A or No Agree Disagree Agree Disagree Response # % # % # % # % # % % % % % 1 1.7% % % 4 6.7% 5 8.3% 3 5.0% % % 5 8.3% 5 8.3% 1 1.7% % % % % 4 6.7% January 2016 Year Six, First Period Report 8

54 54 Non-Compliance Question #5: This question asks if the respondent was reported non-compliant in the last six months and if so, how well they understood the process. Results show that 10.3% of respondents (8) indicated that they had been reported non-compliant. Of these, 62.5% reported they thoroughly understood the process and 12.5% partially understood it. Only two respondents indicated that they did NOT understand the process. A follow-up question requests any comments on this item, however many appear to be general comments. This question was not asked before last period, so comparison data is only displayed for one period. Data Tables 9a and b: Table 9a: Were you reported non-compliant in the last 6 months? This Period (n=78) Last Period (n=60) # % # % No % % Yes % % No Response 1 1.3% Table 9b: If so, (regardless if I agreed/disagreed with the report) I thoroughly understood the process This Period (n=8) This Period (n=11) # % # % % % I partially understood the process % % I did not understand the process % 1 9.1% Actual Comments This Period: **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation and grammar have not been corrected. 1. I feel quite frustrated at times, sometimes my urine is dilute, as I am worried I won't be able to urinate so I may drink extra fluids but at the same time if I can't urinate I am assumed positive. I wish we used a finer test or were able to use hair if need be. 2. Prohibited medications list is unreasonable and has lead to 2ear infections in 2 years with the annual cold. I've never had ear infections before. I need dental work done that im postponing because its just not worth the stress of the RBH hoop hopping it takes to get it done. RBH monitoring prevents me from hiking. I had been section hiking the Pacific Crest Trail in mile peices. If you dont know what that means, watch a You Tube video. I cant even really do an overnighter, stay in cell range, & still be able to get to a testing station. I have put on 20lbs of fat in my 2yrs of monitoring. Your program needs some serious tweaking. I will be strongly encouraging OSBN to use a different provider upon my conclusion of my monitoring. 3. timely process for intake 4. Making someone noncompliant because he needs to change credit cards without at least calling him first is offensive and ridiculous 5. The times to call in should be expanded as well as test sites for the salem area 6. Because the accounting person messed up the billing so it said I was non compliant due to her not being able to process my payment at the time agreed upon 7. Most of the time questions are answered and communication occurs in a timely manner but not always. 8. Please update the holidays for 2016 on website 9. It would be nice to have a vacation or long weekend without checking even if the location is within 20 miles of a testing site. Having to do this creates anxiety especially if you have young children that you'd have to drag along with you. I believe there are test that go back at least 7 days this test as soon as you get back. Just a thought January 2016 Year Six, First Period Report 9

55 55 Enrollment Question #6: This question asks first if respondents were enrolled in the last six months and if so, how they would rate the enrollment process overall. A follow-up question inquires if their intake was completed in-person and if that was beneficial. This question was not asked before last period, so comparison data is only displayed for one period. 28.2% of respondents (22) indicated that they were enrolled in the last six months. (See Table 10a.) This is in comparison to 11.6% of the current population of licenses (25) who were enrolled in the last six months. Although the pool of respondents may be heavily skewed towards the more recently enrolled, it seems more likely that the answer to this question by many of the respondents was not accurate. Regardless, of those who stated that they were enrolled in the last six months, only 60% actually rated the enrollment process. The majority of those who gave a rating, rated it average (6 or 27.3%) and an additional 18.1% rated it above average or excellent. Only 13.6% rated it below average and no one rated it poor. (See Table 10b.) Of those who stated they were enrolled in the last six months, only three (3) indicated that they met their Agreement Monitor in person and nine (9) indicated that they did not. Ten did not respond. (See Table 10c) Of the three who did meet their Agreement Monitor in person, one felt that it significantly improved the enrollment experience and two felt that it partially improved the enrollment experience. Data Tables 10a, b and c: Table 10a: Were you enrolled in the last 6 months? This Period (n=78) Last Period (n=60) # % # % No % % Yes % % No Response % 1 1.7% Table 10b: Overall rating of the enrollment process: This Period (n=22) Last Period (n=19) # % # % Excellent % % Above Average 1 4.5% % Average % % Below Average % % Poor No Response % % Table 10c: If you met your Agreement Monitor in person, do you feel this improved your enrollment experience? This Period (n=22) Last Period (n=19) # % # % No Response % % I did NOT meet my Agreement Monitor in person % % I did meet my Agreement Monitor in person % % It significantly improved my enrollment experience. It partially improved my enrollment experience % % 2 9.1% % It did not change my enrollment experience % It degraded my enrollment experience It significantly degraded my enrollment January 2016 Year Six, First Period Report 10

56 56 Overall Rating of Services Question 7: Respondents are asked to rate the overall services. The mode response was above average at 32.1% this period, an improvement from the last two years. The percentage of excellent responses has also increased over time, starting with 14% in year two and peaking at 25.6% this period. Data Table 11: The mode (most frequent) response is highlighted in red. Table 11: Overall Rating This Period (n=78) This Year (n=125) Year 4 (n=197) Year 3 (n =246) Year 2 (n=367) # % # % # % # % # % Excellent % % % % % Above Average % % % % % Average % % % % % Below Average % 9 7.2% % % % Poor 5 6.4% % % % % No Response 1 1.3% 3 2.4% % % 4 1.1% Figure 3: January 2016 Year Six, First Period Report 11

57 57 Additional Comments At the conclusion of the survey, respondents are asked for any additional comments. Thirty-one (31) comments were received, reviewed, and categorized this period. Comments were received from 39.7% of respondents. Comments were first categorized with an overall type: positive, a concern, neutral / a recommendation, or mixed. This period, 23% were positive, 55% were concerns, 6% were a mixture of positive and negative and 16% were neutral / a recommendation. (See Figure 4.) Comments were also categorized by area (see Data Table 12). Each issue within a comment was categorized to maximize the ability to capture all feedback. Program structure and communication were the most frequently mentioned topics, out numbering agreement monitor comments this period. Table 12: Figure 4: Categories of Comments Received (n=31) Communication: General # % Concern % Positive 1 2.3% Communication: IVR/App Concern 1 2.3% General Program Structure Concern 2 4.5% Neutral/Recc 2 4.5% Positive 2 4.5% Concern % Neutral/Recc 2 4.5% Concern 4 9.1% Staff: Agreement Monitor Positive 3 6.8% Staff: General Positive 4 9.1% Toxicology: Sites Concern % (availability and performance) Neutral/Recc 1 2.3% Actual Comments Received January 2016 **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation, and grammar have not been corrected. Names and locations have been removed for confidentiality purposes. 1. I am going on 4 years of enrollment in the mental health portion of the program. I appreciate the program, but at this point it serves no purpose. In the past, the HPSP had the ability to discharge a participant who clearly no longer meets the need for monitoring based on their diagnosis, third party evaluation results, and their doctor's opinions. Now drug testing and monitoring can be continued even when it has been determined to be unnecessary without any formal review. I am concerned about the checks and balances in a relationship where referrals are from licensing boards and the monitoring agency receives an ongoing financial benefit from continued enrollment of an individual even after healthcare providers and workplace monitors have determined enrollment is no longer necessary. Their needs to be a process in place to make sure that ongoing drug testing and monitoring is necessary rather than being used as a punishment. 2. Some times I am unable to reach my contact person. I am doing better every day. Co-workers have told me that I am look more confident and stronger. Thank you. 3. Very respectful and knowledgeable. Over the past year of enrollment all of my questions and concerns have been met with rapid and accurate information. [Associate Case Coordinator] has been absolutely amazing in his professionalism and goes above and beyond in willingness to assist with travel and test site issues. I have always been treated with respect and a willingness to address all problems and scenarios in a timely manner. Truly an amazing staff that deserves recognition for their professionalism and concern for clients. 4. I was quite ready and willing to be back in recovery so I feel that for me, personally, the monitoring requirement is over the top. However, I understand the reason the board requires it and that it is beneficial for the masses so I will continue to comply. January 2016 Year Six, First Period Report 12

58 5. There seems to be confusion around testing sites (site knew nothing about being a testing site nor who PBH was, nor about medtech ) and hours. Specific questions about products I encounter in a hosp. environment I have difficulty getting strait answers to, from both monitor and Director, and payments are not always withdrawn promptly nor could I look up how much each panel was. This could be a lot easier to understand and be compliant with if a beginning checklist were created for the person being monitored with outlined steps and a packet mailed initially with all papers needed at once with accompanying checklist. Downloading forms makes it feel as though one might miss something. I still always feel as though I am possibly missing something and might inadvertently be labeled as non-compliant due to some oversight. Having everything in writing upfront that can be looked at and checked off as I go would give me much needed peace of mind!!! 6. [Agreement Monitor], [Assistant Case Coordinator] and [Associate Case Coordinator] are very respectful and helpful. 7. Trying to get any helpful advice after hours is horrible. The person who is available had no answers for me and directly resulted im me missing a test. Why didnt that person know that i could just walk into a station and test after missing a call in. Why wasnt there a "tips and tricks" web page telling me what to do in the event of a missed call in and if i have until midnight to test, why on earth dont i have until 11pm to call in? Life in monitoring is slightly better than house arrest and is a noose on my soul in ways alcohol never was. 8. I really wish that the program was tailored towards each individual. Or a lesser term for those who self report (two years?) Everyone has been pleasant to work with, but the cost, inconvenience, and humiliation involved with testing has caused me a lot of stress. On a number of occasions, I have had to wait over an hour to test which has been incredibly uncomfortable. Sometimes I feel like I need a support group for being in monitoring! 9. Monitor person is supportive and very helpful. 10. It would be nice to have text messages sent for UA testing instead of having to check in every day. 11. I have been enrolled in HPSP since Feb I have yet to meet my Agreement Monitor in person. It would be great to have a face-to-face meeting between HPSP member and his/her Agreement Monitor in the first six months of the program. 12. Charging for monitoring groups when I miss one due to an excused absences is unfair. Forcing me to attend more monitoring groups than required in my agreement feels like RBH is in it for the money. The quarterly check-in meetings are superfluous especially as RBH couldn't find anyone nearby to conduct mine. I think RBH overstates its regulatory requirements and its role in achieving public safety. I think RBH is mostly motivated by finances not supporting physicians. 13. More test sites with better hours should be able in my area! It increases my stress level to have to drive to pdx from Dallas oregon to test after 5pm 14. With travel extremely limited testing sites, not conducive to helping clients test (and stay accountable) during travel. For example, in the entire city of New York, only 2 test sites available. 15. I have had several Agreement Monitors. My favorite and most supportive was [Name]. I understand why I was removed from her caseload (she only works with MDs, but I still mourned my loss. I actually enjoyed speaking to her for "check ins". I felt like she listened and cared. Just hearing her voice was a lift. Even her voic message was encouraging. Her voice sounded so positive (because she is a very positive person)! I now have [Agreement Monitor Name]. I spoke with him at length 12/31. Our conversation felt good. I hung up the phone with a smile.i am looking forward to working with him (even though he has "tough shoes to fill..!") Thank you for this program. I am grateful. I am a new person. 16. Disorganized. Poor response time. Tests sites should be easily accessible in searchable database. Should be able to check after 5 pm just for reassurance. Nothing was explained I learned most from others in mandatory group. The group is TERRIBLE; not helpful, depressing, negativivity is insane, pointless waste of time, money and gas. This is a joke, graduation is under 80%? Sad. Explain stuff. My monitor is cool, but seems to only dabble in work, like doesn't work full time. Communication and RBH relationship is VERY confusing. Straight up it is a mess of a program, one may say a sh@t show. 17. The program is to long. Also having to go to two self help meetings a week after the first year of the program is to much, l feel meetings should go by the recomendation of you third party counselor who knows you well. 18. Lack of info in the beginning. I was told one thing, then when getting a new job they changed the rules or guidelines. I just wish the HPSP was on the same page with the board rules so I wouldn't of made a fool. Of myself going to interviews for jobs I wasn't able to take. Everything is fine now but the beginning was very unclear and also felt there was no guidance at all with a huge lack of communication. 19. I am not really sure this program adds any value to my health. It was recommended I self-refer bc this program would help me, but it does not help, just monitors. I feel less comfortable seeking help and being truly honest with my therapist for fear of losing my job bc of this program. What is the purpose of drug testing for patients with depression? 20. Enrollment in HPSP has allowed me to continue working in my chosen career and the process has given me a new sense of gratitude for my profession. 21. Related to question 3: While the program provides structure & accountability, it is not of a helpful nor useful quality, but actually unhelpful. January 2016 Year Six, First Period Report 13 58

59 22. Over the last 6 months or so I've had a new agreement monitor. I've spoken to her once. She is a licensed social worker as I can see her credentials behind her name. This is the first I've heard of any statutory prohibitions. My last agreement monitor and I had what felt like a therapeutic albeit phone relationship. I felt like I got more out of that relationship and actually made this program feel worthwhile. An example I can give is that I recently had a dilute urine. I've never had one before and was notified by . The explained that if it's the first time I would be receiving a call from my agreement monitor to explain the process. I have not received any call. I did take it upon myself to test on Christmas eve and that's all fine. I guess I'm just not really sure what the worth of the program is other than a having random UA screening. It seems to me the a computer could do that for the board and the lab could notify them if there's a positive test. 23. Though I have no comparison of services, never encountering another monitoring program. I have had increased difficulty and complications with home and travel test facilities in the last few months which has been very challenging to encounter and endure. I am thankful to be completing the program shortly. 24. A few times I have had difficulty with the application, as well as calling in to see if testing is required,an error message appears instead. When I have called to report this it was brushed off, "it's working now" instead of looking into why it's happening and trying to fix it. It's happened 3 times in the 7 months I've been monitored, so far. 25. I have scheduled an appointment to go over requirements, program in general and mulitiple questions and concerns I have. Virtually I was put into the program but not oriented about the program to be sucsessfull when trying to obtain employment which is within the criteria of the program. 26. Consider doing more outreach and education about HPSP, including presentations by current or "graduated" monitored professionals. 27. NEVER hear anything from my agreement monitor. I send a check in every week or leave a voice message to check in. Although I do not leave a message to return my call, I never hear a word. I believe part of the program is to at least talk once a month in person. I have been in the program for more than three years and have only talked to her twice. We are held to a high accountability where is your accountability to make sure they are doing their job? Signed, almost done. 28. When I call my monitor I would appreciate a timely response. Often times, I don't hear back for days. 29. As I am new to this program, I did not know what to expect. My monitor and others with whom I have had contact have been professional, courteous, and helpful. 30. You're just enforcers and I understand that. 31. My agreement monitor has been very helps and supportive 59 Summary Analysis The licensee survey response rate this period was 36.3% and the pool of respondents was representative of the licensee population in terms of board affiliation. Nearly 89% of respondents this period indicate that they understand the program s statutory monitoring requirements. Combined, 84% of respondents agree or strongly agree that the program treats them with dignity and respect. 78% of respondents strongly agree or agree that the program requirements are clearly explained. Notably, 61% of respondents indicated that the program provides a significant amount of accountability. An additional 23.1% rated this item with a 3 (more than some but less than a significant amount. ) Looking at the amount of structure provided by the program, 42.3% rated it a significant amount and 25.6% rated it with a 3 (more than some but less than a signficiant amount. ) Looking at customer service and communication, response time frame was rated positively by 74% of respondents. The quality of the response was rated positively by 77% of respondents. Just over 78% of respondents felt that information was communicated clearly and professonally while 82% felt their Agreement Monitor is knowledgeable about their case. Eight respondents indicated they had been reported non-compliant in the last six months. Of these, 62.5% reported they thoroughly understood the process and 12.5% partially understood it. Only two respondents indicated that they did NOT understand the process. Twenty-two respondents indicated that were enrolled in the last six months. This is in comparison to twenty-five licensees in the current population who were actually enrolled in the last six months. Although the pool of respondents may be heavily skewed towards the more recently enrolled, it seems more likely that the answer to this question by many of the respondents was not accurate. Regardless, of those who stated that they were enrolled in the last six months, only 60% actually rated the enrollment process. The majority of those who gave a rating, rated it average (27.3%), and an additional 18.1% rated it above average or excellent. Only 13.6% rated it below average and no January 2016 Year Six, First Period Report 14

60 one rated it poor. Of those who stated they were enrolled in the last six (6) months, only three (3) indicated that they met their Agreement Monitor in person and nine (9) indicated that they did not. Ten did not respond. Of the three (3) who did meet their Agreement Monitor in person, one felt that it significantly improved the enrollment experience and two felt that it partially improved the enrollment experience. 60 Overall services were rated favorably, with 25.6% of respondents rating the program excellent and an additional 32.1% rating it above average and 24.4% rating it average. Nearly 40% of respondents provided a concluding comment this period: 23% were positive, 55% were concerns, 6% were a mixture of positive and negative and 16% were neutral / a recommendation. Program structure and communication were the most frequently mentioned topics, out numbering agreement monitor comments. January 2016 Year Six, First Period Report 15

61 Reliant Behavioral Health Health Professionals Services Program (HPSP) Satisfaction of EMPLOYERS / WORKPLACE MONITORS 61 Purpose The purpose of assessing the Employers, specifically the Workplace Monitors, is to obtain constructive feedback that can be used to improve the services provided by the HPSP Program. RBH strives to maintain the quality, effectiveness, and efficiency of the program, and thus evaluates Employers / Workplace Monitors satisfaction with the HPSP Program twice yearly. Feedback is obtained from Employers via a satisfaction survey that is ed or mailed to Workplace Monitors who are asked to complete the survey online. The survey is short and can be completed in 2-3 minutes. Feedback includes information about timeliness of response, knowledge level of staff, the monthly safe practice form and an overall rating of RBH s support of the supervision of licensees. The survey also asks for any additional comments. One method of determining the value of HPSP is through the Satisfaction Survey. One role of the RBH Policy Advisory Committee (PAC) is that of quality management. Following review of the survey results, the PAC will identify opportunities for improvement and develop interventions if necessary. The PAC will continue to monitor performance at specified intervals following the implementation of the intervention(s). Data Results Response Rate Table 1: Response Rate This Period Year 5 Year 4 Year 3 # Sent # Responses Response Rate 23.3% 20.6% 25.5% 18.8% The HPSP Employers Satisfaction Survey was distributed to Workplace Monitors through and mail. Out of the total 172 surveys distributed this period, 40 responses were received for a response rate of 23.3%. This is similar to the rates received the last few years. Type of Service Provided by Employer Question 1: Respondents are first asked the type of services provided by their organization. The most frequent responses for the period was medical at 40%. This was followed by nursing with 37.5% of responses. This is similar to last year s data. As noted last year, although the breakdown of the licensee population is heavily weighted towards nurses, it can be assumed that a number of these nurses work in medical offices. Thus, the response to this question does not necessarily mean that the data is inconsistent with and unrepresentative of the license population. Data is presented in Table 2 (next page). January 2016 Year Six, First Period Report 16

62 Data Table 2: The mode (most frequent) response is highlighted in red. 62 Table 2: Type of Services Provided This Period (n=40) Year 5 (n=70) Year 4 (n=89) # % # % # % Medical % % % Nursing % % % Pharmacy 3 7.5% 5 7.1% 2 2.2% Dental 2 5.0% 4 5.7% 5 5.6% Other % 2 2.9% 4 4.5% No Response 2 2.9% 2 2.2% Services Question 2: Respondents are asked to rate HPSP s services, including response timeframe; knowledge of licensee when there is a concern in the workplace; ability to respond to questions regarding program administration; and frequency of feedback from RBH. Finally, an overall rating is requested. The mode response to each item was excellent. Less than 10% of responses to any question were below average and there were not any poor responses. Data Tables 3a and 3b: The mode (most frequent) response is highlighted in red. Table 3a Above Below N/A or No Excellent Average Poor This Period Average Average Response (n=40) # % # % # % # % # % # % Response timeframe when I request information % % % 1 2.5% % Staff knowledge of a licensee when there is % % % % concern in the workplace Our ability to respond to questions regarding program % % % 1 2.5% % administration Frequency of feedback from RBH regarding Licensee's compliance % % % % % Overall rating of our services % % % 2 5.0% Data Table 3b is presented at the top of the next page. January 2016 Year Six, First Period Report 17

63 63 Table 3b Year 5 (n=70) Response timeframe when I request information Staff knowledge of a licensee when there is concern in the workplace Our ability to respond to questions regarding program administration Frequency of feedback from RBH regarding Licensee's compliance Above Below N/A or No Excellent Average Poor Average Average Response # % # % # % # % # % # % % % % 2 2.9% % % % 6 8.6% % % % % % % % 4 5.7% 1 1.4% 3 4.3% % Overall rating of our services % % % 2 2.9% 6 8.6% Supervision Support Question 3: The next item reads: RBH supports your supervision of licensees. How satisfied are you with our support? The mode response was very satisfied with 47.5% (19) of responses. This was closely followed by satisfied with 45% of responses. There were only 3 (7.5%) respondents who indicated they were unsatisfied or very unsatisfied. Results are parallel to last year. Data Table 4: The mode (most frequent) response is in red: Table 4: Supervision Support This Period (n=40) Year 5 (n=70) # % # % Very Satisfied % % Satisfied % % Unsatisfied 2 5.0% 4 5.7% Very Unsatisfied 1 2.5% 1 1.4% No Response January 2016 Year Six, First Period Report 18

64 64 Workplace Safety Question 4: RBH s ability to monitor the licensee to ensure safety in the workplace is queried in the next item. As this is one of HPSP s most vital functions it is important to note that only two respondents felt that RBH s ability was below average or poor. Excellent was the mode response at 40% (16). Data last year was slightly more positive but this year s responses are consistent with year four data. Data Table 5: The mode (most frequent) response is highlighted in red: Table 5: Workplace Safety This Period (n=40) Year 5 (n=70) # % # % Excellent % % Above Average % % Average % % Below Average 1 2.5% 3 4.3% Poor 1 2.5% No Response A follow-up question requests any suggested changes or recommendations. Actual Comments This Period: **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation and grammar have not been corrected. 1. better communication and regular check in 's with the monitors 2. Prompt call backs to facility 3. Recommend more frequent interactions with workplace monitors, for example quarterly phone (or ) conferences; also recommend more frequent feedback from RBH regarding licensee's progress. 4. My employees monitor has changed so many times and I am not notified but the company, but rather by my employee. If there has been problems, I would have no idea who to contact. 5. communicate the timeframe for those being monitored and necessary components for completion thereof Overall Experience Question 5: Respondents are asked to rate their overall experience working with RBH. The mode response was excellent at 45% (18). There were an additional 50% of responses that were above average (22.5% or 9) or average (27.5% or 11). There continue to be no poor responses. Data Table 6: The mode (most frequent) response is highlighted in red: Table 6: Overall Experience This Period (n=40) Year 5 (n=70) # % # % Excellent % % Above Average % % Average % % Below Average 1 2.5% 2 2.9% Poor N/A or No Response 1 2.5% 1 1.4% January 2016 Year Six, First Period Report 19

65 65 Additional Comments Actual Comments This Period **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation, and grammar have not been corrected. 1. Numerous time delays in reporting issues with reciept of required monitoring documentation on your end? 2. I have tried two different times to contact the person who is suppose to be my contact at RBH with no results. I did manage to talk to the right person one time when I called 3. My responses reflect what little interaction I've needed to have with RBH. The employee I "monitor" needs no monitoring. It's not your decision to enroll someone or not, so I don't have any strong feelings about the program. 4. my only request is for feedback if the monitored person misses or fails a drug screening. Summary Analysis The HPSP Employers / Workplace Monitor s Satisfaction Survey had a response rate of 23.3% for the period. Primarily, respondents indicated that their organizations provide either medical services (40%) or nursing services (37.5%). Strong ratings were provided for HPSP s customer service, particularly in the case of timeliness of responses, knowledge of licensees when there is a concern in the workplace, ability to respond to questions regarding program administration and frequency of feedback regarding licensee s compliance. Finally, an overall rating is requested. The mode response to each of these items was excellent. Less than 10% of responses to any item were below average and there were not any poor responses. Ninety-two and a half percent (92.5%) of respondents indicated that they were either very satisfied or satisfied with the support they receive when supervising licensees. Forty (40%) of respondents indicated that they rate RBH s ability to monitor the licensee to ensure safety in the workplace as excellent and an additional 55% rated it above average or average. Finally, 45% rated their overall experience working with RBH HPSP as excellent with an additional 50% rating it above average or average. The PAC committee will review the survey data and the comments carefully. January 2016 Year Six, First Period Report 20

66 Reliant Behavioral Health Health Professionals Services Program (HPSP) Satisfaction of PROFESSIONAL ASSOCIATIONS 66 Purpose The purpose of assessing representatives from the Oregon Medical Association, Oregon Nursing Association, Oregon Pharmacy Association, and the Oregon Dental Association is to obtain constructive feedback that can be used to improve and maintain the quality, effectiveness, and efficiency of the HPSP Program. In order to provide continuous quality services, RBH evaluates this stakeholder group s satisfaction with the HPSP Program twice yearly. Feedback is obtained from Association representatives via a satisfaction survey that is ed to representatives who are asked to complete the survey online. The survey is short and can be completed in 2-3 minutes. Feedback includes information about the timeliness of response, knowledge level of staff, ability to enroll licensees and an overall rating of RBH services. Also, the survey asks about the value of the HPSP Program to their membership and asks for any additional comments. One method of determining the value of HPSP is through the Satisfaction Survey. One of the roles of the RBH Policy Advisory Committee (PAC) is that of quality management. Following review of the survey results, the PAC will identify opportunities for improvement and develop interventions if necessary. The PAC will continue to monitor performance at specified intervals following the implementation of the intervention(s). Data Results Response Rate Table 1: Response Rate This Period Year 5 Year 4 Year 3 # Sent # Responses Response Rate 11.1% 11.1% 14.3% 0% The HPSP Satisfaction survey was distributed to representatives of each Professional Association as follows: - Oregon Nursing Association: 2 - Oregon Medical Association: 4 - Oregon Dental Association: 2 - Oregon Pharmacy Association: 1 A total of nine surveys were ed. One response was received for a response rate of 11.1%. This was the same for each period in Year 5. Survey Responses The respondent this period was from the ONA (Oregon Nursing Association). The respondent did not provide ratings for the three items related to a recent contact with RBH. The respondent indicated that HPSP is valuable to ONA members, but that feedback from members about the program is below average. The latter was explained with the following comment: I have had several reports about RBH staff being unresponsive and requiring testing that seems inconsistent either with the underlying issue or with the status in the monitory program. Summary Analysis The only response this period was from the ONA, just like both periods last year. This period the program was rated as valuable but feedback from members was reported as below average. It is recommended that RBH continue to outreach to each of the Professional Associations so that the associations support can be garnered. January 2016 Year Six, First Period Report 21

67 Reliant Behavioral Health Health Professionals Services Program (HPSP) Satisfaction of TREATMENT PROVIDERS 67 Purpose The purpose of assessing representatives from Treatment Providers is to solicit feedback that can be used to improve the services provided through the HPSP Program. RBH strives to maintain the quality, effectiveness, and efficiency of the program, and evaluates the Treatment Providers satisfaction with the HPSP Program on a twice yearly basis. Feedback is obtained from Treatment Providers representatives via a satisfaction survey that is ed or mailed to representatives who are asked to complete the survey online. The survey is short and can be completed in 2-3 minutes. Feedback includes information about RBH s communication, responsiveness of staff, overall rating of experience, and any additional comments. One method of determining the value of HPSP is through the Satisfaction Survey. One of the roles of the RBH Policy Advisory Committee (PAC) is that of quality management. Following review of the survey results, the PAC will identify opportunities for improvement and develop interventions if necessary. The PAC will continue to monitor performance at specified intervals following the implementation of the intervention(s). Data Results Response Rate Table 1: Response Rate This Period Year 5 Year 4 Year 3 # Sent # Responses Response Rate 8.7% 12.2% 7.2% 9.2% This Satisfaction Survey was distributed to those individuals and programs that provide various treatment services to licensees enrolled in HPSP. A total of 172 surveys were sent by mail or this period and 15 responses were received. The response rate this period was 8.7%, which although not a representative sample, is in line with the responses for the last three years. January 2016 Year Six, First Period Report 22

68 68 Role of Respondent The first question asks the respondents the capacity in which they have provided services to HPSP licensees. They are able to provide more than one response. The 15 respondents this period provided a total of 21 responses. As a result, percentages total more than 100%. This is also the case for the other two periods of data presented. For the period, nearly half (7 or 46.7%) of the respondents indicated that one of their roles is mental health therapist. The same number indicated that they are in the role of Monitor (e.g. PMC, GMC or Quarterly Monitor). These two roles have been those of the majority of responders for the last two years. Data Table 2: The mode (most frequent) response is highlighted in red, if applicable. Table 2: Role of Respondent This Period (n=15) Year 5 (n=42) Year 4 (n=28) # % # % # % Chemical Dependency Counselor % % % Evaluator % 3 7.1% 2 7.1% Mental Health Therapist % % % Monitor (PMC / GMC / Quarterly Monitor) % % % Pain Management 1 3.6% Psychiatrist 1 2.4% 2 7.1% Treating physician 2 4.8% 1 3.6% Other* 1 6.7% 2 7.1% Unspecified 2 7.1% *Other for this period was described as Psychiatric/Mental Health Nurse Practitioner, prescribing Customer Service and Communication Question 2: Survey respondents are asked to rate three different statements relating to communication between HPSP and the provider. The mode response for all three statement was agree this period, mirroring last year. However, there was improvement as this period there were not any strongly disagree responses and there were only 3 disagree responses, all of which were to the final item ( I had all the information I needed when I saw the licensee. ). All of the respondents this period felt that their questions/concerns were responded to promptly and that information was communicated clearly and professionally. As we have seen historically, there is the least satisfaction around having all the necessary information when meeting with the licensee. However, 80% of respondents this period did agree or strongly agree with this statement. The three disagree responses came from two mental health professionals and one individual who identified him/herself as an evaluator, monitor and chemical dependency counselor. Data Tables 3 a and b: The mode (most frequent) response is highlighted in red. Table 3a: This Period (n=15) My questions and/or concerns were responded to promptly Information was communicated clearly and professionally I had all the information I needed when I saw the licensee Strongly Strongly No Agree Disagree N/A Agree Disagree Response # % # % # % # % # % # % % % % % % % % January 2016 Year Six, First Period Report 23

69 69 Table 3b: Last Year (n=42) My questions and/or concerns were responded to promptly Information was communicated clearly and professionally I had all the information I needed when I saw the licensee Strongly Strongly No Agree Disagree N/A Agree Disagree Response # % # % # % # % # % # % % % 2 4.8% 1 2.4% % % % 3 7.1% 1 2.4% 4 9.5% % % % 3 7.1% 1 2.4% Overall Experience Question 3: Respondents are next asked Overall, how would you rate your experience working with RBH staff of the HPSP program? The mode response was above average for the period with 40% of the responses. An additional quarter (26.7% or 4) of the responses were excellent and an equal number were average. One respondent did rate his/her experience as below average. Overall the response pattern mimics that of the past two years. Data Table 4: The mode (most frequent) response is highlighted in red where applicable. Table 4: Overall Rating This Period (n=15) Year 5 (n=42) Year 4 (n=28) # % # % # % Excellent % % % Above Average % % % Average % % % Below Average 1 6.7% 3 7.1% % Poor N/A or No Response 3 7.1% January 2016 Year Six, First Period Report 24

70 70 Additional Comments Actual Comments This Period: **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation, and grammar have not been corrected. 1. In my role as a PMC, I get and give information through Box, and so routine contact with HPSP staff is very minimal. However the processes seem to work smoothly; communication and payment goes smoothly. 2. I wish it paid a little better. 3. It has not really been necessary to have contact with RBH since my patient started the program, so I don't have much experience with them at all. 4. No longer working with the licensee. She did excellent work in treatment. Summary Analysis The response rate to the HPSP Treatment Provider Satisfaction Survey for the period was 8.7%. Respondents varied in their relationship to the licensee. Nearly half (7 or 46.7%) of the respondents indicated that one of their roles is mental health therapist. The same number indicated that they are in the role of Monitor (e.g. PMC, GMC or Quarterly Monitor). These two roles have been those of the majority of responders for the last two years. 100% of respondents this period agreed or strongly agreed that their questions/concerns were responded to promptly and that information was communicated clearly and professionally. As we have seen historically, there is the least satisfaction around having all the necessary information when meeting with the licensee. However, 80% of respondents this period did agree or strongly agree with this statement. Above Average was the most common response to the overall experience working with RBH this period with 40% of the responses. An additional quarter (26.7%) of the responses were excellent and an equal number were average. Four comments were received and will be reviewed carefully by the PAC, along with all of the survey data. It should be noted that the respondent who commented about the pay rate does not appear to be paid by RBH based on the role indicated at the beginning of the survey. Regardless, the PAC will review each comment individually and develop an appropriate action plan. A collaborative relationship with the treatment providers is beneficial to the support of the licensees in their recovery and will improve monitoring. January 2016 Year Six, First Period Report 25

71 71 Reliant Behavioral Health Health Professionals Services Program (HPSP) Satisfaction of BOARDS Purpose The purpose of assessing representatives from the Medical Board, Board of Nursing, Board of Dentistry, and the Board of Pharmacy, is to obtain constructive feedback that can be used to improve and maintain the quality, effectiveness, and efficiency of the HPSP Program. In order to provide continuous quality services, RBH evaluates satisfaction with the HPSP Program twice yearly. Feedback is obtained from the Boards via a satisfaction survey that is ed to representatives who are asked to complete the survey online. The survey is short and can be completed in 2-3 minutes. The survey requests feedback on the overall program, timeliness of responses to inquiries, the knowledge level of staff and the quality of information provided. One method of determining the value of HPSP is through the Satisfaction Survey. One of the roles of the RBH Policy Advisory Committee (PAC) is that of quality management. Following review of the survey results, the PAC will identify opportunities for improvement and develop interventions if necessary. The PAC will continue to monitor performance at specified intervals following the implementation of the intervention(s). Data Results Table 1: Response Rate Response Rate This Period Year 5 Year 4 Year 3 # Sent # Returned Response Rate 28.6% 50.0% 61.5% 47.1% The HPSP Boards Satisfaction Survey was ed to representatives at 100% of the participating Boards. The response rate was 28.6% for the period with two (2) responses to the seven (7) surveys sent. The average response rate for the past three years has ranged from 47% to 62%. Respondents Question 1: This question asks which Board the respondent represents. Respondents this period were both from the Medical Board. Surveys were sent to three representatives from the Medical Board, two from the Board of Pharmacy and one each from the other two boards. Table 2: Respondents by Board This Period (n=2) Year 5 (n=7) Year 4 (n=8) # % # % Medical Board 2 100% % % Board of Nursing % % Board of Dentistry % % Board of Pharmacy % % January 2016 Year Six, First Period Report 26

72 72 Communication and Service Question 2: Respondents were asked to reflect on a recent licensee situation, question, or concern and rate three elements. Responders agreed or strongly agreed that they knew who to speak with, that the time frame was within one business day and that RBH had knowledge of the licensee or situation. This question was new last period so data is only available from one period for comparison. Data Table 3a and 3 b: The mode (most frequent) response is highlighted in red. Not all responses have a mode: Table 3a This Period (n=2) I knew who I should speak with Staff had knowledge of the licensee or situation The response time frame was within one (1) business day Table 3b Last Period (n=2) I knew who I should speak with Staff had knowledge of the licensee or situation The response time frame was within one (1) business day Strongly Strongly N/A or No Agree Undecided Disagree Agree Disagree Response # % # % # % # % # % # % 1 50% 1 50% 1 50% 1 50% 1 50% 1 50% Strongly Strongly N/A or No Agree Undecided Disagree Agree Disagree Response # % # % # % # % # % # % 2 100% 1 50% 1 50% 2 100% Question 3 was also new last period and was similar to the above. Respondents were asked to reflect on a broader question or programmatic concern, and rate four elements. Again, responses were positive with either agree or strongly agree values as seen in Table 4a: responders knew who to speak with, felt comfortable bringing concerns forward, felt RBH provided useful and insightful data and felt the time frame was within one business day. Last period s responses are shown on the next page for comparison. Data Table 4a and 4b: The mode (most frequent) response is highlighted in red. Not all responses have a mode: Table 4a This Period (n=2) I knew who I should speak with I felt comfortable bringing my concerns about the program forward RBH provided useful and insightful data to address my questions The response time frame was within one (1) business day Strongly Strongly N/A or No Agree Undecided Disagree Agree Disagree Response # % # % # % # % # % # % 1 50% 1 50% 2 100% 2 100% 1 50% 1 50% January 2016 Year Six, First Period Report 27

73 73 Table 4b Last Period (n=2) I knew who I should speak with I felt comfortable bringing my concerns about the program forward RBH provided useful and insightful data to address my questions The response time frame was within one (1) business day Strongly Strongly N/A or No Agree Undecided Disagree Agree Disagree Response # % # % # % # % # % # % 1 50% 1 50% 1 50% 1 50% 1 50% 1 50% 2 100% Overall Experience Question 4 asks respondents to rate the services overall. This period there was one excellent response and one above average response. Table 6: Overall Rating This Period (n=2) Year 5 (n=7) Year 4 (n=8) # % # % # % Excellent 1 50% % % Above Average 1 50% % % Average % Below Average Poor N/A or No Response What Should We Improve? Actual Comments January 2016: **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation, and grammar have not been corrected. 1. There are times when I think the agreement monitors miss the opportunity to address patterns or issues when someone has fallen out of compliance...things like positive UDS for marji, but then there is a gap before they are tested for the drug again. Or when an issue comes up the agreement monitor should anticipation what might help get the person back on track, or what might be done to increase the quality of monitoring...talk to the work site monitor, or the weekly meeting coordinator, therapist etc. 2. Going out to the nether regions of the state to talk with hospitals and associations about the program and the ability to self refer, etc. January 2016 Year Six, First Period Report 28

74 74 Additional Comments Actual Comments January 2016: **Note that comments are shown as the respondent typed or wrote them. Spelling, punctuation, and grammar have not been corrected. 1. There were some major bumps in the road this past year that hopefully everyone was able to learn from, that remains to be seen. Summary Analysis The response rate this year was 28.6% with two responses from the Medical Board. Data should not be considered to represent the experiences of the other three boards. Results, however, were positive: When reflecting on a recent licensee situation, question, or concern both responders agreed or strongly agreed that they knew who to speak with, that the time frame was within one business day and that RBH had knowledge of the licensee or situation. When reflecting on a broader question or programmatic concern, responders again agreed or strongly agreed that they knew who to speak with, felt comfortable bringing concerns forward, felt RBH provided useful and insightful data and felt the time frame was within one business day. Overall services were rated well with one excellent response and one above average response. Two recommendations for improvement were made and will be carefully reviewed along with the survey results.. January 2016 Year Six, First Period Report 29

75 75 TO: FROM: Oregon State Board of Nursing John Etherington Licensing and Fiscal Manager DATE: May 20, 2016 RE: Licensing and Fiscal Report 1. Statistics: Licensing and Certification Type of License or 03/22/16 05/22/16 + or - certification CNA 18,703 18, CMA 1,037 1,036-1 LPN 4,958 5, RN 55,338 55, CRNA NP 3,542 3, CNS NE N/A Data not available yet Data not available yet Total 84,418 84, Licensing and Fiscal Highlights Staffing: Both new staff members hired in April 2016 are doing very well in their positions as we continue to educate about the Board of Nursing licensing activities. Accountant position is currently vacant and job announcement has been posted for state applicants. Licensing Applications: We are currently into our new graduate busy season and students are eager to obtain their certification or license. We continue to monitor our changes from last year which include the implementation of digital fingerprinting, setting up the ability to accept electronic transcripts from several schools, training and shifting additional back up staff to handle the increased workload, changing forms and instructions for clarity, and conducting outreach by visiting schools beforehand to educate them on the application/licensing process are all improvements implemented to ensure the process runs more smoothly for our applicants this year. Preliminary results point to a more productive licensing result than from last year even with the increases in applications.

76 76 State of Oregon Kate Brown, Governor Oregon State Board of Nursing Ruby R. Jason, MSN, RN, NEA-BC Executive Director SW Upper Boones Ferry Road Portland, OR Telephone: (971) Fax: (971) Memorandum To: From: Oregon State Board of Nursing Members Debra K. Buck, RN, MS Nursing Assistant Program Consultant Date: May 18, 2016 Re: Ratification of Nursing Assistant/ Medication Aide Training Program Approvals & Withdrawals Board staff has approved the training programs and/or revisions below and recommend that you ratify them at the June 2016 Board meeting. If you have any questions, you may request that this item is removed from the Consent Agenda and I will be happy to answer your questions. NURSING ASSISTANT (NA) / MEDICATION AIDE (MA) TRAINING PROGRAM APPROVALS & REAPPROVALS DATE OF APPROVAL FACILITY/ PROGRAM CITY 03/14/2016 Baker Technical Institute NA program approval Baker City, OR 03/14/2016 Baker Technical Institute CNA 2 program approval Baker City, OR 03/15/2016 Dallas Retirement Village Healthcare Center NA program reactivated 03/25/2016 Rogue Community College CNA 2 program revision approval Dallas, OR White City, OR 04/07/2016 Lakeview Gardens NA program re-approval Lakeview, OR 04/18/2016 VanPelt Healthcare Workshops and Tutoring LLC MA program approval 04/18/2016 Southwestern Oregon Community College NA program revision approval Beaverton, OR Coos Bay, OR

77 77 04/19/2016 Caregiver Training Institute LLC NA program revision approval 04/19/2016 Caregiver Training Institute LLC MA program revision approval Portland, OR Portland, OR 04/25/2016 Clatsop Community College NA program re-approval Astoria, OR 04/28/2016 Southwestern Oregon Community College CNA 2 program re-approval 04/28/2016 Southwestern Oregon Community College NA program re-approval 05/11/2016 Lane Community College Eugene CNA 2 program reactivated 05/13/2016 West Hills Health and Rehabilitation Center NA program re-approval Coos Bay, OR Coos Bay, OR Eugene, OR Portland, OR 05/16/2016 EMT Associates NA program approval Eugene, OR NOTICE OF WITHDRAWALS No notices of withdrawals have been processed since the last report. NOTICE OF WAIVER REQUEST No waiver requests have been processed since the last report.

78 78

79 79 State of Oregon SW Upper Boones Ferry Road Kate Brown, Governor Portland, Oregon Telephone: FAX: Website: TO: FROM: All Interested Parties Ruby R. Jason Executive Director DATE: May 2016 SUBJECT: ADMINISTRATIVE RULEMAKING HEARING REGARDING THE ADOPTION OF THE AMENDMENTS TO OAR (AGENCY FEES) On Thursday, June 16, 2016, 9:00 a.m., the Oregon State Board of Nursing will hold a hearing regarding the adoption of the proposed amendments to Chapter 851, Division 2, of the Oregon Administrative Rules regarding Agency Fees. This hearing will be held in the conference room of the Oregon State Board of Nursing, S.W. Upper Boones Ferry Road, Portland, Oregon. Attached is a copy of the Notice of Proposed Rulemaking for this hearing. The Board is authorized by ORS , , and to establish and amend such rules. If you are unable to attend the hearing, you may submit your comments to me in writing by June 14, 2016 and I will see that they are incorporated into the testimony received at the hearing and considered by the Board at their June 16, 2016 meeting. The Board looks forward to receiving your input.

80 Secretary of State NOTICE OF PROPOSED RULEMAKING HEARING* A Statement of Need and Fiscal Impact accompanies this form Board of Nursing 851 Agency and Division Administrative Rules Chapter Number Peggy A. Lightfoot (971) Rules Coordinator Board of Nursing, SW Upper Boones Ferry Rd., Portland, OR Address Add Endorsement application fee of $9 to existing fees per SB 1585 RULE CAPTION Not more than 15 words that reasonably identifies the subject matter of the agency's intended action. Telephone FILED :23 PM Hearing Date Time Location Hearings Officer :00 a.m SW Upper Boones Ferry Rd, Portland, OR Bonnie Kostelecky, Board 80 ARCHIVES DIVISION SECRETARY OF STATE ADOPT: AMEND: OAR RULEMAKING ACTION Secure approval of rule numbers with the Administrative Rules Unit prior to filing. REPEAL: RENUMBER: Secure approval of new rule numbers with the Administrative Rules Unit prior to filing. AMEND AND RENUMBER: Secure approval of new rule numbers with the Administrative Rules Unit prior to filing. Statutory Authority: ORS and Other Authority: SB 1585 Statutes Implemented: ORS RULE SUMMARY SB 1585 added the $9 surcharge to fund the Oregon Nursing Advancement Fund to now include applications for Endorsement, in addition to new and renewal applications. The Agency requests public comment on whether other options should be considered for achieving the rule s substantive goals while reducing negative economic impact of the rule on business :00 p.m. Last Day (m/d/yyyy) and Time for public comment Peggy A. Lightfoot Rules Coordinator Name peggy.lightfoot@state.or.us Address *The Oregon Bulletin is published on the 1st of each month and updates the rule text found in the Oregon Administrative Rules Compilation.

81 Secretary of State STATEMENT OF NEED AND FISCAL IMPACT A Notice of Proposed Rulemaking Hearing accompanies this form. FILED :23 PM 81 ARCHIVES DIVISION SECRETARY OF STATE Board of Nursing 851 Agency and Division Administrative Rules Chapter Number Add Endorsement application fee of $9 to existing fees per SB 1585 Rule Caption (Not more than 15 words that reasonably identifies the subject matter of the agency's intended action.) In the Matter of: OAR Statutory Authority: ORS and Other Authority: SB 1585 Statutes Implemented: ORS Need for the Rule(s): To comply with SB 1585 amending previous legislation and adding the endorsement applications to the surcharge previously established to support the Oregon Nursing Advancement Fund, administered by the Oregon Center for Nursing. Previous legislation during the session applied this surcharge to new and renewal applications only. Documents Relied Upon, and where they are available: Text of SB 1585 Fiscal and Economic Impact: Fiscal impact of additional endorsement surcharge is estimated to be about fee to be about $75,600 all of which would be paid into the Oregon Nursing Advancement Fund with the state treasury and forwarded to the Oregon Center for Nursing. Statement of Cost of Compliance: 1. Impact on state agencies, units of local government and the public (ORS (2)(b)(E)): None. 2. Cost of compliance effect on small business (ORS ): a. Estimate the number of small business and types of businesses and industries with small businesses subject to the rule: None: The cost of the programs are borne by the licensees as individuals and not on their employer. b. Projected reporting, recordkeeping and other administrative activities required for compliance, including costs of professional services: No impact on current operational processes. c. Equipment, supplies, labor and increased administration required for compliance: None. How were small businesses involved in the development of this rule? Not considered due to bill being legislatively adopted. Administrative Rule Advisory Committee consulted?: No If not, why?: Only added a surcharge for a specific application type, legislatively mandated :00 p.m. Last Day (m/d/yyyy) and Time for public comment Peggy A. Lightfoot Printed Name peggy.lightfoot@state.or.us Address

82 Oregon State Board of Nursing Oregon Administrative Rules DRAFT Underlined material is proposed to be added. Strikethrough material is proposed to be deleted. Division 2 Agency Fees RN/LPN Schedule of Fees (1) License Renewal $145. (2) Delinquent fee $100. (3) Surcharge to Support the Workforce Data Analysis Fund at Renewal $5. (4) Surcharge to Support the Oregon Nursing Advancement Fund at for Licensure by Examination and Renewal -$9, Licensure by Endorsement, and Renewal applications $9. (5) License by Endorsement $195. (6) Licensure by Examination $160. (7) Written Verification of License $12. (8) Limited Licenses: (a) Reentry $95. (b) Extension of Reentry $25. (9) Limited Licenses for Educational Experience: (a) International Graduate Nursing Students $65. (b) Extension of International Graduate Nursing Students $25. (c) International RN in Short-Term Educational Experience $35. (d) International Exchange Students $25. (e) U.S. RNs in Distance Learning $15. (f) Extension of Distance Learning $15. (10) Reexamination for Licensure $25. (11) Reactivation $160. (12) Reinstatement by Reactivation $160. (13) Nurse Emeritus -$50 (biennial) Stat. Auth.: ORS & Stats. Implemented: ORS Hist.: NER 26(Temp), f. & ef ; NER 32, f. & ef ; NER , f. & ef ; NER , f. & ef ; NER , f , ef ; NER , f , ef ; NER , f. & ef ; NB , f. & ef ; NB , f. & ef ; NB , f. & cert. ef ; NB , f , cert. ef ; NB , f , cert. ef ; NB , f. & cert. ef ; NB , f , cert. ef ; NB , f. & cert. ef ; NB , f. & cert. ef ; NB f. & cert. ef ; Renumbered from ; NB , f. & cert. ef ; NB (Temp), f. & cert. ef ; NB , f. & cert. ef ; NB , f , cert. ef ; BN (Temp), f. & cert. ef thru ; Administrative correction ; BN , f. & cert. ef ; BN , f. & cert. ef ; BN , f , cert. ef , Renumbered from ; BN , f. & cert. ef ; BN , f. & cert. ef ; BN , f. & cert. ef ; BN , f. & cert. ef ; BN , f , cert. ef ; BN , f. & cert. ef ; BN , f , cert. ef ; BN , f. & cert. ef ; BN , f. & cert. ef ; BN , f , cert. ef ; BN , f , cert. ef Division 2 Page 1

83 83 State of Oregon Kate Brown, Governor Oregon State Board of Nursing Ruby R. Jason, MSN, RN, NEA-BC Executive Director SW Upper Boones Ferry Road Portland, OR Telephone: (971) Fax: (971) Memorandum To: From: Oregon State Board of Nursing Members Debra K. Buck, RN, MS Policy Analyst- Training & Assessment Date: May 19, 2016 Re: CNA/CMA Advisory Group Membership Recommendations On February 18, 2016, the Board approved the formation of a Certified Nursing Assistant (CNA)/Certified Medication Aide (CMA) Advisory Group. Applications for membership on this group have been reviewed by Board staff and membership recommendations are presented for your approval at this time. Per the charter approved by the Board, the term length is for three years. Meetings will be held as needed with at least one month s notice provided prior to each meeting. Priority for membership was focused on obtaining as broad of a representation of employment setting, role, and geographic area as possible. Members submitted for Board approval: Debra Anderson, RN Clackamas Community College NA Training Program Director/Primary Instructor, Clackamas County Telena Bence, RN, BSN Samaritan Health Services: Good Samaritan Regional Medical Center CNA 2 Training Program Director/Primary Instructor, Benton County Joanne Birney, OPA 3 Department of Human Services, Office of Licensing and Regulatory Oversight- Nursing Assistant Programs, State of Oregon Julie Bucher, RN Caregiver Training Institute, NA, CNA 2, & CMA Training Program Director/Primary Instructor, Multnomah County