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DOCUMENT RESUME

ED 301 643 CE 050 968

TITLE 'mask Listing for Introduction to Health Occupations.Competency-Based Education.

INSTITUTION Henrico County Public Schools, Glen Allen, VA.Virginia Vocational Curriculum Center.; VirginiaAssociation of Allied Health Professions.

SPONS AGENCY Virginia State Dept. of Education, Richmond. Div. ofVocational and Adult Education.

PUB DATE 87

NOTE 91p.; For the service area resource document, see CE050 971.

AVAILABLE FROM Virginia Vocational Curriculum and Resource Center,2200 Mountain Road, Glen Allen, VA 23060-2208($4.79).

PUB TYPE Guides Classroom Use Guides (For Teachers) (052)

EDRS PRICE MF01/PC04 Plus Postage.DESCRIPTORS *Allied Health Occupations Education; Behavioral

Objectives; *Competency Based Education; CourseContent; Course Organization; First Aid; Job Skills;Learning Activities; Medical Services; *OccupationalInformation; Postsecondary Education; SecondaryEducation; State Curriculum Guides; *Task Analysis;Vocational Education

IDENTIFIERS Virginia

ABSTRACT

This task listing is designed to be used incombination with the "Health Occupations Education Service AreaResource" in order to implement competency-based education in healthoccupations programs in Virginia. The task listing contains fourmajor sections: (1) content/concept areas; (2) program and coursedescription; (3) content outline; and (4) appendixes. Eachcontent/concept area contains related validated tasks. The purposeand general description of the course, including miggested gradeleve2s, are provided. The course outline, arranges topically, giveseducators a guide to areas to be covered in the course, including thehealth care industry, the health care worker, health careers,regulation, safety, epidemiology, the health care consumer, firstaic, and cardiopulmonary resuscitation. The appendixes contain asample of an occupational area outline, a health careers list,information on raalth regulatory boards, and an abbreviated courseoutline for administrators. (KC)

t*********************************************************************** Reproductions supplied by EDRS are the best that can be made *

* from the original document. *

*****************************************************k*****************

APPLICATION OF TASK LISTING

This t isk ,tfonal uiatri ,1 1

program and

Pro.110.1,

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latrociu, \1 as a prerequisite for the

following pro ;( \ J , I d T,_c_finolog, Health CareersChister, \,,tstant, Or-t,i1CLii Nursing, and SurgicalTechnology .

This course is introductory iii -1,1tati'; t;ierefote, no spei ific or related job titlesfrom the Dictionar) of Occupation Tttl hsted here. Occupational and DOTinformation for sane health care po,,itions (-CI be found in Section I of the HealthOccupations Education Service \rea Resource. CHI Cdes for a number of healthoccupations are listed in 1ppendix 11 in this

ifermatio Jen( ei-u8 the .,),alimt:i)11 _tail use of this publicationma} be o')tained :t.),i) the folio of

1-lc otth Educ,ittorl S;r1D.VoLatIo.1_11

Depaytiii(_ht of Lju, atiouP.O. Box 6,S!

Rii :lend, Vir8inid(3')1-4,)

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JVINIpt01.114.110.04111111111.1.1M

TASK LISTINGFOR

INTRODUCTIONTO

HEALTH OCCUPATIONS

Developed byHealth Assistant Project

Virginia Association of Allied Health Professions

and

Health Occupations Education ServiceVocational and Adult Education

Department of EducationCommonwealth of VirginiaRichmond, Virginia 23216

Published by

Virginia Vocational Curriculum CenterDepartment of Vocational and Community Education

Henrico County Public SchoolsGlen Allen, Virginia 23060

In Cooperation with

Commonwealth of VirginiaDepartment of Education

Vocational and Adult EducationRichmond, Virginia 23216

1986

)C.----w' CONTENTS

PAGE

INTRODUCTION AND USE I

CONTENT/CONCEPT AREAS 7

1. Introducing the Course 9

2. Participating in Health Occupations Students of America 103. Exploring the Health Care Industry 11

4. Becoming a Health Care Worker 125. Discovering the Variety of Health Careers 136. Understanding Health Care Regulatory Systems 147. Practicing Safety 158. Learning About Epidemiology 169. Becoming a Knowledgeable Health Care Consumer 17

10. Administering First Aid 1811. Providing Cardiopulmonary Resuscitation 1912. Preparing for a Health Career 20

PROGRAM AND COURSE DESCRIPTIONS

Program and Course Description for Introduction to Health Occupations . . 21

COURSE OUTLINE

Suggested Course Outline for Introduction to Health Occupations 25

APPENDICES

Appendix AAppendix 13Appendix CAppendix D

Occupational Area Outline 35Health Careers Listing 43Health Regulatory Boards 49Introduction to Heath Occupations Course

Outline (Abbreviated) 99

111

r"t)

1

C INTRODUCTION AND USE ).INTRODUCTION

One of the major characteristics of competency-based education (CL\E) is that the

course content is based upon actual jobs or tasks performed by the worker. In Virginia, the

Department of Education has established standards for competency-based education.

According to these standards, competencies must be role-relevant and based upon

appropriate research. This standard states:

Role-relevant competencies are identified and stated.

The competencies, with standards, will be identified through V-TECS,IDECC, and other appropriate research. Advisory committees shouldbe used to review competencies and standards. Competencies in theaffective domain will be included. Role-relevant ,ompetencies foroccupational preparation programs are those that specifically relateto the occupation for which the student is being prepared, as well asto the personal needs of the student. Role-relevant competencies arerelated also to orientation, exploration, and/or industrial artsexperiences which have been identified for students.

Therefore, role-relevant jobs or tasks, called competencies in CBE, must be identified

ar.i validated before instructional materials are developed and subsequent instruction takes

place.

Since this course is introductory in nature, the tasks are not for occupationalpreparation but are designed for the following purposes:

to acquaint the student with the health care industry

- to survey various health careers

- to help the student determine if he/she wishes to become a worker in the healthcare industry

to help the student in choosing a health career.

The TE.sk Listing for Introduction to Health Occupations was developed by the Teacher

Technical Committee to a special Health Occupations Education (HOE) project. The eleven-

member committee was composed of representatives of the health care industry, the State

Department of Education, and seven teachers with experience in the development and

implementation of health occupations programs. Members were Joyce Bishop; Roxanne

C

2

Burnley; Patricia Eakin; Kathleen Kunze; Barbara Murnpower; Phyllis Russell; Nancy Sparks;

Carol Stickney; Jennie Seaton, Ed.D.; Ned Swartz, Ed.D.; and Carol Hampton, Chairperson.

The project was managed in contract ilVA-83-C-131-2-H0-001 between the Virginia

Association of ,\Ilied Health Professions (VAAHP) and the Virginia Department of

Education, Division of Vocational and Adult Education, Health Occupations Education

Service under provisions of the Vocational Education Amendments of 1976 (Public Law 94-

432).

In J nnation for the task listing and course outline was obtained from the followin;

sources:

I. The current V-TECS catalog for the Healtn Care Worker

2. Review of the literature and selection of appropriate competency-basedmaterials developed by other states and systems

3. Input from a broadly based, statewide health occupations program advisorycommittee representing health care industry workers and educators in publicschools, community colleges, universities, and hospitals

4. Ini it from other teachers of the Introduction to Health Occupations course(8302) and Health Careers Cluster Program.

The next step was validation of the task list, which inolved the following:

1. Field testing of Introduction to Health Occupations by Prince William CountyPublic Schools

2. Review by writing team members

3. Review by the advisory committee to the health occupations special oroject

4. Review by selected representatives of the health care industry

5. Final review and editing by state staff.

As part of the validation process, the following individuals reviewed and critiqued the

outline and related materials in this document:

Susan W. CahoonDirector of Health Site ProgramsAmerican Heart Association, Virginia Affiliate

Joseph 11. Doherty, D.D.S.Director, Division of Dental HealthVirginia Department of Health

3

Ann M. Flowers, Ed. D.Associate Professsor of Speech Pathology EmeritusMedical College of Virginia /Virginia Commonwealth University

Jane R. Hill, Ph. D.Director, Physical TherapyMedical College of Virginia Hospitals/Virginia Commonwealth

University

Harold J. McGrane, D.D.S.Assistant Director, Division of Dental HealthVirginia Department of Health

Richard D. MorrisonPolicy AnalystVirginia Department of Health Regulatory Boards

Stuart D. OgrenPresidentVirginia Hospital Association

It is important in implementation, as well as in development, to keep the task listing

broadly based to apply to the more than 200 health careers.

USE

This task listing is designed to be used in conjunction with the Health Occupations

Education Service Aria Resource in order to implement competency-based education in the

health program. The service area resource contains information which pertains to all

programs within Health Occupations Education. The four sections of the resource are titled:

Occupational Information, Student Organizations (HOSA), Classroom Management Systems,

and Recording Systems.

This task listing contains four major sections: 1) Content/Concept Areas, 2) Program

and Course Description, 3) Content Outline, and 4) Appendices. Each Content/Concept

Area contains related validated tasks. The purpose and a general description of the course,

including suggested grade levels, are included in the Program and Course Descriptions. The

Course Outline, arranged topically, provides educators with a helpful guide, illustrating

areas to be covered in the course. The Appendices contain Appendix A, a sample of an

occupational area outline Appendix B, Health Careers; Appendix C, Health Regulatory

Boards; and Appendix D, an abbreviated course outline for administrators.

4

The steps listed below should be followed when using the task listing and ser /ice area

resource to implement C3E in a vocational program or course:

Using the Introduction to Health Occupations Task Listing:1. Review tasks. Review the Content/Ccncept Areas section to determine \,' ether all

task/competencies are included for the region or locality in which the program .)rcourse is offered. If additional task/competencies are required for theprogram/course, include them in the instructional program.

2. Review course outline. Revise the outline sequence if additional task/competencieshave been identified or if the sequencing needs to be changed.

3. Develop performance objectives. Construct statements, using measurable terms forparticular behaviors to be exhibited by a learner under specified conditions. Eachidentified task should have a corresponding performance objective.

Develop criterion-referenced measures. Construct criterion-reference(' measures,tests, and assessment materials for each task. Develop criterion- referenced measuresand tests for all additional competencies identified.

5. Develop enabling objectives. Identify all individual k.b -goals that a learner must knowor be able to do to complete each performance objective.

6. Develop instructional materials and activities. Develop instructional materials andplan activities such as student handouts, learning packages, clinics, demonstrations,lab exercise sheets, etc. Review instructional materials currently being used todetermine compatibility with the competencies identified for the program/course.

7. Identify instructional equipment and aids. Develop a list of tools, equipment, andsupplies that aid in the performance of each task. Also, identify audio risual andreference materials that complement instruction of each task.

Using the Resource:

8. Select a management system. Select a classroom management or delivery systemfrom Section III. Modification may be necessary to meet individual requirements.Information on the Health Occupations Students of America student organization iscontained in Section II for ease of integration into classroom activities.

9. Select a recording system. Design or select a student recording system from SectionIV. The decision to select a particular recording system will depend on programrequirements and local administrative procedures. A variety of sample system designshas been included in the resource.

Field Testing:

10. Field test and revise instructional materials. This is the final step prior to theimplementation of CBE materials in a vocational program.

5

The use of the service area resource and this task list for implementing CBE in a

vocational program or course is illustrated by the following diagram:

kevieu.

tasks

10Field test

and reviseinstructionalmaterials

Reviewsequencedcompetencies

tSelect a

recordingsystem

t

Select amanagement

system

IMPLEMENTCBE

COURSE

Identif.

instructionalequipment and

aids

Developperformanceobjectives

i

Developcriterion-referencedmeasures

;

Developenablingobjectives

i

Developinstructionalmaterials

The preceding procedure may be modified to meet local program requirements and

needs. It is important to realize that these materials represent only one resource and that

additior.al materials may be necessary to meet local or regional standards.

( CONTENT/CONCEPT AREAS )7

1. INTRODUCING THE COURSE

2. PARTICIPATING IN HEALTH OCCUPATIONS STUDENTS OF AMERI _:A (HOSA)

3. EXPLORING HE HEALTH CARE INDUSTRY

4. BECOMING A HEALTH CARE WORKER

5. DISCOVERING THE VARIETY OF HEALTH CAREERS

6. UNDERSTANDING HEALTH CARE REGULATORY SYSTEMS

7. PRACTICING SAFETY

S. LEARNING ABOUT EPIDEMIOLOGY

9. BECOMING A KNOWLEDGEABLE HEALTH CARE CONSUMER

10. ADMINISTERING FIRST AID

11. PROVIDING CARDIOPULMONARY RESUSCITATION

0 12. PREPARING FOR A HEALTH CAREER

OLCONTENT/CONCEPTAREA 1. INTRODUCING THE COURSE

TASK/COMPETENCY

9

1.1 Explain the purpose of the course

1.2 Define long- and short-term career goals

1.3 List the student responsibilities rn the course

1.4 Identify ways to improve study habits

1011111f

CONTENT /CONCEPTAREA: 2.

APARTICIPATINGIN HEALTH OCCUPATIONS STUDENTS Or'

MERICA (HOSA)

TASK/COMPETENCY

2.1 Define terms relevant to HOSA

2.2 identify the purposes of HOSA

2.3 Participate in a HOSA club ..leeting using parliamentary procedure and a prepared

2.4 Explain officer roles, responsibilities, and qualifications

2.5 Describe various club activities

11

CONTENT/CONCEPTAREA: 3. EXPLORING THE HEALTH CARE INDUSTRY

TASK/COMPETENCY

3.1 Define term: relevant to the health care industry

3.2 Identify outstanding milestones in medical history

3.3 Compare governmental and non-governmental health care systems

3.4 Explain the three major factors influencing health care

3.5 List various health care delivery systems

3.6 Describe the various issues affecting the future of health care

12

[CONTENT/CONCEPTAREA4. BECOMING A HEALTH CARE WORKER

TASK/COMPETENCY

4.1 Detail the physical, mental, and social health characteristics of the successful healthcare worker

4.2 Demonstrate appropriate work habits for the health care worker

4.3 Define ethics as related to the health care worker

4.4 Describe the legal aspects pertaining to health care

13

CONTENT/CONCEPT5. DISCOVERING THE VARIETY OF HEALTH CAREERS

TASK/COMPETENCY

5.1 Define terminology related to the study of health careers

5.2 List the duties performed by a worker in a specific health career

5.3 Identify specialties associated with various health occupations

5.4 State educational requirements necessary for selected he,:ith careers

5.5 Identify personal qualifications needed for one or more health careers

5.6 State the wages and earning potential related to selected occupations

5.7 Describe the iicensing requirements for specific careers

5.8 Explain the work environment associated with particular occupations

5.9 Diagram a career ladder for selected health occupations

5.10 List the advantages and disadvantages of specific occupations

5.11 Identify professional organizations and publications related to particular occupations

1 4

CONTENT/CONCEPTAREA:

6. UNDERSTANDING HEALTH CARE REGULATORY SYSTEMS

TASK/COMPETENCY

6.1 Identify Virginia's law for the regulation of health professions and occupations

6.2 Describe the purposes of health regulatory boards

6.3 Describe public participation in health regulation

6.4 Differentiate between the Virginia Department of Health Regulatory Boards and theVirginia Commission of Health Regulatory Boards

6.5 Explain the methods of regulation of health care providers

6.6 List the ten health professional boards

6.7 Identify specific educational requirements for a regulated occupation

6.8 State the examination requirements for a specific profession

6.9 Define reciprocity and explain how it applies to various professions

TASK/COMPETENCY

CONTENT/CONCEPTAREA: 7. PRACTICING SAFETY

7.1 Identify and explain health care safety regulations

7.2 Demonstrate the use of proper body mechanics

7.3 Explain fire safety procedures

(

16

CONTENT/CONCEPTAREA 8. LEARNING ABOUT EPIDEMIOLOGY

TASK/COMPETENCY8.1 Define terms relevant to epidemiology

8.2 Explain the purposes of health maintenance and disease control

8.3 Describe the purposes and methods of immunizations and medical asepsis

8.4 Demonstrate aseptic handwashing techniques

3.5 Identify the leading causes of death in the United States

) S

.(17

CONTENT/CONCEPTAREA 9. BECOMING A KNOWLEDGEABLE HEALTH CARE CONSUMER

TASK/COMPETENCY

9.1 Define terms relevant to consumerism

9.2 List examples of good health habits

9.3 Explain the rights of a health cai e anncuier

9.4 Compare the types, purposes, and costs of insurance

9.5 Describe the concept of health maintenance organizations

9.6 Identify the effects of America's aging population on health care systems

9.7 Explain yar)ing viewpoints that influence individual health care

9.8 Identify the effects of marketing in the health care industry

2,,J

e18

CONTENT/CONCEPTAREA 10. ADNIINISTERING FIRST AID

TASK/COMPETENCY

10.1 Identify simple first aid terminology and abbreviations

10.2 Give first aid for choking conscious/unconscious adult, infant, child

10.3 Recognize signs and symptoms of shock, and demonstrate proper treatment

!.0.4 Treat external bleeding in major/minor wounds

10.5 Give first aid for poisoned conscious/unconscious victim

10.6 Classify and give appropriate treatment for burns

10.7 Treat victim of heat and cold exposure

10.8 Give first aid for bone/joint injuries

10.9 Apply splints

10.10 Apply a sling

10.11 Apply circular, spiral, figure-eight, and fingertip bandages

10.12 Identify procedures to follow for dental injuries

4CONTENT /CONCEPT

AREA:

11. PROVIDING CARDIOPULMONARY RESUSCITATION

TASK/COMPETENCY

19

11.1 Perform one-rescuer CPR (-leartsaver)

11.2 Perform one-rescuer CPR on an adult

11.3 Perform two-rescuer CPR on an adult

11.4 Clear airway obstruction of a conscious victim

11.5 Clear airway obstruction of choking victim who becomes unconscious

11.6 Clear airway obstruction of unconscious victim

11.7 Perform infant resuscitation

11.8 Perform CPR for conscious choking infant

11.9 Perform CPR for choking infant who becomes unconscious or is found unconscious

e

20

FAONTENT/CONCEPTREA12. PREPARING FOR A HEALTH CAREER

TASK/COMPETENCY

12.1. Set career goals and review personal qualifications

12.2 Evaluate t le course

21

( PROGRAM AND COURSE 3DESMPTIONS

PROGRAM TITLE: INT.',ODUCTORY

DESCRIPTION: Introd1/41ction to Health Occupations is a single-period, one-yearcourse designed to introduce to the student all health occupations andto develop basic skills common to all health occupations. Thepurposes of the course include the following:

* to acquaint the student with the health care industry

* to introduce the student to all health occupations

* to survey carious health careers

* to enable t le student to select one or more careers for an in-depth study

* to help the student determine if he/she wishes to become aworker in the health care industry

* to help the student in choosing a health career, and

* to help the studen, select a specific occupational preparationprogram.

Introduction to Health Occupations is considered a foundation coursethat contains generic skills and knowledge necessary for alloccupational program offerings. Additionally, the course isrecommended to those students interested in a career that requirespostsecondary study.

CIP CODE: Assigned according to occupational sequence selected

SUGGESTEDGRADE LEVELS: 9, 10

APPROVED COURSES VA COURSE CODE DOT CODE AND TITLE

Introduction to Health Occupations 8302 Not Applicable

7.,

INTRODUCTION TO I-LEALTH OCCUPATIONS

COURSE DESCRIPTION: Introduction to Health Occupations is a single-period, one-yearcourse that introduces the student to all health occupationsand develols basic skills common to all health occupations. Itis recommended as the first course for the following occupa-tional of ferings:

Practical Nursing I 8357Nursing Assistant 1 8360Health Assistant I 8331Emergency Medical Technician-A 8333Dental Aide 1 8328Medical Assistant I 8345Surgical Technologist I 8351

Students study families of health careers, such as dental,medical, nursing, allied health, and related occupations.Introduction to basic health care skills prepares students foradvanced occupational skill training. Organizations for healthcare, financing of patient services, and ethics may be studied.Field trips to health care facilities and interviews withselected health workers can be included. Student volunteeractivities, including shadowing experiences and selected skillspractice in health care facilities, are organized by theteacher.

PREREQUISITE: None

SUGGESTEDGRADE LEVEL: 9-.10

TASK/COMPETENCY SEQUENCE

1.1 Explain the purpose of the course1.2 Define long- and short-term career goals1.3 List the student responsibilities in the course1.4 Identify ways to improve study habits2.1 Define terms relevant to HOSA2.2 Identify the purposes of HOSA2.3 Participate in a HOSA club meeting using parliamentary procedure and a prepared

agenda2.4 Explain officer roles, responsibilities, and qualifications2.5 Describe various club activities3.1 Define terms relevant to the health care industry3.2 identify outstanding milestones in medical history3.3 Compare governmental and non-governmental health care systems3.4 Explain the three major factors influencing health care3.5 List various health care delivery systems3.6 Describe the various issues affecting the future of health care4.1 Detail the physical, mental, and social health characteristics of the successful

health care worker

I , 0

23

h I42 Demonstrate appropriate work habits for the health care worker4.3 Defir.e ethics as related to the health care worker4.4 Describe the legal aspects pertaining to health care5.1 Define terminology related to the study of health careers5.2 List the duties performed by a worker in a specific health career5.3 Identify specialties associated with various health occupations5.4 State educational requirements necessary for selected health careers5.5 Identify personal qualifications needed for one or more health careers5.6 State the wages and earning potential related to selected occupations5.7 Describe the licensing requirements for specific careers5.8. Explain the work environment associated with particular occupations5.9 Diagram a career ladder for selected health occupations5.10 List the advantages and disadvantages of specific occupations5.11 Identify professional organizations and publications related to particular

occupations6.1 Identify Virginia's law for the regulation of health professions and occupations6.2 Describe the purposes of health regulatory boards6.3 Describe public participation in health regulation6.4 Differentiate between the Virginia Department of Health Regulatory Boards and

the Virginia Commission of Health Regulatory Boards6.5 Explain the methods of regulation of nealth care providers6.6 List the ten health professional boards6.7 Identify specific educational requirements for a regulated occupation6.8 State the examination requirements for a specific profession6.9 Define reciprocity and explain how it applies to various professions7.1 Identify and explain health care safety regulations7.2 Demonstrate the use of proper body mechanics7.3 Explain fire safety procedures8.1 Define terms relevant to epidemiology8.2 Explain the purposes of health maintenance and disease control8.3 Describe the purposes and methods of immunizations and medical asepsis8.4 Demonstrate aseptic handwashing techniques8.5 Identify the leading causes of death in the United States9.1 Define terms relevant to consumerism9.2 List examples of good health habits9.3 Explain the rights of a hea!th care consumer9.4 Compare the types, purposes, and costs of insurance9.5 Describe the concept of health maintenance. organizations9.6 Identify the effects of America's aging population on health care systems9.7 Explain varying viewpoints that influence individual health care9.8 Identify the effects of marketing in the health care industry

10.1 Identify simple first aid terminology and abbreviations10.2 Give first aid for choking conscious/unconscious adult, infant, child10.3 Recognize signs and symptoms of shock, and demonstrate proper treatment10.4 Treat external bleeding in major/minor wounds10.5 Give first aid for poisoned conscious/unconscious victim10.6 Classify and give appropriate treatment for burns10.7 Treat victim of heat and cold exposure1C.8 Give first aid for bone/joint injuries10.9 Apply splints10.10 Apply a sling10.11 Apply circular, spiral, figure-eight, and fingertip bandages10.12 Identify procedures to follow for dental injuries11.1 Perform one-rescuer CPR (Heartsaver)

2 C

24

11.2 Perform one-rescuer CPR on an adult11.3 Perform two-rescuer CPR on an adult11.4 Clear airway obstruction of a conscious victim11.5 Clear airway obstruction of choking victim who becomes unconscious11.6 Clear airway obstruction of unconscious victim11.7 Perform infant resuscitation11.8 Perform CPR for conscious choking infant11.9 Perform CPR for choking infant who becomes unconscious or is found unconscious12.1 Set career goals and review personal qualifications12.2 Evaluate the course

)25

( CONTENTSINTRODUCTION TO HEALTH OCCUPATIONS (8302)

I. Introduction to Course

A. Purpose, competencies, textbooks, and references of course

B. Student goals

1. Long-term2. Short-term3. Personal4. Career

C. Classroom management

1. Student responsibilities2. Grading policies3. School policies

D. Study habits

1. Note taking2. Outlininz3. Test taking4. Study methods

II. Health Occupations St.iJents of America (1-10SA)

A. Terminology

B. Purposes

C. Structure of meetings

1. Parliamentary procedure2. Agenda

D. Functions and qualifications of officers

E. Activities of club

1. Leadership skill development.2. Use of community health resources3. Involvement in community service4. Participation in school service5. Public relations skills6. Social-recreational skills7. Student achievement and recognition8. Student competition9. Fund raising

26

III. Health Care Industry

A. Terminology

B. History

C. Organization

1. Government agencies

a. World Health Organization (WHO)b. U.S. Department of Health and Human Servicesc. Health departments

1) State2) Local

d. Government hospitals

2. Non-governroent agencies

a. Hospitals and nursing homes1) Public2) Private3) Charitable

b. Non-profit organizations1) American Heart Association2) American Cancer Association3) American Medical Association4) American Dental Association5) Other

3. Profit-making agencies

0. Major factors influencing health care

1. Costa. Indigent patientb. Insurance costs and limitations

2. Accessa. Location

1. Proximity of health care centers to residence2. Access to center

b. Operations1. Hours of operation and scheduling2. Days of operation and scheduling

c. Discrimination1. Cultural factors2. Socio-economic factors

III. D. 3. Quality

a. Religious preferencesb. Recipient needs

1. Physical2. Mental3. Social4. Educational

c. Approaches to meeting needs1. Team2. Holistic3. Other

E. Health care delivery systems

1. Private medical and dental offices2. Hospitals3. Nursing homes and other extended care facilities4. Rehabilitation centers5. Mental health care facilities6. Clinics7. Health maintenance organizations (HMO's)8. Private diagnostic centers9. Pharmacies

10. Home health care services11. Other

F. Future of health care industry

1. Cost of health care2. Access to health care3. Quality of health care4. Government versus non-government control (social versus private)5. Technological advances6. Ethical issues in health care

IV. Health Care Worker

A. Qualities and characteristics

1. Physical healtha. Personal hygieneb. Appearancec. Uniform and dressd. Good health habits

1) Nutrition2) Rest3) Recreation

27

28

IV. A. 2. Mental and emotional health

a. Basic human needs1) Love2) Security3) Acceptance

b. Self awareness1) Interests2) Abilities

3. Social health

a. Communication skills1) Verbal/nonverbal skills2) Body language3) Listening skills

b. Values1) Honesty2) Integrity

B. Employment skills

1. Dependability2. Tactfulness3. Patience4. Punctuality/attendance5. Accuracy6. Interpersonal relationships7. Enthusiasm/initiative

C. Ethics

1. Historical origin2. Philosophy of code of ethics3. Ethical issues

D. Legal aspects

1. Confidentiality2. Patient records3. Negligence4. Malpractice5. Patient's rights

V. Health Careers*

"I.

A. TerminologyB. DutiesC. SpecialitiesD. EducationE. Personal qualificationsF. Earning potentialG. LicensingH. Work environmentI. Career laddersJ. Advantages/disadvantagesK. Professional organizations and publications

Regulation of the Health Professions and Occupations**

A. Virginia's law: See Code of Virginia, Chapter 29, Section 54

B. Purpose

1. Consumer protection2. Initial competency3. Professional discipline4. Complaint resolution5. Incompetent practitioners

C. Public participation in regulation

1. Public participation2. Citizen involvement

D. Virginia Department of Health Regulatory Boards

E. Virginia Commission of Health Regulatory Boards

F. Methods of regulation of health care providers

1. Registration2. Statutory Certification3. Licensure

G. Virginia's ten health professional boards and whom they regulate

1. Board of Medicine2. Board of Nursing3. Board of Psychology4. Board of Optometry5. Board of Pharmacy

29

* A sample information sheet based on this outline is illustrated in Appendix A; acomprehensive listing of health careers is provided in Appendix B.

** Appe 'idix C contains detailed tables on aspects of the Health Regulatory Boards.

1

30

VI. G. 6. Board of Dentistry7. Board of Professional Counselors3. Board of Social Work9. Board of Funeral Directors and Embalmers

10. Board of Veterinary Medicine

H. Educational or other entry requirements for regulated professions oroccupations (by Board)

I. Examination requirements for regulated professions and occupations (byBoard)

J. Reciprocity provisions

ViI. Safety

A. Safety regulations

. Occupational Safety and Health Act (OSHA)..

2. Institutional policies and procedures3. General safety principles (including electrical)4. Risk management

B. Body mechancics for the health worker

1. Balance and alignment2. Transfer/transport technique3. Basic body positions4. Assistive devices

C. Fire safety

1. Local fire department regulations2. Institutional 'policies and procedures3. Initial patiert rescue4. Patient carries

VIII. Epidemiology

A. Terminology

B. Purpose

1. Health maintenance2. Infection/communicable disease ..:vention

C. Methods

1. Immunizations2. Medical asepsis

tJ

31

VIII. D. Aseptic handwashing

E. Leading causes of death

IX. Consumerism

A. Terminology

B. Health maintenance

1. Diet2. Exercise3. Sleep/rest4. Proper balance between work and recreation5. Health habits

C. Consumer rights

1. Increased awareness of rights2. Patient's Bill of Rights

D. Insurance

1. Purpose2. Types

a. Government1) Federal insurance (Medicare)2) State insurance supplement (Medicaid)

b. Privately-sponsored health insurance1) Blue Cross2) Blue Shield3) Other

c. Worker': _ompensationd. Prepaid group practice

3. Cost

E. Health maintenance organizations

F. Effect of the elderly on health care systems

G. Varying viewpoints in health care

1. Folk medicine2. Supernatural beliefs3. Religious beliefs

H. Mar'<eting in the health care industry

X. First Aid

A. Terminology and abbreviations

32

X. B. Obstructed airway

1. Adulta. Consciousb. Unconscious

2. Child/infanta. Consciousb. Unconscious

C. Shock

1. Signs and symptoms2. Treatment

D. Bleeding wounds

1. Treatment of minor wounds2. Treatment of major wounds

E. Victim of poisoning

1. Conscious2. Unconscious

F. Burns

1. Degrees2. Treatment

G. Heat and cold exposure

1. Recognition2. Treatment

H. Bone and joint injuries

1.

2.3.

Types and treatment of fracturesa. Simple (closed)b. Compound (open)Types and treatment of sprainsTypes and treatment of strains

I. Splint application procedures

9:./

o

X. J. Sling application procedures

K. Bandage application procedures

1. Circular2. Spiral3. Figure eight4. Fingertip

L. Dental injuries

1. Loosened, chipped, or broken teeth2. Lvulsed or knocked-out teeth

XI. Cardiopulmonary resuscitation

A. One-rescuer CPR (Fleartsaver)

B. One-rescuer CPR

C. Two-rescuer CPR

D. Obstructed airway

1. Conscious victim, sitting or standing; complete airway obstruction2. Choking victim who bt.comes unconscious3. Unconscious victim, supine

E. Infant resuscitation

F. Conscious choking infant

G. Choking infant who becomes unconscious or is found unconscious

XII. Summary

A. Career goals

1. Personal qualifications2. Inventory of skillsI Career identification

B. Course evaluation

33

35

0 APPENDIX A

OCCUPATIONAL AREA OUTLINE

The following occupational area outline was prepared by Ann Flowers, Ed.D.,

Asso Cate Professor of Speech Pathology Emeritus, Medical College of

Virginia/Virginia Commonwealth University for the occupational areas of

Speech/Language Pathology, Audiology, Habilitative Audiology, and Teachers of the

Hearing Impaired. Information contained in this outline is based on data presented in

A Classification of Instructional Programs.

Competencies identified in content/concept area 5 of the task listing and section

V of the content outline are directly correlated to the headings of this occupational

outline. Information specifically related to the occupational areas listed above is then

presented to illustrate the intent of the competencies.

37

OCCUPATIONAL AREA OUTLINE

FOR

SPEECH/LANGUAGE PATHOLOGY, AUDIOLOGY, HABILITATIVEAUDIOLOGY, AND TEACHERS OF THE HEARING IMPAIRED

A. Terminology

1. Speech/Language Pathology is the study and treatment of articulation andlanguage disorders for individuals of all ages. Articulation is the motoractivity of the lips, tongue, palate, etc., necessary to produce the sounds oflanguage. Language deals with the understanding of verbal messages, theability to store those messages and interpret them in an orderly fashion,and to produce coherent messages for those in the environment.

2. Audiology is a science that deals with the way in which individuals hearsounds and language. Many diagnostic devices of an electronic nature areavailable for those employed in this field.

3. Habilitative Audiology is the sum of the services employed after a hearingimpairment has been found. These services prepare the patient to enter alearning situation with an improved ability to gain from that situation.

4. Teachers of the Hearing Impaired are those who teach not onlycommunication skills but also regular school subjects to their clients.

B. Occupational information

1. Duties of Speech/Language Pathologist

a) Administer appropriate speech/language tests to determinecentral and peripheral communication deficits

b) Provide remedial measures throon direct therapyc) Select and recommend devices for alternate communication

systems when necessaryd) Operate various instruments involved in diagnostic and

therapeutic procedures (tape recorders, computerized therapyprograms, etc.)

e) Write evaluative reports and progress notesf) Counsel with family and significant othersg) Conduct researchh) Function supportively for other members of a rehabilitation

teami) Supervise assistants and aidesj) Teach and demonstrate speech pathology techniques to person-

nel in other agenciesk) Maintain caring relationship with clients

3c:

38

2. Duties of Audiologists

a) Conduct and interpret audiological vestibular examinationsb) Operate all types of special audiological instruments such as

evoked potential instrumentation, electronystagmographs, andother instruments used to measure the function of the auditoryand vestibular system

c) Conduct non-medical evaluative procedures of the central andperipheral auditory system regardless of age, physical, ormental status of the individual

d) Refer clients to other appropriate professionals when necessarye) Select, fit, and recommend the use of amplification, specific

hearing aids, and tinnitus instruments when indicatedf) Provide orientation in the use of hearing aids- \6) Counsel family and significant others in how to deal with

patient's disabilityh) Visit other agencies and community groups to explain and

demonstrate audiological techniquesi) Conduct research i communicative disordersj) Serve as a member cm a rehabilitative teamk) Supervise assistants and aides1) Be able to work independently but to be accountable to

administrator

C. Specialties

1. Speech/language pathologists may decide to specialize in any one or acombination of the following:a) Aphasiab) Motor speech disordersc) Voice disordersd) Stutteringe) Language delayf) Speech/language for the foreign borng) Language remediation

2. Audiologists may decide to specialize in any one or a combination ofthe following:a) Diagnostic procedures prior to otological surgery'b) General audiological diagnosticsc) Brain stem audiologyd) Pediatric audiologye) Geriatric audiologyf) Fitting of hearing aids

3. Habilitative audiologists are specialists by choice of profession

4. Teachers of the hearing impaired are specialized by choice ofprofession

35

39

D. Education

1. Must obtain bachelor's degree in a pre-pr-cessional four-year degreeprogram

2. Master's degrees are available at selected colleges and universities

3. Leadership positions and positions requiring extensive training areobtained by those completing a doctoral degree program

4. Virginia institutions of higher education that offer at least a master'sdegree include:a) The University of Virginiab) James Madison Universityc) Hampton Instituted) Old Dominion Universitye) Radford University.

E. Personal qualifications

1. Must like to work with people of all age groups

2. Must be aole to work with persons who are physically or mentallyhandicapped

3 Must maintain confidentiality

4. Must have a desire to help and provide moral support

F. Earning potential

1. Beginning salary in systems with limited resources--$12,000

2. Average salary between $15,000-$25,000

3 Advanced degrees and training and personal qualifications may leadto salaries at the top of scale -- $60,000-$70,000

G. Licensing

1) In Virginia a state licensure law is in effect for persons working inprivate practice and in clinical settings. Some public schoolclinicians may wish to become licensed, although it is not required ofthem.

2) Communication disorders specialists in the schools need certificationfrom the State Board of Education.

3) Certification is granted to communication disorders specialists by thenational organization, The American Speech, Language and HearingAssociation. The examination sponsored by this organization providesthe criteria for licensure.

4u

4/

H. Work environment

1. Public and private schools2. College and university clinics3. College and university faculties4. Clinics sponsored by community org,:.nizations5. Clinics sponsored by government agencies such

ment6. Pre-school programs7. Residential schools for the handicapped8. Nursing homes and programs for the geriatric population9. Research centers

as a state health depart-

I. Career ladders

Avenues for advancement include:

1. Additional training2. Advanced degrees3. Publishing material4. Involvement in sdeciali zed research projects5. Administrative positions

J. Advantages and disadvantages

1. Disadvantages

a.b.

c.d.

e.f.

A long and difficult training programConstant reading and studyinz rcouired toproceduresWorking with handicapped individualsFunding for positions is sometimes

ants are involvedLong hours are often requiredTreatment rooms may not be well equipped

keep up with changes in

requires patience and staminaundependable, especially where

2. Advantages

a. An opportunity to ..ee very favorable changes in the client as a resultof remediation

b. Independence in making determination of a client's problem andgiving follow-through remediation

c. Many job opportunities for a well qualified applicantd. Advancement opportunities are excellent

41

K. Professional organizations and publications

1. American Speech, Language, Heari.ig Association10801 Rockville PikeRockville, MD 20852

a) Journal of Speech and Hearing Disorders7quarterly)

b) Journal of Speech and Hearing Research(quarterly)

c) ASHA Magazine(monthly)

d) Language, Speech oc Hearing Services in Schools(quarterly)

e) Directory of ASHA Members(biennially)

2. Speech and Hearing Association of Virginia109 New Cabell HallCharlottesville, VA

a) The Journal of the Speech and Hearin Association of Virginiab) Directory of SHAV Members

(biennially)

a

43

APPENDIX 13

HEALTH CAREERS

Over 200 careers are identified .n the health care industry. The following is acomprehensive listing based on the organizaticn recommended in A Classification ofInstructional Programs (CIP) by the National Center for Education Statistics, 1981.CIP Code numbers are included for reference. This publication contains definitions ofeach instructional program and is recommended as a resource. The document costs$7.50 and is available from the Superintendent of Documents, U.S. GovernmentPrinting Of fice, Washington, D.C. 20402

The specific career listing in each category is to be used as a guide since there maynot be time to cover every career and since the listing is not inclusl ie.

The following information should be addressed for each career studied:

TerminologyDutiesSpecialitiesEducationPersonal qualificationsEarning potentialLicensingWork environmentCareer laddersAdvantages /disadvantacesProfessional organizations/publications

CIP CODE

A. Medicine 13.10

1. Medicine, General 18.10012. Allergies and Endomology 18.10023. Anesthesiology 18.10034. Colon and Rectal Surgery 18.10045. Dermatology 18.10056. Emergency Medicine 18.10067. Family Practice 13.10078. Geriatrics 18.10089. Imm unolcgy 18.1009

10 Internal Medicine 18.101011. Neurological Surgery 13.101112. Nuclear Medicine 18.101213. Obstetrics and Gynecology 18.101314. Ophthalmology 18.101415. Orthodontic Surgery 18.101516. Orthopedic 18.101617. Otorhinolaryngology/Otolaryngology 18.101718. Pathology 18.1018

44

CIP CODE

19. Pediatrics 18.101920. Physical Medicine and Rehabilitation 18.1C2021. Plastic Surgery 18.102122. Preventive Medicine 18.102223. Psychiatry 18.102324. Neurology 18.102425. Radiology 18.102526. Surgery 18.102627. Thoracic Surgery 18.102728. Urology 18.102829. Medicine, Other 18.109930. Osteopathic Medicine 13.1331. Pre-Medicine 13.1832. Pre-Veterinary 18.2033. Veterinary Medicine 18.24

B. Dentistry 18.04

1. Dentistry, General 18.04-012. Dental Public Health 18.04023. Endodontics 18.0403/1. Oral/Maxial Facial Surgery 18.0404.5. Oral Pathology 18.04056. Orthodontics 18.04067. Pr_dodontics 18.04078. Periodontics 18.04089. Prosthcdontics 18.0409

10. Dentistry, Other 13.049911. Dental Aide12. Dental Assisting 17.01013. Dental Hygiene 17.010214. Dental Laboratory Technology 17.010315. Dental Services, °the: 17.019916. Pre-Dentistry 18.17

C. Nursing 18.11

1. Nursing, General 18.11012. Anesthetist 18.11023. Maternal/Child Health 13.11034. Medical Surgical 13.11045. Nursing Administration 18.11056. Psychiatric/Mental Health 18.11067. Public Health 18.11078. Geriatric Aide 17.0aUl9. Nursing Assisting 17.0602

10. Obstetrical Technology 17.060311. Pediatric Aide 17 .Cg. 0412. Practical Nursing 17.060513. Ward Service Management 17.060614. Nursing, Other 18.119915. Nursing-Related Services, Other el,: 17.0699

45

CIP CODE

D. allied Health

1. Audiology and Speech Pathology 18.01a. Audiology 18.0101b. Speech Pathology 18.0102c. Speech Pathology/Audiology 18.0103d. Audiology and Speech Pathology, Other 18.0199

2. Basic Clinical Health Sciences 18.02a. Clinical Anatomy 18.0201b. Clinical Biochemistry 18.0202c. Clinical Microbiology 18.0203d. Clinical Pathology 18.0204e. Physiology 18.0205f. Basic Clinical Health Sciences, Other 18.0299

3. Bioengineering and Biomedical Engineering 14.05

4. Biomedical Equipment Technology 15.0401

5. Biometrics and Biostatistics 26.0602

6. Chiropractic 18.03

7. Diagnostic and Treatment Services 17.02a. Cardiopulmonary Technology 17.0201b. Dialysis Technology 17.0202c. Electrocardiograph Technology 17.0203d. Electroencephalograph Technology 17.0204e. Emergency Medical Technology--Ambulance 17.0205f. Emergency Medical Technology-Paramedic 17.0206g. Medical Radiation Dosimetry 17.0207h. Nuclear Medical Technology 17.0208i. Radiograph Medical Technology 17.0209j. Respiratory Therapy Technology 17.0210k. Surgical Technology 17.02111. Ultrasound Technology 17.0212m. Diagnostic and Treatment Services, Other 17.0295

8. Emergency/Disaster Science 18.05

9. Epidemiology 18.06

10. Health Sciences Administration 18.07a. Health Care Administration 18.0701b. Health Care Planning 18.0702c. Medical Records Administration 18.0703d. Healti. Sciences Administration, Other 18.0799

11. Hematology 18.08

12. Medical Laboratory 18.09

46

CIP CODE

13. Medical Laboratory Technologies 17.03a. Blood Bank Technology 17,0301b. Chemistry Technology 17.0302c. Clinical Animal Technology 17.0303d. Clinical Laboratory Aide 17.0304e. Clinical Laboratory Assisting 17.0305f. C ytotechnology 17.0306g. Hematology Technology 17.0307h. Histologic Technology 17.0308i. Medical Laboratory Technology 17.0309j. Medical Technology 17.0310k. Microbiology Technology 17.03111. Medical Laboratory Technologies, Other 17.0399

14. Mental Health/Human Services 17.04a. Alcohol/Drug Abuse Specialty 17.0401b. Community Health Work 17.0402c. Genetic Counseling 17.0403d. Home Health Aide 17.0404e. Medical Social Work 44.0702f. Mental Health/Human Service Assisting 17.0405g. Mental Health/Human Services Technology 17.0406h. Rehabilitation Counseling 17.0407i. Therapeutic Child Care Work 17.0408j. Mental Health/Human Services, Other 17.0499

15. Ophthalmic Services 17.07a. Ophthalmic Dispensing 17.0701b. Ophthalmic Laboratory Technology 17.0702c. Ophthalmic Medical Assisting 17.0703d. Optometric Assisting 17.0704e. Optometric Technology 17.0705f. Orthoptics 17.0706g. Ophthalmic Services, Other 17.0799

16. Optometry 18.12

17. Pharmacy 18.14

18. Pre-Pharmacy 18.19

19. Podiatry 18.15

20. Population and Family Planning 18.16

21. Prosectorial Science 18.21

22. Public Health Laboratory Science 18.22

23. Rehabilitation Services 17.08a. Art Therapy 17.0801b. Corrective Therapy 17.0802

46

47

CIP CODE

c. Dance Therapy 17.0803d. Exercise Physiology 17.0804e. Manual Arts Therapy 17.0805f. Music Therapy 17.0806g. Occupational Therapy 17.0807h. Occupational Therapy Assisting 17.0808i. Occupational Therapy Aide 17.0809l Orthotic/Prosthetic Assisting 17.0810k. Orthotics/Prosthetics 17.08111. Orthopedic Assisting 17.0812m. Physical Therapy 17.0813n. Physical Therapy Aide 17.0814o. Physical Therapy Assisting 17.0815p. Recreational Therapy 17.0816q. Recreational Therapy Technology 17.0817r. Respiratory Therapy 17.0818s. Respiratory Therapy Assisting 17.04-$19t. Speech/Hearing Therapy Aide 17.0820u. Speech-Language Pathology/Audiology 17.0821v. Therapeutic Recreation Aide 20.0607w. Rehabilitation Services, Other 17.0899

24. Toxicology (Clinical) 18.23

25. Miscellaneous Allied Health Services 17.05a. Animal Technology 17.0501b. Biomedical Communicatorc. Biomedical Photographerd. Biomedical Writinge. Central Supply Technology 17.0502f. Medical Assisting 17.0503g. Medical illustrating 17.0504h. Medical Office Management 17.0505

Medical Records Technology 17.0506j. Pharmacy Assisting 17.0507k. Physician Assisting--Primary Care 17.05081. Physician Assisting--Specialty 17.0509m. Podiatric Assisting 17.0510n. Veterinarian Aide 17.0511o. Veterinarian Assisting 17.0512p. Ward Clerk 17.0513q. Miscellaneous Allied Health Service, Other 17.0599

26. Allied Health, Other 17.99

27. Health Sciences, Other 18.99Medical Science Writing

1

APPENDIX C

HEALTH REGULATORY BOARDS

4-c;

49

51

SECTION 1

Overview of Regulation of the HI- '"-: Professionsand Occupations

The following overview is based on information provided by Richard D. Morris, PolicyAnalyst, Virginia Department of Health Reguiatory Boards.

A. Virginia's law: See Code of Virginia, Chapter 29, Section 54

B. Purpose

Quote from Code of Virginia, Chapter 29, Section 54-1.17 "... the right ofevery person to engage in any lawful profession, trade or occupation of hischoice is clearly protected by both the Constitution of the United Statesand the Constitution of the Commonwealth of Virginia. The Common-wealth cannot abridge such rights except as a reasonable exercise of itspolice powers when it is clearly found that such abridgement is necessaryfor the preservation of the health, safety and welfare of the public."

The decision to regulate a health occupation or profession is made by theVirginia General Assembly only when there is clear documentation thatunregulated practice would harm the public. Virginia's laws governing theregulated health occupations and professions are set forth in Code ofVirginia Chapter 29, Section 54.

Each regulated group is served by a board appointed by the Governor. Theregulatory boards establish policies governing entry requirements(educational, experiential, and by examination.;, standards of conduct, andprofessional discipline. Any member of the public may make a complaintagainst a regulated practitioner. Complaints are investigated by theDepartment of Health Regulatory Boards. Sanctions appropriate to anybreach of public trust are determined by each board and may includerevocation of license to practice, probation, or other disciplinary actions.

1. Consumer Protection

The Virginia Department of Health Regulatory Boards regulatescertain health professions to reasonably protect public health, safety,and welfare. The ten boards included in the agency are Dentistry,Funeral Directors and Embalmers, Medicine, Nursing, Optometry,Pharmacy, Professional Counselors, sychology, Social Work, andVeterinary Medicine.

Health professional boards regulate more than 100,000 health carepractitioners in Virginia. The boards set liren.sing and initialcompetency standards, resolve complaints, discipline practitionerswhen appropriate, and conduct studies of major issues In healthprofessional regulation.

2. Initial Competency

The Commonwealth sets entrance sta 'ards for those seekinglicensure or certification to practice a health profession in Virginia.

4

52

These standards typically include graduation from an approved schoolor institution and the passing of a written examination. Some boardsalso require applicants to pass a clinical examination. ,N license orcertificate is granted to an applicant who meets these entrancerequirements. The license/certificate may be renewed on a regularbasis providing that continued competency is maintained and thatlaws and regulations that protect the public are not riolated.

3. Professional Discipline

The boards have the responsibility to ensure that all health,-,rofessionals provide quality care and comply with the laws governingtheir professions. All boards possess legal authority to disciplinenegligent, incompetent, and unprofessional practitioners, includingthe power to revoke and suspend licenses and to require remedialeducation.

4. Complaint Resolution

Consumers who believe they have been harmed or have been thevictims of fradulent practice by a health professional are encouragedto inform this agency of their complaint. Valid complaints areinvestigated by a professionally trained staff. The findings ofinvestigations are reviewed by the appropriate board for possibledisciplinary action. Complaints may be made by calling Toll Free 1-800-533-1560 or by writing the Department of Health RegulatoryBoards. Complainants receive written summaries of board findings.

5. Incompetent Practitioners

Major emphasis is placed on the identification of those practitionerswho suffer from drug or alchol problems. Allegations of sexualmisconduct are investigated discreetly and with sensitivity.Suspected criminal activity is ref erred to appropriate lawenforcement authorities for prosecution. Practitioners who pose animminent danger to the public are subject to immediate suspensionfrom practice.

C. Public Participation in Regulation

1. Public Participation

Public hearings are conducted to review the laws and regulationsgoverning health professic -His. The public is invited to submit oraland written comments and attend these hearings. Informationregarding thes hearings may be obtained from the individual boardsand the Virginia Register of Regulations.

2. Citizen Involvement

The Commission of Health Regulatory Boards, which consists both ofpublic and health professional members, was established by theGeneral Assembly to facilitate citizen involvement in healthprofessiona. regulation. The Commission conducts research and

53

fact-finding studies, reviews and comments upon all regulationsproposed by each board, and provides recommendations to theGovernor and General Assembly on the need to regulate variousprofessions and occupations not currently regulated in Virginia. Thestaff of the Department analyzes regulations and assists theCommission and the ten boards in evaluating consumer, professional,and business concerns.

D. Virginia Department of Health Regulatory Boards

The Virginia Department of Health Regulatory Boards was created by theVirginia General Assembly in 1977 to provide centralized administrativesupport to the ten health regulatory boards. The Department operates witha staff of 55-60 persons including 18-20 field investigators who investigatecomplaints against regulated practitioners. Each board office is housed inthe Department and staffed by an executive director and supportpersonnel.

E. Virginia Commission of Health Regulatory Boards

The Virginia Commission of Health Regulatory Boards was also establishedin 1977 to provide for coordination of regulatory and administrative policycommon to all boards. Commission members are appointed by the Gover-nor. One representative from each of the ten boards and four citizenmembers comprise the membership. The Commission is advisory to theDepartment, the Governor, and the General Assembly in all matters ofhealth occupational regulation, including evaluation of all proposals fornew or expanded regulatory programs.

F. Methods of regulation of health care providers

1. Registration: Under this type of regulation, any person may engagein an occupation, but he or she is required to submit informationconcerning the location, nature, and operation of the practice.Registration is not a common form among health care providers sincemost present a clear risk to the public and require more strictregulation.

2. Statutory Certification: As a form of regulation, certificationrecognizes persons who have met certain educational and experiencestandards to engage in an occupation; only those who are certifiedmay use the occupational title. The certification of nursepractitioners and respiratory therapists exemplifies this type ofregulation. Certification is also a common form of recognitiongranted by private organizations, for example A.C.S.W. refers tosocial workers who are certified by the American College of SocialWork.

3. Licensure: Under this method of regulation, it is illegal for anyone toengage in an occupation without a license, and only persons whopossess certain qualifications are licensed. Physicians are one ofmore than 60 occupational groups regulated by licensure in Virginia.

5

55

Section 2

The following tables are extracted from Repot- L of the Task Force on RegulatoryReview of the Virginia Commission of Health Regulatory Boards to the Governor'sRegulatory Reform Advisory Board, May 1985.

Table A -- Regulated Professions

Table B -- Educational Requirements

Table C -- Examination Requirements

Table D -- Reciprocity Arrangements

These tables were prepared for a comprehensive review of the regulations of all healthregulatory boards in 1985. The regulations proposed by each board have yet to beadopted by the boards. The process of adoption of proposed regulations should becomplete by mid-1986

57

TABLE A

Regulated Professions and Occupationsand Methods of Regulation

Board of DentistryA-1(dentists, dental ! igienists, dental assistants, dental laboratories)

Board of Funeral Directors and Embalmers A-1(funeral service licensees, funeral directors, embalmers, residenttrainees, funeral service establishments)

Board of Medicine A-2(physicians, osteopathic physicians, chiropractors, podiatrists,acupuncturists, physical therapists, physical therapy assistants,physician assistants, clinical psychologists, naturopaths)

Board of NursingA-3(registered nurses, licensed practical nurses, nursing education

programs)

Certified Nurse Practitioners A-4

Board of Optometry (optometrists) A-5

Board of PharmacyA-5

(pharmacists, dispensing physicians, pharmacies, drug manufacturers,wholesalers/distributors, cosmetic manufacturers, humane societies/animal shelters, hospitals/nursing homes/other facilities with pharma-cies, correctional institutions, industrial infirmaries, college infirma-ries)

Board of Professional Counselors A-7(professional counselors, marriage and family counselors, pastoralcounselors, rehabilitation counselors, substance abuse counselors,_career counselors, research counselors)

Board of PsychologyA-8

(psychologists, clinical psychologists, industrial/organizational psy-chologists, academic/research psychologists, counseling psychologists,technical assistants)

Board of Social Work A-9( licensed social workers, licensed clinical social workers, registeredsocial workers, associate social workers)

Board of Veterinary Medicine A-9(veterinarians, animal technicians, animal facilities, veterinarymedical students)

59

NOTE: These tables were prepared for acomprehensive review of the regulations of allhealth regulatory boards completed in 1985.The regulations proposed by each board haveyet to be adopted by the boards. The processof adoption of proposed regulations shouldbe complete by mid-1986

TABLE AREGULATED PROFESSIONS, OCCUPATIONS, AND OTHER ENTITIES AND METHODS OF THEIR REGULATION, BY BOARD

BOARD AND EXISTING REGULATIONSPROFESSION/OCCUPATION Regulated Entity Method

DENTISTRY

4,200 Dentists

1,900 DentalHygienists

4,800 Dental Assistants(Who perform x-rays)

166 Dental Laboratones

FUNERAL DIRECTORS ANDEMBALMERS

1,056 Funeral ServiceLicensees

412 Funeral Directors

32 Embalmers

215 Resident Trainc,es

490 Funeral ServiceEstablishments

(Contirued)

Dentists

DentalHygienists

Licensure

Licensure

Not credenualed, but regulationsdefine duties assistants may andmay not perform under supervision.Assistants are certified for x-ray ifthey meet certain standards.

PROPOSED REGULATIONS NOTES AND COMMENTSEntity Method

Same

Same

Same

Not crecienualed, but regulations pre- Samescribe what dentists must include inwork orders given to laboratories.

Funeral ServiceLicensees

Licensure

Licensure renewals Licensureonly; licensure pro-gram closed

Same

Same

Licensure renewals Licensure Sameonly; licensure pro-gram closed

Trainees Registration Same

Establishment Registration Sameand Permit

A-1

Same

Same

Same

Same

Same

Same

Same

Same

Same

STATUTORY REFERENCES

§§54-146 to 54-200 23,Dentists and Dental.Hygienists

§§54-200 1 to 54-200 23 arespecific to dental hygienists

§54-147.2 restncts adver-using by dental laboratones;defines misdemeanor offenses.§54-167 makes laboratonessubject to inspection byBoard.

§§54-260 64 to 54-260 75Funeral Service Laws ofVirginia; §11-24 et seq ,preneed burial contracts,§32 1-249 et seq., healthrequirements.

§54-260 i2

§54-26(i 73

60

BOARD AND EXISTING REGULATIONS PROPOSED REGULATIONS NOTES AND CONNENTS/PROFESSION/OCCUPATION Regulated Entity Method Entity Method STATUTORY REFERENCES

Funeral Directors andEmbalmers (continued)

NE /..Suface Trans-portation andRemoval Ser-vices

Registration §54-260 74 1, enacted 1984and Permit

MEDICLNE

16,859 Physiciai Same Licensure Same Same

175 Osteopathic- Same Licensure Same SamePhysicians

341 Podiatrists Same Licensure Same Same

28 Acupuncturists(included in abovethree categories)

Same Licensure Same Same

400 Chiropractors Same Licensure Same Same

634 Clinical Same Licensure Same SamePsychologists

1,428 Physical Same Licensure Same SameTherapists

184 Physical Therapist Same Licensure Same SameAssistants

160 Physicians' Assistants

Category i Same Certification Same SameCat: gory II Same Certification Same Same

3 Naturopaths(licensed prior to6/30/80)

20 Foreign Prac-titioners teachingin medical schools

(Continued)

Same

Same

(Title 54, Chapter 12generally: PcA-273 to54-325 15)

§54-274.1

§54-279

§54-309 1 (See Bo-:d ofPsychology and Narrative)

§§54-281.1 to 54-281.2;54-295.1 to 54-295.6;04-308.5 to 54-308.7

§§54-281.4 to 54-281 9Board has accepted Task Forcerecommendations to retitle'Physician's Assistant I" asPhysician Assistant I and toredesignate PhysicianAssistant II to lessenconfusion of these differentlytrained occupational classes.

Licensure Same Same §54-274

University Same Same §§54-311 1 and 54-311.2LimitedLicense

A-2

Lv

BOARD ANDPROFESSION/OCCUPATION

MEDICINE (Continued)

NURSING

EXISTLNG REGULATIONSRegulated Entity Method

PROPOSED REGULATIONSEntity Method

NewForeign Medi- Approvalcal schoolsand other foreigninstitutions thatteach the healingarts

49,988 Registered R.N. Licensure Same Sarm!Nurses

20,52.3 Licensed Practical L P.N. Licensure Same SameNurses

89 Nursing Education Programs Accreditation Same ApprovalPrograms

NURSE PRAC I I !TONER S

1,340 Certified NursePractitioners

(Continued)

CNPs in the following Certificationcategories:1) Adult Nurse Practitioner

Health Care2) Family Nurse

Practitioner3) Pediatric Nurse

Practitioner4) Family Planning

Nurse Practitioner5) Ob/Gyn Nurse

Practitioner6) Emergency Room

Nurse Practitioner7) Geriatric Nurse

Practitioner8) Certified Nurse

Ane.,thetist Practitioner9) Certified Nurse Midwife

Practitioner

A-3

Same, plus an Sameadditional cate-gory: Women'sHealth CarePractitioner (2 2 A)

5 (-

61

NOTES AND CONLMENTS/STATUTORY REFERENCES

§54-.,,0 1.2, enacted 1985

§§54-367.1 to 54-367.36

§54-367.11, 54-367.27 and54-367 28 call for"accreditation"; §54-367.29for "approval." Report r.otesthat approval is correct termand that Board will seekchanges needed in statute.Accreditation is appropriateterm used to describerecognition given by a pnvateorganization.

These regulations are promul-gated under the specificauthorization of one paragraphof the five-paragraph §54-274of the Code.

"Nothing in this chapter shallprohibit, limit, restrict, orprevent the rendering of .inymedical or health services bya registered nurse or a licensedpractical nurse under the super-vision of a duly licensedphysician; provided, however,that such services are author-ized by rules and regulationsjointly proms 'gated by theVirginia State Board ofMedicine and the

62


NURSE PRAC:I 1 I IONERS(Continued)

1,340 Certified NursePractitioners

OPTOMETRY

901 Optometrists

393 "Licensedoptometristsauthonzed touse diagnosticpharmaceuticalagents"

EXISTING REGULATIONSRegulated Entity Method

10) School NursePractitioner

11) Medical NursePractitioner

12) Maternal Child Health13) Neonatology Nurse Practitioner

Other cP'-gones maybe dt....e 'led by theBoard. . zgulations,Section III)

Nurse Practitioner ApprovalEducational Programs

Same Licensure

Same

PROPOSED REGULATIONS NOTES AND COMMENTS/Entity Method

Same (§2.2.13.)

Same

Same

Certification Same

Same

Same

Same

PHARMACY

Pharmac'sts Same Licensure Same Same

Dispensing Same Licensure Same SamePhysicians

Pharmacies Same Permit Same Same

Drug Manufacturers Same Permit Same Same

Wholesalers/Distributors Same Permit Same Same

Cosmetics Manufacturers Same Permit Same Same

Human Societies/ Same Licensure Same SameAnunal Shelters

Hospitals, Nursing Same Permit for Same SameHomes, & Skilled PharmacyCare Facilitieshaving Pharmacies

A-4

STATUTORY REFERENCES

Virginia State Board ofNursing, which boards shallbe jointly responsible for theimplementation thereof

§§54-368 to 54-398.02:terms "certificate" and"license" used alternatelythroughout.

§§54-386.1 and 54.386 2enacted 1983 First sectionrequires certification by Boardto acirrunister such agents.Second identifies the agentsand maximum strengths thatmay be used, and makes usewithout certification apunishable offense.

§54-524.21

§54-524.34:1

§54-524 31

§§54-524.36, 54-524.40, &54-524.41:1,2

§54-524.44

§§54-524 36, 54-524.40, &54-524.41.1,2

§54-524 47.1

(Continued)

33

BOARD AND EXISTING REGULATIONS PROPOSED REGULATIONS NOT7S AND COMMENTS/PROFSSSION/OCCUPATION Regulated Entity Method Entity Method STATUTORY REFERENCES

PHARMACY (Continued)

Correctional Insti-tutions

Same Regulations Same Samefor adminis-tering andstoring drugsand for records

Industrial Infirm- Same As above Same Samearies and First AidRooms

College Infirmaries

PROFESSIONAL COUNSELORS

Same As above Deleted Deleted

968 Professional Professional Licensure Same SameCounselors Counselors

apecialties(Generic)

Mamage and Family Licensure Same SameCertification

Pastoral Licensure Same Same

Rehabilitation Licensure Same Same

(Continued)

§54-933 and 54-935 coverspowers and duties ofprofessional counselors;§54-934.1 authorizesSubstance AbuseComnuttee; separately,§54-929 authorizes board topromulgate regulationsnecessary to administereffectively the regulatorysystem administered by theprofessional board." Seenarrative related to specialtydesignations. Task Forcerecommends eventual genericlicensure with specialtydesignation left to privatesector credentialing.

Substance Abuse Licensure Same Same Both existing and proposedregulations treat substanceabuse counselors as specialtyfor professional counselorlicensing, but m othersections these counselors arem separate list forcertification by specialcommittee (see below). Thisis intended. Genericallylicensed professional

-Career Licensure Eliminated counselors may beadditionally licensed as

Research Licensure Eliminated substance abuse counselors,others may be certifiedsubstance abuse counselors

A-5

NEW

Clinical Licensure See narrative related toMental specialry designation.HealthCounselor

64

(Continued)

BOARD AND EXISTING REGULATIONS PROPOSED REGULATIONSPROFESSION/OCCUPATION

PROFESSIONAL COUNSELORS(Continued)

Substance AbuseCertificationCommittee

Regulated Enuty

(Substance Abusecounselors regulatedby special committee)

Method

Certification

Enuty

Same

Method

182 Alcholism Same Certification Same SameCounselors

54 Drug Same Certification Same SameCounselors

PSYCHOLOGY

284 Psychologists(genenc)

Same Licensure Same Same

Sante Licensure Same Same

In addition, Clin-ical Psychologistsare examined byBoard of Psychologyand recommended forlicensure by Boardof Medicine

ClinicalPsycholo gist

Industrial/Orgam-zational Psychologist

Acadenuc/ResearchPsychologist

CounselingPsychologist

Licensure Same Same

Licensure

Licensure

Licensure

Technical Assistants Registration

Proposed regulations eliminateall but School Psychologistand generic license, col-lapsing previous specialtiesinto "Health Service Provider"and "Nonhealth Service Pro-vider"

Same Same

SOCIAL WORK

230 Licensed Social LSW Licensure Same SameWorkers

Licensed Clinical LCSW Licensure Same Same784 Social Workers Casework Specialty Same Same

LicenseGroup work Specialty Same Same

License

(Continued)A-6

5,:

NOTES AND COMMENTS/STATUTORY RERERENCES

Special Committee proposedto be disbanded and functionabsorbed by Board. This willrequire change in statute.

§54-924; 54-928; 54-929,54-931, 54-936 through54-939.1, 54-950 and54-950.2. In addition,§54-929a provides for Board"to promulgate regulations"etc., as for Board of Pro-fessional Counselors, above.

Statutory changes proposed toeliminate dual board govern-ance of clinical psychology(i.e., to regulate solely byBoard of Psychology). TaskForce concurs.

The Task Force concurs withthe Board that specialty II-censmg should be eliminatedand School Psychologistcategory continued (perhapsas registration or certificationvs. licensure program).

Task Force recommendsfurther study of the need toregulate this occupation.

Task Force recommendsstudy of licensing specialtiesfurther of casework andgroup work and of method ofregulating LSWs (i.e., byregistration or certificationvs. licensure).

...65


SOCIAL WORK(Continued)

EXISTING REGULATIONSRegulated Entity Method

PROPOSED REGULATIONSEntity Method

NOTES AND COMMENTS/STATUTORY REFERENCES

431 Registered Social RSW Registration Same SameWorkers

25 Associate Social ASW Registration Same SameWorkers

VETERINARY MEDICINE

1,617 Veterinanans Vetermanans Licensure Same Same §§54-766 to 54-786.8Also related statutes of the

363 Animal Techru-clans

Arurnal Technicians Certification Same Same Drug Control Act(§§54 524 47:1--54-524 94)

403 Animal Facilites Animal Facility Registration Sam:and Permit

Vetennary Medicine Students Preceptorship Same SameStudents

(Continued)

A-7

67

TABLE B

Educational or Other Entry Requirements, by Board

(For professions or occupations regulatedby each board, see Table A.)

Board of Dentistry B-1

Board of Funeral Directors and EmbElmers B-2

Board of Medicine B-3

Board of Nursing B-8

Certified Nurse Practitioners B-10

Board of Optometry B-11

Board of Pharmacy 6-11

Board of Professional Counselors B-12

Board of Psychology B-13

Board of Social Work B-15

Board of Veterinary Medicine B-16

s69

NOTE: These tables were prepared for acomprehensive review of the regulations of allhealth regulatory boards completed in 1985.The regulations proposed by each board haveyet to be adopted by the boards. The processof adoption of proposed regulations shouldbe complete by mid-1986.

TABLE BEDUCATIONAL OR OTHER ENTRY REQUIREMENTS FOR REGULATED PROFESSIONS OR OCCUPATIONS, BY BOARD


DENTISTRYDentists

EXISTING REGULATIONS

Education:

Graduate of dental school recog-nized by Council for DentalEducation of Amencan DentalAssociation and by Board(4.C.1.a.)

Other.

Certificates of good moralcharacter" from two dentists(4.C.1.c)

Pass National Board of DentalExaminers' exam before applyingto Board (4.C.1.d.3.).before applying to Board

Must pass Southern Regional TestingAgency (SRTA) examination asprecondition for licensure

Dental Hygienists Education:

(Continued)

-Graduate of school of dental hygienerecognized by ADA Council onDental Education and by Board(4.C.2.e.)

Other.Certificates "of good moralcharacter" from two dentists(4.C.2.c.)

PROPOSED REGULATIONS

Education:

Graduate of dental schoolrecognized by Commissionon Dental Accreditation ofADA, with D D.S. or D.M.Ddegree;

Or

for foreign graduate, a degreeor certificate from a post-doctoral program approved byComrrussion (2.1.A.)

Other:

"Moral character " reference de-leted.

Pass Parts I 8i II of Jointon National Dental Com-Truss ionEx ammers examsapplying to Board(2.2.A.1).

Same

Education.

Graduate of school of dentalhygiene recognized by ADACommission on DentalAccreditation (2.1.B.).

Other:"Moral character"referencedeleted


Graduate of a "professionallyaccredited and reputable"dental schoolboard deter-mines which schools are such,

Or

for person practicing abroadfive years prior to applying;must have proof of graduationfrom such a school (§54-170).

Applicant "must be cf goodmoral character..." 054-17'4. Report contains noproposal to delete thisrequirement from Code.

Any exams "shall be of suchcharacter as to test the quali-fications of the applicant ..."(§54-171).

Board uses SRTA regionalexamination to supolernen:national examination pi ograrn.

Must be "of good moralcharacter ..." (§54-200.9).Report contains no proposalto delete this requirement fromCode.

70


DENTISTRY(continued)

Dental Hygienists(continued)

FIrNERAL DIRECTORSAND EMBALMERS


Resident Trainees

(Continued)


Pass National Board of DentalExaminers' exam before applying(4.C.2.d.3).

Must pass Southern Regional TestingAgency (SRTA) examination asprecondition for licensure.

Education:Graduate of mortuary scienceprogram {XI.1.(a)]Completion of two-yeartrameeship [X1.1 (e)]

Experience:Participation in arrangementfor and conduct of at least 25funerals.Emblamed at least 25 human bodies[XI.1.9(e)].

Other.Thite citizens' notarizedstatements of applicant'sgood moral character[XI.1.(c)].

Pass exam of National Conferenceof Fir,eral Service Examining Boardsor the National State Board Examadministered by Virginia Board (X 9 )

After submitting application, mustreceive certification from VirginiaBoard that he/she is qualified to take itsexam. (D(.2.)

Education:

Graduate of high school or§54-260.72 prescribes allpresent entry requirements

Other:

Three citizens' notarized state-ments of applicant's "good moralcharacter" (XIII 2.)

B-2


Pass Joint Commission onNational Dental Examiners'exam before applying(2.1.C.3 ).

Same

Same (3.4.A.1)

Same (3.4.S.5)

Same (3.4.A.5.a)

Three citizens' notarized state-ments as character reference("good moral character"deleted) (3.4.A.3.)

Same (3.2.A. & B )

Same (3.4 B.)

Education.

Same (5.2.A.)equivalent (XIII 2 )(listed in existing regulations)for applicants for trameeships

Other.

Three citizens' notarized state-ments as character reference("Moral character referencedeleted) (5 2.B.3) No felonyconvictions (5 2.A.)

l...0

NOTES AND COVLMENTS/STATUTORY REFERENCES

Board to determine type ofany exams given (§54-200 4)

Board uses SRTA regionalexamination to supplementnational examination program.

§54-260 70 prescribes all fivepresent entry requirements(listed in existing regulations)for applicants for licenses

Statute specifies "of goodmoral character." Board Re-port proposes no change inCode to delca this requirement.

Statute specifies "of goodmoral character." Reportproposes no change in Codeto delete this requirement orto add felony conviction.


FUNERAL DIRECTORSAND EMBALMERS(Continued)

Resident Trainees(continued)


Trauung program, licensee whowill supervise it, and faneralestablishment where it will beconducted, must be approved byBoard in advance (XD1.4-7.).

MEDICINE

A. Students of American Institutions:

?hysician

Osteopathy

Podiatry

Acupuncture

(Continued)

Graduate of school of podiatryapproved and recommendedby Council on PodiatryEducation of AmericanPodiatry Association(3.4.A.)

License in medicine,osteopathy or podiatry& 100 hrs. postgraduatetraining in a school ofacupuncture approved bythe Board. No Board examspecified. Registratin topractice acupuncture isspecified. (1.1)

B-3


Same (5 3 and 54)

All applicants in Medicine,Osteopathy, Poidarry &Chiropractic: completechronology of professionalactivcities since graduation§2.2.A.4)

Graduate of medical schoolapproved or accredited by LiaisonCommittee on Medical Educationor other accrediting bodyrecognized by Amencan Medi-cal Association (AMA) or byCommittee for the Accreditationof Canadian Medical Schoolsor its appropriate subsidiaryagenices (2.2.A.2.b.)

71

NOTES AND COMMENTS/STATUTORY RaERENCES

All in Medicine, Osteopathy,Podiatry, and Chiropractic: --1year post-graduate trainingin U.S. or Canadian hospitalrecognized by professionalassociation [ §54.305.(d)]

Completion of all, or suchpart as Board prescnbeb, ofa course of study in thebranch of the healing arts inwhich applicant seeks to belicensed -the course and theeducat'cnal institution pro-viding it to be acceptableto the Board [54-305.(c)].

Good moral character

[§54-3051(b)]

Graduate of college of osteopathicmedicine approved or accreditedby Committee on Colleges and Bureauof Professional Education ofAmerican Osteopathic Association(2.2.A.2.b.)

Same (2 2 A 2.c.)

Same prerequisites butlicensure specified in-stead of registration.No Board exam (4.2.B 1 -3)

§54.274.1 Clarification ofmethod of credentialing(licensure or registration)needed.

72

BOARD ANDPROFESSION/OCCUPATION EXISTING REGULATIONS

MEDICINE

(Continued)

Chiropractic

Clinical Psychology

Physical Therapist

Physical TherapistAssistant

Physician Assistant-Cat:gory I(for privateemployment)

(Continued)

If matriculated after 7/1/75,graduate of chiropractic collegeapproved by Commission onAccreditation of Council ofChuopractice Education. If before7/1/71, graduate of chiropracticcollege approved by AmericanChiropractic Association orInternational ChiropracticAssociation (3.4.A.)

Requirements of Virginia Board ofPsychologist Examiners in separateregulations of that Board (3.1.A.)

Not specified. Statute specifiesgraduate of school of physicaltherapy as in proposed regulations.

Not specified. Statute specifiesas in proposed regulations(at right).

Be of good moral character & "shallhave the burden of proving that heis ..." (III)

Course of study in a curriculumapproved & accredited by Com-mittee on Allied Health Educationand Accreditation of AMA or otheraccrediting agencies approved byVirginia Board. (IX 1)

Regulations distinguish in someinstances "Physicians' Assistants"(implied to mean assistants to adoctor of medicine or osteopathy)& "Podiatrist's Assistant":Former must pass Primary Carequalifying exam of NationalCommission for Certification ofPhysician Assistants [DC.2. ( a)]and , if specialize, pass specialtyexam as such exams becomeavailable [DC.2 (b)1

Podiatrists' Assistant; must: Passexam by E7 amining Board ofAmerican Society of Podiatric

Assistants (DC.3):B-4


Same (2.2.A.2.d.)

Requirements of Virginia Boardof Psychology in separate regu-of that Board (2.1.C.)

Graduate of school of physicaltherapy approved by Councilon Medical Education of AMAor by American PhysicalTherapy Association (2.3 A.)

Graduate o; two-year college-level educational programapproved by Board of Medicine(2.3.B)

Deleted

Prescribed curriculum in a schoolor institution accredited bythe Committee (2.3 A)

Present evidence of eligibilityfor exam of National Com-mission on Certification ofPhysician Assistants (NCCPA)(2.3.B.)

Distinction not made.


See Narrative on Board ofPsychology. Task Forcerecommends elimination ofdual system.

Education [§54-308 5 (e)]Good moral character[§54-308.5.(c)]

Education [§54-308.6. (a) (5)]Good moral character[§54-308 6.(a) (3)1

§54-281 4 (a) & (b)

See notes related to re-namingthis profession PhysicianAssistant (vs. physician'sassistant) in Table A.

§54-281 7


MEDICINE(Continued)

Physician AssistantCategory I(for pnvste employment)(Continued)

Physician

AssistantCategory II(for employmentby Dept. ofcorrections inits institutions

B.

EXLSTING REGULATIONS

Be proficient in English (XI.A.);and possess numerous enumeratedskills (XLB. -E.)

Physician or podia rist with whom

assistant will work must apply toBoard spelling out what the assistantwill do, and obtain Board approval. (II.)

Three years' progressively

responsible experience-in arecognized medical organization orfacility. Six months experiencein medical or radiology lab may besubstitued for six months of requiredthree years. (ILA. & B.) Studies in anapproved school, in armed servicesor maritime services and in collegesor universities in specified subjectsmay also be substituted. (1[11.A-C.)

Interview by supervising physician

at correctional institution wherethe person makes application.

Recommendation by Medical Director

of Dept. of Corrections

Registration by Board of Medic=(n)

Students of Foreign Instin.tigns:

Medicine, Osteopathy,Podiatry, andChiropractic

(Continued)

Standards for Institutions aboardnot included

Documentation of:

Diploma (3.4.F.)

One year is hospital intern orintern or resident in U.S. orCanada (3 4.F)

Documents not in English to betranslated by consul or pro-fessional translation service(3.4.H.)

Chronology of all professionalactiviue since attendedinstitution (3.4.G.)


Essentially same (2.2.C.)

Essentially same (2.2.A-C.)

Same (4.1.A.)

Same except now "Chief

Physician" of Dept. (4.1.B.)

Implicit in 4.1.B.

All applicants in Medicine,Osteopathy, Podiatry, andChiropractic:Institution attended must beone approved under newproposed Regulations§465-05-1 (2.2.A.3.a.)

73


§54-281.4.(c)

(See notes related to redesigna-tion of this occupational classin Table A. Redesignation isdesirable to lessen confusion ofthis differently trained occupa-tion with Physician AssistantI's.

§54-306.1:2, enacted 1985

Documentation of: §54-305(d)

Attendance at institution'spnncipal site at least twostraight years and completionof at least half of degree re-quirements there [2.2.A.3.b (1)]Degree from institution [2.2.A.3 b (2)]

Same [2.2.A.3.b. (3)]

Translation of documents[2.2.A.4.b.(2)]

Same [2.2.A.4.b. (3)]

B-5

Ni

74


MEDICINE(Continued) If discharged from U.S. military

in last 10 years, a notarized copyof discharge papers (3.41.)

Medicine and Osteopathy Standard certificate of EducationalCouncil of Foreign Medical Gradu-ates (ECFMG) or equivalent; QB,hcensure by another state orCanadian province (3.4.A.)

Medicine (Exception)

Clinical Psychology

Physical Therapist

NURSING

graduates oLILLPragam,5

Registered Nurse(R.N.)

Licensed PracticalNurse (L.P.N.)

(Continued)

None specified

None specified

Meet Code §54-308.5 as forAmerican institutions and:English proficiency [VI.6.(a)]Copy of certificate or diplomaand translation if necessary KIKcertificate from school [VI.6.(b)]Evidence the curriculum is sub-stantially equivalent to that approvedby the AMA Council or AmericanPhysical Therapy Association. Boardwill accept verification by CredentialsEvaluation Service of InternationalEducation Research Foundation or"some other" such service approved byBoard [VL6(c)]

Both existing and proposed regulationsall U.S. apphcants--both R.N. and L.Papphcable to both categones.

Transcript from "nursing school"(5.1: 1.b)

Only reference to other entryrequirements is in Section III onaccreditation of programs, under3.2:4 "Students": "Requirementsfor admission to the nursingprogram shall not be less than

NOTES AND COAMENTS/PROPOSED REGULATIONS STATUTORY REFERD10ES

Same (2.2.A.4 C.)

Same (2.2.A.3 c.)

Can take Board exams if:Completed all degree requirementse.scept social services and post-graduate internship (2.2.A.3.d.)Completed clinical training pro-gram as established by AMA t[2A2.A.3.d. (2)]Completed postgraduate hospital trainingin U.S. or Canada [2.2.A.3.d. (3)]Certificate from foreign institutionon work completed [2.2.A.3.d. (4)]

Regulations §465-05-1 also set standardsfor institutions in this field, for whichBoard of Psychology gives the exam.

Graduate of school with course(2.4.A.)

Same (2.4.B.1.)Essentially the same (2.4 B.2. & 3.)

Same, except Board "may accept" venfica-Lion by the Foundation's evaluation serviceor another (2.4.8.4)

state entry requirements forsingle statements

Transcript from "nursingeducation program"(3.1.H.)

Same (2.2.D.1 a.)

B-6

Coda uses separate sections forR.N and for L.P N.applicants.

§54-367.13 specifies for JULlicense apphc ants:(a) (implied for all R.Napplicants though not stated

four years of nigh school orequivalent;

diploma or degree fromaccredited professionalnursing education program:

no acts that are grounds for

BOARD ANDPROFESSION /OCCUPATION

NURSING (Continued)

Licensed PracticalNurse (L.P.N.)(Continued)

Graduates of ForeignProirams

NURSING PRAC I 1 11ONERS

(C NP)

EXISTING REGULATION

the statutory requirements whichwill permit the graduate to beadmitted to the appropriatelicensing examination" -- with across-reference to Code§54-367.13 (a) (2) and an explana-tion of what the equivalent of afour year high school course ofstudy, referred to in Code, isconsidered to be

Existing regulations use the abovedevice of a single statementapplicable to all foreignapplicants (no mention of R N. orL.P.N.) to require.

"Certification of Licensure"fm ., the licensing or accreditingagency in country of nursingpreparation [5.3.b.(2)]Official transcript verifyinggraduation from nursing pro-gram and, if not in English,an official English translation[5.3.b.(3)]Evidence of secondary educationsuch as required for other appli-cants [5.3.b.(4)]Proficiency in English evidencedby score of 550 or above on TOEFL(Test of English as a ForeignLanguage) if English not the firstlanguage of applicant Q. by passingComrnmission on Graduates ofForeign Nursing Schools QualifyingExamination [5.3.bZ` and5.3.e. & g.]The nursing education program musthave covered theory and clinicalpractice m five listed areas ofnursing care (5.3.c.) or else thedeficiencies be made up in a state-accredited school or Board-approvedprogram (5.1.d.)Applicant ";nay be required" to passCommission qualifying exam citedabove (5.3.f.)Notarized "Form I" [5.3.b. (1)]

Virginia license as a registerednurse

Completion of an approved pro-gram "designed to prepare nursepractitioners"

"Where applicable," certificationby an association recognized bythe Boards


Proposed regulations use ablanket statement applicable toboth R.N. and L.P.N. applicantsfor one set of requirments- -thensplit into separate R.N. andL.P.N. 3.3.A.: Licensedapplicants all must "meet thestatutory qualifications forlicensure," and verification oftheir qualifications will bebased documents submitted asspecified in 3.3.B. and 3.3.C.3.3.B. (for R.N.$): Evidence ofpassing score on Commission ofGraduates of Foreign NursingSchool Qualifying Examination3 3.0 (for L.P.N.$):-transcript from the nursing educationprogram submitted directed to Boardoffice;-evidence of secondary education tomeet the statutory requirements",-vertification-of-licensure form submitteddirectly to Board office by the creden-tialing agency in the country wherelicensed.

75


disciplinary action as listedm §54-357 32; and(b) (stipulating for foreigngraduates) applicant "may berequired to pass the Com-mission on Graduates ofForeign Nursing SchoolsQualifying Examination."

§54-367.19 probably single set ofrequirements applicable (norequirements for all L.P.N licensewhether U S. or foreign):specifications as fo.lows:

Completion of two years of highschool or equivalent;diploma from an accreditedpractical nursing program;no acts grounds for &sci-

on plinary action as above

Same (2.3 A.)

Completion of a program"designed to prepare nurseanesthetists, nurse midwives,or nurse practitioner that is"

-approed by Boards

B-7(Continued)

+ LTh

76

BOARD AND NOTES AND COMMENTS/PROFESSION/OCCUPATION EXIFTLNG REGULATIONS PROPOSED REGULATIONS STATUTORY REFERENCES

NURSING PRAC.11110 \TERS(C N P.)

OPTOMETRY

Optometrists

Optome rests certi-fied to prescribed .gnosuc drugs

PHARMACY

(Continued)

(Regs Section V)

Written exam of National Boardadopted as written exam of VirginiaBoard, but Board may substituteown written exam. Applicant mustalso pass it practical exam byVirginia Board (`r1.)

No mention: existing regulationspredate the law

Graduate of 1 of 72 approvedcolleges of pharmacy listed byname (413., 8 .k.-B.)Six months (1,300 hrs.) practicalexperience in compounding anddispensing presrzipuons in apharmac- (2.A.-B., 6 C.)

For sn nts, after completionof firs 3rotessiol,a1 year inpharmacy school"Student Extemes" (2.C.)For graduates"PharmacyInternes" (3 C )Registration with Board requiredin advanced except for studentsenrolled in a college clerkshipprogram (3.A.,C.,F.)Under supervision of a pharmacistwho may supervise only 1 externe orinterne at same time (3.B.1. & D )Practical experience in a college ofpharmacy with program for suchapproved by American Council onPharmaceutical Education miy besubstituted on equal basis (2 D.)

-accredited by an agency identified asone accepted by the Boards (2.3 C.)

Certification by an agency identified asone accepted by the Boards (2 3 C

Board will accept certification by exaimnatio.iby five listed national agencies (2.4- - the denu-ficauon referred to in 2.3)

Same, except that referenceto Boards discretionary useof its own written exam assubstitute for national isdeleted (2.1 A.)

Only mention of exam is in feelist No mention of the pre-requisite course, and no citingof §54-386.1.

Same (2A A.-B.)

Same (2.1 A.-B ,

2 3.C)

Same (2.1 C.)

Same (2 2.C.)

Same (2.2.A.,C , F.)

Same (2 2.B 1 &D )

Same (2.1 D )

B-8

§54-380 authorized Board to sastandards for exams

§54-386.1 requires "a Board-administered, performance-basedexam on general and ocular phar-macology" after successful com-pletion of a Board-approved courseof at least 55 classroom hours inthree specified areas. The coursemust be one given by a collegeor university accredited by a bodyrecognized or approved by theCouncil on Post-SecondaryAccreditation or by the U.SDepartment of Education.

Good moral characterGraduate of School of Pharmacyapproved by Boird and defined asone meeting standards of AmericanCouncil on PharmaceuticalEdi.cauon and listed on itsannual published list.(§54.524.21.)Practical experience not toexceed 12 monthe ( §54.52421.)


PHARMACY(Continued) Out-of-state interne expenence

to be certified by board of theother state (3.C.)For extant t fidavit to be filedwith Board at mid of experienceas evidence of it (3.G.)

.....

Requirements for a nuclearpharmacist:Meet Nuclear Regulatory Com-mission standards of training;Be a licensed pharmacist inState;90 contact hours didactic in-struction in subject fromaccredited college of pharmacy;160 hours clinical training innuclear pharmacy or college; andSubmit affidavit of expenenceand training to Board. (13.1.A.-E)

PROFESSIONAL COUNSELORS

Professional Coun- 60 semester hours (or 90 quarterselors (generic) hours) of graduate study that

is prim.dily counseling in nature,including a gaidulgskrea incounseling from a college or umversa), accredited by SCHEV orregional agency. Specific course-work mandated. Criteria forequivalency broadly stated.

Specialty Licensure(Marnage andFamily, Pastoral,RehabilitationCareer, Research,Mental HealthCounselor)

Substance AbuseCounselu-

(Continued)

Each require generic preparationas above plus special provisionsfor : )stgraduate course content andpracucum supervised by hcensee(or otner) approved by Board.

Person (not necessarily genericprofessional counselor) withspecific educational and experiencerequirements (not necessarilydegreed)


Same (2.2.C.)

Same (2.2.6)

Same (4.2.A.-E.)

Same, except requirement forgraduate degree or equivalentremoved and specific coursework requirement expanded from9 to 10. Also, 4,000 hours(equivalent of two years) post-graduate or postpracticum re-quired under supervisionsatisfactory to Board, in-cluding 200 hours of individualsupervision, 100 of which maybe met by group supervision on 2:1basis. Postgraduate or pos,pracucuminternship may count for one-half of4,000 -hour requirement.

77


Task Force recommends eventualremoval of requirements exceptgraduation from accredited schooland/or successful completion ofexamination.

Specialty Licensure for Re-search and Career Counselor dis-continued,Mamage and Familyand Pastoral specialty continuedwith essentially the samerequirementsMental Health Counselorspecialty created with specificgraduate and pracucum require-ments and Ph.D. in counselingor mental health counselingrequimi by 1990.

Substance Abuse Counselorcontinued, now to be regulateddirectly by Board (CertificationCommittee disbanded) with

Task Force recommends eventualdiscontinuance of specialtyhcensure; specialty designationif any, to be left to privatecredenuahng.

Sei. specialty recommendationabove.

Task Force concurs.See notes in Table A related toinconsistencies in referring toJicensure and certification of

essentially the same requirement substance abuse counselors

78

BOARD ANDPROFESSION/OCCUPATION rDaSTING REGULATIONS

PSYCHOLOGY

Psychologist(generic)

Reouires Ph.D. in psychology.

Clinical Psychologist Required to be psychologist withcompetence in psychologicalevaluation and psychotherapy

Psychologist(clinical)

Counseling Psychologist

School Psychologist

Industrial/Organi-zational Psychologist

Acadenuc/Rm.earchPsychologist

Technical Assistants

SOCIAL WORK

Licensed SocialWorkers (LSW.)

(Continued)

Has identical requirements as forClinical Psychologist, above.

Person (not necessarily genericpsychologist) specializing in"problems in educational systemswho attempt to improve learningconditions for students."Master's degree and specificexpenences required

Person (not necessarily genericpsychologist) specializing insolution of problems arisingin organizations.

Person (not necessarily genericpsychologist) competent to in-struct students.

Required to hold baccalaureatedegiee, with major in psychology.

Two kinds:Bachelor's degree (BSW) in socialwork from program accredited


Board proposes to retain onlygeneric license with doctoraldegree and specific experientialrequirements, and School Psy-chologist requiring Master'sdegree and specific experience.

All 'her specialties collapsedinto two:Health Service Provider, andNonhealth Service Provider.Board also proposes returningClinical Psychology from Boardof Medicine to sole province ofBoard of Psychology.Residencies for "Health 5..:-vice Provider" reduced from twoto one year, one-year intern-ship remains. "NonhealthService Provider" must com-plete one-year full time residency.

Board's specific requirements foreducational content substantiallyreduced from 11 printed pages ofhighly specific requirements forgraduate education content, intern-ships, and residencies.


Task Force concurs.

Task Force concurs with respectto Clinical Psychology. Furtherstudy of proposed "healthprovider", "non-health provider "recommended. Careful reviewof statutory and regulationchanges to implement Boardproposals is needed.

Required to be psychologistspecializing in assessment andtreatment of academic, vocational,marital, family, or personaladjustment, etc.

Essentially the same

Eliminated

Eliminated

Same

There are no substantivechanges in requirements,out Board report indicates

B-10

Task Force recommendscontinuation, possibly asa certi `ication or registrationprogram (vs. licensure).

Task Force concurs

Task Force concurs

Task Force recommends furtherstudy.

Task Force recommendsconsideration of LSW. program ascertification or registration (vs.licensure).



Licensed SocialWorkers (LSW.)(Continued)

by Council on Social WorkEducation (CSWE) with specialexpenence requirements (two-yearpost degree social work practiceand 135 hours of supervision).

Master's degree (MSW) fromprogram accredited by CSWE; noexpenential requirement.

Licensed Cl nical Required to have three yearsSocial Worker (LCSW) full -time post-degree (MSW)

experience in delivenng clinicalservices. Doctoral degree in clinicalsocial work may count as one ofthree years expenence. Must have200 hours supervision with weekly"face-to-face consultation" and otherhighly specific requirements. Allexperience must be in "non-exempt"(i.e., proprietary) setting--casework or srouR work specialtiesrequire LCSW, and will be examinedaccordingly."

Registered SocialWorker (RSD)

Associated SocialWorker (ASW)

VETERINARY MEDICINE

Vetennanans

(Continued)


that "independent contractorsshall be deemed to be inpnvate practice and belicensed by the Board."Statutory change requireddid proposed.

Statutory change alsoproposed such that "Boardwill not register thesupervision of personsobtaining experience inexempt settings, but thesepersons shall be expected tomeet criteria for supervisionin 2.2.B.2 b."

Essentially same

Rezisgml and Associate Social SameWorkers required to completeunspecified examination. Theseare disccntinued categories.

D...gree in Veterinary Medicine froma veterinary college or universityapproved by Board (12.C.)

Pass exam of National Board ofAmerican Veterinary MedicalAssociation (AVMA) X12 D 5 )

Same Q_R have met requirementsof Education Commission ofForeign Graduates of AmencanVetennary Medical Association(2.A.1.)

Not mentioned, but Report saysBaird now offers national examin V irginia.

/Byi 1

79


Statutory authonty to regulate(l'cense) "independent contractors"is not clear. Task Forcerecommends further study.

Task Force recommends eventualgeneric hcensure only for LCSWwith specialty designation, if any,left to pnvate sector creden-tialing. Task Force recommendsfurther study of statutoryproposals to add to Boardauthority to regulate "con-tractors" or "settings."

Graduation from Board-approvedcollege or university veterinarymedicine program required(§54-784 03 1)

Not mentioned

80

BOARD `.NDPROFESSION/OCCUPATION EXISTING REGULATIONS

VETERINARY MEDICINE(Continued)

Vetennanans(Continued)

Animal Technicians

Animal Facilities

Veterinary MedicineStudents

Good moral character (12.B )

Diploma in Animal Technologyfrom a school accredited by AVMAor approved by Board (12 A.3 )

Good moral character (12 A.2)

NOTES AND CONLMENTS/PROPOSED REGULATIONS STATUTORY REFERENCES

'Moral character" T..ference de-leted

Not mentioned, but Board isauthonzed to prescnbe conductand ethical standards.(§54-784.03 8)

Diploma from AVMA-accredited Necessary qualification "mayschool required. Reference, to include graduation from college orBoard-approved schools dropped. university program for animal(3.1.A.1.) technicians or a program approved

by the Board." (54-784.03.1)

"Moral character" reference de-leted

Board inspection and registration Same (4.1.A.)beford opening (8.B.3. and 21 A.)

Licensed veterinarian as the owner,partner, or officer personallyresponsible for maintaining faci-lity within standards (213.)

Meet detailed standards appli-cable to all animal facilities(22.)

Enrolled and in good standing inschool (14 A.)

Preceptorship authonzed by theschool and "officially approved"(14.A.)

Same (4 1 A)

Not mentioned, but conduct andethics standards are authonzedas for veterinarians (§54-784.03 8)

§54-784 03 7 authorized Board toregulate and inspect"establishments ard premisesReport proposes removal of totalban on corporate ownership; tnesexis ting and proposed regulations

may be in confhe with proposal.

Meet detailed standards, somemade more specific (4 2.A.),but with following new flexibilityprovided:

Licensee will need to meet onlythe standards applicable to facilitiesused in kind of practice he/she operates,rather than all standards foi a full-service facility, provided he/she gets alimited permit and posts its limitationsconspicuously. (4.2.B.) (This provisois presented obliquely following athree-and-a-half-page-long list ofrequirements for a full-service facility.)

Same (2.2.A )

Authorized preceptorship "asthe Board" (2 2.A.)Requirement for schoolauthorization dropped.(3.1.A.1.)

General authonty to establish andregulate programs for practicaltraining of qualified studentswhile enrolled in programs ofeither veterinary medicine oranimal technology (!54-784 03 5)

81

TABLE C

Examination Requirements for Regulated Professionsand Occupations, by Boards

(For professions or occupations regulatedby each board, see Table A.)

Board of Dentistry C-1

Board of Funeral Directors and Embalmers C-2

Board of Medicine C-3

Board of Nursing C-4

Certified Nurse Practitioners C-4

Board of Optometry C-5

Boars., of Pharmacy C-5

Board of Professional Counselors C-5

Board of Psychology C-6

Board of Social Work C-7

Board of Veterinary Medicine C-7

r7

NOTE: These tables were prepared for acomprehensive review of the regulations of allhealth regulatory boards completed in 1985.The regulations proposed by each board haveyet to be adopted by the boards. The processof lrlopuon of proposed regulations shouldbe complete by mid-1986.

TABLE CEXAMINATION REQUIREMENTS FOR REGULATED PROFESSIONS AND OCCUPATIONS, BY BOARD

BOARD ANDPROFESSION /OCCUPATION EXISTING REGULATIONS

DENTISTRY

Dentists

Dental Hygienists

(Continued)

Pass Southern Regional TestingAgency (SRTA) exam; Boardwill honor results for fiveyears (4.B.1 )

Pass exam on Virginia Dental lawsand regulations (4.C.1.dA )

Pass National Board of DentalExaminers' exams before applyingto Board (4.C.1.d.3.)

See Table B for renIiirements fornational exammatior program

Pass SRTA exam in dental hygiene;board will honor results for fiveyear (4.B.2.)

Pass exam on Virginia dentalhygiene laws and regulations

D.2.d.4

Pass National Board of DentalExaminers' exams before applyingto Board (4.C.1.d.3.)

See table B for renuirements fornational examination program

C-1


Pass SRTA exam unless anapplicant for reciprocitylicensure. If more than fiveyears elapses before licenseeseeks Virginia license, mustretake exam unless licensee canshow "continuous active,clinical, and legal practice."(2.2.A.2.)

Pass exam on Virginia dentallaws and regulations (2.2.A.3 )

8:3


Exams "of such character as totest the qualifications of theapplicants." (§54-171)

Pass Parts I and H of JointCommission of National DentalExaminers' exams before applyingto Board (2.2.A.1.)

See Table B for requirements fornational examination program

Pass SRTA exam unless areciprocity applicant. Ifmore than five years passbefore licensee seeks Virginialicense, must retake exam un-less licensee can show "continuous...practice" exactly as for dentists.(2.2.B.2)

Board to determine type of examsgiven (§54-200.4)

Pass exam on Virginia dentalhygiene laws and regulations(2.2.3 2 )

Pass Parts I and II of Joint Commissionof National Dental Examiners examsbefore applying to Board (2.2.A.1.)

See Table B for requirements fornational examination program.

84

BOARD ANDPRO FESSIO NiOCCL PATION EXIS I LNG REGULATIONS

DENTISTRY(CONTINUED)

Dental Assistants(Who are speciallyc-redenualed forX-Ray)



Resident Trainees

MEDICINE

Medicine, Osteo-pathy, Podiatry,and Cruropr dale

(Continued)

Pass Board exam in radiation safety& hygiene

Or

an approved course on subject;Or

be certified by American Societyof Radiological Technicians(2.B.2. and 4.B.4.)(Only assistants who elect toqualify; dental assistants arenot regulated by the Board)

13'..ss Virginia State Board-ixanunation (Short Form)(X.I0) covering basic andhealth services, funeral ser-vice arts and sciences,funeral service adminis-tration, and other subjectsthe Board may add (X3)

No examination. For acertificate, a trainee mustcomplete requirements citedin Table G under "Supervisionof Auxiliaries" in a two-yeartraineeship, with progressreports made to Board everysix months by instructor,the training establishment,and the trainee (X111.1-7 )

Three-part examinations requiredPart I, basic sciences;Part II, clinical sciences; andPart III, clinical competence. Listsof individual subjects specifiedunder both Parts I and II as instatutes (3 1.A )


By July 1, 1986, pass clinicaland/or lab course am! didacticcourse and exam given byinstitution approved by ADACommission on Dental Accredi-tation and/or by the Board(4 7.A.I2.)

NOTES AND COMNIENTS/STATUTORY REFERENCE

No specific statutory ref-rence

Same (3.3) covering same §54-260 70 lists the examsubjects, plus added subject of subjects listed in the regula-funeral service law (3 4 B 2) Lions

Same (51-5.5)

Derails deleted in favor ofgeneral statement thatapplicants may take PartsI & II of the "FederationLicensing Examination"(FLEX) as a unit (3 1 A )

C-2

§54-260.72 specifies the two-yearperiod and details the require-ments

§§54-297 to 54-300,2 specify thethree parts and individual subjects

§54-300.3 permits Board to subst--tute corresponding parts of FLEXexam of Federation of the Starg.Boards of Medical Examiners forany parts of own examAlso authomc d Virginia Board to

BOARD ANDPROFESSION/OCCUPATION EXIS IING REGULATIONS PROPOSED REGULATIONS

MEDICINE(Continued)

Medicine, Osteo-pathy, Podiatry,and Chiropractic(continued)

Medicine & Osteo-pathy

Chiropractic

Podiatry

Physic al Therapistand Physical Thera-pist Assistant

Physician Assis-tant- Category I

Physician Ass...3-tantsCategory U

(Continued)

Identical exams required for these twofields

Content differs from above, especiallyParts II and BI.

Chiropractic member of Board administersparts II and DI of this exam

All parts differ widely (3.1.A.)

Podiatrist, who have passed NationalBoard of Podiatry exam and meet allother entry requirements to VirginiaBoard exam may have its basic sciencesportion waived. May also substitutenational Part III exam for VirginiaBoards (3.3)

Exam administered by PhysicalTherapy Advisory Committee (VI)

Same, except once per fiscalyear, rather than twice a year(3.1.B.)

Prepaied and graded by Professional SameExamination Service (PES) [VI.1 (a)]

Scores filed with InternationalReporting Service of PES [VI.1 (b))

Detailed list of subjects specified:for physical therapist (VI.8)for physical therapist assistant(VI.9)

Physicians' Assistant:pass "Primary Care"examgiven by NCCPA (IX.2.a)take specialty exam if tospecialize

Deleted

Deleted

No separate exams or categoriesProficiency exam of NCCPAconstitutes Board exam (3 1 )Must take at time scheduled byNCCPA (3.3)

Assistant to PodiatriF, take exam ofExarnuung Board of American Society ofPodiatric Assistants [D(.2 (c))

May be registered "based upon exper-ience and/or completion of anapproved training program in lieu oftesting." (Preamble)

Same (Preamble)

YwC-3`

85

VOTES AND CONLMENTS/STATUTORY REFERENCES

accept a certificate of the nationalboard for appropriate branch ofhealing arts attesting an appli-cant's passing corresponding partsof that national board's exam ifmatenal and passing grade aredeemed equivalent.

§54-295 6 and 54-308.7

§54-308 6 (e)

§54-281 7

§54-281.7

86


NURSING

NURSE PRAL 11 flONERS

OPTOMETRY

PHARMACY

(Continued)

Board "shall review and adopt"as its exams the "NationalCouncil Licensing Examinations"for RNs and LPNs (5 1.a.)passing score on RN exam(effective 721/82) to be thestandard score of 1600 (5.1.b.)

passing score on LPN exam tobe the standard score of 350(5 1.c.)

No state examinations: Virginiacertificat: in is based on qualifyingas stated in Table B.

Written exam of National Boardadopted as written exam of VirginiaBoard, but board may substitute ownwritten exam. Applicant must alsopass a practical exam by VirginiaBoard. (VI)

No inention; regulations predatethe law

Examination may be in 3 portions- -theory, practical, and pharmacy law(6.A.)

Passing grades are 60 on theory75 on practical, and average forthe two must be 75 Passingpharmacy law takes 75 (6.B.)

NOTES AND COMMENTS/PROPOSED REGULATIONS STATUTORY REFERENCES

Exams of the National Councilof State Board of Nursing con-stitute the Board exams for RNsand LPNs (3.1.A.)passing score on RN exam toto be the scaled score of 1600(3.1 B).

passing score on LPN examto be he scaled score of 350(3.1.C.)

§§54-367 13 (r 1) and 54-367.19(a)(4), for RN LPN applicantsrespectively, specify only that theypass "a written examinationas required by the Board."

No state examinations; Virginiacertification is based on qualifyingas stated in Table B.

Same, except that referenceto Board's discretionary useof its own written exam assubstitute for national isdeleted (2.1.A.)

Only mention of exam is in feelist. No mention of theprerequisite course. No citingof §54-386 1 either.

Same (2.3 A.)

Same (2.3 B.(1)), plus addedprovision that at such time asan integrated exam is given,individual subjects (apparentlymeaning theory and practical)would not be identified andpassing grade would L.. 75 ;pharmacy law, still separate,requires 75 as before (2 3 B (2))

C-4

§54-380 authorizd Board to setstandards for its exams.§54-386.1 requires "a Board-administered, perfom ance-based-exam on general and ocularpharmacolocy" --after successfulcompletion of a Board-approvedcourse of at least 55 classroomhours in three specified areas. Thecourse must be on, given bycollege or university accredited bya body recognized or approved bythe Council on Post-SecondaryAccreditation or by the UnitedStates Departmen. of Education.

Board to give exams at leasttwice a year (§54-524 4)

BOARD ANDPROFFSSICN/OCCUPATIONS EXISTING REGULATIONS

PROFESSIONALCOUNSELORS

PSYCHOLOGY

SOCIAL WORK

(Continued)

Generic: Two part written exam(objective, multiple-choice,source unspecified) offered twiceannually, and an essay examination

:2121kgiostated acticelaws governing practice, regi-lationsof the Board and Code of Ethics ofthe Board. Applicants who passare then required to submit to oralexamination consisting of intenvewby Board including evaluation ofapplicants' "professional, emotionaland social maturity', "extent andnature of applicant's professionalidentity", knowledge of Code ofEthics, discussion of work sample,"probing and evaluating the appli-cant's knowledge of and judgmentin professional counseling." Boardsets passing scores.

Examinations consist of threecomponents:

National Licensing ExamEssay Exam (Board prepared)Oral Exam

National Licensmg Exam is productof Professional Examination Serviceand American Association of StatePsychology Boards. Passing scoresof 65 percent required for Nationaland Essay Exam.Oral exam consists of interview andevaluation of two work samplesgraded blindly. An "orals beef' isalso required setting forth applicant'sg'ecialty interests, theoretical andprofessional orientation, nature ofcurrent practice, statement of areasof competence (e.g., populationsserved, assessment instruments used,intervention techniques, etc.)

Lisensed Social Worker. Two-partexamination required:

National examination (sourceunspecified) consisting ofobjective, multiple-choiceitems.

Essay and/or objectiveitems covering law, regulations,and ethics.


Generic: Basically the sameexcept notation that objectiveexam is "nationally validated"(but unspecified).Specialty: Lxanunation is partof the essay examination, ma-jority of Board determines pass/fail of essay and oral exami-nation Examination Committeemust include a Board member ordesignee in the area ofapplicant's specialty.

Basically the same except U.-.two work samples required fororals differentiate "health serviceproviders" and "non-health ser-vice providers."

87


Board has removed somesubjective aspects relatedto personal characteristics,professional ideologies, etc.Alternatives to examination pro-cedures and requirements (such aseliminating specialty exami-nation and substituting privatesector specialty credenuahng)are not discussed.

Although Board has recommendedabsorption of the Substance AbuseCertification Committee'sfunctions (including examinationprocedures) no discussion orproposals are included in antci-pation of this possibility.

Examinations are for genericlicensure; specialty creden-tailing apparently depends onperformance on oral examinations

Proposed eianunation procedures The Board has clanfied itsand content are basically thesame except for improvementsin clarity of presentation

C-5

examination procedures but someambiguity and subjectivity remain,as in "evaluating maturity,""determining clinical skills asdemonstrated in work sample" andevaluation of "extent and natureof professional identity; his/her

88



VETERINARY MEDICINE

Vetermanans

Animal Technicians

Licensed Clinical Social Worker.Three-part examination required

National exam as aboveWritten exam as above to


Procedures are unclear in bothexisting and proposed regulationsas to how "case-work" and"group work" specialties are

include area(s) of practice examined.Oral exam consisting of inter-view "evaluating the applicant'sprofessional, emotional and sochamaturity." etc. and evaluation of awork sample.

Board sets passing scores. Majority ofBoard must pass applicant on essay andoral exam.Other. Reference is made to exams forAssociate and ..egistered Social Workerbut no detail s provided.

Practical exam given by Board(13.A.2)

Regulations say what applicantmust do "to be qualified to beexamined by the Board for acertificate," but do not mentionthe exam.


knowledge of ethical professionalbehavior and probable ability tosuccessfully apply such knowledgein professional practice."

Same (2.1 A.3.b.) General authority (§54-784 03 3)

NEW:

National clinical competency testrequired. (2.1 A.3 a.)

3.1 states (in the identical languagequoted at left) what one must do "tobe qualified to be examined by theBoard" (3.1.A.)Then under thesame A. specifies:"Pass the examination of the boardtwo parts"--state board practical exam--national board exam (3.1.A.5 a. & b.)

89

TABLE D

Reciprocity Arrangero nts, if any, for RegulatedProfessions and Occupations, by board

(For professions or acct. a tons regulatedby each board, see Table A.)

Board of Dentistry D -1

D-2

D-3

D-5

D-5

D-6

D-6

D-7

D-7

D-8

D-8

Board of Funeral Directors and Embalmers

Board of Medicine

Board of Nursing

Certified Nurse Practitioners

Board of Optometry

Board of Pharmacy

Board of Professional Counselors

Board of Psychology

Board of Social Work

Board of Veterinary Medicine

8 J.-

91

NOTE: These tables were prepared for acomprehensive review of the regulations of allhealth regulatory boards compelted in 1985.The regulations proposed by each board haveyet to be adopted by the boards. The processof adoption of proposed regulations shouldbe complete by mid-1986.

TABLE DRECIPROCITY ARRANCENIENTS, IF ANY, FOR REGULATED PROFESSIONS AND OCCUPATIONS, BY BOARD

BOARD ANDPROFESSION/OCCUPATION EVSTLNG REGULATIONS PROPOSED REGLLATIONS

DENTISTRY

Dentists All applicants must take SRTA Board may "upon properexam (4.B.1). application" license dentists

already licensed by anotherstate with which the Boardhas established reciprocity(2.3.A.). [Note that 2.2.A 3.says all applicants must takeexam on laws and regulations.]'The Board proposes toimplement when asked to do soby individual applicants forlicensure §54-173 and §54 200.5of the Code and enter into areciprocal licensure arrangementwith a state having comparablerequirements, thus waiving theclinical examination for certianout-of-state applicants. AsArkansas, Kentucky, andTennessee are the other threestates that accept the results[of SRTA], it is possible thatthe first requests for licensureby reciprocity may come from...one of these three states.

Dental Hygienusts



(Continued)

All applicants must take SRTAexam (4.B 2.)

Licensee of another state may belicensed in Virgina if the two havereciprocity agreement (Licenseis Virginia Funeral Service(Licerisc)

Regulation cites Code §54-260 72,the resident trainee section.

Board may, on proper appli-cation, license dental hygienistslicensed by another state withwhich it has establishedreciprocity (2.3.B). [Note2.2.B.3. says all must takeexam on laws and regulations.]Proposed reciprocal arrange-ments for dental hygienistswould mirror the proposalfor dentist above.

The equal pnvileges proviso hasa alternatives; "establishment of

similar substantially licensurerequirements and/or reciprocityagreements. ." (4 2.A.)

Same (4.2 A.1)

D-1

NMES AND COMMENTS/STATUTORY REFERENCES

Board at its discretion mayestablish reciprocity with otherstates having comparable require-ments. May give applicant fromsuch states a one-year probation-ary license, then a regularlicense No mention made of anexam. (§54-173). Tying reci-procity to individuals' requestsfrom SRTA--parucipant statesappears to limit reciprocity toor.,trrowly. "Comparable require-ments" assessment could proceedwithout linkage to individuals'requests or SRTA participation.

For hygienists, §54-200.5contains identical provision tothat of §54-173 above fordentists. Comments related todentist reciprocity above applyas well for dental hygienists'reciprocIal arrangements.

§5.4 260.72 authonzes reciprocitylinked to resident trainee,provisions.

If out-of-state person immediatelybefore applying has been employedin the profession full tune:

92


FUNERAL DIRECTO!;S ANDEMBALMERS(Continued)

Funeral ServiceLicensees (Continued)

MEDICINE

Medicine, Osteopathy,Podiatry, andChiropractic

(Continued)

=SUNG F rGULATION

Fee for initial Virginia License ofout-of-state person is S200 "re-gardless of month and year ofissue." (Xl.3.)

Corresponding initial licensure feefor Virguua resident is Sc' ineven-numbered years; S130 inodd-numbered years (Xl.2)

Fee for license renewals foll:Avir.ginitial licensure is "the pre" (flingbiennial renewal fee for uneralService Licenses" (same for all) (XI


Fee for initial Virginia licenseof out-of-state person is S100in even - numbered years andS200 in odd-number:d years.(11.1)

Corresponding fee for Virginiaresident is S50 in even-numberedand S100 in odd-numbered years.(11.1)


for 10 years, is exempt fromtraineeship requirement;

for five years, he is exemptfrom one year of traineeship

Biennial renewal fee for all FuneralServicq licenses is 5100 (11.1)

3) Applicants must pass Virginia Applicants must take only theBoard exam (4 2.A.2.)

Out-of-state licensee practicing in a Same (4 3.)state with substantially similar licenserequirements to Virginia's and whichhas an agreement with Virginia mayobtain a courtesy card from Boardpermitting him/her to remove bodiesfrom and arrange funerals inVirginia, but not to engage g ierallyin establishing, or be employed insuch a business, or to advertiseor solicit busuiess in Virginia.

Arum' renewal fee to be not lessthan hail the prevaili, g biennialrenewal fez (now S7u) for aFuneral Director's license (XI.4 )

Virginia exam

Annual renewal fee 550. (11.1) Statute specifies same provisionsBiennial renewal fee for Funeral (but not fees)Director's license -S70 (11.1)

General: General:

Each applicant on own meats;must have passed exam equivalentto Virginia's; meet other Virginiarequirements. (4.1.A.)Letter from two 'legally qualifiedand reputable" practitioners inU.S. or Canada on ltis/her moralc ester and professional abilityana listing the practioners' medicalschool, date of graduation, andstates where licensed. (4.1 D.)

If applicant not licensed, must havepassed FLEX exams with gradesNual to Virginia requirements (4 1 F )

or

If practiced 10 yrs. or more inU.S. or its Armed Services (4 1 G)(1) Must have been licensed inanotder state 10 years,

Same (4.1.A.)

Deleted

Deleted

D-2

04-310

BOARD ANDPROFESSION/OCCUPATION EXLSITING REGULATIONS

93

NOTES AND COMMENTS/PROPOSED REC' -TONS STATUTORY REFERENCES

MEDICINE(Continued)

Medicine, Osteopathy,

Podiatry, andChiropractic (2) Letters from 2 practitioners(Continued) of same branch who have known

him/her 10 years or more;(3) Proof of practice such as

endorsement by professional,society, iospital o'ficials; and

(4) If or basis of Armed Servicespractice, a certification fromcommanding officer or personneldivision on length of service andhonorable discharge.

If a diplomate of Licensing Medical DeletedCouncil of Canada, submit verificationof license and exam grades, documen-tation of graduation and training.(4.1.H.)

Medicine

Osteopathy

Podiatry

Chiropractic

Passing 3-part exams of NationalBoard of Medical Examiners orequivalent qualifies for licensurewithout exam. (4.11)

Passing 3-part exam of NationalBoard of Examiners for OsteopathicPhysicians and Surgeons doessame. (4.1J)

Being diplomate of National Boardof Podiatry Examiners passing a3-part exam and meeting VirginiaBoard requirements does same. (4.1.K)

Passing exam of National Board ofChiropractic Examiners and meetingVirginia Bo,.al requirements doessame. (4.1,L.)

Same, plus "meets the require-ments of the Virginia Board"(4 1.B.)

Same (§4.1.C.)

Same, "plus "passed a clinicalcompetence examination equivalentto" I/ivma exam (4.1.D.)

Same, plus "passed an exammatior,equivalent to" Virginia Board'sPart III exam. (4.1.E.)

Practitioners Exempted from hcensure for 2 weeks Same if:(any branch implied) if invited by:invited to Virginia A Virgr licensee for consulta- Same (4.3 A.)from another state non (4.3.C.1)or country 'Medical school or organization Deleted

for furthering medical education(4.3.C.2)

'Exemption beyord 2 weeks requires Same (4.3.B)Board approval

Physical Therapist Licerisex4 by exam in another state Same (4.1)and Ph) ,ical Therapist equivalc,it to Virginia c' mAssistant 'VIII.1.)

Boa-d neither accepts nor reports Deletedto another board a candidate'ssmes on P.E.S. exam. These tobe obtained only from InternationalReporting Service P.E.S. (VIII.2.)

D-3

(Continued)

§54-276.5

94

BOARD ANDPROFESSION/OPCCUPATION EXISTING REGULATIONS

MEDICINE(Continued)

Physical Therapistand Physical TherapistAssistant(Continued)

NURSING

-If practiced 10 yrs. or more in U.S.its Armed Services, Public HealthServices, or Veterans' Hospitals,same rules apply as shown forMedicine, Osteopathy, Podiatry,and Chiropractic. (VM.3.)

Graduate of a state-accredited or-approved program licensed by examin another U.S. jurisdiction and whoselicense is in good standing shall beeligible for licensure by endorsement+n Virginia provided requirements ofother jurisdiction for licensure wereequivalent to those in Virginia at timethe applicant was inithnily licensed(5.2.a.)

If application is not completed withinone year of initial filing date, it isdeemed abandoned. (5.2b.)

NOTES AND COMMENTS/PROPOSED REGULATIONS STATUTORY REFERENCES

-Deleted

Same, except "state- accredited §543-367.14 autl_nized Board to-approved program"; is license for professional nursingchanged to an approved by endorsement if applicant meetsnursmg education program': qualifications "required of(3.2.A)Applicant must sub- registered nurses in this state."

nut application and fee andsubmit to the credentialing §54-367.20 provides matchingagency in state of original conditions for licensing LPNs bylicensure the required form for endorsement.vertification of licensure.Board will notify applicant after30 days if form has not beenbeen received(3.2.B.) If not Board of Nursing has widestcompleted within year. will implementation of reciprocity ofbe retained on file by Board all DHRB Boardsas required for adult (3.2.C.)

NURSE PRACHITONERS Reciprocity not mentionedis not pertinent Virginia certification is basedentirely on applicant's meeting all requirements of Virginia regulations;requires both the completion of the applicable educational program and thenational certification specified above (Table B.). Certification by anotherirate is not a factor in this approach.

OPTOMETRY

(Conti ied)

No mention--but no mention either Sameof any Virginia residency requirement.Also fee list - -by making no referenceto state of residency -- provides same feesfor all.

D-4

Person who has "successfullypassed" a standard exam L1optometry in any state of theU.S. and holds certificate fromits board may be issued a certifi-cate to practice in Virginiawithout exam on payment of theregular exam fee, provided:-he has conducted an ethical pro-fessional practice of optometryfor at least one year next pnor;-the standard for his ongmalcertification was at least equalto this state's standard;-he has not failed an exam beforethe Virginia Board, and

-hub former state grants likeprivileges to persons who havepassed the uirginia Board exam(§54-384)

BOARD ANDPROFESSION/OCCUPATION EXIS I LNG REGULATIONS

PHARMACY

PROFESSIONALCOUNSELORS

PSYCHOLOGY

(Continued)

License must be from a state thatalso grants reciprocal licenseto Virgirua licensees (9 A ) andhas requirements at least equalto Virginia's:For legal qualifications (9 A )For exam and passing grades (9 C.)

Graduate of approved school ofpharmacy (9.B.)

Pass Board exam in pharmacy lawwith grade of at least 75. (10 A 1)

Board Secretary may issue licensesubject to acceptance by Board atits next meeting. (10.A.)

Fee for temporary or probationaryor reciprocal license is S300 (1.B.)Regular fee for Virginia licenseeapplicant via exam is $200 (1.A.)

The regulations of the Board ofBehavioral Sciences for the Boardof Professional Counselors pro-vide that the written ex. -runation(s)may be waived for the applicantcertified or licensed in anotherjurisdiction where it is adjudged bythe Board that the applicantwas so certified or licensed byequivalent procedures."

Written exams may be waived for appli-cants from other junsdicuons whoare certified or licensed m accordancewith standards adjudged by the Boardto be eqwvalent. Waivers are con-sidered only on an individual casebasis and in no L.ent are orals waived.

D-5


Deleted

Deleted here (but 24 A -Bapplies to all)

Same (2 5 A.1 )

95

NOTES AND COMMENTSSTATLTORY REFERENCES

Board may issue temporary or pro-bationary license for period notless than one year, without exam,to persons licensed by exam inanother state who present evi-dence of qualifications equalto Virginia requirements At endof year may issue regular licenseto those "whose qualificationsare in accordance the

regulations established by theBoard." --No mention of otherstates' granting reciprocallicensure to Virginia licensees(§54-524.26)

Board Executive Director mayissue to out-of-state licensee"who possesses the legal quali-fications," subject to Board ac-ceptance next meeting (2 5 A )

Same (LB.) Fee for above license to bedetermined by Board (§54-524 6)

Sam,. (1.A.)

The Board may waivethe objectm examinationif it adjudges that appli-cant has been certified orlicensed in anotherjurisdiction by standards andprocedures equivalent to itsown.

Foreign graduates are not spe-cifically addressefi

Provisions are essentiallythe same except waivers forABPP diplomates are nolonger permitted. Boardhas added provision thatrequirements for examin-ation may be waived inextraordinary circumstances(defined as achievement ofstate or national recognitionin the field of psychology by

The Board has proposed that itsreciprocity provisions be mademore restricitive by iequiring out-of-state candidates to submit toboth essay and orals, rather thanthe previous requirement for oralsonly.

Reciprocity is presently in effectfor Idaho and California. Therequirements of the Virguua Boardare possibly the most restncuvein the U.S , therefore, expandedreciprocity under present systemwould appear to be limited.Proposed regulations do notaddress foreign graduates but theBoard states "licensing foreign-trained counselors is not a seriousproblem; each counselor is dealtwith individually."

Virginia's requirements aregenerally know . to be the mostspecific and difficult of allstates It is unlikely thatentrants from other states could beconsidered equivalent. Reciprocityshould be applicable on a class,not individual basis, i.e., allthose credentuilexi by stateshaving comparable requirementsshould be eligible for waivers

96


PSYCHOLOGY(Continued)

SOCIAL WORK

VETERINARY MEDICLNE

Vetennanans

Continued)

Wntten exams may also bewaived for applicants who arediplomates of the Amencan Boardof Professional Psychology

Licensed Social WorkerWntten exams may be waived forapplicant certified in anotherjurisdiction when Board adjudgesrequirements to be equivalent.

Licensed Clinical Social WorkerA portion of the written examina-tion may be waived. Oral examina-tions may not be waived.

At its discretion, Board may grant alicensed based on a practical examadministered by Virginia Board, toan applicant licensed in anotherjurisdiction subject to fiveprovisos:

Board's opinion he/sh, has met allrequirements for other applicantsexcept filing of the InterstateReporting Service report of his/hergrades on the national board exam;

Endorsement in writing to theVirginia Board by the boardof state(s) where he/she holds orhas held a license;

Proof that license is valid andin gcod standing:

Documentation of all professionalactivities since graduation fromapproved school, with verificationby the other state's board, andacceptance by Virginia Board ofthe documentation; and

To in. ire the competence c: theapplicant, the (Virginia) Br andmay require and specify a 'ienodof adclitional cun'cal experienceunder the supervision of a veter-.nanan or uistitution approvedby the Boa- I." (13 B 1-5)

D-6

NOTES X \ D comma "1'S/PROPOSED REGULATIONS STATUTORY REFERENCES

those whose education andtrau-ung equals or exceedsthat otherwise required).

The Board may waive the wnttznexamination in whole or in partif it adjudges candidate credentialedfrom anothei jurisdiction to havemet equivalent requirements.

Oral examinations may not be waived

Discretionary licensing ofout-of-state licensee pro-vided for those graduatedfive years or i tore beforeapplying and subject torevise l five Irovisos(2.1.8.):

Meeting all other re-quirements of section(2.1.3.3 )

Passinz, national clinicalcompetency test - -withsuboroviso that this toomay be waied if he/she hasbeen continuously inpractice the last five years(2.2.B.1.);

Venfication by the otherboard that the applicant isin good standing (2.13 4.),

Board has authority to establishthe qualifications necessary forlicenstr , to practice veterinarymedicine in this state(§54-784 03.1)

Documentation by applicant specified.but requirement for verification byhis board of these activities is deleted(2.1.B.5.).

Reference to obtaining additionalexperience deleted. Passing Boardpractical exam added (2.1.B 2 ).

BOARD ANDPROFESSION /OCCUPATION EXISTING REGULATIONS

VETERINARIANS(Continued)

Animal Technicians

(No reference to other state's havingrequirements equal to Virginia'sor to establishing reciprocityagreements.)

Board may waive national board examfor animal technician certified orlicensed in another state wnen he/sheapplies, subject to following fourprovisos:

Board's opinion he/she has met allrequirements for examination byBoard

"The applicant has filed the requiredapplication . "

97

NOTES AND CONLMENTS/PROPOSED REGULATIC STATUTORY REFERENCES

(No reference to reciprocity orequal standards)

Boarl may grant certificate, Board has authority "to establishbased on a Board-Adtrurustered the qualifications necessary topractical exam, to technician act is animal techrucan in thiscertified or licensed out- state . . (§54-784 03.1)of-state who has not takennational examsubject to samefour provisos in existing re-gulations (3.1.B .1 -4 ).

The applicant has a certificate from a state"whose requirements are at least equalto" Virginia's, and

The applicant furnishes certificate of goodstanding from the other state attime of applying to this state.(17.A.1-4.)

APPENDIX D

INTRODUCTION TO HEALTH OCCUPATIONS (3302) COURSE OUTLINE*

I. Introduction to Course

A. Purpose, competencies, textbooks, and references of courseB. Student goalsC. Classroom managementD. Study habits

II. Health Occupations Students of America (HOSA)

A. TerminologyB. PurposesC. Structure of meetingsD. Functions and qualificati,_, .s of officersE. Activities of club

Health Care Industry

A. TerminologyB. HistoryC. OrganizationD. Major factors influencing health careE. Health care delivery systemsF. Future of health care industry

IV. Health Care Workers

A. Qualities acid characteristicsB. Employment skillsC. EthicsD. Legal aspects

V. Health Careers

A. TerminologyB. DutiesC. SpecialitiesD. EducationE. Personal qualificationsF. Earning poter tealG. LicensingH. Work environmentI. Career laddersJ. Advantages/disadvantagesK. Professional organizations and publications

* Abbreviated version

99

100

VI. Regulation of the Health Professions and Occupations

A. Virginia's lawB. PurposeC. Public participation in regulationD. Virginia Department of Health Regulatory BoardsE. Virginia Commission of Health Regulatory 3oardsF. Methods of regulation of health care providersG. Virginia's ten health professional boards and whom they regulateH. Educational or other entry requirements for regulated professions or

occupations (by Board)I. Examination requirements for regulated professions and occupations (b,

Board)J. Reciprocity provisions

VII. Safety

A. Safety regulati.wsB. Body mechanics for the health workerC. Fire safety

VIII. Epidemiology

A. TerminologyB. PurposeC. MethodsD. Aseptic handwashingE. Leading causes of death

IX. Consumerism

A. TerminologyB. Health maintenanceC. Consumer rightsD. InsuranceE. Health maintenance organizationsF. Effer_L of the elderly on health care systemsG. Varying viewpoints in health careH. Marketing in the health care industry

X. First Aid

A. Terminology and abbreviations3. Obstructed airwayC. ShockD. Bleeding woundsE. Victim of poisoningF. BurnsC.. Heat and cold exposureF. Be ic and joint injuries

i:_i

101

I. Splint application proceduresJ. Sling application proceduresK. Bandage application proceduresL. Dental injuries

Xl. Cardiopulmonary Resuscitation

A. One-rescuer CPR (Heartsaver)B. One-rescuer CPRC. Two-rescuer CPRD. Obstructed airwayE. Infant resuscitationF. Conscious choking infantG. Choking infant who becomes unconscious or is found unconscious

XII. Summary

A. Career goalsB. Course evaluation