CLEAR

How can we reduce record levels of health care burnout and distress?

        

CLEAR thanks our premier technology partner, Thentia, for contributing to CLEAR Regulatory News. 
The guest post below is provided by Thentia.

Dr. Marie Bismark joined Ascend Magazine Editor Paul Leavoy on an episode of the Ascend Radio podcast to discuss her research findings, the mounting problem of health care burnout and psychological distress, and the enormous challenges faced by health care workers during the pandemic – something she is intimately familiar with as both a researcher focusing on the intersection between patient safety, medical regulation, and clinician well-being, and a practicing physician pursuing advanced training in psychiatry who provided mental health care in the COVID wards and emergency departments of Australian hospitals during the pandemic.

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UK: consultation on Equality, Diversity and Inclusion Standard

The Professional Standards Authority in the UK has opened a consultation on a new Standard on Equality, Diversity and Inclusion to be added to its Standards for Accredited Registers (registers of people in health and/or social care roles that are not subject to statutory regulation). The proposed standard reads

"The organisation demonstrates its commitment to equality, diversity and inclusion and ensures that its processes are fair and free from unfair discrimination.
a) The register’s regulatory functions are underpinned by fairness and equity of access to registrants and service users.
b) The register understands the diversity of its registrants, service users and complainants and has an awareness of issues that may impact those with protected characteristics.
c) The register works to promote and enhance EDI by seeking to understand and act on issues affecting the roles registered and service users."

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PA: new rules for nursing home regulations

New Department of Health regulations for state nursing homes have been approved by Pennsylvania's Independent Regulatory Review Commission. The required number of hours of direct care per day per patient will be increased in July 2023 and again by July 2024. The number of patients that nursing assistants and nurse aides can be required to care for will decrease in July 2023 and again in July 2024. The health department will also begin posting notice of nursing home ownership changes, and regulators will be required to analyze the financial strength and past performance of owners in order to approve license applications.

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BC: new Health Professions and Occupations Act

A new Health Professions and Occupations Act in British Columbia replaces the Health Professions Act to "streamline the process to regulate new health professions, provide stronger oversight, provide more consistent discipline across the professions, act in the public interest and protect patient care in the province, while also laying the groundwork to further reduce the total number of regulatory colleges.”  Counselors and diagnostic and therapeutic professionals will now be regulated. The colleges for dietitians, occupational therapists, opticians, optometrists, physical therapists, psychologists, and speech and hearing professionals will be combined.  The colleges for chiropractors, massage therapists, naturopathic physicians, traditional Chinese medicine and acupuncturists will be combined. A new regulatory oversight body and an independent disciplinary tribunal will be created, as well as a reformed complaints process that takes into account cultural safety and humility.

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UK: report urges regulation of care staff in children's homes

The final report of the Independent Inquiry into Child Sexual Abuse recommends "introducing the regulation of care staff working in children’s homes in England and young offender institutions and secure training centres in England and Wales." The report also recommends that all professionals should be legally mandated to report child sexual abuse and face criminal sanctions for failure to do so. Mandated reporters would include police officers, social workers, family court advisers, foster carers, children’s home staff, teachers and healthcare staff working with children.

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US: trends in makeup of funeral industry

The National Funeral Directors Association has indicated that 79% of this year's mortuary students are female, up from 35% in 1995, reflecting a nationwide trend of changes to the makeup of the funeral industry. The funeral industry is responding to chronic staff shortages and an aging workforce by recruiting a younger and more diverse workforce. An example in Vermont is the introduction of new and more affordable certificate programs leading to licensure.

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DEA waiver and future impact on teleheatlh

At the start of the COVID-19 pandemic, the Drug Enforcement Agency waived the requirement for an in-person medical evaluation before prescribing of controlled substances as long as the prescription was for legitimate medical purposes, issued by a practitioner in the usual course of their professional practice, in accordance with federal and state laws, and prescribed following a real-time, two-way interactive telemedicine communication. This article explores what may happen to the waiver, and thus its impact on telehealth, when the public health emergency ends.

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Virginia considers reduced cosmetology education hours

The Virginia Board for Barbers and Cosmetology has voted to reduce the number of education hours required for licensure from 1,500 to 1,000. As indicated by West Virginia University economist Edward Timmons, 15 other states have made similar reductions to cosmetology license hours in the past decade, with no evidence of negative outcomes of the policy change.

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Guest commentary on Florida case - interrelationship of criminal case and licensure

Jon Pellett, CLEAR member and attorney with Pennington Law in Florida, offers this summary and commentary on a recent case in Florida:

Client was arrested and charged with domestic violence. In less than 30 days from the arrest, the State Attorney’s Office, looking at the circumstances that led to his arrest, declined to pursue it and the charge was dropped.

More than 60 days from his arrest, AHCA – Medicaid removed him from the program due to a law that allows them to do so on the basis of the arrest for domestic violence. It is an automatic disqualification under the law without a right to challenge it. The law at issue applies to AHCA licensed facilities and Medicaid. Once Background Screening flags the arrest, AHCA removes the individual from Medicaid and notifies facilities that the individual is not eligible to be employed or practice at the licensed facilities.

Upon notice of the flag by Background Screening, AHCA made the Medicaid removal retroactive to the date of his arrest. AHCA was unaware at the time of termination that the criminal case had been dropped. Fortunately, once AHCA was shown the decision was based on incomplete information, within days of the decision to terminate him, they reversed course and placed him back in the system as eligible and the reinstatement was done in a way to render the earlier termination null.  

At the time they decided to remove him, over 80% of his practice was Medicaid. Had the termination been allowed to stand, he could have lost 80% of his practice. He would have been required to return money paid by Medicaid for services from the date of his arrest to the termination date, and he would have not been allowed to renew his medical license in Florida when it comes-up for renewal in January 2023. The interrelationship of the various statutory provisions between Department of Health and AHCA – Medicaid can cause substantial unintended harm. Being allowed to take action on the basis of the arrest without allowing some opportunity to challenge the decision, places individuals in a very precarious spot. If the criminal case had gone the regular route, the criminal case might not have been resolved before 2023. Within that time period, the parade of horribles that I outlined would have come to pass.

California: cannot discipline for off-duty marijuana use

AB2188 in California prohibits employers from taking adverse action against an employee for off-duty marijuana use. Adverse action is still authorized for employees who are impaired in the workplace. The new law goes into effect January 1, 2024.

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