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Open Book

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Setting the BAR: The Board self-Assessment Resource


The Board Assessment Task Force created a new tool that will help boards conduct a self-assessment and provide resources to improve performance and advance their missions. This article is based on a presentation by Michelle Sigmund-Gaines and Charlotte Martin at the 2019 FSBPT Annual Meeting as well as a May 2020 webinar by Leslie Adrian.

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Since the Supreme Court ruling in favor of the Federal Trade Commission in the North Carolina Board of Dental Examiners case, regulatory boards are feeling pressure to demonstrate their value and effectiveness, with few ways to do so. Regulators are coming under increasing scrutiny from economists, public policy groups, politicians, and federal and state agencies to demonstrate that regulatory boards are necessary for public protection.

Responding to the current environment and membership’s concerns regarding criticism of occupational licensing boards, deregulation, and board consolidation, the FSBPT Board of Directors formed the Board Assessment Task Force (BATF) in 2018. The board charged the members to explore the development of an assessment tool for a member board to use that would help demonstrate the value of boards and the role that boards have in protecting the public.

Creating the Tool

The task force, listed below, started working early in 2018.

2018 Board Assessment Task Force Members
Charlotte F. Martin, MPA, LA, Chairman
Kathy Arney, PT, NC, Member
Jason Kaiser, CA, Member
Jeffrey Vinzant, AL, Member
Deborah Richardson-Peter, MPA, VI, Member
Michelle Sigmund-Gaines, OR, Member

They presented their initial findings at the 2018 Leadership Issues Forum where attendees discussed functional areas and operational metrics. The dialogue and feedback from the small group discussions were very helpful.

However, the task force members also realized that the opinion of the board’s operations and activities, as they contribute to protection of the public, would vary by stakeholder group and interest. Therefore, the task force identified a comprehensive list of stakeholders:

  • Consumer/public
  • Licensees
  • Government
  • Licensure boards
  • Physical therapist and physical therapist assistant interest groups
  • Payers
  • Consumer watchdog groups
  • Other policymaking groups

Once the comprehensive stakeholder list was complete, the task force began exploring measurements to demonstrate effectiveness. Depending on the stakeholder, these topics could determine whether the stakeholder considered a board effective or ineffective. The task force members continually focused on identifying characteristics of a high functioning board and identified the following broad topic areas for measuring board effectiveness:

  • Board functioning
  • Board finances
  • Licensing
  • Education/prevention/outreach
  • Legislation/rulemaking
  • Discipline/enforcement

The task force kept all of these considerations and recommendations in mind and realized that there were certain themes emerging in terms of how to demonstrate public protection. After much discussion and thought, the task force decided the tool should cover four categories with three areas of best practice in each category.

    • Board Performance
      • Planning
      • Training
      • Reviewing Relevant Documents
    • Outreach and Education
      • Soliciting Feedback
      • Proactively Providing Information
      • Responding to Stakeholders
    • Licensure
      • Qualification of Providers
      • Workforce data
      • Verification
    • Complaint Resolution
      • Publication

Employs Evaluation of Data

Within the tool, each of the sub categories has several questions. The task force decided that the questions should be in a yes/no question format rather than open-ended in order to keep it simple and easy to use. Depending on how the user answers the questions, the system generates different advice and resources.

For example, these are the questions for the section on “Employs Consistent Process” under “Complaint Resolution”:

  • Does the board have a standardized process for board actions?
  • Does the board maintain a historical record of decisions related to violations?
  • Does the board reference a historical record of decisions related to violations?
  • Is the process consistently used?
  • Is the process used transparent to licensees and to the public?

The best practice is for the board to use a transparent, consistent, standardized, objective process to determine the appropriate application of discipline or remediation. If the board answers “no” on any of the questions above, they will get specific, relevant resources to help them move forward to fulfill the complete best practice.

Soliciting Feedback

We sent several members a copy of the tool in print form and asked them to respond to a survey to assess various factors. In general, respondents valued each of the four areas and thought the tool would be useful.

 

Question: In reviewing the draft Board Assessment Tool, the following categories are meaningful regarding the function of my board

Area

Neutral

Agree

Strongly Agree

Board Performance

1

7

7

Outreach and Education

3

7

5

Licensure

0

4

11

Complaint Resolution

0

4

11

 

Questions on Usefulness and Actionability

 

Neutral

Agree

Strongly Agree

A tool of this nature would be useful to my board.

1

6

8

I could use this tool to create an action plan for my board.

0

7

8

Many respondents also had thoughtful feedback on each area that we took into account.

Board Performance

  • “As [an] Umbrella Board, dependent of overall agency to answer/coordinate answers; still meaningful, and in this respect, would show support received from agency.”
  • “Our board is currently working on statutory language changes, trying to make wording more clear and getting rid of language that is no longer necessary.”
  • “This would make the board accountable to the stakeholders by being proactive.”

Outreach and Education

  • “I am not convinced our board does much of this. I am fairly new to this board, so I may be mistaken. I do not believe we are using any kind of tool, survey, etc. soliciting information regarding our performance.”
  • “Our board currently performs this service, but could use other ideas.”
  • “The Board presently receives feedback from a variety of means and does solicit feedback from stakeholders; however, they are often targeted stakeholders. Does give us something to think about as it relates to how the Board can improve upon this. The Board is very proactive and does a great job with disseminating educational information to stakeholders.”
  • “Our Board presents at our state organizational meetings and really tries to be an advocate for our therapists and for public safety.”
  • “This category would help with discussion of information dissemination to our licensees, applicants, association, and students.”

Licensure

  • “It clearly depicts the area being analyzed.”
  • “This is one of the main functions of our board. The Agency has a standard process all boards adhere to.”
  • “The Board does collect some data that can be useful as it relates to workforce data; however, the statutes limit the collection of other information. In addition, there are limited resources to analyze even the data we do obtain. As a result, it is difficult to sometimes see how the data could better inform decision-making and the larger plan and mission of the Board. That being said, the Board and I are putting some thought into ways to begin such an analysis with limited resources.”
  • “As one of the key functions of the Board, this is a helpful category.”

Complaint Resolutions

  • “Our board only meets [two times] per year and has recently been moving toward teleconferences. The Board Administrator is great about setting the agenda to cover any and all complaints. We generally sit down at that time and give a written response. Our timeliness in responding is probably not so great since we only meet [two times]  per year.”
  • “This is one of the main functions of our board. The Agency has a standard process all boards adhere to.”
  • “Also a key function area of Board.”

Using the Tool

The BAR is located in the Members’ Area under Resources & Topic Papers. (If you are unsure of your credentials to access the members’ website, please contact communications@fsbpt.org).

At minimum, the board administrator should complete the BAR and discuss it with board members. However, all board members may desire to complete the tool.

The individual completing the BAR should answer the yes/no questions to the best of their knowledge about the operations of the board. When the assessment is complete, the tool will generate a summative report that may be saved by the user or printed for future reference. However, it is important to note that FSBPT will not store it and the report is not able to be compared to another jurisdiction or region At the completion of the assessment, the tool provides the user with a list of resources to help improve the board in the areas where the board is not currently using best practices.

Going Forward

In using this tool, along with objective metrics, jurisdiction licensing boards may develop a comprehensive plan that will lead to high performance and best practices. This tool is intended to identify areas for improvement as well as demonstrate improvement in performance with subsequent assessments.

We hope member boards find this tool useful. If you have feedback or questions, please contact us.

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Michelle Sigmund-Gaines

Executive Director, Oregon Board of Physical Therapy

Michelle Sigmund-Gaines has served in a leadership capacity in health professional regulation in Oregon since 2008 and as the Executive Director for the Oregon Board of Physical Therapy since December 2017. Michelle has over twenty-five years of experience in organizational governance, information technoloy management, assessment, and instructional design in both the government and education sectors. She currently serves on the FSBPT Board Assessment Task Force.

 

Charlotte Martin, MPA

Executive Director, Lousiana Physical Therapy Board

Charlotte has served as the Executive Director of the Louisiana Physical Therapy Board since 2014. She is the current Chair of the FSBPT Council of Board Administrators (CBA) and Board Assessment Task Force and the former Chair of the FSBPT Foreign Educated Standards Committee. Charlotte is a National Certified Investigator and Inspector through the Council on Licensure, Enforcement & Regulation (CLEAR). Charlotte received a baccalaureate degree from the Louisiana State University (LSU) College of Humanities & Social Sciences in 2004 and a Master’s degree in Public Administration from the LSU E.J. Ourso College of Business in 2008.

 

Leslie Adrian, PT, DPT, MPA

Director of Professional Standards, Federation of State Boards of Physical Therapy

Physical Therapy (FSBPT) since 2008. Her education includes a Doctor of Physical Therapy from Shenandoah University, Master of Science in Physical Therapy from Ithaca College, and a Master of Public Administration from Virginia Tech. Leslie has over ten years of professional regulatory experience with both the American Physical Therapy Association and FSBPT. Leslie was part of the planning and development staff for the origin and fruition of the Physical Therapy Compact. Leslie’s responsibilities include responding to the needs and requests of member state boards, researching and authoring resource papers, tracking legislative and regulatory activities relevant to physical therapy, and developing standards for internationally educated physical therapists.