172 Neb. Admin. Code, ch. 4, § 003

Current through June 17, 2024
Section 172-4-003 - CRITERIA AND STANDARDS FOR A NEW CREDENTIAL

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.

003.01CRITERION 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.
003.02CRITERION 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.
003.03CRITERION 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.
003.04CRITERION 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.

172 Neb. Admin. Code, ch. 4, § 003

Amended effective 1/10/2021