1. 2007 Annual Conference Professional Discipline Ruby E. Brice, J.D. S.C. Department of Labor, Licensing and Regulation

2. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation The Disciplinary Process  Use of Administrative Hearings  Nature of Proceeding  Role of the Board  Participants  Jurisdiction of the Board

3. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Steps in a Disciplinary Action Initial Complaint Investigation Formal Complaint Informal Disposition Formal Hearing Sanction Judicial Review

4. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Steps in the Enforcement Process Intake – Receiving and acknowledging complaints, setting up files and initiating complaint tracking. Assessment – Screening complaints; determining the type of response appropriate for the complaint; determining jurisdiction. In cases of perceived immediate public risk statute may permit immediate suspension of registration. Investigation – Assigning an investigator or investigative teams for determining the details of the case and producing a final report.

5. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Steps in the Enforcement Process Review – Determining the disposition of investigated complaints: those without merit, closed; those with merit, a determination of the level of action to be taken. Formal and Informal Resolution – Informal resolution by stipulated agreement; or Formal Hearings – formal resolution by hearings before the board or administrative law judge. Final Orders – Determining facts, legal conclusions and sanctions in appropriate cases. Compliance – Following up on all final orders to assure the orders are being obeyed.

6. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Practitioner Misconduct Misconducts may include but are not limited to: Direct physical harm to a client Abuse of a client Improper advertising Failure to provide access to records Failure to keep records as required

7. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Practitioner Misconduct Falsification of records Failure to maintain Standards of Practice Failure to comply with the Code of Conduct Falsifying financial records Practicing the profession while mentally incompetent Practicing the profession while impaired

8. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Mental or Physical Impairment Appropriate mental and/or physical evaluations be completed to ensure that the board has complete information on which to base their decisions in these cases.

9. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Chemical Impairment The process of drug impairment in regulated professionals typically progresses along a continuum from use, to misuse, to abuse, to dependency on a chemical substance. A regulatory authority should be careful in determining if a licensee’s drug activity is for legitimate reasons, and not interfering with competent performance.

10. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Informal Disposition of Complaints Advantages of Informal Disposition Disposition by Correspondence Consent Order Settlement The Board’s Role in Informal Dispositions

11. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation The Formal Hearing Format: Hearing Officer Panel Full Board Issues: Confidentiality Recusal Taint

12. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Rights of the Parties Right to Appear and Be Heard Right to Present Evidence Right to Cross Examine Witnesses Right to Be Accompanied and Advised by Counsel Right to a Fair and Impartial Hearing Right to Judicial Review

13. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Forms of Evidence Oral testimony Documentary evidence Visual, physical, illustrative evidence Admissions Facts officially noted

14. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Making the Decision Fact Finding Function:  Determine the Facts Solely on Evidence Submitted at the Hearing  Determine whether the facts support the Charges Conclusion of Law:  Determine Whether the Charges are a Violation of the Relevant Law or Rule.

15. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Determining Sanctions The Nature/Circumstances of Offense The Severity of the Allegations The Number of Times Incident Occurred The Length of Time Over Which Behavior Occurred The Licensee’s Motivation for Action Public Injury/Harm The Protection of the Public The Standards of the Profession

16. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Types of Disciplinary Actions Include Dismissal Revocation Suspension or Other Restriction of the License Surrender Probation Censure/Public Reprimand Requirement of Additional Education/Supervision Administrative Fine Cease and Desist Restitution

17. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Judicial Review Remands to Board

18. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Characteristics of a Strong Enforcement Process Publicize their existence and role in handling consumer complaints. Options include: Toll-free complaint lines; Information brochure with wide distribution; Notices about where and how to file complaints posted in all licensed professionals’ offices;

19. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Characteristics of a Strong Enforcement Process Public service TV and radio ads; Speeches by board members to community associations; Coordination of publicity/consumer information with local consumer groups; Including complaint filing information in statute and/or rules.

20. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Characteristics of a Strong Enforcement Process Develop a well-organized complaint handling process. Establish appropriate periods of time for notice and for investigative review. Observe due process. Specify the reasons for which the board may take disciplinary actions. Consider ways to establish internal consistency with regard to charges and sanctions.

21. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Receiving and Sharing Information The board should make provisions through the practice act to receive information from professional associations, professional review organizations (PROs), hospitals, clinics or other institutions in which a licensee performs professional services, on possible chemical abuse, or incompetent or unethical behavior within a specified time. Circulate notice of sanctions taken by the board to other licensing jurisdictions.

22. Atlanta, Georgia 2007 Annual Conference Council on Licensure, Enforcement and Regulation Speaker Contact Information Ruby E. Brice, JD Assistant Deputy Director Office of Health and Medically Related Professions S.C. Department of Labor, Licensing and Regulations 110 Centerview Drive Columbia, SC 29210 (803) 896-4724 – Office (803) 896-4719 – Fax mcclainr@llr.sc.gov