September 2011 PE 11-07-496 REGULATORY BOARD REVIEW WEST VIRGINIA BOARD OF PHYSICAL THERAPY AUDIT OVERVIEW The Board of Physical Therapy Is in Compliance With the Gerneral Statutory Requirements for Regulatory Boards and Has Improved Its Financial Condition Compared to Previous Years WEST VIRGINIA LEGISLATIVE AUDITOR PERFORMANCE EVALUATION & RESEARCH DIVISION JOINT COMMITTEE ON GOVERNMENT OPERATIONS Senate House of Delegates Agency/ Citizen Members Herb Snyder, Chair Jim Morgan, Chair John A. Canfield Douglas E. Facemire Dale Stephens, Vice-Chair W. Joseph McCoy Orphy Klempa Ron Fragale Kenneth Queen Brooks McCabe Eric Nelson James Willison Clark S. Barnes Ruth Rowan Vacancy Scott G. Varner, Nonvoting JOINT COMMITTEE ON GOVERNMENT ORGANIZATION Senate House of Delegates Herb Snyder, Chair Jim Morgan, Chair Rupert Phillips, Jr. Mike Green, Vice-Chair Dale Stephens, Vice-Chair Margaret A. Staggers Richard Browning William Romine, Minority Chair Randy Swartzmiller H. Truman Chafin Tom Azinger, Minority Vice-Chair Joe Talbott Dan Foster Brent Boggs Eric Householder Orphy Klempa Greg Butcher Gary G. Howell Brooks McCabe Samuel J. Cann, Sr. Larry D. Kump Ronald F. Miller Ryan Ferns Eric Nelson Joseph M. Minard Roy Givens John D. O’Neal, IV Corey L. Palumbo Daniel J. Hall Rick Snuffer Bob Williams William G. Hartman Erikka Storch Jack Yost Barbara Hatfield Donna J. Boley Ronnie D. Jones Dave Sypolt Helen Martin WEST VIRGINIA LEGISLATIVE AUDITOR PERFORMANCE EVALUATION & RESEARCH DIVISION Building 1, Room W-314 State Capitol Complex Charleston, West Virginia 25305 (304) 347-4890 Aaron Allred John Sylvia Michael Midkiff Jared Balding Keith Brown Legislative Auditor Director Research Manager Research Analyst Referencer Regulatory Board Review September 2011 CONTENTS Executive Summary ....................................................................................................................................................................... 5 Background ...................................................................................................................................................................................... 7 Issue 1: The Board of Physical Therapy Is in Compliance With the General Statutory Requirements for Regulatory Boards and Has Improved Its Financial Condition Compared to Previous Years .................................................................................................................. 9 List of Tables Table 1: Number of Persons Licensed by the Board of Physical Therapy ................................................................ 7 Table 2: West Virginia Board of Physical Therapy Operating Budget Fiscal Year 2006-2010 ..........................10 Table 3: Profession Licensing Fees in WV and Bordering States ...............................................................................11 Table 4: Neighboring States’ Continuing Education Requirements for PTs .........................................................12 Table 5: Complaint Resolution Statistics ...........................................................................................................................15 List of Figures Figure 1: Board of Physical Therapy Complaint Process ...............................................................................................16 List of Appendices Appendix A: Transmittal Letter to Agency ..........................................................................................................................19 Appendix B: Objective, Scope and Methodology ............................................................................................................21 Appendix C: Continuing Education Requirements for PTs ............................................................................................23 Appendix D: Agency Response ...............................................................................................................................................25 Performance Evaluation & Research Division | pg. Board of Physical Therapy pg. 4 | West Virginia Legislative Auditor Regulatory Board Review September 2011 EXECUTIVE SUMMARY This report represents the Regulatory Board Review of the West Virginia Board of Physical Therapy (Board), as required by West Virginia Code §4-10-10. The Legislative Auditor finds that the Board is in compliance with the general provisions of Chapter 30. However, the Board can make improvements in its operations by adopting recommendations made by the Legislative Auditor in addition to promulgating rules in accordance with Code. Report Highlights: The Board of Physical Therapy Is in Compliance With the General Statutory Requirements for Regulatory Boards and Has Improved Its Financial Condition Compared to Previous Years. The Board Has Improved Its Financial Condition. € The Board had a precariously low end-of-year cash balance from FY 2006 through FY 2008. As of FY 2010 the Board’s finances are in better condition with an ending balance that is greater than its yearly expenditures. The West Virginia Board of Physical Therapy Does Not Require Licensees to Report Continuing Education for Licensure Renewal. € The Board should amend its license renewal application to allow applicants to list continuing education information such as course titles, institution and completion dates. The Board Does Not Have the Legal Authority to Administer Federal Criminal Background Checks € The Board uses the Federation of State Boards of Physical Therapy Licensure and Disciplinary Database (LDB). However, the (LDB) does not capture information regarding criminal charges and/or convictions that may have occurred outside of the licensees professional practice. Consequently, the Board could inadvertently license or renew licensees with a criminal background. Performance Evaluation & Research Division | pg. Board of Physical Therapy Complaints to the Board Are Resolved Timely and With Due Process € All complaints, with the exception of two pending cases, were resolved within the 18-month time frame as mandated by statute. The Legislature Transferred the WV Board of Education’s Responsibility for Licensing Athletic Trainers to the WV Board of Physical Therapy Per the Legislative Auditor’s 2007 Recommendation € The Board is currently accepting athletic trainer applications and estimates 225 to 250 registrations for the current registration period. Recommendations 1. The Board should request that the Legislature consider granting it the authority to conduct federal criminal background checks on applicants seeking licensure. 2. The Board should consider revising its licensure application to allow licensees to list relevant information concerning their continuing education, such as course titles, provider and completion dates. 3. The Board should promulgate procedural rules that govern the notice of meetings rule as required by Code §6-9A-3. 4. The Board should carefully monitor its financial condition in order to maintain cash reserves equivalent to or greater than its yearly expenditures. 5. The Board should consider conducting state criminal background checks on licensure applicants until it receives authorization to conduct federal criminal background checks. pg. 6 | West Virginia Legislative Auditor Regulatory Board Review September 2011 BACKGROUND The West Virginia Board of Physical Therapy (Board) is established in West Virginia Code §30-20-4 and is responsible for licensing physical therapists (PTs), physical therapy assistants (PTAs). The Board is also the disciplinary body for all professions licensed by the Board. The Board collects and processes applications for licensure as well as complaints filed against licensees in addition to renewing licenses. The Board of Physical Therapy licenses 2,000 persons. Table 1 displays the number of individuals licensed in each occupation. Table 1 Number of Persons Licensed by the Board of Physical Therapy Physical Therapists 1,166 Physical Therapy Assistants 834 Total 2,000 Source: West Virginia Board of Physical Therapy To become licensed by the Board, PTs are required to have graduated from an accredited school of physical therapy approved by the Commission on Accreditation in Physical Therapy Education or a successor organization. PTAs must have graduated from a two-year college level education program for physical therapist assistants that meets the standards established by the Commission on Accreditation in Physical Therapy Education and the West Virginia Board of Physical Therapy. In 2010, the Board granted new licenses to 100 PTs and 83 PTAs. Performance Evaluation & Research Division | pg. 7 Board of Physical Therapy pg. | West Virginia Legislative Auditor Regulatory Board Review September 2011 ISSUE 1 The Board of Physical Therapy Is in Compliance With the General Statutory Requirements for Regulatory Boards and Has Improved Its Financial Condition Compared to Previous Years. Issue Summary The Board of Physical Therapy is in compliance with the requirements set forth in Chapter 30 of the West Virginia Code. The Board is financially self-sufficient with a cash balance of $193,418; however, between FY 2006 and FY 2008 the Board had precariously low cash reserves. Licensing fees are higher than those of surrounding states. The required continuing education has been established and the number of hours required is comparable to the national average. However, licensees are not required to provide proof of continuing education when applying The Board does not have the legal au- thority