Chapter A3 – Article 10. Investigations, Discipline, Suspension, or Revocation

Sec. A3.10.010. Investigating Complaints.

The Board may investigate the conduct or professional performance of a certified behavioral health aide or practitioner, community health aide or practitioner, or dental health aide. Upon receipt of a formal written complaint to the Board or any of its members, or if the Board becomes aware of information sufficient to justify an investigation regarding professional conduct, the Board may appoint an Inquiry Panel to investigate, subject to the consent and approval of the Area Director of the Alaska Area Native Health Service (AANHS).

Sec. A3.10.020. Inquiry Panel.

An Inquiry Panel of the Board shall be comprised of four (4) appointed members of the Board, with the AANHS federal representative to the Board serving as the Presiding Official for the Inquiry Panel. The Inquiry Panel shall have at least one member that shall be in the same general professional discipline as the individual who is the subject of any written complaint or investigation on behalf of the Board.

The purpose of the Inquiry Panel is to investigate formal written complaints or information regarding professional conduct, and to make recommendations to the full Board regarding possible discipline or other actions that may be appropriate to be taken by the Board.

1. the Presiding Official shall oversee the Inquiry Panel, including establishing meeting dates/times, handling requests for information from complainants/subjects of any complaint, or other parties, conducting the investigation, presiding over and participating in deliberations, and submitting any recommendations [written report] to the Board.
2. to the extent any member of the Board has an interest that may conflict with their duties on the Inquiry Panel, including an affiliation with a tribal health organization or entity that may be involved in any complaint or investigation, including as employer of any subject of an investigation, that individual Board member shall not participate as an Inquiry Panel member. To the extent any additional steps are necessary to avoid a conflict of interest or the appearance of a conflict of interest, the Board member should consider whether it is appropriate to take additional steps including recusal for purposes of considering any potential recommended discipline or further Board action.
3. A majority of Members of the Inquiry Panel (3) shall constitute a quorum and shall be sufficient to take any action consistent with the Standards and Procedures regarding any investigation.

Sec. A3.10.030. Grounds for Discipline.

The Board may investigate and impose a disciplinary sanction under this chapter on a person holding a certificate under these Standards if the Board finds that the person engaged in any of the following, including but not limited to:

1. secured a certificate through deceit, fraud, or intentional misrepresentation;
2. engaged in deceit, fraud, or intentional misrepresentation in the course of providing professional services or engaging in professional activities, including holding themselves out as another health provider for which they have not met applicable licensing or other credentialing requirements;
3. failed to surrender the certificate if required to do so under section B1.10.050, C1.10.050, D1.10.050 [surrender of a certificate];
4. has been convicted of a felony or other crime that affects the certified behavioral health aide or practitioner’s community health aide or practitioner’s, or dental health aide’s ability to continue to practice competently and safely;
5. intentionally or negligently engaged in or permitted the performance of patient care by persons under the certified behavioral health aide or practitioner’s, community health aide or practitioner’s, or dental health aide’s supervision that does not conform to minimum professional standards regardless of whether actual injury to a patient occurred;
6. failed to comply with any requirement or order of the Board applicable to the certified behavioral health aide or practitioner, community health aide or practitioner, or dental health aide, including failure by any behavioral health aide or practitioner, community health aide or practitioner, or dental health aide to participate in an investigation conducted consistent with the Standards and Procedures;
7. continued to practice after becoming unfit due to:
   1. professional incompetence;
   2. failure to keep informed of current professional practices;
   3. addiction or dependency on alcohol or other drugs that impair the ability to practice safely; or
   4. physical or mental disability;
8. engaged in lewd or immoral conduct in connection with the delivery of service to patients;
9. engaged in unprofessional conduct, including having:
   1. failed to use sufficient knowledge, skills or judgment for the behavioral health aide or practitioner’s, community health aide or practitioner’s, or dental health aide’s level of certification;
   2. assumed duties and responsibilities:
      1. without sufficient preparation;
      2. for which competency has not been maintained;
      3. for which the behavioral health aide or practitioner, community health aide or practitioner, or dental health aide, is not certified, provided that such duties were not assumed as part of meeting the requirements for the next level of certification;
      4. for which the behavioral health aide or practitioner, community health aide or practitioner, or dental health aide has not been trained through training described in sections B2.20.100 [BHA I training, practicum, and experience requirements] through B2.30.010 [BHA/P knowledge, skills, and scope of practice], 20.100 [CHA I training and education requirements] through C2.20.510 [CHP Competencies], or D2.20.100 [PDHA I: education and preceptorship] through D2.20.700 [DHATP: prerequisites and credentialing], as applicable, or continuing education approved under chapter B-3, C-3, D-3, provided that the behavioral health aide or practitioner, community health aide or practitioner, or dental health aide may provide services under this paragraph only at the direction of their employer; or
      5. a behavioral health aide or practitioner, community health aide or practitioner, assigned to be available on-call failed to respond to an emergency;
   3. knowingly delegated a behavioral health aide or practitioner, community health aide or practitioner, or dental health aide function to another who is not certified to perform that function;
   4. violated the confidentiality of information or knowledge concerning a patient;
   5. physically or verbally abused a patient;
   6. performed duties as a behavioral health aide or practitioner, community health aide or practitioner, or dental health aide while under the influence of alcohol, illegal drugs or any other substance likely to impair the behavioral health aide or practitioner’s, community health aide or practitioner’s, or dental health aide’s ability to provide competent care;
   7. violated state or federal laws regulating drugs, including but not limited to forging prescriptions or unlawfully distributing drugs or narcotics;
   8. failed to maintain a record for each patient which accurately reflects the patient encounter and interventions provided, or falsification of a patient’s records or intentionally making an incorrect entry in a patient’s record;
   9. left a clinic assignment without properly notifying the appropriate personnel;
   10. failed to report, through proper channels, facts known to the behavioral health aide or practitioner, community health aide or practitioner, or dental health aide regarding incompetent, unprofessional or illegal practice of another healthcare provider;
   11. signed a record as a witness attesting to the wastage of controlled substances which the behavioral health aide or practitioner, community health aide or practitioner, or dental health aide did not actually witness;
   12. exploited a patient for financial gain or offering, giving, soliciting, or receiving fees for referral of a patient;
   13. was responsible for untruthful or misleading advertisement of available services;
   14. knowingly violated laws regulating health insurance or the potential for health insurance reimbursement;
   15. been found guilty of, or entered a plea of nolo contendere or guilty to, any offense under Federal, State or Tribal law involving crimes of violence; sexual assault, molestation, exploitation, contact or prostitution; or crimes against persons within the meaning of section 408 of the Indian Child Protection and Family Violence Prevention Act, P.L. 101-630, 25 U.S.C. § 3207;
   16. failed to comply with applicable mandatory reporting laws of the State of Alaska; or
   17. failed to respond to a request for services where a duty to respond existed.

Sec. A3.10.040. Process for Conducting an Inquiry.

Upon assignment, the Inquiry Panel shall provide notice of the nature of the complaint or investigation to the subject of any inquiry and shall provide the subject an opportunity to respond. Any investigation shall be intended to inform the Board regarding details necessary to conduct its duties under the Standards and Procedures. An inquiry is intended to be investigatory as opposed to punitive or non-punitive.

The Inquiry Panel may gather and review relevant information as necessary, including but not limited to statements by witnesses or other knowledgeable individuals; any Board monitoring activities; letters of complaint; incident reports; pertinent medical records, reports, recommendations, or evaluations of any supervisor or peer review; any prior professional review or disciplinary actions; and any provider statements.

In general, the process for conducting an investigation shall be conducted as expeditiously as possible.

Sec. A3.10.100. Behavioral Health Aide or Practitioner, Community Health Aide or Practitioner, Dental Health Aide Sanctions.

If the Board, following any investigation or corresponding recommendations from an Inquiry Panel, finds that a person holding a certificate as a behavioral health aide or practitioner, community health aide or practitioner, or dental health aide has violated one of the conditions of section A3.10.030 [grounds for discipline], the Board may impose the following sanctions singly or in combination, including after a hearing conducted consistent with chapter A-4 [hearings, requests for consideration, and appeals]:

1. permanently revoke a certificate to practice;
2. suspend a certificate for a determinate period of time;
3. censure a person holding a certificate;
4. issue a letter of reprimand;
5. place a person holding a certificate on probationary status and require the person to:
   1. report regularly to the Board upon matters involving the basis of probation;
   2. limit practice to those areas prescribed; and/or
   3. continue professional education until a satisfactory degree of skill has been attained in those areas determined by the Board to need improvement;
6. impose limitations or conditions on the practice of a person holding a certificate and/or
7. if the Board finds that any complaints or charges are unproven or unsubstantiated, the Board may dismiss a complaint or take other action as appropriate consistent with the Standards and Procedures.

Sec. A3.10.110. Withdrawing Probation.

The Board may withdraw previously applied probationary status if it subsequently finds that the deficiencies that required the sanction have been remedied.

Sec. A3.10.120. Summary Suspension.

Notwithstanding any other provision, the Board may summarily suspend a certificate before or during any investigation, before any final hearing as described in chapter A-4 [hearings, requests for consideration, and appeals], or during the appeals process as described in chapter A-4 [hearings, requests for consideration, and appeals] if at any time the Board finds that the person holding a certificate poses a clear and immediate danger to the safety of any individual patient or the public health if the person continues to practice. A person whose certificate is suspended under this subsection shall be entitled to a hearing pursuant to section A4.10.010 [hearings]. The person may appeal the suspension after a hearing to the Area Director of the Alaska Area Native Health Service.

Sec. A3.10.130. Consistency.

The Board shall seek consistency in the conduct of any investigation by an Inquiry Panel and its associated recommendations, application of disciplinary sanctions, with any significant departure from prior decisions involving similar situations to be explained in findings of fact or appropriate orders.