David Relling, PT, PhD
The FSBPT Finance Committee finalized their review of the proposed 2024 FSBPT budget and provided their recommendations to the FSBPT Board of Directors earlier this month. The board followed with its own review and then approved the FSBPT budget for 2024. The budget was distributed to the Council of Board Administrators with a request to share the information with the jurisdictional board members and delegates. The budget review and approval process are centered on the fiduciary responsibility of each member of the FSBPT Board. The fiduciary responsibility of the board is very important; however, a fiduciary mode is also just one part of the governance triangle as described by Richard P. Chait and colleagues in the book Governance as Leadership. The authors propose there are three modes to effective governance: fiduciary, strategic, and generative.
The members of the board perform their fiduciary role by acting on behalf of FSBPT members to pursue the mission of the organization by, individually and collectively, following the duty of care, duty of loyalty, and duty of obedience. The duty of care involves making decisions in the best interest of the organization after reviewing materials and asserting a level of care that a prudent person would use in a like position and within a similar situation. The duty of loyalty is most often related to conflicts of interest. A board member must acknowledge any conflicts of interest and put the interests of the organization before any personal or professional interests. The duty of obedience addresses the stipulation to follow any legal requirements along with the FSBPT bylaws and policies. The budget review process is part of the annual governance steps at FSBPT. If you are interested in learning more about the components of the annual governance process, please contact a member of the board. Additionally, I recommend reading Nancy Kirsch’s outline of the FSBPT annual governance and fiduciary role in her Spring 2019 President’s Perspective for the FSBPT Forum.
The strategic mode of governance is grounded in the relationship among the FSBPT Board, staff, and membership. This year, the board and staff will develop a strategic plan for the next three to five years. A substantial amount of data will be collected and reviewed in preparation for strategic planning. Information from similar organizations, the regulatory environment, and nonprofit organizations will be combined with trends in the physical therapy profession and higher education. The board has garnered important member input through the 2023 membership survey, member board staff strategic planning, Leadership Issues Forum, and Annual Education Meeting. FSBPT will leverage consultants to assist with the strategic planning meeting to facilitate discussion, identify areas of concern, extract opportunities to advance, and fully engage each attendee in honing the strategic goals. The strategic plan goals will help guide the organization’s accomplishments and initiatives for the next few years.
Finally, during the generative mode of governance, the organization analyzes cues and data through various frames of reference, then applies retrospective thinking to achieve a “sense making” state. The board and staff gather information from the membership and then work together during the “sense making” process to develop major—sometimes audacious—goals and objectives to support the organization's mission. An example of the substantial impact of this generative process on the FSBPT mission is the enhancement of the Exam, Licensure, and Disciplinary Database (ELDD) through the creation of the Physical Therapy Licensure Compact and jurisdictional grant program. The initial cues and data leading to the consideration of the PT Compact came from our member jurisdictions. There were questions about licensure portability and increasing public access to physical therapy services while also addressing growing scrutiny of professional licensure. At the same time, member jurisdictions were seeking pathways to fully participate in the ELDD but faced procedural, financial, and technical barriers.
A generative mode of governance that engaged jurisdictional members and fostered stakeholder collaboration birthed the PT Compact, the FSBPT ID, an invigorated FSBPT grant program, and an application programming interface (API). The PT Compact provides licensure portability through a privilege to practice that is both efficient and supportive of state-based regulation. The PT Compact enhances the ELDD by using the FSBPT ID instead of the social security number as the licensee’s unique identifier. The FSBPT ID addresses security concerns around the use of social security numbers and provides greater accuracy and reliability of the ELDD with more frequent sharing of data. Prudent fiscal management from reduced travel and in-person meetings due to the pandemic provided an opportunity to invigorate the FSBPT jurisdictional grant program. The grant funds to jurisdictions have supported implementation of the FSBPT ID, increased reporting of jurisdictional data using API technology, added PT Compact information to websites, and enabled workforce data collection. The jurisdictional grants have resulted in substantial enhancements to public protection through the ELDD. The use of the FSBPT ID as the unique identifier increased from zero to twenty-eight jurisdictions; at least weekly licensure file updates from member jurisdictions increased from zero before the PT Compact to thirty-seven; timely disciplinary action reporting increased from sixteen states prior to the PT Compact to thirty-eight states currently. Notably, the funded API implementation over the past two years has resulted in nearly 140,000 licenses being added or updated at least once through the API, including the automation of licensure file updates that has allowed eight jurisdictions to provide daily updates and one state updating every thirty minutes. FSBPT grant funding remains available to enhance the ELDD through the FSBPT ID, API implementation, programming and technological upgrades, and workforce initiatives.
The application of fiduciary, strategic, and generative modes of governance provides opportunities for successful collaboration between jurisdictional members, FSBPT Board and staff, and external stakeholders. These types of collaborations provide opportunities to set and pursue “audacious” goals like the PT Compact and enhancing the ELDD. Progress toward unifying goals, such as enhancing the ELDD highlights the benefits to jurisdictions and FSBPT, but most importantly, pursuing major goals supports our collective mission to protect the public.