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COMMONWEALTH OF VIRGINIA

DEPARTMENT OF HEALTH PROFESSIONS

BOARD OF SOCIAL WORK

TITLE OF REGULATIONS: 18 VAC 140-20-10 et seq.

REGULATIONS GOVERNING THE PRACTICE OF SOCIAL WORK

STATUTORY AUTHORITY: §§ 54.1-2400 AND § 54.1-3700 et seq.

OF THE CODE OF VIRGINIA

Effecfive: November 29, 1995

CHAPTER 20.

REGULATIONS GOVERNING THE PRACTICE OF SOCIAL WORK

PART I

GENERAL PROVISIONS

18 VAC 140-20-10. Definitions.

In addition to those defined in § 54.1-3700 of the Code of Virginia, words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise:

"Accredited school of social work" means a school of social work accredited by the Council on Social Work Education.

"Applicant" means a person who has submitted a completed application for licensure as a social worker with the appropriate fees.

"Board" means the Virginia Board of Social Work.

"Candidate for licensure" means a person who has satisfactorily completed all educational and experience requirements for licensure and has been deemed eligible by the board to sit for the required examinations.

"Clinical course of study" means graduate course work which includes courses in human behavior and social environment, social policy, research, clinical practice with individuals, families, groups and a clinical practicum which focuses on diagnostic, prevention and treatment services.

"Exempt practice" is that which meets the conditions of exemption from the requirements of licensure as defined in § 54.1-3701 of the Code of Virginia.

"Non-exempt practice" is that which does not meet the conditions of exemption from the requirements of licensure as defined in § 54.1-3701 of the Code of Virginia.

"Supervision" means the relationship between a supervisor and supervisee which is designed to promote the development of responsibility and skill in the provision of social work services. Supervision is the inspection, critical evaluation, and direction over the services of the supervisee. Super-vision shall include, without being limited to, the review of case presentations, audio tapes, video tapes, and direct observation.

18 VAC 140-20-20 (REPEALED.)
18 VAC 140-20-30. Fees.

A. The board has established fees for the following:

1. Registration of supervision ...........................................................................................$25

2. Application processing ..................................................................................................65

3. Initial license .........................................................................................prorated portion of
                                                                                                                  Biennial license fee

4. Biennial license

        a. Registered social worker....................................................................................... 35

        b. Associate social worker.........................................................................................35

        c. Licensed social worker........................................................................................ 125

        d. Licensed clinical social worker............................................................................. 125

5. Penalty for late renewal................................................................................................. 10

6. Endorsement to another jurisdiction............................................................................... 10

7. Additional or replacement licenses................................................................................. 10

8. Additional or replacement wall certificates...................................................................... 15

9. Returned check............................................................................................................. 15

10. Reinstatement following disciplinary action ................................................................. 200

B. Examination fees shall be paid directly to the examination service according to its requirements.

PART H
REQUIREMENTS FOR LICENSURE

18 VAC 140-2040. General requirements.

A. No person shall practice as a social worker or clinical social worker in the Commonwealth of Virginia except as provided for in the Code of Virginia and this chapter.

B. The individual obtaining the two years of required experience shall not call himself a licensed clinical social worker, solicit clients, bill for his services, or in any way represent himself as a licensed clinical social worker until such time that a license has been issued.

C. Licensure by this board to practice as a social worker or clinical social worker shall be determined by examination.

D. Every applicant for examination for licensure by the board shall:

• 1 . Meet the education and experience requirements prescribed in 18 VAC 140-20- or 18 VAC 140-20-60 for the category of practice in which licensure is sought.

• 2. Submit in one package, the following items to the board office, not less than 90 days prior to the date of the written examination:

• a. A completed notarized application;

• b. Documentation, on the appropriate forms, of the successful completion of the supervised experience requirements of 18 VAC 140-20-50 or 18 VAC 14020-60 along with documentation of the supervisor's out-of-state license where applicable;

• c. The application fee prescribed in 18 VAC 140-20-30;

• d. Official transcript or transcripts in the original sealed envelope submitted ftom the appropniate institutions of higher education directly to the applicant; and
  

• e. Documentation of applicant's out-of-state licensure where applicable.

18 VAC 140-20-50. Education and experience requirements for licensed clinical social worker.

A. Education. The applicant shall hold a minimum of a master's degree from an accredited school of social work. Graduates of foreign institutions must establish the equivalency of their education to this requirement through the Foreign Equivalency Determination Service of the Council on Social Work Education.

• 1. The degree program shall have included a graduate clinical course of study; or

• 2. The applicant shall provide documentation of having completed specialized experience, coursework or training acceptable to the board as equivalent to a clinical course of study.

B. Experience. The applicant shall have had two years of full-time post-master's degree experience in the delivery of clinical services or the equivalent in part-time experience. The post-master's degree experience, whether full- or part-time, shall be under supervision satisfactory to the board as prescribed in these regulations.

• 1. Full-time experience in the delivery of clinical services is defined as a minimum of 3,000 hours of work experience acquired in no less than two years.

• a. Of these 3,000 hours, trainees shall average no less than 15 hours per week in face-to- face client contact, for a minimum of 1,380 hours in the two-year period.

• b. The remaining hours may be spent in ancillary duties and activities supporting the delivery of clinical services.

2. Part-time equivalent experience in the delivery of clinical services for a total of 3,000 hours of work experience.

• a. Of the 3,000 hours, 1,380 hours shall be spent in face-to-face client contact.

• b. The remaining hours may be spent in ancillary duties and activities supporting the delivery of clinical services.

3. Supervision and experience obtained prior to the effective date of these regulations may be accepted towards licensure if this supervision met the requirements of the board which were in effect at the time the supervision was rendered.

4. An individual who does not become a candidate for licensure after four years of supervised training in a non exempt practice shall submit evidence to the board showing why the training should be allowed to continue.

C. Supervision requirement for applicants in non-exempt practices.

• 1. An individual who proposes to obtain supervised post-graduate experience in a non-exempt practice in Virginia shall, prior to the onset of such supervision:

• a. Be registered on a form provided by the board and completed by the supervisor and the supervised individual; and

• b. Pay the registration-of-supervision fee prescribed by the board.

2. The supervisor providing supervision under subdivision I of this subsection shall:

• a. Be a licensed clinical social worker with at least five (5) years post-Master of Social Work (MSW) clinical experience, or an individual who the board finds is qualified to supervise after a finding that the requirement for a supervisor who is a licensed clinical social worker with at least five years post clinical experience constitutes an undue burden on the applicant. Undue burden shall include issues such as geography or disability which limits supervisee's access to licensed clinical social worker supervision.

• b. Be responsible for the casework activities of the prospective applicant as set forth in subdivisions 2 c and 2 d of this subsection once the supervisory arrangement is accepted.

• c. Review and approve the diagnostic assessment and treatment plan of a representative sample of the clients assigned to the applicant during the course of supervision. The sample should be representative of the variables of gender, age, diagnosis, length of treatment and treatment method within the client population seen by the applicant. It is the applicant's responsibility to assure the representativeness of the sample that is presented to the supervisor. The supervisor shall be available to the applicant on a regularly scheduled basis for supervision. The supervisor will maintain documentation, for five (5) years post supervision, of which clients were the subject of supervision.

• d. Provide supervision only for those casework activities for which the supervisor has determined the applicant is competent to provide to clients.

• e. Provide supervision only for those activities for which the supervisor is qualified.

• f. The supervisor shall evaluate the supervisee's knowledge in the areas of an identified theory base, application of a differential diagnosis, establishing and monitoring a treatment plan, development and appropriate use of the professional relationship, assessing the client for risk of imminent danger, and implementing a professional and ethical relationship with clients.

• g. Provide documentation, at the time of application for licensure, on forms provided by the board, that the supervisee is at least minimally competent in the areas listed in subdivision 2 f of this subsection before the supervisee will be eligible to take the written examination.

3. The experience shall include at least 100 hours of face-to-face supervision during the period of supervision. A minimum of one hour of individual faceto-face supervision per week shall be provided for the period of supervision.

4. Supervision between members of the immediate family (to include spouses, parents, and siblings) will not be approved.

D. Documentation of supervised experience. At the time of application for licensure, applicants shall provide to the board documentation of the supervised experience from all supervisors or, if a supervisor is unavailable, shall provide a satisfactory explanation of such circumstances to the board.

• 1. Applicants for licensure who have worked full-time for a minimum of two years in the delivery of clinical social work services need document only their full-time employment provided the experience requirement has been met.

• 2. Applicants for licensure who have worked part-time in the delivery of clinical services will need to document the experience as prescribed in subdivision B 2 of this section.

• 3. Applicants whose former supervisor is deceased, or whose whereabouts is unknown, shall submit to the board a notarized affidavit from the present chief executive officer of the agency, corporation or partnership in which the applicant was supervised.

• 4. The affidavit shall specify dates of employment, job responsibilities, supervisor's name and last known address, and the total number of hours spent by the applicant with the supervisor in face-to-face supervision.

E. Supervision requirements for applicants in exempt practices. Individuals may obtain the required supervision and experience without registration of supervision provided such experience:

• 1. Is obtained in an exempt practice.

• 2. Meets all other requirements of the board for supervised experience as set forth in these regulations.

§ 18 VAC 140-20-60. Education and experience requirements for licensed social worker.

A. Education. The applicant shall hold a bachelor's or a master's degree from an accredited school of social work. Graduates of foreign institutions must establish the equivalency of their education to this requirement through the Foreign Equivalency Determination Service of the Council on Social Work Education.

B. Experience - master's degree applicants. Master's degree applicants are not required to have professional experience in the field.

C. Experience - bachelor's degree applicants. Bachelor's degree applicants shall have had two years of full-time post-bachelor's degree experience or the equivalent in part-time experience in casework management and supportive services under supervision satisfactory to the board.

• 1. Full-time experience in casework management and supportive services is defined as a minimum of 3,000 hours of work experience acquired in no less than two years.

• 2. Part-time equivalent experience in casework management and supportive services is defined as at least 3,000 hours of work experience acquired in no less than four years.

D. Supervision requirement for bachelor's degree applicant in non-exempt practices.

• 1. An individual who proposes to obtain supervised post-bachelor's degree experience in Virginia shall, prior to the onset of such supervision:

• a. Be registered on a form provided by the board and completed by the supervisor and supervised individual; and

• b. Pay the registration-of-supervision fee as prescribed by the board.

2. The supervisor providing super-vision shall:

• a. Be a licensed social worker with a master's degree, or a licensed clinical social worker, or an individual who the board finds is qualified to supervise after a finding that the requirement for a supervisor who is a licensed social worker with a master's degree or a licensed clinical social worker constitutes an undue burden on the applicant. Undue burden shall include issues such as geography or disability which limits supervisee's access to supervision listed above;

• b. Be responsible for the social work practice of the prospective applicant once the supervisory arrangement is accepted by the board;

• c. Review and approve the diagnostic assessment and treatment plan of a representative sample of cases assigned to the applicant during the course of supervision. The sample should be representative of the variables of gender, age, diagnosis, length of treatment and treatment method within the client population seen by the applicant. It is the applicant's responsibility to assure the representativeness of the sample that is presented to the supervisor. The supervisor shall be available to the applicant on a regularly scheduled basis for supervision. The supervisor will maintain documentation, for five (5) years post supervision, of which clients were the subject of supervision;

• d. Provide supervision only for those casework management and support services activities for which the supervisor has determined the applicant is competent to provide clients;

• e. Provide supervision only for those activities for which the supervisor is qualified; and

• f. The supervisor shall evaluate the supervisee in the areas of professional ethics and professional competency.

3. Supervision and experience obtained prior to the implementation of these regulations may be accepted towards licensure if this supervision met the requirements of the board which were in effect at the time the supervision was rendered.

4. The supervised experience shall include at least 100 hours of weekly face-to-face supervision during the two-year period.

5. Supervision between members of the immediate family (to include spouses, parents, and siblings) will not be approved.

E. Documentation of supervised experience.

• 1. At the time of application, applicants shall provide to the board documentation of the supervised experience from all supervisors or, if a supervisor is unavailable, shall provide a satisfactory explanation of such circumstances to the board.

• 2. Applicants whose former supervisor is deceased or whose whereabouts is unknown, shall submit to the board a notarized affidavit from the present chief executive office of the agency, corporation, or partnership in which the applicant was supervised.

• 3. The affidavit shall specify dates of employment, job responsibilities, the supervisor's name and last known address, and the total number of hours spent by the applicant with the supervisor in face-to-face supervision.

Supervision requirements for applicant in exempt practice. Individuals may obtain the required supervised experience without registration of supervision provided such experience:

• 1.Is obtained in an exempt practice.

• 2. Meets all other requirements of the board for supervised experience as set forth in these regulations.

PART III

EXAMINATIONS

18 VAC 140-20-70. General examination requirements.

A. The board may waive the written examination if the applicant has been certified or licensed in another jurisdiction by standards and procedures equivalent to those of the board.

B. An applicant for licensure by the board as a social worker or clinical social worker shall pass a written examination at times prescribed by the board.

C. A written examination shall be administered at least twice each year. The board may schedule such additional examinations as it deems necessary.

• 1. The Executive Director of the board shall notify all candidates in writing of the time and place of the examinations for which they have been approved to sit and of the fees for these examinations.

• 2. The candidate shall submit the applicable fees following the instructions under 18 VAC 140-20-30 B.

18 VAC 140-20-80. Written examination.

A. The written examination comprises an examination consisting of standardized multiple-choice questions. These questions may cover all or some of the following areas: human growth and development, social work practice with individuals, families, couples and groups, supervision, social policy, administration, social work research, community organization and planning, and ethical principles of social work practice in addition to other areas deemed relevant to the board.

B. The board will establish passing scores on the written examination.

PART IV

ADDITIONAL DOCUMENTATION OF COMPETENCE

18 VAC 140-20-90. Candidates who took and failed an oral examination.

Candidates who have previously taken and failed an oral examination administered by the Board of Social Work shall reapply and submit the appropriate form from their supervisor stating that the candidate meets the minimum competency levels in the six skill areas as follows:

1. Skill in the application of an identified theory base.

2. Skill in the application of a differential diagnosis.

3. Skill in establishing and monitoring a treatment plan.

4. Skill in the development and appropriate use of the professional relationship.

5. Skill in assessing the client for risk of eminent danger and taking appropriate and necessary action to protect the safety of the client, the public, and the social worker when necessary.

6. Skill in implementing a professional and ethical relationship with clients.

PART V

LICENSURE RENEWAL; REINSTATEMENT

18 VAC 140-20-100. Biennial renewal of licensure

A. All licensees shall renew their licenses on or before June 30 of each odd-numbered year and pay the renewal fee prescribed by the board.

B. Failure to receive a renewal notice from the board shall not relieve the licensee from the renewal requirement,

18 VAC 140-20-110. Renewal of expired license.

A. A social worker or clinical social worker whose license has expired may renew that license within four years after its expiration date by:

• 1. Providing evidence of having met all applicable requirements.

• 2. Paying the penalty for late renewal and the biennial license fee as prescribed in 10 VAC 140-20-30.

B. A social worker or clinical social worker who fails to renew the license for four years or more and who wishes to resume practice shall reapply on forms provided by the board, submit evidence satisfactory to the board that he is prepared to resume practice in a competent manner, and pay the fees prescribed in 10 VAC 140-20-30.

18 VAC 140-20-120. Repealed.

18 VAC 140-20-130. Renewal of registration for associate social workers and registered social workers.

The registration of every associate social worker and registered social worker with the former Virginia Board of Registration of Social Workers under former § 54-775.4 of the Code of Virginia shall expire on June 30 of each odd-numbered year.

1. Each registrant shall return the completed application before the expiration date,accompanied by the payment of the renewal fee prescribed by the board,

2. Failure to receive the renewal notice shall not relieve the registrant from the renewal requirement.

PART VI
COMMITTEES

18 VAC 140-20-140. Examining and advisory committees.

The board may establish advisory and examining committees to assist it in carrying out statutory responsibilities. 1. The committees may assist in evaluating the professional qualifications of applicants and candidates for licensure and renewal of licenses and in other matters the board deems necessary.

2. The committees may assist in the evaluation of the mental or emotional competency, or both, of any licensee or applicant for licensure when such competence is an issue before the board.

PART VII

STANDARDS OF PRACTICE

18 VAC 140-20-150. Professional conduct.

Persons whose activities are regulated by the board shall:

1. Practice in a manner that is in the best interest of the public and does not endanger the public health, safety, or welfare.

2. Be able to justify all service rendered to clients as necessary for diagnostic or therapeutic purposes.

3. Practice only within the competency areas for which they are qualified by education or experience, or both.

4. Report to the board known or suspected violations of the laws and regulations governing the practice of social work.

5. Neither accept nor give commissions, rebates, or other forms of remuneration for referral of clients for professional services.

6. Ensure that clients are aware of fees and billing arrangements before rendering services.

7. Keep confidential their counseling relationships with clients and disclose client

records to others only with written consent of the client, with the following exceptions: (1) when the client is a danger to self or others; or (2) as required by law.

8. When advertising their services to the public, ensure that such advertising is neither fraudulent nor misleading.

9. Not engage in dual relationships with clients, former clients, supervisees, and supervisors that might compromise the client's, former client's, or supervisee's wellbeing, impair the social worker's or supervisor's objectivity and professional judgment or increase the risk of exploitation. This includes but is not limited to, such activities as counseling close friends, sexual partners, employees or relatives, and engaging in business relationships with clients. Engaging in sexual intimacies with current clients or supervisees is prohibited.

10. Maintain clinical records on each client. The record shall include identifying information to substantiate diagnosis and treatment plan, client progress, and termination. The clinical record shall be preserved for at least five years post termination.

11. Ensure that clients have provided informed consent to treatment.

18 VAC 140-20-160. Grounds for denial, revocation, suspension, or denial of renewal of license.

Action by the board to deny, revoke, suspend or decline to renew a license shall be in accordance with the following:

1. Conviction of a felony or of a misdemeanor involving moral turpitude;

2. Procurement of license by fraud or misrepresentation;

3. Conducting one's practice in such a manner so as to make the practice a danger to the health and welfare of one's clients or to the public. In the event a question arises concerning the continued competence of a licensee, the board will consider evidence of continuing education in one or more of the following categories as a demonstration of effort to maintain minimum competence to engage in practice:

• a. Academic social work courses taken for credit or audited.

• b. Continuing education offered by accredited social work education programs, other accredited educational programs, and other providers, including professional associations, agencies and private entrepreneurs:

• (1) Seminars, institutes, workshops, or mini-courses oriented to the enhancement of social work practice, values, skills and knowledge; and

• (2) Cross-disciplinary offering from medicine, law, and the behavioral sciences if they are clearly related to the enhancement of social work practice, values, skills and knowledge.

• c. Planned self-directed study in collaboration with other professionals;

• (1) Independent study in a social work curriculum area or a closely related field. Examples include a planned reading program, individual supervision or consultation; and

• (2) The content and plan of instruction developed by the licensee.

d. Publication of books, papers, or presentations given for the first time at a professional meeting;

e. Other professional activities, including:

• (1) Preparation for the first time of an academic social work course, in-service training workshop or seminar, or other professional seminar; and

• (2) Research not resulting in publication.

• f. Social work-related academic courses such as mental health, health and social work research, psychology, human growth and development, and child and family development.

4. Being unable to practice social work with reasonable skill and safety to clients by reason of illness, excessive use of alcohol, drugs, narcotics, chemicals or any other type of material or as a result of any mental or physical condition;

5. Conducting one's practice in a manner contrary to the standards of ethics of social work or in violation of 18 VAC 140-20-150, standards of practice;

6. Performing functions outside the board-licensed area of competency;

7. Violating or aiding and abetting another to violate any statute applicable to the practice of social work or any provision of these regulations.

18 VAC 140-20-170. Reinstatement following disciplinary action.

Any person whose license has been suspended, revoked, or denied renewal by the board under the provisions of 18 VAC 140-20-160 shall, in order to be eligible for reinstatement, (i) submit a new application to the board for a license, (ii) pay the appropriate reinstatement fee, and (iii) submit any other credentials as prescribed by the board. After a hearing, the board may, at its discretion, grant the reinstatement.

SUBTITLE 1.

GENERAL PROVISIONS RELATING TO REGULATORY BOARDS

CHAPTER 1.

GENERAL PROVISIONS

§ 54.1-100. Regulations of professions and occupations.-The right of every person to engage in any lawful profession, trade or occupation of his choice is clearly protected by both the Constitution of the United States and the Constitution of the Commonwealth of Virginia. The Commonwealth cannot abridge such rights except as a reasonable exercise of its police powers when it is clearly found that such abridgment is necessary for the preservation of the health, safety and welfare of the public.

No regulation shall be imposed upon any profession or occupation except for the exclusive purpose of protecting the public interest when:

1. The unregulated practice of the profession or occupation can harm or endanger the health, safety or welfare of the public, and the potential for harm is recognizable and not remote or dependent upon tenuous argument;

2. The practice of the profession or occupation has inherent qualities peculiar to it that distinguish it from ordinary work and labor;

3. The practice of the profession or occupation requires specialized skill or training and the public needs, and will benefit by, assurances of initial and continuing professional and occupational ability; and

4. The public is not effectively protected by other means.

No regulation of a profession or occupation shall conflict with the Constitution of the United States, the Constitution of Virginia, the laws of the United States, or the laws of the Commonwealth of Virginia. Periodically and at least annually, all agencies regulating a profession or occupation shall review such regulations to ensure that no conflict exists.

§ 54.1-100.1. Department of Commerce continued as Department of Professional and Occupational Regulation.-The Department of Professional and Occupational Regulation, formerly known as the Department of Commerce, is continued, and wherever "Department of Commerce" is used in this Code, it shall mean the Department of Professional and Occupational Regulation. The Board for Professional and Occupational Regulation, formerly known as the Board of Commerce, is continued, and wherever "Board of Commerce" is used in this Code, it shall mean the Board for Professional and Occupational Regulation.

§ 54.1-101. Copies of examinations filed by regulatory boards.-A copy of examinations given by regulatory and advisory boards within the Department of Professional and Occupational Regulation and the Department of Health Professions authorized to conduct examinations of applicants for admission to practice or pursue any profession, vocation, trade, calling, or art shall be kept on file at the office of the secretary of each board. A copy of the examination shall be placed on file within ten days after it is administered, and shall be preserved for at least one year as a public record accessible to any person desiring to examine it during usual business hours. After the expiration of one year from the time the examination is filed, the secretary of the respective board may withdraw and destroy the examination. However, this section shall not be construed or interpreted in a manner to require the filing or release of examinations or other information which would result in compromising the validity or security of future examinations conducted by regulatory or advisory boards of the Department of Professional and Occupational Regulation or the Department of Health Professions. In the event any provision of this section results in a conflict with the provisions of § 54.1-108, the provisions of § 54.1-108 shall prevail.

§ 54.1-102. Unlawful procurement of certificate, license or permit; unauthorized possession of examination or answers; penalty.

A. It shall be unlawful:

• 1. For any person to procure, or assist another to procure, through theft, fraud or other illegal means, a certificate, license or permit, from any state board, or other body charged by law with the responsibility of examining persons desiring to engage in a regulated business or profession, by giving to, or receiving from, any person any information, oral, written or printed, during the administration of the examination, which is intended to, or will, assist any person taking the examination in passing the examination and obtaining the required certificate, license or permit;

• 2. For any person, other than a member or officer of the board or body, to procure or have in his possession prior to the beginning of an examination, without written authority of a member or officer of the board or body, any question intended to be used by the board or body conducting the examination, or to receive or furnish to any person taking the examination, prior to or during the examination, any written or printed material purporting to be answers to, or aid in answering such questions;

• 3. For any person to attempt to procure, through theft, fraud or other illegal means, any questions intended to be used by the board or body conducting the examination, or the answers to the questions;

• 4. To promise or offer any valuable or other consideration to a person havingaccess to the questions or answers as an inducement to procure for delivery to the promisor, or any other person, a copy or copies of any questions or answers. If an examination is divided into separate parts, each of the parts shall be deemed an examination for the purposes of this section.

B. Any person violating the provisions of subsection A shall be guilty of a Class 2 misdemeanor.

§ 54.1-103. Additional training of regulated persons; reciprocity; endorsement.

A. The regulatory boards within the Department of Professional and Occupational Regulation and the Department of Health Professions may promulgate regulations specifying additional training or conditions for individuals seeking certification or licensure, or for the renewal of certificates or licenses.

B. The regulatory boards may enter into agreements with other jurisdictions for the recognition of certificates and licenses issued by other jurisdictions.

C. The regulatory boards are authorized to promulgate regulations recognizing licenses or certificates issued by other states, the District of Columbia, or any territory or possession of the United States as full or partial fulfillment of qualifications for licensure or certification in the Commonwealth.

§ 54.1-104. Suspension of license, certificate, registration, or authority for dishonor of fee payment; reinstatement.--The Department of Professional and Occupational Regulation and the Department of Health Professions may suspend the license, certificate, registration or authority it has issued any person who submits a check, money draft or similar instrument for payment of a fee required by statute or regulation which is not honored by the bank or financial institution named. The suspension shall become effective ten days following delivery by certified mail of written notice of the dishonor and the impending suspension to such person's address. Upon notification of suspension, the person may reinstate the license, certificate, registration or authority upon payment of the fee and penalties required under statute or regulation. Suspension under this provision shall be exempt from the Administrative Process Act (§ 9- 6.14:1 et seq.).

§ 54.1-105. Majority of board or panel required to suspend or revoke license, certificate or registration; imposition of sanctions.--An affirmative vote of a majority of those serving on a board who are qualified to vote or those serving on a panel of a health regulatory board convened pursuant to § 54.1-2400 shall be required for any action to suspend or revoke a license, certification or registration or to impose a sanction on a licensee. However, an affirmative vote of a majority of a quorum of the regulatory board shall be sufficient for summary suspension pursuant to specific statutory authority.

§ 54.1-106. Health care professionals rendering services to patients of certain clinics exempt from liability.
A. No person who is licensed or certified by the Boards of/for Audiology and Speech-Language Pathology, Dentistry, Medicine, Nursing, Optometry, Opticians, Pharmacy, Hearing Aid Specialists, Psychology, Social Work or Professional Counselors who renders at any site any health care services within the limits of his license or certification, voluntarily and without compensation, to any patient of any clinic which is organized in whole or in part for the delivery of health care services without charge, shall be liable for any civil damages for any act or omission resulting from the rendering of such services unless the act or omission was the result of his gross negligence or willful misconduct.

B. For the purposes of Article 5.1 (§ 2.1-526.1 et seq.) of Chapter 32 of Title 2.1 any person rendering such health care services who (i) is registered with the Division of Risk Management and (ii) has no legal or financial interest in the clinic from which the patient is referred shall be deemed an agent of the Commonwealth and to be acting in an authorized governmental capacity with respect to delivery of such health care services. The premium for coverage of such person under the Risk Management Plan shall be paid by the Department of Health.

§ 54.1-107. Appointments, terms and removal of members of regulatory boards; citizen members.-All members of regulatory boards shall be citizens of the United States and residents of Virginia. Members shall be appointed by the Governor and may be removed by him as provided in subsection B of § 2.1-43. Any vacancy occurring other than by expiration of terms shall be filled for the unexpired term. Members shall hold office after expiration of their terms until their successors are duly appointed and have qualified. Appointment to fill an unexpired term shall not be considered a full term. All members of regulatory boards appointed by the Governor for terms commencing on or after July 1, 1988, shall be appointed for terms of four years. No member shall serve more than two successive full terms on any regulatory board.
"citizen member" of a regulatory board shall be a person who (i) is not by training or experience a practitioner of the profession or occupation regulated by the board, (ii) is not the spouse, parent, child, or sibling of such a practitioner, and (iii) has no direct or indirect financial interest, except as a consumer, in the practice of the profession or occupation regulated by the board. The provisions of this section shall not apply to the Board for Branch Pilots.

§ 54.1-108. Disclosure of official records.-Official records of the Department of Professional and Occupational Regulation or the Department of Health Professions or any board named in this title shall be subject to the disclosure provisions of the Virginia Freedom of Information Act (§ 2.1-340 et seq.), except for the following:

I Examination questions, papers, booklets and answer sheets, which may be disclosed at the discretion of the board administering or causing to be administered such examinations.

2. Applications for admission to examinations or for licensurs, and the scoring records maintained by any board or by the Departments on individual licensees or applicants. However, this material may be made available during normal working hours for copying by the subject individual at his expense at the office of the Department or board which possesses the material.

3. Records of active investigations being conducted by the Departments or any board.

§ 54.1-109. Reviews and appeals.-Any person who has been aggrieved by any action of the Department of Professional and Occupational Regulation, Department of Health Professions, Board for Professional and Occupational Regulation, Board of Health Professions, any regulatory board within the Departments or any panel of a health regulatory board convened pursuant to § 54.1-2400 shall be entitled to a review of such action. Appeals from such actions shall be in accordance with the provisions of the Administrative Process Act (§ 9-6.14:1 et seq.).

§ 54.1-110. Presiding officer; participation of board in hearing; disqualification of board member.

A. Every hearing in a contested case shall be conducted in accordance with the provisions of the Administrative Process Act (§ 9-6.14:1 et seq.). When a hearing officer presides, the regulatory board shall determine whether the hearing officer is to hear the case alone or with a panel of a health regulatory board convened pursuant to § 54.1-2400 or whether the board is to hear the case with the hearing officer.

B. A board member shall disqualify himself and withdraw ftom any case in which he cannot accord fair and impartial consideration. Any party may request the disqualification of any board member by stating with particularity the grounds upon which it is claimed that fair and impartial consideration cannot be accorded. The remaining members of the board or panel shall determine whether the individual should be disqualified.

§ 54.1-111. Unlawful acts; prosecution; proceedings in equity.

A. It shall be unlawful for any person, partnership, corporation or other entity to engage in any of the following acts:

• • 1. Practicing a profession or occupation without holding a valid license as required by statute or regulation.

• • 2. Making use of any designation provided by statute or regulation to denote a standard of professional or occupational competence without being duly certified or licensed.

• • 3. Making use of any titles, words, letters or abbreviations which may reasonably be confused with a designation provided by statute or regulation to denote a standard of professional or occupational competence without being duly certified or licensed.

• • 4. Performing any act or function which is restricted by statute or regulation to persons holding a professional or occupational license or certification, without being duly certified or licensed.

• • 5. Failing to register as a practitioner of a profession or occupation as
    required by statute or regulation.

• • 6. Materially misrepresenting facts in an application for licensure, certification or registration.

• • 7. Willfully refusing to furnish a regulatory board information or records required or requested pursuant to statute or regulation.

• • 8. Violating any statute or regulation governing the practice of any profession or occupation regulated pursuant to this title.

Any person who willfully engages in any unlawful act enumerated in this section shall be guilty of a Class I misdemeanor. The third or any subsequent conviction for violating this section during a thirty-six-month period shall constitute a Class 6 felony.

B. In addition to the criminal penalties provided for in subsection A of this section, the Department of Professional and Occupational Regulation or the Department of Health Professions, without compliance with the Administrative Process Act, shall have the authority to enforce the provisions of subsection A of this section and may institute proceedings in equity to enjoin any person, partnership, corporation or any other entity from engaging in any unlawful act enumerated in this section. Such proceedings shall be brought in the name of the Commonwealth by the appropriate Department in the circuit court of the city or county in which the unlawful act occurred or in which the defendant resides.

54.1-112. Copies of records as evidence.-Copies of all records, documents and other papers of the Department of Professional and Occupational Regulation and the Department of Health Professions and their regulatory boards which bear the official seal and which are duly certified and authenticated in writing on the face of such documents to be true copies by the custodian thereof and by the person to whom the custodian reports shall be received as evidence with like effect as the original records, documents or other papers in all courts of the Commonwealth.

54.1-113. Regulatory boards to adjust fees.-Following the close of any biennium, when the account for any regulatory board within the Department of Professional and Occupational Regulation or the Department of Health Professions maintained under § 54.1-308 or § 54.1-2505 shows expenses allocated to it for the past biennium to be more than ten percent greater or less than moneys collected on behalf of the board, it shall revise the fees levied by it for certification or licensure and renewal thereof so that the fees are sufficient but not excessive to cover expenses.

54.1-114. Biennial report.-The Board of Bar Examiners, the Department of Professional and Occupational Regulation and the Department of Health Professions shall submit biennial reports to the Governor and General Assembly on or before November 1 of each evennumbered year. The biennial report shall contain at a minimum the following information for the Board of Bar Examiners and for each board within the two Departments: (i) a summary of the board's fiscal affairs, (ii) a description of the board's activities, (iii) statistical information regarding the administrative hearings and decisions of the board, (iv) a general summary of all complaints received against licensees and the procedures used to resolve the complaints, and (v) a description of any action taken by the board designed to increase public awareness of board operations and to facilitate public participation. The biennial report shall be distributed in accordance with the provisions of § 2.1-467.

54.1-115.Extension of deadlines; military service.-Notwith standing any other provision of law, the Department of Commerce, the Department of Health Professions, the Supreme Court of Virginia, and local governing bodies shall extend the time allowed to comply with certification or licensure requirements, including those pertaining to the application for or renewal of any license, certificate, registration or authority, until one year after the person's release from active military duty, if the person is on active military duty during 1991 and such extension would not constitute a danger to the public health, safety, or welfare. The provisions of this section shall expire on July 1, 1992.

SUBTITLE III.

PROFESSIONS AND OCCUPATIONS REGULATED BY BOARD

WITHIN THE DEPARTMENT OF HEALTH PROFESSIONS

CHAPTER 24.

GENERAL PROVISIONS

§ 54.1-2400. General powers and duties of health regulatory boards.-The general powers and duties of health regulatory boards shall be:

• 1. To establish the qualifications for registration, certification or licensure in accordance with the applicable law which are necessary to ensure competence and integrity to engage in the regulated professions.

• 2. To examine or cause to be examined applicants for certification or licensure. Unless otherwise required by law, examinations shall be administered in writing or shall be a demonstration of manual skills.

• 3. To register, certify or license qualified applicants as practitioners of the particular profession or professions regulated by such board.

• 4. To establish schedules for renewals of registration, certification and licensure.

• 5. To levy and collect fees for application processing, examination, registration, certification or licensure and renewal that are sufficient to cover all expenses for the administration and operation of the Department of Health Professions, the Board of Health Professions and the health regulatory boards.

• 6. To promulgate regulations in accordance with the Administrative Process Act (§ 9-6.14:1 et seq.) which are reasonable and necessary to administer effectively the regulatory system. Such regulations shall not conflict with the purposes and intent of this chapter or of Chapter I and Chapter 25 of this title.

• 7. To revoke, suspend, restrict, or refuse to issue or renew a registration, certificate or license which such board has authority to issue for causes enumerated in applicable law and regulations.

• 8. To take appropriate disciplinary action for violations of applicable law and regulations.

• 9. To convene, at their discretion, a panel consisting of at least five board members or, if a quorum of the board is less than five members, consisting of a quorum of the members to conduct formal proceedings pursuant to § 9-6.14:12, decide the case, and issue a final agency case decision. Any decision rendered by majority vote of such panel shall have the same effect as if made by the full board and shall be subject to court review in accordance with the Administrative Process Act (§ 9-6.14:1 et seq.). No member who participates in an informal proceeding conducted in accordance with § 9-6.14:11 shall serve on a panel conducting formal proceedings pursuant to § 9-6.14:12 to consider the same matter.

§ 54.1-2400.1. Mental health service providers; duty to protect third parties; immunity.

A. As used in this section:

• "Certified substance abuse counselor" means a person certified to provide substance abuse counseling in a state-approved public or private substance abuse program or facility.

• "Client" or 'Patient" means any person who is voluntarily or involuntarily receiving mental health services or substance abuse services from any mental health service provider.

• "Clinical psychologist" means a person who practices clinical psychology as defined in § 54.1-3600.

• "Clinical social worker" means a person who practices social work as defined in § 54.1- 3700.

• "Licensed practical nurse" means a person licensed to practice practical nursing as defined in § 54.1-3000.

• "Mental health professional" means a person who by education and experience is professionally qualified and licensed in Virginia to provide counseling interventions designed to facilitate an individual's achievement of human development goals and remediate mental, emotional, or behavioral disorders and associated distresses which interfere with mental health and development.

• "Mental health service provider" or "provider" " refers to any of the following: (i) a person who provides professional services as a certified substance abuse counselor, clinical psychologist, clinical social worker, licensed practical nurse, mental health professional, physician, professional counselor, psychologist, registered nurse, school psychologist, or social worker; (ii) a professional corporation, all of whose shareholders or members are so licensed; or (iii) a partnership, all of whose partners are so licensed.

• "Professional counselor" means a person who practices counseling as defined in § 54.1- 3500.

• "Psychologist" means a person who practices psychology as defined in § 54.13600.

• "Registered nurse" means a person licensed to practice professional nursing as defined in § 54.1-3000.

• "School psychologist" means a person who practices school psychology as defined in § 54.1-3600.

• "Social worker" means a person who practices social work as defined in § 54.1-3600.

B. A mental health service provider has a duty to take precautions to protect third parties from violent. behavior or other serious harm only when the client has orally, in writing, or via sign language, communicated to the provider a specific and immediate threat to cause serious bodily injury or death to an identified or readily identifiable person or persons, if the provider reasonably believes, or should believe according to the standards of his profession, that the client has the intent and ability to carry out that threat immediately or imminently. If the third party is a child, in addition to taking precautions to protect the child from the behaviors in the above types of threats, the provider also has a duty to take precautions to protect the child if the client threatens to engage in behaviors that would constitute physical abuse or sexual abuse as defined in § 18.2-67.10. The duty to protect does not attach unless the threat has been communicated to the provider by the threatening client while the provider is engaged in his professional duties.

C. The duty set forth in subsection B is discharged by a mental health service provider who takes one or more of the following actions:

• • I Seeks civil commitment of the client under Chapter 2 (§ 37.1-63 et seq.) of Title 37.1.

• • 2. Makes reasonable attempts to warn the potential victims or the parent or guardian of the potential victim if the potential victim is under the age of eighteen.

• • 3. Makes reasonable efforts to notify a law-enforcement official having jurisdiction in the client's or potential victim's place of residence or place of work, or place of work of the parent or guardian if the potential victim is under age eighteen, or both.

• • 4. Takes steps reasonably available to the provider to prevent the client from using physical violence or other means of harm to others until the appropriate law-enforcement agency can be summoned and takes custody of the client.

• • 5. Provides therapy or counseling to the client or patient in the session in which the threat has been communicated until the mental health service provider reasonably believes that the client no longer has the intent or the ability to carry out the threat.

D. A mental health service provider shall not be held civilly liable to any person for:

• • 1. Breaching confidentiality with the limited purpose of protecting third parties by communicating the threats described in subsection B made by his clients to potential third party victims or law-enforcement agencies or by taking any of the actions specified in subsection C.

• • 2. Failing to predict, in the absence of a threat described in subsection B, that the client would cause the third party serious physical harm.

• • 3. Failing to take precautions other than those enumerated in subsection C to protect a potential third party victim from the client's violent behavior.

§ 54.1-2401. Monetary penalty.-Any person licensed, registered or certified by any health regulatory board who violates any provision of statute or regulation pertaining to that board and who is not criminally prosecuted, may be subject to the monetary penalty provided in this section. If the board or any special conference committee convened pursuant to § 54.1-3010 determines that a respondent has violated any provision of statute or regulation pertaining to the board, it shall determine the amount of any monetary penalty to be imposed for the violation, which shall not exceed $1,000 for each violation. The penalty may be sued for and recovered in the name of the Commonwealth. All such monetary penalties shall be deposited in the Literary Fund.

§ 54.1-2402. Citizen members on health regulatory boards.-Citizen members appointed to boards within the Department of Health Professions after July 1, 1986, shall participate in all matters. Of the citizen members first appointed to boards with two citizen members, one shall be appointed for a term of two years and one for the maximum term established for members of the respective board. On boards with one citizen member, the citizen member initially appointed shall be appointed for the maximum term established for members of that board. The provisions of this section relating to terms of citizen members on such boards shall not apply to the Board of Medicine or to the Board of Funeral Directors and Embalmers. For the purposes of this section, "citizen member" shall have the meaning provided in § 54.1- 107.

§ 54.1-2402.1. Appointments, removals, and limitation of terms of members of regulatory boards.--Except as otherwise expressly provided, members shall be appointed by the Governor and may be removed by him as provided in § 2.1-43 B. Any vacancy occurring other than by expiration of term shall be filled for the unexpired term. Members shall hold office after expiration of their terms until their successors are duly appointed and have qualified.

All members of regulatory boards appointed by the Governor for terms commencing on or after July 1, 1988, shall be appointed for terms of four years. No members shall serve more than two successive full terms on any regulatory board.

§ 54.1-2403. Certain advertising prohibited.-No person licensed by one of the boards within the Department shall use any form of advertising that contains any false, fraudulent, misleading or deceptive statement or claim.

§ 54.1-2403.1. Protocol for certain medical history screening required.

A. As a routine component of every pregnant woman's prenatal care, every practitioner licensed pursuant to this subtitle who renders prenatal care, regardless of the site of such practice, shall establish and implement a medical history protocol for screening pregnant women for substance abuse to determine the need for a specific substance abuse evaluation. The medical history protocol shall include, but need not be limited to, a description of the screening device and shall address abuse of both legal and illegal substances. The medical history screening may be followed, as necessary and appropriate, with a thorough substance abuse evaluation.

B. The results of such medical history screening and of any specific substance abuse evaluation which may be conducted shall be confidential and, if the woman is enrolled in a treatment program operated by any facility receiving federal funds, shall only be released as provided in federal law and regulations. However, if the woman is not enrolled in a treatment program or is not enrolled in a program operated by a facility receiving federal funds, the results may only be released to the following persons:

• 1. The subject of the medical history screening or her legally authorized representative.

• 2. Any person designated in a written release signed by the subject of the medical history screening or her legally authorized representative.

• 3. Health care providers for the purposes of consultation or providing care and treatment to the person who was the subject of the medical history screening.

C. The results of the medical history screening required by this section or any specific substance abuse evaluation which may be conducted as part of the prenatal care shall not be admissible in any criminal proceeding.

D. Practitioners shall advise their patients of the results of the medical history screening and specific substance abuse evaluation, and shall provide such information to third-party payers as may be required for reimbursement of the costs of medical care. However, such information shall not be admissible in any criminal proceedings. Practitioners shall advise all pregnant women whose medical history screenings and specific substance abuse evaluations are positive for substance abuse of appropriate treatment and shall inform such women of the potential for poor birth outcomes from substance abuse.

54.1-2403.2. Record storage.- Medical records, as defined in § 42.1-77, may be stored by computerized or other electronic process or microfilm, or other photographic, mechanical, or chemical process; however, the stored record shall identify the location of any documents or information that could not be so technologically stored. If the technological storage process creates an unalterable record, a health care provider licensed, certified or registered by a health regulatory board within the Department shall not be required to maintain paper copies of medical records that have been stored by computerized or other electronic process, microfilm, or other photographic, mechanical, or chemical process. Upon completing such technological storage, paper copies of medical records may be destroyed in a manner that preserves the patient's confidentiality. However, any documents or information that could not be so technologically stored shall be preserved.

54.1-2404. Itemized statements required upon request.-Upon the request of any of his patients, any health care provider licensed or certified by any of the boards within the Department, except in the case of health care services as defined in Chapter 43 of Title 38.2, shall provide to such patient an itemized statement of the charges for the services rendered to the requesting patient regardless of whether a bill for the services which are the subject of the request has been or will be submitted to any third party payor including medical assistance services or the state/local hospitalization program.

54.1-2405. Transfer of patient records in conjunction with sale of practice; notice required.- No person licensed, registered, or certified by one of the health regulatory boards under the Department shall transfer records pertaining to a current patient in conjunction with the sale of a professional practice until such person has first attempted to notify the patient of the pending transfer, by mail, at the patient's last known address, and by publishing prior notice in a newspaper of general circulation within the provider's practice area. The notice shall specify that, at the written request of the patient or an authorized representative, within a reasonable time period, the records or copies will be sent to any other like-regulated provider of the patient's choice or destroyed.

54.1-2406. Treatment records of practitioners.- No records of the identity, diagnosis, prognosis, or treatment of any practitioner of any profession regulated by any of the regulatory boards within the Department of Health Professions obtained by the Department or any health regulatory board from a health care provider or facility that is treating or has treated such practitioner for drug addiction or chronic alcoholism shall be disclosed except:

• 1.In a disciplinary hearing before a health regulatory board or in any subsequent trial or appeal of a board action or order;

• 2. To licensing or disciplinary authorities of other jurisdictions or to hospital committees located within or outside this Commonwealth which are concerned with granting, limiting, or denying a physician hospital privileges if a final determination regarding disciplinary action has been made; or

• 3. Pursuant to an order of a court of competent jurisdiction.

54.1-2407. Requirements for human research.--Any person licensed, registered, or certified by any health regulatory board who engages in the conduct of human research, as defined in § 32.1- 162.16, shall comply with the provisions of Chapter 5.1 (§ 32.1-162.16 et seq.) of Title 32.1. Failure to so comply shall constitute unprofessional conduct.

54.1-2408. Disqualffication for license, certiflcate or registration.- A board within the Department of Health Professions shall refuse to admit a candidate to any examination and shall refuse to issue a license, certificate or registration to any applicant if the candidate or applicant has had his license, certificate or registration to practice the profession or occupation revoked or suspended, and has not had his license, certificate or registration to so practice reinstated by the jurisdiction which revoked or suspended his license, certificate or registration.

54.1-2409. Mandatory suspension or revocation; reinstatement; appeal.-Upon receipt of documentation by a court or agency, state or federal, that a person licensed, certified or registered by a board within the Department of Health Professions has had his license, certificate or registration to practice the same profession or occupation revoked or suspended in another jurisdiction and has not had his license, certificate or registration to so practice reinstated within that jurisdiction, or has been convicted of a felony or has been adjudged legally incompetent, the Director of the Department shall immediately suspend, without a hearing, the license, certificate or registration of any person so disciplined, convicted or adjudged. The Director shall notify such person or his legal guardian, trustee, committee or other representative of the suspension in writing to his address on record with the Department. Such notice shall include a copy of the order of such court or agency, certified by the Director as the order received from such court or agency. Such person shall not have the right to practice within this Commonwealth until his license, certificate or registration has been reinstated by the Board.

The clerk of any court in which a conviction of a felony or an adjudication of incompetence is made, who has knowledge that a person licensed, certified or registered by a board within the Department has been convicted or found incompetent, shall have a duty to report these findings promptly to the Director.

When a conviction has not become final, the Director may decline to suspend the license, certificate or registration until the conviction becomes final if there is a likelihood of injury or damage to the public if the person's services are not available.

Any person whose license, certificate or registration has been suspended as provided in this section may apply to the board for reinstatement of his license, certificate or registration. Such person shall be entitled to a hearing not later than the next regular meeting of the board after the expiration of thirty days from the receipt of such application, and shall have the right to be represented by counsel and to summon witnesses to testify in his behalf

The reinstatement of the applicant's license, certificate or registration shall require the affirmative vote of three-fourths of the members of the board. The board may order such reinstatement without further examination of the applicant, or reinstate the license, certificate or registration upon such terms and conditions as it deems appropriate.

54.1-2409.1. Criminal penalties for practicing certain professions and occupations without appropriate license.-- Any person who, without holding a current valid license, issued by a regulatory board pursuant to this title (i) performs an invasive procedure for which a license is required; (ii) administers, prescribes, sells, distributes, or dispenses a controlled drug; or (iii) practices a profession or occupation after having his license to do so suspended or revoked shall be guilty of a Class 6 felony.

CHAPTER 24.1.

PRACTITIONER SELF-REFERRAL ACT.

§ 54.1-2410. Definitions.--As used in this chapter or when referring to the Board of Health Professions regulatory authority therefor, unless the context requires a different meaning:

"Board" means the Board of Health Professions.

"Community" means a city or a county.

"Demonstrated need" means (i) there is no facility in the community providing similar services and (ii) alternative financing is not available for the facility, or (iii) such other conditions as may be established by Board regulation.

"Entity" means any person, partnership, firm, corporation, or other business that delivers health services.

"Group practice" means two or more health care practitioners who are members of the same legally organized partnership, professional corporation, not-for-profit corporation, faculty practice or similar association in which (i) each member provides substantially the full range of services within his licensed or certified scope of practice at the same location as the other members through the use of the organization's office space, facilities, equipment, or personnel; (ii) payments for services received from a member are treated as receipts of the organization; and (iii) the overhead expenses and income from the practice are distributed according to methods previously determined by the members.

"Health services" means any procedures or services related to prevention, diagnosis, treatment, and care rendered by a health care worker, regardless of whether the worker is regulated by the Commonwealth.

"Immediate family member" means the individual's spouse, child, child's spouse, stepchild, stepchild's spouse, grandchild, grandchild's spouse, parent, stepparent, parent-in-law, or sibling.

"Investment interest" means the ownership or holding of an equity or debt security, including, but not limited to, shares of stock in a corporation, interests or units of a partnership, bonds, debentures, notes, or other equity or debt instruments, except investment interests in a hospital licensed pursuant to Article 1 (§ 32.1-123 et seq.) of Chapter 5 of Title 32.1.

"Investor" means an individual or entity directly or indirectly possessing a legal or beneficial ownership interest, including an investment interest.

"Office practice" means the facility or facilities at which a practitioner, on an ongoing basis, provides or supervises the provision of health services to consumers.

'Practitioner'' means any individual certified or licensed by any of the health regulatory boards within the Department of Health Professions, except individuals regulated by the Board of Funeral Directors and Embalmers or the Board of Veterinary Medicine.

"Referral" means to send or direct a patient for health services to another health care practitioner or entity outside the referring practitioner's group practice or office practice or to establish a plan of care which requires the provision of any health services outside the referring practitioner's group practice or office practice.

54.1-2411. Prohibited referrals and payments; exceptions.

A. Unless the practitioner directly provides health services within the entity and will be personally involved with the provision of care to the referred patient, or has been granted an exception by the Board or satisfies the provisions of subsection D of this section, a practitioner shall not refer a patient for health services to an entity outside the practitioner's office or group practice if the practitioner or any of the practitioner's immediate family members is an investor in such entity.

B. The Board may grant an exception to the prohibitions in this chapter, and may permit a practitioner to invest in and refer to an entity, regardless of whether the practitioner provides direct services within such entity, if there is a demonstrated need in the community for the entity and all of the following conditions are met:

1. Individuals other than practitioners are afforded a bona fide opportunity to invest in the entity on the same and equal terms as those offered to any referring practitioner;

2. No investor-practitioner is required or encouraged to refer patients to the entity or otherwise generate business as a condition of becoming or remaining an investor;

3. The services of the entity are marketed and furnished to practitioner investors and other investors on the same and equal terms;

4. The entity does not issue loans or guarantee any loans for practitioners who are in a position to refer patients to such entity;

5. The income on the practitioner's investment is based on the practitioner's equity interest in the entity and is not tied to referral volumes; and

6. The investment contract between the entity and the practitioner does not include any covenant or clause limiting or preventing the practitioner's investment in other entities.

Unless the Board, the practitioner, or entity requests a hearing, the Board shall determine whether to grant or deny an exception within ninety days of the receipt of a written request from the practitioner or entity, stating the facts of the particular circumstances and certifying compliance with the conditions required by this subsection. The Board's decision shall be a final administrative decision and shall be subject to judicial review pursuant to the Administrative Process Act (§ 9- 6.14:1 et seq.).

C. When an exception is granted pursuant to subsection B:

1. The practitioner shall disclose his investment interest in the entity to the patient at the time of referral. If alternative entities are reasonably available, the practitioner shall provide the patient with a list of such alternative entities and shall inform the patient of the option to use an altemative entity. The practitioner shall also inform the patient that choosing another entity will not affect his treatment or care;

2. Information on the practitioner's investment shall be provided if requested by any third party payor;

3. The entity shall establish and utilize an internal utilization review program to ensure that practitioner-investors are engaging in appropriate and necessary utilization; and

4. In the event of a conflict of interests between the practitioner's ownership interests and the best interests of any patient, the practitioner shall not make a referral to such entity, but shall make alternative arrangements for the referral.

D. Further, a practitioner may refer patients for health services to a publicly traded entity in which such practitioner has an investment interest, without applying for or receiving an exception from the Board, if all of the following conditions are met:

1. The entity's stock is listed for trading on the New York Stock Exchange or the American Stock Exchange or is a national market system security traded under an automated interdealer quotation system operated by the National Association of Securities Dealers;

2. The entity had, at the end of the corporation's most recent fiscal year, total net assets of at least $50,000,000 related to the furnishing of health services;

3. The entity markets and furnishes its services to practitioner-investors and other practitioners on the same and equal terms;

4. All stock of the entity, including the stock of any predecessor privately held company, is one class without preferential treatment as to status or remuneration;

5. The entity does not issue loans or guarantee any loans for practitioners who are in a position to refer patients to such entity;

6. The income on the practitioner's investment is not tied to referral volumes and is based on the practitioner's equity interest in the entity; and

7. The practitioner's investment interest does not exceed one half of one percent of the entity's total equity.

§ 54.1-2412. Board to administer; powers and duties of Board; penalties for violation.

A. In addition to its other powers and duties, the Board of Health Professions shall
administer the provisions of this chapter.

B. The Board shall promulgate, pursuant to the Administrative Process Act (§ 96.14:1 et seq.), regulations to:

• 1. Establish standards, procedures, and criteria which are reasonable and necessary for the effective administration of this chapter;

• 2. Establish standards,procedures, and criteria for determining compliance with, exceptions to, and violations of the provisions of § 54.1-2411;

• 3. Establish standards, procedures, and criteria for advising practitioners and entities of the applicability of this chapter to activities and investments;

• 4. Levy and collect fees for processing requests for exceptions from the prohibitions set forth in this chapter and for authorization to make referrals pursuant to § 54.1-2411 B;

• 5. Establish standards, procedures, and criteria for review and referral to the appropriate health regulatory board of all reports of investigations of alleged violations of this chapter by practitioners and for investigations and determinations of violations of this chapter by entities;

• 6. Establish standards, procedures, and criteria for granting exceptions from the prohibitions set forth in this chapter; and

• 7. Establish such other regulations as may reasonably be needed to administer this chapter.

• C. Upon a determination of a violation by the Board, pursuant to the Administrative Process Act (§ 9-6.14:1 et seq.), any entity, other than a practitioner. that presents or causes to be presented a bill or claim for services that the entity knows or has reason to know is prohibited by § 54.1-2411 shall be subject to a monetary penalty of no more than $20,000 per referral, bill, or claim. The monetary penalty may be sued for and recovered in the name of the Commonwealth. All such monetary penalties shall be deposited in the Literary Fund.

• D. Any violation of this chapter by a practitioner shall constitute grounds for disciplinary action as unprofessional conduct by the appropriate health regulatory board within the Department of Health Professions. Sanctions for violation of this chapter may include, but are not limited to, the monetary penalty authorized in § 54.1-2401.

§ 54.1-2413. Additional conditions related to practitioner-investors.

A. No hospital licensed in this Commonwealth shall discriminate against or otherwise penalize any practitioner for compliance with the provisions of this chapter.

B. No practitioner, other health care worker, or entity shall enter into any agreement,arrangement, or scheme intended to evade the provisions of this chapter by inducing patient referrals in a manner which would be prohibited by this chapter if the practitioner made the referrals directly.

C. No group practice shall be formed for the purpose of facilitating referrals that would otherwise be prohibited by this chapter.

D. Notwithstanding the provisions of this chapter, a practitioner may refer a patient who is a member of a health maintenance organization to an entity in which the practitioner is an investor if the referral is made pursuant to a contract with the health maintenance organization.

54.1-2414. Applicability of chapter; grace period for compliance.-This chapter shall apply, in the case of any investment interest acquired after February 1, 1993, to referrals for health services made by a practitioner on or after July 1, 1993. However, in the case of any investment interest acquired prior to February 1, 1993, compliance with the provisions of this chapter is required by July 1, 1996.

CHAPTER 25.

DEPARTMENT OF HEALTH PROFESSIONS

§ 54.1-2500. Definitions.-As used in this chapter, unless the context requires a different meaning:

"Board" means the Board of Health Professions.

"Department" means the Department of Health Professions.

"Director" means the Director of the Department of Health Professions.

"Health regulatory board" or "regulatory board" means any board included within the Department of Health Professions as provided in § 54.1-2503.

§ 54.1-2501. Department established.-The Department of Health Professions established within the executive branch, shall be under the supervision and management of the Director of the Department.

§ 54.1-2502. Use of consultants in investigations.-The Department of Health Professions shall establish a roster of consultants in health care specialties for each health regulatory board, as required. The Department shall contract with each consultant to assist in the investigation and evaluation of violations of statute or regulations of the health regulatory boards and to provide expert testimony as necessary in any subsequent administrative hearing. The cost of the consultants shall be paid by the board for which the services are provided.

Any consultant under contract to the Department shall have immunity from civil liability resulting from any communication, finding, opinion or conclusion made in the course of his duties unless such person acted in bad faith or with malicious intent.

§ 54.1-2503. Boards within Department.--In addition to the Board of Health Professions, the following boards are included within the Department: Board of Audiology and SpeechLanguage Pathology, Board of Dentistry, Board of Funeral Directors and Embalmers, Board of Medicine, Board of Nursing, Board of Nursing Home Administrators, Board of Optometry, Board of Pharmacy, Board of Professional Counselors, Board of Psychology, Board of Recreation Specialists, Board of Social Work and Board of Veterinary Medicine.

§ 54.1-2504. Appointment of Director.-The Director of the Department of Health Professions shall be appointed by the Governor, subject to confirmation by the General Assembly, to serve at the pleasure of the Governor.

§ 54.1-2505. Powers and duties of Director of Department.-The Director of the Department shall have the following powers and duties:

1 . To supervise and manage the Department;

2. To perform or consolidate such administrative services or functions as may assist the operation of the boards;

3. To prepare, approve and submit to the Governor, after consultation with the boards, all requests for appropriations and be responsible for all expenditures pursuant to appropriations;

4. To provide such office facilities as will allow the boards to carry out their duties;

5. To employ personnel as required for the proper performance of the responsibilities of the Department subject to Chapter 10 (§ 2. 1 -110 et seq.) of Title 2.1 within the limits of appropriations made by law; 6. To receive all complaints made against regulated health care professionals;

7. To develop administrative policies and procedures governing the receipt and recording of complaints;

8. To monitor the status of actions taken under the auspices of the boards regarding complaints until the closure of each case;

9. To provide investigative and such other services as needed by the boards to enforce their respective statutes and regulations;

10. To provide staff to assist in the performance of the duties of the Board of Health Professions;

11. To collect and account for all fees to be paid into each board and account for and deposit the moneys so collected into a special fund from which the expenses of the regulatory boards, Department and Board of Health Professions shall be paid;

12. To make and enter into all contracts and agreements necessary or incidental to the performance of his duties and the execution \ of his powers, including, but not limited to, contracts with the United States, other states, agencies and govern mental subdivisions of the Commonwealth;

13. To accept grants from the United States government, its agencies and instrumentalities, and any other source. The Director shall have the power to comply with onditions and execute agreements as may be necessary, convenient or desirable;

14. To promulgate and revise regulations necessary for the administration of the Department;

15.To report promptly, after consultation with the presiding officer of the appropriate health regulatory board or his designee, to the Attorney General or the appropriate attorney for the Commonwealth any information the Department obtains which, upon appropriate investigation, indicates, in the judgment of the Director, that a person licensed by any of the health regulatory boards has violated any provision of criminal law relating to manufacturing, distributing, dispensing, prescribing or administering drugs other than drugs classified as Schedule VI drugs. When necessary, the Attorney General or the attorney for the Commonwealth shall request that the Department of Health Professions or the Department of State Police conduct any subsequent investigation of such report. For the purpose of this section, the terms manufacturing, distributing, dispensing, prescribing or administering drugs shall not include minor administrative or clerical errors which do not affect the inventory of drugs required by Chapter 34 (§ 54.1-3400 et seq.) of this title and do not indicate a pattern of criminal behavior;

16. To keep records of the names and qualifications of registered, certified or licensed persons;

17. To exercise other powers and perform other duties required of the Director by the Governor; and

18. To issue subpoenas in accordance with the Administrative Process Act (§ 9-6.14:1 et seq.) for any informal fact finding or formal proceeding within the jurisdiction of the Department or any regulatory board.

54.1-2506. Enforcement of laws by Director and investigative personnel; authority of investigative personnel.-The Director and investigative personnel appointed by him shall be swom to enforce the statutes and regulations pertaining to the Department, the Board, and the health regulatory boards and shall have the authority to investigate any violations of those statutes and regulations and to the extent otherwise authorized by law inspect any office or facility operated, owned or employing individuals regulated by any health regulatory board. The Director or his designee shall have the power to subpoena witnesses and issue subpoenas requiring the production of patient records, business records, papers, and physical or other evidence in the course of any investigation.

All investigative personnel shall be vested with the authority to (i)administer oaths or affirmations for the purpose of receiving complaints of violations of this subtitle, (ii) serve and execute any warrant, paper or process issued by any court or magistrate, the Board, the Director or in his absence a designated subordinate, or by any regulatory board under the authority of the Director, and (iii) request and receive criminal history information under the provisions of § 19.2389.

§ 54.1-2506.1. Submission of required inform ation.-The Department is authorized to require individuals applying for initial licensure and individuals who are licensed to practice medicine, osteopathic medicine, dentistry, or to practice as a physician's assistant, nurse practitioner or dental hygienist, to provide information in addition to that which is required to determine the individual's qualifications to be licensed. Such additional information shall identify the individual's specialty and subspecialty; credentials and certifications issued by professional associations, institutions and boards; and locations of practice and number of hours spent practicing at each practice location. Such information shall be collected and maintained by the Department for manpower planning purposes in cooperation with agencies and institutions of the Commonwealth and shall be released by the Department only in the aggregate without reference to any licensee's name or other individual identifying particulars. Prior to collecting any information described in this section from individual licensees, the Department shall first attempt to obtain from other sources information sufficient for manpower planning purposes.

§ 54.1-2507. Board of Health Professions; membership, appointments,and terms of office.- The Board of Health Professions shall consist of one member from each health regulatory board appointed by the Governor, and five members to be appointed by the Governor from the Commonwealth at large. No member of the Board of Health Professions who represents a health regulatory board shall serve as such after he ceases to be a member of a board. The members appointed by the Governor shall be subject to confirmation by the General Assembly and shall serve for four-year terms.

§ 54.1-2508. Chairman; meetings of Board; quorum.-The chairman of the Board of Health Professions shall be elected by the Board from its members. The Board shall meet at least once quarterly and may hold additional meetings as necessary to perform its duties. A majority of the Board shall constitute a quorum for the conduct of business.

§ 54.1-2509. Reimbursement of Board members for expenses.-All members of the Board shall be compensated in accordance with § 2.1-20.3 from the funds of the Department.

§ 54.1-2510. Powers and duties of Board of Health Professions.-The Board of Health Professions shall have the following powers and duties:

1. To evaluate the need for coordination among the health regulatory boards and their staffs and report its findings and recommendations to the Director and the boards;

2. To evaluate all health care professions and occupations in the Commonwealth, including those regulated and those not regulated by other provisions of this title, to consider whether each such profession or occupation should be regulated and the degree of regulation to be imposed. Whenever the Board determines that the public interest requires that a health care profession or occupation which is not regulated by law should be regulated, the Board shall recommend to the General Assembly a regulatory system to establish the appropriate degree of regulation;

3. To review and comment on the budget for the Department;

4. To provide a means of citizen access to the Department;

5. To provide a means of publicizing the policies and programs of the Department in order to educate the public and elicit public support for Department activities;

6. To monitor the policies and activities of the Department, serve as a forum for resolving conflicts among the health regulatory boards and between the health regulatory boards and the Department and have access to departmental information;

7. To advise the Governor, the General Assembly and the Director on matters relating to the regulation or deregulation of health care professions and occupations;

8. To make bylaws for the government of the Board of Health Professions and the proper fulfillment of its duties under this chapter;

9. To promote the development of standards to evaluate the competency of the professions and occupations represented on the Board;

10. To review and comment, as it deems appropriate, on all regulations promulgated or proposed for issuance by the health regulatory boards under the auspices of the Department. At least one member of the relevant board shall be invited to be present during any comments by the Board on proposed board regulations;

11. To review periodically the investigatory, disciplinary and enforcement processes of the Department and the individual boards to ensure the protection of the public and the fair and equitable treatment of health professionals;

12. To examine scope of practice conflicts involving regulated and unregulated professions and advise the health regulatory boards and the General Assembly of the nature and degree of such conflicts;

13. To receive, review, and forward to the appropriate health regulatory board any departmental investigative reports relating to complaints of violations by practitioners of Chapter 24.1 (§ 54.1-2410 et seq.) of this subtitle;

14. To determine compliance with and violations of and grant exceptions to the prohibitions set forth in Chapter 24.1 (§ 54.1-2410 et seq.) of this subtitle; and

15. To take appropriate actions against entities, other than practitioners, for violations of Chapter 24.1 (§ 54.1-2410 et seq.) of this subtitle.

CHAPTER 37.

SOCIAL WORK

§ 54.1-3700. Definitions.-As used in this chapter, unless the context requires a different meaning:

"Adiministration " means the process of attaining the objectives of an organization through a system of coordinated and cooperative efforts to make social service programs effective instruments for the amelioration of social conditions and for the solution of social problems.

"Board" means the Board of Social Work.

"Casework" means both direct treatment, with an individual or several individuals, and intervention in the situation on the client's behalf with the objectives of meeting the client's needs, helping the client deal with the problem with which he is confronted, strengthening the client's capacity to function productively, lessening his distress, and enhancing his opportunities and capacities for fulfillment.

"Casework management and supportive services" means assessment of presenting problems and perceived needs, referral services, policy interpretation, data gathering, planning, advocacy, and coordination of services.

"Clinical social worker" means a social worker who, by education and experience, is professionally qualified at the autonomous practice level to provide direct diagnostic, preventive and treatment services where functioning is threatened or affected by social and psychological stress or health impairme