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www.bocatc.org 1 Representation in the healthcare profession matters. As members of the athletic training community, we are all vested in efforts around reimbursement, legislation and recognition by others in the healthcare profession. One way for the athletic training community to increase this representation is by acquiring National Provider Identifier (NPI) numbers. According to the NATA, only about 35% of Athletic Trainers have their NPI – yet acquiring it is a quick process that lends credibility to the individual and the profession. “There is definitely strength in numbers. Using NPI statistics gives ATs more power in legislative, regulatory and healthcare initiatives, increasing our value as allied healthcare providers,” said Kathy I. Dieringer EdD, ATC, LAT, in a BOC blog post. Dieringer said legislators, regulatory agencies and insurance companies all use the NPI database to determine market penetration of healthcare providers. Increased representation in the database increases Athletic Trainers’ power in these market studies. It’s also important to remember that all electronic health records require the Athletic Trainer to identify themselves with their NPI number. This is a HIPAA requirement. In addition, NPIs are also essential when billing third party payers for services performed by a healthcare provider. If a claim is submitted to an insurance company by an Athletic Trainer with no NPI, the claim will be rejected, said Dieringer. Here, we answer a few common questions about the NPI. Read on to find out how an NPI helps you, instructions for getting one and more. Featured Stories • Help! How Do I List My Credentials? • Task Force Discusses Maintenance of Competence • More Activities Will Count for EBP CEUs • Exam Confidentiality • In-Depth Look: An AT in an Orthopaedic Clinic • Featured BOC Approved Provider: Postural Restoration Institute • Updates Made to BOC Standards of Professional Practice • And More! EvEry AThlETic TrAinEr should hAvE An npi A PUBLICATION FROM THE BOARD OF CERTIFICATION SUMMER 2016 CERT UPDATE FOLLOW US: BLOG (Continued on Page 15) “Using NPI statistics gives ATs more power in legislative, regulatory and healthcare initatives.”2 SUMMER 2016 The BOC has the only accredited certification program for ATs in the US. Since 1982, the BOC has been continuously accredited by the National Commission for Certifying Agencies (NCCA). The BOC must undergo review and reaccreditation every 5 years through the NCCA, which is the accreditation body of Institute for Credentialing Excellence (ICE). The Board of Certification, Inc. (BOC) has been responsible for the certification of Athletic Trainers (ATs) since 1969. The BOC was the certification arm of the professional membership organization the National Athletic Trainers’ Association (NATA) until 1989 when the BOC became an independent non-profit organization. BOC Vision: The BOC exists so that healthcare professionals worldwide have access to globally recognized standards of competence and exceptional credentialing programs that support them in the protection of the public and the provision of excellent patient care. BOC Mission: To provide exceptional credentialing programs for healthcare professionals to assure protection of the public. BOC Values: Integrity, Professionalism, Fairness, Transparency, Service HELP! How Do I List My Credentials? Background Proper treatment of degrees, licenses and credentials has been a source of confusion and misuse for years. Many Athletic Trainers are unsure how to list or abbreviate the qualifications that follow their names. Consistency in how ATs identify themselves alleviates confusion and lends credibility to the profession. The following is intended to provide clarity as you identify yourself in signatures, business cards, letterhead or any other written format. Guidelines A 2003 article by Ken Knight, Chad Starkey and Chris Ingersoll* established guidelines for displaying degrees, licenses and credentials, and this information is still valid today. The article says it is proper to list academic degrees first, licenses second and credentials last. Here, credentials include BOC certification. For instance, an AT holding a master’s degree and working in a state where licensure is not required should write, “Sally Snow, MS, ATC” – not “ATC, MS.” The same AT working in a state with licensure would correctly write, “Sally Snow, MS, LAT, ATC.” What do these qualifications mean? Licensure provides a legal right to practice, while certification, which is voluntary, states that a professional body – in this case, the BOC – has determined that your knowledge and skills have met a pre-determined standard. If you use more than one credential, list them in order of difficulty of obtaining them. With credentials of similar difficulty, such as ATC and PT, list them in chronological order. Common Errors and Exceptions Because confusion has persisted over the years, we know of several common errors. One error involves listing licensure and certification as a single abbreviation; such incorrect examples include ATC/L, LATC and ATC/R. The first example implies that certification is more important than licensure, which is not the case. The second and third examples improperly append the ATC ® credential, which is a registered trademark and cannot be modified. Two exceptions exist: • Wisconsin, by state law, does not allow you to use ATC ® ; the law specifies the use of LAT • And in Texas, everyone is an LAT because not all Texas ATs have to be certified. Texas has its own set of requirements to earn a license, BOC certification and/or the Texas licensing exam As far as BOC and our protection of the credential, we do not regulate against the improper treatment of licensure and regulation. However, we do regulate against those who use the ATC ® credential and are not currently certified. Finally, we offer one more note on usage. Despite the common misconception, ATC is not a noun. An AT is the person who holds the credential, while ATC is the credential. For this reason, it would be inappropriate to say, “Bob Jones is the ATC for the Cardinals.” Instead, it is correct to say, “Bob Jones is the AT for the Cardinals.” *Access the article at www.bocatc.org/ats/market-your- certification, and click on the “Public Relations” tab. boc newswww.bocatc.org 3 Susan McGowen, PhD, ATC President PResIDenT’s LeTTeR BOC BOARD 2016 Officers President Susan McGowen, PhD, ATC Vice President Erin Cramer, MS, PA-C, ATC Treasurer Jan Lauer, MA, ATC Athletic Trainer Director Jim Malseed, MEd, ATC, RAA Athletic Trainer Director Russell McKune, MS, ATC Athletic Trainer Director Patrick Sexton, EdD, ATC Athletic Trainer Director-Elect Kimberly Detwiler, MS, LAT, ATC, CSCS Corporate/Educational Director Ed Christman, AT Ret. Physician Director Douglas Gregory, MD Public Director Amy DeRosa This is an exciting time to be part of the athletic training community. Because of your work every day, Athletic Trainers have reached new levels of recognition. The BOC Board of Directors has 4 strategic priorities: 1. BOC’s examination and certification are accredited and their processes are recognized as the industry standard of initial and ongoing competence, practice and ethics. 2. Legislative, public policy and oversight agencies recognize the value of BOC certificants. 3. Collaboration among organizations fosters excellence in the athletic training profession. 4. Certification candidates/applicants have clear pathways to achieve certification at a reasonable cost. Below are a few key updates on the BOC priorities. The Board approved revisions to the Standards of Professional Practice. We are grateful to those who participated in the open comment period last summer. We received over 1,000 public comments and your input helped revise the Standards. The revised Standards will be effective September 1, 2016. The Board also took action to expand the EBP opportunities. Further information can be found on page 5. The Maintenance of Competence (MOC) Task Force met for the first time on April 1-2. This group, pictured on page 5, was charged with and made great progress on the initial objective: Identifying strategies that allow ATs to demonstrate maintenance of competence beyond accumulation of CE credit alone. The group has representation from a variety of professional settings, including the Strategic Alliance, which is a demonstration of our commitment to collaboration as stated in Priority 3. The task force is working to present a draft report to the BOC Board in fall of 2016. We will publish updates as this group continues their work, and at the appropriate time there will be an opportunity for public comments. The BOC has been very active on the regulatory front advocating for the value of BOC certification and the certified/ licensed AT. In order to strengthen our legislative efforts, the BOC became a voting member of Federation of Associations of Regulatory Boards (FARB). FARB’s mission is to advance excellence in regulation of the professions in the interest of public protection. FARB member boards represent almost 12 million licensees. Athletic Trainers are not the only professionals whose regulation is being challenged in legislatures across the country. FARB and its member boards have supported our efforts on the “Great minds discuss ideas; average minds discuss events; small minds discuss people.” -Eleanor Roosevelt (Continued on next page)4 SUMMER 2016 regulatory front by educating legislators and regulators on the importance of state licensure. A summary of our regulatory activities is on page 6. BOC Board Elections This past March we welcomed Kimberly Detwiler as the new BOC AT Director- elect. She will take office in January 2017, following a period of mentorship and learning. One of the key responsibilities of the Board is to ensure representation of the certificants we serve. This fall, the BOC Nominating Committee will be charged with identifying candidates for 2 AT Director positions, based upon qualifying characteristics set forth by the Board. Then, you, as a BOC Certified Athletic Trainer, vote to select which candidates serve on the BOC Board of Directors. We encourage Athletic Trainers who have previous experience in leadership roles to apply for these positions. The full call for candidates and candidate information packet is available on the BOC website. The period for AT Director nominations and applications is open until July 5, 2016. BOC Paul DeMartinis Public Advocacy Award The Board approved changing the name of our Public Advocacy Award. Next year, when the award is given at the BOC Regulatory Conference, it will be the BOC Paul DeMartinis Public Advocacy Award. The award is designed to recognize an individual, group or organization who has demonstrated leadership in the conception, construction and/or modification of Athletic Trainer regulation that protects the public and athletic training consumers. Paul’s constant reminder to the Board was to remember the BOC’s responsibility to “protect the public.” There are many of you who are doing wonderful work in the regulatory arena, and we hope you will put forth a nomination for next year’s award. The BOC stands ready to assist everyone who is working in this area. Commitment to Quality On behalf of the Board I want to thank you for your commitment to providing quality healthcare services to your patients, athletes and clients. The BOC Board of Directors and staff are committed to providing you with timely information that we trust will be beneficial to you as a practitioner, educator, BOC Approved Provider, or member of the public and regulatory communities. Be Certain.™, as the BOC vision states: The BOC exists so that healthcare professionals worldwide have access to globally recognized standards of competence and exceptional credentialing programs that support them in the protection of the public and the provision of excellent patient care. The BOC is dedicated to providing quality service. Please contact us with your questions and comments. President’s Letter (Continued from previous page.) Independence Day | July 4 Labor Day | September 5 Thanksgiving | November 24-25 Winter Holiday | December 26, 2016 - January 2, 2017 2016 BOC Holiday Closures boc newswww.bocatc.org 5 boc news The BOC is dedicated to a quality certification program that helps ATs maintain their competence and use best practices throughout their career. Certification maintenance requirements assure the ATC © credential is a sign of quality. Because healthcare is a dynamic field, we continuously seek to provide innovative ways for the AT to develop and maintain competence. For example, more than 500 ATs have volunteered to participate in a pilot study of an Athletic Trainer Portfolio system. The system will help ATs identify and design a personalized CE experience. Additionally, the BOC Board of Directors has commissioned a Maintenance of Competence Task Force, which began meeting this spring to develop recommendations that will be open for public comment. This task force has been charged with the following: • Identifying strategies that allow ATs to demonstrate maintenance of competence beyond accumulation of CE credit alone • Recommending enhancements of the current certification maintenance system, which will allow ATs to maintain their competence through varied educational and assessment activities • Identifying the components of the self-assessment module(s) and the subject matter areas that can be offered for future CE credit Please watch for developments in the months ahead. We will keep you informed via Cert Update, email and our website as these conversations develop. Members of the Maintenance of Competence Task Force include, from left, Larry Cooper, John Parsons, Anita James, Eric Fuchs, Gail Samdperil, Tom Woods, Michael Goldenberg, Kim Terrell, Dr. Doug Gregory, Kent Scriber, Stacy Walker, Dr. Jim Kinderknecht and Kitty Newsham. New activities will qualify for Evidence Based Practice (EBP) CEUs during the 2016-2017 reporting period. The expanded list will help ATs receive credit for activities that rely on EBP principles but were not previously counted under this category. At right is a list of these activities. ATs can search the BOC’s new online directory to find all BOC approved home studies and live events, including EBP Category programs. The directory is continuously updated. Complete information on eligible EBP Category programs is available in the 2016-2017 Certification Maintenance Requirements document. New Ways to Earn EBP CEUs Qualifying journal quizzes that were previously counted in Category A Accreditation Council for Continuing Medical Education (ACCME) Category 1 CME programs offered by BOC Approved Providers Authorship of a peer-reviewed journal article addressing patient-oriented clinical research or translational research Post-certification coursework from a CAATE accredited AT post professional program Accredited medical or healthcare provider residency or fellowship with a focus closely related to athletic training Graduate of a PhD/EdD/DSc/DAT program may qualify if dissertation has a narrow focus of athletic training More Activities Will Count for EBP CEUs Task Force Discusses Maintenance of Competence6 SUMMER 2016 State RegulatoRy NEWS The BOC tracks state and federal regulatory action affecting the athletic training profession. In recent legislative sessions, states have brought or considered 196 bills that mention athletic training or ATs. At the federal level, 6 relevant bills have been considered. Following is a summary of bills the BOC has recently supported or opposed. Florida: Important Update Regarding Athletic Training Licensure During the 2015 Legislative session, CS/HB 541 passed, which affects the licensure requirements for the Athletic Training profession. Effective July 1, 2016, any new applicant must submit to a background screening. Applicants must also pass the national examination to be certified by the Board of Certification. An approved Livescan service provider must be used to electronically submit a set of fingerprints to the Florida Department of Law Enforcement (FDLE) to conduct a search for any criminal history records that may pertain to the applicant. See www.bocatc.org/RegNews for complete details. State and Bill Number Action Arizona • BOC was notified by the Arizona Board of Athletic Training of potential legislation that would, among other items, repeal AT licensure • BOC sent a letter opposing the AT provision of the bill • ATs were successfully taken out of the bill • Licensure remains a requirement for ATs in Arizona Colorado SB161 • Bill drafted to keep registration • If bill is not passed, ATs will no longer be regulated as of July 1, 2016 • BOC sent a letter of support of registration • Bill has passed the Senate and the House and, as of press time, was awaiting the governor’s signature Connecticut SB00356 • Bill drafted to update AT practice act and allow ATs to practice to the full extent of their education and training • BOC sent a letter of support • Bill received a favorable fiscal analysis report Illinois HB6231 SB2742 • Bill drafted to update AT practice act and allow ATs to practice in settings not included in the current practice act • BOC sent a letter of support • Unrelated to the bill, the department sent BOC draft of updated rules • BOC reviewed the rules and provided feedback Minnesota HF3038, SF2609 • Bill drafted to update AT practice act and to go from registration to licensure • BOC sent letter of support • Bill to be carried over to the next legislative session Mississippi• Updated rules were proposed and the BOC provided feedback New Hampshire HB1213 • Bill introduced to repeal AT law • BOC sent letter of opposition • The bill failed North Carolina • Bill drafted to repeal AT law • BOC sent letter of opposition • Senator Wells replied to our letter with questions, and the BOC responded • Bill has been put on hold for further investigation; with a short session, the bill will likely be revisited in 2017 North Dakota • Board requested assistance with online licensure renewal process • BOC submitted a proposal, which has been accepted Utah• Rules were proposed for clarification regarding direction of a physician • BOC submitted a letter to the Division of Occupational & Professional Licensing (DOPL) and its counsel supporting a clarification • It was determined that a rule change was not necessary; rather a clarification was noted in meeting minutes Washington• Updated rules were proposed, and the BOC provided feedback sTATe ReGULATIonwww.bocatc.org 7 sTATe ReGULATIon Professional Practice and Discipline The Professional Practice and Discipline Committee is responsible for the oversight and adjudication of the BOC Standards of Professional Practice, which consist of the Practice Standards and the Code of Professional Responsibility. The Committee has jurisdiction over all BOC Certified ATs and current and prospective BOC exam applicants. This is a summary of the violations that were reported and decided by the Committee from September 11, 2015, to April 12, 2016. BOC Exam Applicants/Candidates • 10 Candidates failed to provide the BOC with accurate information in regard to their exam applications (Code 3.7); all provided incorrect graduation dates • 67 Candidates were found guilty of taking action(s) that led to or may have led to a conviction (Code 3.11) and were: o granted exam eligibility and if necessary placed on probation for a period of 3 years once certified (65) o granted predetermination of eligibility (1) o granted exam eligibility and proof of completion of ethics course prior to certification (1) BOC Certified Athletic Trainers • 3 ATs failed to comply with the most current BOC recertification policies and requirements (Code 2.3) and were issued the following disciplinary action(s): o private censure (2) o private censure and ethics course (1) • 33 ATs failed to comply with the most current BOC recertification policies and requirements (Code 2.3) and were not candid, responsible and truthful in making any statement to the BOC, and in making any statement in connection with athletic training to the public (Code 3.9) and were issued the following disciplinary actions: o private censure (13) o private censure and audit of the 2014-2015 CE reporting period (5) o suspension and have since reinstated to certified (2) • Jeremy Cleveland (080102039) • Chad Martin (060702072) o suspension (15) • Deanna Clark (2000005164) • Timothy Conley (000100448) • Meghan Dwyer (2000004076) • Roni Emert (060602171) • Suzanne Francingues (060002040) • Anthony Inzirillo (2000010710) • Yasuhiro Kitagawa (2000002538) • Kristina Lash (100702065) • Joshua Lee (120602579) • Sheri Martinelli (000010833) • Kyle O’Day (020302249) • Jose Paniaqua (060402599) • Jill Russell (010102019) • Tommi Seedorf (2000002531) • Jason Wolf (070802366) • 24 ATs failed to comply with state law pertaining to the practice of athletic training (Code 3.2); and were found guilty of practicing without a state license for a period of time. They were issued the following disciplinary actions: o private censure (17) o private censure and/or an ethics course (5) o public censure and an ethics course (2) • Michael Evans (069702628) • Brandon Holland (050602009) • 4 ATs failed to comply with applicable local, state and/ or federal rules, requirements, regulations and/or laws related to the practice of athletic training (Code 3.2) and were found guilty and/or did not contest taking action(s) that led to or may lead to a conviction (Code 3.11). They were issued the following disciplinary actions: o private censure and ethics course (1) o suspension (3) • Justin Anlauf (080602148) • Justin Blankenbecler (2000004480) • Melinda Ilg (010702014) • 1 AT failed to comply with applicable local, state and/ or federal rules, requirements, regulations and/or laws related to the practice of athletic training (Code 3.2), failed to report any suspected or known violation (Coder 3.5), did not report a criminal conviction (Code 3.6) and for actions that led to a conviction (Code 3.11). The AT was issued the following disciplinary action: o private censure and ethics course (1) • 9 ATs were found guilty and/or did not contest taking action(s) that led to or may lead to a conviction (Code 3.11). They were issued the following disciplinary actions: o suspension (2) • Donald Bills (119202412) • Christopher Patterson (2000003148) o private censure and probation (7) • 7 complaints were submitted regarding an AT. The statuses of these complaints are as follows: o pending (1) o dismissed for insufficient evidence (3) o included in numbers above for disciplinary action taken (3) • 16 cases were dismissed The BOC posts all public disciplinary actions on the online Disciplinary Action Exchange (DAE). The DAE is also available to states to post state regulatory disciplinary actions. If any member of the public (BOC Certified Athletic Trainer, employer, consumer, etc.) feels that an individual has violated one or more of the BOC Standards of Professional Practice, he/she can file a complaint. The online complaint form can be found on the BOC website at www.bocatc.org. Notice: The BOC recently updated the BOC Professional Practice and Discipline Guidelines to include secure electronic delivery as a means of sending notices to ATs or candidates involved in a discipline matter. Please see the full document on the BOC website. The new delivery option will be effective September 1, 2016.8 SUMMER 2016 cAnDIDATes Sometimes, fellow students may be a good resource for learning about questions on previous exams. This is not the case when preparing for the BOC exam. Whether you are an exam candidate or you have already earned your BOC certification, remember it is illegal and unethical to memorize and share questions that appear on the BOC exam. Doing so can jeopardize your ability to practice as an Athletic Trainer. On the day of the exam, candidates must agree to the Candidate Attestation statement. This is a confidentiality agreement asserting that no part of the exam may be copied or reproduced in any way before, during and after exam. This includes, but is not limited to, emailing, copying or printing of electronic files, reconstructing content through memorization and/or dictation. In the confidentiality agreement, you agree to not discuss the exam questions and/or answer options with anyone at any time. “Anyone” includes, but is not limited to: • Past or future examinees • Educators • Co-workers • Test preparation companies Any violation of the confidentiality agreement is also a violation of the BOC Standards of Professional Practice and may result in disciplinary action, assessment of monetary damages and legal liability. Please protect yourself and your colleagues, and abide by the confidentiality agreement. More information is available in the BOC Exam Candidate Handbook. Sharing is good, but not when it comes to the BOC exam. When you sit for the BOC exam, you agree to keep all content confidential – meaning you agree you will not copy, reproduce or even memorize and repeat exam questions. Violating the confidentiality agreement could jeopardize your current or potential BOC certification. It could do the same for your colleagues. Protect yourself. Don’t share exam content. ExAM CONFIDENTIALITy: Protect Yourself and Your Peers Shhhh… Photo: Brian Tomlinson, Flickr The first BOC Paul Grace Scholarship will be awarded at the 67th NATA Clinical Symposia and AT Expo in June. The Board approved this new scholarship in honor of past BOC Executive Director Paul Grace (1981-1997). Paul was instrumental in the BOC certification program achieving national accreditation. Congratulations Paul! First Paul Grace Scholarship to be Awardedwww.bocatc.org 9 ATHLeTIc TRAIneR FeATURe Describe your setting: I am a Clinic Coordinator and work as an AT for Dr. Peter Millett at The Steadman Clinic in Vail, Colorado. The Steadman Clinic delivers orthopaedic care whether the patient is an injured professional athlete or wants to be able to walk again without pain. The clinic specializes in knee, hip, shoulder, elbow, hand, spine, foot and ankle injuries. How long have you worked in this setting? I have worked in this setting for 3 years. Describe your typical day: I usually arrive around 7:00am or 7:30am and begin preparing for clinic or surgery. This typically involves reviewing the patients for the day and making sure we have all notes and images we need for their visit. If we are having a clinic day, we usually start by seeing the patients who had surgery the prior day either in physical therapy or in the hospital to make sure they are ready to go home. We then start clinic around 8:30am. My main responsibilities include seeing the patients initially, formulating a differential diagnosis for new patients and determining how surgical patients are recovering from their surgery. I then go in with Dr. Millett and see the patient and coordinate any follow-up care the patient may need, including MRI, labs or surgery. We also have another AT and 2 Physician Assistants (PAs) who do the same thing. We typically see 30 to 40 patients per day. At the end of the day, I make sure there are no outstanding issues such as MRI authorizations, patient phone questions and missing notes. After that, I dictate about all of the patients I saw that day. On surgical days, I get in about the same time and help make sure we are ready for all of our cases for the day. We typically do 7 to 10 cases a day. We make sure the patients know what procedure we are performing and that they are comfortable with the procedure. We also go over post- operative pain management medications to make sure there are no contraindications to the medications. I then either scrub in and act as a first assistant in surgery or I stay in clinic and catch up on paperwork. That way I’m available for patients who call in with questions or concerns. What do you like about your position? I like being on a team of healthcare professionals who include orthopedic surgeons, PAs and ATs. I also enjoy that we have a fellowship program for both ATs and physicians, with whom we can exchange knowledge. What do you dislike about your position? The insurance industry is getting harder and harder to get approval from in a timely manner. As a clinic, we try to get patients everything they need within 24 hours. Unfortunately, insurance companies do not always see it that way. What advice do you have about your practice setting for a young AT looking at this setting? I would advise young ATs to get some experience prior to coming to this setting. This is still a relatively new setting and role for our profession. We need to be very knowledgeable of injuries and be able to diagnose independently and confidently. IN-DEPTH LOOk: an at in an orthopaedic Clinic Athletic Trainer Joe Cygan Joe Cygan, MS, ATC, OTC, RMSK is a Clinic Coordinator for an orthopaedic clinic. In this role, he works as an AT and extends the services of the physician in an orthopaedic clinic.Next >