Missouri Professional Licensing Attorney Discusses Ethical Complaints Against Nurses

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Missouri’s legislature enacted the Nurse Practice Act (“the Act”) designed to govern the practice of nursing in Missouri. The Act entrusts licensing and discipline of nurses to the Missouri State Board of Nursing (“the Board”).  The Missouri Legislature gave the Board rule-making authority, which authorizes the Board to pass regulations for the profession. Consequently, the Board issued regulations establishing the ethical responsibilities and minimum practice requirements for nurses. Additionally, the regulations establish the complaint procedure for alleged ethical violations. The regulations also establish the minimum educational, character, and ethical obligations for both registered nurses and licensed practical nurses. Missouri professional licensing attorney Danielle Sangerng understands that nurses are vital components of our health care system and a responsible for delivering a high standard of care to their patients.

The regulations issued by the Board prescribe the proper procedure for filing a complaint against a nurse for an ethical violation.  The regulations permit only complaints against nurses to be filed if there is evidence to investigate misconduct. Individuals who learn of or witness unethical behavior committed by a nurse are encouraged to notify the nurse and the administration of the medical facility as soon as possible to allow the facility to rectify the situation and immediately correct the nurse’s behavior.  Reporting unethical behavior to the facility also serves as an alternate dispute resolution process which has the potential to informally discipline the nurse while serving to correct the offending behaviors.

The Board received complaints filed against a nurse. The regulations establish a clear and concise procedure to investigate the allegations.  The Board has a gatekeeping obligation to screen out complaints which fail to allege a violation of the Act and also provide sufficient information to commence an investigation.  Anyone may file a complaint with the Board alleging misconduct.  The complaint must be in writing and may be on a form prescribed by the Board. The complaint and any information gathered as a result of the investigation is not a public record. The Board must notify the complainant in writing of receipt of the complaint, and the Board must also notify the complainant if the Board dismisses the complaint or, if not dismissed, the disposition of the complaint.  If the Board finds sufficient information to warrant a disciplinary action, then the Board will file a formal complaint with the Missouri Administrative Hearings Commission.

The regulations impose a duty upon certain health care organizations to report unethical behavior to the Board.  Hospitals, surgical centers, and nurse staffing agencies are mandatory reporters to the Board. Those agencies must report any disciplinary action taken by these agencies against a nurse. The agencies must also report any voluntary resignation by the nurse in the face of discipline or any reports of misconduct pending before the health care facility.  In this context, disciplinary action is any final action taken by the board of the listed agencies to discipline, reprimand, or restrict the practice of the nurse in a meaningful way.  However, disciplinary actions will be considered by the Board only if the actions complained of are also violations of the ethical rules and would warrant disciplinary action by the Board. The complaint in filed by a mandatory reporting agency must be filed within 15 days of the date of the disciplinary action.  Also, the complaint must be in writing and include specific facts which set forth the allegations.   Notwithstanding, if the nurse submits to an employee assistance program in an effort to treat a drug or alcohol addiction, then the agency should not report the nurse. However, the agency must report the nurse if the nurse violates the employee assistance program.

Nurses Need Help Too

Missouri Professional Licensing Attorney Danielle Sanger prides herself on zealously representing nurses, and other professional licensees, who face professional discipline.  Call Attorney Sanger today at 785-979-4353 to schedule your free consultation.

Kansas And Missouri Professional Licensing Attorney Discusses Ethical Teletherapy Practice

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Use of emerging technologies is increasing in many aspects of healthcare. Teletherapy has grown significantly in health care professions such as psychology and other disciplines such as speech therapy.  Teletherapy as a recognized tool for treating patients has become a widely accepted practice. Teletherapy helps deliver treatment to people who have difficulty ambulating, or have to commute long distances like people who reside in rural areas, with greater ease and frequency. Accordingly, ethical obligations such as protecting patient-therapist confidentiality and informed consent are of paramount concern to practitioners utilizing the latest technological advances.  Kansas and Missouri professional licensing attorney Danielle Sanger cautions healthcare professionals who use teletherapy as a component of their practice to maintain the highest levels of data security as well as obtaining the informed consent of the patient to preserve patient-therapist confidentiality and trust.

The American Psychological Association (“APA”) mandates that therapists strictly maintain patient-therapist confidentiality.  Therapists must take every reasonable precaution to guard against disclosure of confidential patient communications. Therapists are obligated not to disclose patient confidences and are further obligated to protect patient data, such as notes, reports, and the like, from disclosure as well. Additionally, the APA imposes an obligation on therapists to discuss the limits of confidentiality. In the context of teletherapy, the therapist must discuss the risks of loss of privacy and limits of confidentiality when using teletherapy as a means to deliver patient services.

Therapists must understand the technology before treating a patient remotely with teletherapy.  HIPPA rules also require therapists to protect confidential client information. The APA mandates that psychologists become knowledgeable about and competent in the technologies used in teletherapy. Treatment providers have to make certain that their patients know about the potential for data or security breach and the potential, if a breach occurs, for loss of confidentiality. Practitioners should consider using all of the security advances available to them such as encryption, use of firewalls, backup systems, password protection of computers and computer files, updated virus protection, as well as reputable third-party vendors who provide data security. Guarding against disclosure also means protecting the records when they are destroyed.  Practitioners must be aware of the proper means to destroy electronic data to prevent unwanted disclosure.

The threat of a data breach is real. Stories are legion about reputable firms, businesses, and government agencies getting hacked. In other words, internet security is illusory, and 100% internet safety cannot be guaranteed. The APA requires therapists to take reasonable steps to ensure confidentiality.  Reasonableness requires the licensee to become competent in the use of the technology and the means employed to secure it.  By way of example, a reasonable means to protect data is to update security software to the latest version and take other precautions that are currently in practice. Also, therapists must inform their patients about any potential data breaches.

Therapists in both Kansas and Missouri use teletherapy are a component of their practice. In theory, therapists can practice out of state because of internet technology. Practitioners must approach this prospect cautiously. Failure to adhere to each state’s out-of-state licensing requirements can result in the practitioner committing a misdemeanor.  Therefore, practitioners must be very careful when delivering services to clients who receive the services in another state.  The better practice for the psychologist and other therapists is to be licensed in the state in which they practice regularly and the state in which the patient receives their services.

For More Information

Kansas and Missouri Professional Licensing Attorney Danielle Sanger has vast experience representing psychologists and other therapeutic professionals facing licensing discipline. Attorney Sanger prides herself on zealously representing professional licensees against disciplinary action. Call Attorney Sanger today at 785-979-4353 to schedule a free consultation.

Kansas And Missouri Professional Licensing Attorney Warns Healthcare Practitioners of Potential Disciplinary Pitfalls

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Many healthcare professionals have formed the opinion that childhood vaccinations are detrimental to children. The debate has raged for some time now. For one California pediatrician who not only ascribes to the belief that children should not be vaccinated but is a vocal advocate for eliminating the practice, the specter of disciplinary action is quite real. The L.A. Times recently reported that Dr. Robert Sears could face disciplinary action from the Medical Board of California for his decision to discontinue vaccinating a school-aged boy.  The Board filed the complaint against Dr. Sears on September 2, 2016.   The case has the potential to set a precedent for other medical licensing authorities across the United States.  Kansas and Missouri professional licensing attorney Danielle Sanger zealously advocates for healthcare providers who face disciplinary action.

According to the L.A. Times article, “Dr. Sears is one of the leading voice in the anti-vaccination world.”  Many parents who do not want their children to be immunized go to Dr. Sears for advice. Dr. Sears faces disciplinary action for writing a medical note on behalf of a two-year-old boy who was entering daycare. The note specifically stated that the boy should not have any additional vaccinations while he is of school age.  Dr. Sears now faces discipline for that decision.

Consequently, the Medical Board of California filed an accusation seeking professional discipline against Dr. Sears. In its accusation, the Medical Board of California alleges that Dr. Sears committed gross negligence, repeated negligent acts, unprofessional conduct, and insufficient record keeping when writing the note for the boy without previously examining the child. The Board alleges that the doctor wrote the note for the child after only receiving an oral history about prior vaccinations and anecdotal information from the child’s mother concerning the child’s reaction to his previous vaccinations.  Additionally, the child’s mother sought treatment for her child regarding head trauma and a cold. Dr. Sears merely indicated in his records that the child had a mark on his head and treated the child’s cold with garlic without further testing.

According to the Medical Board of California, Dr. Sears actions require discipline.  The Medical Board of California seeks suspension or revocation of Dr. Sears’ license or, in the alternative, requests that Dr. Sears’ license be subject to probation. The Medical Board of California also requested that Dr. Sears no longer have authority to supervise subordinate healthcare providers. The Board alleges that Dr. Sears’ failure to fully examine the child before writing the note excusing the boy from further vaccination requirements was grossly negligent. The Board alleges that the standard of care in the profession obligates a physician to examine the child fully for possible adverse reactions to vaccinations. Additionally, the standard of care in the professional demands that a physician obtains a full medical history of the nature of the previous vaccinations as well as a detailed description of the physical reaction the child suffered.  More significantly, the failure to obtain a full medical history prevented Dr. Sears from having all of the critical information necessary to make an informed opinion regarding the decision to order no further vaccinations. The Board argued that the doctor’s failure to adhere to the standard of care in the profession potentially endangered the child and his mother from exposure to preventable communicable diseases.

While many applaud the California Medical Board’s decision to pursue disciplinary action against Dr. Sears, others fear that the pursuit could result in a “witch hunt” for other anti-vaccination doctors in the U.S.  Many criticize the decision as interfering with a physician’s ability to treat their patients properly.

Experienced Advocate For Healthcare Professionals

Missouri Professional Licensing Attorney Danielle Sanger vigorously defends healthcare professionals, as well as other professional licensees, against professional discipline.  Call Attorney Sanger today at 785-979-4353 for a free consultation and learn how Attorney Sanger’s experience will make the difference for you.

Missouri and Kansas Professional Licensing Attorney Discusses Substance Abuse Counselor Ethics In Missouri

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With opiate addiction rates rising across the country, licensed addiction counselors are in high demand.  In Missouri, addiction counselors must obtain their credentials to practice from Missouri’s Credentialing Board (“the Board”).  The Board promulgated a set of ethical rules and responsibilities by which an addiction counselor must abide to remain credentialed.  The Board possesses the authority to investigate and sanction a credentialed counselor. Consequently, addiction counselors must familiarize themselves with the ethical rules and understand that they bear the responsibility for doing so.  Missouri professional licensing attorney Danielle Sanger maintains her law practice by vigorously defending professional licensees facing professional discipline.

The rules by which addiction counselors must conduct themselves are substantially similar to the ethical rules governing other healthcare professions.  Addiction counselors owe a duty to their clients to inform them of the course of counseling as well as the consequences of refusing the course of treatment. Clients, of course, are free to refuse any course of treatment. However, aftercare is vital to the success of initial counseling. Therefore, addiction counselors are ethically obligated to warn of the consequences of refusing aftercare.  Furthermore, addiction counselors must inform their clients of the counselor’s obligation to maintain confidentiality and the boundaries of that duty.

Addiction counselors are responsible for maintaining appropriate professional relationships with their clients. Counselors must take pains to ensure that no harm befalls their clients.  Maintaining a strictly professional relationship with clients, while treating them with dignity and respect, permits counselors to adhere to the lofty standards required of addiction counselors.  Treating clients professionally also means referring clients to other professionals when the situation requires consistent with the needs of the client.  The counselor must avoid dual relationships as well.  The addiction counselor must refer the client to another professional if the possibility of a dual relationship arises. A dual relationship is one in which the counselor is asked to provide counseling to the client, but the client is a family member, friend, financial or other close relationship.  Similarly, the ethical rules prohibit addiction counselors from entering into an intimate relationship with a client within two years after the counselor-client relationship ends.

Addiction counselors must take every precaution against disclosing confidential client information.  A counselor not only must guard against disclosure but also be aware of foreseeable situations which could lead to the disclosure of private client information.  The counselor is vicariously responsible for their subordinates’ actions when protecting clients’ private information.  In conjunction with guarding clients’ privacy right, an addiction counselor must preserve the confidentiality of any records generated by counseling.  A counselor should only release records to competent clients with the caveat that the records should not contain any information detrimental or embarrassing to the client.

Addiction counselors have an affirmative duty to learn about the diversity of their clientele. The addiction counselor has an affirmative duty to learn about their clients’ cultural background as well as learning how the counselor’s cultural background may impact the manner in which the counselor delivers their services.

Addiction counselors have a duty to do no harm to their clients. Doing no harm means refusing to counsel clients when the counselor because of personal incapacity poses a risk of doing harm to clients or others. Addiction counselors need to be role models for their clients and their community. Consequently, addiction counselors have the responsibility to obey all criminal laws and follow all ethical rules.

Who To Call For Help

Kansas Professional Licensing Attorney Danielle Sanger zealously represents all professional -licensees including addiction counselors facing discipline. Count on the experience of Attorney Sanger to vigorously defend your livelihood. Call Attorney Danielle Sanger at 785-979-4353 to schedule a free consultation today.

Kansas Professional Licensing Attorney Explains The Role Of A Presiding Officer At An Administrative Hearing In Kansas

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Kansas’ Office of Administrative Hearings (OAH) is the quasi-judicial body designated by the Kansas Legislature to preside over disputes involving state agencies’ professional licensing decisions. Efficient dispute resolution is the purpose of OAH, and a necessary step parties must take before seeking relief from the courts. The OAH functions similarly to a court. The presiding officer is called an “administrative law judge” and has a similar role as a judge in a “constitutional” court. Familiarity with the presiding officer, also known as an “ALJ,” officiating over your professional licensing appeal in Kansas may help you win your appeal. Kansas professional licensing attorney Danielle Sanger has many years of experience appearing before presiding officers at OAH.

OAH presiding officer’s main duty is to provide litigants with a fair and impartial hearing. A person’s rights to Due Process guaranteed by the United States Constitution must be protected. The presiding officer is trained to guard against procedural failures which could strip of a person of their guaranteed protections. Accordingly, the presiding officer has numerous responsibilities designed to protect the parties’ interests at stake. The primary responsibility of an ALJ is to remain a neutral and detached magistrate, or referee. Consequently, no party should contact the presiding officer personally. Neither a party nor their attorney if counsel represents them may telephone the presiding officer unless the other party or their counsel are present. If a party must contact the presiding officer, it must be in writing and mailed, with copies to the opposing party.  Using email is discouraged. Furthermore, OAH rules prohibit a presiding officer from dispensing legal advice. Presiding officers must presume that a person representing themselves at a hearing knows the substantive and procedural laws about an OAH hearing. Closely adhering to these rules prevents presiding officers from developing a personal bias for another party and avoids the appearance of impropriety.

The presiding officer does not possess the power to punish or hold a person in contempt as a means to preserve the integrity of the proceedings. Notwithstanding, the presiding officer has the authority to sanction a party for failure to obey the rules of administrative hearings. The presiding officer may enter an order of default and enter an adverse ruling against a party for failure to obey the administrative hearing rules. For instance, the presiding officer has the power to enter a default against a person arriving more than ten minutes late for a hearing.  Similarly, failure to respond, or responding late to a pleading or motion gives authority to the presiding officer to enter a default against the offending party. The presiding officer enjoys the authority to default a party whose conduct during the hearing violates decorum necessary to conduct a hearing. Parties must treat each other, witnesses, OAH staff, and the presiding officer with respect and dignity. Failure to do so has serious consequences. In addition to entering an order of default against the offending party, the presiding officer can suppress evidence, strike testimony, or enter other orders to compel respectful behavior.

The ALJ conducts the hearing as a trial in a court, with one notable exception: there is no right to a jury in an administrative hearing. Therefore the presiding officer will listen to the facts of the case, apply the law to the facts of the case, and render a prompt decision.  The ALJ requires the agency who’s decision the aggrieved party appealed to present its witnesses and evidence first. The aggrieved party presents its witnesses and evidence second.  The hearings are designed to last for two hours, with each party enjoying equal time to present its case. The ALJ may permit the hearing to run longer if necessary.

Having A Home Field Advantage Can Make the Difference For You

Kansas Professional Licensing Attorney Danielle Sanger has extensive experience appearing before many presiding officers of Kansas’ Office of Administrative Hearings. Attorney Sanger has the insider’s perspective of how administrative hearings work. You need that specialized knowledge and experience if you face professional licensing discipline.  Call Kansas and Missouri professional licensing attorney Danielle Sanger today at 785-979-4353 for a free consultation.

Kansas Professional Licensing Attorney Discusses Opioid Addiction In Kansas

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Substance abuse in the United States has reached near pandemic proportions. Nearly one in every twelve Americans suffer from the scourge of addiction. New methods for treating addiction, especially opioid addiction, are constantly tested by medical and treatment professionals. This problem created an enormous need for additional addiction counselors and treatment facilities. One highly-regarding health care professional suggests psychiatrists can be used to help break the cycle of addiction. Both addiction counselors and psychiatrists are subject to regulatory agencies with authority to discipline the licensees for unethical practices. Kansas professional licensing attorney Danielle Sanger aggressively represents addiction counselors and psychiatrists facing accusations of unethical or unprofessional behavior.

Regarding opioid addiction, researchers linked prescription drug abuse to heroin abuse. Prescription painkillers such as Percocet and Oxycodone (Oxycontin) are readily available and are in high demand among addicts. These prescriptions are so prevalent on the street from physicians overprescribing pain medications as a method of treating injuries and chronic pain. They are strong medications which must be taken only under a physician’s care. Oxycontin specifically eases pain from cancer. Regrettably, people of all ages turned to abusing pain medications.

Once the high from pain medications is unavailing to the addict, they frequently turn to heroin. Heroin is an opioid, as are most prescription painkillers. However, heroin is a potentially lethal narcotic and is highly addictive. Whereas pain medications are made in a laboratory and theoretically were approved for prescription use, heroin is a raw powder made from a poppy seed. Mixing the pain-killing medication Fentanyl with heroin or drug dealers substituting Fentanyl for heroin is a common trend. Fentanyl is a prescription painkiller that presents in appearance like heroin but is much stronger than the average street-level dosage of heroin. Addicts, believing the substance is heroin, inject the amount they need to get their “fix.” Unwittingly, the addict injects Fentanyl instead of heroin and dies from an overdose as a result.

Many addicts need intensive treatment to combat their problem. Addiction counselors step in and help those who can no longer help themselves. The Kansas Behavioral Sciences Regulatory regulates and licenses addiction counselors. Addiction counselors are not beyond reproach despite providing consumers with a valuable resource. Addiction counselors must comply with Kansas’ ethical and professional rules of their profession. Kansas Legislature recently passed a bill creating an additional level of counseling in an attempt to combat this problem.

Addiction prevention, as opposed to addiction management, helps alleviate the opioid crisis. One recent theory espoused by Nora D. Volkow, M.D., Director of the Nation Institute on Drug Abuse challenges the prevailing treatment paradigm of pain management to reduce the need for prescription painkillers. Dr. Volkow suggests that the trend of physicians overprescribing painkilling medications in the 1990s to treat many patients’ pain symptoms lacked a basis in science. Dr. Volkow suggests that reducing painkilling prescriptions will curb the opioid problem.

What, then, becomes of the person suffering from chronic pain not attributed to cancer? Dr. Volkow recommends turning to psychiatry for help. Dr. Volkow hypothesizes that cognitive-behavioral therapy is a modality that can be very useful in combatting chronic pain. Dr. Volkows suggests that training pain sufferers to think and feel differently about the pain from which they suffer. Consequently, increasing psychiatric intervention will decrease the patient’s need for painkilling medication in addition to providing the patient with a means to ease their suffering.

For More Information

Kansas Professional Licensing Attorney Danielle Sanger aggressively and zealously represents health care professionals facing discipline. If you face professional discipline from your work as an additional counselor or psychiatrist, or any other medical profession, you need an experienced advocate on your side like Attorney Sanger. Call Attorney Sanger today at 785-979-4353 today to schedule your free consultation.

ouri and Kansas Professional Licensing Attorney Explains The Rules When Appearing Before The Administrative Hearings Commission

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A licensing professional disciplined by the agency that issued the discipline has the right to appeal that decision. In Missouri, an aggrieved licensee must appeal that decision to Missouri’s Administrative Hearings Commission (AHC). Several procedural rules govern hearings before the AHC. A party appearing before the AHC must know, or at least be familiar with, the AHC’s procedural rules. Failure to know and follow the procedural rules may cause you to lose your appeal. The best option for an aggrieved licensee is to hire an experienced attorney who has vast experience appearing before the AHC. Missouri professional licensing attorney Danielle Sanger has the necessary experience you need when appealing an adverse decision by a licensing agency.

An administrative law judge decides appeals before the AHC. The administrative law judge is also called a commissioner. The commissioner is an attorney licensed to practice law in Missouri. The commissioner is an impartial arbiter of the case. The commissioner is responsible for the progress of the appeal through the hearings process. That process begins with a complaint. The aggrieved party files the complaint with the AHC and serves the state agency responsible for the issuing professional discipline. The state agency, represented by attorneys for the State, then have the chance to file an answer to the complaint. The respondent must file an answer to the complaint within 30 days from the date when they received the complaint.

After a party responds to the complaint, a party can file motions. The party filing motions must serve them upon the opposing party. A motion is a pleading that asks the commissioner to make a ruling on issues such as issuing subpoenas to witnesses, ordering parties to answer discovery requests, or to produce evidence. Discovery may consist of written questions called interrogatories, requests for admissions, and taking depositions. The commissioner has the obligation to decide the pre-trial motions and issue rulings to the parties.

Once the period for discovery and other motions elapses then, the commissioner schedules a final hearing. The commissioner has the obligation to conduct the hearing fairly and decide the issues based on the evidence presented by the parties. The commissioner listens to the testimony of the witnesses and evaluates their credibility. The commissioner also analyzes the exhibits admitted into evidence. The parties can, if they wish, file a stipulation of facts. The commissioner will decide the case based upon the testimony and exhibits or the stipulation of facts.

The person aggrieved by a decision of the agency has the Constitution right to a fair hearing.  The commissioner must preserve those rights. A fair hearing means that the aggrieved party has an opportunity to be heard, to compel witnesses to testify on their behalf, and to cross-examine a witness who testifies against the aggrieved party.  Following these Constitutional mandates ensures the hearing and the commissioner’s decision is fairly decided.

The petitioner has the burden of proof in an AHC hearing. That means the person who filed the complaint must prove to the commissioner that the licensing authority wrongfully disciplined the licensee.  The licensee must produce evidence and witnesses at the hearing. The state agency has the right to respond and offer witnesses and evidence as well.  At the conclusion of the hearing, the commissioner can issue a bench decision. A bench decision is announced by the commissioner at the end of the hearing while the parties are present. If the parties wish, they can request a memorandum decision. The commissioner authors the memorandum decision. The memorandum contains the commissioner’s findings of facts and rulings of law.

Call An Experienced Missouri Professional Licensing Attorney If You Must Appear Before The AHC

Missouri and Kansas Professional Licensing Attorney Danielle Sanger has the experience you need to prove a licensing authority aggrieved you. Call attorney Danielle Sanger today at 785-979-4353 to schedule your free initial consultation. Do not hesitate. Getting Attorney Sanger on your side early in your case exponentially increases your chances of success.

Missouri Professional Licensing Attorney Explains Discipline Against Emergency Medical Technicians

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Emergency Medical Technicians (EMTs) and paramedics are unsung heroes in today’s world. Police and fire personnel are glorified (and vilified) for their actions. EMTs, on the other hand, get little thanks for the job they perform. They are on the front lines and a glimmer of hope for those in desperate situations. EMTs are inadequately compensated comparatively, yet they are required to maintain the highest ethical standards and competency standards as other more highly compensated professions in the medical field. EMTs study hard and train hard to obtain and keep their EMT license. If you or someone you love is an EMT or paramedic facing disciplinary action in Missouri, professional licensing attorney Danielle Sanger can help.

Missouri legislature determined the qualification and ethical responsibilities for EMTs in their state. The legislature established a Bureau of Emergency Medical Services (“Bureau”). The Bureau has the authority to review the conduct of licensed EMTs.  The Bureau falls under the purview of the Department of Health and Senior Services (“The Department”). The Department has the power to authorize new licenses, renew licenses, and deny applications for new licenses and renewals. The department is authorized to suspend or revoke licenses as well.

The Department derives its authority from a state statute as well as the Missouri regulations. The Department may discipline an EMT for one or more of many specified reasons. Alcohol and drug consumption if such consumption affects the EMT adversely; being convicted or pleading nolo contendre to criminal charges if the criminal conduct relates to the duties of an EMT or the criminal conduct was fraudulent in nature are two of the reasons the Department may take disciplinary action against an EMT. The Department may also take disciplinary action against the EMT if the EMT becomes incompetent, commits fraud, gross negligence, or violates a professional trust or confidence. Furthermore, the Department is authorized to take disciplinary action on an EMT license if the EMT commits repeated acts of negligence.  The statute and regulations require compliance and cooperation with any investigation into wrongdoing conducted by the Department.

The Department must follow the established administrative procedure under Missouri law before taking disciplinary action. There is an exception. The regulations authorize the Department to take immediate adverse action against EMT and suspend the EMT’s license if the Department finds that there is an “imminent threat to the public health.” The Department must file a complaint with the Administrative Hearings Commission containing those allegations contemporaneous with the decision to suspend the EMT’s license.  The Department must give the EMT proper written notice. The notice must include a statement setting forth the reasoning for the Department’s action. Additionally, the notice must set forth the rights of the EMT to appeal the Department’s decision.

The imminent threat suspension appeal procedure is designed to move quickly. Once the Department files a complaint against the EMT alleging an imminent threat, then the EMT has ten days to appeal that finding to the Department.  The Department must conduct the appeal hearing within ten days of the notice of appeal. The Department’s decision remains in effect until a court or the Administrative Hearings Commission overturns the Department’s decision.

In the normal case, the Department files a complaint with the Administrative Hearings Commission and litigates the case. The EMT enjoys all of the rights a licensee has before the Administrative Hearings Commission. The EMT has the right to proper notice of the allegations, the right to discover the Department’s evidence and then to a fair hearing at which the EMT can cross-examine witnesses and put on evidence in his defense.  The Department has the authority to punish the EMT with a sanction such as a fine, additional educational requirements, probation, or suspend the license for up to three years. The Department may revoke the license as well.

Missouri Professional Licensing Attorney Ready To Help

If you are an EMT or other medical professional facing discipline in Missouri, do not take the allegations lightly. Missouri Professional Licensing Attorney Danielle Sanger will thoroughly investigate allegations of misconduct so that you can put forth the best defense to save your career and your livelihood. Call Missouri professional licensing attorney Danielle Sanger at 785-979-4353 today to schedule your free consultation.

Kansas And Missouri Professional Licensing Attorney Discusses The Complications Surrounding Emergency Medical Responder Ethics

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EMTs, paramedics, and other medical first responders have a high-stress job. EMTs and other “pre-hospital” personnel (collectively EMTs) are highly trained, highly skilled professionals upon whom we relied as a society to treat our sick and injured without regard to race, color, creed, or nationality. They are essentially doctors in the field. We rely upon them to properly and expeditiously treat us when we call them. We expected EMTs to provide accurate medical advice and counseling while maintaining our privacy and protecting our dignity. The responsibility they take upon themselves in choosing the profession is enormous. Treating numerous people in various scenarios creates potential ethical problems for EMTs on a daily basis. Kansas and Missouri professional licensing attorney Danielle Sanger respects their profession and stands ready, willing, and able to defend their licenses should their ethical judgment be challenged.

EMTs respond to thousands upon thousands of calls per year for service across our nation. In 2012, Kansas City, MO fire departments received 58,610 calls for Emergency Medical Services (EMS) alone. Kansas City ranked 21st out of the top 100 cities in the United States for the total number of calls. Given the sheer extraordinary number of patient contacts per year, EMTs must make voluminous, rapid, and correct treatment decisions. Each patient contact is another opportunity to make a mistake, through intentional or unintentional conduct.

EMTs must learn the ethical canons that guide their professional decision making. The ethical canons for EMTs are the same as those medical doctors and nurses must follow. The notion of justice, meaning the medical system must be “fair and reasonable,” guides EMT decision making.  EMTs must follow the idea of beneficence, which is acting in the “best interest of the patient.” Lastly, EMTs must adhere to the philosophy of autonomy, or complying with the patient’s wishes.

Learning and following the EMTs’ ethical mandates appear to be easy to do at first blush, however, successfully implementing the rules in practice is challenging. For instance, the issue of the advanced directive is particularly vexing. A patient’s family member may present the EMT with a “Do Not Resuscitate (DNR)” order, or a living will, or some other document purporting to be the wishes of the patient. EMTs may need to question the authenticity of the document because, absent a clear and unambiguous order, the EMT must perform lifesaving measures. Conversely, if the EMT knows about a valid advanced directive and wishes to honor it, the EMT can become conflicted when a family member begins to question the validity of the document or the true intentions of the stricken.  The scenarios are difficult. The EMT is well advised to perform lifesaving measures in the field and transport the patient to a medical facility for further evaluation and treatment.

An EMT may only treat a patient with their consent. An ethical conundrum occurs when bystander calls for EMS, yet the potential patient has withheld consent to treatment. The EMT must treat the patient if the patient is unable to speak for themselves. However, the EMT must respect the wishes of the patient if the patient understands the situation and the ramifications for refusing, or accepting medical care. Problems occur when the patient has consumed alcohol or has a head injury, which causes cloudy judgment. The EMT is must decide whether providing care is appropriate.

EMTs must also bear in mind that patient confidentiality is paramount. EMTs must take every precaution to avoid disclosing confidential information about a patient. Disclosing patient information can lead to serious ethical problems.

Where To Turn For Help

Kansas and Missouri professional licensing attorney Danielle Sanger dedicates herself to providing professional licensees, like EMTs and other medical professionals, with exemplary and expert legal service. Attorney Sanger understands the commitment licensed professionals make to their callings and uses her skill and ability to protect their livelihood. Call Kansas and Missouri Professional Licensing Attorney Danielle Sanger at 785-979-4353 today to schedule your free consultation.

Kansas Professional Licensing Attorney Examines The Social Worker Turnover Problem At DCF

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Kansas’ Department of Children and Families (DCF) serves children who are in need. Social workers employed by the agency are in great need. In 2015, the agency experienced a nearly 25% turnover of its social workers. The agency’s remaining social workers absorbed the departing social workers’ caseloads.  Social workers already suffer from tremendous stress and are overburdened by enormous caseloads. Losing one-quarter of the workforce in a calendar year causes an ethical dilemma. A social worker is not exempted from ethically performing her duties simply because a social worker has a large caseload. Kansas professional licensing attorney Danielle Sanger represents professional licensees, such as social workers, who face discipline.

The glut of social workers employed at DCF in Kansas created a very dangerous situation for children in need throughout the state. DCF claims that no child faced any danger because of the shortage. DCF recognizes that its failure to offer competitive salaries coupled with social workers working in potentially dangerous situations contributed to the loss of personnel. DCF proposed to fix these problems by providing social workers with mobile devices allowing social workers to complete reports remotely and to contact police if they find themselves in a hazardous situation while investigating cases in the field.

DCF also proposed expanding its ranks to include practitioners of other behavioral sciences. The expanded list includes licensed social workers with a bachelor’s degree, licensed psychologists with a master’s degree, licensed professional counselors, clinical psychotherapists, and certified marriage counselors. DCF workers lauded expanding the list because it alleviated some of the burdens upon existing social workers.

Some questioned the wisdom of expanding the list of behavior scientists beyond social workers. The idea received criticism because commentators questioned the methodology of other professions to perform social work. Psychotherapists and marriage counselors, for example, provide consumers with counseling and therapy, not social work. Social work entails asking tough, probing questions of frequently reticent and uncooperative clientele. Conversely, working for DCF requires social workers to remove children from homes, find placements, and deal with emergency situations. Additionally, social workers are specifically trained by DCF to write reports to be used in court. They are also trained to recognize and possibly diffuse dangerous situations while visiting residences. The other professionals have no training in these matters. Critics of the proposed expansion question whether counselors and therapists practice beyond what their licenses allow.

Kansas Behavioral Sciences Regulatory Board (“the Board”) issues licenses for social workers, psychotherapists, and marriage counselors.  The Kansas Legislature authorized the Board to discipline social workers and other behavioral scientists for unprofessional conduct. Regarding social workers, the Board characterizes unprofessional conduct into approximately 56 different categories. Overburdened DCF social workers can unwittingly commit an act of unprofessional conduct as a result of attempting to juggle an overwhelming caseload. Overburdened social workers easily suffer fatigue leading to a lapse in judgment. Lapses in judgment can violate a social worker’s code of professional conduct.

The Board defines lapses in judgment as unprofessional conduct.  A social worker must recognize and seek treatment for their mental health and emotional problems that interfere with their practice as a social worker. Consequently, if an overburdened DCF social worker’s performance diminishes or their ability to function as a social worker decreases, then the social worker must address the problems. In other words, if a social worker is drowning in work that they cannot meet the needs of a particular client, they must act to rectify that situation. Failing to do so is unprofessional conduct. It is easy to see how a DCF social worker could fall into that trap unwittingly.

Help For Those Who Help Others

If you are a social worker and find yourself facing professional discipline, call Kansas Professional Licensing Attorney Danielle Sanger. Attorney Sanger prides herself on fighting for those people who fight for others. Call Attorney Danielle Sanger today at 785-979-4353 to schedule a free consultation.