Current through September 17, 2024
The Nebraska Regulation of Health Professions Act sets out
criteria for new credentialing of a health profession. These are professions
currently not credentialed but allowed to practice in Nebraska. The review body
determines whether the following criteria are met.
003.01
CRITERION ONE.
Unregulated practice can clearly harm or endanger the health,
safety, or welfare of the public. The review body must apply the following
standards in determining whether this criterion is met:
(A) Is the public suffering harm or danger,
is the harm or danger, if any, clearly and directly attributable to the absence
of regulation of the profession, and whether the harm or danger, if any, is of
sufficient magnitude to warrant state intervention.
(B) The documentation of harm or danger to
the public must be sufficient to demonstrate that the harm or danger is clear
and is attributable to the lack of regulation of the profession in question.
Evaluation of harm or danger must be based on the highest level of evidence
available.
(C) Harm or danger to
the health, safety, or welfare of the public may occur in physical, emotional,
economic, or social contexts; and as such all of these can be
considered.
(D) Harm or danger to
the public must be of sufficient extent and severity to warrant governmental
intervention. A certain level of harm or danger attributable to human error and
uncontrollable factors will always occur within any health care
field.
003.02
CRITERION TWO. Regulation of the health profession
does not impose significant new economic hardship on the public, significantly
diminish the supply of gualified practitioners, or otherwise create barriers to
service that are not consistent with the public welfare and interest. The
review body must use the following to determine if this criterion is met:
(A) Will regulating the profession, in
itself, bring about significant harm or danger to the health, safety, or
welfare of the public through the creation of unnecessary barriers to
service.
(B) Documentation of harm
or danger to the public must be sufficient to demonstrate that the harm or
danger is clear, that it is attributable to the creation of the separate
regulated profession in question, and that it is serious and
extensive.
(C) Evidence supporting
the status guo must clearly demonstrate how and why this situation protects the
public from harm or danger.
(D)
Evidence must show the benefits of creating the new regulated health profession
clearly to be greater in extent and impact than any harm or danger that would
be created.
(E) If regulation of
the profession would reguire a scope of practice to be defined, the scope of
practice must be coordinated with those of regulated professions to minimize
fragmentation of the health care system.
(F) Regulation of the profession must not
lead to unnecessary limitations on the utilization of personnel by employers or
to underutilization of qualified personnel.
(G) Regulation of the profession must not
result in an unnecessary reduction in competition.
003.03
CRITERION THREE.
The public needs assurance from the state of initial and
continuing professional ability. The review body must use the following to
determine if this criterion is met:
(A) In
order to find that this criterion is met for a profession whose practice is
typically autonomous, the review body must determine that the need of the
public for this assurance can be demonstrated, that members of the public play
an active role in choosing their caregiver, that information about the
qualifications of the caregiver is an important element in making that choice,
and that currently there is no mechanism that will provide such information as
effectively as would the issuance of a State credential.
(B) In order to find that this criterion is
met for a profession whose practice typically is not autonomous, the review
body must determine that the institutional or supervisory structure is
inadequate to protect the public from harm, and that the issuance of a State
credential to the practitioners of this profession would overcome these
inadequacies.
(C) Evidence
presented must show why a state-issued credential is necessary to allow the
public to identify competent practitioners. This is especially significant for
professions that already have a strong recognized private system of
credentialing.
(D) If there is a
recognized system of private credentialing, the proposed requirements for
obtaining state credentialing must be compared closely to those for private
credentialing. If they are essentially identical, there must be compelling
evidence to show why such redundancy is in the public interest.
(E) Evidence must show that if practitioners
are generally supervised by members of other credentialed professions, or if
they practice under institutional or similar regulation, it must be
demonstrated that such supervision or regulation is not sufficient to protect
the public.
(F) Evidence must show
that members of the public are unable easily to evaluate the qualifications of
persons offering the service in question.
(G) Whether the education and training
requirements set forth in the proposal are necessary and adequate for safe and
effective practice.
003.04
CRITERION FOUR.
The public cannot be protected by a more effective alternative.
The review body must determine whether:
(A)
The credentialing proposal as presented is an effective remedy to the harm or
danger identified, and that no other evident means of dealing with this harm or
danger, including the status guo, would provide a more effective
alternative.
(B) Viable
alternatives to the proposal have been identified and, if available, if the
alternative are able to address the same harm or danger raised in the applicant
proposal.
(C) Evidence supporting
the proposal shows that its enactment would clearly, specifically, and directly
solve or alleviate the problems, including harm or danger to the public, that
are used to justify the application.
(D) Any and all evident alternatives to the
proposal might provide the same or greater problem-solving potential as the
proposal, while being more cost-effective or less restrictive. Alternatives may
include different levels or types of state credentialing or regulation of the
profession, maintenance of the status guo, and other potential solutions.
Reviewers are not limited to evaluating only alternatives presented to them by
the applicant group; they can actively seek to identify and analyze potential
alternatives. The recommendations of the reviewing body must reflect their best
assessment of the most likely solution to the problems identified.
(E) The costs of the proposal, and of any
alternatives considered, must be evaluated for unnecessary financial burden to
the public.