REGULATORY BOARD REVIEW BOARD OF OCCUPATIONAL THERAPY October 2012 PE 12-11-522 AUDIT OVERVIEW The Regulation of the Board of Occupational Therapy Is Necessary To Protect the Public The West Virginia Board of Occupational Therapy Is in Compliance With Most of the General Provisions of Chapter 30 The Board of Occupational Therapy Should Make Improvements to Its Website to Enhance User-Friendliness and Transparency The Board of Occupational Therapy Board Members’ Terms Have Expired WEST VIRGINIA LEGISLATIVE AUDITOR PERFORMANCE EVALUATION & RESEARCH DIVISION
Transcript
REGULATORY BOARD REVIEW
BOARD OF OCCUPATIONAL THERAPY
October 2012PE 12-11-522
AUDIT OVERVIEW
The Regulation of the Board of Occupational Therapy Is Necessary To Protect the Public
The West Virginia Board of Occupational Therapy Is in Compliance With Most of the General Provisions of Chapter 30
The Board of Occupational Therapy Should Make Improvements to Its Website to Enhance User-Friendliness and Transparency
The Board of Occupational Therapy Board Members’ Terms Have Expired
The Board’s procedure for financial management lacks controls with respect tosegregationofduties.AlthoughtheBoardhasproceduresforprocessingcashreceipts,theBoardcannotestablishappropriatesegregationofdutiesbecause itonlyhasoneemployee.Inordertocorrectthisproblem,theLegislativeAuditorrecommendsthattheBoardbeginutilizingtheStateTreasurer’sOfficelockboxbankingsystem.
TheBoard is incompliancewithcontinuingeducation requirements, complaintsareresolvedinatimelymannerwithdueprocess,andtheBoardispubliclyaccessible.
5. The Legislative Auditor recommends that the Legislature consider combining therequirementsinCodethatrequireChapter30boardstosubmitanannualreporttoboththeLegislatureandtheGovernor’sOffice,andhavingtheannualreportpublishedonacentralStatewebsite.
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ISSUE1
Individuals who seek the services of occupational therapists have devel-oped or are at risk of developing vari-ous illnesses, injuries, disorders, im-pairments, or activity limitations that affect their ability to function at home, in the workplace, and other settings.
The Regulation of the Board of Occupational Therapy Is Necessary To Protect the Public.
Issue Summary
The West Virginia Board of Occupational Therapy is chargedwith addressing physical, cognitive, psychosocial, sensory, and otheraspectsofperformanceofindividuals.Individualswhoseektheservicesofoccupational therapistshavedevelopedor are at riskofdevelopingvariousillnesses,injuries,disorders,impairments,oractivitylimitationsthataffecttheirabilitytofunctionathome,intheworkplace,andothersettings.IndeterminingtheneedfortheBoard,aprimaryconsiderationistheextenttowhichsignificantanddiscernibleadverseeffectsonpublicwelfarewouldoccuriftheBoardwereabolished.The Legislative Auditor finds that the licensing of Occupational Therapists is necessary for protecting the citizens of West Virginia.
AccordingtotheBoard,inordertoprotectthepublic,promotequalityofoccupationaltherapyservices,andassurethehighestdegreeofprofessionalcare,itisimportanttorestrictthepracticeofoccupationaltherapy to individuals who have proven training and qualifications.Withoutregulationtoallowonlyqualifiedindividualstoobtainalicense,define scope of practice, provide supervision guidelines, documentcontinuing education, and a means to receive and resolve complaintsfromthepublicregardingoccupationaltherapyproviders,thehealthandsafetyof thepublicwouldbeat risk. Figure1 shows that from2001to2011,thenumberofOccupationalTherapist(OT)andOccupationalTherapyAssistant(OTA)licenseeshasincreasedalmosteveryyear.
Without regulation to allow only qual-ified individuals to obtain a license, define scope of practice, provide su-pervision guidelines, document con-tinuing education, and a means to re-ceive and resolve complaints from the public regarding occupational therapy providers, the health and safety of the public would be at risk.
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Board of Occupational Therapy
Figure 1: Number of Licensees From 2001 to 2011
All 50 States Require Occupational Therapists to Be Licensed
According to theDepartmentofLabor’sOccupationalOutlookHandbook, all states require Occupational Therapists to be licensed.LicensurerequiresadegreefromanaccreditededucationalprogramandpassingtheNationalBoardforCertificationofOccupationalTherapists(NBCOT) certification exam. Other requirements, such as continuingeducationandfees,varybystate. Additionally,according toNBCOT,Occupational Therapy Assistants are required licensure in 40 states;sixrequirecertification,andfouronlyrequiresupervisionofalicensedOccupationalTherapist.
Occupational Therapists held approximately 108,800 jobs in2010.Forty-eightpercentofOccupationalTherapistsworkedinofficesofphysical,occupationalandspeechtherapists,audiologists,orhospitals.Othersworkedinschools,nursinghomes,andhomehealthservices.
Licensees Are Nationally Accredited
Amaster’sdegreeorhigherinoccupationaltherapyistheminimumrequirementforentryintothefieldasanOccupationalTherapist.Entrylevel education for Occupational Therapy Assistants is an associatedegree. Both must attend schools accredited by the Accreditation
According to the Department of La-bor’s Occupational Outlook Hand-book, all states require Occupational Therapists to be licensed.
A master’s degree or higher in occu-pational therapy is the minimum re-quirement for entry into the field as an Occupational Therapist. Entry level education for Occupational Therapy Assistants is an associate degree.
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Insurance carriers require that Oc-cupational Therapists be licensed by the State in which services are per-formed.
Council forOccupationalTherapyEducation (ACOTE) inorder to sitforthenationalcertifyingexam.ThisnationalexamisadministeredbyNBCOT,and is recognizedbyall state regulatoryentities. Applicantsmustpassthisexamtobeeligibleforlicensure.
Insurance Carriers Require Licensure in Order For Treatment or Services To Be Covered
InsurancecarriersrequirethatOccupationalTherapistsbelicensedbythestateinwhichservicesareperformed.AccordingtotheCentersfor Medicare & Medicaid Services, under its Physical, Occupational&SpeechTherapyBillingGuide,a“qualifiedprofessional”referstoaphysical therapist,occupational therapist, speech-languagepathologist,physician, nurse practitioner, clinical nurse specialist, or physician’sassistant, who is licensed or certified by the state to perform therapyservices,andwhoalsomayappropriatelyperformtherapyservicesunderMedicarepolicies.Inaddition,inordertoreceivecoveragefromPEIA,anOccupationalTherapistmustbelicensed.
Conclusion
Currently,50statesrequirelicensureforOccupationalTherapistsand 40 states for Occupational Therapist Assistants. The number ofOccupational Therapist and Occupational Therapy Assistant licenseeshas increased almost everyyear since2001. In 2011, therewere588Occupational Therapists and 358 Occupational Therapy Assistantslicensed in West Virginia. Licensure in West Virginia assures thatOccupationalTherapistsarenationallyaccreditedandhaveobtainedatleast a master’s degree in OccupationalTherapy. Both Medicare andPEIA require licensurebyOccupationalTherapists inorder to receivecoverage.Withoutregulationthehealthandsafetyofthepublicwouldbeatrisk.TheLegislativeAuditorfindsthatthelicensingofOccupationalTherapistsisnecessaryforprotectingthecitizensofWestVirginia.
Recommendation
1. The Legislative Auditor recommends that the licensing ofOccupationalTherapistsisnecessaryforprotectingthecitizensofWestVirginia.
In 2011, there were 588 Occupation-al Therapists and 358 Occupational Therapy Assistants licensed in West Virginia. Licensure in West Virginia assures that Occupational Therapists are nationally accredited and have obtained at least a master’s degree in Occupational Therapy.
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The West Virginia Board of Occu-pational Therapy is in satisfactory compliance with most of the general provisions of Chapter 30 of the West Virginia Code.
The West Virginia Board of Occupational Therapy Is In Compliance With Most of the General Provisions of Chapter 30.
TheWestVirginiaBoardofOccupationalTherapyisinsatisfactorycompliancewithmostofthegeneralprovisionsofChapter30oftheWestVirginiaCode.Theseprovisionsareimportantfortheeffectiveoperationof regulatory boards. The Board is in compliance with the followingprovisions:
Financial self-sufficiency of regulatory boards is required byWestVirginiaCode§30-1-6(c).AsshowninTable1,theBoard’send-of-yearbalancesfromFY2007throughFY2011havebeenincreasingandconfirmthattheBoardiscurrentlyself-sufficient.
Issue2
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Effective May 1, 2012, the initial li-cense fee for an Occupational Thera-pist was reduced from $250 to $150; and for an Occupational Therapy Assistant license the fee was reduced from $200 to $100.
Table 1Board of Occupational Therapy
Revenues and Expenditures 2007 to 2011Beginning of
EffectiveMay1,2012,theinitiallicensefeeforanOccupationalTherapist was reduced from $250 to $150; and for an OccupationalTherapyAssistantlicensethefeewasreducedfrom$200to$100.ThereductioninlicensingfeeswastheresultofthecurrentfinancialpositionoftheBoardandtoprovidethelicenseeswithapositivechange.AccordingtoacostanalysisconductedbytheBoard,areductioninthesefeeswillimpacttheBoard’sbudgetbyadecreaseofapproximately$10,000peryear.TheBoardstillanticipateshavingsufficientfundstooperateasaresultofthesefeereductions.
In August 2012, the West Virginia State Treasurer’s OfficenotifiedtheBoardthatitscashbalancewasmorethantwiceitsannualbudgetbytheamountof$8,461.TheStateTreasurer’sOfficeinformedtheBoardthattheamountmustbesweptintothestateGeneralRevenueFundpursuanttoWVC§30-1-10.AccordingtotheStateTreasurer,thetransferofexcesscashtotheGeneralFundwascompletedonSeptember4,2012.
In the Past the Board Has Over-Charged Its Per Diem
AlthoughtheBoardhascorrectedtheproblem,from2009to2011,theBoardover-chargeditsperdiemby$2,180.AccordingtoWVC§30-1-11,eachmemberoftheBoardisentitledtoreceivecompensationforattendingofficialmeetingsorengaginginofficialdutiesnot toexceedtheamountpaidtomembersoftheLegislaturefortheirinterimdutiesasrecommended by the Citizens Legislative Compensation Commission.WVC §4-2A-3 allows members of the Legislature a compensation of$150perday.From2009to2011,theBoardpaidboardmembers$18.75foreachhourattributedtowardsboardactivitieswiththereasoningthat
In August 2012, the West Virginia State Treasurer’s Office notified the Board that its cash balance was more than twice its annual budget by the amount of $8,461.
Although the Board has corrected the problem, from 2009 to 2011, the Board over-charged its per diem by $2,180.
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The Board’s procedure for financial management lacks controls with re-spect to segregation of duties. Al-though the Board has procedures for processing cash receipts, the Board cannot establish appropriate segrega-tion of duties because it only has one employee.
$150dividedby8hoursequals$18.75perhour.However,thereweremany instances where board members worked more than 8 hours andwerepaid thedifference. The Board is aware of the error and has since become compliant with WVC §4-2A-3, limiting the per diem to $150 per day.
Better Financial Internal Controls Should Be Established in Regards to Segregation of Duties
TheBoard’sprocedureforfinancialmanagementlackscontrolswithrespecttosegregationofduties.AlthoughtheBoardhasproceduresfor processing cash receipts, the Board cannot establish appropriatesegregationofdutiesbecauseitonlyhasoneemployee.SegregationofdutiesisanimportantinternalcontrolthatguardsagainstinappropriateuseoffundsreceivedbytheBoard.TheBoard’ssingleemployeehandlesallcomponentsoftransactionsrelatedtofinancessuchasreceivingallrevenues,imagesanddepositsallchecks,andinformstheWestVirginiaStateTreasurer’s Office of the deposit amounts and the source of therevenue.
The Legislative Auditor recommends that the Board beginutilizing the State Treasurer’s lockbox. Use of the lockbox wouldestablish a segregation of financial duties. The StateTreasurer offerslockboxbankingtostateagenciesforanominalcost.ThischangewouldrequirethattheBoard’slicenseesmailfeesdirectlytoapostofficeboxaccessibleonlybytheStateTreasurer.SeeAppendixDforadescriptionofthelockboxservice.
Complaints to the Board Are Resolved Timely and With Due Process
The Legislative Auditor reviewed all 11 complaints receivedfrom2008 to2010. Thenatureof the complaintswere allegationsoffalsification of records, practicing on expired license (late renewal),alleged neglect of patient, and fraudulent billing for services. Thesecomplaintswere resolvedwithin the18-monthperiod asmandatedbystatute.ThecomplaintresolutiontimefortheBoardfrom2008to2010rangedfrom2monthsto8months,withanoverallresolutiontimeaverageof4months.Table2showsthenumberofcomplaintsreceivedyearlyforthepastthreefiscalyearsandtheaveragetimetoresolution.
The Legislative Auditor recommends that the Board begin utilizing the State Treasurer’s lockbox. Use of the lockbox would establish a segregation of financial duties.
The complaint resolution time for the Board from 2008 to 2010 ranged from 2 months to 8 months, with an overall resolution time average of 4 months.
WhenacomplainttotheBoardisreceivedandfiled,theBoardisrequiredtoforwardacopytothelicenseeforaresponse.Thelicenseemustrespondtothecomplaintwithin30days.Afterreceiptandreviewofcomplaint,theBoardshallrequireanyreasonableinquiryorinvestigationitconsidersnecessarytobeconductedtodeterminethetruthandvalidityoftheallegationssetforthinthecomplaint.AnassignedcommitteeoftheBoardoraninvestigator/inspectorshall,within60days,reviewandinvestigate the complaint and provide the Board with a report. Oncetheinvestigatorreportsfindings,theBoardvotestodetermineprobablecauseofCodeviolations.Ifprobablecauseisdetermined,disciplinaryactionsaretakenandaformaldecisioniswritten.Figure2illustratestheBoard’sprocessforinvestigatingandresolvingcomplaints.
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Each licensee shall complete a minimum of 24 contact hours of continuing education and compe-tency activities during the two-year period preceding the application for renewal.
Figure 2: Board of Occupational Therapy Complaint Process
The Board Is Complying With Continuing Education Requirements
TheBoardiscomplyingwithcontinuingeducationrequirementsforitslicensees.Eachlicenseeshallcompleteaminimumof24contacthoursofcontinuingeducationandcompetencyactivitiesduringthetwo-yearperiodpreceding the application for renewal. The types of approved continuingeducationandcompetencyactivitiesrecognizedbytheBoardarelistedandexplainedinCSR§13-4-3.8,withthemaximumnumberofhoursthatmaybe earned for each category, if applicable. It is the responsibility of thelicenseetoassurethattheselectedcoursesmeethisorherindividualneedstomaintainknowledgeoftheoryandpracticeinaccordancewiththecontinuingeducationandcompetencyoptionsasoutlinedintheCSR.
The Board randomly selects seven percent of active licenseeseachrenewalcycle toaudit forcompliancewithcontinuingeducationandcompetencyrequirements.Aletternotifyingselectedlicenseesisattachedto
The Board randomly selects seven percent of active licensees each re-newal cycle to audit for compliance with continuing education and competency requirements.
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During the time period from 2010 to 2012, the Board found that only 4 out of 115 licensees had been out of com-pliance regarding continuing educa-tion completion.
therenewalapplication.Tocomplywiththeaudit,licenseesmustsubmitcopiesofcertificatesofcompletionorotherdocumentationsubstantiatingcompletionofthecontinuingeducationactivitieslistedontheirrenewalapplication.Ifalicenseefailstosubmittheauditinformationrequestedby the Board or meet the unit requirements, the Board communicateswiththelicenseeanddoesnotrenewthelicenseuntilallrequirementsaremet.
During the time period from 2010 to 2012, the Board foundthatonly4outof115licenseeshadbeenoutofcomplianceregardingcontinuing education completion. The reason for the non-compliancewas due to licensees not renewing their license or not sending incontinuingeducationcertificatesofcompletion(seeTable3).AccordingtotheBoard,inallcaseswhereauditedlicenseesdidnotrenew,itwasconfirmed that theywereno longerworking inWestVirginiaandhadmovedoutofstate.Inaddition,thereasontherearefewerauditsfor2011and2012isduetotheBoard’smovetoabiennialrenewalschedule.
Table 3Number of Licensee Audits for Continuing Education Compliance
Year Number of Audits Number of Licensees Not in Compliance
Reason for Non-Compliance
2010 52 1 DidNotRenewLicense
2011 31 1 DidNotRenewLicense
2012 32 2 DidNotRenewLicense
Source:WestVirginiaBoardofOccupationalTherapy.
The Board’s Register Is Incomplete
The Board has compiled a register of applicants, but it isincomplete.AccordingtoWVC§30-1-12(a):
Thesecretaryofeveryboardshallkeeparecordof its proceedings and a register of all applicants forlicenseorregistration,showingforeachthedateofhisor her application, his or her name, age, educationalandotherqualifications,placeofresidence,whetheranexamination was required, whether the applicant wasrejectedoracertificateoflicenseorregistrationgranted,thedateofthisaction,thelicenseorregistrationnumber,all renewals of the license or registration, if required,andanysuspensionorrevocationthereof.
According to the Board, in all cases where audited licensees did not re-new, it was confirmed that they were no longer working in West Virginia and had moved out of state.
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The register has the date-of-birth for some licensees, but not all. In addi-tion, the educational qualifications for licensees are not included as required in WVC §30-1-12(a).
The register contains the applicant’s name, address, status oflicense, date of license, and all renewals of the license. The registerhas the date-of-birth for some licensees, but not all. In addition, theeducationalqualifications for licenseesarenot includedas required inWVC§30-1-12(a).
The Board Submits Annual Reports to the Legislature But Not to the Governor
As required in Code, the Board submits annual reports to theLegislatureeachyear,but itdoesnotsubmitreports to theGovernor’sOffice.WVC§30-1-12(b)states:
DocumentationshowsthattheBoardhasprovidedtheLegislatureanannualreportfortheyears2007to2011.However,areporthasnotbeen received by the Governor’s Office for those same years. The Legislative Auditor recommends that the Board submit an annual report to the governor each year as required in Code.
Since Chapter 30 boards have dual requirements to send theirannualreportstotheLegislatureandtheGovernor’sOffice,duplicationcouldbeeliminatedbycombiningtheserequirementsandreportingtheannual report on a central State website. Therefore, the Legislative Auditor recommends that the Legislature should consider combining these annual report submission requirements and having the report published on a central State website.
The Board of Occupational Therapy Is Publicly Accessible
The Board of OccupationalTherapy is in compliance with thegeneral provisions of Chapter 30 that require public accessibility. Incompliance with statute, the Board has its telephone number listed inthe Charleston telephone book. The website lists information such asprofessionalcredentialsandtermdatesforeachboardmemberaswellasstaff.Additionally,thewebsiteallowsuserstoaccessdisciplinarymeasurestakenbytheBoardagainstalicensee,legislativerulesandapplications/renewalforms,scheduledboardmeetingsandfeeinformation.TheBoardofOccupationalTherapy’sLicenseeSearchallowsthepublictoaccess
Documentation shows that the Board has provided the Legislature an an-nual report for the years 2007 to 2011. However, a report has not been re-ceived by the Governor’s Office for those same years.
Since Chapter 30 boards have dual requirements to send their annual reports to the Legislature and the Governor’s Office, duplication could be eliminated by combining these re-quirements and reporting the annual report on a central State website.
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informationaboutanyofitslicensees.Inaddition,thepubliccanaccesscomplete license details and a statement of any disciplinary actionsregardingthelicensureofanylicensee.FormoredetailontheBoard’swebsite,seeIssue3.
Conclusion
TheWestVirginiaBoardofOccupationalTherapyisincompliancewithmostofthegeneralprovisionsofChapter30oftheWestVirginiaCode.TheBoardisfinanciallyself-sufficient;howevertheBoardshouldbeginutilizingtheStateTreasure’slockboxbankingsystemtoestablishbetterfinancial internalcontrolsregardingsegregationofduties. Complaintsto the Board are resolved timely and with due process, the Board iscomplyingwithcontinuingeducationrequirementsforitslicensees,andtheBoardispubliclyaccessible.Nevertheless,althoughtheBoardkeepsa register, it is incomplete. Inaddition, theBoardneeds to submitanannualreporttotheGovernorasrequiredinCode.Ultimately,from2009to2011,theBoardover-chargeditsperdiemby$2,180.TheBoardisawareoftheerrorandhassincebecomecompliantwithWVC§4-2A-3,limitingtheperdiemto$150perday.
Recommendations
2. TheLegislativeAuditorrecommendsthattheBoardbeginutilizingtheStateTreasure’s lockboxbanking system to establishbetterfinancialinternalcontrolsregardingsegregationofduties.
3. The Board of Occupational Therapy should add to its registertheapplicant’sage,andeducationalqualificationsasrequiredinWVC§30-1-12(a).
4. The LegislativeAuditor recommends that the Board submit anannualreporttotheGovernoreachyearasrequiredinWVC§30-1-12(b).
5. TheLegislativeAuditorrecommendsthattheLegislatureconsidercombining the requirements in Code that require Chapter 30boardstosubmitanannualreporttoboththeLegislatureandtheGovernor’sOffice,andhavingtheannualreportpublishedonacentralStatewebsite.
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The Board of Occupational Therapy integrates 36 percent of the checklist items within its website. This rating is at a level that shows the agency has given consideration to the issues of transparency and user-friendliness in the use of website technology; howev-er, more improvements can be made.
Issue3
The Board of Occupational Therapy Should Make Improvements to Its Website to Enhance User-friendliness and Transparency.
Issue Summary
It has become common and expected that government conveyto the public what it is doing through website technology. A numberoforganizationshavedevelopedassessmentcriteriatoevaluatefederaland state government websites for transparency and user-friendliness.TheLegislativeAuditorconductedaliteraturereviewonassessmentsofgovernmentwebsitesanddevelopedanassessmenttooltoevaluateWestVirginia’sstateagencywebsites(seeAppendixC).Theassessmenttoollistsalargenumberofwebsiteelements;however,someelementsshouldbeincludedineverystatewebsite,whileotherelementssuchassocialmedia links, graphics, and audio/video features may not be necessaryor practical for certain agencies. Table 4 indicates that the Board ofOccupationalTherapyintegrates36percentofthechecklistitemswithinits website. This rating is at a level that shows the agency has givenconsideration to the issuesof transparencyanduser-friendliness in theuseofwebsitetechnology;however,moreimprovementscanbemade.
The Board Website Has Both User-friendly and Transparency Components But Improvements Are Needed
Inorderforcitizenstoactivelyengagewithanagencyonlinetheymustfirstbeabletoaccessandcomprehendinformationongovernmentalwebsites. Therefore, governmental websites should be designed withcitizensinmind.Auser-friendlywebsiteisreadable,efficientandallowsforcitizenstoeasilynavigatefrompagetopage.Governmentalwebsitesshould also be transparent and provide citizens with confidence andtrustintheagency.Transparencypromotesaccountabilityandprovidesinformationforcitizensaboutwhatgovernmentisdoing.
A user-friendly website is readable, ef-ficient and allows for citizens to eas-ily navigate from page to page. Gov-ernmental websites should also be transparent and provide citizens with confidence and trust in the agency.
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TheLegislativeAuditorreviewedtheBoardwebsiteforbothuser-friendlinessandtransparency.Table5demonstratestheBoardwebsitehas both user-friendly and transparency components; however, moreimprovementsareneededtoaddressareasthatarelacking.
Table 5West Virginia Board of Occupational Therapy Website Evaluation Score
The Board Website is Well-Designed But More Improvements Are Needed
The Board website is easy to navigate as every page is linkedtotheagency’shomepagewhichhasasearchtoolthatactsasanindexoftheentirewebsite.TheBoardwebsitecanalsobecomprehendedbymostcitizens.AccordingtotheFleschKincaidReadingTest,theaveragereadabilityofthetextisona9thgradereadinglevelmakingitreadableforthemajorityofcitizens.
• Site Map-Alistofpagescontainedonthewebsitethatcanbeaccessedbytheuser.
• Foreign Language Accessibility-A link to translate all webpagesintooneormorelanguagesotherthanEnglish.
• Site Functionality- The website should use sans serif fonts, thewebsiteshouldincludebuttonstoadjustthefontsize,andresizingoftextshouldnotdistortsitegraphics.
• Feedback Options- A page where users can voluntarily submitfeedbackaboutthewebsiteorparticularsectionofthewebsite.
According to the Flesch Kincaid Reading Test, the average readability of the text is on a 9th grade reading level making it readable for the ma-jority of citizens.
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The Board Website Is Transparent, But Could Benefit From Additional Content
A website that is transparent will have elements such as emailcontact information, the location of the agency, the agency’s phonenumber,aswellaspublicrecords,thebudgetandperformancemeasures.Atransparentwebsitewillalsoallowforcitizenengagementsothattheirgovernment can make policies based on the information shared. TheBoard of OccupationalTherapyWebsite Criteria Checklist and PointsSystem(seeAppendixC)demonstratesthattheBoard’swebsitehaslessthanhalfofcoreelementsthatarenecessaryforageneralunderstandingof theagency. However, itemssuchasemailcontact information, thelocationandtelephonenumberoftheBoard,andaprivacypolicyenablecitizenstoadequatelycommunicatewiththeagency.
• Agency History- The agency’s website should include a pageexplaininghowtheagencywascreated,whatithasdone,andhow,ifapplicable,hasitsmissionchangedovertime.
• Mapped Location of Board Office-TheBoard’scontactpageshouldincludeanembeddedmapthatshowstheBoard’slocation.
• Administrator(s) Biography- A biography explaining theadministrator(s)professionalqualificationsandexperience.
Conclusion
Theemerginguseoftechnologyfrompayingbillstointeractivecommunicationhasfiltereditswaytostategovernment.Inordertotakeadvantageof this trend,stateagenciesareutilizingwebsites toengagecitizensasactiveparticipantsinthegovernmentalprocess.Fewstudieshavefocusedon legislativewebsitesand those thathave,usedifferentcriteria when reviewing sites. A literature review was conducted and
A website that is transparent will have elements such as email contact infor-mation, the location of the agency, the agency’s phone number, as well as public records, the budget and perfor-mance measures.
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utilizedtoformulateawebsitechecklistthatgradedtheBoardwebsiteon its user-friendliness and transparency. The Board website is welldesignedbutmoreimprovementsareneeded.Thewebsitecouldbenefitfrom incorporating some interactive features such as a sitemapor byproducingitsannualbudgettobecomemoretransparent.
The current Board website enables users to review contactinformation,andasummaryoftheBoardlegislativeregulations.CurrentlytheBoard’sperformancemeasuresandbudgetinformationarenotlistedwithinthewebsite.Providinguserswiththisinformationwouldenhancetransparency.It is the Legislative Auditor’s opinion that to continue to strive for open government and transparency, the Board should consider implementing elements identified as deficient.
Recommendation
6. The Board should consider providing public access to itsperformance goals via its website and include the current andhistoricalperformancemeasures,budgetinformation,andotheruser-friendlyandtransparencywebsiteelementsidentifiedbytheLegislativeAuditor.
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Issue4
The Board of Occupational Therapy Board Members’ Terms Have Expired.
Issue Summary
The terms for all five members of the Board have expired.According to Code, the Governor’s Office is required to appoint newmembersorre-appointexistingmemberstotheBoardoncetheirtermisup.Boardmembers’termsareforthreeyearsandmaynotservemorethantwoconsecutivefullterms.Nevertheless,amembermaycontinuetoserveuntilasuccessorhasbeenappointed.TheBoardhascontactedthe Governor’s Office numerous times requesting new appointments.However,theGovernor’sOfficehasnotactedontheserequests.
The Term For Each Board Member Has Expired
The terms for all five board members have expired. Statuteindicatesthataboardmember’stermisforthreeyearsandmaynotservemore than two consecutive full termsunless a successor hasnot beenappointed.WVC§30-28-5(e)states:
Thetermshallbefor threeyearscommencingonJanuary1.Amembermaynotservemorethantwoconsecutivefullterms.Amemberhavingservedtwoconsecutivefulltermsmaynotbeappointedforoneyear after completion of his or her second full term. A member maycontinuetoserveuntilasuccessorhasbeenappointedandqualified.
Position Date When Term EndedPresident–KathyQuesenberry December31,2010Secretary/Treasurer–MartinDouglas December31,2005BoardMember–PhilSimpson December31,2010BoardMember–BambiHill December31,2011ConsumerMember–GeneBrooks December31,2007Source:WestVirginiaBoardofOccupationalTherapy
According to Code, the Governor’s Of-fice is required to appoint new mem-bers or re-appoint existing members to the Board once their term is up.
The terms for all five board members have expired.
The Governor’s Office Has Not Made Board Member Appointments
TheBoardhasmadepreparationsandhascontactedtheGovernor’sOffice numerous times requesting board member appointments.BetweenSeptember2011andAugust2012,theBoardhascontactedtheGovernor’sOfficeseventimesrequestingboardmemberappointments.InalettersentbytheBoardtotheGovernor’sOfficeinNovember2011,theBoard stated that it had received lettersof interest and resumes tobeamemberof theBoardand ithadmadea recommendation for theappointment. However, the Governor’s Office has not acted on theserequests. The Legislative Auditor recommends that the governor make the necessary board member appointments.
Conclusion
EachmemberoftheBoardhashadtheirtermexpire.TheBoardhasmadenumerousattemptstohavetheGovernor’sOfficeappointboardmemberswhichisrequiredbyCode. However, theGovernor’sOfficehasnotactedontheserequests.Currently,alloftheBoard’smembersarestillattendingmeetings.However,ifthosememberschoosetovacatetheirpositions,thissituationcouldpotentiallyaffecttheBoard’sabilitytoholdaquorumforfuturemeetingswhichcouldpreventtheBoardfromcarryingoutitsmandatedduties.
Presently, the Board does not have any problems having a quorum for its meetings. However, overextension of board members’ terms could poten-tially affect the Board’s ability to hold a quorum for future meetings if these positions become vacant, which could prevent the Board from carrying out its mandated duties.
The Board has made preparations and has contacted the Governor’s Of-fice numerous times requesting board member appointments.
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AppendixA:TransmittalLetter
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AppendixB:Objective,ScopeandMethodolgy
ThePerformanceEvaluationandResearchDivision(PERD)withintheOfficeoftheLegislativeAuditorconductedthisRegulatoryBoardReviewoftheBoardofOccupationalTherapyasrequiredandauthorizedbytheWestVirginiaPerformanceReviewAct, Chapter 4,Article 10, of the West Virginia Code, as amended. ThepurposeoftheBoardofOccupationalTherapy,asestablishedinWestVirginiaCode§30-28,istoprotectthepublicthroughitslicenseprocess,andtobetheregulatoryanddisciplinarybodyofoccupationaltherapistsandoccupationaltherapistsassistantsthroughoutthestate.
Objective
ThepurposeofthisreviewistodetermineiftheBoardshouldbecontinued,consolidated or terminated, and if conditions warrant a change in the degree ofregulations.Inaddition,thisreviewisintendedtoassesstheBoard’scompliancewiththegeneralprovisionsofChapter30,Article1oftheWestVirginiaCode,theBoard’senablingstatute,andotherapplicablerulesandlawssuchastheOpenGovernmentalProceedings(WVC§6-9A),andpurchasingrequirements.Finally,itwastheobjectiveof the Legislative Auditor to assess the Board’s website for user-friendliness andtransparency.
Scope
The evaluation included a review of the Board’s internal controls, policyand procedures, meeting minutes, complaint files, complaint-resolution process,disciplinaryproceduresandactions,revenuesandexpendituresfortheperiodofFY2007through2011,continuingeducationrequirementsandverification,theBoard’scompliance with the general statutory provisions for regulatory boards and otherapplicablelaws,andkeyfeaturesoftheBoard’swebsite.
Methodology
Theprimarymethodologyforthisreviewincludedcommunicationwithandreceipt of information from the Board of Occupational Therapy, State Treasurer’sOffice, State Budget Office, Secretary of State’s Office, Governor’s Office, WestVirginia Legislature, National Board for Certification of Occupational Therapists(NBCOT), Accreditation Council for Occupational Therapy Education (ACOTE),PEIA, Medicare, and United States Department of Labor. Interviews and verbalcomments made by these agencies were confirmed by written statements and inmanycaseswere confirmedby corroborating evidence aswell.Data collected andanalyzedfromtheBoardincludedtheBoard’scomplaintlog,meetingminutes,annualreports, licensee roster and register,boardmembers’ cashexpenses,procedures forinvestigatingandresolvingcomplaints,proceduresforprocessingcashreceipts,andcontinuingeducation.
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Board of Occupational Therapy
InevaluatingtheBoard’swebsite,theLegislativeAuditorconductedaliteraturereviewofgovernmentwebsitestudiesandperformedareviewoftoprankedgovernmentwebsitesandgroupsthatrategovernmentwebsitesinordertoestablishamasterlistofelementsthatwouldincreasecitizenengagement.TheBrookingsInstitute’s“2008StateandFederalE-Government in theUnitedStates”and theRutgersUniversity’s2008“U.S.StatesE-GovernanceSurvey (2008):AnAssessmentofStateWebsites”helped identify the top ranked states in regards to e-government. The LegislativeAuditor identified threestates (Indiana,MaineandMassachusetts) thatwererankedinthetopteninbothstudiesandreviewedallthreestates’mainportalsfortrendsandcommonsimilarities in transparencyandopengovernment.TheLegislativeAuditoralsorevieweda2010reportfromtheWestVirginiaCenteronBudgetandPolicythatwasuseful in identifying agroupof core elements from themaster list that shouldbe incorporated into every state and local website to increase its transparency ande-governance. It is understood that not every item listed in the master list is to befoundinadepartmentoragencywebsitebecausesomeofthetechnologywouldnotbepracticaloruseful.Therefore,theLegislativeAuditorisrecommendingthatanagencyordepartmentdetermineifitisprogressinginstepwiththee-governmentmovementthatisemphasizingtransparencyanduser-friendliness.
