Missouri Professional Licensing Attorney Danielle Sanger: Who is Subject to Missouri Behavioral Analyst Licensing Requirements?

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Behavior analysts are professionals entrusted to provide helpful environmental adjustments for autistic children and other people with behavioral disorders. In 2010 the Missouri legislature created a licensure requirement for anyone engaged in “behavior analysis.”  Their goal was to regulate and provide oversight over people who worked with these populations. Prior to 2010, Missouri simply accepted the national certification for behavioral analysts, which is administered through the Behavior Analyst Certification Board.

If you find yourself under scrutiny by the Missouri Behavior Analyst Advisory Board for your licensed practice of behavioral analysis, call an experienced Missouri licensing attorney immediately.

The Definition of “Applied Behavior Analysis”

Are you subject to licensure requirements for behavior analysis?  In Missouri, being subject to licensure is outlined by RSMo. § 337.300, which defines “applied behavior analysis” as the following practice:

(1) “Applied behavior analysis”, the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relationships between environment and behavior. Applied behavior analysis does not include cognitive therapies or psychological testing, personality assessment, intellectual assessment, neuropsychological assessment, psychotherapy, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, family therapy, and long-term counseling as treatment modalities.

In addition, the statute defines the “practice of applied behavior analysis” as:

. . . the application of the principles, methods, and procedures of the experimental analysis of behavior and applied behavior analysis (including principles of operant and respondent learning) to assess and improve socially important human behaviors. It includes, but is not limited to, applications of those principles, methods, and procedures to:

(a) The design, implementation, evaluation, and modification of treatment programs to change behavior of individuals;

(b) The design, implementation, evaluation, and modification of treatment programs to change behavior of groups; and

(c) Consultation to individual and organizations.

Accordingly, if you are working with individuals’ environments and environmental stimuli to improve their behavior, you are likely subject to RSMo. § 337.300 and must attain  one of several available licenses, which are ranked based on the degree of education attained by the holder. The licensure process and legal practice of behavioral analysis is governed by the Missouri Behavior Analyst Advisory Board.

What Licenses are Available for Behavioral Analysts?

LBA:               Licensed Behavior Analyst;

LaBA:             Licensed Assistant Behavior Analyst;

PLBA:             Provisionally Licensed Behavior Analyst;

PLABA:          Provisionally Licensed Assistant Behavior Analyst;

TLBA:             Temporary Licensed Behavior Analyst;

TLaBA:           Temporary Licensed Assistant Behavior Analyst.

The appropriate licensure depends on a practitioner’s level of education, training, and meeting requirements outlined by statute. The different licensure requirements also mandate certain amounts of supervision by a behavior analyst or analysts with superior certification.

Failing to meet these requirements can have significant consequences. It is important to note that in Missouri it is a crime under RSMo. 337.335, a class A misdemeanor, to either practice behavior analysis without a license or to practice beyond the scope of one’s license. It is clear that practicing without a license is inappropriate, but analysts also need to be aware of the bounds of their specific licensure.

Before you increase your degree of professional responsibility or take on significant types of new work, make sure it is within your license.  Attain written confirmation regarding the appropriateness of your work from your supervisor. While not a perfect defense, this sort of documentation may indicate in a subsequent review of your actions that you acted in good faith and were not trying to evade certification.

If you are a behavioral analyst in Missouri and are facing a threat to your license or an investigation by the Missouri Behavior Analyst Advisory Board, call Danielle Sanger today.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend your livelihood and career. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation with an experienced and aggressive attorney for behavior analysts facing an investigation or occupational discipline.

Kansas and Missouri Professional Licensing Attorney Danielle Sanger: As a Nurse, Should You Accept Probation in a Discipline Matter?

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Given nurses’ backbreaking workload, incredible degree of professional responsibility, and extensive one-on-one contact with patients, allegations of misconduct arise.  These allegations can be complicated by unfortunate facts such as drug or alcohol dependence, mental health issues, and poor documentation. Misconduct allegations can be difficult to disprove and are potentially career ending.

On the other hand, misconduct allegations are frequently false, trumped up, or based on weak foundations of rumors or bad blood. Out of fear, we see too many nurses facing discipline accept probations or some other “lesser” penalty out of fear, embarrassment or ignorance of how to challenge the allegations. You should not allow an allegation of misconduct end your career and ruin your finances and future, nor should you just blindly accept a disciplinary board’s offer of a “lesser” penalty out of fear.

In Kansas and Missouri, nurses facing professional discipline can rely on Danielle Sanger, Esq. to defend their rights. Attorney Sanger has spent her career defending licensees before administrative and licensing boards, protecting nurses accused of making mistakes and other misconduct from losing their professions, savings, and homes.

How Should You Decide Whether to Accept a Deal or Fight?

As a licensing attorney, I always try to achieve the best possible outcome for my client. There are always two roads to that outcome, negotiating some sort of deal or going to a hearing. Obviously, a negotiated penalty is attractive because it is a low-risk choice with a known outcome. On the other hand, a hearing is a high-risk choice with a possibility of prevailing with no discipline or losing and facing an unknown penalty.

Preparing for a hearing and challenging the evidence being used against you is the vital to both prevailing ultimately at a hearing and getting the best possible offer of a lesser penalty. Excluding hearsay—rumors and other unsubstantiated statements—against you, challenging the validity of evidence, and making an administrative board second-guess the strength of the case against you will result in their settlement offer becoming increasingly favorable to you.

In my experience, administrative hearing boards and their experienced attorneys make “low ball” settlement offers to unrepresented nurses early on in cases. Without the advice of counsel, these offers may seem like generous ways to avoid the extreme penalties that could be imposed after a hearing.  However, what licensing attorneys know is that the case against you always has flaws, and that “low ball” offer is simply a first attempt to get you to give up on a hearing where those flaws may be exposed. Those offers are to be avoided, especially when they include permanent discipline, prohibitions on working for periods of time, or other onerous conditions.

After hiring a licensing attorney with experience before the board seeking to discipline you, the offers to settle usually get much more attractive. An aggressive challenge to the evidence against you and a willingness to go to a hearing often results in a dismissal of charges of misconduct. But that sort of outcome is not going to come about without an experienced advocate by your side.

I sometimes urge clients to accept reasonable offers when the risk of a serious penalty after a hearing is simply too great to accept. Sometimes clients accept deals because their fear of an unknown outcome drives their decision-making. That said, the decision to settle a case instead of going to a hearing is ultimately yours.

There is no time to waste if you are accused of misconduct. Too many nurses try to talk their way out of misconduct, try to represent themselves before licensing boards, or accept “low ball” initial offers with long-lasting consequences. You should not respond to an investigation until you have attained representation by a skilled licensing attorney. Having a zealous advocate by your side challenging the validity of the evidence against you and cross-examining those who testify against you is not a luxury, it is a necessity.

If you are a nurse in Kansas or Missouri and are facing a threat to your license, call Danielle Sanger today.

Kansas and Missouri professional licensing attorney Danielle Sanger is prepared to advocate for your best interests and defend your livelihood and career. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation with an experienced and aggressive attorney for nurses facing occupational discipline.

 

Kansas and Missouri Licensing Attorney Shares Missouri Chiropractor’s Criminal Conviction as a Cautionary Tale for Medical Professionals

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Clients often ask what sort of behavior leads to the loss of a license. Medical billing fraud can lead to the loss of license as well as a criminal conviction. Whether due to financial stress, drug or alcohol addiction, or just a lapse in judgment, medical professionals often succumb to economic pressure and submit false claims for services they either did not provide or that were medically unnecessary.

Sometimes people think that the size of the false claim makes a difference or that isolated instances are not as serious as patterns of behavior. Both of these assumptions are incorrect, as a single instance can constitute fraud, and lying to the government or an insurance company is a crime regardless of the size of the bill attached to the false statement.  Additionally, while there are statutes of limitation limiting how far into the past the government can investigate and bring charges, you are not “out of the woods” just because some time has passed since you submitted a fraudulent bill.

It is vital to underscore that if you find yourself in this dire situation, you must contact an experienced licensing attorney immediately. Having provided that warning, the following recent case out of Missouri illustrates each of the above points.

A Missouri resident chiropractor, James Briggs, was convicted in October 2017 for filling out and sending a false medical claim to Medicare for an ankle orthodic in 2013. The submitted billing was “only” for several thousand dollars. However, because Medicare is a program administered by the federal government, his fraudulent act was a federal offense. In essence, defrauding Medicare is defrauding the federal government. Because he was convicted of lying to the government, the amount he actually acquired as part of his deception was irrelevant.

However, it is worth noting that not only did he have to pay back thousands of dollars that he fraudulently billed, but he also had a $10,000 fine and was subjected to six months of home confinement, which means his home would serve as a jail and he could not leave it. Now convicted, he will be on probation monitoring for five years. While it is too soon to say definitively, his professional career is likely over.

But this sort of mistake does not have to cost you your career. Deciding whether you speak to investigators and what documents to provide them requires experienced counsel, and you cannot just call any attorney you find in the phonebook to deal with complex licensing issues. Expert, proactive legal advice can mean the difference between retaining your livelihood and a loss of your license and a criminal conviction.

Call attorney Sanger today at (785)-979-4353 to protect your professional license.

Contact Missouri Licensing Attorney Sanger to help you protect your license and career. Call her immediately if you are being investigated for fraud. An administrative investigation by a licensing board can evolve into criminal charges without any notice to you. Having her counsel at that moment protects your rights and your investment in your career.

Attorney Danielle Sanger is an experienced Kansas and Missouri licensing attorney and has the experience to resolve your licensure issues in a way that allows you to protect your profession, your home, and your family. She has the experience to deal with licensing bodies, appear before administrative boards, and provide clients with advice to best position themselves professionally when allegations of fraud arise.

Kansas Professional Liability Defense Attorney Advises Medical Professionals: Five Ways to Lose Your License

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Whether you are a doctor, a nurse, a pharmacist, or physical therapist, your license is critical to your livelihood. While it took you years to attain your license, it can be taken from you in an instant because of a simple mistake or lapse of judgment.

As an experienced licensing attorney, clients often ask what are the most common ways that they can lose their professional license. Before I get into those individual ways, I must stress that if you find yourself being investigated, there is no time to waste, contact a professional licensing attorney immediately. The following are the five of the most commonly seen ways that medical professionals lose their licenses:

  1. Abusing Controlled Substances or Alcohol

A number of factors lead to medical professionals abusing medications and alcohol.  Often it is a combination of a high-stress career, access to pharmaceuticals, and a level of comfort with administering them. It is not always drugs, however, as alcohol abuse is also a prevalent way for professionals to deal with stress or problems. All it takes is a DUI or a complaint from coworkers to result in a referral to an administrative board and investigation into your behavior.

  1. Committing Fraud

With the complex billing practices and medical data entry required in the modern medical office, many professionals believe that charging or entering codes for procedures they did not perform will go unchecked. That is a mistake. Healthcare is a multi-billion dollar industry, and there are sophisticated controls built into the billing system.  Professionals may not be investigated the first time they enter a false code, but find themselves under scrutiny after making a serious of fraudulent entries.

  1. Violations of Professional Ethics

Medicine is a profession filled with redundant forms and checklists created to make sure that patients’ wishes are followed and that medical procedures are performed safely. Given the time pressure medical professionals sometimes find themselves under, some unfortunately resort to forging either patients’ or providers’ signatures or filling out checklists falsely.

  1. Improper Dispensing of Medication

Dispensing and prescribing medication is complex. When medications are prescribed or dispensed to patients that should not take them because of an allergy or known reaction to another prescribed medication, there can be dramatic results, including death. Sloppy administration of medications can be caused by overwork, stress, or burnout. Some patients seek out medications they should not have because they have become addicted to them; too often, medical professionals continue to provide medications to addicts who offer extra payment for them. Whether out of sympathy or greed, providing extra medications to drug-seeking patients is illegal and never wise.

  1. Discrimination.

Engaging in discrimination against patients, treating them differently based on their age, sex, race, citizenship or other “protected class” status is illegal. A complaint that you have differentiated in how you provide medical treatment to those individuals can result in an investigation and suspension or loss of your license. Careful documentation of your fair treatment of individuals is your best defense to a claim that you have treated some differently than others.

As this list demonstrates, professionals with good intentions can make honest or inadvertent mistakes. Otherwise good people can also have lapses of judgment due to work or financial pressure.  But these mistakes do not have to cost you your career.

Call attorney Sanger today at (785)-979-4353 to protect your professional license.

Contact Kansas Professional Liability Defense Attorney Danielle Sanger to protect your license and career. If you are being investigated for a workplace mistake or misconduct, call her immediately. Attorney Danielle Sanger has the experience to deal with licensing bodies, appear before administrative boards, and provide clients with advice to best position themselves professionally.