STATE OF NEVADA BOARD OF EXAMINERS FOR AUDIOLOGY AND SPEECH PATHOLOGY MINUTES OF PUBLIC MEETING February 10, 2012 Members Present: Members Absent: Staff Present: Public Present: Rebecca Bailey-Torres, Katherine Ross, Anthony Zamboni Richard Johnson, Nighat Abdulla Loretta L. Ponton, Henna Rasul, Senior Deputy Attorney General None Call to Order, Confirmation of Quorum - The meeting was called to order at 1:00 p.m. by Rebecca Bailey-Torres, President. A roll call confirmed a quorum was present. Public Comment There was no public comment. Approval of the Minutes Rebecca asked if there were any comments or revisions to the minutes of the meeting of December 2, 2011. Rebecca noted under the first Public Comment item, the wording should be revised to indicate there was no public comment. No further revisions were noted. Katherine made the motion, seconded by Dr. Zamboni to approve the minutes of the meeting of December 2, 2011 as revised. The motion passed. Executive Director s Report Rebecca turned the floor over to Loretta. Loretta reported the transition activities were extensive and were the primary focus since the last meeting. Transition went fairly smooth and has been completed. Members were directed to the written report. Licensing Statistics The license renewal process has been completed, with 81 licensees not renewing or reinstating their licenses as of January 27 th. Late renewal applications received after January will not be accepted, a reinstatement application and fee will be required. Katherine asked if the number of non-renewals was high. Loretta stated there are no historical records to compare the attrition rate; that based on her experience with other boards, it is not uncommon to have 45 60 licenses expire each year. It is still early, late renewals are still being received so the licensee numbers will most likely increase. The reinstatement application has been revised to capture the reason a license lapsed so as to establish a statistical base for analysis in the future. Financial Reports - Loretta provided a summary of the financial reports as of December 31 st stating the financials include estimated beginning balances pending completion of an audit of FY 11 records. There were no questions on the financial reports. Order of Suspension Loretta reported no further action is required by the Board. 1
State Reports Loretta reported all reports have been filed and the Board is now in compliance with reporting requirements Loretta reported a new website is currently being developed and should be completed in the near future. Co-Location Agreement Rebecca asked Loretta to present. Loretta stated the Cost Allocation and Agreement to co-locate the administrative office with the Board of Occupational Therapy was approved by the Board of Occupational Therapy at their meeting of January 21, 2012. The agreement is being presented for Board consideration and approval. Rebecca called for a motion. Dr. Zamboni made the motion, seconded by Katherine to approve the Cost Allocation and Agreement with the Board of Occupational Therapy. The motion passed. Banking Rebecca asked Loretta to present. Loretta reported that new signatory authorizations are required for the US Bank savings account in order to access the money. Loretta stated funds should be consolidated into one banking institution and should be covered under the Nevada Collateral Pool which oversees public funds deposits, requiring collateralization by the institutions in lieu of FDIC insurance requirements. Loretta stated the action required is to designate new signatories for the US Bank account. Rebecca stated a motion is requested to approve Rebecca Bailey-Torres, Katherine Ross and Loretta Ponton as authorized signatories on the US Bank account. Dr. Zamboni so moved, seconded by Katherine. The motion passed. Loretta stated the Board previously authorized a credit card for use by the Executive Director. An application has been completed which requires the signature of two Board members. Since Rebecca and Katherine are the signatories on the Wells Fargo account, they have been designated as the Board members on the authorization form. Loretta explained the credit card would be used for travel and meeting expenses of board members and staff and other necessary board business and expenses, such as pre-payment of services to obtain discounts or the purchase of items not otherwise available. Rebecca asked for a motion to approve the credit card application. Katherine so moved, seconded by Dr. Zamboni. The motion passed. Audit Services Proposal Loretta stated she solicited a proposal from Kohn Kolodny LLP, a certified public accounting firm, for an audit of the Board s FY 11 financial records. The proposal includes inputting an entire year of financial information into an accounting program in addition to the audit of the resulting financial statements. The proposed cost is $5,000.00. 2
Katherine asked if there was a state requirement for an audit; Loretta responded a single audit is required when total revenue reaches $50,000. The Board s revenue is reported at just under the $50,000 mark. The financial records should be maintained on an accrual basis; however, previous year s records have not been verified as accurate as an audit has not been completed since 2004. An audit is necessary not only to establish the correct beginning balance for revenue, but also to validate the expenses incurred. Questions were asked regarding the experience in conducting like kind audits and whether Loretta has worked with this firm before. Loretta stated she has worked with Kohn Kolodny LLC and that they work well with staff and also the bookkeeping firm. They have conducted audits of several other state Boards. Rebecca called for a motion to approve the audit proposal for FY 11with Kohn Kolodny LLC. Katherine so moved, seconded by Dr. Zamboni. The motion passed. NRS and NAC Discussion Loretta provided background information on the status of prior sessions legislative items, SB 58 from 2008 and 2011, NAC regulatory revisions LCB R122-08 and proposed NAC revisions regarding endoscopy. SB 58 was not passed in 2008 nor was it submitted for the 2011 session; language in LCB 122-08 was revised by LCB which was not brought to the Board for approval and therefore remains pending; the proposed changes to NAC regarding endoscopy were not submitted to LCB and also remains pending. Loretta briefly summarized the provisions of each of the documents. SB 58 made revisions to update educational requirements for licensing; remove the licensing qualification section regarding equivalent education and training and revised provisions for temporary licensure. Loretta reported the Board held public hearings and adopted revisions to NAC in 2007 and 2008 prior to submitting the proposed language to the Legislative Council Bureau. The LCB made revisions to the adopted language and assigned file number LCB R122-8; however the LCB revisions were never brought back to the Board for approval. All regulations must be approved in final form by the Board and must then be submitted to the Legislative Commission for final approval. Loretta stated that due to the length of time that has passed, it would not be recommended to continue to pursue the NAC changes at this time. Loretta continued that the proposed changes regarding endoscopy were developed as a result of a committee review. Katherine stated the committee included Dr. Waterson and that Dr. Waterson should be included when the Board reviews the NAC. Loretta added that the current NAC does not have a specific scope of practice section, the endoscopy issue would be appropriate to be included in a scope of practice section. Katherine agreed and stated that there are resources available through ASHA for development of scope of practice, they have a model practice act that can be used as a resource. Discussion was heard regarding changes in the Medicaid law that precipitated the review of endoscopy practice and revisions made by the committee. Since then, those provisions have been rescinded. Dr. Zamboni stated that this issue needs to be addressed as Medicaid may again try to write it out as not reimbursable. 3
Loretta recommended the Board conduct a review of NRS and NAC as priority for the coming year. Loretta stated the review process may be done in multiple meetings and/or during a working retreat over two days, which is an option. Loretta continued stating the entire process from the start of the review to final approval for both NAC and NRS revisions will be approximately 2 years. The first thing is to prioritize what we can get done; establish a timeline, and formulate the process. The Board s responsibility will be in the review, identification and development of revisions. Discussion was heard regarding board terms; Katherine s term is expiring June 30, 2012. Rebecca stated she was not aware of the deficiencies that existed with the Board when she was appointment; but is more comfortable now that administrative issues are now being addressed. Rebecca asked for a motion to establish the review of NRS 637B and NAC 637B as a priority goal for the Board over the next two years. Dr Zamboni so moved, seconded by Katherine. The motion passed. Executive Order Report Loretta provided the Board with a draft report to the Governor as required by Executive Order 2011-01. Loretta stated she has prepared the report after review of the NAC 637B regulations and added the report is being submitted late due to the extenuating circumstances outlined in the report. Members reviewed each section of the report, with questions answered by Loretta. Clerical corrections were noted on page one and page four. Dr. Zamboni made the motion, seconded by Katherine to approve and submit the report to the Governor with corrections as noted. The motion passed. Application for License Loretta stated Ms. McClain-Miller is applying under the equivalent training and experience authority of NRS 637B.160(2). Loretta stated she has reviewed the law and the regulations; however, the applicability of the equivalent training and education authority must be determined by the Board. Loretta summarized the applicant s qualifications, stating Ms. McClain-Miller holds a Bachelor s degree and does not have ASHA certification. Rebecca noted the information provided to document 300 hours of supervision does not validate supervision by a certified Speech Pathologist. Discussion was heard regarding the supervision requirements in relation to ASHA certification. Dr. Zamboni asked if the applicant has only worked in the school district as a speech therapist; which was confirmed. Dr. Zamboni stated if licensed, the applicant would be allowed to perform the full speech language pathologist scope of practice spectrum. Katherine added the continuing education courses submitted are not specific to speech-language courses equivalent to those required of a speech pathologist. Discussion of the education documentation continued in regards to the requirements in law. Henna added that each of the requirements must be met and should be documented as determined by the Board. Loretta pointed out that the Praxis test results submitted is for Teaching Speech to Students w/language Impairments, test code 0880. The Praxis test Speech Pathology is the not the same, it has a test code 0330. It was determined the test submitted is not approved by the Board. 4
Katherine made the motion to deny the application of Christine McClain-Miller for a license to practice speech pathology as not meeting the requirements for equivalent education and training pursuant to NRS 637B.160 based upon: NRS 637B.160 (1) ( e) completion of 300 hours of supervised clinical experience; NRS 637B.160 (1) (g) did not pass the NTE examination for a Speech Pathologist and NRS 637B.160 (2) lack of sufficient evidence to document equivalent training and experience as a speech pathologist. The motion was seconded by Dr. Zamboni. The motion passed. Board Member Report Katherine Ross reported she attended the 2 day conference in Las Vegas held by the National Council of State Boards. Katherine reported the conference was very informative, participants reported the types of activities each Board conducted. In larger states, there are a lot more licensees and disciplinary actions and the boards meet more during the year and have more Board business. Some states provide training, others do not some attend meetings in person and by conference calls, others must be physically present. Each state has their own specific processes. Sample documents were also available such as a Model bill. The conference was very interactive and educational; Katherine recommended the board maintain membership and continue to attend the conferences. The participants ranged in age and experience, but all were very well versed in the practice. Loretta stated the next meeting of the NCSB will be in Williamsburg, Virginia on October 11-13, 2012; and recommended the members attend if possible. Report from Board Chair Rebecca asked for discussion on a meeting schedule and whether to consider having a retreat. After discussion, Rebecca established the next meeting for May 18th at 2:00 p.m. at the Board office. Loretta suggested that a retreat be considered for January of next year; also a meeting might be appropriate to be scheduled in Las Vegas. Rebecca asked that a plan for the review of NRS and NAC be on the agenda for the May 18 th meeting. Discussion of the NCSB model bill language was heard with a consensus the American Academy of Audiology also be considered as a resource when looking at bill language revisions. Report from Legal Counsel Henna stated she is pleased with the new direction and activities of the Board, under the guidance of Loretta. Public Comment There was no public comment. Adjournment Dr. Zamboni made the motion, seconded by Katherine to adjourn. Rebecca adjourned the meeting at 2:45 p.m. 5