Vermont Admin. Code Agency 04 | Vermont Code of Rules, Agency 04 — Secretary of State

Subagency 000 GENERAL

Chapter 001 RULE ON RULEMAKING

04-001 Code Vt. R. 04-000-001-X RULE ON RULEMAKING

Section 1. Introduction.

This rule is required by 3 V.S.A. § 847(e) for the effective administration of 3 V.S.A. Chapter 25. It applies to every agency of state government adopting rules under the Vermont Administrative Procedures Act (APA). For a fuller understanding of the rulemaking process, consult 3 V.S.A. §§ 801 - 849 and the rules of procedure of the Legislative Committee on Administrative Rules (LCAR). For the purpose of the Rule on Rulemaking, the filing of any new rule, amendment, or repeal of an existing rule shall be described as a rule.

Section 2. Filings.

The APA requires agencies to make filings of every new, amended, or repealed rule at least four times during the rule making process.

2.1 Prefiling

The first filing is the Prefiling with the Interagency Committee on Administrative Rules (ICAR). This begins the rulemaking process.

2.2 Proposed

The second filing is the Proposed Rule with the Office of the Secretary of State . This begins the notice and public comment period.

2.3 Final Proposed

The third filing is the Final Proposed Rule, which is filed with the Office of the Secretary of State and LCAR. This signals the end of the notice and public comment period.

2.4 Adopted Rule

After LCAR review, the fourth and last filing is the Adopted Rule (filed with both the Office of the Secretary of State and LCAR), which marks the beginning of the minimum 15-day period required by 3 V.S.A. § 845(d) for the effective date of the rule.

All filings with the Office of the Secretary of State shall arrive no later than 3:30 p.m. on the last day of the scheduled workweek.

Section 3. Forms.

Agencies must use the forms published by the Office of the Secretary of State ; altered forms will not be accepted. All forms requiring the signature of the adopting authority to be filed with the Office of the Secretary of State shall include an original signature or, if filed electronically with the Office of the Secretary of State , a conformed signature.

"Conformed signature" means a typed signature on a form provided by the Office of the Secretary of State that is submitted electronically to the Office of the Secretary of State for filing. The Secretary of State will accept forms electronically submitted for filing if all of the following conditions have been met:

Full name of person who signed the original form is typed in this format: /s/ Name of Person;
Form is submitted electronically in the file format and in the manner prescribed on the form; and
Form with the original signature of the adopting authority is retained by the adopting authority as required by 3 V.S.A. § 843(e).

The forms are available for download from the Office of the Secretary of State 's website. Due to compatibility issues use the forms in the formats in which they are provided. The forms include:

Proposed Rule Filing provides information about the proposed rule for the required notice.
Final Proposal Filing delineates any changes from the proposed rule.
Adopted Rule Filing, lists the procedural history of the rule and indicates that the rule has been reviewed by LCAR, has been adopted by the agency, and assigned an effective date.
Adopting Page provides information about the type of filing submitted and whether it is a new rule, an amendment, or a repeal of an existing rule and if so, what those existing rules are.
Economic Impact Analysis explains the expected economic impact of the rule.
Environmental Impact Analysis explains the expected impact the rule will have on greenhouse gases if it is adopted.
Scientific Information form identifies the scientific information upon which the rule has been based and explains the procedure for obtaining such studies and underlying research data from the agency if the rule depends on scientific information for its validity.
Public Input form outlines the agency's plan to maximize public input.
Incorporation by Reference form explains the material to be incorporated, and where it can be obtained and at what cost.
Emergency Rule Filing replaces the Proposed Rule Filing for Emergency Rules.

If the Office of the Secretary of State finds that a filing meets statutory and regulatory requirements the rule will be accepted for filing. The Office of the Secretary of State will notify an agency of any defects in a filing within 3 business days from receipt.

In addition to the appropriate forms, an agency must also submit the text of the proposed or adopted rule and an annotated text showing changes from any existing rules. Submitting a paragraph or page of a larger rule is not sufficient and a complete annotation is required. A new proposed rule need not be accompanied by an annotated text.

Section 4. Public Notice.

Notices of completed filings of proposed rules received by 3:30 p.m. on the last day of the scheduled workweek will be posted online the following week. Links to the notices will be available on the Secretary of State 's APA web pages and the notices will appear in the newspapers of record the week following the posting of the online notice.

When an agency needs to hold a new hearing, reschedule a hearing, or extend the public comment period, the agency must notify the Office of the Secretary of State and must notify by mail all individuals who have contacted the agency about the rule. The Office of the Secretary of State shall amend the notices to reflect the changes in hearing and deadline for public comment.

When a public hearing has not been scheduled, an agency shall set a deadline for public comment not less than 14 calendar days following the publication in the newspapers of record.

History

EFFECTIVE DATE:
November 1985 Secretary of State Rule Log #85-63
AMENDED:
May 25, 2001 Secretary of State Rule Log #01-25; August 8, 2003 Secretary of State Rule Log #03-23; February 10, 2010 Secretary of State Rule Log #10-04; October 15, 2010 Secretary of State Rule Log #10-035; December 12, 2021 Secretary of State Rule Log #21-023

Chapter 002 UNIFORM SCHEDULE OF PUBLIC RECORD CHARGES FOR STATE AGENCIES

04-002 Code Vt. R. 04-000-002-X UNIFORM SCHEDULE OF PUBLIC RECORD CHARGES FOR STATE AGENCIES

Pursuant to 1 VSA 316(d) and Acts 1996, No. 159 section 1, the following fees are established as the actual cost of providing a copy of a public record: *

(1) For staff time involved in physically duplicating a record, $ .33 per minute after the first 30 minutes.

(2) For senior-level staff time, and information technology specialists' time spent extracting data from databases, or performing similar tasks necessary to comply with a request to create a new public record, $ .57 per minute.

(3) For any other staff time for which cost can be charged and collected under this section, $ .45 per minute.

(4) For photocopies, $ .05 per single-sided page, $ .09 per double-sided page for pages up to 8.5 by 14 inches.

(5) For color photocopies, $ 1.00 per single-sided page.

(6) For computer-generated copies, $ .02 per page for pages up to 8.5 by 14 inches.

(7) For computer diskettes, $ .28 each for 3.5-inch diskettes.

(8) For compact discs, $ .86 each for write-once CD w/case, $ 2.31 each for re-writable CD w/case.

(9) For audio tapes, $ .81 each.

(10) For video tapes, $ 1.69 each.

(11) For DVD's, $ 2.00 each for write-once DVD w/case, $ 4.00 each for re-writable DVD w/case.

Note that there are fees for copies of public records that are established by statute that may override the fees established by this schedule. 1 V.S.A. § 316(d)

History

EFFECTIVE DATE: December 19, 1996 Secretary of State Rule Log # 96-77
AMENDED: December 1, 2003 Secretary of State Rule Log # 03-48

Chapter 003 SAFE AT HOME ADDRESS CONFIDENTIALITY PROGRAM

04-003 Code Vt. R. 04-000-003-X SAFE AT HOME ADDRESS CONFIDENTIALITY PROGRAM

Section A Statement of Purpose

These rules are promulgated pursuant to the address confidentiality statute ( 15 V.S.A. § 1150-1160, 18 V.S.A. § 5083 & 5132, 17 V.S.A. § 2122 & 2126) and 3 V.S.A. § 831 et seq.

Section B Definitions

"Actual address" means the physical location where the applicant resides and may include a school address, or work address of an individual, as specified on the individual's application to be a program participant.
"Agency" means any subdivision of the state of Vermont, a municipality, or a subdivision of a municipality.
"Application assistant" means an employee of a state or local agency, or of a non-governmental agency or program that provides counseling, referral, or shelter services to victims of sexual assault, domestic violence, or stalking, who has been designated by their respective program, and who has been registered with the Secretary of State to assist individuals in the completion of program participation applications.
"Blind ballot voter" means a program participant who has applied and qualified as a voter in a town in accordance with the rules herein. The blind ballot voter's name will not appear on a checklist and the town clerk will send absentee voter ballots to the Secretary of State's office in accordance with the rules herein.
"Bona fide purpose" means a statutory or administrative requirement the agency is unable to fulfill without possession of an individual's actual address.
"Cancelled" means the status of a person who is no longer certified in the SAH program.
"Domestic violence" means an act of abuse as defined in subdivision 1101(1) of Title 15 and includes a threat of such acts committed against an individual in a domestic situation, regardless of whether these acts or threats have been reported to law enforcement officers.
"Law enforcement agency" means:

(i) the Department of Public Safety, a municipal police department, a sheriff's department, the Attorney General's office, a State's Attorney's office, and certified law enforcement officers employed by the Department of Motor Vehicles, the Agency of Natural Resources, or the Department of Liquor Control, and,

(ii) the Department of Social and Rehabilitation Services when the Department is engaged in:

a) the investigation of child abuse and neglect;

b) the delivery of services to families and children that the department is working with pursuant to the provisions of chapter 55 of Title 33; or

c) the performance of the department's responsibilities pursuant to an interstate compact to which the state is a party.

"Law enforcement purpose" means all matters relating to:

(A) the prevention, investigation, prosecution, or adjudication of criminal offenses, civil matters, or juvenile matters;

(B) the investigation, prosecution, adjudication, detention, supervision, or correction of persons suspected, charged, or convicted of criminal offenses or juvenile delinquencies;

(D) the execution and enforcement of court orders;

(E) service of criminal or civil process or court orders;

(F) screening for criminal justice employment;

(G) other actions taken in performance of official duties, as set forth by statutes, rules, policies, judicial case law, and the United States and Vermont constitutions; and

(H) criminal identification activities, including the collection, storage, and dissemination of criminal history records, as defined in subdivision 2056a(a)(1) of Title 20, sex offender registry information, and DNA material and information.

"Program participant" means a person certified as a program participant in the address confidentiality program in accordance with the rules herein.

"Public record" means a public record as defined in 1 V.S.A. §

"Resident" means an individual domiciled in the state of Vermont as evidenced by an intent to maintain a dwelling place in Vermont indefinitely and to return there if temporarily absent, coupled with an act or acts consistent with that intent.
"Safe At Home (SAH)" means the address confidentiality program created pursuant to 15 V.S.A. § 1150 et seq. within the Vermont Secretary of State's Office.
"Secretary" means the Secretary of State.

"Sexual assault" means an act of assault as defined in subsection 3252(a) or (b) (sexual assault) or in subsection 3253(a) (aggravated sexual assault) of Title 13, and includes a threat of such acts, regardless of whether these acts or threats have been reported to law enforcement officers.

"Stalking" means conduct as defined in section 1061 (stalking) or in section 1063 (aggravated stalking) of Title 13, and includes a threat of such acts, regardless of whether these acts or threats have been reported to law enforcement officers.
"Substitute address" means the Secretary's designated address for the address confidentiality program.
"Vital record" means any record of birth, death, marriage, civil union, annulment or divorce held by the Department of Health.

Section C Program Eligibility

An applicant must be a resident of Vermont and have recently relocated or plan to relocate in the next few weeks to a location unknown to the abuser.
An applicant, or the minor or incapacitated person on whose behalf the application is made, is a victim of domestic violence, sexual assault or stalking.
The parent or legal guardian applying on behalf of a minor or incapacitated person must have legal authority to act on the person's behalf.
If the applicant is under the supervision of the Department of Corrections, the applicant has notified the Department of the actual address and the applicant authorizes the release of the actual address to the Department.
If the applicant is required to report the actual address for the sex offender registry under subchapter 3 of chapter 167 of Title 13, the applicant authorizes the release of the actual address to the registry.

Section D Application Assistants

Any person may apply to the Secretary to become an application assistant. If the request is approved by the Secretary, that person shall be designated by the Secretary as an application assistant. Application assistants shall provide their name and the name and phone number of the government agency or non-governmental agency or program of which they are employed or affiliated, and when appropriate, the address of the agency or program.

Agency or program directors shall approve employee designations prior to application assistant registration. All persons must be registered with the Secretary to serve as application assistants. Application assistants' registrations shall be renewed annually.

Application assistants must be trained, and the training shall include, but is not limited to, the application process, program components, program guidelines, program limitations, and the importance of safety planning.
The SAH program shall provide application assistants with all necessary application materials.

Section E Application Process

Prospective participants may obtain SAH applications at local domestic violence or sexual assault programs, from victim advocates, or from any other application assistant.
Applicants must be given orientation information about the SAH program from an application assistant.
Application assistants shall request one or more forms of identification from program applicants. Upon request by the application assistant, a program participant shall provide identification to the application assistant that establishes the applicant's identity to the satisfaction of the application assistant. In the event that a program participant cannot provide such identification due to exigent circumstances, the Secretary may temporarily approve the application absent the identification if the application is otherwise properly completed. The application shall be temporarily approved for no more than 45 days upon which the participant must provide identification to the application assistant or Secretary.
A properly completed application form shall contain the following information:

(a) the applicant's name and date of birth, and the name and date of birth of the minor or incapacitated person on whose behalf the application is made; and

(b)

(1) a statement made by the applicant that the applicant, or the minor or incapacitated person on whose behalf the application is made, is a victim of domestic violence, sexual assault or stalking; and

(2) a statement made by the applicant that the applicant fears for her or his safety or her or his children's safety, or the safety of the minor or incapacitated person on whose behalf the application is made; and

(c) a designation of the Secretary as agent for purposes of service of process and for the purpose of receipt of first-class mail; and

(d) the actual address or addresses that the applicant requests not be disclosed; and

(e) the phone number or numbers where the applicant can be called by the Secretary; and

(f) the name and phone number of the application assistant, and the name of the respective program or agency, and the date on which the applicant signed the application; and

(g) the applicant's signature; and

(h) a signed statement that the applicant has read and understands the checklist of participant responsibilities; and

(i) a statement made under oath that the applicant has affirmed under the penalties of perjury that the information on the application is true and accurate.

An application shall be considered properly completed when the application form is completed in accordance with 4) above and the following requirements are otherwise met:

a) All household members living in one location shall file a single application including each co-applicant's name, date of birth, and relationship to applicant; and

b) Applicants must sign an authorization card form for themselves and for each minor child or incapacitated person included on the application; and

c) Applications shall be filed with the Secretary via first-class mail, in person, or fax provided that a hard copy is sent within 7 days following the fax transmittal.

d) The legal guardian, if any has provided official copies of her or his appointment from probate court, and all orders that set forth the guardian's duties; and

e) In emancipation situations, the minor has provided an official copy of the emancipation order.

Section F Program Certification

Upon receipt of a properly completed application, the Secretary shall certify the applicant as a program participant.
An authorization card shall be issued within five working days after the application is received by the Secretary and the Secretary has certified the participant. The SAH program shall issue a program participant authorization card to each individual named on the completed application form. The authorization card shall include the program participant's name, authorization code, substitute mailing address, certification expiration date, applicant's signature, toll free number of the SAH program, and a statement that the authorization card is not a legal form of identification.
Applicants shall be certified for four years following the date of certification, unless the certification is withdrawn or cancelled before that date.
A program participant shall notify the Secretary of any change of actual address or phone number within seven days of the change.

Section G Certification Renewal

A program participant may renew her or his program certification by filing with the SAH program:

(a) a copy of her or his current authorization card or a statement that the authorization card has been lost or destroyed; and

(b) a properly completed certification renewal form, which shall require the applicant to provide all the information as set forth in E. 4 above; and

If an applicant meets the requirements noted in section G. above, the SAH program shall:

(a) certify a program participant who has filed a properly completed certification renewal form to participate in the program for an additional four year term unless the certification is withdrawn or cancelled before that date.

(b) notify in writing the supervisor of Vital Records Registration if the participant has a protected birth, death, marriage, civil union, divorce or annulment record in the Health Department.

Section H Certification Withdrawal

Upon receipt of a request for withdrawal, the Secretary shall ensure withdrawal is not coerced by using a secure method, which may include phone calls to the participant or application assistant, an investigation, or by requesting documents that support the withdrawal and to confirm the identity of the program participant.
Upon determination of withdrawal by the Secretary, if the withdrawn participant;

(a) has a protected birth, death, marriage, civil union, divorce or annulment record, the Secretary shall notify the supervisor of Vital Records Registration of the participant's withdrawal in writing. Upon receipt of the withdrawal notification, the supervisor of Vital Records Registration shall revise the record to reflect the participant's actual address as of the day the record was created. The supervisor of Vital Records Registration shall transmit all appropriate vital records pertaining to the program participant to the appropriate town clerk's office, and will no longer be responsible for maintaining the confidentiality of a withdrawn program participant's record.

(b) was a blind ballot absentee voter, it shall be the program participant's responsibility to reapply for addition to the voter checklist in the town where she or he resides. The Secretary shall notify the clerk in the town where the program participant resided that the participant no longer qualifies for blind ballot voter privileges.

Section I Certification Cancellation

The Secretary may cancel a program participant's certification if, after the passage of 14 days:

(a) from the date of changing her or his name, the program participant does not notify the Secretary that she or he has obtained a name change. The program participant may reapply under her or his new name by returning the old SAH authorization card, a new completed SAH application, and an identification card form reflecting the name change. If the program participant obtained a legal name change through any court proceeding or through marriage or civil union, the participant shall provide a copy of the court order or appropriate certificate; or

(b) from the date of changing her or his actual address, the program participant fails to notify the Secretary of the change of address; or

(c) from the date that mail forwarded to the program participant's actual address is returned as nondeliverable to the Secretary.

The Secretary shall cancel program certification if it has been determined that false information has been provided on an application.
The Secretary may cancel a program participant's certification if the program participant's certification term has expired and certification renewal has not been completed.
The Secretary shall notify the program participant that she or he has been cancelled from the SAH program by a method determined by the Secretary most likely to result in contact with the program participant by first-class mail and phone calls, or other methods reasonably likely to provide notice.

(a) Notice of cancellation shall set out the reasons for cancellation. The program participant shall have 30 days from the date of cancellation notice to appeal the cancellation decision by submitting in writing to the Secretary a request to reverse the cancellation decision including any information and documentation that supports the appeal.

(b) The Secretary shall review all submissions and render a decision within 30 days of the receipt of the appeal based on the written record and/or oral communication with the program participant. The Secretary's decision shall constitute final agency action.

If the cancelled participant;

a) has a protected birth, death, marriage, civil union, divorce or annulment record, the Secretary shall notify the supervisor of Vital Records Registration of the participant's cancellation in writing within 40 days unless an appeal is received, and in that case within 10 days of denial of the appeal.

(i) Upon receipt of the cancellation notification, the supervisor of Vital Records Registration shall revise the record to reflect the participant's actual address as of the day the record was created. The supervisor of Vital Records Registration shall transmit all appropriate vital records pertaining to the program participant to the appropriate town clerk's office, and will no longer be responsible for maintaining the confidentiality of a cancelled program participant's record.

b) was a blind ballot absentee voter, it shall be the program participant's responsibility to reapply for addition to the voter checklist in the town where she or he resides. The Secretary shall notify the clerk in the town where the program participant resided that the participant no longer qualifies for blind ballot voter privileges.

c) The Secretary shall not take further action until all appeal periods have expired or any appeal taken has been resolved.

Section J Service of Process

Service on the Secretary of any summons, writ, notice, demand, or process shall be made by mail to the substitute address or by personal service on the Secretary.
When any summons, writ, notice, demand, or process is served on the Secretary, the Secretary shall immediately forward a copy to the program participant at the participant's current actual address.
The Secretary shall maintain in the program participant's file the date of service and a record of all summonses, writs, notices, demands, and processes served upon the Secretary.
Return of service shall not contain a participant's actual address.

Section K Agency Use of Designated Address - Other than Law Enforcement Agency

At the time any state or local government agency creates a new public record or updates an existing public record, a program participant may request that the agency use the substitute mailing address as the participant's actual address.
A program participant shall show her or his authorization card to the agency and request address confidentiality through the use of the substitute mailing address as it appears on the authorization card in lieu of her or his actual address.
An agency shall accept the substitute mailing address for any public record that is the subject of the request unless the agency has received a written waiver from the Secretary pursuant to paragraph L. "Agency Waiver", or if pursuant to law, waiver or court order the agency is not required to use the substitute address for any such record.

Section L Agency Waiver

An agency requesting a waiver must provide in writing to the Secretary the following:

(a) identification of the statute or administrative rule which demonstrates the agency's bona fide purpose for the use of the actual address of a participant; and

(b) identification of the specific program participant's record for which the waiver is requested; and

(d) an explanation of how the agency's acceptance of a substitute address will prevent the agency from meeting its obligations under the statute or rule identified above; and

(e) an explanation of why the agency cannot meet its statutory or administrative obligations by a change in its internal procedures.

During the review, evaluation, and appeal of an agency's request, the agency shall accept the use of a program participant's substitute address for any record that is the subject of the waiver request under review, evaluation or appeal.
The Secretary's determination to grant or withhold a requested waiver must be based on, but not limited to, an evaluation of the information under this section.
Acceptance or denial of the agency's waiver request constitutes final agency action. An aggrieved party may appeal.
Prior to granting the waiver, the Secretary shall notify the program participant of the waiver, including the name of the agency and the reasons for the waiver.
If granted a waiver, the agency shall maintain the confidentiality of a program participant's actual address information by redacting the actual address when the record is released to any person unless release of the actual address to the person is authorized by law, waiver or court order.
Any agency receiving a waiver may not make the program participant's actual address available for inspection or copying, except under the following circumstances:

(a) if requested by a law enforcement agency for a law enforcement purpose as defined in 15 V.S.A. 1151(5); or

(b) if directed by a court order to a person identified in the order.

The Secretary shall keep a record of all waivers and all documentation relating to requests for waivers.

Section M Law Enforcement Agency Exceptions

a) The Secretary may not make a program participant's actual address available unless requested by a law enforcement agency for a law enforcement purpose as defined in 15 V.S.A. 1151 (5).

In circumstances where there is not an immediate need for disclosure, the Secretary shall expediently release the actual address of a participant. The request shall be in writing (mail, e-mail or fax), or by personal contact, to the Secretary on agency letterhead stationary and shall contain:

(a) the name, signature if available, case identification number if available, address and phone number of the law enforcement employee requesting the information; and

(b) the request date; and

(d) the name, address and phone number of the law enforcement employee's supervisor.

(e) Notwithstanding the provisions of sections M. a) 1)(a)-(d), if the Secretary is otherwise assured that the request is made by a law enforcement agency for a law enforcement purpose, disclosure may occur.

In circumstances when immediate disclosure is necessary, the Secretary shall immediately release the participant's actual address. The request shall be made by phone, or in writing (mail, e-mail or fax), or by personal contact, to the Secretary and shall include:

(a) the name, case identification number if available, address and phone number of the law enforcement officer requesting the information; and

(b) the name of the program participant.

b) The Secretary may request that an agency review its disclosure requests to determine whether such requests were appropriate.

c) A program participant may request of a law enforcement employee creating the record noted below, and prior to the creation of the record and upon proof of participation in the program to the satisfaction of the law enforcement agency, that the participant's substitute address be used in:

(1) a summons or complaint for a violation within the jurisdiction of the judicial bureau as set forth in section 1102 of Title 4 (i.e. traffic violations, civil ordinance violations, etc);

(2) a citation to appear under Rule 3 of the Vermont Rules of Criminal Procedure (i.e. arrest without warrant); or

(3) an accident report filed with the Department of Motor Vehicles.

d) Nothing in this subchapter shall prevent a law enforcement agency from requiring that a program participant provide his or her actual address upon request from the agency.

e) A law enforcement agency may, in its discretion, use a substitute address in any record released by the agency.

Section N Disclosure by Secretary

The Secretary shall not make a program participant's actual address available except if directed by court order to a person identified in the order, or pursuant to law or waiver.
The Secretary may verify the participation of a specific program participant in which case the Secretary may only confirm information supplied by the requester.
The Secretary shall provide immediate notification of disclosure to a program participant when disclosure takes place pursuant to 15 V.S.A. 1155(a) (2) and (3).

Section O Voting as Blind Ballot

A program participant may notify the SAH program of any request for confidentiality in voting records by requesting to exercise blind ballot voter privileges. The Secretary shall send an application to the checklist and absentee voter request form to the program participant for completion.
The program participant shall enter the blind ballot voter number, as provided by the Secretary, on the line for the name and enter the substitute address as the mailing address. A properly completed application to the checklist and absentee voter request form shall be received by the SAH program by the third Saturday prior to any election. If the program participant was not previously registered to vote in Vermont, the voters oath must be administered by a notary and subscribed on the registration form.
The Secretary shall consult with the town clerk to determine the proper district where the participant resides for voting purposes. The Secretary shall sign an affirmation of the program participant's residency in the town and district.
The SAH program shall keep a copy of all applications and shall send to the clerk of the town where the participant resides:
a copy of the absentee voter request form omitting any information intended to be confidential,
the application to the checklist omitting any information intended to be confidential, and
the Secretary's affirmation of residency. Town clerks shall not have access to the confidential information of program participants.
The town clerk shall include blind ballot voters on the checklist by using blind ballot numbers and the substitute address in lieu of the voters' actual names and addresses.
The SAH program shall send the form authorizing removal from previous town checklists to the previous town clerk.
Not later than 30 days prior to the election, or within 1 day of receipt of a request for absentee ballots if the request is less than 30 days before the election, the town clerk will send the absentee voting ballots to the SAH program who will forward them to participants at their actual addresses.

Section P Recording of Vital Statistics

When vital records are created and filed with the supervisor of Vital Records Registration they shall not contain the actual address of any program participant.
The supervisor of Vital Records Registration shall notify the SAH program when a vital record is received concerning a program participant. The SAH program shall then mail to the supervisor of Vital Records Registration the participant's actual address as of the date the vital record was created. The supervisor of Vital Records Registration shall keep the actual address confidential.Statutory Authority: 15 V.S.A. §§ 1150 through 1160, 17 V.S.A. §§ 2122 and 2126, 18 V.S.A §§ 5083 and 5132

History

Effective Date: June 25, 2001 (Secretary of State Rule Log # 01-35)

Subagency 010 ELECTIONS DIVISION

Chapter 004 VERMONT ELECTIONS - ADMINISTRATIVE COMPLAINT PROCEDURE

04-004 Code Vt. R. 04-010-004-X VERMONT ELECTIONS - ADMINISTRATIVE COMPLAINT PROCEDURE

Section I Authority

In accordance with the provisions of 42 USC § 15512(a) and 17 VSA § 2458 this rule provides for a uniform, nondiscriminatory procedure for the resolution of a complaint alleging a violation of provisions of Title 17 of the Vermont Statutes or Title III of the Help America Vote Act of 2002 (HAVA). It is not intended to over-ride any specific provisions of Title 17 that provide for dispute resolution for specific aspects of Vermont elections (e.g. complaint in superior court for recounts).

Section II Definitions

A. "Complaint" means an allegation in writing that there is a violation of provisions of Title 17 of the Vermont Statutes or Title III of the HAVA that has occurred, is occurring or is about to occur in an election.

B. "Complainant" means any person filing a complaint in accordance with the provisions of paragraph III, below.

C. "Election" means a primary or general election in which a federal office appears on the ballot.

D. "Respondent" means any state or local elections official whose actions are alleged to be in violation of Title 17 or Title III.

E. "Secretary" means the Vermont Secretary of State or his or her designee.

F. "Title 17" means 17 V.S.A. sections 2451 - 2602.

G. "Title III" means Title III of the Help America Vote Act of 2002; 42 United States Code §§ 15281 - 15485.

Section III Complaints

Any person who believes that a violation of provisions of Title 17 or Title III by any state or local election official has occurred, is occurring or is about to occur may file a complaint with the Secretary.

A. Complaints must be in writing, sworn under oath under penalty of perjury, signed by the complainant and notarized

B. Complaints must include the full name, telephone number and mailing address of the complainant.

C. Complaints must include a description of the alleged violation sufficient to make the Secretary and respondent aware of the nature and specifics of the complaint.

D. If a hearing on the record is requested, the complaint must so state.

E. The notarized complaint must be filed with the Secretary at 26 Terrace Street, Drawer 9, Montpelier, VT 05609-1101.

F. The complainant must also send a copy of the complaint to each respondent by first class U.S. mail.

Section IV Procedures

The Secretary may process complaints in any of the following ways:

A. Dismiss the complaint and issue a final determination if the complaint does not comply with the requirements of paragraph III, above; or if the complaint does not, on its face, allege a violation of Title 17 or Title III with regard to an election.

B. Dismiss the complaint and issue a final determination if the complaint is not filed within sixty (60) days of the final certification of the federal election at which the alleged violation took place.

C. Resolve the complaint informally, and issue a final determination without a formal proceeding unless the complaint requests a hearing on the record.

D. Designate a hearing officer and schedule a date, time and place for a hearing on the record.

E. Consolidate multiple complaints into a single proceeding if the complaints relate to the same actions or events giving rise to the complaints, or the complaints raise common questions of law or fact.

Section V Hearing Procedures

If requested in the complaint, and if no other summary action has occurred, the Secretary shall schedule a hearing as follows:

A. Written notice of the hearing shall be given to all parties setting out the date, time and place of the hearing. Notice shall be sent to the mailing addresses set out in the complaint. Notice must be sent by first class US mail at least seven (7) days prior to the date of the hearing.

B. The hearing shall be recorded. The audio recording shall constitute the official record of the hearing.

C. An extension of time for a hearing may be granted for good cause.

D. At the hearing all parties shall have the opportunity to be heard and to present evidence relevant to the determination of the complaint. Witnesses shall be sworn.

E. Any party may be represented by legal counsel.

F. If a complainant fails to appear at the hearing then the complaint shall be dismissed with prejudice.

Section VI Determination

A. A written determination on the complaint shall be made within ninety (90) days of the filing of the complaint.

B. A written determination shall be issued within ten (10) days of the conclusion of any hearing.

C. The determination shall be final. The determination may be appealed to the superior court in the county where an appellant resides.

Section VII Alternative Dispute Resolution

If, for any reason, the Secretary does not make a final determination within ninety (90) days after the complaint was filed, or within any extension of time to which the complainant consents, the complaint shall be resolved under this section:

A. The Secretary shall immediately designate a three-member arbitration panel which shall consider the complaint and any record previously created and reach a final determination by majority vote of the panel. If no record has been created, or the record is incomplete, the panel may receive evidence in accordance with the provisions contained in paragraph V, above.

B. The panel shall issue a written, final determination within thirty (30) days of its designation.

C. The final determination of the panel may be appealed to the superior court in the county in which an appellant resides. 17 V.S.A. § 2458

History

EFFECTIVE DATE: April 6, 2004 Secretary of State Rule Log # 04-10

04-005 Code Vt. R. 04-010-005-X ADMINISTRATIVE RULE 2000-1: VERMONT CAMPAIGN FINANCE LAW; REGULATION OF RELATED EXPENSES

Pursuant to the rulemaking authority given to the Secretary of State in 17 V.S.A. section 2809(f), the following rules are necessary for the proper administration of provisions of section
For purposes of section 2809(c), which states "for the purposes of this section, a related campaign expenditure made on the candidate's behalf means any expenditure intended to promote the election of a specific candidate or group of candidates, or the defeat of an opposing candidate or group of candidates, if intentionally facilitated by, solicited by or approved by the candidate or the candidate's political committee:"

a.) A campaign expenditure may be a "related campaign expenditure" even if the candidate or the candidate's political committee did not have a specific intent to make an activity or expense a "related campaign expenditure on a candidate's behalf." However, some knowledge of the fact, or willful blindness toward the fact that the action will be used in connection with an activity or expenditure on the candidate's behalf is necessary.

b.) "Intentionally facilitated" means for a candidate or the candidate's political committee to consciously, and not accidentally, have done an action to make the activity or expenditure possible.

c.) "Solicited" means for the candidate or the candidate's political committee to appeal or ask directly or by an intermediary or by any other means, procure the activity.

d.) "Approved" means for the candidate or the candidate's political committee to have consciously, and not accidentally, taken any prior action or inaction that indicates permission or approval. Simply knowing that an activity or expenditure is taking place does not, alone, constitute approval.

For purposes of section 2809(d) which states, in pertinent part, that "an expenditure made by a political party or by a political committee that recruits or endorses candidates, that primarily benefits six or fewer candidates who are associated with the political party or political committee making the expenditure, is presumed to be a related expenditure made on behalf of those candidates. An expenditure made by a political party or by a political committee that recruits or endorses candidates, that substantially benefits more than six candidates and facilitates party or political committee functions, voter turnout, platform promotion or organizational capacity shall not be presumed to be a related expenditure made on a candidate's behalf':

a.) An expenditure "primarily benefits" six or less candidates when the principal purpose of the expenditure is to promote six or fewer specific candidates.

b.) The fact that an activity may incidentally benefit all candidates of the same party, for example, by increasing voter participation of a particular of a particular party, or by some other means, will not prevent an activity from being presumed to be a related campaign expenditure.

c.) While an expenditure or activity does not have to equally benefit all candidates, it will "primarily benefit" more than six candidates if a reasonable person receiving the mailing or seeing the advertisement will believe that its purpose is to promote more than six candidates.

d.) When an expenditure is presumed to be a related expenditure, the presumption can be overcome by evidence that the elements of the definition in section 2809(c) were not met or that the elements in 2809(d)(1-3) apply. When an expenditure is not presumed to be a related expenditure because it substantially benefits more than six candidates, the expenditure may still be treated as a related expenditure made on behalf of each candidate if the elements of the definition in section 2809(c) were met and the elements of (d)(1-3) do not apply.

For purposes of section 2809(d) which states, in pertinent part, that "an expenditure shall not be considered a related campaign expenditure made on the candidate's behalf" if all of the following apply:

a.) The expenditures were made in connection with a campaign event whose purpose was to provide a group of voters with the opportunity to meet the candidate personally;

b.) The expenditures were made only for refreshments and related supplies that were consumed at that event, and

c.) The amount of the expenditures for the event was less than $ 100.00.

An expenditure that meets the requirements above will not be a related expenditure on a candidate's behalf even if the expenditure was intentionally facilitated by, solicited by, or approved by the candidate.

For the purpose of section 2809(c) & (e), "opposing candidate" means any person who seeks the same office that the candidate seeks.

History

EFFECTIVE DATE:
May 30, 2000 Secretary of State Rule Log #00-030

Subagency 030 OFFICE OF PROFESSIONAL REGULATION

Chapter 006 ADMINISTRATIVE RULES FOR RESPIRATORY CARE PRACTITIONERS

04-006 Code Vt. R. 04-030-006-X ADMINISTRATIVE RULES FOR RESPIRATORY CARE PRACTITIONERS

Part 1 GENERAL INFORMATION

Section 1.1 The Purpose Of Licensure

The Director of Professional Regulation (who is referred to as "the Director" in this rule) has been given power by Vermont law to license respiratory care practitioners in order to protect the public health, safety and welfare. This is done by setting standards for issuing licenses, licensing only qualified applicants and regulating license holders and their practices.

Section 1.2 Business Location

The Director's business location is c/o Secretary of State, Office of Professional Regulation, 26 Terrace Street, Montpelier (the Office). Mailing address:

Secretary of State

Office of Professional Regulation

26 Terrace Street

Montpelier, Vermont 05609-1106

The telephone number is (802) 828-2363 and the website address is http: www.vtprofessionals.org.

An interested person may get copies of these rules and more information about licensure and its requirements and procedures by writing or telephoning the Office.

Section 1.3 Advisors To The Director Of Professional Regulation

The Secretary of State appoints two respiratory care practitioners to serve as advisors who help the Director carry out the program and advise the Director on such matters as selecting an examination, setting a passing score, making administrative rules, and approving or denying licensure. The Director refers disciplinary matters to an administrative law officer.

Section 1.4 Laws That Govern Licensure

The practice of respiratory care is governed by a specific state law ( 26 V.S.A. §§ 4701-4715) that establishes responsibilities for setting standards, issuing licenses and regulating the profession. In addition, the Director is obligated to ensure compliance with several other state laws, including the Administrative Procedure Act ( 3 V.S.A. §§ 801-847), the Open Meeting law ( 1 V.S.A. §§ 311-314), the Access to Public Records law ( 1 V.S.A. §§ 315-320), and the laws of the secretary of state's office of professional regulation applicable to all professions regulated by the office ( 3 V.S.A. §§ 121-131). These laws spell out the rights of applicants, license holders and members of the public. A copy of these laws may be obtained by contacting a town clerk or librarian. Most have copies of these statutes, which are also available online at www.leg.state.vt.us.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Definitions

The definitions in the Act at 26 V.S.A. § 4701 also apply to these rules. In addition, as used in these rules:

(1) "The Act" means the respiratory care practitioners Act, 26 Vermont Statutes Annotated, Chapter 91 ( 26 V.S.A. §§ 4701-4715).

(2) "AARC" means the American Association for Respiratory Care.

(3) "The Director" means the Director of the Office of Professional Regulation.

(4) "The Office" means the Office of Professional Regulation in the Office of the Secretary of State.

(5) "V.S.A." means Vermont Statutes Annotated: for example 26 V.S.A. § 4701 means section 4701 of Title 26 of the Vermont Statutes Annotated.

Section 2.2 Where To Get An Application

Applications for licensure and information about the application process are available on the Office's website at www.vtprofessionals.org or may be obtained by calling or writing the Office.

Section 2.3 Licensure As A Respiratory Care Practitioner (By Examination)

Eligibility for licensure is set forth in statute at 26 V.S.A. § 4707:

(a) Education: The applicant must have a degree from an educational program for respiratory care practitioners that is accredited by the committee on accreditation for respiratory care or by the commission on accreditation of allied health education programs, or their successor organizations. This does not apply to applicants who passed the examination and were conferred credentials prior to July 31, 1977.

(b) Examination: The applicant must submit proof of having passed the exam approved by the Director. Information on applying for and scheduling the exam is available from the Office or the national examining body. Candidates who fail the exam must retake the exam and are ineligible to practice until its successful completion.

Section 2.4 Licensure Without Examination (By Endorsement)

To qualify for a license by endorsement, respiratory care practitioner applicants must be currently certified or licensed in another jurisdiction. The requirements of that jurisdiction must be substantially equivalent to Vermont's, as determined by the Director.

Section 2.5 Temporary Licensure For Applicants By Endorsement

(a) A temporary license may be issued by the Director for a period of up to 100 days to a person who applies for the first time to practice respiratory therapy in this state. The temporary license is issued to allow one who meets the licensing requirements of statute and Rule 2.4 above, to practice pending the Director's receipt of the necessary data for licensure without exam.

(b) Applicants for temporary licensure shall apply on forms provided by the Director prior to performing respiratory care services. The application will include the designation of a Vermont licensed supervisor of record willing to take responsibility for the applicant.

(c) Qualified applicants under temporary licensure (other than student temporary licenses, below) may practice under the indirect supervision (see 26 V.S.A. § 4701 for a definition) of a respiratory care practitioner licensed in Vermont.

Section 2.6 Temporary Licensure As A Student Respiratory Care Practitioner

(a) A student currently enrolled in an accredited respiratory care education program may perform respiratory care services when those services are incidental to the clinical aspect of the student's course of study. Such students are exempt from licensure.

(b) Students employed to perform respiratory care services under supervision and not as part of their clinical program shall apply for a student temporary license prior to performing respiratory care services. A student may apply for a student temporary license after beginning his or her third semester of study. The application will be made on forms provided by the Director and will include the designation of a Vermont licensed supervisor of record willing to take responsibility for the student therapist.

(c) The student temporary license is valid from the date of application approval until ninety (90) days after the next scheduled graduation date for that student's educational program. This ninety (90) day window is to allow the student time to take and pass the examination and obtain full and permanent licensure as a respiratory care practitioner.

(d) After obtaining a student temporary license, a student may render respiratory care services under the direct supervision (see 26 V.S.A. § 4701 for a definition) of a Vermont licensed respiratory care practitioner with at least two years experience in respiratory care. The student's scope of practice is limited to those activities for which the supervisor has documented the student's competency, including verification from the clinical director of the student's accredited respiratory care program.

Section 2.7 Foreign Trained Graduates

Applicants trained in countries without accreditation standards similar to those in the United States must have completed a respiratory care educational program equivalent to the standards of accredited schools. The Office will evaluate those academic credentials received with completed application in consultation with a credentials evaluation service. The applicant is responsible for the costs of this credential review. The Office will provide a current list of acceptable services and steps for requesting credential review.

Section 2.8 Right To A Written Decision And Appeal

Applicants are notified in writing whether or not they meet requirements to be licensed. If the Director denies an application he or she shall give specific reasons and inform the applicant of the right to request a hearing for review of this decision. The hearing will be held by an administrative law officer. After an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, remand or modify the Director's preliminary decision. The burden is on the applicant to prove eligibility for licensure. The applicant may appeal the administrative law officer's decision, by sending a written notice of appeal to the Director within 30 days of the decision.

Section 2.9 Use Of Title

A person may not use letters, words or insignia indicating or implying that the person is an respiratory care practitioner unless the person is licensed. See 26 VSA § 4702.

Part 3 INFORMATION FOR LICENSED RESPIRATORY CARE PRACTITIONERS

Section 3.1 Renewing Licenses Biennially

Licenses expire every two years and must be renewed before the expiration date. The Office will mail a renewal application and notice of the renewal fee found at 3 V.S.A. § 125. However, it is the licensee's responsibility to maintain a current address with the Office and renew the license prior to expiration. Any renewal application received after the deadline results in a lapsed license. Late renewals are subject to a late fee set by statute.

Section 3.2 Continuing Education Requirements

(a) "Continuing education" means formal presentations, inservice programs, conferences, and self-study courses, such as distance learning and online courses promoting continuing competency in respiratory care theory and practice in the interest of protecting the public. A total of 12 (twelve) hours of continuing education shall be earned in a two year renewal period.

(b) A respiratory care practitioner who is renewing his or her license for the first time after initial licensure is subject to a 6 (six) hour continuing education requirement per full year of licensure. If the license has been held for one year or less, no continuing education is required. If held more than one year but less than two years, 6 (six) hours is required.

(c) Programs or offerings shall be approved or sponsored by an organization approved by the Director. The Office maintains a list of approved providers and courses. Continuing education offerings may include, but are not limited to the following categories and hours are credited as follows:

Category I: Formal continuing education programs that may consist of workshops, inservice programs, professional continuing education activities and scientific meetings and self-directed continuing education activities that may consist of local, regional, national symposia, colloquia, journal clubs, self-study courses, online courses, distance learning activities and/or institutes, or recredentialing examinations through the National Board of Respiratory Care. Half of the continuing education (up to 6 hours) may be online or distance learning (non-didactic).

Credit: One hour for each hour attended except for the recredentialing exam which carries a specific number of hours set by the AARC.

Category II: Formal presentations by the licensee at a conference or seminar where continuing education credit has been approved by one of the sponsoring organizations previously approved by the Director.

Credit: Two hours for each hour of instruction, up to a maximum of 6 (six) hours per renewal period.

Section 3.3 Continuing Education Reporting

(a) At renewal time the Office will provide a form upon which all continuing education must be reported. The form must be submitted with the biennial renewal form.

(b) Requests for extension because of unforeseen circumstances may be granted. Under extenuating circumstances, the Director may waive all or part of the continuing education requirements if the applicant provides a written request for a waiver and provides evidence of an illness, injury, financial hardship, family hardship, or other extenuating circumstance which precluded the applicant's completion of the requirements.

(c) Licensees shall maintain the required proof of completion for continuing education activity for a minimum of two years following the last day of the renewal period for which the continuing education was earned. Licensees should not send their documentation to the Office unless audited or otherwise requested to do so.

(d) The Office may perform a random audit of licensees' continuing education. A licensee who fails to comply with continuing education requirements is subject to disciplinary action.

Section 3.4 Continuing Education Program Approval For Sponsors

(a) Provided that the continuing education is consistent with the provisions of these rules, the Director shall grant pre-approval to offerings:

sponsored or approved by the Vermont/New Hampshire Society for Respiratory Care;
sponsored or approved by the American Association for Respiratory Care; or
others approved by the Director on a list maintained by the Office which shall be available to licensees upon request.

(b) A provider who wishes to obtain approval of continuing education offerings shall submit to the Office, at least 90 days in advance of the program, all required information, including:

Course description;
Learning outcomes;
Target audience;
Content focus;
Detailed agenda for the activity;
Amount of credit offered;
Qualifications of the presenter(s);
Sample documentation for demonstrating satisfactory completion by course participants such as a certificate of completion.

(c) Upon review of the completed application, the office shall notify the provider as to whether or not the program has been approved and, if approved, the number of continuing education hours to be awarded.

Section 3.5 Reinstating Licensure

If a license has expired because it was not renewed on time, the licensee may apply for reinstatement and pay the renewal fee for the current renewal period and a late renewal penalty. Practicing with a lapsed license is considered unlicensed practice and may result in a charge of unauthorized practice and possible disciplinary action. The licensee does not have to pay renewal fees for years during which the license was lapsed. If a license has been lapsed for over five years, the Director may require proof of competence in the form of education, experience or examination prior to reinstating the license.

Section 3.6 Unprofessional Conduct

The Act sets forth specific grounds of unprofessional conduct. A licensee may be disciplined for a violation of any of those grounds, which are found in 26 V.S.A. § 4714 as well as the grounds for unprofessional conduct found at 3 V.S.A. § 129a.

Section 3.7 Complaint Procedure

The Office has a procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Section 3.8 Disciplinary Actions

Hearings on charges of unprofessional conduct are held before an administrative law officer. A party aggrieved by a decision of the administrative law officer may, within 30 days of the decision, appeal by filing a written notice with the Director. The appeal shall be decided by the superior court of Washington County on the basis of the record before the administrative law officer. 26 V.S.A. § 4704(b)

History

EFFECTIVE DATE: September 1, 2005 (Secretary of State Log # 05-029)

Chapter 007 ADMINISTRATIVE RULES FOR PROPERTY INSPECTORS

04-007 Code Vt. R. 04-030-007-X ADMINISTRATIVE RULES FOR PROPERTY INSPECTORS

Part 1 GENERAL INFORMATION

Section 1.1 The Purpose of Licensure

The Director of the Office of Professional Regulation (the "Director") is responsible, pursuant to Vermont law, for licensing property inspectors in order to protect the public health, safety and welfare. The Director's responsibilities include setting standards for issuing licenses, regulating the practice of property inspection and enforcing Vermont's professional conduct laws.

Section 1.2 Laws that Govern Licensure

The enabling statutes specific to professional property inspection practice in Vermont can be found at 26 V.S.A. §§ 1051-1095. Among the laws governing the regulation of professional practice are: the Professional Regulation law ( 3 V.S.A. §§ 121-131); the Administrative Procedure Act ( 3 V.S.A. §§ 801-849); the Open Meeting law ( 1 V.S.A. §§ 310-314); and the Access to Public Records law ( 1 V.S.A. §§ 315-320). These laws set forth the rights of an applicant, license holder or member of the public. The complete "Vermont Statutes" are available online at http://legislature.vermont.gov. These administrative rules implement and interpret the statutory laws governing the profession. The Office of Professional Regulation (the "Office") posts the most recent statutes and administrative rules governing the practice of the profession at www.sec.state.vt.us/professional-regulation/profession/property-inspectors.

Section 1.3 Business Address

The Office mailing address is: Office of the Secretary of State, Office of Professional Regulation, 89 Main Street, FL3, Montpelier, VT 05620-3402. Copies of these rules and more information about the profession and its requirements can be obtained by contacting the Office at 1-802-828-2363. This information may also be obtained from the Office's web site at www.sec.state.vt.us/professional-regulation.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Where to Get an Application

An application for licensure or more information about the application process may be found on the Office's web site at www.sec.state.vt.us/professional-regulation/profession/property-inspectors. Applicants must submit a completed application with all supporting documentation and fee to the Office. Supporting documentation may include, but is not limited to, evidence of required education, examination results, evidence of a license in any and all jurisdictions and their respective licensing standards, or other licensing standards. An initial license issued to an applicant within 90 days of the current expiration date will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.2 Education Requirements for Licensure

(a) A person may satisfy the 80-hour education requirement for licensure as a property inspector pursuant to 26 V.S.A. § 1091(2) by completing coursework covering the following core property systems:

(1) heating systems;

(2) cooling systems;

(3) plumbing systems;

(4) electrical systems;

(5) structural components;

(6) foundations;

(7) roof coverings;

(8) exterior and interior components; and

(9) site aspects as they affect the building.

(b) The Office shall maintain a list of education providers and courses approved by the Director. The List of Approved 80-Hour Courses may be obtained from the Office's web site at www.sec.state.vt.us/professional-regulation .

(c) Proof of certification issued by one of the independent, nationally recognized organizations that provides certification for property inspectors identified in Rule 2.4 below satisfies the education requirement.

Section 2.3 Examination Requirements for Licensure

(a) The Director adopts the National Home Inspector Examination developed by the Examination Board of Professional Home Inspectors for the examination required by 26 V.S.A. § 1091(3). Examination results are valid for a period of one year from the date the examination is passed. An examination is considered passed when an applicant has received a passing grade on both parts of the examination. An applicant who fails the examination three consecutive times may not apply for reexamination or submit a new license application unless the applicant submits evidence satisfactory to the Director that the applicant has completed additional core education.

(b) Proof of certification issued by one of the independent, nationally recognized organizations that provides certification for property inspectors identified in Rule 2.4 below satisfies the examination requirement.

Section 2.4 Acceptable Organizations that Provide Certification

The Office shall maintain a list of approved independent, nationally recognized organizations that provide certification for property inspectors. The List of Approved Organizations that Provide Certification may be obtained from the Office's web site at www.sec.state.vt.us/professional-regulation.

Part 3 INFORMATION FOR LICENSEES

Section 3.1 Definitions

(a) "Inaccessible" means a condition determined by the inspector which does not allow the inspector to safely observe a component or system without the need to move obstacles, the need for personal protection equipment, the use of special tools or equipment, or the need for coded or keyed access, or access resulting in damage or requiring third-party permission, and other similar observation limitations; not readily accessible.

(b) "Further evaluation" means examination and analysis by a qualified professional, tradesman, or service technician beyond that provided by a property inspector.

(d) "Representative number" means a sufficient number to serve as a typical or characteristic example of the item(s) or component(s) inspected.

Section 3.2 Standards of Practice

(a) These standards of practice define the minimum requirements for inspections. A property inspection is a non-technical, limited, visual survey and basic performance evaluation of the systems and components of a building using normal controls and does not require the use of specialized equipment or procedures. The purpose of the inspection is to provide the client with information regarding the general condition of the real property at the time of inspection and provide recommendations for further evaluation by a specialist where necessary to correct, or monitor for future correction, the deficiencies reported. If qualified by education, training and experience, the inspector may provide a higher level of inspection performance than required by these standards of practice, and may inspect components and systems in addition to those described by the standards of practice.

(b) General Standards for Inspection.

The property inspector shall:

(1) operate fixed or installed equipment and appliances in at least one mode with ordinary controls at typical settings;

(2) visually inspect readily accessible, observable installed systems and components from near proximity to the systems and components; and

(3) prepare and deliver a written inspection report covering those systems and components required to be inspected pursuant to subsection (c) below, including recommendations for further evaluation by a specialist where necessary, to the person for whom the inspection was performed within five (5) days unless otherwise agreed to in writing by the client.

(1) When inspecting structural systems the inspector shall inspect:

(A) the structural components including the foundation, framing, floor structure, wall structure, ceiling structure and roof structure; and

(B) a representative number of structural components where deterioration is suspected or where clear indications of possible deterioration exist.

(2) When inspecting the exterior the inspector shall inspect:

(A) siding, flashing, and trim;

(B) all exterior doors;

(D) eaves, soffits, and fascias where accessible from the ground level; and

(E) entryway walkways, patios, driveways, grading, surface drainage, and retaining walls which are likely to adversely affect the building.

(3) When inspecting roof systems the inspector shall inspect:

(A) roofing materials;

(B) roof drainage systems;

(D) skylights, chimney exteriors, and roof penetrations.

(4) When inspecting the plumbing system the inspector shall inspect:

(A) interior water supply and distribution systems including all fixtures and faucets;

(B) drain, waste and vent systems including all fixtures;

(D) fuel storage and fuel distribution systems within the structure; and

(E) drainage sumps, sump pumps, and related piping.

(5) When inspecting the electrical system the inspector shall inspect:

(A) service drop;

(B) service entrance conductors, cables, and raceways;

(D) service grounding;

(E) interior components of service panels and sub panels;

(F) conductors;

(G) over-current protection devices;

(H) a representative number of installed lighting fixtures, switches, and receptacles;

(I) wiring methods;

(J) the estimated amperage and voltage rating of the service;

(K) presence of solid conductor aluminum branch circuit wiring; and

(L) presence and absence of smoke detectors, carbon monoxide detectors, ground fault circuit interrupters, and arch fault circuit interrupters.

(6) When inspecting the heating system the inspector shall open readily accessible panels and inspect:

(A) central heating system;

(B) unitary heating system(s) and wall furnaces;

(D) vent systems and chimney exteriors; and

(E) fuel storage and distribution systems excluding propane tanks.

(7) When inspecting the air conditioning system the inspector shall open readily accessible panels to inspect:

(A) permanently installed central systems; and

(B) distribution systems.

(8) When inspecting the interior the inspector shall inspect:

(A) walls, ceilings, and floors;

(B) steps, stairways, and railings;

(D) garage doors and garage door operators; and

(E) a representative number of windows and doors.

(9) When inspecting the insulation and ventilation the inspector shall inspect:

(A) the presence or absence of insulation and vapor barriers in unfinished spaces;

(B) ventilation of attics and foundation areas; and

(10) When inspecting fireplaces the inspector shall inspect:

(A) built-in and free-standing fireplaces and heating stoves; and

(B) chimney exterior and vents.

(d) The inspection report shall be in writing and shall include:

(1) the name and license number of each inspector who participated in performing the inspection;

(2) the address or other unique description of the property on each page of the report;

(3) the client's name;

(4) a description of the type and distinguishing characteristics of the systems and components required to be inspected pursuant to subsection (c) above;

(5) an explanation of the systems and components inspected that the inspector has reason to believe or suspect may be significantly deficient, unsafe, functioning improperly, or near the end of their service lives; and

(6) a recommendation for further evaluation by a specialist where necessary to evaluate the areas of concern noted in subsection (5) immediately above.

(e) General Limitations. The inspector is not required to:

(1) inspect:

(A) items other than those listed within these standards of practice;

(B) anything buried, hidden, latent, inaccessible or concealed;

(C) detached buildings, decks, docks, fences, or waterfront structures or equipment, including seawalls, break-walls, and docks;

(D) screening, shutters, awnings, and similar seasonal accessories;

(E) geological and/or soil conditions;

(F) recreational facilities;

(G) erosion control and earth stabilization measures;

(H) concrete flatwork such as driveways, sidewalks, walkways, paving stones or patios;

(I) sub-surface drainage systems;

(J) automated or programmable control systems, automatic shut-offs, photoelectric sensors, timers, clocks, metering devices, signal lights, lightning arrestor systems, remote controls, security or data distribution systems, solar panels or smart home automation components;

(K) elevators;

(L) antennae;

(M) interiors of flues or chimneys on or attached to the roof;

(N) structural components when probing would damage any finished surface or where no deterioration is visible or presumed to exist;

(O) wells, well pumps, or water storage related equipment;

(P) water conditioning systems;

(Q) solar systems;

(R) fire and lawn sprinkler systems;

(S) private waste disposal and sewer ejector systems;

(T) low voltage wiring systems and components;

(U) heat exchangers;

(V) humidifiers or dehumidifiers;

(W) electronic air filters;

(X) mechanical dampers;

(Y) paint, wallpaper, and other finish treatments; or

(Z) window or wall mounted air conditioning units;

(2) report:

(A) past repairs that appear to be effective and workmanlike except as specifically required by these standards;

(B) cosmetic or aesthetic conditions; or

(C) wear and tear from ordinary use, provided such wear and tear does not otherwise affect the function or safety of an inspected component;

(3) determine:

(A) insurability, warrantability, suitability, adequacy, compatibility, capacity, reliability, marketability, operating costs, recalls, counterfeit products, product lawsuits, life expectancy, exact age, energy efficiency, thermostatic performance, compliance with any code, listing, testing or protocol authority, utility sources, or manufacturer or regulatory requirements;

(B) the presence or absence of pests, termites, or other wood-destroying insects or organisms; provided, however, that licensees shall report visible and patent evidence of infiltration of pests, termites, or other wood-destroying insects or organisms;

(C) the presence, absence, or risk of asbestos, lead-based paint, mold, mildew, corrosive or contaminated drywall or any other environmental hazard, environmental pathogen, carcinogen, toxin, mycotoxin, pollutant, fungal presence or activity, or poison; provided, however, that licensees shall report visible and patent evidence of asbestos, lead-based paint, mold, mildew, corrosive or contaminated drywall or any other environmental hazard, toxin, pollutant, fungal presence or activity, or poison;

(D) types of wood or preservative treatment and fastener compatibility;

(E) the cause or source of a condition;

(F) whether water supply and waste disposal systems are public or private;

(G) water supply quantity or quality;

(H) amperage, voltage or impedance;

(I) cooling supply adequacy or distribution balance;

(J) heat supply adequacy or distribution balance; or

(K) types of insulation;

(4) anticipate future events or conditions, including but not limited to:

(A) decay, deterioration, or damage that may occur after the inspection;

(B) deficiencies from abuse, misuse or lack of use;

(D) the consequences of the inspection or its effects on current or future buyers and sellers;

(E) common household accidents, personal injury, or death;

(F) the presence of water penetrations; or

(G) future performance of any item;

(5) operate shut-off, safety, stop, pressure or pressure-regulating valves or items requiring the use of codes, keys, combinations, or similar devices;

(6) designate conditions as safe;

(7) recommend or provide engineering, architectural, appraisal, mitigation, physical surveying, realty, or other specialist services;

(8) review historical records, installation instructions, repair plans, cost estimates, disclosure documents, or other reports;

(9) verify sizing, efficiency, or adequacy of the ground surface drainage system;

(10) verify sizing, efficiency, or adequacy of the gutter and downspout system;

(11) operate recirculation or sump pumps;

(12) remedy conditions preventing inspection of any item;

(13) apply open flame or light a pilot to operate any appliance;

(14) turn on decommissioned equipment, systems or utility services; or

(15) provide repair cost estimates or re-inspection services.

(f) In the event of a conflict between specific provisions and general provisions in the standards of practice, specific provisions shall take precedence.

(g) An inspector may depart from the inspection of a component or system required by the standards of practice only if:

(1) the inspector and client agree the item is not to be inspected;

(2) the inspector is not qualified to inspect the item;

(3) in the reasonable judgment of the inspector, conditions exist that prevent inspection of an item;

(4) the item is a common element of a multi-family development and is not in physical contact with the unit being inspected, such as the foundation under another building or a part of the foundation under another unit in the same building;

(5) the inspector reasonably determines that conditions or materials are hazardous to the health or safety of the inspector; or

(6) in the reasonable judgment of the inspector, the actions of the inspector may cause damage to the property.

(h) If an inspector departs from the inspection of a component or system required by the standards of practice, the inspector shall:

(1) notify the client in writing at the earliest practical opportunity that the component or system will not be inspected; and

(2) make an appropriate notation on the inspection report, stating the reason the component or system was not inspected.

Section 3.3 Unprofessional Conduct; Practice Standards

In addition to the conduct prohibited pursuant to 3 V.S.A. § 129a, the following acts by a property inspector violate essential standards of acceptable and prevailing practice and constitute unacceptable client care:

(a) performing or offering to perform, for an additional fee, any repairs to a structure on which the inspector, or the inspector's company, has prepared a property inspection report in the past 12 months;

(b) inspecting for a fee any property in which the inspector, or the inspector's company, has any financial interest or any interest in the transfer of the property;

(c) offering or delivering any compensation, inducement, or reward to the owner of the inspected property, the broker, or agent, for the referral of any business to the inspector or the inspection company;

(d) soliciting or accepting any compensation, inducement, or reward from contractors, engineers, architects, repair persons, or other providers of property repair services for the referral of any business arising from a property inspection;

(e) accepting an engagement to make an inspection or to prepare a report in which the employment itself, the fee payable for the inspection, or the expectation of future assignments is contingent upon the conclusions in the report, pre-established findings, or the close of escrow;

(f) cooperating with any real estate broker or salesperson in any plan, practice, or arrangement tending to frustrate the purpose of 26 V.S.A. § 2296(a)(9) (requiring a broker or salesperson to fully disclose to a buyer all material facts within the licensee's knowledge concerning the property being sold);

(g) performing any property inspection in a manner that is negligent, incompetent, or beyond the inspector's scope of training and experience;

(h) failing to disclose to a client, orally and again in the written inspection report, any personal, familial, or pecuniary interest the inspector may have in the outcome of an inspection;

(i) delivering a written inspection report to any third party without the written consent of the client; or

(j) failing to comply with a standard of practice set forth in these rules.

History

STATUTORY AUTHORITY: 26 V.S.A. §§ 1051 to 1095
EFFECTIVE DATE: July 1, 2015 Secretary of State Rule Log #15-023

Chapter 008 ADMINISTRATIVE RULES FOR CERTIFIED APPRENTICE ADDICTION PROFESSIONALS, CERTIFIED ALCOHOL AND DRUG ABUSE COUNSELORS, AND LICENSED ALCOHOL AND DRUG ABUSE COUNSELORS

04-008 Code Vt. R. 04-030-008-X ADMINISTRATIVE RULES FOR CERTIFIED APPRENTICE ADDICTION PROFESSIONALS, CERTIFIED ALCOHOL AND DRUG ABUSE COUNSELORS, AND LICENSED ALCOHOL AND DRUG ABUSE COUNSELORS

Part 1 GENERAL INFORMATION

Part 2 APPRENTICE ADDICTION PROFESSIONAL (A.A.P.) CERTIFICATION

Part 3 ALCOHOL AND DRUG ABUSE COUNSELORS (A.D.C.) CERTIFICATION

Part 4 LICENSED ALCOHOL AND DRUG ABUSE COUNSELORS (L.A.D.C.) LICENSURE

Part 5 REQUIRED DISCLOSURE OF INFORMATION

Part 6 RENEWAL, REINSTATEMENT, CONTINUING EDUCATION

Part 7 UNPROFESSIONAL CONDUCT

History

EFFECTIVE DATE:
April 23, 2001 Secretary of State Rule Log #01-018
AMENDED:
September 26, 2016 Secretary of State Rule Log #16-035 [amended and renumbered from 13 100 005]
Statutory Authority: 26 V.S.A. § 3235(b) and 3 V.S.A. § 802(b) 11)

Chapter 009 ADMINISTRATIVE RULES FOR FORESTERS

04-009 Code Vt. R. 04-030-009-X ADMINISTRATIVE RULES FOR FORESTERS

Part 1 Definitions and Clarification of Terms

Part 2 Administration

Part 3 Procedures

Part 4 Eligibility for Licensure

Part 5 License Renewal and Continuing Education

Part 6 Duties and Standards

Part 7 Discipline

History

STATUTORY AUTHORITY: 26 V.S.A. § 4911(b)
EFFECTIVE DATE: August 1, 2017 Secretary of State Rule Log #17-041

Chapter 010 ADMINISTRATIVE RULES FOR THE BOARD OF PUBLIC ACCOUNTANCY

04-010 Code Vt. R. 04-030-010-X ADMINISTRATIVE RULES FOR THE BOARD OF PUBLIC ACCOUNTANCY

Part 1 INTRODUCTION

Section 1.1 The Board's Purpose

The Board of Public Accountancy (the "Board") sets standards for issuing licenses, regulates the practice of public accounting within the State of Vermont and protects the public by enforcing Vermont professional conduct laws. Title 26, Chapter 1 contains the Board's enabling statutes.

Section 1.2 Business Location

The Board's mailing address is:

Vermont Board of Accountancy

Office of Professional Regulation

89 Main Street, 3 [rd ]Floor

Montpelier, Vermont 05620-3402.

The Board's business location is: Office of Professional Regulation, 89 Main Street, 3 [rd ]Floor, Montpelier, Vermont 05620-3402 (the "Office").

Copies of these rules and other applicable statutes are found at http://vtprofessionals.org

Section 1.3 Applicable Law

The Vermont Board of Public Accountancy is authorized by and responsible for implementing Title 26 V.S.A., Chapter 1. Laws that govern the Board include the following: Administrative Procedure Act ( 3 V.S.A. §§ 801-849), the Right to Know Law ( 1 V.S.A. §§ 311-314 ), Access to Public Records Law ( 1 V.S.A. §§ 315-320) and the Office of Professional Regulation enabling statutes ( 3 V.S.A. §§ 121-131). Law libraries and most Town Clerk's Offices maintain volumes of the Vermont Statutes Annotated. The Board posts the most recent statutes and administrative rules governing the practice of the profession at www.vtprofessionals.organd

http://vtprofessionals.org/oprl/accountants/.

Section 1.4 Regulations

These administrative rules are promulgated pursuant to 26 V.S.A. § 54. These rules represent the law governing Board proceedings. In revising these administrative rules, the Board shall follow the provisions of the Administrative Procedure Act.

Part 2 DEFINITIONS

Section 2.1 Definitions

For purposes of these administrative rules the following terms have the meanings indicated:

(a) "Act" means Title 26, Vermont Statutes Annotated, Chapter 1, Accountants.

(b) "Advertising" includes print, television or radio ads of any type, internet, World Wide Web or electronic media displays of any variety, stationary, business cards, signs and other audio, visual or print notices or depictions related to professional services.

(d) "Attest" is defined at 26 V.S.A. § 13(1)(A).

(e) "Client" means the person or entity that agrees with a licensee or registered firm to receive professional services.

(f) "Compilation" is defined at 26 V.S.A. § 13(3).

(g) "Contingent fee" is a fee based on the result of a service. It is a fee obtained pursuant to a specified finding or result attained by the licensee. This definition does NOT include fees set by courts or other public authorities. A court ordered fee based on the results of judicial or government agency proceedings is NOT a contingency fee for purposes of these rules.

(h) "CPA" means Certified Public Accountant holding a license pursuant to 26 V.S.A. §§ 71a, 72b, or 74c.

(i) "CPE" means continuing professional education.

(j) "Enterprise" means any person or entity, whether organized for profit or not, for which a licensee performs professional services.

(k) "Examination" means the Uniform Certified Public Accountant Examination.

(l) "Financial statements" means statements and footnotes related thereto that undertake to present an actual or anticipated financial position as of a point in time, or results of operations, cash flow, or changes in financial position for a period of time in conformity with U.S. generally accepted accounting principles or another comprehensive basis of accounting. The term does not include incidental financial data included in management advisory services reports to support recommendations to a client, nor does it include tax returns and supporting tax form schedules.

(m) "Firm" is defined at 26 V.S.A. § 13(5).

(n) "One year of public accounting experience" means 2,080 hours of employment.

(o) "Opinion on financial statements" means an opinion expressed in accordance with U.S. generally accepted auditing standards as to whether the presentation of information used for guidance in financial transactions or for accounting for or assessing the status or performance of commercial and noncommercial enterprises, whether public, private, or governmental, is in conformity with U.S. generally accepted accounting principles or some other comprehensive basis of accounting.

(p) "Partner" includes an equity owner of any firm.

(q) "Partnership" includes any firm.

(r) "Peer review report" shall be the report, letter of acceptance, and may include at the request of the Board, any letter(s) of comment(s), responses or remedial actions and subsequent follow-ups by the licensee submitted to the individual or the firm by the peer review entity. Acceptable peer review entities include the AICPA, New England Peer Review (NEPR), and other nationally recognized organizations. The Board may accept other organizations that perform peer reviews, but only after Board review. The Board may review any organization that conducts peer reviews.

(s) "Place of business" means a place that is regularly accessible by customers or clients and functions as a normal business location.

(t) "Practicing accountant" means a certified public accountant or registered public accountant, including those practicing on a temporary basis from other jurisdictions.

(u) "Professional services" means any service a licensee performs or offers to perform for a client in the course of the practice of public accountancy.

(v) "Public bookkeeping" means the rendering of record keeping services, which are not the practice of public accountancy.

(w) "Report" is defined at 26 V.S.A. § 13(13).

(x) "Review of financial statements" is defined at 26 V.S.A. § 13(1)(A) (iii).

(y) "RPA" means a Registered Public Accountant holding a license.

(z) "Semester hours" means the conventional college semester hours. Quarter hours may be converted to semester hours by multiplying them by two-thirds.

(aa) "Standards" means any reference to U.S. Generally Accepted Accounting Principles (GAAP) or other comprehensive bases of accounting, Generally Accepted Auditing Standards (GAAS), and other standards approved for use in the United States of America.

(bb) "V.S.A." means Vermont Statutes Annotated.

Part 3 PROHIBITIONS

Section 3.1 Issuance of a Report

No report as defined herein shall be issued without the firm registration number or temporary registration number appearing somewhere on the report.

Section 3.2 Public Bookkeeping and Tax Service; Safe Harbor Language

(a) Nothing in the Act prohibits individuals, partnerships or corporations from rendering public bookkeeping and tax services, including those services specified at 26 V.S.A. § 15(3).

(b) The following language may accompany the transmittal of financial information in order to conform with the Act:

(1) (I/we) have prepared as a bookkeeping service the following financial statement(s) [insert name(s) of statement(s)].

(2) (I am/we are) not licensed by the State of Vermont to express an opinion or any other assurance or representation on the financial information transmitted herewith.

Part 4 STATE BOARD OF PUBLIC ACCOUNTANCY

Section 4.1 Board Meetings

An annual meeting of the Board shall be held each year and other meetings shall be held as deemed appropriate to conduct the business of the Board. Meeting dates are available from the office. The chairperson or any two members have the authority to call meetings of the Board. A majority of the board constitutes a quorum.

Section 4.2 Election and Tenure of Officers

At the annual meeting, the Board shall elect from among its members the chairperson, secretary, and other officers the Board may determine appropriate. The officers shall assume their duties at the conclusion of the annual meeting at which they were elected. They shall serve a term of one year, and be eligible for reelection.

Section 4.3 Fees

Application, licensing and renewal fees are established by statute. A current fee schedule may be obtained by writing to the office.

Part 5 INITIAL LICENSE TO PRACTICE

Section 5.1 Applications

(a) License applications are processed pursuant to §§ 71a and 72b of the Act. License applicants shall use forms provided by the office. Upon receipt of the licensing fee and all information required of an applicant, the Board shall deem the application "filed."

(b) Applicants will have 4 years to complete the application process after passing the certified public accountant's examination.

Section 5.2 Recognized Colleges and Universities

For purposes of §§ 71a and 72b of the Act, the Board will recognize a two or four year degree-granting college or university in the United States which, at the time the applicant's credits were received, was regionally accredited by bodies approved by the Council on Postsecondary Accreditation and the United States Department of Education; in Canada, held a membership in the Association of Universities and Colleges of Canada; or in other countries, was accredited by the respective official organization having such authority. The Board may recognize other educational experiences in exceptional circumstances.

Section 5.3 Studies in Accounting, Auditing and Business

Studies in accounting, auditing and business shall include accounting, auditing, and business subjects at the college level, of not less than six semester hours in financial accounting (which shall not include introductory financial accounting courses), three semester hours in auditing, three semester hours in United States income tax, and three semester hours in United States business law. Accounting, auditing, business, and other college level courses may be counted toward the total semester hours required. The Board may allow substitution of courses when an applicant can demonstrate that the course of study undertaken is fully equal to the course of study described above.

Section 5.4 Applications for Examination

(a) Applications to take the Examination must be made on a form obtained from the Board or its designee.

(b) Except as provided in subsection (c), an application will not be considered filed until the application fee and examination fee required by the Act and all required supporting documents have been received.

(c) Applicants whose course completion or graduation occurs within sixty days following the examination must file official transcripts not later than 120 days after the examination. Failure to file the required transcripts may void any conditional credit obtained.

(d) An applicant who fails to appear for examination or reexamination shall forfeit the fees charged for the examination or reexamination. Application fees will not be refunded for any reason. Upon request, examination or reexamination fees may be refunded at the Board's discretion for hardship or other just cause.

(e) Each applicant for examination shall submit with his or her application the required identification as required by the Board or its designee for identification purposes at the examination site.

Section 5.5 Omitted by Agency

Section 5.6 Ethical Mandate

(a) All candidates shall complete a course of study in professional ethics for accountants equivalent to eight hours of continuing professional education that shall include the AICPA Code of Conduct or Vermont accountancy statutes and rules. In order to qualify under this section, candidates must complete an ethics course within two years of the filing date of the application. See Rule 5.1 for when an application is deemed "filed."

(b) A candidate who engages in disorderly conduct or cheating during an examination may be prohibited from applying for reexamination or licensure for a period of five years.

Section 5.7 Passing Grades

A passing grade for each subject shall be 75 as determined by a national recognized grading service approved by the Board.

Section 5.8 Conditional Credit for Sections of the Examination Passed

Candidates for computer-based examinations may take each section of the exam individually and in any sequence and will retain credit for any section passed for eighteen months.

Section 5.9 Experience in Public Accounting

(a) An applicant shall obtain accounting experience under direct supervision of a certified public accountant or other licensee deemed equal by the National Association of State Boards of Accountancy reciprocity agreements. The experience shall include practical public accounting experience or its equivalent including a reasonable variety of experience.

(b) Public accounting experience shall consist of a portfolio of experience of such non-routine accounting nature that continually requires independent thought and judgment on important accounting matters.

(1) Experience shall consist of the application of United States generally accepted accounting principles (GAAP) and the application of one or more of the following: generally accepted auditing standards (GAAS), standards of accounting and review services (SSARS), standards for accountants' services on prospective financial information, financial forecasts and projections, and other services subject to comprehensive sets of generally accepted professional standards issued by an appropriate standard setting body which the Board determines is equivalent. Examples of work qualifying under this section are:

i. review and evaluation of internal control policies and procedures;

ii. testing of compliance with control policies and procedures;

iii. preparation of working papers in connection with elements of work accomplished;

iv. planning, revision, or updating of audit programs to be followed;

v. drafting or reviewing memoranda, conclusions, notes;

vi. preparation and/or analysis of financial statements and reports;

vii. performance of procedures for verification of transactions and balances; and

viii. appropriate analytic review of accounts and comparison to industry data.

(2) Experience may consist of the review and preparation of tax provisions and reserves including research for determination of tax provision and related reserves, research for determination of taxable earnings and profits, reconciliation of book to tax return adjustments, review of tax returns to determine adequacy of income tax reserves, analysis of tax positions taken in making judgments affecting tax provisions and reserves.

(3) Experience may consist of financial statement preparation from the books of account without audit and the preparation of related tax returns; performance of other related services requiring a knowledge of generally accepted accounting principles; tax related activities; review of financial projections; accounting for estates and fiduciaries; preparation of books of original entry, preparation of payrolls, checks, payroll tax reports, sales or similar tax returns, and posting of subsidiary ledgers.

(4) Experience may consist of design and installation of accounting, cost or other systems, when not related to an extension of auditing assignments and other management advisory services.

(5) If an applicant presents public accounting experience which satisfies the elements contained in 5.9(b)(2), (3), or (4), but not the elements included in 5.9(b)(1), the Board may consider a detailed evaluation of the applicant's portfolio of experience.

(c) Non-public accounting experience shall consist of a portfolio of experience of such non-routine accounting nature that continually requires independent thought and judgment on important accounting matters.

(1) The experience may have resulted in reports which comment on the financial condition and operating results of the agency or organization being audited and should be prepared for an executive function which does not have operating responsibility or control for the organization, department, division, or other entity being reported upon.

(2) The applicant's experience may include:

i. assessing the adequacy of the employer's internal controls by developing an understanding of the employer's transaction streams and information systems;

ii. tax return preparation and research, preparation and analysis of financial statements, cost accounting, budgeting and the application of accounting principles; and

iii. demonstrating a working understanding of the industry in which the applicant's employer operates, including the employer's competition and key competitiveness factors that affect the industry.

(3) The Board shall consider whether:

i. the applicant performed work resulting in opinions on financial statements or in reports on financial analyses or accounts;

ii. the applicant participated with an independent auditor who relied on the applicant's work, wholly or partially, in attesting to the entity's finances;

iii. the applicant performed substantial financial work, compliance work, systems design, or tax accounting;

iv. any limitations on scope, approach or work were imposed;

v. significant proportions of work consisted of field work as opposed to desk or office work;

vi. there was exposure to two or more types of industries;

vii. the work was of sufficient duration to permit meaningful involvement in the process; and

viii. the applicant's accounting duties required fiduciary responsibilities, or does the applicant treat accounting related duties as a fiduciary to a third party.

(d) In order to qualify under this section, an applicant must attain the experience within a period beginning four (4) years prior to completing the examination and ending not more than four (4) years after completing the examination. Applications are complete when filed in accordance with Rule 5.1.

Section 5.10 Evidence of Applicant's Experience

(a) Licensees shall honor any reasonable applicant request to submit evidence to the Board of the applicant's experience.

(b) Any licensee who has furnished evidence of an applicant's experience to the Board shall upon request by the Board explain in writing or in person the information so provided.

(c) The Board may require inspection, by the Board or by its designee, of documentation relating to an applicant's experience.

(d) Proof of experience must be submitted on a form provided by the Board.

(e) Licensees submitting evidence of an applicant's experience must provide proof of holding a license in good standing as a CPA or equivalent license for the period of supervision.

Section 5.11 Endorsement

An applicant to practice as a certified public accountant by endorsement must hold a license in good standing as a certified public accountant in a jurisdiction that has licensure requirements substantially equal to Vermont's.

(a) An applicant by endorsement must provide the Board with a certificate of good standing from each jurisdiction where the applicant is licensed, and one photograph signed on the back before a notary public or similar public official.

(b) Applicants by endorsement must provide proof of completing a four (4) hour professional ethics course for public accountants that shall include the AICPA Code of Conduct or Vermont accountancy statutes and rules. The ethics course shall be completed within two years of filing the application.

(c) After review of an application for endorsement, the Board will notify applicants in writing of its decision. If the Board denies a license application, it will inform the applicant of the specific reason(s). The Board will also inform applicants of any appeal rights afforded by Vermont law.

(d) Meet the requirements of 1 V.S.A. § 72b.

Part 6 REGISTRATION OF FIRMS

Section 6.1 Applications

(a) Applications by firms for initial registration pursuant to § 74 of the Act shall be made on a form provided by the Board. Applications will not be considered filed until the applicable fee is received.

(b) A sole proprietor is considered a firm (See 26 V.S.A. § 13(5)) and must apply for a firm registration.

(c) Applications shall include the firm name, addresses and telephone numbers of the main office, of any branch office(s) of the firm in this state.

(d) Registrations must be renewed every two years.

(e) Each firm shall be assigned a firm registration number.

Section 6.2 Notification of Changes by Firms

(a) A firm registered pursuant to these regulations shall file with the Board a written notification of any of the following events within thirty days after its occurrence:

(1) any change in the name of the firm;

(2) termination of the partnership or corporation;

(3) establishment of a new branch office or the closing or change of address of a branch office in this state; and

(4) the occurrence of any event or events, which would cause such partnership or professional corporation or other entity not to be in conformity with the provision of the Act or these rules.

(b) Within thirty days of a firm changing its legal form, the new firm shall file an application for initial registration in accordance with section 6.1.

Part 7 TEMPORARY REGISTRATION

Section 7.1 Temporary Registration

(a) Applications for temporary registration pursuant to § 74a of the Act shall be made on a form provided by the Board, and accompanied by the appropriate fee.

(b) Each application shall include:

(1) the name and office address of each person who will be engaged in the performance of the engagement in this State.

(2) evidence that each person performing work for the firm is licensed and in good standing in another jurisdiction to practice public accounting;

(3) identification of the professional engagement to be performed pursuant to the temporary permit; and

(4) Applicants performing attest functions within the State of Vermont must provide satisfactory evidence of a peer review in accordance with Rule 10.7.

Section 7.2 Time Limits

Temporary registrations expire three months after issuance. A firm may receive only one temporary registration per calendar year. Practicing more than three months in a calendar year requires licensure by endorsement.

Part 8 RENEWALS and REINSTATEMENT

Section 8.1 Application for Renewal of Licensure and Firm Registration

(a) Application for renewal of licensure and firm registrations shall be made on a form provided by the Board.

(b) Licenses renew on a fixed biennial schedule: July 31st of odd-numbered years. Initial licenses issued within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full license period. Applicants issued a license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

(c) Before the license expiration date, the Office will mail notice of the renewal fee and a renewal application to the address of record. A license will expire automatically if the application and fee are not returned to the office by the expiration date.

Section 8.2 Application for Reinstatement of Licensure and Firm Registration

(a) An expired license or firm registration may be reinstated upon completion of the Board's reinstatement form, meeting all renewal requirements, and payment of all applicable reinstatement and renewal fees.

(b) An applicant whose license has expired for more than ten years must file a new application for licensure and satisfy the initial licensure requirements of the Board or the endorsement requirements of the Board.

Section 8.3 Hardship Exceptions

The Board may, in its discretion, make exceptions to the requirements for renewal or reinstatement set out in the statute for reasons of individual hardship including health, military service, foreign residence, or other good cause.

Part 9 CONTINUING PROFESSIONAL EDUCATION

Section 9.1 Continuing Professional Education Requirements for Renewal of Licenses

(a) A licensee seeking regular biennial renewal shall show that he or she has completed no fewer than 8 0 hours of continuing professional education during the two year period ending on the renewal date on a form provided by the Board ( see rule 8. 1(A)).

(b) A licensee seeking renewal after an initial license period, not by endorsement, shall show that he or she has completed 40 hours of continuing professional education for each full year the license has been held during the two year period preceding renewal.

(c) An applicant whose license has lapsed at the time of application for renewal shall have completed the continuing professional education hours required during the lapsed two year period immediately preceding the date of application for reinstatement.

(d) An applicant may carryover from one biennium a maximum of ten continuing professional education hours. The carryover hours cannot be the required eight hours of auditing and accounting or the four hours of ethics.

(e) In fulfilling these requirements, licensees must successfully complete at least four hours of continuing education in the subject area of ethics for accountants.

(f) Licensees must successfully complete at least eight hours of continuing education in the subject area of accounting and auditing.

Section 9.2 Programs Qualifying for Continuing Professional Education Credit

(a) Standards - A program meets board qualifications if it is a formal course of learning, which contributes to the growth of professional knowledge, skills, and abilities in the practice of public accountancy, and meets the minimum standards of quality of development and presentation and of measurement and reporting of credits set forth in the National Registry of CPE Sponsors published by the National Association of State Boards of Accountancy or similar educational standards as may be established from time to time by the Board.

(b) Subject Areas - Acceptable programs may deal with the following general subject areas:

(1) accounting and auditing;

(2) taxation;

(3) management;

(4) information technology;

(5) ethics;

(6) mathematics, statistics, probability and quantitative applications in business;

(7) economics;

(8) business law;

(9) functional fields of business, including finance, production, marketing, personnel relations, and business management and organization; and

(10) specialized areas of industry (film industry, real estate, farming, etc.).

Subjects other than those listed above may be acceptable if the applicant can demonstrate that they contribute to his or her professional competence as a CPA. The responsibility for demonstrating that a particular program is acceptable rests solely upon the applicant.

(c) Group Programs - Group programs such as the following are acceptable so long as they meet the standards specified in subsection (a) and deal with subjects referred to in subsection (b):

(1) Professional education and development programs of national, state and local accounting organizations;

(2) Technical sessions at meetings of national, state and local accounting organizations and their chapters;

(3) University or college courses, both credit and non- credit;

(4) Formal in-firm education programs;

(5) Programs of other organizations (accounting, industrial, professional, etc.);

(6) Committee meetings of professional societies, which are structured as formal educational programs;

(7) Dinner, luncheon and breakfast meetings, which are structured as formal educational programs; and

(8) Firm meetings for staff or management groups, which are structured as formal education programs. Portions of such meetings devoted to the communication and application of general professional policy or procedure may qualify; but portions devoted to firm administrative, financial and operating matters generally will not qualify.

(d) Credit - Continuing professional education credit will be given for whole hours only, with a minimum of fifty minutes constituting one hour. As an example, one hundred minutes of continuous instructions would count as two hours; however, more than fifty minutes but less than one hundred minutes of continuous instruction would count only as one hour. Only time spent in instruction, and not preparation time, will be credited. For university or college courses, each semester hour of credit shall equal fifteen hours toward the requirement, and a quarter hour of credit shall equal ten hours.

(e) Correspondence and Formal Individual Study Programs - The amount of credit to be allowed for correspondence and formal individual study programs (including taped study programs) will be that which is recommended by the program sponsor. Applicants claiming credit for such correspondence or formal individual study courses are required to obtain evidence of satisfactory completion of the course from the program sponsor. Credit will be allowed in the renewal period in which the course is completed.

(f) Instructor, Discussion Leader, or Speaker - Applicants who have served as instructors, discussion leaders, and speakers at programs coming under subsections (a), (b) and (c) may claim continuing professional education credit for both preparation and presentation time. Credit may be claimed for actual preparation time up to two times the program or class contact hours. The maximum credit for such preparation and teaching is fifty percent of the applicable renewal period requirement. Credit may be claimed only once, unless the program or course has changed substantially. The responsibility for demonstrating that a particular program or course has changed rests solely upon the applicant.

(g) Published Articles, Books - Credit toward the continuing professional education requirement may be claimed for published articles and books, provided they contribute to the professional competence of the licensee. Credit for preparation of such publications may be claimed on a self- declaration basis for up to twenty-five percent of the renewal period requirement. In exceptional circumstances, a licensee may request additional credit by submitting the article(s) or book(s) to the Board with an explanation of the circumstances which justify a greater allowable credit. The amount of credit awarded for a given publication will be determined at the Board's discretion.

Section 9.3 Continuing Professional Education Records

(a) Applicants for renewal of licenses shall file with their applications a signed statement affirming that they have completed the required continuing professional education programs.

(b) Responsibility for documenting the acceptability of the program, completion of the hours and the validity of the credits rests with the applicant. Licensees must retain the documentation for a period of five years after the completion of the program. Documentation may consist of the following:

(1) Copy of the course outline prepared by the course sponsor along with the following information:

(i) sponsoring organization;

(ii) location of program;

(iii) title of program or description of content;

(iv) dates attended; and

(v) hours completed.

(2) For courses taken for scholastic credit in accredited universities and colleges, evidence of satisfactory completion of the course is sufficient; for non-credit courses, a statement of the hours of attendance signed by the instructor is required.

(3) Formal individual study programs require documented evidence of completion.

(c) The Board will randomly verify information submitted by applicants. If the Board determines an applicant did not meet the requirement it may, for cause shown, grant additional time to cure deficiencies prior to taking further action.

Part 10 PROFESSIONAL CONDUCT

Section 10.1 Introduction

(a) The professional conduct rules are promulgated pursuant to 26 V.S.A. § 54(b)(2), which delegates to the Board the authority and duty to adopt rules of professional conduct for establishing and maintaining high standards of competence and integrity in the profession of public accountancy. These rules of conduct are in addition to the laws governing professional conduct at 3 V.S.A. § 129a.

(b) The rules of conduct are based on the premise that the general public has a right to rely upon the professional competence that inheres to the use of a legally restricted title relating to the practice of public accountancy.

(c) Acceptance of licensure to engage in the practice of public accountancy requires the licensee to abide by the laws governing the practice of the profession.

(d) The rules of conduct apply to all professional accountancy services.

(e) A licensee practicing public accountancy outside the United States shall conform to the standards of professional conduct applicable to the practice of public accountancy in the country where the licensee is practicing. If a licensee's foreign practice reasonably implies to clients conformity with United States conduct standards, the licensee shall comply with these rules of conduct.

Section 10.2 Independence

A licensee shall not perform attest services unless the licensee is exercising independent judgment. The Board considers a licensee's independence to be impaired if a licensee fails to follow the current AICPA Code of Conduct, PCAOB, the Government Accountability Office standards or Securities and Exchange Commission's standards.

Section 10.3 Integrity and Objectivity

A licensee shall not knowingly misrepresent facts or subordinate his or her judgment to others. In tax practice it shall not be unprofessional conduct for a licensee to resolve doubt in a client's favor based on reasonable support for the position.

Section 10.4 Commissions

To help insure the public receives independent judgment, licensees shall not accept or pay commissions in the following circumstances:

(a) Licensees shall not recommend or refer to a client any product or service for a commission and licensees shall not receive a commission for recommending or referring any product or service supplied by a client when the licensee also performs for that client:

(1) an audit or review of a financial statement; or

(2) a compilation of a financial statement when the licensee expects, or reasonably might expect, that a third party will use the financial statement and the licensee's compilation report does not disclose a lack of independence; or

(3) an examination of prospective financial information.

(b) The prohibition on commissions applies during the period in which the licensee is engaged to perform any professional service listed in this section, and the period covered by any historical financial statement related to a professional service listed in this section.

(c) A licensee who is not prohibited from receiving a commission, and who is paid or expects to be paid a commission, shall disclose this fact to any person the licensee recommends or refers a product or service that may generate a commission.

(d) If a licensee accepts a referral fee for recommending professional services, the licensee shall disclose this to any client who is the subject of a referral fee. If a licensee pays a referral fee to obtain a client, the licensee shall disclose the fee to any client who is the subject of a referral fee.

Section 10.5 Contingent Fees

(a) Licensees may not work for or receive a contingency fee for any professional service rendered to a client for whom the licensee or the licensee's firm performs:

(1) an audit or review of a financial statement; or

(3) an examination of prospective financial information.

(b) Licensees may not receive contingency fees for preparing an original or amended tax return or claim for a tax refund for any client.

(c) The prohibition on contingency fees applies during the period in which the licensee is engaged to perform any professional service listed in this section, and the period covered by any historical financial statement related to a professional service listed in this section.

Section 10.6 Incompatible Occupations

A licensee shall not concurrently engage in the practice of public accountancy and in any other business or occupation that impairs the licensee's independence or objectivity in rendering professional services.

Section 10.7 Peer Review

(a) If no attest services were performed by a firm within the meaning of the Act, then no peer review is required. A firm must state to the Board, under penalty of perjury, that no reports within the meaning of the Act were issued during the immediately preceding three years. Each application for renewal or reinstatement under Part 8 of these rules by a firm required to participate in a peer review program shall include an attestation that the firm, within the three years immediately preceding the application, had been subjected to a peer review conducted in accordance with a peer review program approved by the Board, except for a firm subject to its initial peer review as defined by Rule 10.7(e).

(b) Such peer review reports are exempt from disclosure to the public under 1 V.S.A. § 317(b)(3) and (b)(6), except in cases of continuing deficiencies and noncompliance as described below.

(c) Each firm required to participate in a peer review program shall continue participating in a peer review program until the firm or its successor in interest has, for a period of at least one year outside of its peer review year, not performed any attest services and has no intention to do so in the foreseeable future. A peer review report and letter of acceptance shall be submitted to the Board no later than 30 days of receipt from the peer review entity.

(d) Any firm that receives a report with a rating of pass with deficiency(ies) or fail (formerly a qualified or adverse report) shall abide by the peer review entity's required follow-up action(s) recommendations, including fulfilling such follow-up action(s) recommendations within the time frame established by the peer review entity, and subsequently obtain a final peer review acceptance letter from the peer review entity. A peer review shall not be considered by the Board to be complete until the final letter of acceptance has been issued by the peer review entity. Such final letter of acceptance shall indicate the new due date of the firm's next peer review.

(e) Within 30 days of first performing an attest service, a firm shall notify the board in writing and provide proof of enrollment in a peer review program that meets the requirements of this part. Failure to comply with the peer review requirements of this part shall subject the firm to disciplinary action by the board in accordance with 26 V.S.A. § 78. Within 18 months of the year-end date of the report on the attest engagement the firm first agrees to undertake, the firm shall undergo a peer review. Within 28 months of the year-end date of the report on the engagement the firm first agrees to undertake for a service listed above, the firm shall furnish to the Board a peer review final acceptance letter. If a firm is unable to furnish a final acceptance letter within 28 months of being issued a report with a rating of pass with deficiency(ies) or fail (formerly a qualified or adverse report), the firm shall, within the 28 month period, provide to the board an accept-provided-that letter, describing required follow-up actions and their due date, from the peer review entity. If the final letter of acceptance has not been issued as of the date the CPA firm files a firm registration, renewal or reinstatement form, the status of the peer review in process, as is within confidentiality requirements, must be obtained from the peer review entity and submitted with the firm registration, renewal or reinstatement form or if the firm is unable to furnish a final acceptance letter due to being issued a report with a rating of pass with deficiency(ies) or fail (formerly a qualified or adverse report), the firm shall provide to the board an accept-provided-that letter, describing required follow-up actions and their due date, from the peer review entity.

(f) In the case of an individual associated with a firm, the individual will be covered by the firm peer review.

(g) Such reports shall not be used to initiate a disciplinary action against a licensee or firm unless the deficiency is found to continue after due notice to the licensee or firm. Due notice means the Board has received a report, or reports, of a firm which are substandard; that correspondence has been provided by the peer review entity detailing the deficiencies; that the firm has had an opportunity to respond to the correspondence; and that after such response by the firm the peer review entity directs the firm to take corrective action and the firm does not or refuses to take the corrective action. Such corrective action recommended by the peer review entity is a recommendation only and the Board, if it desires to enforce the peer review entity's recommendations, must then initiate an investigation or disciplinary proceeding in accordance with these rules.

Section 10.8 Confidential Client Information; Retention of Records

(a) A licensee shall treat any information obtained from a client confidentially. A licensee shall not disclose, without the consent of the client, any information pertaining to his or her client obtained in the course of performing professional services. If a licensee receives a subpoena or other judicial process seeking a client's information, the licensee has an obligation to immediately notify the client and cooperate with any lawful and good faith effort of the client to prevent disclosure of the client's information.

(b) In addition to all legal and contractual provision governing specific engagements licensees shall retain records for no less than five years from the date of completion of the engagement. Records shall include work papers and other documents that contain conclusions, opinions and analyses or financial data related to the engagement.

Section 10.9 Acting through Others

A licensee shall not delegate any task that, if performed by the licensee, would violate the statutes or rules governing the practice of public accountancy.

Section 10.10 Advertising

(a) A licensee shall not use or permit advertising that contains false, fraudulent, misleading, deceptive or unfair statements or claims. False, fraudulent, misleading, deceptive or unfair statements or claims include:

(1) Misrepresentations of fact;

(2) Failure to make full disclosure of relevant facts;

(3) Statements intended or likely to create false expectations of favorable results; or

(4) Any representation an ordinarily prudent person will likely misunderstand, cause them to be deceived or which the licensee reasonably believes will lead to misunderstanding or deception.

(b) Any licensee performing professional services on-line or offering to perform professional services on-line shall prominently display for clients and potential clients:

(1) the licensee's name, firm name and firm registration number;

(2) the licensee's principal place of business;

(3) the licensee's business phone number;

(4) a statement that the individual holds a Vermont license; and

(5) a link to the Office of Professional Regulation's Website at http://vtprofessionals.org or its successor or updated site URL.

(c) Any direct personal communication or solicitation related to professional services must comply with the advertising guidelines set forth in section (a).

Section 10.11 Omitted by Agency

Section 10.12 Misleading Firm Names

(a) A licensee may not use a misleading firm name.

(b) Firm names that are misleading include, but are not limited to:

(1) A name that falsely implies the existence of a corporation when the firm is not a corporation (for example: by using abbreviations such as "P.C." or "P.A."); or

(2) A firm name that falsely implies the existence of a partnership when there is not a partnership (for example: "Smith & Jones, C.P.A.s").

History

HISTORY: STATUTORY AUTHORITY: 26 V.S.A. § 54
EFFECTIVE DATE: December 13, 1993 Secretary of State Rule Log #93-90
AMENDED: September 1998 [Renumbered from Rule No. 04 040 001]; August 22, 2003 Secretary of State Rule Log #03-26; August 7, 2009 Secretary of State Rule Log #09-024; February 20, 2013 Secretary of State Rule Log #13006; June 1, 2014 Secretary of State Rule Log #14-013

Chapter 011 ADMINISTRATIVE RULES FOR WASTEWATER SYSTEM AND POTABLE WATER SUPPLY DESIGNERS

04-011 Code Vt. R. 04-030-011-X ADMINISTRATIVE RULES FOR WASTEWATER SYSTEM AND POTABLE WATER SUPPLY DESIGNERS

Part 1 Definitions and Clarification of Terms

Part 2 Administration

Part 3 Procedures

Part 4 License Requirements and Grades

Part 5 License Renewal; Continuing Education

Part 6 Duties and Standards

Part 7 Discipline

History

STATUTORY AUTHORITY: 26 V.S.A. § 5011(b)
EFFECTIVE DATE: August 1, 2017 Secretary of State Rule Log #17-045

Chapter 012 ADMINISTRATIVE RULES FOR POLLUTION ABATEMENT FACILITY OPERATORS

04-012 Code Vt. R. 04-030-012-X ADMINISTRATIVE RULES FOR POLLUTION ABATEMENT FACILITY OPERATORS

Part 1 Definitions and Clarification of Terms

Part 2 Administration

Part 3 Procedures

Part 4 License Requirements and Grades

Part 5 Provisional Licenses

Part 6 License Renewal; Continuing Education; Status Changes

Part 7 Duties and Standards

Part 8 Discipline

History

EFFECTIVE DATE:
August 1, 2017 Secretary of State Rule Log #17-046

Chapter 013 ADMINISTRATIVE RULES FOR POLLUTION ABATEMENT FACILITY OPERATORS

04-013 Code Vt. R. 04-030-013-X ADMINISTRATIVE RULES FOR THE ASSESSING OF PROFESSIONAL CREDENTIALS OBTAINED OUTSIDE THE UNITED STATES

Part 1. Purpose.

1-1 The Office is not equipped to determine whether professional qualifications (e.g., professional licenses, education, work experience and examinations) obtained in a country or jurisdiction other than the United States are equivalent to similar qualifications obtained in a United States jurisdiction.

1-2 There are independent, private credential evaluation services (CES) that specialize in evaluating professional qualifications obtained in a country or jurisdiction other than the United States , and in determining whether such qualifications are equivalent to States qualifications for professional licensure.

1-3 These Rules provide a process for applicants, who obtained qualifications for their profession in a country or jurisdiction other than the United States , to provide an evaluation and equivalency determination to the Office as part of their application for professional licensure in Vermont.

Part 2. Definitions and Clarification of Terms.

2-1 "Applicant" means an individual applying for a professional license in Vermont in a profession attached to the Office that does not have laws addressing the verification and recognition of credentials obtained in a country or jurisdiction outside of the United States .

2-2 "Director" means the Director of the Vermont Office of Professional Regulation.

2-3 "Office" means the Vermont Office of Professional Regulation.

2-4 "Credential Evaluation Service (CES)" means a third-party entity that specializes in the review and evaluation of professional credentials, education, work experience, examinations and other professional qualifications earned in a country or jurisdiction other than United States , and that is capable of providing a determination regarding equivalency of those professional qualifications, as compared to Vermont qualification requirements for a license in the relevant profession.

2-5 "United States " for the purposes of these rules means a States of the United States , the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States .

Part 3. Waiver or Variance.

3-1 The Director will not grant routine waivers or variances from any provisions of these rules without amending the rules. See 3 V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Director may, upon written request of an interested party, grant a waiver with or without particular conditions and limitations, and record the action and justification in a written memorandum. This rule shall not be construed as creating any hearing right or cause of action.

Part 4. Procedures.

4-1 Applicants, who acquired all or part of the qualifications for a profession for which they are seeking licensure in a country or jurisdiction other than the United States , shall have the qualifications obtained in a country or jurisdiction other than the United States evaluated by a CES that is a member of the National Association of Credential Evaluation Services (NACES) or of the Association of International Credential Evaluators, Inc. (AICE).

4-2 Process

a) Applicants shall apply for and obtain from a CES one or both of the following, as applicable:

i. If educational qualifications for licensure in the relevant profession were obtained in a country or jurisdiction other than the United States , a detailed, course-by-course translation and evaluation report of foreign transcripts;

ii. If the applicant has obtained other qualifications for professional licensure in a country or jurisdiction other than the United States , including, but not limited to, a professional license, supervised practice or work experience hours, or professional competency examination passage, a determination of equivalency of that qualification as compared to the qualification requirements for licensure in the relevant profession in Vermont.

b) Applicants shall comply with the procedures required by the CES for obtaining a translation and evaluation report regarding educational equivalency or an equivalency determination for other licensure qualifications.

c) The CES must send the education report and/or the determination of equivalency directly to the Office as part of the applicant's application for licensure in the relevant profession. Only original reports and equivalency determinations from a CES will be accepted by the Office as part of the applicant's application for licensure in the relevant profession in Vermont. No copies of reports or determinations of equivalence will be accepted from applicants.

d) In addition to the report and all accompanying determinations of equivalency from the CES, applicants shall submit, as part of their application for a professional license, all other materials and documentation of qualifications required for a license in the relevant profession.

4-3 Cost

a) The cost of a third-party, credential-evaluation agency evaluation, report and determination shall be in addition to and separate from the license application fee assessed by the Office in the relevant profession.

b) The cost of a third-party, credential-evaluation agency evaluation, report and determination shall be paid by the applicant.

Part 5. Effect of Third-Party, Credential-Evaluation Agency Determination Regarding Equivalency.

5-1 Determination of Equivalence

a) Upon a determination of equivalence of education or other qualifications from a CES, the Office shall accept the education or qualification obtained in a country or jurisdiction other than the United States as equivalent to and in substitution of the same education or qualification obtained in the United States .

b) In addition to a determination of educational equivalence or qualifications equivalence from a CES, applicants shall pass the examinations required in relevant professional statutes and rules for licensure in that profession.

5-2 Determination of Non-Equivalence

a) Upon a determination from a CES that an applicant's education or qualifications are not equivalent to the educational or qualification requirements required for licensure in the relevant profession in Vermont, OPR shall preliminarily deny the applicant's application for the relevant professional license.

b) The provisions relating to preliminary denials of applications for licensure set forth in 3 V.S.A. § 129(e) shall apply to a license application that is preliminarily denied for nonequivalence under this section.

5-3 Determination of Partial Equivalence

a) Upon a determination from a CES that an applicant's education and/or qualifications in a profession that were obtained in a country or jurisdiction other than the United States fulfill some, but not all, of the education and/or qualifications requirements for licensure in the relevant profession in Vermont, the CES shall submit to the Office a report detailing which Vermont education and/or qualifications for licensure in the relevant profession remain unfulfilled.

b) Upon completion of the unfulfilled education and/or qualifications and submission of documentation of completion of the education and/or qualifications to the Office, the applicant may be eligible for licensure in the relevant profession.

5-4 The Director may verify the accuracy and sufficiency of a CES's report and determinations regarding equivalency. If the Director finds that a CES report or determination regarding equivalency is inaccurate or insufficient, the Director may

a) Preliminarily deny the applicant's application for the relevant professional license in accordance with 3 V.S.A. § 129(e), or

b) Take the steps necessary to address and remedy the insufficiency or inaccuracy of the report or determination regarding equivalency with the CES responsible for the report. The Director may preliminarily deny the applicant's application for the relevant profession license, in accordance with 3 V.S.A. § 129(e), should the insufficient or inaccurate report or determination regarding equivalency not be able to be remedied.

History

EFFECTIVE DATE:
November 19, 2021 Secretary of State Rule Log #21-025

Chapter 014 ADMINISTRATIVE RULES FOR NOTARY PUBLIC CONTINUING EDUCATION

04-014 Code Vt. R. 04-030-014-X ADMINISTRATIVE RULES FOR NOTARY PUBLIC CONTINUING EDUCATION

Part 1. Definitions.

1-1 "Commission" means a notary public commission issued by the Vermont Office of Professional Regulation.

1-2 "Director" means the Director of the Office of Professional Regulation. 1-3 "Office" means the Office of Professional Regulation.

Part 2. Administration.

2-1 Applicable Laws. 26 V.S.A. § 5343(b) requires notaries public applying for renewal of a Vermont Commission to complete continuing education approved by the Office during the two-year period preceding application for renewal of the Commission. Per 26 V.S.A. § 5343(c), the Office shall establish by rule the guidelines and criteria for obtaining continuing education credit.

2-2 Waiver or Variance. The Director will not grant routine waivers or variances from any provisions of these rules without amending the rules. See 3 V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Director may, upon written request of an interested party, so find, grant a waiver with or without particular conditions and limitations, and record the action and justification in a written memorandum. This rule shall not be construed as creating any hearing right or cause of action.

Part 3. Commission Renewal Requirement.

3-1 Hours of Continuing Education.

a. As a condition of Commission renewal, notaries public shall complete no fewer than one hour of continuing education over the two-year period preceding the application for renewal.

b. One hour is defined as 60 minutes.

3-2 Documentation.

a. Documentation of successful completion of continuing education must be included in a notary public's application for renewal of a Commission.

b. Documentation of continuing education must include sufficient information to indicate the notary public's successful completion of a course that complies with these Rules, such as the name and date of the course, proof of attendance, and the number of continuing education credit hours awarded.

3-3 New Commission Holders.

a. Commissions are valid for fixed, two-year biennial periods and shall expire if not renewed before the end of each biennial period. Expiration dates are printed on Commission. A lookup tool on the Office website may be considered a primary source verification as to the license status and expiration date of all Office licensees.

b. Commission holders are required to complete one hour of continuing education prior to the first renewal of a Commission after a full, two-year biennial period.

i. The continuing education requirement is not mandatory for an initial renewal of the Commission if the notary public has held the Commission for less than two years. In turn, Commission holders who first obtain a Commission during a two-year biennium period do not need to complete one hour of continuing education before the first renewal of the Commission.

c. If an initial Commission is issued fewer than 90 days prior to the beginning of a two-year biennial Commission period

i. The Commission holder does not need to renew the Commission at the beginning of that biennial period.

ii. The Commission shall be valid through the end of that next two-year biennial period.

iii. The Commission holder is required to complete one hour of continuing education during that two-year biennial period and show compliance with the continuing education requirements when renewing the Commission at the end of that two-year biennial period.

Part 4. Continuing Education Course.

4-1 Content. The content of a continuing education course being used by a notary public as a basis for renewal of a Commission shall be directly related to the maintenance and enhancement of the skill, knowledge, and competency to perform notarial acts in accordance with Vermont's laws and requirements.

4-2 Form.

a. A continuing education course shall be at least one hour in length.

b. The continuing education course may be synchronous or asynchronous, recorded or live, or in-person or remote. The course may be interactive but does not have to be.

c. A continuing education course must include both audio and visual content.

4-3 Approval of Courses.

a. Continuing education courses that fulfill the requirements for Rules 4-1 and 4-2 and that are provided or approved by the following organizations are approved without prior review by or approval from the Office: American Bar Association, Vermont Bar Association, and any Vermont State government agency.

b. Except for those courses offered by an organization listed in Rule 4-3(a), continuing education course providers shall not advertise or hold out a course as approved for continuing education credit in Vermont unless the Director has approved the course as satisfying the requirements of these Rules. Course providers must apply to the Director for approval of the continuing education course through the Office's online portal.

4-4 Acceptable Hours. Continuing education credit will be granted only for the actual time a notary public spends as a learner during the course. Breaks, business meetings, and lunches are not to be counted toward continuing education credits.

4-5 Continuing Education Audits.

a. The Office shall conduct continuing education audits of randomly selected Commission holders, including Commission holders whose Commissions are conditioned. The Office may also audit reinstating Commission holders, and Commission holders who, in any of the preceding two renewal cycles, were initially found to have not met continuing education renewal requirements.

b. When a Commission holder appears on the audit list, the Office shall review the documentation provided by the Commission holder as part of the renewal application to determine whether the continuing education requirements have been satisfied. The Office may also request additional documentation and information from the Commission holder showing a detailed account of the credits claimed.

c. Under 3 V.S.A. § 129(k), the Office may give Commission holders ninety (90) days to develop and complete a corrective action plan to cure any deficiencies in continuing education requirements. Courses taken pursuant to a corrective action plan may be counted for only the Commission period being audited. Failure to comply with a corrective action plan may result in disciplinary action per 3 V.S.A. § 129a(a)(4).

History

EFFECTIVE DATE:
10/21/2023 Secretary of State Rule Log #23-034
STATUTORY AUTHORITY: 3 V.S.A. § 801; 26 V.S.A. § 5343(c)

Chapter 015 ADMINISTRATIVE RULES FOR NOTARIES PUBLIC

04-015 Code Vt. R. 04-030-015-X ADMINISTRATIVE RULES FOR NOTARIES PUBLIC

Part 1. Definitions and Clarification of Terms.

The definitions in 26 V.S.A. Chapter 103, the Uniform Law on Notarial Acts, are incorporated into these Administrative Rules.

1-1 "Commission" means a license, as that term is defined in 3 V.S.A. § 121, that is an official authorization issued by the Office permitting a holder to perform notarial acts.

1-2 "Commission Number" means the credential number associated with the Commission when issued by the Office.

1-3 "Digital Certificate" means the digital certificate obtained from a third-party that verifies the identity of the notary public and, after being applied to an electronic record, makes any changes to the electronic record tamper evident.

1-4 "Director" means the Director of the Office of Professional Regulation.

1-5 "Electronic" is defined at 26 V.S.A. § 5304.

1-6 "Electronic notarial certificate" means the part of, or attachment to, an electronic record that is completed by a notary public evidencing the notarial act and that contains the information required under 26 V.S.A. §§ 5367 and 5379, including the notary public's electronic signature.

1-7 "Electronic Official Stamp" means an electronic image attached to or logically associated with an electronic record.

1-8 "Electronic record" means information that is stored in an electronic form and is retrievable in perceivable form.

1-9 "Electronic signature" means an electronic symbol, sound, or process attached to or logically associated with a record and executed or adopted by an individual with the intent to sign the record.

1-10 "Judiciary-Related Employee" is defined at 26 V.S.A. § 5305.

1-11 "Law-Enforcement-Related Employee" is defined at 26 V.S.A. § 5305.

1-12 "Notarization" means the performance of a notarial act, as that term is defined in 26 V.S.A. § 5304.

1-13 "Notary public" means a notary public commissioned in Vermont under these Rules and 26 V.S.A. Chapter 103.

1-14 "Office" means the Office of Professional Regulation within the Office of the Secretary of State.

1-15 "Official duties" is defined at 26 V.S.A. § 5305.

1-16 "Physical Official Stamp" means a physical image affixed to or embossed on a tangible record.

1-17 "Remote electronic notarial act" means a notarial act performed on an electronic record for a Remotely Located Individual.

1-18 "Remotely located individual" is defined a 26 V.S.A. § 5304.

1-19 "Special Endorsement" means an official authorization issued by the Office permitting a notary public, who already holds a Commission to perform notarial acts in Vermont, to perform notarial acts on electronic records and for Remotely Located Individuals.

1-20 "Tamper evident" means that any change to an electronic record is detectable after the performance of the notarial act.

1-21 "Tamper-evident technology" means a set of applications, programs, hardware, software, or other technologies designed to enable a notary public to perform a notarial act on an electronic record and to display evidence of any changes made to an electronic record.

Part 2. Administration.

2-1 Applicable Laws. The practice of notaries public is defined and regulated pursuant to 26 V.S.A. § 5301 et seq. Copies of these and other statutes are available online.

The Director administers licensure in conformity with these and other Vermont laws, to include the Administrative Procedures Act, 3 V.S.A. § 800 et seq.; the Public Records Act, 1 V.S.A. § 315 et seq.; and the Laws of Professional Regulation, 3 V.S.A. § 121 et seq.

2-2 Resources for Applicants and Licensees. The Office maintains a website with information and links relevant to all licensed professionals. Information specific to notaries public, including forms and online applications, is available on the Office website.

Part 3. Procedures.

3-1 Applications. Commission and Special Endorsement applications must be completed through the Office website.

a) Incomplete applications will not be processed. Applications are complete only when all required questions have been answered fully, all attestations made, all required documentation and materials provided, and all fees paid.

b) When the Office intends to deny an application based on unprofessional conduct or an ongoing investigation for unprofessional conduct, notice stating the reasons for the action shall be sent to the applicant by certified mail, whereupon the applicant shall have 30 days to seek a hearing before an Administrative Law Officer in accordance with 3 V.S.A. § 129(e)(1).

c) When the Office denies an application for a commission based on a finding by the Director that the applicant has not fulfilled the qualifications or met the standards required for issuance of the Commission or Special Endorsement, notice stating the reasons for the denial shall be sent to the applicant by certified mail, whereupon the applicant will have a right to appeal the decision in accordance with 3 V.S.A. §§ 129(e)(2) and 130a.

d) The Office may refuse to accept any application found to be redundant with a denied or in-process application.

e) The Office may deem expired any application for a Commission or Special Endorsement that is left incomplete for six months.

3-2 Complaints. Complaints against notaries public, applicants for a notary public Commission, or unauthorized persons practicing without a required Commission or Special Endorsement may be submitted through the Office website.

3-3 Contested Cases. Procedures in contested cases relating to Commissions, Special Endorsements, or discipline are governed by the Office of Professional Regulation Administrative Rules of Practice, CVR 04-030-005, as those rules may from time to time be modified.

3-4 Declaratory Rulings. Petitions for declaratory rulings as to the applicability of any statutory provision or of any rule or order of the Office may be made pursuant to 3 V.S.A. § 808 and Office procedure.

3-5 Reasonable Accommodation. The Office complies with applicable provisions of the Americans with Disabilities Act.

3-6 Conflict of Standards. Where a standard of unprofessional conduct set forth in statute conflicts with a standard set forth in rule, the standard that is most protective of the public shall govern. 3 V.S.A. § 129a(e).

3-7 Waiver or Variance. The Director will not grant routine waivers or variances from any provisions of these rules without amending the rules. 3 V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Office may, upon written request of an interested party, so find, grant a waiver with or without particular conditions and limitations, and record the action and justification in a written memorandum. This rule shall not be construed as creating any administrative hearing right or cause of action.

Part 4. Commissioned Notary Public - General.

4-1 Commission Required. Except as provided in Part 4-3, below, an individual must obtain a Commission to perform notarial acts in Vermont. Notaries public holding a Commission may perform notarial acts only on tangible records and only for people appearing physically before the notary public. For all other notarial acts, notaries public shall obtain a Special Endorsement in accordance with Part 6, below.

4-2 Eligibility - General. Except as provided in Part, below, an applicant shall fulfill the following requirements to qualify for a Commission:

a) Be at least 18 years old;

b) Be a citizen or permanent legal resident of the United States;

c) Be a resident or have a place of employment or practice in the State of Vermont;

d) Not be disqualified to obtain a Commission based on the grounds listed in 26 V.S.A. § 5342;

e) Pass an examination approved by the Office based on the statutes, rules, and ethics relevant to the provision of notarial acts;

f) Execute and submit to the Office a notarized oath of office; and

g) Pay the required non-refundable fee.

4-3 Exemptions. Except as noted for Law-Enforcement-Related Employees, these exemptions apply only to Commissions, not Special Endorsements.

a) Judiciary-Related Employees.

i. Judiciary-Related Employees must obtain a Commission to perform notarial acts in Vermont. Judiciary-Related Employees are exempt from the following requirements:

A. Passage of the examination required under Part 4-2(e), above;

B. Paying the required fee; and

C. Completing the continuing education as a condition of renewing a Commission under Part 9, below.

ii. Judiciary-Related Employees who perform notarial acts outside the scope of their Official Duties must comply with all the requirements of these Rules and 26 V.S.A. Chapter 103.

b) Attorneys. Attorneys who are licensed and in good standing in Vermont are subject to all the requirements of these Rules and 26 V.S.A. Chapter 103 except for the following requirements:

i. Passage of the examination required under Part 4-2(e), above; and

ii. Completing the continuing education as a condition of renewing a Commission under Part 9, below.

c) Town Clerks, Assistants, and Justices of the Peace. Town clerks, town clerk assistants, and justices of the peace are subject to all the requirements of these Rules and 26 V.S.A. Chapter 103 except for paying the required fee.

d) Law-Enforcement-Related Employees do not have to obtain a Commission to perform notarial acts within the scope of their Official Duties. They also do not have to obtain a Special Endorsement to perform, within the scope of their Official Duties, notarial acts on electronic records or for remotely located individuals.

4-4 Location of Notary Public. Notaries public shall be physically located within Vermont's borders when performing all notarial acts under the authority of a Vermont notary public commission.

4-5 Name and Name Change.

a) Form. Notaries public shall sign notarial acts using the same name they signed on the notarized oath of office submitted in their Commission.

b) Name Change. Within thirty days after a change of name, address, or e-mail address, notaries public shall report the change to the Office by updating the notary public's online file and, for name changes, shall submit court documentation of the name change, and an updated notarized oath of office signed with the notary public's new signature. Notaries public shall not perform notarial acts after a name change until the updated oath is submitted.

4-6 Renewal Requirements - Continuing Education. As a condition of renewal, and unless an exemption under Part 4-3 applies, notaries public shall complete continuing education in accordance with Part 9, below.

4-7 Biennial Commission and Special Endorsement Period. Commissions and associated Special Endorsements are valid for fixed, two-year periods. Expiration dates are printed on the Commission. A Commission and any associated Special Endorsement expires if not renewed by midnight at the conclusion of the date of expiration. Practice under an expired Commission or an expired Special Endorsement is a violation of 3 V.S.A. § 127. A search tool on the Office website may be considered a primary source verification as to Commission and Special Endorsement status and expiration.

4-8 Commission and Special Endorsement Renewal. Online Commission and Special Endorsement renewal applications must be completed through the Office website. The Office transmits email reminders to Notaries public at the end of each biennial commission period; however, non-receipt of such reminders shall not excuse a Notaries public from the obligation to continuously maintain a Commission and, where applicable, a Special Endorsement, or the consequences of failing to do so.

4-9 Initial Commission and Special Endorsement Issuance. An applicant issued an initial Commission or Special Endorsement within 90 days of the end of a biennial period will not be required to renew, pay any renewal fees, or complete any continuing education prior to the end of that biennial period. The Commission and any associated Special Endorsement will be issued through the next full biennial period. Notaries public must fulfill renewal requirements for subsequent renewals.

4-10 Late Renewal Penalties. Late renewal applications are subject to reinstatement penalty fees. Waivers of such fees may be requested through the online licensing system. 3 V.S.A. § 127(d).

Part 5. Commissioned Notary Public - Notarial Acts.

5-1 Notarial Acts.

a) Notaries public may perform only the following notarial acts and only in accordance with 26 V.S.A. § 5363 and these Rules:

i. Taking an acknowledgement of a record and determining that the individual appearing before the notary public has the identity claimed, is the person who signed the document, and is signing the record for the purposes stated in the record;

ii. Taking a verification of a statement on oath or affirmation and determining that the individual appearing before the notary public has the identity claimed, is the person who signed the document, and is stating the declarations made in the underlying record are true;

iii. Attesting to a signature and determining that the individual appearing before the notary public has the identity claimed and is the person who signed the document;

iv. Noting a protest of a negotiable instrument.

v. Certifying that a tangible copy of an electronic record is an accurate copy of the electronic record.

b) With regard to certifying a copy, Vermont-Commissioned notaries public may certify only that a tangible copy of an electronic record is an accurate copy of the electronic record. Vermont-Commissioned notaries public may not certify any other forms of records.

c) the following acts are not notarial acts regulated under these Rules and are governed by the statutes and rules regarding those acts:

i. the administration of an oath swearing to or affirming the truth of oral testimony following the oath;

ii. issuing a subpoena; and

iii. administering an oath of office

5-2 Performance of a Notarial Act on a Tangible Record when Individual is Physically Present Before Notary Public. When a notary public is performing a notarial act on a tangible record for an individual physically appearing before the notary public, the notary public shall adhere to the following procedures:

a) Personal Appearance. the individual shall share the same physical space as the notary public.

b) Identification of the individual. the notary public performing an acknowledgement, verifying an oath or affirmation, or attesting to a signature shall identify the individual through one of the following means:

i. Personal knowledge of the individual, meaning that the notary public personally knows the individual through dealings sufficient to provide reasonable certainty that the individual has the identity claimed.

ii. Satisfactory evidence of an individual's identity, meaning the notary public identifies the individual through one of the forms of identification listed in 26 V.S.A. § 5365(b). A notary public may require additional means of identification if necessary to assure the notary public of the identity of the individual.

c) A notary public noting a protest of a negotiable instrument shall determine the matters set forth in 9A V.S.A. § 3-305(b).

d) A notary public certifying that a tangible copy of an electronic record is an accurate copy of the electronic record:

i. shall reasonably determine whether the electronic record is in a tamper-evident format;

ii. shall personally print or supervise the printing of the electronic record onto paper or other tangible medium; and

iii. may not make the certification if the notarial officer has detected a change or an error in an electronic signature or other information in the electronic record.

e) Representative. If an individual who physically appears before a notary public is physically unable to sign a record, the individual may direct another individual to sign on the record the name of the individual who is physically unable to sign. In such circumstances, the notary public shall insert the following statement into the certificate:

"Signature affixed by [NAME OF THE INDIVIDUAL SIGNING RECORD] at the direction of [NAME OF INDIVIDUAL WHO IS PHYSICALLY UNABLE TO SIGN]."

A representative may not sign a record pursuant to this subsection if an individual is not able to physically sign a record because the individual is remotely located.

f) Certificates. Notarial acts shall be evidenced by a certificate containing the information and meeting the requirements of 26 V.S.A. § 5367.

i. the certificate shall be executed

A. by the individual, when required, and the notary public; and

B. contemporaneously with the performance of the notarial act; provided that the notary public's signature shall not be affixed to the record until after the notarial act is performed.

ii. By executing a certificate, a notary public certifies that

A. the notary public has complied with the applicable requirements of 26 V.S.A. Chapter 103;

B. the individual has personally appeared before the notary public; and

C. the notary public has personal knowledge or satisfactory evidence of the identity of the individual.

iii. A certificate shall be part of, printed on, stamped on, embossed on, or otherwise securely attached to the tangible record.

iv. For notarial acts that involve the signature of an individual, every effort should be made for the certificate to be on the same page as the name and signature of the individual; however, if they must be on different pages, the notarial certificate shall include the name of the individual.

v. the form of such a certificate is sufficient if it

A. Is in a short form set forth in 26 V.S.A. § 5368;

B. Is in a form otherwise permitted by the laws of this State;

C. Is in a form containing the information required in 26 V.S.A. § 5367; and

D. Sets forth the actions of the notary public and the actions are sufficient to meet the requirements of the notarial act as required in 26 V.S.A. §§ 5362 - 5364 or another Vermont law.

5-3 Physical Official Stamp. Notaries public are not required to use a physical official stamp. To complete a certificate of a notarial act, a notary public may use a physical official stamp, may print or type the certificate information, or may use a combination of these methods.

a) No Physical Official Stamp. If a notary public chooses not to use a physical official stamp, the notary public shall clearly print or type the notary public's name, commission number, and the expiration date of their commission on the certificate, along with the other information required to be included in a certificate by Vermont law and these Rules.

b) Requirements for Use of a Physical Official Stamp. If the notary public chooses to use a physical official stamp to perform a notarial act on a tangible record, the notary public shall comply with the following requirements:

i. the physical official stamp must be an ink stamp or an embosser.

ii. the physical official stamp must be capable of being copied together with the record to which it is affixed or attached or with which it is logically associated.

iii. Contents.

A. the physical official stamp may not include the Vermont State Seal.

B. the physical official stamp shall include, at a minimum, the following information:

the notary public's name, which shall be the same name the notary public signed on the notarized oath of office submitted in their Commission application;
the word "Vermont" ;
the title "Notary Public" ; and
the notary public's Commission number.

C. the notary public shall print or type any other information required to be included in the certificate that is not on the physical official stamp.

D. If the physical official stamp includes a notary public's Commission expiration date, upon expiration of the Commission the notary public shall either:

Replace the stamp with one that includes an updated Commission expiration date or that does not include any expiration date; or
Discontinue the use of a physical official stamp.

5-4 Refusal. Notaries public may refuse to perform a notarial act for any reason unless such a refusal is prohibited by law. 26 V.S.A. § 5372.

Part 6. Special Endorsement.

6-1 Special Endorsement Required.

a) Except as provided below, a notary public must obtain a Special Endorsement to perform notarial acts on electronic records and for Remotely Located Individuals. Notaries public who do not hold a Special Endorsement may perform notarial acts only on tangible records for people appearing physically before the notary public.

b) Law-Enforcement-Related Employees do not have to obtain a Commission or a Special Endorsement to perform notarial acts within the scope of their Official Duties.

6-2 Eligibility. To be eligible for the Special Endorsement, a notary public shall:

a) hold a current notary public commission in good standing;

b) attest to selecting and using, for any notarial acts on electronic records, tamper-evident technology that complies with requirements herein;

c) attest to selecting and using, for any notarial acts for remotely located individuals, communication technology that complies with requirements herein;

d) attest to selecting and using, for any notarial acts for remotely located individuals, identity proofing technology that complies with the requirements herein; and

e) pay all required application fees.

Part 7. Notarial Act on an Electronic Record.

7-1 Special Endorsement Required. A notary public shall obtain a Special Endorsement, in accordance with Part 6 of these Rules, to perform notarial acts on electronic records. Notarial acts on electronic records may be performed for individuals appearing physically before the notary public or for Remotely Located Individuals.

7-2 Performance of a Notarial Act on an Electronic Record

a) Tamper-Evident Technology. A notary public shall select one or more tamper-evident technologies that conform with the requirements of Part 147-3, below, to perform electronic notarial acts.

i. A notary public may refuse to perform a notarial act on an electronic record using technology not selected by the notary public.

b) Personal Appearance and Identification. Requirements for the personal appearance and identification of the individual seeking a notarial act on an electronic record are the same as for a notarial act on a tangible record.

c) Electronic Notarial Certificate.

i. A notarial act performed on an electronic record shall be evidenced by an electronic notarial certificate which shall

A. Be affixed to or logically associated with the electronic record;

B. Indicate that the notarial act was performed electronically on an electronic record; and

C. Contain the information required under 26 V.S.A. §§ 5367 and 5380, as applicable, and Part 5-2(f), herein.

ii. By executing a certificate, a notary public certifies that

A. the notary public has complied with the requirements of 26 V.S.A. § 5363 and, where applicable, 26 V.S.A. § 5366;

B. the individual has personally appeared before the notary public in accordance with 26 V.S.A. § 5364 or 5380; and

C. the notary public has identified the individual in accordance with 26 V.S.A. § 5365 or 5379.

d) Electronic Signature and Digital Certificate. A notary public performing a notarial act on an electronic record shall, by use of a digital certificate, affix to or logically associate with the electronic notarial certificate and the record the notary public's electronic signature and electronic official stamp, if using.

7-3 Standards for Tamper-Evident Technology.

a) A notary public shall select one or more tamper-evident technologies to perform notarial acts on electronic records. A person seeking a notarial act may not require a notary public to use a technology that the notarial officer has not selected.

b) the tamper-evident technology must be capable of

i. Affixing or attaching the notary public's electronic signature to the electronic record in a manner that is capable of independent verification and renders evident any subsequent change or modification to the electronic record; and

ii. Using a valid digital certificate issued by a third-party provider.

c) A notary public shall not perform a notarial act with respect to an electronic record if the digital certificate:

i. Has expired;

ii. Has been revoked or terminated by the issuing or registering authority;

iii. Is invalid; or

iv. Is incapable of authentication.

7-4 Reliability and Confidentiality.

a) A notary public authorized to perform notarial acts on electronic records shall use the same electronic signature and electronic official stamp, if using, for all electronic notarial acts.

i. the notary public shall submit to the Office copies of the notary public's electronic signature and electronic official stamp, if using.

ii. the notary public's electronic signature and electronic official stamp shall be unique to the notary public.

iii. A notary public's electronic signature and electronic official stamp, if using, shall be retained under the notary public's sole control and access. A notary public shall not allow any other individual to use the notary public's electronic signature or electronic official stamp. A notary public's employer must not permit the use of a notary public's electronic signature or electronic official stamp by anyone except the notary public.

b) A notary public shall not disclose any access information used to affix the notary public's electronic signature or the electronic image of the notary public's official stamp, except when requested by the Office or a designee, a judicial subpoena, and, with precautions, electronic document preparation and transmission vendors. the notary public shall retain sole control of security aspects, such as, but not limited to, passwords, token devices, biometrics, PINS, phrases, and software on protected hardware.

c) Upon resignation, revocation, or expiration of a notary public's Commission or Special Endorsement, the notary public shall destroy and disable their electronic signature and electronic official stamp, if using, including any coding, disk, digital certificate, card, software or password that enables the notary public to attach or logically associate the electronic signature or electronic official stamp to electronic records, so as to prohibit their use by any other person.

d) A notary public shall immediately notify the Office of the theft of the notary public's electronic signature, electronic official stamp or digital certificate.

Part 8. Notarial Act for a Remotely Located Individual.

8-1 Special Endorsement Required. A notary public shall obtain a Special Endorsement, in accordance with Part 6 of these Rules, to perform notarial acts for Remotely Located Individuals. A notarial act for a remotely located individual may be performed on a tangible record or on an electronic record.

8-2 Performance of a Notarial Act for a Remotely Located Individual

a) Personal Appearance. A notary public shall select one or more communication technologies that conform with the requirements of Part 8-5, below, to perform a notarial act for a Remotely Located Individual.

b) Identification. Prior to performing a notarial act for a Remotely Located Individual, a notary public shall verify the identity of the Remotely Located Individual through one of the three following methods:

i. Personal knowledge of the identity of the Remotely Located Individual in accordance with 26 V.S.A. § 5365(a);

ii. Satisfactory evidence of the identity of the Remotely Located Individual by oath or affirmation from a credible witness who personally appears before a notary public in accordance with 26 V.S.A. § 5365(b); or

iii. Satisfactory evidence of the identity of the Remotely Located Individual by means of both forms of the identity-proofing technology listed in Part 8-6, below.

c) Record Confirmation. Before performing a notarial act for a Remotely Located Individual, a notary public must be reasonably able to confirm that the record before the notary public is the same record in which the Remotely Located Individual made a statement or on which the individual executed a signature.

i. though other methods may be used, the requirements of this Part 8-2(c) shall be satisfied when a notary public is performing a notarial act for a Remotely Located Individual on a tangible record not physically present before the notary public, if the notary public and the Remotely Located Individual comply with the provisions of 26 V.S.A. § 5379(d).

ii. To use Communication Technology to take an acknowledgement of a signature on a tangible record when the tangible record is physically before the notary public,

A. the notary public shall display the tangible record to the Remotely Located Individual;

B. the Remotely Located Individual shall identify the tangible record as the record the Remotely Located Individual signed;

C. the act of displaying the record and the Remotely Located Individual's identification of the tangible record shall be recorded in accordance with Part 8-2(f), below.

d) Certificate. the Certificate for a notarial act performed for a Remotely Located Individual shall include the information required under these Rules and 26 V.S.A. §§ 5367 and 5379, and a statement that the notarial act was performed using communication technology.

e) Electronic Record. If the notarial act for the Remotely Located Individual is being performed on an electronic record, the notary public shall also comply with Part 7, above.

f) Recording. A notary public, or a person acting on behalf of a notary public, shall create an audio-visual recording of the performance of a notarial act for a Remotely Located Individual. the recording must be made simultaneously with the performance of the notarial act. Such a recording shall be maintained as follows:

i. for at least seven years from the date of the notarial act; and

ii. by :

A. the notary public who performed the notarial act; a guardian, conservator, or agent of the notary public;

B. a personal representative of a deceased notary public; or

C. a repository designated by or on behalf of the person required to retain the recording.

8-3 Administering an Oath or Affirmation for a Remotely Located Individual.

Except as otherwise provided by other Vermont laws, a notary public shall comply with 26 V.S.A. § 5379(g) when administering an oath or affirmation for a Remotely Located Individual.

8-4 Location of Remotely Located Individual. A notary public who is commissioned under these Rules and who holds a Special Endorsement may perform a notarial act for a Remotely Located Individual when the notary public is in Vermont and when the Remotely Located Individual is located

a) Within the United States; or

b) Outside the United States if

i. the notarial act is not prohibited in the jurisdiction where the Remotely Located Individual is physically located at the time the notarial act is performed; and

ii. the record

A. is to be filed with or relates to a matter before a public official or court, governmental entity, or other entity subject to the jurisdiction of a State within the United States or the United States; or

B. involves property located in the territorial jurisdiction of the United States; or

C. involves a transaction substantially connected with the United States.

8-5 Standards for Communication Technology

a) A notary public performing a notarial act for a Remotely Located Individual shall use communication technology that complies with these Rules and 26 V.S.A. § 5380.

b) the communication technology used to perform notarial acts for Remotely Located Individuals shall

i. provide sufficient audio clarity and visual resolution to enable the notary public and the Remotely Located Individual to see and speak to each other, simultaneously and without interruption, through live, real-time transmission throughout the duration of the notarial act, including through identity proofing, the signing by any parties present during the transaction, and the application of the notary's signature and seal;

ii. facilitate communication with a Remotely Located Individual who has a vision, hearing, or speech impairment;

iii. permit sufficient visual clarity to enable the notary to view, read, and record the front and back of any identification card presented as verification of identity;

iv. provide for confirmation of the record under Part 8-2(c), above;

v. include a means of authentication that reasonably ensures only the authorized parties have access to the communication technology;

vi. provide reasonable security measures to prevent unauthorized access to the following:

A. Live communication between the notary public and Remotely Located Individual;

B. the recording of the notarial act;

C. Verification methods and credentials used to verify the identity of the Remotely Located Individual; and

D. Any electronic records presented for the performance of a notarial act;

vii. be capable of producing recordings of notarial acts for remotely located individuals in response to a request from the notary public, the Office, a court, or law enforcement in the course of an investigation; and

viii. be capable of securely creating, storing, accessing, and reproducing a copy of a recording of a notarial act as required by Part 8-2(f), above.

8-6 Standards for Identity Proofing

a) If a notary public does not have satisfactory evidence of the identity of a Remotely Located Individual in accordance with 26 V.S.A. §§ 5365(a) or (b), the notary public shall verify the Remotely Located Individual's identity through both a credential analysis procedure and a dynamic knowledge-based authentication assessment as provided in this Part, below.

b) Credential analysis shall use public or private data sources to confirm the validity of the identification credential presented by a Remotely Located Individual and shall, at a minimum:

i. Use automated software processes to aid the notary public in verifying the identity of each Remotely Located Individual;

ii. Require the identification credential to pass an authenticity test, consistent with sound commercial practices, that uses appropriate technologies to confirm the integrity of visual, physical, or cryptographic security features and to confirm that the identification credential is not fraudulent or inappropriately modified;

iii. Use information held or published by the issuing source or an authoritative source, as available and consistent with sound commercial practices, to confirm the validity of personal details and identification credential details; and

iv. Enable the notary public visually to compare for consistency the information and photograph on the identification credential and the Remotely Located Individual as viewed by the notary public in real time through communication technology.

c) A dynamic knowledge-based authentication assessment is successful if it meets the following requirements:

i. the Remotely Located Individual must answer a quiz consisting of a minimum of five questions related to the individual's personal history or identity formulated from public or private data sources;

ii. Each question must have a minimum of five possible answer choices;

iii. At least eighty percent of the questions must be answered correctly;

iv. All questions must be answered within two minutes;

v. If the Remotely Located Individual fails the first attempt, the individual may retake the quiz once within twenty-four hours;

vi. During a retake of the quiz, a minimum of forty percent of the prior questions must be replaced;

vii. If the Remotely Located Individual fails the second attempt, the individual must not be allowed to retry with the same online notary public within twenty-four hours of the second failed attempt; and

viii. the notary public must not be able to see or record the questions or answers.

Part 9. Continuing Education.

9-1 Continuing Education Requirements for Renewal.

a) Commission renewal. Except as exempted under Parts 4-3 and 4-6, above, and 26 V.S.A. chapter 103, as a condition of Commission renewal, notaries public shall complete no fewer than one hour of continuing education over the full two-year biennial period preceding the application for renewal.

b) Special Endorsement renewal. Special Endorsement renewal requires one additional hour of continuing education. the additional hour must pertain to the performance of notarial acts on electronic records or for remotely located individuals or both.

9-2 Documentation.

a) Documentation of completion of the continuing education must be included in a notary public's application for renewal of a Commission or Special Endorsement, as applicable.

b) Documentation of continuing education must include sufficient information to indicate the notary public's successful completion of a course that complies with these Rules, including the name and date of the course, proof of attendance, and the number of continuing education credit hours awarded.

9-3 Course Content and Form.

a) Content. the content of a continuing education course being used by a notary public as a basis for renewal of a Commission shall be directly related to the maintenance and enhancement of the skill, knowledge, and competency to perform notarial acts in accordance with Vermont's laws and requirements.

b) Form.

i. A continuing education course shall be at least one hour in length. One hour means 60 minutes.

ii. the continuing education course may be synchronous or asynchronous, recorded or live, or in-person or remote. the course may be interactive but does not have to be.

iii. the course must include both audio and visual content.

iv. Continuing education credit will be granted only for actual time a notary public spends as a learner during the course. Breaks, business meetings, and lunches do not count toward continuing education credits.

9-4 Approval of Courses.

a) Continuing education courses that fulfill the requirements for Parts 9-1 through 9-3 and that are provided or approved by the following organizations are approved without prior approval from the Office: American Bar Association, Vermont Bar Association, and any Vermont State government agency.

b) Except for those courses offered by an organization listed above, continuing education course providers shall not advertise or hold out a course as approved for continuing education credit in Vermont unless the Director has approved the course as satisfying the requirements of these Rules. Course providers must apply to the Director for course approval through the Office's online portal. Courses that are not pre-approved may be reviewed as part of a notary public's renewal application.

9-5 Continuing Education Audits.

a) the Office shall conduct continuing education audits of randomly selected notaries public, including all notaries public whose Commissions are conditioned. the Office may also audit notaries public who are reinstating or who, in any of the preceding two renewal cycles, were initially found to have not met continuing education requirements.

b) When a notary public appears on the audit list, the Office shall review the documentation provided with renewal application to determine whether the continuing education requirements have been satisfied. the Office may also request additional documentation and information from the notary public showing a detailed account of the credits claimed.

c) Under 3 V.S.A. § 129(k), the Office may give notaries public ninety (90) days to develop and complete a corrective action plan to cure any deficiencies in continuing education requirements. Courses taken pursuant to a corrective action plan count only for the Commission period being audited. Failure to comply with a corrective action plan may result in disciplinary action. 3 V.S.A. § 129a(a)(4).

Effectiveness.

These Rules shall take effect February 26, 2025

History

EFFECTIVE DATE:
2/26/2025 Secretary of State Rule Log #25-007
STATUTORY AUTHORITY: 3 V.S.A. § 801; 26 V.S.A. § 5323

Chapter 020 RULES OF THE BOARD OF ARCHITECTS

04-020 Code Vt. R. 04-030-020-X RULES OF THE BOARD OF ARCHITECTS

Part 1 GENERAL INFORMATION

Section 1.1 THE BOARD'S PURPOSE

The Board of Architects ("the Board") has been created by Vermont law, which confers certain powers and duties on the Board. The Board's purpose is to protect the public health, safety, and welfare by setting standards for issuing licenses, licensing qualified applicants, and regulating licensed architects and their practice.

Section 1.2 LAWS THAT GOVERN THE BOARD

The Board is governed by a specific state law that establishes its responsibilities for setting standards, issuing licenses, and regulating the profession. The law is the Architects Act, 26 V.S.A. §§ 121-211. In addition, the Board is governed by several other state laws, such as the Administrative Procedure Act, 3 V.S.A. §§ 801-849, the Open Meeting Law, 1 V.S.A. §§ 310-314, the Law of Professional Regulation, 3 V.S.A. §§ 121-131, and the Access to Public Records Law, 1 V.S.A. §§ 315-320. These laws set forth the rights of an applicant, licensed architect, or member of the public. The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us. In addition, the Board has a home page on the Internet at http://www.vtprofessionals.org/architects/.

Section 1.3 DEFINITIONS

1.3.1 A "licensed architect" is a person licensed or registered to practice architecture in the jurisdiction in which he or she practices.

1.3.2 A person practices as a "principal" by being (a) a licensed architect and (b) the person in charge of the organization's architectural practice, either alone or with other licensed architects.

1.3.3 An organization will be considered to be "an office of a licensed architect" if:

(a) the architectural practice of the organization in which the applicant works is in the charge of a person practicing as a principal, and the applicant works under the direct supervision of a licensed architect; and

(b) the architectural practice of the organization encompasses the comprehensive practice of architecture including each of the categories found in the Intern Development Program Training Requirement.

1.3.4 "Training Unit" means eight hours of acceptable work in an acceptable work setting.

Part 2 INFORMATION FOR APPLICANTS FOR INITIAL LICENSURE

Section 2.1 APPLICATIONS

Applications and information about licensure requirements are available from the Office of Professional Regulation. An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office. The Board reviews applications only after the fully completed application and documentation are received, including evidence of any required education, supervision, or training.

Licenses renew on a fixed biennial schedule: January 31 of the odd-numbered years. Applicants issued an initial license within 90 days of the renewal date will not be required to renew and pay the renewal fee. The license will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.2 HOW TO OBTAIN A LICENSE BY TAKING AN EXAMINATION

Qualifying for the Examination:

2.2.1. To qualify to take the examination, an applicant must have earned a high school diploma or GED (General Equivalency Degree) and must have attained the age of majority (age 18). In addition an applicant must have accomplished one of the following:

2.2.1.1. Option One - Professional Degree and Three Years of Experience. Graduated from a school or college of architecture accredited by the National Architectural Accrediting Board, and received at least 3 years of PRACTICAL EXPERIENCE under the supervision of an experienced architect. For purposes of this and the succeeding subsection 2.2.1.2, "an experienced architect" is defined as a practicing architect who has been licensed and in general practice for at least three (3) years. For purposes of this and the succeeding subsection 2.2.1.2 "practical experience" is defined as experience acquired through practice rather than theory. Practice, in this context, encompasses the broad variety of skills ordinarily exercised by those in general architectural practice and requires direct and meaningful participation in the various architectural, structural, mechanical, electrical, and civil engineering functions. "Supervision" is defined as overseeing the work of another, where the supervisor has both control over and detailed professional knowledge of the work prepared under his or her supervision. Experience Requirements: Applicants shall present evidence of actual experience or significant exposure in the essential areas of architectural practice as outlined below. Such evidence shall be in the form of official records of a structured intern development program approved by the Board (National Council of Architectural Registration Boards Intern Development Program). Alternatively, until January 1, 2002, such evidence may be incorporated in the candidate's application and verified by employers (architect/employer reference form). Contact the Board for the architect/employer reference form. A minimum total of 36 months of experience is required for licensure.

Category A - Design and Construction Documents

Minimum of months' work in this category is 18 months. Experience must include the following:

| Environmental Analysis | Code Analysis | | --- | --- | | Client Exposure | Cost Analysis | | Programming | Design Development | | Schematic Design | Quality Control | | Working Drawings | Materials Research | | Project Management | Consultant Coordination | | Shop Drawing Review | Document Coordination | | Agency Interface | Specification Preparation |

Category B - Construction Administration

Minimum number of months' work in this category is 5 months. Experience must include the following:

| Bidding Procedures | Change Order Preparation | | --- | --- | | On Site Observation | Schedule of Values Review | | Dispute Resolution | Payment Requisitions Review | | Progress Meetings | Project Closeout | | Time Schedule Review | Punchlist Preparation |

Category C - Office Management

Minimum number of months' work in this category is 3 months.

Time Cost Budgeting

Proposal Development

Consultant Contract Preparation

Architectural Contract Preparation

If work experience has allowed only limited access to activities in category C, candidates may provide detailed information on how they have acquired knowledge in areas in which they have little or no direct exposure. Alternatives may include seminars, correspondence courses, professional publications, continuing education courses, workplace instruction programs, etc. The Board may request verification of alternative methods.

Applications and guidelines for the NCARB Intern Development Program (IDP) may be obtained by request from:

National Council of Architectural Registration Boards

Suite 700

1735 New York Avenue, NW

Washington, DC 20006

2.2.1.2. Option Two - Nine Years of Experience. Completed at least nine (9) years of diversified practical experience working under the supervision of an experienced practicing architect who has been licensed for more than three (3) years. "Supervision" is defined as overseeing the work of another, where the supervisor has both control over and detailed professional knowledge of the work prepared under his or her supervision. For purposes of this subsection "diversified practical experience" is defined as a minimum of three (3) years of experience as described in the foregoing subsection and in addition six (6) years of diversified experience in architecture working in the office of an experienced architect or a combination of such experience and education as described in Table A below. Applicants without professional degrees from NAAB-accredited programs in architecture and who are applying through Option Two (nine years of experience) must submit verified Architect Employer Reference forms for each employer indicating a minimum of nine years of total experience with all employers. If qualifying education is included as part of the nine years, transcripts must be included which meet the requirements of the Table of Education Equivalents (Table A below). The Board will determine the maximum credit allowed for education from the Table.

Please note that:

2.2.1.2.1. Education credits will be subject to the following conditions: Applicants not qualifying under A-1 or A-2 (Table A) may not accumulate more than three (3) years of education credits in the aggregate from all degree programs. Thirty-two (32) semester credit hours or forty-eight (48) quarter credit hours are considered to be one (1) year. Fractions of a year of one-half or greater will be considered one-half year, and smaller fractions will not be counted. Foreign education credits will be granted only upon submission of a comprehensive evaluation report. Evaluation reports may be obtained by candidates from Educational Credential Evaluators, Inc., P.O. Box 17499, Milwaukee, Wisconsin 53217. Any cost of translation and evaluation will be borne by the applicant.

2.2.1.2.2. Training credits will be subject to the following conditions: No credit used as an education credit may be used as a training credit. An organization will be considered to be "an office of a practicing architect" if: The architectural practice of the organization in which the applicant works is in the charge of a person practicing architecture as a principal and the applicant works under the direct supervision of a licensed architect. A "licensed architect" for training purposes is a person registered to practice architecture in the jurisdiction in which (s)he practices. In deciding if training represents "diversified practical experience", the Board will compare the training with the training requirements set forth in Rule 2.2.1.1 and Rule 2.2.1.2 Table A (A-7). To earn full credit under A-7, an applicant must work at least 35 hours each week for a minimum period of ten consecutive weeks. An applicant may earn one-half the credit specified under A-7 for work of at least 20 hours per week in periods of six (6) or more consecutive months. In evaluating credits, the Board will, prior to acceptance for the examination, require substantiation of the quality and character of the applicant's experience, notwithstanding the fact that the applicant has complied with the technical education and training requirements set forth. A person seeking licensure under the nine-year rule may qualify through a combination of education and training totaling nine years, at least 3 years of which must be in an I.D.P. or equivalent documented, verified training program (see 2.2.1.1.).

Table A identifies and explains the education and training alternatives for the remaining 6 years.

| TABLE A | | | | | --- | --- | --- | --- | | Experience Description | Education Credits/Training Credits | | | | First 2 | Succeeding | Max.Credit | | | Years | Years | Allowed | | | A-1 Credit toward the first professional degree in architecture where the degree program has been accredited by the National Architectural Accrediting Board (NAAB) not more than 2 years after termination of enrollment. | 75% | 100% | 4 years | | A-2 First professional degree in architecture, or credit toward that degree, where the degree program has not been accredited by NAAB. | 75% | 75% | 3.5 years | | A-3 Bachelor degree, or credit toward that degree, in architectural engineering, in architectural technology, or in civil, mechanical, or electrical engineering, accredited by Engineering Council for Professional Development (ECPD) or Accreditation Board for Engineering and Technology (ABET) or in interior architecture accredited by the Foundation for Interior Design Education Research. | 50% | 75% | 3.0 years | | A-4 Any other bachelor degree. | -- | -- | 2.0 years | | A-5 Associate degree, or credit toward that degree, in architectural technology accredited by ABET. | 100% | -- | 2 years | | A-6 Degree or credits in courses (university, college, junior college, technical school) other than those courses of study listed in A-1 and A-3. | 50% | 50% | 1.5 years | | A-7 Diversified experience in architecture in the office of a licensed architect. "Diversified Experience" requires a range of work in a variety of projects covering: Architectural Programming Design Structural Systems Environmental Systems Life Safety Systems Barrier Free Design Project Finance Construction Laws and Regulations | 100% | 100% | 6 years |

2.2.1.2.3 Option Three - Training Equivalent to That Required Herein Other education, training or practice experience may be substituted for the requirements as outlined in all the foregoing only insofar as the Vermont Board of Architects considers them to be equivalent to the required education, training, or practice experience.

2.2.2. Application and fee schedule. An application and a schedule of fees may be obtained from the Office of Professional Regulation. The check accompanying the application should be made payable to the Vermont Board of Architects. The application and check should be mailed to:

Vermont Board of Architects

Office of the Secretary of State

Office of Professional Regulation

109 State Street

Montpelier, Vermont 05609-1106

2.2.3. Personal interview. The Board may contact the applicant and schedule a personal interview to verify the applicant's experience. The applicant should bring to this interview examples of working drawings, specifications, and designs prepared by the applicant (which will be retained by the Board) sufficient to demonstrate the breadth of his or her practical experience. The Board may refuse to permit an applicant to take the examination if it concludes on the basis of the application and the materials submitted during the interview that (s)he has not met the requirements of "practical experience" or "diversified practical experience" as outlined in 2.2.1.1. and 2.2.1.2.

2.2.4. Examination. The Board offers the examination at least once a year at a time and place set well in advance. Information on scheduling the examination may be obtained from the Office. The examination is prepared by the National Council of Architectural Registration Boards. Specific information about the examination may be obtained from the Office or through NCARB. Examinations may be taken before the applicant completes the experience categories in Rule 2.3.1.1 above, provided that the applicant has completed all but the final year of required practical experience. Licensure will not be granted, however, until after completion of either the Intern Development Program or the required experience categories and after appropriate verification forms are submitted to and approved by the Board.

2.2.5. Notification. Notification of the results of the examination shall be mailed to each candidate upon completion of the Board's grading process. Grades are usually available within 90 days.

2.2.6. Re-examination on parts failed. A candidate may retake any one or more of the separate and unconnected examination, while retaining credit for those passed.

Section 2.3 HOW TO OBTAIN A LICENSE WITHOUT EXAMINATION

2.3.1. Qualifications. To qualify for a Vermont license without taking an examination, an applicant must either:

2.3.1.1. be certified by the National Council of Architectural Registration Boards, or

2.3.1.2. be licensed in another state. If an applicant is licensed in another state, the Board must determine that the standards of that license are at least equal to those in Vermont, as described in 2.2.1.1. and 2.2.1.2. In making this determination the Board may request that an applicant appear for an interview.

2.3.2. Application and fee schedule. An application and a schedule of fees may be obtained from the Office of Professional Regulation. The check accompanying the application should be made payable to the Vermont Board of Architects. The application and check should be mailed to:

Vermont Board of Architects

Office of the Secretary of State

Office of Professional Regulation

109 State Street

Montpelier, Vermont 05609-1106

Section 2.4 APPLICANT NOTIFICATION

The Board will notify an applicant of its decision as soon as possible after it has received the completed application. If the Board denies the application, the applicant may file a petition within 30 days asking the Board to review its preliminary action and to provide more specific information about the reasons for denial. The Board will then hold a hearing to review its preliminary decision.

Section 2.5 APPEALS

The Board will issue its final decision in writing. The Board's final decision may be appealed to an appellate officer. Information about the appeals process is available from the Office.

Part 3 INFORMATION FOR LICENSED ARCHITECTS

Section 3.1 LICENSE RENEWAL

Licenses renew on a fixed biennial schedule: January 31 of the odd-numbered years. Applicants issued initial licenses within 90 days of the renewal date will not be required to renew and pay the renewal fee. The license will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee. A license will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

If a license has lapsed for more than three (3) years, the license is no longer valid and a new application must be filed with the applicable fees.

Section 3.2 LICENSE CERTIFICATES AND SEALS

An architect must display the certificate conspicuously in the principal place of practice, and must also obtain an approved seal. The seal must be stamped on all plans and specifications prepared or directly supervised by the licensed architect. An architect may not stamp the seal on plans or specifications not prepared or directly supervised by that architect. A seal may not be used if the architect's license is not currently valid. After an applicant is approved for licensure as an architect, the Office will send him or her an exact replica of the seal design to be used in the State of Vermont. The architect must then purchase a seal which impresses the same design, plus the architect's name, and send an impression to the Office for filing.

Section 3.3 CHANGE OF NAME OR ADDRESS

A licensee is responsible for notifying the Office promptly if he or she changes name, mailing address, or business address. Acceptable documentation of change of name includes a notarized copy of a marriage certificate, instrument of change of name from a probate court, or other court order. Acceptable documentation of change of name also included a notarized copy of current identification, such as a driver's license or Social Security card, in both the former and present names. The Board may require additional documentation at its discretion.

Section 3.4 CONTINUING EDUCATION/CONTINUING PROFESSIONAL DEVELOPMENT REQUIREMENTS

All persons licensed to practice architecture must complete a minimum of 24 hours of continuing education during the two-year renewal period and must report these hours at the time of license renewal. The continuing education requirement does not apply for the renewal period during which a person initially obtained licensure. It will begin with the first full two-year renewal period. "Continuing education" means the direct participation of a licensed architect in an educational program directly related to competency in architectural topics concerning public health, safety, and welfare. Acceptable topics are those covered in the Architectural Registration Examination. Continuing education hours are calculated in the following manner:

Academic Coursework

(1) One semester college credit equals 15 continuing education hours.

(2) One quarter college credit equals 10 continuing education hours.

Other Continuing Education Activity

(3) Type I: Three hours of self-directed learning activity equal one continuing education hour. Learning objectives must be established prior to engaging in the learning activity. Learning resources (materials or people) utilized must possess in-depth knowledge of the information covered. Both learning objectives and learning resources must be documented.

(4) Type II: Two hours of structured learning programs or projects equal one continuing education hour. Documented, interactive (non-passive) learning activities must be a significant part of the program or project. A structured learning program or project must meet the criteria of a Type I self-directed learning activity in paragraph (3) above.

(5) Type III: One hour of a structured learning activity with performance evaluation equals one continuing education hour. Some of the learning objectives must be based on actual, documented learning needs. Systematic, documented feedback must be obtained concerning knowledge gained as a result of participation in the program or project. A structured learning activity with performance evaluation must meet the criteria of a Type II structured learning program or project in paragraph (4) above.

At the time of license renewal, each licensee must certify on the official renewal form that he or she has complied with the continuing education requirements. The Board or its designee may randomly audit licensees to insure compliance. A licensee residing in another jurisdiction who has met the continuing education requirements for the current biennial renewal period in that jurisdiction will be deemed by the Board to have met the continuing education requirements for license renewal in Vermont.

A licensee who is audited will be notified in writing by the Board or its designee and will be required to produce written documentation verifying successful completion of the 24 hours of continuing education during the two-year period at issue. The Board may require a licensee who cannot produce such documentation to develop and complete a specific corrective action plan within 90 days, prior to renewal.

Section 3.5 UNPROFESSIONAL CONDUCT

Grounds of unprofessional conduct for applicants and licensees are set forth in 26 V.S.A. § 210 and 3 V.S.A. § 129a.

The Board adopts the following definitions of unprofessional conduct:

3.5.1. Fraudulent procuring or use of a license.

3.5.1.1. An architect shall not assist the application for registration of a person known by the architect to be unqualified in respect to education, training, experience, or character.

3.5.1.2. An architect shall not engage in conduct involving fraud or wanton disregard of the rights of others.

3.5.2. Exercising undue influence on or taking advantage of a person using the individual's services, or promoting the sale of professional goods or services in a manner which exploits a person for the financial gain of the practitioner or of a third party.

3.5.2.1. An architect shall not accept compensation for services from more than one party on a project unless the circumstances are fully disclosed to and agreed to (such disclosure and agreement to be in writing) by all interested parties.

3.5.2.2. If an architect has any business association or direct or indirect financial interest which is substantial enough to influence his or her judgment in connection with the performance of professional services, the architect shall fully disclose in writing to his or her client or employer the nature of the business association or financial interest, and if the client or employer objects to such association or financial interest, the architect will either terminate such association or interest or offer to give up the commission or employment.

3.5.2.3. An architect shall not solicit or accept compensation from material or equipment suppliers in return for specifying or endorsing their products.

3.5.2.4. When acting as the interpreter of building contract documents and the judge of contract performance, an architect shall render decisions impartially, favoring neither party to the contract.

3.5.2.5. An architect, making public statements on architectural questions, shall disclose when he or she is being compensated for making such statement.

3.5.2.6. An architect shall neither offer nor make any payment or gift to a government official (whether elected or appointed) with the intent of influencing the official's judgment in connection with a prospective or existing project in which the architect is interested.

3.5.2.7. An architect shall neither offer nor make any gifts, other than gifts of nominal value (including, for example, reasonable entertainment and hospitality), with the intent of influencing the judgment of an existing or prospective client in connection with a project in which the architect is interested.

3.5.3. Failing to comply with provisions of federal or state statutes governing the profession.

3.5.3.1. If, in the course of his or her work on a project, an architect becomes aware of a decision taken by his or her employer or client, against the architect's advice, which violates applicable state or municipal building laws and regulations and which will, in the architect's judgment, materially affect adversely the safety to the public or the finished project, the architect shall:

3.5.3.1.1. Report the decision to the local building inspector or other public official charged with the enforcement of the applicable state or municipal building laws and regulations,

3.5.3.1.2. Refuse to consent to the decision, and

3.5.3.1.3. In circumstances where the architect reasonably believes that other such decisions will be taken notwithstanding his objection, terminate his services with reference to the project.

3.5.3.2. An architect shall not, in the conduct of his or her architectural practice, knowingly violate any state or federal criminal law.

3.5.3.3. An architect shall comply with the registration laws and regulations governing his or her professional practice in any United States jurisdiction.

3.5.4. Wilfully making or filing false professional reports or records, wilfully impeding or obstructing the proper making or filing of professional reports or records, or wilfully failing to file the proper professional report or record.

3.5.4.1. An architect shall not deliberately make a materially false statement or fail deliberately to disclose a material fact requested in connection with his or her application for registration or renewal.

3.5.5. Practicing or offering to practice beyond the scope permitted by law.

3.5.5.1. In designing a project, an architect shall take into account all applicable state and municipal building laws and regulations. While an architect may rely on the advice of other professionals (e.g., attorneys, engineers, and other qualified persons) as to the intent and meaning of such regulations, once having obtained such advice, an architect shall not knowingly design a project in violation of such laws and regulations.

3.5.6. Accepting and performing responsibilities which the licensee knows or has reason to know that he or she is not competent to perform.

3.5.6.1. In practicing architecture, an architect shall act with reasonable care and competence, and shall apply the technical knowledge and skill which is ordinarily applied by architects of good standing, practicing in the same locality.

3.5.6.2. An architect shall undertake to perform professional services only when he or she, together with those whom the architect may engage as consultants, are qualified by education, training, and experience in the specific technical areas involved.

3.5.6.3 An architect shall not practice architecture if his or her professional competence is substantially impaired by abuse of alcohol or any other drug.

3.5.7. Agreeing with any other person, as defined in 1 V.S.A. § 128, or subscribing to any code of ethics or organizational bylaws, when the intent or primary effect of that agreement, code or bylaw is to restrict or limit the flow of information concerning alleged or suspected unprofessional conduct to the Board.

3.5.7.1 An architect possessing knowledge of a violation of these rules by another architect shall report such knowledge to the Board.

3.5.8. Using the licensee's seal on drawings prepared by others not in the licensee's direct employ, or using the seal of another.

3.5.8.1. An architect shall accurately represent to a prospective or existing client or employer his or her qualifications and the scope of his or her responsibility in connection with work for which he or she is claiming credit.

3.5.8.2. An architect shall not sign or seal drawings, specifications, reports or other professional work which was not prepared under his or her direct supervision; provided, however, that in the case of the portions of such professional work prepared under the direct supervision of persons consulting with or employed by the architect and who are registered under this or another professional registration law of this jurisdiction, the architect may sign or seal those portions of the professional work if the architect has reviewed such portions and has coordinated their supervision. "Direct supervision" shall be that degree of supervision by a person overseeing the work of another whereby the supervisor has both control over and detailed professional knowledge of the work prepared under his or her supervision.

3.5.8.3. Each office maintained for the preparation of drawings, specifications, reports, or other professional work shall have an architect resident and regularly employed in that office having direct knowledge and supervisory control of such work.

Part 4 COMPLAINT PROCEDURE

Section 4.1 INITIATING A COMPLAINT

The Office has a procedure for receiving, investigating, and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

History

Effective Date: March 1, 1992 (Secretary of State Rule Log # 92-5)
AMENDED: May 19, 1999 (Secretary of State Rule Log # 99-21)
February 2002 - Not an amendment - correction of statutory authority

Chapter 030 ADMINISTRATIVE RULES FOR BARBERS, COSMETOLOGISTS, ESTHETICIANS AND NAIL TECHNICIANS

04-030 Code Vt. R. 04-030-030-X ADMINISTRATIVE RULES FOR BARBERS, COSMETOLOGISTS, ESTHETICIANS AND NAIL TECHNICIANS

Part 1 Definitions and Clarification of Terms

Section 1-1 "Accredited"

"Accredited" means, of a college, university, or degree, that a course of study was certified as meeting standards of integrity and rigor set out by an accrediting organization approved by the United States Department of Education, or in the case of foreign institution, was verified to the Director's satisfaction as substantially equivalent to a course of study so certified.

Section 1-2 "Client"

"Client" means a person who receives the professional services of a person regulated under these rules.

Section 1-3 "Director"

"Director" means the Director of Professional Regulation.

Section 1-4 Foreign

"Foreign" means a governmental jurisdiction other than the State of Vermont.

Section 1-5 "License" or "licensure"

"License" or "licensure" refers to any credential issued by the Office under these rules, including a certification or registration, except where context clearly indicates reference to a foreign or other professional license.

Section 1-6 "Licensee"

"Licensee" means a person or entity seeking or holding a license under these rules.

Section 1-7 "Office"

"Office" means the Office of Professional Regulation.

Section 1-8 "Office website"

"Office website" means https://sos.vermont.gov/opr/.

Section 1-9 "School"

"School" means a facility or facilities regularly used to train or instruct persons in the practice of barbering or cosmetology.

Section 1-10 "Shop" or "Facility"

"Shop" or "Facility" means any physical premises or mobile facility where services licensed under these rules regularly are provided. "Regularly," for purposes of this definition, means under circumstances where repeated use for the provision of licensed services has been established or reasonably is expected.

Section 1-11 "Site"

"Site" means a temporary or transient location where professional services are provided to clients.

Part 2 Administration

Section 2-1 Applicable Law

The practices of barbering, cosmetology, and esthetics are defined and regulated pursuant to 26 V.S.A. § 271 et seq. Exemptions to licensure requirements are found at 26 V.S.A. § 273. Copies of these and other statutes are available online at www.legislaturevermont.gov/statutes/. The Office administers licensure in conformity with these and other Vermont laws, to include the Administrative Procedure Act, 3 V.S.A. § 800 et seq.; the Public Records Act, 1 V.S.A. § 315 et seq.; and the Laws of Professional Regulation, 3 V.S.A. § 121 et seq.

Section 2-2 Resources for Applicants and Licensees

The Office maintains a website at https://sosvermont.gov/opr/ with information and links relevant to all licensed professionals. Information specific to barbers, cosmetologists, estheticians, and nail technicians is available from https://sos.vermont.gov/barbers-cosmetologists/.

Section 2-3 US Armed Forces

The Director may accept toward the requirements of these rules relevant military education, training, or service completed by a member of the U.S. Armed Forces and may expedite licensure of a person who left licensed employment in another state secondary to a spouse's military transfer to Vermont 3 V.S.A. § 123(g). Service members and the spouses of service members should visit the Office website for details.

Section 2-4 Location of Practice

The practices of barbering, cosmetology, esthetics, or manicure and pedicure (nail technician) are permitted only in shops licensed by the board, except as permitted in sections 281 and exempted by section 273(3) of Title 26.

Section 2-5 Display of License

Any person practicing a profession governed by these rules must display a license. See Rule 9.2(g). Each person practicing a profession subject to these rules is required to have in his or her possession a current Vermont Photo Operator's License or current Vermont State issued photo identification.

Part 3 Procedures

Section 3-1 Applications

Online license applications must be completed through the Office website

(a) Incomplete applications will not be processed. Applications are complete only when all required questions have been answered fully, all attestations made, all required documentation and materials provided, and all fees paid.

(b) When the Director intends to deny an application, notice stating the reasons for the action shall be given to the applicant by certified mail, whereupon the applicant shall have 30 days to petition for a hearing before an administrative law officer.

(d) The Office may deem expired any application that is left pending for six months.

Section 3-2 Complaints

Complaints against licensees, applicants for licensure, or persons practicing without a license may be submitted online, on a standard form available from the Office website. Complaint procedures are explained in detail at https://sos.vermont.gov/opr/complaints-conduct-discipline/.

Section 3-3 Contested Cases

Procedures in contested cases relating to licensure or discipline are governed by the Office of Professional Regulation Administrative Rules of Practice, CVR 04-030-005, as those rules may from time to time be modified.

Section 3-4 Declaratory Rulings

Petitions for declaratory rulings as to the applicability of any statutory provision or of any rule or order of the Office may be made pursuant to 3 V.S.A. § 808.

Section 3-5 Conflict of Standards

Where a standard of unprofessional conduct set forth in statute conflicts with a standard set forth in rule, the standard that is most protective of the public shall govern. See 3 V.S.A. § 129a(e).

Section 3-6 Determination of Equivalency

Where the Director is permitted by law or rule to accept certain training or experience on the basis of equivalence to a fixed standard, it is the burden of the applicant or licensee to establish equivalence to the Director's satisfaction, by producing credible, clear, and convincing evidence of the same. The Director has no obligation to research the bona fides of any institution, program, course, degree, certification, practicum, fellowship, or examination and may resolve all inferences in favor of withholding a credential, approval, or recognition.

Section 3-7 Waiver or Variance

The Director will not grant routine waivers or variances from any provisions of these rules without amending the rules. See V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Director may, upon written request of an interested party, so find, grant a waiver with or without particular conditions and limitations, and record the action and justification in a written memorandum. This rule shall not be construed as creating any hearing right or cause of action.

Section 3-8 Endorsement from a Foreign Jurisdiction

A person licensed or certified in good standing under the laws of another jurisdiction may be eligible for licensure as specified by 26 V.S.A. § 285:

(a) if the sending jurisdiction's requirements for licensure are substantially equivalent to those of Vermont; or

(b) if the sending jurisdiction's requirements for licensure are not equivalent, but the applicant has 1,500 documented hours of practice in not less than one year.

Section 3-9 Inspection

All premises, shops, schools, or facilities licensed by the Office, and all sites where services licensed under these rules are provided, shall be open to announced or unannounced visits by Office inspectors during regular business hours.

Section 3-10 Contacting the Office

See the Office website for contact details. Send mail to: Office of Professional Regulation, ATTN: Barbering & Cosmetology, 89 Main Street, 3rd Floor, Montpelier, VT 05620-3402.

Part 4 Barbers

Section 4-1 Scope of Practice

A barber engages in cutting, shampooing, or styling hair; shaving the face, shaving around the vicinity of the ears and neckline, or trimming facial hair; facials, skin care, or scalp massages, and bleaching, coloring, straightening or permanent-waving hair, or similar work by any means, with hands or mechanical or electrical apparatus or appliances. Barbering also includes esthetics. Core barber training does not include permanent-waving, chemical relaxing, or more advanced esthetic work such as microdermabrasion and waxing; a barber may perform these functions only if he or she has documented training, education, and experience additional to that required for licensure.

Section 4-2 Eligibility

A person shall be eligible for licensure as a barber if he or she:

(a) holds a high-school diploma or equivalent;

(b) has successfully completed an Office-approved apprenticeship under Part 9, or a course of study not fewer than 750 hours at a school of barbering accredited at the time of matriculation by an authority recognized by the United States Department of Education, or a school recognized by the Director as substantially equivalent thereto; and

Section 4-3 Core Competencies

An acceptable course of study shall establish and test competency in:

(a) shampooing;

(b) straight razor shaves and beard trims;

(d) hair lightening and coloring, including temporary, semi-permanent, and permanent;

(e) hair cutting, hairstyling, and hair shaping;

(f) clipper cutting;

(g) hair analysis and scalp treatments;

(h) equipment sanitation and sterilization techniques applicable to supplies, general and specific chemical waste and storage;

(i) anatomy, personal health, hygiene, and sanitation;

(j) safe chemical storage, use, and disposal and understanding related reference materials;

(k) laws, rules, and professional ethics;

(l) knowledge and history of the profession.

Section 4-4 Crossover Licensure for Cosmetologists

(a) A cosmetologist licensed under these rules shall be eligible for separate and additional licensure as a barber if he or she:

(1) has successfully completed an Office-approved crossover apprenticeship under Part 9, or a course of study not fewer than 150 hours at a school of barbering accredited at the time of matriculation by an authority recognized by the United States Department of Education, or a school recognized by the Director as substantially equivalent thereto; and

(2) has passed written and practical barbering examinations recognized by the Director.

(b) An acceptable course of crossover study shall establish and test competency in:

(1) straight razor shaves and beard trims;

(2) barber-specific facials;

(3) barber-specific clipper cutting, safety, and sanitation; and

(4) the history of barbering.

Part 5 Cosmetologists

Section 5-1 Scope of Practice

A cosmetologist engages in work on the hair, including dressing, curling, waving, cleansing, cutting, bleaching, coloring, or similar work by any means, with hands or mechanical or electrical apparatus or appliances. Cosmetology also includes esthetics and manicuring. A cosmetologist may not use straight razors upon the face or neck

Section 5-2 Eligibility

A person shall be eligible for licensure as a cosmetologist if he or she:

(a) holds a high-school diploma or equivalent;

(b) has successfully completed an Office-approved apprenticeship under Part 9 or has successfully completed a course of study not fewer than 1,000 hours at a school of cosmetology accredited at the time of matriculation by an authority recognized by the United States Department of Education, or a school recognized by the Director as substantially equivalent thereto; and

Section 5-3 Core Competencies

An acceptable course of study shall establish and test competency in:

(a) shampooing;

(b) waxing;

(d) finger waving, pin curls, roller formation;

(e) manicuring (nail technician practice);

(f) facials;

(g) hair analysis and scalp treatments;

(h) hair lightening and coloring, including temporary, semi-permanent and permanent;

(i) hair cutting, clipper cutting, hairstyling, and hair shaping;

(j) equipment sanitation and sterilization techniques applicable to supplies, general and specific chemical waste and storage;

(k) anatomy, personal health, hygiene, and sanitation;

(l) safe chemical storage, use, and disposal and understanding related reference materials;

(m) laws, rules, and professional ethics.

Section 5-4 Crossover Licensure for Barbers

(a) A barber licensed under these rules shall be eligible for separate and additional licensure as a cosmetologist if he or she:

(1) has successfully completed an Office-approved crossover apprenticeship under Part 9, or a course of study not fewer than 250 hours at a school of cosmetology accredited at the time of matriculation by an authority recognized by the United States Department of Education, or a school recognized by the Director as substantially equivalent thereto; and

(2) has passed written and practical cosmetology examinations recognized by the Director.

(b) An acceptable course of crossover study shall establish and test competency in:

(1) waxing;

(2) permanent waving and straightening;

(3) finger waving, pin curls, roller formation;

(4) manicuring (nail technician practice);

(5) cosmetology-specific facials;

(6) cosmetology-specific hair analysis and scalp treatments;

(7) equipment sanitation and sterilization techniques applicable to supplies, general and specific chemical waste, and storage;

(8) safe chemical storage, use, and disposal and understanding related reference materials.

Section 5-5 Beginning a Barber Apprenticeship

(a) Applications must be filed with the Office prior to the beginning of the apprenticeship. If the proposed apprenticeship satisfies the requirements of these rules, the Board will issue a letter of approval. The apprentice shall not touch a paying customer prior to receipt of the approval letter and completion of 500 hours of study. The apprenticeship is intended to provide continuous week-by-week supervised practical experience equivalent or greater to the supervised practicum provided in a traditional school.

(b) In no instance can the apprenticeship extend beyond 36 months.

Section 5-6 Education Component

The apprenticeship must include subjects as presented by standard cosmetology and barbering text books and shall include:

(a) anatomy and physiology, specific to the industry license;

(b) bacteriology, including the spread of and control of contagious or infectious diseases, contamination and decontamination, sterilization, sanitation, and basic cleanliness in general and as it pertains to the barber and cosmetology industry and state requirements; and

Section 5-7 Competencies Acquired

At the conclusion of the barber apprenticeship, the apprentice shall have acquired the following competencies:

(a) shampooing;

(b) hair cutting, hairstyling, and hair shaping;

(d) permanent waving and straightening;

(e) hair analysis & scalp treatments;

(f) basic facials;

(g) clipper cutting;

(h) straight razor shaves and beard trim;

(i) sanitation and sterilization techniques for all equipment, supplies, general and specific chemical and waste storage areas;

(j) sanitary personal health and hygiene understanding

(k) safe chemical storage, use, and disposal and reference material requirements;

(l) sanitation, sterilization, hazardous substances, hygiene, anatomy;

(m) professional ethics, and;

(n) knowledge of the history of the profession.

Section 5-8 Transfer of School Hours

Persons who within three (3) months of applying for an apprenticeship have successfully completed barbering training consisting of 500 hours or more in a trade or vocational school, or a school of barbering, or school of cosmetology offering a program in barbering, or in an accredited program or course of barbering studies approved by the Board, may upon proper documentation, apply no more than 500 hours toward the barber's apprenticeship.

Part 6 Estheticians

Section 6-1 Scope of Practice

An esthetician engages in massaging, cleansing, stimulating, manipulating, beautifying, or otherwise working on the scalp, face, or neck by using cosmetic preparations, antiseptics, tonics, lotions, or creams.

Section 6-2 Eligibility

A person shall be eligible for licensure as an esthetician if he or she:

(a) holds a high-school diploma or equivalent;

(b) has successfully completed an Office-approved apprenticeship under Part 9, or has successfully completed a course of study not fewer than 500 hours at a school of esthetics accredited at the time of matriculation by an authority recognized by the United States Department of Education, or a school recognized by the Director as substantially equivalent thereto;

Section 6-3 Core Competencies

An acceptable course of study shall establish and test competency in:

(a) facials;

(b) microdermabrasion;

(d) mask therapy;

(e) chemicals;

(f) electrical machines used in esthetics;

(g) waxing;

(h) makeup techniques and services;

(i) equipment sanitation and sterilization techniques applicable to supplies, general and specific chemical waste and storage;

(j) anatomy, personal health, hygiene, and sanitation;

(k) safe chemical storage, use, and disposal and understanding related reference materials;

(l) laws, rules, and professional ethics.

Section 6-4 Those Not Eligible for Endorsement

An applicant who does not meet the requirements for licensure by endorsement must satisfy the requirements of 26 V.S.A. § 278 and Rule 6.2.

Section 6-5 Beginning a cosmetology apprenticeship

(a) Applications must be filed with the Office prior to the beginning of the apprenticeship. If deemed appropriate, the Board will issue a letter of approval. The apprentice shall not touch a paying customer prior to receipt of the approval letter and completion of 500 hours of study. The apprenticeship is intended to provide continuous week-by-week supervised practical experience equivalent or greater to the supervised practicum provided in a traditional school.

(b) In no instance can the apprenticeship extend beyond 36 months.

Section 6-6 Education Component

The apprenticeship must include subjects as presented by standard cosmetology and barbering text books which shall include:

(a) anatomy and physiology, specific to the industry license;

(b) bacteriology including the spread of and control of contagious or infectious diseases, contamination and decontamination, sterilization, sanitation, and basic cleanliness in general and as it pertains to the barber and cosmetology industry and state requirements; and

Section 6-7 Competencies Acquired

At the conclusion of the cosmetology apprenticeship, the apprentice shall have acquired the following competencies:

(a) shampooing;

(b) hair cutting, clipper cutting, hairstyling, and hair shaping;

(d) permanent waving and straightening;

(e) hair analysis & scalp treatments;

(f) basic facials;

(g) waxing;

(h) manicuring and pedicuring (nail technician practice);

(i) finger waving pin curls/roller formation;

(j) sanitation and sterilization techniques for all equipment, supplies, general and specific chemical and waste storage areas;

(k) sanitary personal health hygiene understanding;

(l) safe chemical storage, use, and disposal and reference material requirements;

(m) sanitation, sterilization, hazardous substances, hygiene, anatomy, and;

(n) professional ethics.

Section 6-8 Transfer of School Hours

Persons who within three (3) months of applying for an apprenticeship have successfully completed cosmetology training consisting of 500 hours or more in a trade or vocational school, or a school of cosmetology, or in an accredited program or course of studies in cosmetology approved by the Board, may upon proper documentation, apply no more than 500 hours toward the cosmetologist apprenticeship.

Part 7 Nail Technicians

Section 7-1 Eligibility

A person shall be eligible for licensure as a nail technician if he or she:

(a) has successfully completed an Office-approved apprenticeship under Part 9 or has successfully completed a course of study not fewer than 200 hours at a school of manicuring accredited at the time of matriculation by an authority recognized by the United States Department of Education, or a school recognized by the Director as substantially equivalent thereto, and

(b) has passed written and practical nail-technician examinations recognized by the Director.

Section 7-2 Core Competencies

An acceptable course of study shall establish and test competency in:

(a) manicuring;

(b) nail drill;

(d) liquids and powder brush-ons;

(e) pedicuring;

(f) equipment sanitation and sterilization techniques applicable to supplies, general and specific chemical waste and storage;

(g) anatomy, personal health, hygiene, and sanitation;

(h) safe chemical storage, use, and disposal and understanding related reference materials;

(i) laws, rules, and professional ethics.

Section 7-3 Licensure by Endorsement

Applicants for esthetician licensure by endorsement shall:

(a) have a current esthetician license in good standing in another jurisdiction;

(b) whose laws the Board considers to be substantially equal to those of this state;

or;

(c) If licensed and in good standing in another state whose laws the Board does not consider to be substantially equal to those of this state, the applicant may be issued a license if the applicant has been in active practice for the period specified in 26 V.S.A. § 289 immediately preceding application. The Board may grant a license if the Board determines that the applicant's experience provides assurance of competency in areas in which the other state's licensing standards are not substantially equal to those of this state;

and;

(d) successfully complete the Vermont laws and rules examination.

Section 7-4 Those Not Eligible for Endorsement

An applicant who does not meet the requirements for licensure by endorsement must satisfy the requirements of 26 V.S.A. § 279 and Rule 7.2.

Section 7-5 Beginning an Esthetician Apprenticeship

(a) Applications must be filed with the Office prior to the beginning of the apprenticeship. If deemed appropriate, the Board will issue a letter of approval. The apprentice shall not touch a paying customer prior to receipt of the approval letter and completion of 100 hours of study. The apprenticeship is intended to provide continuous week-by-week supervised practical experience equivalent or greater to the supervised practicum provided in a traditional school.

(b) In no instance can the apprenticeship extend beyond 18 months.

Section 7-6 Education Component

The apprenticeship must include subjects as presented by standard cosmetology and barbering text books which shall include:

(a) anatomy and physiology, specific to the industry license;

Section 7-7 Competencies Acquired

At the conclusion of the esthetician apprenticeship, the apprentice shall have acquired the following competencies:

(a) facial treatments;

(b) chemical peels, exfoliation;

(d) makeup techniques and services;

(e) mask therapy;

(f) chemicals;

(g) electrical machines used in esthetics;

(h) eyebrow arching and hair removal;

(i) sanitation and sterilization techniques for all equipment, supplies, general and specific chemical and waste storage areas;

(j) sanitary personal health and hygiene understanding;

(k) safe chemical storage, use, and disposal and reference material requirements, and;

(l) sanitation, sterilization, hazardous substances, hygiene, anatomy, laws, rules, regulations; professional ethics.

Section 7-8 Transfer of School Hours

Persons who have successfully completed esthetician training consisting 200 hours or more in a trade or vocational school or a program of esthetics approved by the Board within three (3) months of applying for an apprenticeship may, upon proper documentation, apply no more than 200 hours toward the apprenticeship.

Part 8 Schools

Section 8-1 License Required; Significance

No postsecondary school of barbering, cosmetology, esthetics, or nail-technician practice may operate without a certificate of approval from the Director. Such certificate is a license subject to the laws of professional regulation. A regional vocational center overseen by the Vermont Agency of Education is not required to be licensed but may elect to seek license from the Director. Licensure of a postsecondary school or regional vocational center signifies that the school or center, at the time of license issuance or renewal, complies with the requirements of these rules and has in place a program of education fit to ensure that a graduate meets the educational requirements of barber, cosmetologist, esthetician, or nail- technician licensure.

Section 8-2 Application

A school shall apply in the manner specified by the Director, showing:

(a) the equipment used in the school;

(b) the floor plan of the school, size and arrangement of classrooms, location of equipment, entrances, bathrooms, and storage areas;

(c) the curricula to be offered, its scope and sequence, textbooks or workbooks used, and equipment and supply requirements;

(d) the school's policies on non-discrimination, student participation in customer services, sale or lending of equipment, material, professional garb to students;

(e) documentation of incorporation, trade name, partnership agreement, and other evidence of ownership structure or controlling interest; and

(f) such other information as the Director may require to assess the school's ability to operate in the public interest and in a manner consistent with the requirements of these rules, including data indicating applicable examination pass rates, rates and durations of program completion, and evidence of financial stability and operational ability to see entrants through successful graduation.

Section 8-3 General Operation

A school shall:

(a) employ signage clearly indicating to the public that it is a school of cosmetology, barbering, esthetics, or nail-technician practice, including a sign reading "All work done by instructor-supervised students," in room(s) used for practical instruction;

(b) develop and execute a program of curricular instruction suited to the core competencies of the profession for which students are training;

(c) educate and test students in Vermont laws and rules pertaining to the practice of the profession for which students are training;

(d) possess equipment and facilities necessary competently to educate students in the practical execution of skills within its approved curriculum;

(e) maintain accurate records of daily student and instructor attendance and corresponding subjects studied;

(f) make known to students and prospective students, in clear, written material, all costs of attendance, including tuition, fees, and required purchases of equipment, textbooks, supplies, and professional garb;

(g) compile, and make available to the Office on request, accurate data reflecting student program completion, examination pass rates, and post-graduation attainment of licensure;

(h) track the continuing-education status of its instructors and enforce instructor compliance with these rules;

(i) obtain the informed consent of clients prior to the provision of services by students;

(j) have and enforce written policies specifying the minimum training and showing of competence required before a student may work on a paid client under supervision, which policies shall ensure that a student has satisfied at least one-quarter of the training-hour requirements for barbering, cosmetology, esthetics, or nail-technician licensure before initiating practical work on any paid client;

(k) not allow instructors to work on patrons except in the course of instructing students, unless additionally licensed as a shop;

(l) not require students to study or practice more than 40 hours in any one week;

(m) not exploit students financially or withhold transcripts reflecting accomplished education for which tuition has been paid;

(n) not require students to purchase cosmetics or merchandise from the school as a condition of enrollment;

(o) retain attendance and examination records for at least seven years; and

(p) make compliance documentation relative to the requirements of this Part available to the Director upon request or license renewal.

Section 8-4 Instructors

A school shall display each instructor's license and specialty designation in a location conspicuous to students. A school and instructor may request specialty designation through the Office website. A school is responsible for ensuring, and may be required at inspection to show by competent documentation, that each instructor employed to teach students:

(a) is licensed by the Office, in good standing, to perform the professional acts he or she teaches;

(b) has attained at least 1,500 hours of practical experience in not less than one year;

(c) is fit not only to practice at a standard that consistently exceeds minimum expectations, but also to convey curricular material to students, as evidenced by completion of an instructor's examination or instructor training recognized by the Director; and

(d) once employed, has maintained competency by participating in at least 24 hours of professional education recognized by the Director each biennial licensure period, of which not fewer than 8 hours shall pertain to teaching and none may relate to marketing or business management.

Section 8-5 Substitutes

A school may permit an otherwise-qualified person not designated an instructor to stand in when an instructor is ill or indisposed; provided, however, that such a substitute shall not oversee the provision of services to a client. A substitute may be used for no more than fifteen percent of total course hours.

Section 8-6 Ratios

A school shall employ a sufficient number of instructors to ensure that students obtain a meaningful educational benefit from each hour of schooling. The student:instructor ratio shall not exceed 1:16 for hands-on training or 1:40 for didactic training.

Section 8-7 Credit

Credit may be issued only for time a student is present and engaged in a course of instruction or supervised practice; not for lunch, rest periods, or non-instructional time.

Section 8-8 School as Testing Authority

A licensed school may apply to the Director for recognition as a testing authority. The Director's decision as to testing-authority recognition shall be final and shall not be subject to any administrative hearing right or appeal. Students who pass the capstone examination of a school so recognized shall be deemed to have satisfied the requirements of 26 V.S.A. § 283. Approval as a testing authority shall be indicated by the addition of a specialty designation to the school's license and shall be valid through the school's next biennial license renewal. To qualify as a testing authority, a school must:

(a) demonstrate the ability to administer a professional skills examination commensurate in rigor to those prevailing nationally for barbers, cosmetologists, estheticians, and/or nail technicians;

(b) use examiners not regularly employed by the school or dependent upon the school as their primary source of income, each holding a Vermont license in good standing in the field or fields of practice under evaluation, and each having practiced in those fields for not fewer than three years;

(c) use objective, written evaluative criteria and rubrics, known to examinees in advance and specified in the school's memorandum of understanding with the Office;

(d) establish procedural safeguards to maximize the objectivity and fairness of examination, including means of insulating examiners from undue financial or social influence;

(e) administer written exam components in a secure setting, using appropriate means to prevent cheating, proctored by persons licensed under these rules and accountable for maintaining exam integrity;

(f) administer practical exam components under video recording, retained for not fewer than five years and available to the Office on request;

(g) provide mandatory, written notice to each examinee, supplied by the Director, explaining how to contact the Office to report cheating or other exam irregularities;

(h) not charge students of the school an examination fee in excess of actual and necessary costs of exam provision; and

(i) advise students of possible complications to out-of-state portability that may result from selecting school-based examination and allow students to elect between the school-sponsored exam and the corresponding, Director-approved national examination.

Part 9 Apprenticeships

Section 9-1 Initiation

An applicant wishing to commence an apprenticeship under Part 4, 5, 6, or 7 may do so by completing an online apprenticeship application, including an Office Apprenticeship Initiation Form, the contents of which shall set out a detailed plan for structured training under the supervision and mentorship of a qualified supervisor, to be completed within:

(a) 1,125 hours for barbers;

(b) 1,500 hours for cosmetologists;

(d) 300 hours for nail technicians; and

(e) 300 hours for crossover licensing under Rules 4-4 or 5-4.

No apprenticeship may commence until the apprenticeship plan is approved and an apprenticeship license is issued to the apprentice.

Section 9-2 Acceptable Plans

A plan must detail the means and pace at which an apprentice will be oriented to the core competencies required of the profession; must specify any texts or training tools employed; and must be verifiable through contemporaneous documentation created by an identified supervisor and apprentice. All plans must be completed within two years of inception. The Director may reject or require amendment of any plan that is not adequate to permit Office verification attained competencies, that appears exploitative of the apprentice, or that appears unsuited to prepare the apprentice to pass required examinations.

Section 9-3 Acceptable Supervisors

To supervise another, a licensee must have at least three years of experience practicing the profession in which his or her apprentice seeks licensure; must not have a disqualifying disciplinary history in Vermont or any other jurisdiction; and may be required to take a supervision course approved by the Office. Supervision is not a right vested in a licensee. The Director's decision on the acceptability of a supervisory arrangement shall be final and shall not be subject to any administrative hearing right or appeal. A supervisor may not oversee more than one full-time apprentice or any group of part-time apprentices with aggregate weekly apprenticeship hours exceeding 40.

Section 9-4 Orderly, Accurate Documentation

Apprenticeship progress shall be documented on apprenticeship log forms supplied by the Office, in compliance with Office procedures. All forms shall be signed by supervisor and apprentice. The negligent or willful submission of materially inaccurate or misleading logs is cognizable as unprofessional conduct under 3 V.S.A. §§ 129a(a)(1) &(7).

Section 9-5 Logs to be Produced on Request

Apprenticeship logs shall be promptly submitted upon the request of the Office or a designated inspector. It is the responsibility of each apprentice and supervisor to submit progress reports when requested; failure to do so may result in denial of denial of training-hour recognition. The Office may identify and require correction of any deviation from the apprenticeship plan; however, the Office's final assessment of license eligibility occurs only at the completion of an apprenticeship.

Section 9-6 Recognition of Hours Earned

The Director shall recognize toward apprenticeship requirements only those hours of apprenticeship actually earned and properly documented in conformity with an approved apprenticeship plan. Clerical tasks, reception, and cleaning may occupy no more than ten percent of the hours accrued. The Director may refuse to credit hours that are insufficiently documented or unverifiable, that were unsupervised, or that fail to advance learning in the core competencies for the relevant profession. The Director's decision on the recognition of apprenticeship hours shall be final and shall not be subject to any administrative hearing right or appeal.

Part 10 Shops

Section 10-1 License Required

All shops must be licensed. A distinct license is required of each location or mobile facility, regardless of common ownership. Shop and staff licenses shall be conspicuously displayed. Shop licenses are not transferrable.

Section 10-2 Application

A shop shall apply in the manner specified by the Director, showing:

(a) its floor plan;

(b) that it has a designated licensee responsible for overall cleanliness, sanitation, and safety of the shop;

(c) documentation of incorporation, trade name, partnership agreement, and other evidence of ownership structure or controlling interest;

(d) its compliance with the sanitation and safety standards set out in Part 13 of these rules; and

(e) the satisfactory results of an inspection by an Office inspector, approved third-party inspector, or designated licensee.

Section 10-3 Non-discriminatory Pricing

A shop may not price services differently on the basis of a client's race or gender. Prices may reflect non-discriminatory factors such as the supplies, effort, skill, and time required of a service, or market supply and demand for the service.

Section 10-4 Duty to Verify Licensure

A shop shall employ only licensed persons to perform licensed services. Real-time license status is available from the Office website. Knowledge of license status is imputed to all shops.

Section 10-5 Mobile Shops

Shops generally are located in permanent buildings and licensed at fixed addresses; however, a licensee may apply for licensure of a mobile shop, which may be an automobile or tow-behind trailer specially adapted for the safe, convenient, and accessible provision of professional services. A mobile shop application must demonstrate that the mobile shop can be operated safely and without creating a public nuisance. Requirements imposed by the Director shall be developed on a case-by-case basis specific to the vehicle and intended use, but shall include at a minimum:

(a) verification, by a person accepted by the Director as qualified to give such opinion, that the mobile shop is adequately ventilated, has appropriate egress, is fire safe, is fit for the use intended by the licensee-applicant, and otherwise is able to satisfy the applicable requirements of Part 13;

(b) a policy for chocking wheels to prevent rollaway incidents if transmission and parking brakes are disengaged;

(d) appropriate commercial liability insurance;

(e) a functioning carbon-monoxide detector;

(f) equipment and a related policy ensuring that electricity is supplied safely and without the use of portable gasoline or propane generators;

(g) equipment and a related policy ensuring that appropriate amounts of fresh potable water are available and that wastewater is appropriately contained, drained regularly, and lawfully disposed; and

(h) appropriate verification from the Department of Motor Vehicles that the mobile shop is roadworthy, lawfully registered, and operated by a person or persons duly licensed to drive or tow the mobile shop.

Section 10-6 Manicurist (nail technician) Course Requirements

The school, if offering a manicurist (nail technician) course, must offer a 400 hour course of study which shall include at a minimum the following:

(a) manicuring;

(b) nail drill;

(d) acrylic: liquid and powder brush-ons;

(e) pedicuring;

(f) sanitation and sterilization techniques for all equipment, supplies, general and specific chemical and waste storage areas;

(g) sanitary personal health and hygiene understanding;

(h) safe chemical storage, use, and disposal and reference material requirements.

(i) sanitation, sterilization, hazardous substances, hygiene, anatomy, laws, rules, regulations, and;

(j) professional ethics.

Section 10-7 Credits, Conditions

(a) Time absent must be made up to complete the requirements of the course.

(b) A student found working in a paid school clinic before completing his or her first 500 hours of study may lose partial or complete credit.

(d) No student shall be credited for hours not spent in the class.

Section 10-8 Instructor/student Ratios

(a) For Hands on training: Each school shall have a ratio of no fewer than one (1) instructor for every eight (8) students;

(b) For general classroom training: Each school shall have a ratio of no fewer than one (1) instructor for every fifteen (15) students

(c) For classes where schools provide some type of additional tutoring or technical support for students who need assistance, each school shall provide no fewer than one (1) instructor for up to twenty (20) students.

Section 10-9 Prohibitions

No school shall:

(a) Permit a student to charge a customer for the student's work or for the material and supplies used by the student until the student has completed the following number of hours for the following areas of study:

(1) Barbering 500 hours;

(2) Cosmetology 500 hours;

(3) Estheticians 100 hours; and

(4) Manicurists (nail technicians) 50 hours;

(b) Allow the instructors to work on patrons except in the course of instructing students.

(d) Require students to purchase cosmetics or other materials from the school as a condition of enrollment in a school.

Section 10-10 Badges

Schools shall require students to wear badges identifying themselves as students.

Section 10-11 Posting Board Rules

Current Board laws and rules must be posted in a conspicuous location accessible to the students.

Part 11 License Renewal

Section 11-1 Biennial Licensing Period

Licenses are valid for fixed, two-year periods. Expiration dates are printed on licenses. A license expires if not renewed by midnight on the date of expiry. Practice under an expired license is prohibited. An initial license issued fewer than 90 days prior to the beginning of the fixed biennial period shall be valid through the end of full biennial licensing period following initial licensure. A lookup tool on the Office website may be considered a primary source verification as to license status and expiration.

Section 11-2 License Renewal

Online license renewal applications must be completed through the Office website. The Office transmits email reminders to licensees at the end of each biennial licensing period; however, non-receipt of such reminders shall not excuse a licensee from the obligation to maintain continuous licensure or the consequences of failing to do so. Practicing while a license is lapsed is a violation of 3 V.S.A. § 127. Instructors must demonstrate compliance with Rule 8-4 as a condition of license renewal.

Section 11-3 Late Renewal Penalties

Late renewal applications are subject to reinstatement fees, which may be waived in certain circumstances. See, 3 V.S.A. § 127(d). Reinstatement waivers may be requested through the online licensing system.

Section 11-4 Extended License Lapse

When a license has been expired for five or more years, a licensee's preparation to return to practice will be assessed on a case-by-case basis. The Director may require re-training, testing, or re-application. See, 3 V.S.A. § 135.

Part 12 Reporting Duties

Section 12-1 Duty to Update and Self-Report

Applicants and licensees owe a duty of candor to the Office and shall disclose circumstances that may call for further investigation to protect the public. That a matter is reportable does not imply that the matter necessarily is a basis for discipline. A licensee, including an applicant for licensure, shall report to the Office, in writing, within 15 calendar days:

(a) any material inaccuracy or change in circumstance relative to any application question, where the changed circumstance arises between submission of a license application and issuance of the license sought;

(b) any conviction for a criminal act;

(d) any adverse action against a foreign professional license, where the adverse action relates to an allegation of misconduct, substandard practice, or unethical conduct;

(e) for apprentices, a change in supervision or designated supervisor; and

(f) for shops and schools, a change in name, location, controlling ownership interest, designated licensee, or floorplan, and

(g) for schools, the addition of an instructor, except substitutes.

Section 12-2 Mandated Reporters

Any hospital, clinic, community mental health center, or other health care institution in which a licensee performs professional services shall report disciplinary action against a licensee, as further specified by 3 V.S.A. § 128. A nursing home or long-term-care facility is a health care institution for purposes of this rule.

Section 12-3 Professional Standards

An administrative law officer may consider codes of ethics of established and nationally-recognized professional associations, as well as the degree of acceptance of a practice within the community of Vermont licensees, when determining "the essential standards of acceptable and prevailing practice" for purposes of 26 V.S.A. § 129a(b).

Section 12-4 Compliance with Other Law

Licensees must comply with all federal, state and local laws, codes, ordinances, and regulations as they apply to business operation, physical construction, and maintenance, safety, and public health.

Part 13 Sanitation and Safety

Section 13-1 Universal Standards

The standards set out under this Part (13) shall be observed by all licensees, shops, and schools, at all sites where professional services are provided:

(a) Disinfection and Storage of Implements. Single use, disposable articles should be used whenever possible. If non-disposable articles are used, they shall be disinfected after each use.

(b) Wet disinfection units. Portions of articles which come into contact with customers are to be disinfected by completely submerging them in a disinfectant solution. A wet disinfection unit must have a cover to prevent contamination of the solution. The solution must be an Environmental Protection Agency (EPA) registered hospital grade and tuberculocidal disinfectant solution. Disinfection is to be carried out in the following manner:

(1) remove hair and all debris from the object;

(2) wash thoroughly with hot water and soap;

(3) rinse thoroughly with clean water and dry thoroughly with a clean paper towel;

(4) fully immerse instruments into solution for ten (10) minutes; and

(5) after immersion, rinse articles, thoroughly dry with a clean paper towel and store in a clean pre-disinfected and dry cabinet, drawer, or non-airtight covered container, in a UV light cabinet, or leave instruments in an EPA registered disinfection/storage solution used according to manufacturer's directions.

(c) Isolation of Disinfected Articles. Undisinfected articles (i.e., pens, pencils, money, paper, mail, etc.) shall not be kept in the same container or cabinet as disinfected articles. For the purpose of recharging, rechargeable clippers may be stored in an area other than in a closed cabinet or container. However, such area is to be clean and the cutting edges of such clippers are to be disinfected.

(d) Clippers. Electrical clipper blades and scissors shall be appropriately sanitized after each use.

(e) Miscellaneous Materials. All materials including brushes, sponges, chamois, spatulas, galvanic electrodes, etc. must be cleaned with warm water and soap or detergent to remove all debris. Implements should then be rinsed thoroughly, dried with clean paper toweling, and completely immersed in an EPA registered, hospital-grade and tuberculocidal disinfectant solution. Such implements shall be soaked for ten (10) minutes or more, removed, rinsed, dried thoroughly and stored in a pre-disinfected drawer, cabinet or non-airtight covered container, in a UV light cabinet, or left in an EPA registered disinfection/storage solution used according to the manufacturer's directions.

(f) Wax Pots. All wax pots will be cleaned and disinfected with an EPA-registered, hospital-grade and tuberculocidal disinfectant solution with no sticks left standing in the wax at any time.

(g) Nail Technician Disinfection Units. Each working nail technician must have an assigned station appointed with a wet disinfection unit, a non-airtight covered receptacle, and a UV light cabinet or EPA-registered disinfectant/storage system. Large units may be shared by individual stations.

(h) Nail Implements. Nail brushes, nippers, finger bowls, disinfectable and/or washable files and buffers and other instruments must be washed in soap and water. Files are to be scrubbed with a brush to remove all debris. All instruments shall be rinsed thoroughly, dried with a clean paper towel, and then completely immersed in an EPA registered hospital grade and tuberculocidal disinfectant solution for ten (10) minutes after each use. After disinfection they must be rinsed, dried thoroughly with a clean paper towel, and placed in a pre-disinfected, non-airtight covered receptacle, cabinet or drawer, or in or a UV light cabinet, or left in an EPA registered disinfectant/storage system used according to manufacturer's directions.

(i) Drills. Drill bits are to be soaked and/or scrubbed with a wire brush to remove all debris. The drill bits must then be cleaned with warm water and soap or detergent. Drill bits should then be rinsed thoroughly and dried with a clean paper towel, and completely immersed in an EPA registered hospital grade and tuberculocidal disinfectant solution. Such implements shall be soaked for ten (10) minutes or more, removed, rinsed, dried thoroughly, and stored in a pre-disinfected drawer, cabinet or non-airtight covered container, in a UV light cabinet, or left in an EPA registered disinfection/storage solution used according to manufacturer's directions.

(j) Pedicure Water. Pedicure equipment that holds water for pedicures including whirlpools and spas, "pipe-less" units, foot baths, basins, tubs, sinks, and bowls, shall be cleaned and disinfected before use on each client.

(k) Pedicure Screens. Screens from pedicure equipment shall be cleaned at the end of each day and after the last client. Clean the screen with a brush and surfactant soap and water to remove all visible residues. Completely immerse the screen in either an EPA registered disinfecting solution or ten (10) minutes, or a 10% bleach solution for five (5) minutes.

Section 13-2 Facilities

Licensees are responsible to ensure that any shop, school, or facility that is the site of barbering, cosmetology, esthetics, or nail technician practice is clean and sanitary at all times. The following minimum standards shall be observed at all facilities:

(a) Floors. Floor surfaces in the immediate work area must be of a washable surface other than carpet. The floor must be routinely swept, kept clean, and free of hair, dropped articles, spills and electrical cords.

(b) Surroundings. Walls and ceilings in the immediate work area(s) must be in good repair, free of water seepage, stains, and dirt.

(c) Restrooms. A fully-functional bathroom must be readily available to customers. Such bathroom may not be shared with residential occupants and may not be a site of open storage of chemicals. Fixtures must be in good condition. The bathroom must be lighted and sufficiently ventilated. If there is a window, it must have a screen. Liquid soap and clean, individual towels must be available to clients. Laundering of towels is allowed, space permitting. The bathroom must not be used as a work area.

(d) Common Areas. General areas for customer use must be neat and clean with a covered waste receptacle for common trash.

(e) Accessibility. Access to and from the shop shall be safe, without chips or damage to stairs, have a handrail for access, and any mats must be secured or flat.

(f) Electrical Equipment. Electrical cords shall be placed to prevent tripping or entanglement. Electrical outlets shall be properly grounded and covered by plates.

(g) Plumbing. Hot and cold potable water shall be available. At least one sink exclusive of bathroom and kitchen facilities must be designated for the washing of hands and equipment.

(h) Ventilation. The shop area shall be sufficiently ventilated to exhaust hazardous or objectionable airborne chemicals, and allow the free flow of air.

(i) Lighting. Adequate lighting shall be provided.

(j) Fire Suppression. Whether or not protected by sprinklers, all facilities shall have a conspicuously-marked, charged ABC-class fire extinguisher of at least 5 lbs. capacity.

(k) Pests and Animals. All shops and immediate work areas shall be free of insects, rodents, or any type of animals. Animals may not be present in shops or schools, except bona fide service animals required by individuals with disabilities; provided, however, that schools may allow animals in areas not used for the provision of licensed services, if permitted by applicable law and regulation.

Section 13-3 Specific Equipment

The following sanitation practices shall be observed:

(a) Sinks. Sinks or shampoo bowls located within the working area shall be kept clean and sanitized after each use, and adequately supplied with soap or shampoo.

(b) Tables. Massage tables, manicuring tables, sinks/shampoo bowls, facial and waxing tables, apparatus for waxing and facials, tanning beds, ear piercing equipment, and any other objects which touch the client shall be sanitized or sterilized after each use.

(c) Work Surfaces. The top of work stands, back bars, service chairs, dryers and dryer chairs shall be routinely cleaned and sanitized. Work areas shall be uncluttered.

(d) Heated Appliances. Heat-producing appliances and equipment shall be placed so as to prevent any accidental injury.

(e) Electrical Appliances. Electrical appliances and equipment shall be in safe working order at all times, shall be supplied from a properly-grounded supply, and shall be protected with a ground-fault circuit interrupter (GFCI) device at the breaker or outlet.

Section 13-4 Use of Articles, Tools, and Products

The following standards shall be observed when handling articles, tools, and products:

(a) Susceptibility to Sanitation. Any multi-use article, tool or product which cannot be cleansed or sanitized is prohibited. Powder puffs, lip color, cheek color, sponges, or styptic pencils, which cannot be sanitized or sterilized, are not to be used on more than one client.

(b) Cleaning Between Clients. Tools, implements, linens, and multi-use articles shall be cleaned, sanitized and/or sterilized prior to use upon each client.

(c) Separation of Soiled Implements. Soiled implements must be removed from the tops of work stations immediately after use and deposited in a container made of cleanable, impervious materials.

(d) Sealed Containers. Lotions, ointments, creams, and powders shall be kept in closed containers.

(e) Manicure Equipment. A sanitary container or finger bowl shall be provided to each manicure client. Emery boards must be discarded after use.

(f) Hair Implements. Clippies, curlers, bobby pins, or hairpins must be sanitized after each use. If an object drops on the floor, it must not be used until it is sanitized or sterilized.

(g) Storage & Disposal. All sharp tools and implements and heat-producing appliances shall be safely stored. Any disposable sharp object, whether or not coming into contact with blood or other body fluids, shall be disposed of in an approved sharps container.

(h) Protection of Sanitized Implements. Pre-sanitized tools, implements, linens and equipment shall be stored for use in a sanitary enclosed cabinet or covered receptacle.

(i) Bleeding Control. No substance other than a sterile styptic powder or sterile liquid astringent approved for hemostasis, applied with a sterile single use applicator, shall be used to check bleeding.

(j) Bodily-fluid Contamination. Any disposable material coming into contact with blood or other body fluid shall be disposed of in a sealed plastic bag according to guidelines provided by the Vermont Department of Health and removed from the premises at least daily.

Section 13-5 Chemicals

The following chemical-safety practices shall be observed:

(a) MSDS. Shops and facilities shall have, in the immediate working area, a binder with all Material Safety Data Sheets (MSDS) for chemical products used. These are provided by manufacturers and shall be followed.

(b) Blood Kit. Shops and facilities shall have a blood spill clean-up kit in all work areas.

(c) Eye Wash. Shops and facilities shall have a plumbed eye wash or an eye-wash station consisting of one, 32-ounce bottle or two, 16-ounce bottles.

(d) Flammables. Flammable chemicals shall be isolated from potential sources of ignition and stored in a non-flammable storage cabinet or a properly ventilated room.

(e) Separation of Hazardous Chemicals. Chemicals which could interact in a hazardous manner (oxidizer, catalysts and solvents) shall be separated in storage.

(f) Prohibited Chemicals. No shop or school shall have on the premises cosmetic products containing hazardous substances which have been banned by the U.S. Food and Drug Administration for use in cosmetic products, including liquid methyl methacrylate monomer and methylene chloride. No product shall be used in a manner that is disapproved by the FDA.

Section 13-6 Licensee/Client Health

A licensee shall not perform services in such a manner as to expose himself, herself, or clients to suspected communicable diseases. A licensee shall not perform professional services on a client if the licensee or the client has a communicable or infectious disease or condition which could reasonably be expected to be transmitted during the course of rendering those services, such as tuberculosis, influenza, ringworm, scabies, head lice, pink eye, impetigo, poison ivy, poison oak, flu, strep throat, chicken pox, and viral infections. A licensee shall not perform services on a client or handle equipment that will be used on clients if the licensee has an open sore or other non-intact skin surface that may come into direct contact with the client or equipment.

Section 13-7 Health Department Requirements

In addition to any requirements set forth in this section, all licensees shall adhere to guidelines set forth by the Vermont Department of Health for the control of communicable or infectious diseases including blood-borne pathogens.

Section 13-8 New Technologies and Techniques

Beauty practices and technologies change constantly. Before applying a new technology or technique to any client a licensee shall establish that it is:

(a) lawful for use by the licensee and for the purpose offered;

(b) not marketed on the basis of false or misleading claims;

Section 13-9 Excluded Technologies and Techniques

No license issued under these rules authorizes the bearer to:

(a) use lasers for any purpose;

(b) perform cosmetic tattooing, permanent cosmetics, or microblading; or

Part 14 Discipline

Section 14-1 Unprofessional Conduct

Unprofessional conduct includes those acts set out at 3 V.S.A. § 129a (applicable to all professional licensees). Violation of these rules is cognizable as unprofessional conduct pursuant to 3 V.S.A. § 129a(a)(3).

Section 14-2 Remedies

Upon a finding by an administrative law officer that a licensee, applicant, or person who later becomes an applicant has committed unprofessional conduct, within or without this State, or has had a license application denied or a license revoked, suspended, limited, conditioned, or otherwise disciplined by a licensing agency in another jurisdiction for conduct which would constitute unprofessional conduct in this State, or has surrendered a license while under investigation for unprofessional conduct, the Director may warn, reprimand, suspend, revoke, limit, condition, deny, or prevent the renewal of a license. See 3 V.S.A. § 129(a). A license may be summarily suspended pending further proceedings, consistent with 3 V.S.A. § 814(c), upon a finding that public health, safety, or welfare imperatively requires emergency action.

Section 14-3 Non-masking

A shop or school may not evade license discipline by re-incorporating or changing its trade name following discipline. Where the principal, principals, or controlling management of a shop or school that has been the subject of discipline establish any other shop or school, the Director may attach related disciplinary cases to the new shop or school in all public lookup tools.

Section 14-4 Reinstating Licenses

A license which has expired may be reinstated by submitting an application to the Board and paying a renewal fee plus a late renewal penalty.

Section 14-5 Long term lapses

If more than three (3) years has passed between license expiration and a request for reinstatement, an applicant who is not eligible for licensure by endorsement must successfully complete the Vermont Board of Barbers and Cosmetologists practical, written, and state laws and rules examinations. Applicants should contact the Board Office for instructions on how to renew an expired license.

Part 15 UNPROFESSIONAL CONDUCT

Section 15-1 Complaints of Unprofessional Conduct

The Board follows Office procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure, complaint forms and more information about the complaint process may be obtained from the Office or via the Office of Professional Regulation web site, http://vtprofessionals.org.

Section 15-2 Grounds for Discipline

(a) 3 V.S.A. § 129a defines unprofessional conduct for all professions including those governed by these rules and the statutes governing those subject to these rules. Whenever its provisions are in conflict or overlap with the statutes specifically governing these professions, or these rules, the provisions which provide the most safety to the public shall apply. Chapter 6 of Title 26 of the Vermont Statutes contains specific definitions of unprofessional conduct for the professions subject to these rules.

(b) The Board also has authority to decide complaints of unauthorized practice as indicated in 3 V.S.A. § 127.

Section 15-3 Sanctions for Unprofessional Conduct

Possible disciplinary actions the Board may impose on the license of a person subject to these rules may include:

(1) denial of a license;

(2) warnings or reprimands;

(3) suspension for a period of time to be determined by the Board;

(4) revocation;

(5) limitations on practice;

(6) setting conditions for practice or resumption of practice;

(7) denial of reinstatement; and/or

(8) imposition of a civil penalty of up to $ 1,000 for each instance of unauthorized practice or unprofessional conduct.

Section 15-4 Public Records

All Board decisions on disciplinary complaints are public records. Unprofessional Conduct decisions are available online or from the office. 26 V.S.A. § 276

History

August 10, 1998 Secretary of State Rule Log #98-51
AMENDED:
November 7, 2005, Secretary of State Rule log #05-043; December 22, 2020 Secretary of State Rule log #20-042.

Chapter 040 BOXING CONTROL BOARD RULES

04-040 Code Vt. R. 04-030-040-X BOXING CONTROL BOARD RULES

Part 1 GENERAL INFORMATION

Part 2 INFORMATION FOR APPLICANTS

Section 1.1 NEED FOR A LICENSE

You are not allowed to hold or conduct or participate in a boxing contest or training exhibition in Vermont unless you are currently licensed by the Board. You will need a license to participate as a contestant, second, manager of professional contestant, matchmaker, promoter, referee, or judge in any boxing contest or training exhibition.

Section 1.2 WHERE TO GET AN APPLICATION

If you would like an application for a license or more information about the application process, call or write the Division.

Section 1.3 HOW TO GET A LICENSE

(1) Complete your application and send it with the correct fee.

Call or write the Division for an application. When you receive the application, complete it fully and accurately. Then look at the fee schedule included with your application and set out below to find the amount of the fee. The Board is authorized to issue licenses and renewals according to the following fee schedule:

For professional contestants and seconds, $ 5.00 per year;

For managers of professional contestants, $ 15.00 per year;

For promoters of amateur or professional bouts, $ 25.00 per year; and in addition, for out-of-state promoters, $ 10.00 for each show;

For professional referees, $ 10.00 per year; and for such other occupations as the Board may by regulation prescribe, $ 10.00 per year;

No fee shall be required for licenses for judges; they shall be appointed by the Board as capable of judging boxing bouts;

No fee is charged for participants in amateur boxing contests other than promoters, although an annual license is required.

Make out a check for the correct amount to the "Vermont Boxing Control Board". Mail the application and your check to: Vermont Boxing Control Board, Office of the Secretary of State, Division of Licensing and Registration, 109 State Street, Montpelier, Vermont 05602.

(2) File a Bond.

If you are an out-of-state promoter, you must file a surety bond with the Vermont Secretary of State. The principal sum of the bond is $ 500.00. You must submit a proof to the Board that you have filed the bond. The Board may accept in lieu thereof cash or certified check in equal amount, conditioned on the faithful performance by the promoter of the provisions of 31 V.S.A. Chapter 3, and these rules, the fulfillment of contracts with contestants and their managers, and the payment of license and permit fees and taxes on gross receipts.

(3) Receive notification.

Once you submit an application, you should receive notification, within 30 days, of our decision on your application. We shall issue you a license if you meet all the requirements. You must have a copy of this license with you at times during a boxing contest or training exhibition.

Section 1.4 TAX ON CONTESTS

According to 31 V.S.A. § 108, any person or corporation holding or conducting any boxing contest, for which an admission fee is charged or received, shall notify the Board not less than five days in advance of the holding of such contest, and after the holding of such contest shall pay forthwith to the Board a sum, designated as a "gate tax", which shall be an amount equal to five percent of the gross receipts, exclusive of any federal tax thereon. Payments of money required by this section shall be accompanied by reports in such form as shall be prescribed by the Board. All tickets of admission to any such boxing contest shall bear clearly on the face thereof the purchase price.

Section 1.5 RULES FOR PROFESSIONAL BOXING CONTESTS

(1) The Board has the power to supervise and regulate boxing contests and training exhibitions under Vermont Statutes Annotated, Title 31, Chapter 3. For the safety and welfare of participants in boxing contests, the Board has promulgated these rules and regulations pursuant to 31 V.S.A. § 103 in order to carry out its statutory mandate.

(2) No boxing contest shall be conducted except in the city, town, or village specified on the license issued and in such places in the city, town, or village as the Board approves.

No boxing "exhibitions" shall be allowed without special permission from the Board.

(3) All applications for licenses shall be made on forms furnished by the Board. Associations or persons holding licenses issued by the Board shall not lend out the license nor conduct a contest under any name other than that stated in the license.

(4) The following shall be the age limits for boxers:

(a) Minimum Age. The minimum age for an individual to qualify as a professional boxer is eighteen years.

(b) Maximum Age. No contestant who has reached his thirty-fifth birthday shall be permitted to engage in any boxing or sparring match or exhibition, unless given specific approval by the Board, except that this age requirement shall not apply to a boxing champion of the world who is still active as a professional boxer, or to a former boxing champion of the world who has not been inactive as a professional boxer for more than two years from the date of his last boxing contest. The foregoing shall not apply to courses of instruction in boxing, boxing or sparring matches, or exhibitions, sponsored and conducted by recognized boys' clubs, schools, or colleges, or by municipal or state parks or recreational departments, under the supervision of qualified instructors or directors.

The Board may, at any time, demand such information concerning an applicant's or a licensed boxer's mental or physical condition as it shall deem necessary. Such information may be in addition to that required in physical examinations under other rules of this Board. At the boxer's expense, the Board may demand a complete physical examination consisting of EKG, Stress Test, CAT scan, X-ray, blood, and urine tests. Each boxer must complete a medical information history, physical and mental.

(5) Boxing contests shall not exceed ten rounds in length, but if such contests are to determine championships, they may, at the discretion of the Board, exceed ten rounds in length but not fifteen. No contest to determine a State championship shall be scheduled for less than ten rounds. No round in any contest shall exceed three minutes. All main bouts or feature bouts shall consist of three-minute rounds.

(6) The boxing ring shall be not less than 16 feet nor more than 24 feet square within the ropes, and shall be formed of posts and ropes, the latter extending in triple lines 18 inches, 25 inches, and 52 inches from the flooring of the ring. The floor of the ring shall extend beyond the lower rope a distance of not less than 2 feet on all sides. The posts shall be properly padded, ropes wrapped in soft material, and be not less than 1 inch in diameter. The floor padding shall extend to and around the outside edge of the flooring or apron of the ring, and shall be not less than 1 1/2 inches in thickness of ensolite or foam rubber or 2 inches of dura-foam or an equivalent to 2-inch thickness. Padding should be canvas covering to protect boxers against accident or injury. When the floor of the boxing ring is not elevated at least 3 feet above the floor of the building, there shall be a clear space of 4 feet from the posts on all sides of the ring. Within the limits stated, the size and condition of the ring to be used in specific places, or on specific occasions, shall be subject to the approval of the Board.

(7) All contests shall be conducted under the Marquis of Queensberry rules, except where changed or modified by rules or orders of the Board.

RULES FOR CONTESTANTS

(8) To participate as CONTESTANT in a professional boxing contest in Vermont you must be licensed by the Vermont Boxing Control Board. To obtain a license from the Vermont Boxing Control Board, write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. The fee for contestant in a professional boxing contest is $ 5.00 per year.

(9) No contestant under the same management as his opponent shall be permitted to engage in any contest.

(10) No collection shall be made at any contest unless permission in writing has previously been obtained from the Board.

STANDARD OF WEIGHTS

(11) The following is the Vermont Boxing Control Board standard of weights:

| Pounds | | | --- | --- | | Flyweight | 112 | | Bantamweight | 118 | | Featherweight | 126 | | Jr. Lightweight | 130 | | Lightweight | 135 | | Jr. Welterweight | 140 | | Welterweight | 147 | | Jr. Middleweight | 154 | | Middleweight | 160 | | Light Heavyweight | 175 | | Cruiserweight | 190 | | Heavyweight | All over 190 |

No contest shall be permitted when there is a difference in weight of more than the following:

| Pounds | | | --- | --- | | Flyweight | 3 | | Bantamweight | 4 | | Featherweight | 5 | | Light Heavyweight | 7 | | Welterweight | 10 | | Middleweight | 12 | | Light Heavyweight | 15<1> | | Heavyweight | No restriction |

(12) The commissioner, a person appointed by the commissioner, or his assigned delegate in attendance, shall weigh cach contestant using suitable scales to be furnished by the promoter. He shall see that the weights of opposing contestants comply with Rule 1.5(11) of these rules. If the weights do not comply with Rule 1.5(11), the commissioner shall notify the promoter.

(13) The Board shall consider it cause for suspension if a manager does not notify a promoter, at least 48 hours before a contest, if a boxer managed by him cannot for some valid reason participate in a contest for which he had made oral agreement or written contract; and any boxer who manages himself may be suspended if he does not fulfill his agreement or contract to box, or notify the promoter at least 48 hours in advance of the contest that he cannot, for some valid reason, participate.

(14) No contestant shall participate in more than one contest during any period of 48 hours.

(15) All bouts shall be decided by the round system. A boxer shall be credited either with a win, a loss, or a draw at the end of each round. At the end of the bout the boxer winning the greatest number of rounds shall be declared the winner; or if judged by points, ten points shall be the maximum number to be scored in any round. The contestant winning the round shall receive five points and his opponent proportionately less. If the round is even, each contestant shall receive five points.

In accordance with the rules, the awarding of any round, or the contest, in the case of a draw, shall be based on four factors to be scored in the following order:

(a) Clean hits;

(b) Effective aggressiveness;

(d) Ring generalship.

Sportsmanship should be taken into consideration by the officials, as well as the condition of the boxer at the end of the bout.

The items listed do not have the same scoring value. Clearly, a man who hits his opponent and is aggressive throughout the contest is entitled to more credit than one who is merely defensive and shows ring generalship.

If the referee or the Board should decide, at any time, that either contestant did not enter into a contest in good faith, or if the Board or referee discovers, at any time, that either or both contestants are not performing their part in good faith, or are guilty of any foul tactic, or of faking, or of violating any rule of the Board, the referee or Board may stop the contest.

The referee or the Board may stop the contest when either contestant shows marked superiority or is apparently outclassed.

If a contestant is knocked down, or falls through weakness, he must get up unassisted within ten seconds. The referee shall count off the seconds. If the contestant attempts to get up and goes back down, the count shall be continued by the referee where he left off. During the count, the opponent shall go to the farthest neutral corner and remain there. Should the opponent refuse to do so, or leave the farthest corner, the referee may stop counting. After compliance by the opponent, however, the referee shall continue counting where he left off.

If a contestant who has fallen out of the ring during a contest fails to return by the count of "10", the referee shall count him out as if he were "down".

In every round but the last round of a bout, should a boxer be down at the time the bell rings ending the round, the count shall continue until the boxer gets up or is counted out.

Three knockdowns in the same round shall constitute an automatic knockout. The termination of the bout is at the discretion of the referee or the Board.

Should a contestant leave the ring during the one-minute period between rounds, and fail to be in the ring when the gong rings to resume boxing, the referee shall declare his opponent the winner.

A contestant shall be deemed "down" when:

a. Any part of his body, other than his feet, is on the floor; or

b. He is hanging helplessly over the ropes; or

c. He is rising from a "down" position.

Should a contestant finish any one round of a contest and fail to answer the bell for the succeeding round for any one of numerous reasons, such as cuts, injuries, or admission of overwhelming superiority, the proper termination of the bout is by a technical knockout in the round for which he fails to answer the bell.

For instance, both contestants have finished round 6. One of them fails to answer the bell for round 7, or indicates to the referee that he will not answer the bell. It is a "TKO-7". Indeed, the man should be regarded as technically counted out while seated in his corner just as though the bell sounded for the seventh round. Certainly he completed round 6 and cannot, therefore, be charged with a loss in the sixth.

A boxer suffering a knockout shall automatically be suspended for a period of 30 days and shall have a physician's medical examination, a neurosurgical examination, and a scan of the head within 24 hours. The boxer shall immediately surrender his license to the Board. The attending physician shall determine whether the boxer was knocked out.

(16) The referee shall collect the judges' cards and present them to the commissioner in attendance to be checked. The referee shall then announce, or shall cause to be announced, to the public, the name of the winning contestant, according to the majority vote, and unless the decision be unanimous, the individual score of each official for each contestant shall be announced. In the event there is no majority vote, the decision shall be a "Draw".

(17) All division titles must be defended, at least every six months, when a suitable opponent is willing and available.

(18) Wagering on contests is prohibited in any arena under the jurisdiction of the Board.

(19) Only beverages served in paper or plastic foam cups may be sold in the hall where boxing contests or exhibitions are conducted.

(20) Contestants shall box in proper athletic costume, including a foul protection cup of a type satisfactory to the Board and the contestant. The cup shall be firmly strapped to the body before leaving the dressing room.

Each contestant shall supply himself with a pair of trunks, loose fitting and made of light cloth, similar to athlete's "running pants". The belt of the trunks shall not extend above the waist line. Each contestant shall wear an abdominal guard of standard type approved by the Board which provides sufficient protection to withstand any so-called low or illegal blow that might temporarily incapacitate a contestant.

Shoes of soft material must be worn and must not be fitted with spikes, cleats, hard soles, or hard heels. Shoelaces shall be held in place by a strip of adhesive tape around the shoe tops.

While performing, boxers must wear mouthpieces for the protection of tongue and teeth. This regulation shall be enforced by the referee.

The hands of a contestant shall be covered by layers of soft bandage. Bandages shall be restricted to soft cloth not more than 10 yards in length and 1 1/2 inches in width, held in place by not more than 5 yards of surgeon's tape 1 inch in width, for each hand, in all classes. These bandages shall be adjusted in the dressing room in the presence of a Board official and both contestants. The use of a pad of either soft or hard tape over the knuckles shall constitute a violation of this rule.

In all contests the gloves used must weigh not less than 8 ounces each.

(21) All licenses issued by the Board must be shown to officials when requested.

(22) All boxers must be certified as physically fit by a licensed physician.

(23) In a championship match, if the champion is overweight and the challenger meets the weight requirements, the titleholder loses his crown at weighing-in time. The bout then goes on as an overweight match and if the challenger wins, he is recognized as the new champion. When both challenger and champion are overweight, the title is vacant. If the title is vacant and one challenger is overweight while the other meets the weight requirements, the title remains vacant.

(24) No drug, alcohol in any form, stimulant, injection, depressant, or analgesic of any kind shall be applied, administered, or given to any contestant before or during a boxing contest. Use of standard agents or compounds for the control of excessive bleeding are exempt from this rule. Stimulants in the form of liquids that have a food value may be given internally, provided that these have been presented to the commissioner in charge. Any and all substances or liquids used, or samples thereof, may be taken for analysis by the commissioner in charge.

(25) The Board may bar, for up to a lifetime period, any participant who conspires to break these rules and regulations.

RULES FOR PROMOTERS

(26) To participate as PROMOTER in a professional boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. The fee for promoter of a professional contest is $ 25.00 per year.

(27) A promoter must study, and become thoroughly familiar with, the contents of this booklet.

(28) A promoter must notify the Board about the main bout at least 48 hours beforehand.

(29) All bouts must first be approved by the Board. Before the commencement of any bout, the promoter shall furnish the Board with a contract, or a signed copy of a contract, between the promoter and the boxing contestants.

Before acting on any application for a license the Board may, in its discretion, examine, under oath, the applicant and other witnesses. At the time of submitting a match for approval, promoters of professional boxing matches shall submit to the Board a record of the proposed boxers in the match, including the last six contests in which each proposed boxer participated, together with location of bout, date, and results. Matches shall not be approved unless this is done.

(30) Send check or money order to cover the 5% gate tax on your gross receipts, to the Office of the Secretary of State, exclusive of any federal tax thereon. Payments of money required by this section shall be accompanied by reports in such form as prescribed by the Board. All tickets of admission to any such boxing contest shall bear clearly on the face thereof the purchase price.

(31) Promoters must determine that all contestants, seconds, managers, and officials are duly licensed before permitting them to participate in any capacity at any boxing contest. Promoters shall be held liable for all unpaid fees.

(32) No person connected with the promotion of professional boxing may have anything to do with the management of boxers; and no persons involved in professional boxing as managers, boxers, trainers, or seconds, shall have anything to do with the promotion of such bouts.

(33) A promoter must keep a sufficient quantity of all types of application blanks and forms on hand. Apply to the Board for more when your supply runs low.

(34) No return bout guarantee clause shall be written into any championship fight contract without special permission of the Board.

(35) No promoter shall advertise or declare for publication that any match is to be held to determine a State Championship until he has secured the approval of the Board.

(36) All requests for championship matches must be in writing and must be received by the Board at least one full week before the scheduled date of the bout.

(37) Promoters are required to file with the Board copies of the contracts with both contestants, or their managers, before approval of a State Championship match will be granted. These contracts shall accompany the written request for approval, and must indicate that all parties concerned understand and agree that the bout shall determine a championship.

(38) A promoter shall be required to pay to a boxer a sum not less than 1/3 of his agreed purse in any case where a boxer appears ready and able to fulfill his agreement or contract to box but, through no fault of his own, does not appear on the program. This ruling shall not apply if the boxer received notice from the promoter 24 hours in advance of the contest that, for some valid reason, his services could not be used at the agreed place and time.

All boxers licensed as such by the Board shall be covered by accident insurance, provided by the promoter, in the event of injury or death while competing in a properly licensed boxing or sparring match or exhibition. Such insurance shall be covered by a policy to be issued by a recognized insurance company with prior approval of the Board as to form, premium, and coverage. Promoters must supply the commissioner with a Certificate of Liability Insurance at least 10 days before a match.

(39) Promoters shall provide adequate police protection at all contests.

(40) One or more licensed physicians shall be provided with a ring-side seat, and shall be required to remain at ring-side until the end of the final bout.

(41) The judges will be provided with seats at ring-side, on opposite sides of the ring, preferably on a raised dais or platform commanding a clear view of the entire ring area. They shall be isolated by at least the space of one seat on each side and to the rear.

(42) The names of the referee and judges shall be announced to the public over a public address system or from the center of the ring before the start of the contest. Any change of officials made during the program shall be similarly announced.

(43) Promoters must provide a foolproof protection device of standard make for all contestants. A minimum of four are to be kept on hand at all times.

(44) Promoters shall supply suitable watches for timekeepers.

(45) Promoters shall provide a suitable stretcher at ring-side at all times for emergency use and for ambulance staff members of the rescue squad.

(46) At no time shall a promoter schedule a bout between a professional boxer and an amateur boxer or the amateur will lose his amateur standing.

(47) Any promoter, referee, second, boxer, or manager, who, in the judgment of the Board, is guilty of intentional conniving at or participation in any prearranged or "fake" contest shall forfeit his license and shall not again participate in any capacity in boxing unless a new license is subsequently issued to the offending party.

(48) Gloves for all main events shall be new and furnished by the promoter.

RULES FOR MANAGERS AND SECONDS

(49) To participate as a MANAGER or SECOND in a professional boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. The fee for a manager of a professional contest is $ 15. 00 per year. The fee for a second is $ 5.00 per year.

(50) Any person who negotiates with a promoter, copromoter, or matchmaker for the services of a boxer shall be considered a manager by the Board, and shall be required to obtain the proper license.

(51) The Board requires copies of all existing bona fide contracts between managers and boxers to be filed in the Office of the Board before a manager's license will be granted. All managers shall have a written contract with all boxers under their control and a copy of the original contract shall be filed with the Board.

If a manager after securing a license should sell all his existing contracts, he must surrender his manager's license to the Board until such time as he has another Vermont licensed boxer under contract. At that time his license will be returned, or if expired he may purchase a new license.

(52) A contestant's manager or managers shall not be permitted to participate in more than thirty-three and one third (33 1/3) per cent of the contestant's earnings.

(53) Managers or seconds shall not coach or instruct their boxers by gesture or word of mouth during the progress of the rounds. No more than three seconds to be allowed in one corner.

(54) Managers or seconds are not to throw into the ring a towel, sponge, or any article as an acknowledgment of defeat. A manager or second may, however, ask the referee to stop a bout to protect a contestant from serious injury at the end of the round.

(55) Any profanity or disobedience of the referee's instructions during the progress of a contest shall be deemed sufficient cause for removal of a contestant's manager or second from the corner.

(56) A manager or second of a contestant may be present to examine the application of the bandages and tape to the hands of the opposing boxer and may accompany the boxer to the ring until the referee takes charge.

(57) Managers who sign or orally agree for their boxers to fight when they know they are improperly conditioned or physically inadequate shall be subject to suspension by the Board.

RULES FOR REFEREES

(58) To participate as REFEREE in a professional boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. The fee for referee of a professional contest is $ 10.00 per year.

(59) Every new applicant for a referee's license, or any applicant who has been inactive for three years, shall furnish the Board with satisfactory proof of physical fitness before the application shall be considered.

(60) At every boxing contest there shall be in attendance a duly licensed referee, who shall direct and control the contest and shall not referee more than twelve consecutive rounds.

(61) The referee shall study, and become thoroughly familiar with, the contents of this booklet. Particular attention should be paid to Rule 15.

(62) No active boxer, manager, promoter, or second shall be allowed to hold a license as a referee.

(63) The referee shall have full power to stop a contest whenever he deems it advisable because of the physical condition of the contestant or contestants, or when one of the contestants is clearly outclassed by his opponent, or for other sufficient reasons.

(64) If, in the referee's opinion, any contestant or contestants are not or were not competing in good faith, that official, after consulting with the commissioner in attendance before reaching such a decision, may by announcement to the public withhold any prize, remuneration, or purse, or any part thereof, belonging to the contestant, or contestants. The referee shall then notify the promoter of such action. The impounded purse or prize shall be held by the Board and the contestant or contestants involved shall be granted a hearing before the Appeals Panel if requested in writing within thirty days.

(65) Hitting below the belt; hitting an opponent who is down or rising after being down; holding an opponent with one hand and hitting with the other; holding or deliberately maintaining a clinch; wrestling or roughing at the ropes; pushing an opponent about the ring or into the ropes, or striking an opponent who is helpless as a result of blows and so supported by the ropes that he does not fall; butting with the head or shoulder or using the knee or elbow; hitting with the open glove, or with the heel of the glove and hitting with the back of the hand; purposely going down without being hit or for the purpose of avoiding a blow; striking deliberately at the part of the body over the kidney; the use of the pivot or rabbit punch; jabbing opponent's eyes with the thumb of the glove; the use of abusive language in the ring; and any unsportsmanlike trick or action causing injury to an opponent are fouls and shall not be tolerated by the referee.

(66) The referee may penalize a boxer one or more points for striking a foul blow. At the conclusion of the round in which the foul blow is delivered, the referee shall inform the judges and the public of the number of points he has taken from the score of the offending boxer.

(67) A contestant who persists in using foul tactics may be disqualified by the referee and his purse forfeited.

(68) In case of a deliberate foul, so designated by the referee, a boxer's license may be suspended for a period of time to be determined by the Board.

(69) In his instructions to the contestants prior to each bout, the referee shall caution both contestants to retire to the farthest neutral corner, at his direction, immediately upon scoring a knockdown, and to remain there until the signal to resume boxing is given, or until the count is completed, or the bell has rung terminating the round. After having so instructed both contestants, the referee is authorized to hold his count in the event any boxer who has scored a knockdown refuses to retire to the proper corner to await the signal, the count, or the bell as the case may be. The knockdown timekeeper shall not start the split-second hand to time the knockdown until the referee so indicated by his first count.

In all bouts except championship bouts, if the contestant who is down rises during the count, the referee shall continue to count to "8" and assure himself that the contestant is in fit condition to continue. If so assured, he shall without loss of time order both contestants to go on with the contest. During such intervention by the referee, the striking of a blow by either contestant may be ruled "foul". This is the mandatory "8" count.

(70) Referees are instructed to stop any bout in which a boxer has been knocked down three times in one round as the result of a blow. This rule may be waived in championship bouts. The rule does not apply to a boxer who slips or falls down from being off balance.

(71) Should a boxer be knocked down by a blow that, in the opinion of the referee, was a foul blow, the referee may stop the contest at that point. He will award the decision to the boxer suffering the foul blow, other than the so-called "low blow", as explained in Rule 72.

(72) Should a boxer be knocked down by a blow that he claims to have been foul, but that, in the opinion of the referee, was not foul, the referee shall pick up his count as usual in the event of a knockdown.

All contestants shall agree to equip themselves with an approved and foul-proof protection cup that will obviate the necessity of any claims being made for low blows during a contest. It is to be expressly understood that no contest will be terminated by a "low blow", as the protector selected by the boxers is, in their own opinion, sufficient protection to withstand any so-called "low blow" that might temporarily incapacitate them.

(73) If at the end of a regulation round a boxer is "down" and the referee is in the course of counting, the gong indicating the end of the round shall be sounded to commence the one-minute rest period.

(74) When a boxer has been knocked unconscious, the referee shall immediately remove that contestant's mouthpiece.

If, in the opinion of the referee, a fallen boxer has been so seriously injured that removal to his corner might prove injurious, he shall request that the physician examine the boxer in the ring before permitting his removal.

(75) A contestant who has been knocked through or over the edge of the ring platform during a contest shall not be helped back by his manager or seconds. The referee shall begin to count, in accordance with Rule 69 of the Rules for Referees, as soon as the contestant leaves the inside of the ring ropes. If the contestant fails to return by the count of "10", he is knocked out. The same procedure shall apply to a contestant who leaves the ring during the progress of the bout under any circumstances.

When one contestant has fallen through the ropes, the other shall retire to the farthest neutral corner and remain there until the count is completed or his opponent is on his feet in the ring.

A contestant who deliberately wrestles or throws his opponent from the ring, or who hits him when he is partly out of the ring and prevented by the ropes from assuming a position of defense, may be disqualified.

In case of serious injury to a contestant, the referee shall automatically be under suspension until investigation by the Board establishes whether the injury was the result of negligence or incompetence on the part of the referee or of circumstances not reasonably within his control.

(76) When a contestant fails to answer the bell for a round "coming up", his opponent shall be credited with a "T.K.O." in the round that is "coming-up" and not in the preceding round that has been fought.

(77) In all contests the gloves used must weigh not less than 8 ounces each.

The referee shall examine the gloves and protectors of each contestant before the start of the contest. This shall include the correct insertion of a mouthpiece. He shall determine that the gloves have not been "broken", nor the padding over the knuckles removed, and new gloves substituted. If the gloves have been used in other bouts, they must be whole, clean, and in sanitary condition if to be used again. The referee shall inspect each boxer's gloves and make sure that no foreign detrimental substances have been applied to either the gloves or the bodies of the boxers.

The referee may also inspect the bandages of contestants and each contestant may be permitted to inspect the bandages of his opponent. The purpose of the bandages is to protect the hand and not to add force to a blow.

(78) Referees shall not permit unfair practices that may cause injury to a contestant, and will be held strictly responsible for enforcing these rules.

RULES FOR JUDGES

(79) To participate as JUDGE in a professional boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration; Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. No fee will be charged for the license. All judges shall be appointed by the Board as capable of judging boxing bouts.

(80) At every professional contest there shall be in attendance two or more duly licensed judges.

(81) No active boxer, manager, promoter, or second shall hold a license as a judge.

(82) The judges must be familiar with the Vermont Statutes and the Rules and Regulations of the related to boxing. Particular attention shall be given to Rule 15 describing the point system and its application.

(83) Upon notification by the referee of a penalty imposed for a foul, at the end of the round each judge shall follow the instructions of the referee in deducting one or more points from his score for the boxer committing the foul. Each judge shall mark a "P" (for Penalty) beside his original score, then he shall mark the new score in the space provided for that round.

(84) When a contestant fails to answer the bell for a round "coming up" his opponent shall be credited with a "T.K.O." in the round that is "coming up" and not in the preceding round that has been fought.

(85) Judges shall not confer with each other during the contest, nor express in any way to anyone their opinions as to the winner, except by final written vote.

RULES FOR PHYSICIANS

(86) Within ten hours before each contest, the PHYSICIAN shall examine each contestant, and shall report on the condition of each contestant. If, in his or her opinion, the condition of any contestant is not favorable, the physician shall notify the promoter at once, and shall so report over his or her signature.

(87) It shall be the duty of the physician to remain at the scene of the contest until he has ascertained that no serious injuries have been received by any contestant, or until such injuries have been given attention.

All injuries shall be reported and registered by the physician at the office of the Vermont Boxing Control Board, Office of the Secretary of State, Division of Licensing and Registration, 109 State Street, Montpelier, Vermont 05602, with any recommendations.

(88) Among other things, the physician shall provide himself with a stethoscope, manometer, sterile syringe with medication for relieving pain, alcohol, cotton, gauze, ice bag, and aromatic ammonia (capsules).

(89) During the progress of the bout, the physician shall remain at ring-side in a seat to be provided by the promoter, and shall have his medical kit immediately available.

(90) Any boxer who suffers a concussion shall be automatically suspended 30 days. Any boxer who suffers a knock out shall also be automatically suspended for 30 days.

(91) No contestant shall be allowed to engage in any boxing contest if the following conditions be found by the physician:

(a) Any hernia, or bubonocele;

(b) Organic heart murmurs;

(d) Temperature over 98.8;

(e) Systolic pressure over 150;

(f) Infectious skin lesions, such as boils or infected wounds;

(g) Recent wounds, especially on face and ears;

(h) Hand injuries, and fractures less than six weeks old, if, in the physician's opinion, the injury would be detrimental;

(i) Use of narcotics, drugs, stimulants, depressants, or analgesics of any description; or

(j) Any other medical reason deemed sufficient by the physician.

RULES FOR TIMEKEEPERS

(92) TIMEKEEPERS shall be responsible for each round being of exactly equal duration as announced before such contest, with rest periods of one-minute's duration. Timekeepers shall not leave the gong until the completion of a contest. The call "Get Ready" shall be given 10 seconds before the round starts.

(93) When a contestant is knocked down and takes the count, if the round ends before the count is completed, the timekeeper shall indicate the end of the round in accordance with Rule 73 of the Rules for Referees.

RULES FOR KNOCK-DOWN TIMEKEEPER

(94) When one of the contestants is knocked down and takes the count, the KNOCK-DOWN TIMEKEEPER shall start the split-second hand with the first count of the referee. The timekeeper shall tell the count in a standing position and in a clear voice, causing his hand to go up and down with the count. The referee shall make similar motions in unison with the timekeeper until the contestant rises or the expiration of the count of ten; which should be equivalent to a period of ten seconds. If there is a variation between the two officials, the knock-down timekeeper shall announce the expiration of the ten seconds, which shall be considered official. In case the round ends before the ten seconds are completed, the timekeeper shall indicate the end of the round in accordance with Rule 73 of the Rules for Referees.

(95) If the contestant who is knocked down rises during the count, the knock-down timekeeper shall continue to count to "8" with the referee. This is the mandatory "8" count rule.

PHYSICAL AND MENTAL CONDITION

(96) The Board may deny, revoke, or suspend the license of any boxer because of his physical or mental condition. For the purpose of this rule, the Board shall be deemed to have acted properly if the Board shall by personal observation, medical reports, psychological reports, past records, or from other information bearing on his physical or mental condition, determine that it would be injurious to the boxer's physical or mental health to participate in a boxing contest. At the boxer's expense the Board may demand a complete physical examination consisting of an EKG, Stress Test, KAT scan, X-ray, blood and urine tests. Each boxer must complete a medical information history both mental and physical.

If the Board suspends or revokes a license and such suspension or revocation could extend for a period of time in excess of 30 days, the boxer may request a hearing before the Board and offer what evidence he shall have bearing on his physical or mental condition. If after a hearing the Board is satisfied that the disqualifying condition does exist and is expected to persist, it may indefinitely suspend, revoke, or deny a license to the boxer. Any decision of the Board may be appealed to the Appeals Panel within 30 days.

In the event that any commissioner shall observe or have notice of any such physical or mental condition existing within 10 hours of any scheduled bout, the commissioner shall have the authority to suspend immediately the boxer's license for a 48-hour period. If the Board fails to affirm such suspension, the suspension shall expire after the 48-hour period has elapsed.

Section 1.6 RULES FOR AMATEUR BOXING CONTESTS

(1) The Vermont Boxing Control Board has the power to supervise and regulate boxing contests and training exhibitions under Vermont Statutes Annotated, Title 31, Chapter 3. For the safety and welfare of participants in boxing contests, the Board has promulgated these rules and regulations pursuant to 31 V.S.A. § 103 in order to carry out its statutory purpose.

(2) No boxing contest shall be conducted except in the city, town, or village specified in the permit issued and in such places in the city, town, or village as are approved by the Board.

No boxing "exhibitions" shall be allowed without special permission from the Board.

(3) All applications for license must be made on forms furnished by the Board. Associations or persons holding licenses issued by this Board shall not lend out the license nor conduct a contest under any name other than that stated in the license.

(4) The following shall be the age limits for boxers:

(a) Minimum Age. The minimum age for an individual to qualify as an amateur boxer is 12 through 15 for the junior class and 16 years of age for the senior or open class.

(b) Maximum Age. The maximum age at which an individual may qualify as an amateur boxer shall be at the sole discretion of the Board. The Board may, at any time, demand such information concerning an applicant's mental or physical condition as it deems necessary. Such information may be in addition to that required in physical examinations under other rules of this Board. At the boxer's expense the commission may demand a complete physical examination consisting of an EKG, Stress Test, KAT scan, X-ray, blood and urine tests. Each boxer must complete a medical history, both mental and physical.

(5) No contestant shall be permitted to participate in any amateur boxing contest on more than two days in any seven, except in official-sanctioned tournaments requiring more than two days to complete.

(6) All officials taking part in amateur contests shall be licensed by the Board.

(7) The boxing ring shall be not less than 16 feet nor more than 24 feet square within the ropes. The floor of the ring shall extend beyond the lower rope a distance of 2 feet on all sides. The ring shall not be more than 4 feet above the floor of the building or grounds of an outdoor arena, and shall be provided with suitable steps for the use of contestants, coaches, and officials. The ring shall be equipped with at least 3 ropes. The ropes shall be not less than 1 inch in diameter. Such ropes shall be manila rope, synthetic, plastic rope or any similar material, and shall not be made of metal of any type. All ropes shall be wrapped securely in soft material. If 3 ropes are used, they shall extend in triple parallel lines 2, 3, and 4 feet above the ring floor. If 4 ropes are used, the lower rope shall be 18 inches above the ring floor, the second rope 30 inches, the third rope 42 inches, and the fourth rope 54 inches above the ring floor. The ring floor shall be padded with a 1 1/2 inch layer of ensolite or foam rubber (or equivalent), placed on a 1 1/2 inch base of celotex (building material). The padding shall be covered with canvas, duck, or similar material tightly stretched and laced securely in place, preferably under the apron. Ring posts shall be not less than 3 inches or more than 8 inches in diameter, extending from the floor to the height of 58 inches above the ring floor. The ropes shall be connected to posts with the extension not shorter than 18 inches. The turn-buckles must be covered with a protective padding.

(8) All contests shall be conducted under the Marquis of Queensberry rules, except where changed or modified by these rules or by the Board.

(9) No collection shall be made at any contest unless permission in writing has previously been obtained from the Board.

STANDARD OF WEIGHTS

(10) The following is the Vermont Boxing Control Board standard of weights for amateur boxing:

| Pounds | | | --- | --- | | Light Flyweight | 106 | | Flyweight | 11 2 | | Bantamweight | 119 | | Featherweight | 12 5 | | Lightweight | 132 | | Light Welterweight | 139 | | Welterweight | 147 | | Light Middleweight | 156 | | Middleweight | 165 | | Light Heavyweight | 178 | | Heavyweight | over 190 No limit |

(11) No contestant may compete in a weight class unless he weighs more than the maximum limit for the class below, and no more than the maximum limit for the class in which he desires to compete. For example: To compete in the 139 pounds class, a contestant must weight more than 132 pounds but not more than 139 pounds.

The following limitations of weights are placed on amateur boxing bouts:

| Pounds | | | --- | --- | | Light Flyweight | 3 | | Flyweight | 3 | | Bantamweight | 3 | | Featherweight | 5 | | Lightweight | 5 | | Light Welterweight | 5 | | Welterweight | 6 | | Light Middleweight | 6 | | Middleweight | 7 | | Light Heavyweight | 7 | | Heavyweight | No limit |

(12) The Three Point System shall be used in deciding all boxing contests and the scoring of such points shall be adjudged by at least two duly licensed judges and, in the absence of a third such official, by the referee. In awarding points, the following qualities are to be considered:

(a) Contestant doing the greatest amount of leading;

(b) Contestant landing the greatest number of clean solid blows;

(c) Ring generalship, to include evasive action, blocking, footwork, and feinting both in offensive and defensive action; and

(d) General form during performance.

The maximum number of points any contestant may receive for each round is twenty. Knockdowns as the result of a solid blow should be considered in the scoring at the discretion of the referee. Knockdowns as the result of a slip or loss of balance through bodily contact other than blows should be discounted. Scoring shall be accomplished on a judge's score card furnished by the Board. Points shall be recorded for each of the contestants immediately following the end of each round. At the conclusion of every bout, the points given each contestant shall be added carefully by the official. The winner's name should then be written clearly on the card, signed by the official. A winner must be named. In case of a draw, the judge must arrive at a decision.

(13) The referee shall collect the judges' cards and present them to the commissioner in attendance to be checked. The referee shall then announce or shall cause to be announced to the public the name of the winning contestant, according to the majority vote, and unless the decision be unanimous, the individual score of each official for each contestant shall be announced.

(14) The referee should present the awards in the ring at the end of each bout.

(15) Wagering on contests is prohibited in any arena under the jurisdiction of the Board.

(16) Only beverages served in paper or plastic foam cups may be sold in the hall where boxing contests or exhibitions are conducted.

RULES FOR CONTESTANTS

(17) To participate as CONTESTANT in an amateur boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. No fee is charged for the amateur license, which nevertheless must be annually renewed.

(18) Contestants shall box in proper costume, including a foul protection cup of a type satisfactory to the Board and the contestant. This cup shall be firmly adjusted before leaving the dressing room.

Each contestant shall supply himself with a pair of trunks, loose fitting and made of light cloth, similar to athlete's "running pants". The belt of the trunks shall not extend above the waist line.

Boxing shoes or sneakers must be worn and must not be fitted with spikes, cleats, hard soles, or hard heels. Shoelaces shall be held in place by a strip of adhesive tape around the shoe tops.

While performing boxers must wear mouthpieces for the protection of tongue and teeth. This regulation shall be strictly enforced by the referee.

Boxers should wear headgear while performing in any bout. This is mandatory for boxers in the junior class, age 12 through 15. Use of any type of grease or other substance is prohibited.

Bandages shall consist of soft cotton or linen. In all classes up to 156 pounds, one roll of 2-inch gauze bandage, not to exceed 10 yards, should be used for each hand held in place by a strip of 1 inch adhesive tape, not more than 6 inches long around each wrist. In the 165 pounds class and over, one roll of 2-inch gauze bandage, not to exceed 12 yards in length should be used for each hand, held in place by a strip of 1-inch adhesive tape, not more than 8 inches long around each wrist. No tape, cotton, powder, or any substance other than the aforementioned may be used between the fingers or over the knuckles. In all senior or open class contests, the gloves used must weight not less than 10 ounces each. In all junior class contests the gloves used must weigh not less than 12 ounces each. If gloves have been used in other bouts, they must be whole, clean, and in sanitary condition.

(19) The commissioner in attendance shall weigh each contestant using scales furnished by the promoter. He shall see that the weights of opposing contestants comply with Rule 11 of these rules and regulations. If the weights do not comply with Rule 11, the commissioner shall notify the promoter, and shall so indicate to the Board.

RULES FOR PROMOTERS

(20) To participate as PROMOTER in any amateur boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. The fee for promoter of an amateur contest is $ 25.00 per year.

(21) One or more licensed physicians shall be provided with a ring-side seat, and shall be required to remain at ring-side until the end of the final bout.

(22) The judges shall be provided with seats at ring-side, on opposite sides of the ring, preferably on a raised dais or platform commanding a clear view of the entire ring area. They shall be isolated by at least the space of one seat on each side and to the rear.

(23) The names of the referee and judges shall be announced to the public over a public address system or from the center of the ring before the start of the contests. Any change of officials that is made during the program shall be similarly announced.

(24) Promoters must provide a foolproof protection device of standard make for all contestants. A minimum of four are to be kept on hand at all times.

(25) At no time shall a promoter schedule a bout between a professional boxer and an amateur boxer or the amateur will lose his amateur standing.

(26) Promoters shall provide a suitable stretcher at ring-side at all times for emergency use; an ambulance and a rescue squad should be in attendance.

(27) Promoters shall supply suitable watches for time-keepers and aides.

(28) Amateur boxers shall be covered by accident insurance, provided by the promoter, in the event of injury or death while competing in a properly licensed boxing or sparring match or exhibition. Such insurance shall be covered by a policy issued by a recognized insurance company, and must be approved at least ten (10) days beforehand by the Board as to form, premium, and coverage. Promoters must also provide the Board with a Certificate of Liability Insurance stating the amount at least ten (10) days beforehand.

RULES FOR SECONDS

(29) To participate as SECOND in an amateur boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. No fee is charged for the amateur license, which must nevertheless be annually renewed.

(30) Any profanity or disobedience of the referee's instructions during the progress of a contest shall be deemed sufficient cause for removal of a contestant's second from the corner.

(31) A second of a contestant may be present to examine the application of the bandages and tape to the hands of the opposing boxer, and may accompany the boxer to the ring until the referee takes charge.

RULES FOR REFEREES

(32) To participate as REFEREE in an amateur boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. No fee is charged for an amateur license, which must nevertheless be annually renewed.

(33) Every new applicant for a referee's license, or any applicant who has been inactive for 3 years, shall furnish the Board with satisfactory proof of physical fitness before the application shall be considered.

(34) At every boxing contest a duly licensed referee shall be in attendance. The referee shall be prohibited from acting as a referee for more than 12 consecutive rounds unless the twelfth round is within the bout, in which case he may finish the bout.

(35) The referee shall study, and become thoroughly familiar with, the contents of this booklet. Particular attention should be given to Rule 12 describing the point system.

(36) No active boxer, manager, promoter, or second shall be allowed to hold a license as a referee.

(37) The referee or commissioner shall have full power to stop a contest whenever he deems it advisable because of the physical condition of the contestant or opponent, or for other sufficient reasons.

(38) Correct Blows. Each blow to have scoring value must, without being blocked, land directly with the knuckles part of the closed glove of either hand on any part of the front or sides of the head or body above the belt. Swings landing as described are scoring blows.

The value of blows scored in a rally of fighting shall be assessed at the end of such a rally and shall be credited to the boxer who has had the better of the exchanges according to the degree of his superiority. The following blows are not scoring blows and therefore do not count when struck by a boxer:

(a) while infringing on any of the rules;

(b) with the side, the heel, the inside, the back of the glove, or with any part of the glove other than knuckles part;

(d) which merely make contact, without the weight of the shoulder or body.

(39) Fouls. The competitor who does not obey the instructions of the referee, violates the boxing rules, boxes in an unsportsmanlike manner, or commits fouls, can at the discretion of the referee be cautioned, warned, or disqualified without warning. Only two warnings may be given to the same boxer in one contest. The third offense brings prompt disqualification.

Each boxer is responsible for the conduct of his seconds. A referee may, without stopping a contest, caution a boxer at some safe opportunity.

If a referee decides to warn a boxer, he shall stop the contest, and shall demonstrate the infringement. He will then point to the boxer and to each of the judges. Before issuing a warning, a referee should remember that a warning may carry a heavy penalty, and that a warning should not be lightly given.

The following are fouls:

(a) Hitting or holding below the belt, tripping, kicking, and butting with foot or knee.

(b) Hits or blows with head, shoulder, forearm, elbow, throttling of the opponent's face, pressing the head of the opponent back over the ropes.

(d) Hits landing on the back of the opponent, and especially any blow on the back of the neck or head, and the kidney punch.

(e) Pivot blows.

(f) Attack while holding the ropes or making any unfair use of the ropes.

(g) Lying on, wrestling, and throwing in a clinch.

(h) An attack on an opponent who is down or who is in the act of rising.

(i) Holding.

(j) Holding or locking of the opponent's arm or head, or pushing an arm underneath the arm of the opponent.

(k) Holding and hitting, or pulling and hitting.

(l) Ducking below the belt of the opponent in a manner dangerous to the opponent.

(m) Completely passive defense by means of double cover and intentionally falling to avoid a blow.

(n) Useless, aggressive, or offensive utterances during the round.

(o) Not stepping back when ordered to "Break".

(p) Attempting to strike opponent immediately after the referee has ordered "Break" and before taking a step back.

(q) If a boxer has received a low blow (punch below the belt line), the referee shall, if he has seen the foul blow delivered, use his discretion and may permit, if the blow was of damaging effect, a rest period to the victim not to exceed five minutes. If the offended boxer refuses to box after a five minute rest period, his opponent shall be named the winner. If a referee has any reason to believe that he himself has not seen a blow, he may consult the judges.

A boxer cannot be named the winner of a bout as a result of receiving a low blow unless, in the opinion of the referee, the blow was delivered deliberately and was of such force as to seriously incapacitate the offended boxer so that he could not continue to box. Under this condition, the offender should be disqualified immediately.

(40) In his instructions to the contestants before each bout, the referee shall caution both contestants to retire to the farthest neutral corner, at his direction, immediately after scoring a knockdown, and to remain there until the signal to resume boxing is given, or until the count is completed, or the bell has rung terminating the round. After having so instructed both contestants, the referee is authorized to hold his count in the event any boxer who has scored a knockdown refuses to retire to the proper corner to await the signal, the count, or the bell as the case may be. The knockdown timekeeper shall not start the split-second hand to time the knockdown until the referee so indicates by his first count.

(41) In all bouts, if the contestant who is down rises during the count, the referee shall continue to count to "8" and assure himself that the contestant is in fit condition to continue. This is the mandatory "8" count. If so assured, he shall without loss of time order both contestants to go on with the contest. During such intervention by the referee, the striking of a blow by either contestant may be ruled "Foul".

(42) Should a boxer be knocked down by a blow that he claims to have been foul, but that, in the opinion of the referee, was not foul, the referee shall pick up his count as usual in the event of a knockdown.

All contestants shall agree to equip themselves with an abdominal guard of their own selection, which will obviate the necessity of any claims being made for "low blows" during a contest. It is to be expressly understood that no contest shall be terminated by a low blow, as the protector selected by the boxers is, in their own opinion, sufficient protection to withstand any so-called low blow that might temporarily incapacitate a contestant.

In connection therewith, referees are instructed to count boxers out who fall to the floor claiming foul as a result of a low blow, since they are equipped with a protector of their own selection which they agree is of sufficient protection to withstand any so-called low blow that might temporarily incapacitate them.

(43) If at the end of a two-minute round, other than the last round, a boxer is "down" and the referee is in the course of counting, the gong indicating the end of this two-minute round will not be sounded. If the downed contestant does not rise by the count of ten, the other contestant will be the winner by a knockout. If the downed boxer does get up before the count of ten, the gong shall be sounded to indicate the end of the round and the beginning of the one-minute rest interval.

(44) When a boxer has been knocked unconscious the referee shall immediately remove that contestant's mouth-piece.

(45) If, in the opinion of the referee, a fallen boxer has been so scriously injured that removal to his corner might prove injurious, he shall request that the physician examine the boxer in the ring before permitting his removal.

(46) A contestant who has been knocked through or over the edge of the ring platform during a contest shall not be helped back by his manager or seconds. The referee shall begin to count, in accordance with Rule 40 of the Rules for Referees, as soon as the contestant leaves the inside of the ring ropes. If the contestant fails to return by the count of "10", he is knocked out. The same procedure shall apply to a contestant who leaves the ring during the progress of the bout under any circumstances.

When one contestant has fallen through the ropes the other shall retire to the farthest neutral corner and remain there until the count is completed or his opponent is on his feet in the ring.

In case of serious injury to a contestant, the referee shall be automatically under suspension until investigation by the Board establishes whether the injury was the result of negligence or incompetence on the part of the referee or of circumstances not reasonably within his control.

(47) When a contestant fails to answer the bell for a round "coming up", his opponent shall be credited with a "T.K.O." in the round that is "coming up" and not in the preceding round that has been fought.

(48) The referee shall examine the gloves and protectors of each contestant prior to the start of the contest. This shall include the correct insertion of a mouthpiece. He shall determine that the gloves have not been "broken" nor the padding over the knuckles removed or disturbed. In case the padding over the striking part of the gloves shows evidence of having been disturbed other than through actual use, he may order the glove or gloves removed and new gloves substituted.

(49) Referees shall not permit unfair practices that may cause injury to a contestant. Referees shall be held strictly liable for enforcing these rules.

RULES FOR JUDGES

(50) To participate as JUDGE in an amateur boxing contest in Vermont, you must be licensed by the Vermont Boxing Control Board. You may obtain a license from the Vermont Boxing Control Board. Write to the Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602. No fee is charged for the license. All judges shall be appointed by the Board as capable of judging bouts.

(51) At every boxing contest there shall be in attendance two or more duly licensed judges.

(52) The judges shall familiarize themselves with the Vermont Statutes and the Rules and Regulations of the Board related to boxing. Particular attention should be given to Rule 12 describing the point system and its application.

(53) No active boxer, manager, promoter, or second shall hold a license as a judge.

(54) After notification by the referee of a penalty imposed for a foul, at the end of the round each judge shall follow the instructions of the referee in deducting one or more points from the score in the space provided for that round.

(55) When a contestant fails to answer the bell for a round "coming up", his opponent shall be credited with a "T.K.O." in the round that is "coming up" and not in the preceding round that has been fought.

(56) Judges shall not confer with each other during the contests, nor express in any way to anyone their opinions as to the winner, except by final written vote.

RULES FOR PHYSICIANS

(57) Within ten hours before each contest, the PHYSICIAN shall examine each contestant, and shall report the condition of each contestant. If, in his opinion, the condition of any contestant is not favorable, he shall notify the promoter at once, and shall so report to the Board.

(58) It shall be the duty of the physician to remain at the scene of the contest until he has ascertained that no serious injuries have been received by any contestant, or until such injuries have been given attention. All injuries shall be reported by the physician to the Vermont Boxing Control Board, Division of Licensing and Registration, Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602.

(59) Among other things, the physician shall provide himself with a stethoscope, manometer, sterile syringe with medication for relieving pain, alcohol, cotton, gauze, ice bag, and aromatic ammonia (capsules).

(60) No contestant shall be allowed to engage in any boxing contest if the following conditions be found by the physician:

(a) Any hernia, or bubonocele;

(b) Organic heart murmurs;

(d) Temperature over 98.8;

(e) Systolic pressure over 150;

(f) Infectious skin lesion, such as boils or infected wounds;

(g) Recent wounds, especially on face and ears;

(h) Hand injuries, and fractures less than six weeks old, if, in the physician's opinion, the injury would be detrimental;

(i) Use of narcotics, drugs, stimulants, depressants, or analgesics of any description;

(j) Any other medical reason deemed sufficient by the physician.

RULES FOR TIMEKEEPERS

(61) TIMEKEEPERS shall be responsible for each round being of exactly equal duration as announced before the contest, with rest periods of one minute's duration. Timekeepers shall not leave the gong until the completion of a contest. The call "Get Ready" shall be given ten seconds before the round starts.

(62) When a contestant is knocked down and if the round ends before the count is completed, the timekeeper shall indicate the end of the round in accordance with Rule 43 of the Rules for Referees.

RULES FOR KNOCK-DOWN TIMEKEEPERS

(63) When one of the contestants is knocked down and takes the count, the KNOCK-DOWN TIMEKEEPER shall start the split-second hand with the first count of the referee. The timekeeper shall toll the count in a standing position and in a clear voice, causing his hand to go up and down with the count. The referee shall make similar motions in unison with the timekeeper until the contestant rises or the expiration of the count of ten, which should be equivalent to a period of ten seconds. If there is variation between the two officials, the knock-down timekeeper shall announce the expiration of the ten seconds, which shall be considered official. In case the round ends before the ten seconds are completed, the timekeeper shall indicate the end of the round in accordance with Rule 43 of the Rules for Referees.

(64) If the contestant who is knocked down rises during the count, the knock-down timekeeper shall continue to count to "8" with the referee. This is the mandatory "8" count.

PHYSICAL AND MENTAL CONDITION

(65) The Board may deny, revoke, or suspend the license of any boxer because of his physical or mental condition. For the purpose of this rule, the Board shall be deemed to have acted properly if the Board shall by personal observation, medical reports, psychological reports, past records, or from other information bearing on his physical or mental condition, determine that it would be injurious to the boxer's physical or mental health to participate in a boxing contest. At the boxer's expense the Board may demand a complete physical examination consisting of an EKG, Stress Test, KAT scan, X-ray, blood and urine tests. Each boxer must complete a medical information history both mental and physical.

If the Board suspends or revokes a license and such suspension or revocation could extend from a period of time in excess of 30 days. The boxer may request a hearing before the Board and offer what evidence he shall have bearing on his physical or mental condition. If, after a hearing, the Board is satisfied that the disqualifying condition does exist and is expected to persist, it may indefinitely suspend, revoke, or deny a license to the boxer. Any such decision of the Board may be appealed to the Appeals Panel within 30 days.

Section 1.7 CONTROL BOARD HEARINGS

As provided in 31 V.S.A. § 111, each member of the Control Board shall have the power to administer oaths and affirmations and examine witnesses concerning any matters within the jurisdiction of the Board. The Board is also vested with power to issue subpoenas as to matters within its jurisdiction. False swearing on the part of any witness before the Board shall be punishable in the same manner as false swearing before a trial board, and obedience to any subpoena issued by the Board may be compelled in the same manner as subpoenas issued by a trial board.

Section 1.8 YOUR RIGHT TO A WRITTEN DECISION

We must make all decisions in writing on whether you are granted or denied a license. If we deny you a license we give you our specific reasons. You have the right to appeal our decision to the Appeals Panel within thirty days.

Section 1.9 YOUR RIGHT TO APPEAL

If you are not satisfied with our decision, you may appeal to the Appeals Panel within thirty days of receiving the decision. The Appeals Panel is created by Vermont Law under Title 3, V.S.A. Section 114a, and has its own procedural rules. You can get information about the Panel and copies of its rules from the Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05602.

REVISED MARQUIS OF QUEENSBERRY RULES

RULE 1. All contests to be decided in a roped ring, not less than 16 feet nor more than 24 feet square.

RULE 2. Contestants to box in light boots or shoes (without spikes) or in socks.

RULE 3. In all contests the number and duration of rounds must be specified. The limit of rounds shall be 20 three-minute rounds; the interval between the rounds shall be one minute. All championship contests shall be of 20 three-minute rounds. The gloves to be of a minimum weight of 6 ounces, and shall be provided by the promoter.

RULE 4. The contestants shall be entitled to the assistance of not more than four seconds, who are to be approved of by the promoter; and no advice may be given by the seconds during the progress of a round.

RULE 5. In all contests the decision shall be given in favor of the contestant who attains the greatest number of points. The points shall be for -- attack: direct, clean hits with the knuckle part of the glove on any part of the front or sides of the head or body above the belt; defense: guarding, slipping, ducking, or getting away. When points are otherwise equal, the preference to be given to the contestant who does most of the leading off, or displays the best style.

RULE 6. The referee may disqualify a contestant for delivering a foul blow intentionally or otherwise, for holding, butting, palming, shouldering, falling without receiving a blow, wrestling, or for boxing unfairly by hitting with the open glove, the inside or butt of the hand, with the wrist or elbow, or for roughing.

RULE 7. If, in the opinion of the referee, a deliberate foul is committed by a contestant, such contestant shall not be entitled to a prize.

RULE 8. The referee shall have power to stop a contest if, in his opinion, a man is unfit to continue, and that man shall be deemed to have lost the contest.

RULE 9. No seconds or any other person shall be allowed in the ring during the rounds. Each contestant shall be entitled to the assistance of not more than four seconds, who must take up position outside the ring during the rounds, and who must not, under pain of disqualification of their principal by the referee, coach, assist in any manner, or advise their principal during the rounds or enter the ring during the progress of a contest. A second refusing to obey the orders of the referee shall be removed from his position, and replaced by another approved by the referee.

RULE 10. The contestant failing to come up when time is called, or refusing to obey the referee, shall lose the contest. A man on one knee, or when on the ropes with both feet off the floor, shall be considered down.

RULE 11. If a contestant slips down he must get up again immediately. His opponent must stand back out of distance until the fallen man is on his feet, then the contest shall be resumed. A contestant who has knocked down his opponent must immediately walk to his own corner, but should the fallen man be knocked down in the corner, the contestant delivering the knock-down shall retire to the farthest corner. A man knocked down must rise unassisted in ten seconds or lose the contest.

RULE 12. Should a glove burst or come off, it must be replaced immediately to the satisfaction of the referee. The time thus lost shall be considered no part of the stipulated period of the round.

RULE 13. The contestants shall not hit while in a clinch. A clinch shall be constituted by both men holding, either with one or both hands.

RULE 14. The referee shall decide:

(1) Any question not provided in these rules;

(2) The interpretation of these rules.Statutory Authority: 31 V.S.A. § 103

History

Effective Date: September 3, 1983 (Secretary of State Rule Log #83-61)
- Formerly Rule No. 04 043 001. This rule has not been changed. It has been renumbered and relocated to insure that all rules issued under this Office are properly and uniformly numbered.*

Chapter 050 BOARD OF CHIROPRACTIC ADMINISTRATIVE RULES

04-050 Code Vt. R. 04-030-050-X BOARD OF CHIROPRACTIC ADMINISTRATIVE RULES

Part 1 General Information

Section 1.1 Purpose

(a) The Board of Chiropractic ("the Board") has been created and given powers by Vermont law. Its purpose is to protect the public health, safety and welfare. It does this by setting standards for issuing licenses, licensing only qualified applicants, and regulating practices of license holders.

(b) The Board maintains a website at http://vtprofessionals.org. Practitioners should periodically consult the website for matters of interest to the profession.

Section 1.2 Definitions

(a) "Accredited school of chiropractic" means:

an educational program leading to the doctor of chiropractic degree, accredited by an agency that is approved by the board, and which is recognized by the United States Department of Education for accreditation of programs of chiropractic education; or,
a foreign educational program that is accredited by a foreign chiropractic accrediting agency which is recognized and endorsed by the Council on Chiropractic Education (CCE-US).

(b) "Board" means: the State of Vermont Board of Chiropractic.

(c) "Direct supervision" means: a chiropractor agrees to procedures or treatment performed by appropriate personnel by being physically present at the chiropractic facility for consultation or intervention.

(d) "Director" means: the Director of the Office of Professional Regulation.

(e) "Good standing" means: the professional holds a current, unrestricted license.

(e) "Office" means: Office of Professional Regulation (OPR).

(f) "P.A.C.E." means: Providers of Approved Continuing Education, which is a service of the Federation of Chiropractic Licensing Boards.

(g) "Unprofessional Conduct" means: any violation of 3 V.S.A. § 129a or 26 V.S.A. § 541. Unprofessional conduct includes failing to comply with provisions of federal or state statutes or rules governing the practice of the profession.

(h) "Unrestricted license" means: the licensed or registered professional is not subject to a sanction.

(i) "V.S.A." means: Vermont Statutes Annotated, the official compilation of statutes enacted by the Vermont legislature.

Section 1.3 Definitions

Business Location The Board's business location is the Office of the Secretary of State, Office of Professional Regulation, National Life Bldg., North, FL2, Montpelier, VT 05620-3402. Address correspondence to "Board of Chiropractic" at the same address.

Section 1.4 Definitions

Board Members and Officers The Board is composed of three chiropractic physicians who are graduates of an accredited school of chiropractic, and two public members. Each member has been appointed by the governor for a five year term. A member may not serve more than two consecutive terms on the Board. Officers are elected once a year.

Section 1.5 Definitions

Regular, Special and Emergency Meetings The Board holds at least one regular annual meeting in September. It meets as needed, generally monthly. The chair or two members may call a special or emergency meeting if it is necessary. Information on meeting time and location maybe obtained from the Office or online at http://vtprofessionals.org/. A majority of Board members constitutes a quorum for all meetings. Formal action may be taken at a meeting if a majority of those present and voting are in favor of the action.

Section 1.6 Laws That Govern the Board

(a) The Board is created by Chapter 10 of Title 26 of the Vermont Statutes Annotated, which establishes the Board's responsibilities for setting standards, issuing licenses, and regulating the profession.

(b) Board powers are also conferred by subchapter III of Chapter 5 of Title 3 "Professional Regulation," and the statutes creating and governing the Office of Professional Regulation ( 3 V.S.A. §§ 121-131).

(c) In addition to the "Professional Regulation" statutes, the Board is subject to other state laws including the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314), the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320), and the "Law of Professional Regulation" ( 3 V.S.A. §§ 121-131).

(d) In contested cases, the Board follows the Vermont Rules of Evidence, as amended by the Administrative Procedure Act. These laws set forth the rights of applicants, license holders and members of the public.

(e) The statutes are online at http:// www.leg.state.vt.us/statutes/chapters.cfm?Title=26.

(f) The Office provides legal counsel to help the Board comply with all laws affecting Board business.

Section 1.7 Board Rules

The Board's rules have the effect of law and govern its proceedings. In making rules, the Board must follow the Administrative Procedure Act, Chapter 25 of Title 3 of the Vermont Statutes Annotated. These rules were approved by the Vermont Legislative Committee on Administrative Rules before adoption and are presumed valid. These rules have the force of law. 3 V.S.A. § 845(a).

Section 1.8 Legislative Changes Affecting Rules

Legislative changes from time to time may create inconsistencies between statutes and administrative rules. When a rule and a statute are inconsistent, the statute governs.

Section 1.9 Legislative Changes Affecting Rules

Advisory Opinions Interpretation of the meaning of Board Rules and statutes often occurs when the Board is deciding an unprofessional conduct case. The Board is not authorized to issue advisory opinions.

Part 2 Information for Applicants

Section 2.1 Legislative Changes Affecting Rules

Need for a License No person may practice chiropractic in Vermont without being currently licensed by the Board.

Section 2.2 Legislative Changes Affecting Rules

Where to Request an Application Applications and more information about the types of licenses and their requirements are available on line at http://vtprofessionals.org or from the Office.

Section 2.3 Legislative Changes Affecting Rules

Licensure by Examination Applicants for a license by examination must have:

(a) reached the age of majority;

(b) graduated from an accredited school of chiropractic as defined by these rules;

(c) passed the written and practical examinations approved by the Board. The examination(s) selected by the Board are specified on application forms;

(d) for foreign-educated applicants whose training, including texts, was not in the English language, successfully passed the TOEFL examination or other similar examination approved by the Board, and;

(e) successfully completed the Board's jurisprudence examination. The examination questions are available from the Office or online at http://vtprofessionals.org.

Section 2.4 Legislative Changes Affecting Rules

Unprofessional Conduct and Licensing Decisions A license may be denied or conditioned if the applicant has engaged in unprofessional conduct.

Section 2.5 Licensure by Endorsement

(a) An applicant who is licensed and in good standing in another United States or Canadian jurisdiction, whose licensing requirements are substantially equivalent to Vermont, and who is otherwise eligible may be granted a license without written competency examination.

(b) The applicant must successfully complete the Board's jurisprudence examination. The examination questions are available from the Office or online at http://vtprofessionals.org.

Section 2.6 Right to a Written Decision, Grant or Preliminary Denial

(a) The Board will notify applicants in writing of all decisions to either grant or deny a license or license renewal. If a license or renewal is denied, the Board will give the applicant specific reasons and will also inform the applicant of the right to appeal the Board's decision. This is called a "preliminary denial."

(b) The Board, or the Office on behalf of the Board, most often issues a preliminary denial of licensure or renewal when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure, or because of unprofessional conduct, should not be granted a license. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing by the Board. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the Board issues a final decision in writing. If the final decision is to deny a license or renewal, the written decision notifies the applicant of his or her appeal rights.

Section 2.7 Right to a Written Decision, Grant or Preliminary Denial

Right to Appeal Licensing Decisions If the applicant believes that the Board's final decision concerning the denial of a license or renewal is in error, the applicant may appeal the decision to the Director. The appeal must be filed within 30 days of the date of the denial. An appellate officer will review the record made before the Board for legal errors. Information about the appeal process may be obtained from the Office or online at http://vtprofessionals.org/.

Part 3 Information for Licensed Chiropractic Physicians

Section 3.1 Right to a Written Decision, Grant or Preliminary Denial

Display of License The Chiropractor's license, or a photo copy if the licensee practices at more than one location, must be conspicuously displayed in the licensee's place(s) of practice. Licensees may black out or cover their residence address if it appears on the license.

Section 3.2 Right to a Written Decision, Grant or Preliminary Denial

Renewing a License Licenses are issued for a two-year period, and must be renewed by the expiration date printed on the license certificate. The Office mails renewal notices in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not, and a license is not valid after its expiration. Those who practice after expiration of a license are subject to late fees before renewal, possible unprofessional conduct prosecution, or other penalties.

Section 3.3 Late Renewals

(a) A lapsed license may be renewed within five years of expiration upon payment of the renewal fee, documentation of 24 hours of continuing education within 2 years preceding the application, and late renewal fee.

(b) To renew a license which has lapsed 5 years or more and the applicant has not held a license in good standing to practice chiropractic in another U.S. or Canadian jurisdiction during that period, a new application must be filed and application fee paid. An applicant must

(1) successfully complete within one year of applying the Special Purpose Examination for Chiropractors or its successor or equivalent examination approved by the Board; and,

(2) successfully complete the Board's jurisprudence examination. The examination questions are available from the Office or online at http://vtprofessionals.org.

(c) A renewal applicant whose Vermont license lapsed more than 5 years, but who has maintained a license in good standing in another U.S. or Canadian jurisdiction must document completion of 24 hours of continuing education in the two years preceding the application.

Section 3.4 Late Renewals

Change of Name or Address A licensee shall notify the Office within 30 days of any change of name or change of address. Notice of a change of name must be accompanied by legal proof of the change.

Section 3.5 Late Renewals

Adjunctive Therapies Adjunctive therapies are therapies a chiropractor may use in addition to chiropractic adjustment to treat patients. Chiropractors may use adjunctive therapies in which they have been adequately trained. Adjunctive therapies for chiropractic are physiotherapy modalities, rehabilitative exercises, nutritional therapy, massage techniques and acupuncture. Adjunctive therapy includes the use of topically applied therapeutic agents incident to any of the above listed therapies.

Part 4 Chiropractic Interns

Section 4.1 Late Renewals

Registration of Chiropractic Interns A student enrolled in the fourth academic year of an accredited school of chiropractic, upon registration as an intern, may practice under the supervision of a licensed chiropractor.

Section 4.2 Late Renewals

Intern Registration An applicant for intern registration must:

(a) show current enrollment in an accredited school of chiropractic, and

(b) provide an agreement to supervise from a Vermont licensed chiropractor.

Section 4.3 Late Renewals

Documentation Each licensed chiropractor who provides supervision of an intern must create and retain a supervisor's report and all records pertaining to services provided by the intern for no less than three years after the internship concludes.

Section 4.4 Permitted Activities / Liability

(a) An intern may perform activities delegated to him or her by the supervising chiropractor, including the activities described in subdivision 521(3) of title 26 under the direct supervision of the chiropractor.

(b) "The supervising chiropractor shall be legally liable for such activities performed by the intern." 26 V.S.A. § 536.

Section 4.5 Permitted Activities / Liability

Board Jurisdiction Intern applicants and approved interns are subject to the jurisdiction of the Board and subject to sanctions for any unprofessional conduct found.

Part 5 Continuing Professional Education

Section 5.1 Permitted Activities / Liability

Approval of Continuing Education Programs A program or activity is acceptable if it facilitates learning which contributes to the growth of professional knowledge and competence.

Section 5.2 Permitted Activities / Liability

Exemption for Applicants Granted an Initial License to Practice by the Office There is no continuing education requirement before the first license renewal. For the subsequent renewals, the licensee must complete and document 24 hours of continuing education. The Board recommends, but does not require, continuing education for initial licensees during their first licensing period

Section 5.3 Permitted Activities / Liability

Documentation Continuing education shall be documented on forms available from the Office or on line http://vtprofessionals.org.

Section 5.4 Permitted Activities / Liability

Failure to Certify Compliance A licensee who fails to certify compliance with continuing education requirements on a renewal application may be denied renewal.

Section 5.5 Permitted Activities / Liability

Corrective Action Plans The Board may require the licensee to develop and complete a specific corrective action plan of remedial course work within 90 days, See, 3 V.S.A. § 129(k).

Section 5.6 Continuing Professional Education Records

(a) Responsibility for documenting the acceptability of a program or activity and the validity of the credits rests with the applicant.

(b) Documentation should be retained for a period of four years after the completion of the program.

(c) Documentation should consist of the following: course outline, statement of hours attended signed by the instructor, pamphlets, certificates of attendance received during the instruction, receipt of registration, or brief summary of the work content.

(d) Evidence of satisfactory completion of courses taken for scholastic credit in accredited universities and colleges is sufficient. Non-credit courses require a statement of the hours of attendance signed by the instructor.

Section 5.7 Specially Designated Subjects

(a) In its discretion, the Board may designate in advance not more than 12 hours in a specific subject area or areas related to public health and safety in which licensees will be required to obtain continuing education credit during the succeeding two-year license renewal period.

(b) In exercising its discretion, the Board will apply the following standards:

(1) there must be a demonstrated general need for licensees to acquire and maintain competence in the specific subject area or areas, including but not limited to an increase in complaints of unprofessional conduct in the specific subject area or areas;

(2) the Board must be assured that continuing education courses in the specific subject area or areas are reasonably available to licensees; and

(3) the Board must review any such designation prior to expiration of the two-year license renewal period to ascertain whether the designation should remain in place or should be removed.

Section 5.8 Time

(a) Only time spent in instruction, and not preparation time, will be credited.

(b) For university or college courses, each semester hour of credit shall equal 15 hours toward the requirement.

Section 5.9 Time

Case-by-case approval An individual course or activity may be approved upon submitting to the Board a course outline, instructor qualifications, sponsoring organization, and dates of presentation. Advance approval is not required.

Section 5.10 Time

Pre-approval Courses in the following categories are approved without further action by the Board:

(a) Postgraduate courses in core curriculum subjects offered for credit by a CCE-accredited school;

(b) Courses approved for continuing education credit by chiropractic boards of other states where the participant is licensed and practicing;

(c) Courses approved for continuing education credit toward category I of the Physician's Recognition Award of the American Medical Association, provided that such courses do not exceed 12 hours in a biennial renewal period;

(d) courses approved by P.A.C.E. for continuing education.

Section 5.11 Time

Courses not approved Approval will not be granted for:

(a) Courses in practice management;

(b) Courses in financial management.

Section 5.12 Time

Modification of Continuing Education Requirement Upon a showing of hardship, the Board may in its sole discretion modify the continuing education requirement.

(a) To apply for modification, the licensee must submit a written statement not less than 60 days before expiration of the license renewal period setting forth the conditions of hardship with specificity.

(b) After review, the Board shall send written notification of its decision, and the reasons therefore, to the licensee.

Section 5.13 Time

Format of Continuing Education Programs Continuing education will be accepted if:

(a) it is a course conducted or designed by a qualified instructor who will be able to instruct and interact in the formats below:

(1) Classroom Instruction - Traditional in-classroom, with instructor and student interaction and written materials;

(2) Interactive Television which permits continuous mutual communication between the instructor and all students, continuous observation of the instructor by all students, and continuous observation of all students by the instructor;

(3) Distance Courses /Online Delivery Distance education courses are defined as programs whereby instruction does not take place in a traditional classroom setting but rather through other media where teacher and student communicate by electronic means; or

(b) it is self-study which may include printed or electronic media, if the study is demonstrated by a journal.

Section 5.14 Time

Journals The Board wishes to encourage practitioners to avail themselves of technical, profession related literature whenever possible. Toward that end, the Board will construe "individual course" as it appears in Board Rule 5.9 to include practitioner created journals.

(a) The Board will permit continuing education credit for journals at the rate of one hour for each 8 pages of chiropractic articles or texts read, summarized, and documented. Each entry should be dated. Documentation must occur at the time of the reading. Effective with the 2014 biennial renewal, practitioner created journals may not be used for more than 12 hours of the 24 hours of required continuing education.

(b) Journals of chiropractic readings must be retained by the licensee for 4 years.

Section 5.15 Audits

(a) Each biennium, the Board shall conduct a random audit of no fewer than ten percent (10%) of the licensees applying for renewal. The Board may also audit currently conditioned licensees, late renewing licensees, and licensees who in any of the preceding three (3) renewal cycles were initially found to have not met continuing education renewal requirements.

(b) When a licensee appears on the audit list, the Board will require documentation from the licensee showing a detailed account of the various credits claimed. The Board will review the documentation and determine if continuing education requirements have been satisfied.

(c) Licensees who upon audit are found to be deficient in continuing education may be permitted 90 days to develop and complete a corrective plan. 3 V.S.A. § 129(k).

(d) A licensee who fails to comply with a corrective plan is subject to license suspension or other disciplinary action by the Board.

Part 6 Competency Requirements of Licensees

Section 6.1 Audits

Ionizing Radiation 26 V.S.A. § 525 requires licensees to demonstrate competency before applying ionizing radiation to human beings for diagnostic purposes.

(a) Competency to apply ionizing radiation to human beings is shown by graduation from a CCE accredited school of chiropractic.

(b) upon receipt of the application and payment of the required fee, the Board will issue the ionizing radiation endorsement.

Section 6.2 Periodic competence recertification

(a) A Board authorized evaluator shall visit premises as the Board deems necessary to conduct a competency evaluation of practicing chiropractors who use ionizing radiation on patients.

(b) The evaluation shall include, but not be limited to quality control evaluation, random film evaluation for collimation, film blackening, positioning, appropriate patient shielding, and processing; review of method of documentation of last menstrual period (LMP); report of equipment type, including film/screen combinations; and report on evaluation of processor chemicals and cleanliness of chemicals if manual processing technique used.

(c) The evaluation shall also include a quality control check of films selected randomly for diagnostic quality of film and quality control (collimation, processing, and appropriate patient shielding).

(d) the evaluation and re-certification fee is set by statute.

Section 6.3 Periodic competence recertification

Ionizing Radiation Endorsement Renewal An ionizing radiation endorsement must be renewed every two years and a renewal fee must be paid. The licensee is responsible for renewing on time. An ionizing radiation endorsement not renewed by the expiration date will expire automatically. To reinstate an ionizing radiation endorsement after it has expired, a licensee must apply to the Board for approval and pay the required fee.

Section 6.4 Periodic competence recertification

Violations The Attorney General or an OPR prosecuting attorney or a State's Attorney may bring a civil action to enjoin continuing violations of the law. Any person who applies ionizing radiation to human beings without having the proper endorsement or license may be subject to civil or criminal penalties.

Part 7 Minimal Record Keeping Standards

Section 7.1 Explanation

(a) These rules apply to all licensed chiropractic physicians during the normal course of care with new or established patients, regardless of whether the fee for services was charged, reduced, or waived by means of advertisement or otherwise.

(b) Chiropractic records are maintained to serve as a basis for planning patient care and for continuity in the evaluation of a patient's condition and treatment; to furnish documentary evidence of the course of the patient's clinical evaluation, treatment, and change in condition; and to document communication between the practitioner responsible for the patient and any other health care professional who contributes to the patient's care.

(1) identify the treating doctor and address where chiropractic care was provided;

(2) identify the patient;

(3) support the diagnosis/assessment;

(4) substantiate the treatment; and

(5) document the course and results of treatment accurately.

(d) Patient records shall include, at a minimum,

(1) patient histories;

(2) examination results;

(3) test results;

(4) records of substances dispensed, administered, or recommended;

(5) reports of consultations and hospitalizations; and

(6) copies of records or reports or other documentation obtained from other health care practitioners at the request of the physician whether relied upon by the physician in determining the appropriate treatment of the patient or not.

(e) Initial and follow-up services (daily records) shall consist of documentation of current status and treatment rendered.

Section 7.2 Patient Records

(a) All patient records shall include:

(1) patient history;

(2) condition presented or wellness care, or both; and

(3) examination findings, including x-rays when clinically indicated.

(b) Abbreviations may be used in a patient's record, provided that the record also contains a legend or key explaining the meaning of any abbreviations used.

Section 7.3 Providing records

A licensed chiropractic physician must provide copies of a patient's records within 30 days, when the chiropractic physician receives a written request for the records from the patient, the patient's representative, or succeeding health care professionals or institutions. This rule applies to patient records which are in the possession of or under the control of the chiropractic physician. 3 V.S.A. § 129a(a)(8). Vermont statutes set permissible fees for copying and providing records. See, e.g. 18 V.S.A. § 9419.

Part 8 Complaint Procedures

Section 8.1 Providing records

Disciplinary Procedure The Board follows the Office procedure for processing, investigating, and prosecuting unprofessional conduct and unauthorized practice complaints. A copy of the complaint procedure may be obtained from the Office or online under "Disciplinary Procedures" at http://vtprofessionals.org/.

Section 8.2 Grounds for Discipline

(a) Unprofessional conduct is defined by statutes 26 V.S.A. § 541(b) and 3 V.S.A. § 129a. Both apply to licensees, applicants and interns. Unprofessional conduct includes failing to comply with the administrative rules governing the practice of a profession. 3 V.S.A. § 129a(a)(3).

(b) When a standard of unprofessional conduct in 3 V.S.A. § 129a conflicts with a standard set forth in a 26 V.S.A. § 541 or a standard set in these rules, the standard that is most protective of the public shall govern. 3 V.S.A. § 129a(e).

(c) No person subject to these rules may provide services which he or she is not qualified to perform or which are beyond the scope of his or her education, training, capabilities, experience, or practice.

(d) Advice: Licensees are advised to check 3 V.S.A. § 129 a regularly for changes occurring after enactment of these rules. The statute may be found online at http://www.leg.state.vt.us/statutes/fullsection.cfm?Title=03&Chapter=005&Section=00129a

Section 8.3 Sanctions for Unprofessional Conduct and Unauthorized Practice

(a) Vermont statutes permit the Board to discipline a licensee following a hearing upon a finding of unprofessional conduct. Possible disciplinary actions the Board may impose on a license may include, but are not limited to:

(1) warnings or reprimands;

(2) suspension for a period of time to be determined by the Board;

(3) revocation;

(4) limitations on practice;

(5) setting conditions for practice or resumption of practice;

(6) denial of reinstatement; or

(7) imposition of civil penalties.

(b) All Board disciplinary actions are public records available online or from the Office.

(c) The Board may levy a civil penalty of up to $ 1,000.00 for each instance of unprofessional conduct or unauthorized practice.

(d) A person who violates 26 V.S.A. § 522 is subject to the penalties provided in 3 V.S.A. § 127(c).

History

STATUTORY AUTHORITY: 26 V.S.A. §§ 529, 534
EFFECTIVE DATE: October 6, 1993 Secretary of State Rule Log #93-73
AMENDED: October 6, 1995 Secretary of State Rule Log #95-65; June 1, 2001 Secretary of State Rule Log #01-15; July 15, 2012 Secretary of State Rule Log #12-019

04-070 Code Vt. R. 04-030-070-X ADMINISTRATIVE RULES FOR LICENSED CLINICAL SOCIAL WORKERS

Part 1 GENERAL INFORMATION

Section 1.1 Administrative Rules

(a) Title 26 Chapter 61 of the Vermont Statutes Annotated gives the Director of the Office of Professional Regulation (Director) certain powers and duties regarding licensure and discipline of licensed master's social workers and licensed independent clinical social workers to protect the public health, safety, and welfare. The Director has adopted these rules to aid applicants, licensees, and the general public in understanding the requirements for these professions.

(b) Copies of these rules and more information about the regulation of social workers may be obtained by contacting the Office of Professional Regulation (Office). This information may also be obtained from the Office of Professional Regulation website at http://vtprofessionals.org/.

Section 1.2 General Definitions

These words and phrases are defined as follows:

(a) "Accredited Social Work Education Program" means a program approved by the Council on Social Work Education or the Council's equivalent.

(b) "A.S.W.B." means Association of Social Work Boards.

(c) "Completed application" means an application which shows that the applicant has fulfilled all prerequisites to licensure.

(d) "Direct service" means time spent with a client directly regardless of setting, or in consulting with another professional about the client, for example, the client's physician or psychiatrist. It may include any phone time or emergency time with the client, but overall it involves being with the client or the client's other service providers.

(e) "Indirect service" means creating case notes, staff meetings, supervision, workshops and conferences, general consultation, teaching, case management activities, advocacy and policy work, and any other social work other than direct client contact.

(f) "Director" means the Director of the Office of Professional Regulation;

(g) "L.M.S.W." means licensed master's social worker as set forth in Part 2 of these rules. Per 26 V.S.A. § 3201(2) psychotherapy is not part of the scope of practice of an L.M.S.W.

(h) "L.I.C.S.W." means Licensed Independent Clinical Social Worker.

(i) "N.A.S.W." means National Association of Social Workers.

(j) "N.A.S.W. Vermont" means, the National Association of Social Workers, Vermont Chapter.

(k) "Office" means the Office of Professional Regulation (OPR);

(l) "Psychotherapy is defined in 26 V.S.A. § 3201(4).

(m) "V.S.A." means the Vermont Statutes Annotated.

Section 1.3 Business Location

The Office's business location is the Office of the Secretary of State, Office of Professional Regulation, in the City, Center 89 Main Street, Fl. 3 in Montpelier. Its current mailing address is:

Vermont Secretary of State

Office of Professional Regulation

89 Main St., Fl. 3

Montpelier, VT 05620-3402

Section 1.4 Advisors to the Director of the Office of Professional Regulation

The Secretary of State appoints two licensed social workers to serve as advisors to assist the Director of the Office of Professional Regulation with the regulation of this profession.

Section 1.5 Laws Governing Regulation of the Profession

The Director of the Office of Professional Regulation is authorized by Chapter 61 of Title 26 of the Vermont Statutes Annotated to set standards, issue licenses, and regulate the profession. The statutes are online at . The Director's authority is also conferred by subchapter III of Chapter 5 of Title 3 "Professional Regulation," the statutes creating and governing the Office of Professional Regulation ( 3 V.S.A. §§ 121-132). In addition to the "Professional Regulation" statutes, the regulation of this profession is subject to other state laws including the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314), and the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320). In contested cases, the Office follows the Vermont Rules of Evidence as amended by the Administrative Procedure Act. These laws set forth the rights of applicants, license holders, and members of the public. Applicants and licensees should be aware that Chapter 5 of Title 3 of the Vermont Statutes contains several statutes which govern regulation of licensed professionals. See among them, 3 V.S.A. § 129a which defines unprofessional conduct.

Section 1.6 Legislative Changes Affecting Rules

Legislative changes from time to time may create inconsistencies between statutes and administrative rules. When a statute and rule are inconsistent, the statute governs.

Section 1.7 No Advisory Opinions

Interpretation of the meaning of this profession's administrative rules and statutes often occurs in the course of deciding an unprofessional conduct case. The Office is not authorized to issue advisory opinions.

Section 1.8 Other Sources of Information: The Web page

The OPR web site at http://vtprofessionals.org contains information including periodic newsletters, information about licensing, discipline, and other matters of interest to practicing social workers. Practitioners are encouraged to visit the web page regularly.

Part 2 LICENSED MASTER'S SOCIAL WORKERS: LICENSURE

Section 2.1 Routes to Licensure

There are three routes to licensure as a master's social worker:

(a) licensure by examination;

(b) licensure by endorsement; and

Section 2.2 Licensure by Examination

To be eligible for licensure as a licensed master's social worker (L.M.S.W.) by examination an applicant must:

(a) receive a master's or doctoral degree from a social work educational program accredited by the Council on Social Work Education;

(b) successfully complete the Association of Social Work Boards master's level examination or its successor examination as selected by the Director taken within five years of completing all requirements for licensure; and

(d) There is no supervised practice requirement for an L.M.S.W. license.

Section 2.3 Licensure by Endorsement

To be eligible for licensure as a licensed master's social worker by endorsement an applicant must:

a) hold an active license to practice licensed master's social work or licensed independent clinical social work in another United States or Canadian province whose requirements for licensure are substantially equivalent to Vermont's requirements; and

b) successfully complete the jurisprudence examination.

Section 2.4 Licensed Experience: Five Year Rule

The Director may grant a license to practice as a licensed master's social worker to a person licensed as a master's social worker in another United States or Canadian jurisdiction whose licensing requirements are determined by the Director to be not substantially equivalent to those of this state if:

(a) the applicant holds an active unencumbered license and has no disciplinary history in any jurisdictions currently or previously licensed;

(b) the applicant has practiced 1,200 hours per year or more for a minimum of five years; and

Part 3 LICENSED INDEPENDENT CLINICAL SOCIAL WORKERS

Section 3.1 Routes to Licensure

There are three routes to licensure as a licensed independent clinical social worker:

(a) licensure by examination;

(b) licensure by endorsement; and

Section 3.2 Licensure by Examination

To be eligible for licensure as a licensed independent clinical social worker (L.I.C.S.W.) by examination an applicant must:

(a) receive a master's or doctoral degree from a social work educational program accredited by the Council on Social Work Education;

(b) successfully complete 3,000 hours of supervised practice as specified in Part 5 of these rules;

(c) successfully complete the Association of Social Work Boards clinical examination or its successor examination as selected by the Director; taken within five years of completing all requirements for licensure; and

(d) successfully complete the Vermont jurisprudence examination.

Section 3.3 Licensure by Endorsement

To be eligible for licensure as a licensed independent clinical social worker by endorsement an applicant must:

(a) hold an active license to practice independent clinical social work or its equivalent in another United States or Canadian jurisdiction whose requirements for licensure are substantially equivalent to Vermont's requirements; and

(b) successfully complete the Vermont jurisprudence examination.

Section 3.4 Licensed Experience: Five Year Rule

The Director may grant a license to practice as a licensed independent clinical social worker to a person licensed as an independent clinical social worker in another United States or Canadian Jurisdiction whose licensing requirements are deemed by the Director to be not substantially equivalent to those of this state if:

(a) the applicant holds an active unencumbered license, and has no disciplinary history in any jurisdictions currently or previously licensed;

(b) the applicant has practiced for at least 1,200 hours per year for a minimum of five years;

(c) the Director, in his or her discretion, has determined that the applicant's practice experience or education overcomes any lesser licensing requirements of the other jurisdiction (s); and

(d) the applicant has successfully completed the Vermont jurisprudence examination.

Part 4 SUPERVISED PRACTICE

Section 4.1 Supervised Practice Toward Licensure as an L.I.C.S.W

Supervised practice toward licensure as an L.I.C.S.W. means:

(a) clinical social work that is supervised by a qualified supervisor who is familiar with the nature of the applicant's clinical activities and who monitors the quality of the work and contributes to the enhancement of self-knowledge and of clinical work. The supervisor is responsible for an applicant's work.

(b) Provision of psychotherapy must comprise 2,000 direct service hours of the required 3,000 hours of supervised practice. The definition of "psychotherapy" is found in 26 V.S.A. § 3201(4).

Section 4.2 Registration Requirements

(a) For L.I.C.S.W. applicants already licensed as master's social workers: No supervised practice toward licensure within the State of Vermont and no psychotherapy services may be provided as part of any supervised practice in Vermont until and unless the licensed master's social worker has registered for supervised practice with the Office. This registration shall be renewed with the license during the period of supervised practice. A licensee who provides psychotherapy services without registering with the Office is engaged in unauthorized practice and subject to disciplinary action. No unauthorized practice of psychotherapy will be counted toward the supervised practice requirement.

(b) For L.I.C.S.W. applicants not already licensed as master's social workers: No supervised practice toward licensure within the State of Vermont and no psychotherapy services may be provided in Vermont as part of supervised practice in Vermont until and unless the applicant is registered on the roster of non-licensed and non-certified psychotherapists. Applicants are required to remain on the roster for the duration of the supervised practice.

Section 4.3 Unlicensed or Un-Rostered Practice: Responsibilities and Penalties

(a) Both the supervisor and person engaged in supervised practice are responsible for verifying that the applicant is properly registered with the Office.

(b) Supervisors should have a copy of the supervision form before supervision begins. Both the supervisor and applicant are expected to be familiar with these administrative rules at the beginning of the supervised practice.

(c) Unlicensed, unregistered, or un-rostered supervised practice is unauthorized practice and may subject the applicant and the supervisor to disciplinary action.

(d) Unauthorized practice in Vermont will not be counted toward the supervised practice requirement.

Section 4.4 L.I.C.S.W Supervised Practice Disclosure Requirements

Individuals engaged in supervised practice in Vermont toward independent clinical social worker licensure must comply with the disclosure requirements of Part 7 of these rules.

Section 4.5 Supervisors: Experience and Standing Requirements

Supervised practice beginning after the effective date of these rules must occur under a supervisor who:

(a) has acquired 4,500 hours licensed practice in no fewer than three years; and

(b) at all times during the period of supervision holds an unencumbered license in a permitted supervisory licensed profession in the jurisdiction where the supervised practice occurs.

Section 4.6 Verification of Supervisor Credentials

If the supervised practice occurred in a Canadian province or a state other than Vermont, the supervisor must submit verification of his or her licensure, registration, or certification directly to the Office. The verification must come from the licensing or certifying authority of the other state or province. Supervision reports will be reviewed only after the verification is received.

Section 4.7 Areas of Practice

An applicant will receive credit in an area of practice only if the clinical supervisor is knowledgeable and experienced in that area, and only for work that is acceptable to the supervisor and satisfies the requirements of these rules.

Section 4.8 Frequency and Nature of Supervision

An applicant must have one hour of supervision for each thirty (30) hours of supervised practice. The supervision must occur in a face-to-face setting. Face-to-face supervision via HIPAA compliant electronic media is acceptable.

Section 4.9 Supervision Settings

Face-to-face supervision may be in either an individual setting, between the supervisor and the applicant, or in a group setting, including the supervisor and up to eight individuals. Of the total hours of supervision, at least half must be in an individual setting.

Section 4.10 Supervisor Prerequisites

For supervised practice commencing after the effective date of these rules, a supervisor of anyone engaged in supervised practice toward licensure as an independent clinical social worker must be currently engaged in licensed practice and have no less than three years' and 4,500 hours experience in licensed practice as:

(a) a licensed independent clinical social worker;

(b) a licensed clinical mental health counselor;

(d) a licensed physician or a licensed osteopathic physician who has completed a residency in psychiatry; or

(e) a person licensed or certified in another state or Canada in one of these professions or its substantial equivalent.

Section 4.11 Excluded from Supervising

Preface: Successful supervision requires that the future licensee and supervisor have a full and candid exchange regarding all aspects of the supervised practice. Treatment issues, including issues of sexual attraction and other matters between practitioner and client, and work conditions affecting practice should be fully explored. Because full candor is needed, conflicts of interest between supervisor and future licensee must be avoided.

(a) Supervisors and supervisees must comply with ethical requirements for social workers, including. those governing conflicts of interest. (See, Rule 9.1.) Social workers should not engage in any dual or multiple relationships with supervisees in which there is a risk of exploitation of or potential harm to the supervisee. (See, NASW Code of Ethics 3.01(c)). Financial relationships between supervisor and supervisee should be discussed to ensure that both can be completely candid and so that all issues arising from practice and the practice setting can be adequately addressed.

(b) Certain persons are excluded from being supervisors. A ''clinical supervisor" may not include a spouse, life partner, former spouse, or family member.

(1) supervision by current or former family members or any other persons where the nature of the personal relationship prevents or makes difficult the establishment of a professional relationship;

(2) administrative supervision (for example, clinical practice performed under administrative rather than clinical supervision of an institutional director or executive);

(3) classes, workshops, or seminars;

(4) consultation, staff development, or orientation to a field or program, or role-playing of family interrelationships as a substitute for current clinical practice.

Section 4.12 Supervisors Wherever Supervision Occurs

The supervisor must be licensed or otherwise properly credentialed in the jurisdiction where the supervised practice occurs.

Section 4.13 Distribution of Supervised Practice Hours

(a) L.I.C.S.W: Of the 3,000 required practice hours 2,000 hours shall be the provision of direct service psychotherapy services, with the remaining 1,000 hours in either direct or indirect social work services.

(b) "Direct service" means time spent with a client directly regardless of setting, or in consulting with another professional about the client, for example, the client's physician or psychiatrist. It may include any phone time or emergency time with the client, but overall it involves being with the client or the client's other service providers.

(c) "Indirect services" means creating case notes, staff meetings, supervision, workshops and conferences, general consultation, teaching, case management activities, and any other related social work practice other than direct client contact.

Section 4.14 Time Allowed for Supervised Practice

Supervised practice towards licensure as an independent clinical social worker may be completed in no less than two years.

Section 4.15 Current Competency: Timing of Supervised Practice

(a) The issuance of a license reflects the applicant's demonstration of current minimum competence to practice social work. To ensure current competence, no fewer than half of the supervised practice hours must occur within five years of completing all requirements for licensure.

(b) No more than 1,500 hours per year may be credited toward the supervised practice requirement.

Section 4.16 Expiration of applications

Applications not completed within five years of their filing expire. They will receive no further action. After five years, a new application and filing fee will be required for anyone seeking licensure.

Section 4.17 Supervision Reports

A supervision report must be submitted by a clinical supervisor. The supervision report shall contain sufficient detail to permit the Board to evaluate an applicant's supervised practice. The supervision report must contain, at a minimum:

(a) applicant's name;

(b) supervisor's name, signature, address, certification or licensure number, state where granted, date granted, and area of specialization;

(d) specific beginning and ending dates of practice covered;

(e) number of practice hours during this period listing separately direct service hours and indirect service hours (to include all duties);

(f) applicant's specific duties;

(g) number of one-to-one supervisory hours;

(h) number of group supervision hours with a maximum of eight individuals in a group supervised by at least one clinical supervisor;

(i) detailed assessment of the applicant's performance;

(j) ethical practices reviewed;

(k) an evaluation of the applicant's ability to provide psychotherapy and practice as an independent clinical social worker.

Part 5 DECISIONS ON LICENSURE

Section 5.1 Right to a Written Decision

(a) The Office will notify applicants in writing of all decisions to either grant or deny a license or license renewal. If a license or renewal is denied, the Office will give the applicant specific reasons and will also inform the applicant of the right to appeal the decision. This is called a "preliminary denial".

(b) The Office most often issues a preliminary denial of licensure or renewal when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing by an Administrative Law Officer. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the Administrative Law Officer issues a final decision in writing. If the decision affirms the preliminary denial of a license, the decision informs the applicant of his or her appellate rights.

Section 5.2 Right to Appeal Licensing Decisions

If the applicant is not satisfied with the final decision concerning the denial of a license or renewal, the applicant may appeal as set forth in 3 V.S.A. § 130a.

Part 6 INFORMATION FOR LICENSEES

Section 6.1 Change of Name or Address

A licensee is responsible for notifying the Office within 30 days if he or she changes name, mailing address or business address. 3 V.S.A. § 129a(a)(14)

Section 6.2 Continuing Education Requirements

Continuing education is intended to enhance the licensee's knowledge and skills toward the goals of safe, ethical, and competent practice of social work.

(a) With the first renewal application after two years of licensure, and with each subsequent renewal application, documentation of completed acceptable continuing education is required. Only continuing education taken within two years of the renewal date is counted.

(1) L.I.C.S.W.: Each licensed independent clinical social worker is required to document and complete twenty (20) hours of continuing education taken during the concluding licensing period.

(2) L.M.S.W.: Each licensed master's social worker is required to document and complete ten (10) hours of continuing education taken in a formal setting during the concluding licensing period.

(b) Only actual time spent in acceptable educational activities may be claimed. Breaks and meals are excluded.

Section 6.3 Eligible Continuing Education Subject Areas

Relevant areas of continuing education may include but shall not be limited to:

(a) clinical theory and techniques; human growth and development; child and family development; individual, marital, family and social change;

(b) social and health research; social and public policy development and implementation (for example, welfare, mental health laws, health care regulation); social work education and supervision;

(c) topics in the fields of medicine, law, administration, education, and behavioral sciences, if specifically relevant to the safe and competent practice of clinical social work.

(d) Those who serve as supervisors are encouraged to take some continuing education training related to supervision.

Section 6.4 Ethics Requirement

At least one and one half (1.5) hours of the total required hours shall be in ethics of social work practice, including such issues as boundaries, confidentiality, and dual relationships.

Section 6.5 Formal Educational Activities

(a) For L.I.C.S.W.'s: At least 15 hours shall consist of formal in person education.

(b) For L.M.S.Ws: All hours must consist of formal education. Formal educational activities may include but are not be limited to:

(1) Conferences, workshops, seminars, academic courses, in-service programs (regularly scheduled staff meetings are not eligible);

(2) Offerings approved or sponsored by national, regional, or state professional organizations in social work and allied disciplines and accredited social work universities and colleges.

Section 6.6 Informal or Self-Directed Educational Activities: For L.I.C.S.W.'s Only

No more than five hours of continuing education may be in informal or self-directed educational activities. Informal or self-directed educational activities may include:

(a) eligible study groups and viewing of educational or training videos, on line offerings or taped programs.

(b) independent study projects or study groups sponsored by organizations listed in these rules or approved by the Director.

(c) on line courses or programs approved by organizations specified in these rules or approved by the Director that do not allow for a live exchange among participants.

Section 6.7 Ineligible Activities

(a) Lectures, teaching, or other activities performed for financial remuneration are not eligible for continuing education credit.

(b) Peer supervision is not eligible for continuing education credit.

Section 6.8 Pre-Approved Activities and Sponsors

The Director will accept eligible continuing education activities offered by the following organizations:

(a) courses and continuing education activities offered by accredited colleges and universities;

(b) seminars, courses, conferences, or workshops sponsored or approved by official national, regional, or state social work professional organizations or state boards;

(c) courses and continuing educational activities sponsored and approved by the appropriate national, regional, or state professional organization in the fields of medicine, law, administration, education, and behavioral sciences;

(d) in-service and continuing education activities sponsored by hospitals, public and private human service agencies and schools which have been approved for continuing education credit by the above organizations.

(e) Credit hours assigned by sponsoring organizations for independent study projects will be accepted by the Office.

(f) Professional development programs, regardless of format, approved by N.A.S.W., N.A.S.W. Vermont, Council on Social Work Education, or A.S.W.B. qualify as approved continuing education programs.

(g) No more than five hours may be claimed for informal or self-directed educational activities. This includes eligible study groups and viewing of educational or training videos, on line offerings or taped programs.

Section 6.9 Documentation and Retention of Records

Licensees maintain the following evidence of continuing education for four years and shall make available to the Office upon request:

(a) documentation of formal educational activities should include programs listing content and speakers, date offered, actual hours of attendance, certification of attendance, course outlines, statements of attendance signed by the instructor, pamphlets, brief summary of work content, and transcripts, if applicable.

(b) documentation of informal educational activities shall include outline of curriculum, objectives, names, addresses and qualifications of speakers or leaders, names and addresses of other participating members, and annotated bibliographies as appropriate, and verification of attendance.

Section 6.10 Continuing Education Audits

(a) The Office will conduct continuing education audits of randomly selected licensees as well as licensees whose licenses are conditioned. The Office may also audit late renewing licensees, and licensees who in any of the preceding two renewal cycles were initially found to have not met continuing education renewal requirements.

(b) When a licensee appears on the audit list, the Office will request documentation from the licensee showing a detailed account of the various credits claimed. The Office will review the documentation and determine if continuing education requirements have been satisfied.

(c) Under 3 V.S.A. § 129(k) the Director may give a licensee 90 days to develop and complete a corrective plan to correct any deficiencies in his or her continuing education requirements.

(d) Failure to comply with a corrective plan may result in disciplinary action. 3 V.S.A. § 129a(a) (4).

Part 7 DISCLOSURE

Section 7.1 Disclosure of Information

(a) As used in this Part 7 only, the term "Social Worker" includes both an L.I.C.S.W. and a person in supervised practice toward licensure as a L.I.C.S.W.

(b) Each social worker shall disclose to each client the following information, printed or typed in easily readable format:

(1) The Social Worker's professional qualifications and experience, including; and

(A) all relevant graduate programs attended and all graduate degrees and certificates earned, including the full legal name of the granting institution, and

(B) a brief description of any special qualifications and areas of practice.

(2) A copy of the statutory definitions of unprofessional conduct ( 26 V.S.A. § 3210, 3 V.S.A. § 129a).

(3) Information on the process for filing a complaint with, or making a consumer inquiry to the Director.

(4) Sample disclosure forms are available from the Office.

(1) a copy of the statutory definitions of unprofessional conduct ( 26 V.S.A. § 3210 and 3 V.S.A. § 129a);

(2) Information on the process for filing a complaint with, or making a consumer inquiry to the Director.

(3) Sample disclosure forms are available from the Office.

(d) Social worker's employed by a designated agency which provides to each client disclosure regarding:

(1) those actions that constitute unprofessional conduct;

(2) the method for filing a complaint or making a consumer inquiry;

(3) the client's right to receive full individual disclosure as provided for Social workers are not employed by designated agencies; are not required to make individual disclosures to each client unless specifically requested by the client. If requested by the client, the Social Worker must document the disclosure as required by these rules.

Section 7.2 Definition

Disclosure means, at a minimum:

(a) posting the information and informing the client where the information is posted, or

(b) having the information printed, displaying the printed information in an easily accessible location, and informing the client where the information is displayed, or

Section 7.3 Timing of Disclosure

(a) Not later than the third office visit, the Social Worker required to make individual disclosures shall present to the client for signature a document stating that the information required to be disclosed above was disclosed to the client. The Social Worker shall also sign the document and shall retain the signed original. If, by the third office visit, disclosure cannot be made, or the client declines to sign, the Social Worker shall prepare and sign a written statement explaining the omission, which shall be retained in place of the signed copy.

(b) Social Worker who provides psychotherapy services to an institutionalized client shall not be required under this rule to repeat information already disclosed to the client pursuant to requirements of other governmental regulatory agencies such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). However, in such cases, the Social Worker shall obtain from the client the signed document required in the paragraph immediately preceding, clearly indicating that the information required to be disclosed under this rule was disclosed to the client pursuant to the requirements of this rule or the requirements of another governmental regulatory agency.

(c) When the client is not able to understand the disclosure, as in the case of an institutionalized person, a minor, or an adult who is under the supervision of a guardian, the disclosure shall be made to a parent or legal guardian.

(d) The Director may audit a Social Worker's records of information disclosure. Social Workers to be audited may be selected at random.

Part 8 License Renewal

Section 8.1 License Renewal

Licenses are issued for a two-year period on a schedule set by the Office of Professional Regulation, and must be renewed by the expiration date printed on the license certificate.

(a) The Office sends emails renewal notices in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not.

(b) A license which is not renewed by its the expiration date expires and is no longer valid.

(c) Initial licenses issued within 90 days of the renewal date will not require renewal and payment of the renewal fee. The license will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 8.2 Expired Licenses

An expired license may be reinstated as permitted by statute upon payment of the required fees.

Section 8.3 Inactive License Status

A license may be placed on inactive status if permitted by statute.

Part 9 DISCIPLINE

Section 9.1 Unprofessional Conduct

(a) Unprofessional conduct for social workers is defined by 26 V.S.A. § 3210 and 3 V.S.A. § 129a. Unprofessional conduct includes failing to comply with provisions of federal or state statutes or rules governing the practice of the profession. Violation of the provisions of the N.A. S.W. Code of Ethics may constitute unprofessional conduct.

(b) The N.A.S.W. Code of Ethics may be found at the NASW website, http://www.socialworkers.org/pubs/code/default.asp.

Section 9.2 Sanctions for Unprofessional Conduct and Unauthorized Practice

(a) The licensee may be disciplined following a hearing upon a finding of unprofessional conduct. Possible disciplinary sanctions that may be imposed on the license of a licensee may include, but are not limited to:

(1) warnings or reprimands;

(2) suspension for a period of time;

(3) revocation;

(4) limitations or conditions on practice;

(5) setting conditions for practice or resumption of practice;

(6) denial of renewal or reinstatement; or

(7) imposition of civil penalties.

(b) All disciplinary actions are public records available online or from the Office.

Section 9.3 Disciplinary Procedure

The Office has a procedure for processing, investigating, and prosecuting unprofessional conduct and unauthorized practice complaints. A copy of the complaint procedure may be obtained from the Office or online under "Disciplinary Procedures" at http://vtprofessionals.org/.

Section 9.4 Confidentiality

The Office follows the confidentiality provisions of 3 V.S.A. § 131

Section 9.5 Appeal

A party aggrieved by a final decision in a disciplinary matter may appeal as set forth in 3 V.S.A. § 130a.

History

EFFECTIVE DATE:
September 1, 1989 Secretary of State Rule Log #89-33
AMENDED:
September 19, 1991 Secretary of State Rule Log #91-48; April 1, 1997 Secretary of State Rule Log #97-03; April 1, 2000 Secretary of State Rule Log #00-13; July 1, 2017 Secretary of State Rule Log #16-029
Statutory Authority: 26 V.S.A. § 3203(b); 3 V.S.A. § 801(b)(11)

Chapter 080 RULES OF THE BOARD OF DENTAL EXAMINERS

04-080 Code Vt. R. 04-030-080-X RULES OF THE BOARD OF DENTAL EXAMINERS

Part 1 General Information

Section 1.1 Appeal

Introduction These rules are divided into general information for all professions regulated herein and individual sections for each of the professions governed: dentists, dental hygienists, and dental assistants These rules also contain rules governing the practice areas of sedation, analgesia, anesthesia, and general supervision of dental hygienists in public or private schools or public or private institutions.

Section 1.2 Appeal

Duty to Inform It is the responsibility of each supervising dentist to inform each person hired to work in an office subject to these rules of the responsibilities and licensing and registration requirements imposed by these rules and to ensure that all employees are properly licensed or registered and trained A copy of these rules shall be readily available to all persons subject to these rules All persons subject to these rules are reminded that 3 Vermont Statutes Annotated (VSA) § 129a(6) includes within the definition of "unprofessional conduct" " Delegating professional responsibilities to a person whom the licensed professional knows, or has reason to know, is not qualified by training, experience, education or licensing credentials to perform them".

Section 1.3 Appeal

The Board's Purpose The State Board of Dental Examiners ("the Board") has been created and given powers by Vermont law The Board's purpose is to protect the public health, safety, and welfare The Board does this by setting standards for issuing licenses and registrations, by licensing and registering only qualified applicants, and regulating license and registration holders and their practices.

Section 1.4 Appeal

Business Address The Board's mailing address is the Office of the Secretary of State, Office of Professional Regulation, Board of Dental Examiners, National Life Bldg, North, FL2, Montpelier, VT 056203402 ("the Office") Copies of these rules and more information about the Board and its requirements and procedures can be obtained by contacting the Office at 18028282363 This information may also be obtained from the Board's Web site at http://vtprofessionalsorg/.

Section 1.5 Appeal

Board Members and Officers The Board is composed of five dentists, two dental hygienists, and two public members all of whom reside in Vermont The dentists are in active practice and have practiced in Vermont for at least five years The dental hygienists are in active practice and have practiced in Vermont for at least three years All members may serve two consecutive five year terms Members are appointed by the Governor.

Section 1.6 Appeal

Terms of Office A chair, vice chair, and secretary are elected annually, usually in September or the Board's first meeting after September Their duties are:

(a) The Chair calls Board meetings, presides at meetings and signs all certificates, vouchers and other official Board papers.

(b) The Vice Chair is authorized to act when the chair is not present or is unable to attend to the duties of office.

(c) The Secretary may, unless delegated to the OPR administrative staff, handle the Board's correspondence, take the minutes of meetings, certify transcripts of proceedings, sign all certificates, and inform the public and all members of Board meetings.

Section 1.7 Appeal

Contacting the Board Names of the Board members and officers may be obtained from the Office or the Board's Web site at http://vtprofessionalsorg/ Members may be contacted through the Office.

Section 1.8 Regular, Special, and Emergency Meetings

(a) The Board holds at least one regular meeting a year, but usually meets monthly. The chair or two other Board members may call a special or emergency meeting when it is necessary.

(b) A majority of the Board constitutes a quorum for all meetings. No formal action at any meeting may be taken unless a majority of the quorum votes in favor of the action. The Office can provide meeting dates and locations. Notice of meetings may usually be found online at http://vtprofessionals.org/.

Section 1.9 Laws Governing the Board

(a) The Board is created by law, Title 26, V.S.A., Chapter 13, which establishes its responsibilities for setting standards, issuing licenses and regulating the profession. The statutes are online at http://www.leg.state.vt.us/statutes/statutes2.htm. In addition, the Board is subject to several other state laws such as the Administrative Procedure Act (Title 3, V.S.A., Chapter 25), the "Law of Professional Regulation" (Title 3, V.S.A., Sections 121-131), the "Right to Know Law" (Title 1, V.S.A., Sections 311-314), and the "Access to Public Records Law" (Title 1, V.S.A., Sections 315-320). These laws spell out the rights of applicants, license holders or members of the public.

(b) The Vermont Statutes Annotated contain the complete text of these laws. They can usually be found in any Town Clerk's office or public library. "Vermont Statutes Online" are also available at http://www.leg.state.vt.us. The Board's statutes and rules may be accessed through the Board's website at http://vtprofessionals.org/.

Section 1.10 Effect of Rules

(a) The Board is authorized to make these rules under Title 26, V.S.A., Sections 767 and 804. These rules are approved by the Vermont Legislative Committee on Administrative Rules and have the effect of law and govern the Board's proceedings. Rules are made following the Administrative Procedure Act ("APA"). The Office of Professional Regulation ("Office") helps the Board to comply with the Act. Rules are reviewed and revised periodically. Rules regulating supervised practice of dental hygienists in public or private schools or public or private institutions will become effective only upon passage of an authorizing amendment to 26 V.S.A. § 854.

(b) Legislative changes from time to time may create inconsistencies between statutes and administrative rules. When rules and statutes conflict, the statutes govern.

Section 1.11 Permitted Practices

(a) Dentists: The following tasks may be performed by licensed dentists only:

(1) Practices permitted by Chapter 13 of Title 26 including diagnosis, treatment planning and prescription, including prescription for drugs and medicaments or authorization for restorative, prosthodontic or orthodontic appliances; or

(2) Surgical procedures on hard and soft tissues within or ancillary to them related to the treatment of the maxillofacial complex and any other intraoral procedure that contributes to and results in an irreversible alteration to the oral anatomy.

(3) Dentists are responsible for general supervision of dental hygienists and "direct supervision" of dental hygienists where specifically required elsewhere in these rules.

(4) Dentists are responsible for the direct supervision of dental assistants.

(b) Clarifications, Limitations on Scope of Practice, Dentists or Dental Hygienists: Oral prophylaxis, oral debridement, periodontal descriptions and charting, including periodontal probing and placement of subgingival chemotherapeutic agents shall be performed only by a licensed dentist or dental hygienist.

Part 2 Definitions

Section 2.1 Definitions

As used in these rules:

(a) "Active practice" -

"active practice" for dentists: means maintaining a valid license in good standing in this or another U.S. or Canadian jurisdiction and providing dental services to patients for at least 800 hours, or accumulating 100 continuing education credits (1 hour = 1 credit) approved by the Board in patient care related subjects during the previous five years. A combination of practice hours and continuing education hours in that ratio may be accepted in the discretion of the Board.
"active practice" for dental hygienists means practicing under a valid license in this or another U.S. or Canadian jurisdiction for no fewer than 50 hours in five years.

(A) Active practice for dental hygienists includes activities which the Board determines to be reasonably related to the retention of competency skills. These may include, but are not limited to traditional clinical practice or volunteer work at dental clinics, public health practice, teaching undergraduate or graduate education, teaching patient education or dental health education at schools, fairs, or meetings of dental professionals.

for dental assistants: there is no active practice requirement.

(b) "ACLS"- means Advanced Cardiac Life Support.

(d) "Board" - means State of Vermont Board of Dental Examiners.

(e) "CODA" - means Commission on Dental Accreditation of the American Dental Association.

(f) "CITA" means Council of Interstate Testing Agencies.

(g) "CPR" - means Cardio-Pulmonary Resuscitation.

(h) "CRDTS" - means Central Regional Dental Testing Service.

(I) "CSE" - means Conscious Sedation Endorsement.

(j) "DANB" - means Dental Assisting National Board.

(k) "Direct Supervision" - means a dentist agreeing to procedures or treatment performed by appropriate personnel by being readily available at the dental facility for consultation or intervention.

(l) "Director" - means the Director of the Office of Professional Regulation.

(m) "Emergency Office Procedures" - means courses in external cardiopulmonary resuscitation which are approved by the Vermont Heart Association or the American Red Cross, or courses which include a review of health conditions and factors which might produce emergencies. Acceptable courses will be consistent with current educational curricula in schools of dentistry and dental hygiene accredited by the Commission on Accreditation of the American Dental Association.

(n) "General Supervision" - (1) in the office of a licensed dentist means a dentist with the responsibility to periodically examine patients, agreeing to procedures or treatment performed by appropriate personnel. The dentist must be available for consultation, but does not necessarily have to be physically present at the dental facility when providing general supervision.

"General supervision" (2) in a public or private school or public or private institution means supervision by a dentist with no less than three years experience in accordance with a general supervision agreement as set forth in Part 10 of these rules. When providing general supervision the dentist must be available for consultation but does not have to be physically present at the site where dental hygiene services are provided.

(o) "GAE" -means General Anesthesia Endorsement.

(p) "Good standing" means that the professional holds a current, unrestricted license and has not been subject to disciplinary action resulting in a finding of unprofessional conduct within the previous five years.

(q) "OPR" - means the Office of Professional Regulation.

(r) "Office" - means the Office of Professional Regulation.

(s) "PALS" - means Pediatric Advanced Life Support.

(t) "PGY1" -means Post Graduate Year.

(u) "NERB - means Northeast Regional Board of Dental Examiners.

(v) "SRTA" - means Southern Regional Testing Agency.

(w) "Supervising dentist" - means that dentist in a practice who is designated to ensure compliance with the licensing and registration requirements of these rules. The designation need not be formal and is not required to be reported to the Board. Each dentist in a practice is charged with ensuring that there is a designated supervising dentist. If no dentist has been designated as the supervising dentist, every dentist in the practice is responsible for ensuring compliance with the licensing and registration requirements of these rules.

(x) "Unrestricted license" - means that the licensed or registered professional is not subject to a sanction following a completed disciplinary action which resulted in a finding of unprofessional conduct.

(y) "V.S.A." - means Vermont Statutes Annotated.

(z) "WREB" - means Western Regional Examining Board.

Part 3 General Licensing and Registration Information

Section 3.1 Definitions

Need for a License or Registration No person may practice in Vermont as a dentist, dental hygienist or dental assistant unless licensed or registered by the Board as specified by these rules and the statutes governing these professions.

Section 3.2 Where to Obtain Applications

(a) License or registration applications may be obtained by writing the Office at:

Vermont Secretary of State

Office of Professional Regulation

National Life Bldg., North, FL2

Montpelier, VT 05620-3402

(b) License or registration applications may also be obtained online at http://vtprofessionals.org/ in the section dedicated to The Board of Dental Examiners.

(c) Submitted applications for licensure or registration must show that the applicant meets the prerequisites listed below for each profession.

Section 3.3 Responsibility for Compliance with the Licensing Requirements

(a) Each supervising dentist must inform each person hired to work in a dental office of the responsibilities and licensing and registration requirements imposed by these rules and to ensure that all employees are properly licensed or registered. If there is no designated supervising dentist, every dentist in the practice shares this duty.

(b) A copy of these rules shall be readily available to all persons subject to these rules.

(c) All persons subject to these rules are reminded that 3 V.S.A. § 129a(6) includes within the definition of "unprofessional conduct" "Delegating professional responsibilities to a person whom the licensed professional knows, or has reason to know, is not qualified by training, experience, education or licensing credentials to perform them."

Section 3.4 Decisions on Licensure and Renewal: Applicant's Right to a Written Decision

(a) The Board will notify applicants in writing of all decisions concerning the granting or denial of a license or registration or renewal of either. If a license or registration or renewal of either is denied, the applicant will be given specific reasons and will also be informed of the right to appeal the Board's decision.

(b) In some instances the Board, or the Office on behalf of the Board, will issue a preliminary denial of licensure or renewal. This most often occurs when it appears from the application and accompanying documents that the applicant does not meet the qualifications for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard in a formal hearing by the Board. If the applicant does not appeal the preliminary denial within 30 days, the denial becomes final. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error, and that he or she is entitled under the statutes and rules to licensure. After that hearing the Board issues a written final decision. The decision will advise the applicant of how to file an appeal.

Section 3.5 Decisions on Licensure and Renewal: Applicant's Right to a Written Decision

Applicant's Right to Appeal a Final Licensing Decision If the applicant is not satisfied with the Board's final decision denying a license or registration or renewal, after a formal hearing the applicant may appeal within 30 days of the date of the decision as provided by law Further information about the appeal process may be obtained from the Office or at http://vtprofessionalsorg.

Part 4 Information for Dentists

Section 4.1 How to Obtain a License as a Dentist

(a) Qualifications for licensure as a dentist are set forth by 26 V.S.A. Chapter 13 §§ 801 through 805. 26 V.S.A. § 804 gives the Board authority to promulgate rules relating to 1) the qualifications of applicants; 2) conducting the examinations; and 3) granting licenses.

(b) Applications for a dental license may be obtained from the Office or online at http://vtprofessionals.org/. An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office.

(c) An applicant may obtain a license as a dentist through one of the following three paths: examination, credentials (also referred to as "endorsement"), or licensed practice experience.

(d) Regardless of route to licensure, each applicant shall:

have graduated from a school of dentistry or dental college accredited by the Commission on Dental Accreditation of the American Dental Association (CODA) or, if the applicant has completed a program of dental education in an unregistered and unaccredited foreign dental school, evidence of successful completion of a minimum of one year of study in a school of dentistry accredited by the Commission on Dental Accreditation of the American Dental Association, resulting in the awarding of a dental degree (D.D.S. or D.M.D.) by that institution;
be at least 18 years of age and not in violation of these rules or statutes governing the profession;

Section 4.2 How to Obtain a License as a Dentist

Licensure by Examination The application and accompanying documents must show that the applicant:

(a) Is at least 18 years of age and not in violation of these rules or statutes governing the profession.

(b) Has graduated from a school of dentistry or dental college accredited by the Commission on Dental Accreditation of the American Dental Association or, if the applicant has completed a program of dental education in an unregistered and unaccredited foreign dental school, evidence of successful completion of a minimum of one year of study in a school of dentistry accredited by the Commission on Dental Accreditation of the American Dental Association, resulting in the awarding of a dental degree (D.D.S. or D.M.D.) by that institution;

(d) Has passed every part of one of the following examinations:

(1) the American Dental Licensing Exam (ADLEX) administered by the Northeast Regional Board (NERB);

(2) the Central Regional Dental Testing Service Examination (CRDTS);

(3) the Council of Interstate Testing Agencies (CITA);

(4) the Southern Regional Testing Agency Examination (SRTA);

(5) the Western Regional Examining Board Examination (WREB);

(6) another regional or national clinical examination approved by the Board before the examination is taken, or;

(7) has passed the board certifying examinations of the American Dental Association's recognized specialty boards.

(e) Has completed training in emergency office procedures required in Rule 2. 1(m), and;

(f) Has successfully completed the Vermont dental statutes and rules examination. The examination questions are available from the Office or online at http://vtprofessionals.org/.

Section 4.3 Testing Information

(a) Information on the NERB may be obtained by writing to:

Office of the Secretary

Northeast Regional Board of

Dental Examiners

8484 Georgia Avenue, Suite 900

Silver Spring, MD 20910

(b) Information on the CRDTS may be obtained by writing to:

Central Regional Dental Testing Service

5200 Huntoon Street

Topeka, Kansas 66604

Southern Regional Testing Agency

1072 Laskin Road

Suite 203

Virginia Beach, Virginia 23451

(d) Information on the WREB may be obtained by writing to:

Western Regional Examining Board

10040 North 25th Avenue

No. 116

Phoenix, Arizona 85021

(e) Should changes occur after adoption of these rules, the Office should be able to provide up-dated contact information.

(f) If other regional board or national testing organizations are formed, the Board, at its discretion, may accept passage of their examinations as fulfilling the requirements of this rule.

(g) The Board will compare additional regional or national examinations and examination services to the ones listed before deciding whether other examinations should be approved.

(h) Applicants should check with the Board before taking an examination other than one specifically named herein to verify whether the examination has been approved by the Board.

Section 4.4 Testing Information

Previously Licensed, but Who Do Not Meet Active Practice Requirements If the applicant meets all the requirements for licensure but has not actively practiced dentistry for five years or more, the applicant must:

a) successfully complete a clinical course approved by the Board which will assure competence to reenter dental practice. A course taken to satisfy this rule must be one offered by a CODA accredited dental school, or;

b) successfully complete the NERB, or the written portion of NERB and CRDTS, SRTA, WREB, or other examination as in Rule 4.3 immediately preceding the filing of the application.

c) successfully complete the Vermont dental statutes and rules examination. The examination questions are available from the Office or online at http://vtprofessionals.org/.

Section 4.5 Licensure by Endorsement

(a) The Board may issue a license to an applicant who meets the requirements of Rule 4.1(d) and:

(1) is currently licensed to practice dentistry in any jurisdiction of the United States or Canada whose licensing requirements are deemed by the Board to be substantially equivalent to those of this state and;

(2) is in good standing as verified to the Board by the licensing authority of that jurisdiction, and;

(3) has been in active practice and;

(4) has passed an examination administered by the Board testing the applicant's knowledge of Vermont laws and rules of the profession; and

(5) has completed the emergency office procedure training as described in Rule 2.1(m).

(b) For purposes of determining active practice the Board may include periods of

(1) dental practice within the military service,

(2) teaching in an accredited dental school,

(3) accredited dental residency programs, and

(4) residency programs in American Dental Association recognized board specialties may be considered.

Section 4.6 PGY Licensed Experience: Endorsement, 5 Year Rule

The Board may grant a license to a person licensed in a jurisdiction of the United States or Canada who obtained licensure through a CODA approved PGY1 residency program, rather than passing the examination required in Rule 4. 3, if the Board in its discretion, determines:

(a) that the applicant has been in practice full time of at least 1,200 hours per year for a minimum of five years, and is in good standing in all jurisdictions in which licensed;

(b) that the applicant's practice experience or education overcomes any lesser licensing requirement of that other jurisdiction; and

(c) that the applicant has successfully completed the Vermont dental statutes and rules examination. The examination questions are available from the Office or online at http://vtprofessionals.org/, and;

(d) met the requirements of 4.1(d).

Section 4.7 Licensure by Licensed Experience, 5 Year Rule

(a) The Board may issue a license to an applicant who is currently licensed to practice dentistry in any jurisdiction of the United States or Canada whose licensing requirements are deemed by the Board to be not substantially equivalent to those of this state if:

(1) the applicant meets the requirements of Rule 4. 1(d);

(2) the applicant is in good standing as verified to the Board by the licensing authorities of all jurisdictions in which licensed;

(3) the applicant has been in practice full time of at least 1,200 hours per year for a minimum of five years before the application, and;

(4) the Board in its discretion determines that the applicant's practice experience or education overcomes any lesser licensing requirement(s) of that other jurisdiction, and;

(5) the applicant has successfully completed the Vermont dental statutes and rules examination. The examination questions are available from the Office or online at http://vtprofessionals.org.

(b) For purposes of determining active practice the Board may include periods of:

(1) dental practice within the military service,

(2) teaching in an accredited dental school,

(3) accredited dental residency programs, and

(4) residency programs in American Dental Association recognized board specialties may be considered.

Section 4.8 Licensure by Licensed Experience, 5 Year Rule

Transient Practice Permit A person who is not licensed in Vermont may obtain, without payment of a licensing fee, a transient practice permit from the Board to perform acts constituting the practice of dentistry, provided that:

(a) The practice in Vermont does not exceed 10 days in any calendar year;

(b) The person is licensed as a dentist in another jurisdiction of the United States or Canada which, in the opinion of the Board, has regulatory standards substantially equivalent to those currently in effect in Vermont; and

Section 4.9 Licensure by Licensed Experience, 5 Year Rule

Display of Dentist License The dental license or certificate, or a photo copy if the licensee practices at more than one location, must be conspicuously displayed in the licensee's place(s) of practice Licensees may black out or cover their residence address if it appears on the license.

Section 4.10 Licensure by Licensed Experience, 5 Year Rule

Maintaining a Dentist License The Board will renew a license when the dentist shows the active practice, / continuing education, and emergency office procedures requirements set forth below have been met.

Section 4.11 Licensure by Licensed Experience, 5 Year Rule

Active Practice Requirement In order to renew a license each dentist must maintain a license in good standing and engage in active practice, for at least 800 hours, or accumulate 100 continuing education credits approved by the Board in practice related subjects during the previous five years A combination of practice hours and continuing education hours in that ratio may be accepted in the discretion of the Board.

Section 4.12 Licensure by Licensed Experience, 5 Year Rule

Continuing Education Requirement In addition to meeting the active practice requirement in subsection (a) above, a dentist must also document completion of 30 hours professional education which shall include emergency office procedures courses during the two year licensing period preceding renewal Except for emergency office procedures, this provision shall apply only to renewals after an applicant's initial two years of practice in Vermont.

Section 4.13 Approval of Continuing Education Programs

(a) Standards - A program meets Board qualifications if it is a formal course of learning which contributes to the growth of professional knowledge and competence in providing patient care.

(b) The board will consider a continuing education course to be a "formal course of learning" if it meets the following criteria: The course is conducted by a qualified instructor who will be able to instruct and interact in any of the following formats:

(1) Classroom Instruction - Traditional in-classroom, with instructor and student interaction and written materials;

(4) Self-study courses which conclude with an examination may be accepted.

(c) Case-by-case approval - Individual courses may be approved upon submitting to the Board a course outline, instructor qualifications, sponsoring organization, and dates of presentation. Advance approval is not required. The Board will not approve a course or program for continuing education credit if, in its discretion, the Board determines that the program does not contain sufficient educational content.

(d) Approved sponsors may include the ADA, ADHA, ADAA, and their constituent and component dental societies and associations, CODA accredited schools or programs, and home study programs sponsored by any of the above groups. Approved sponsors will also include any sponsor that has ADA, CERP, or AGD, PACE certification.

(e) Courses in practice management and financial management will be accepted if they contribute to the growth of professional knowledge and competence in providing patient care. Examples include, but are not limited to the following:

(1) courses that promote communication among members of the dental team and between members of the dental team and patients;

(2) ethics;

(3) insurance billing and coding; and

(4) proper patient record keeping.

(f) The Board considers that the following are among the subjects that do not contribute to the growth of professional knowledge and competence in providing patient care, and will not be approved by the Board for continuing education credit:

(1) accounting and similar topics;

(2) business administration or management;

(3) cultural matters;

(4) general office and computer skills:

(5) memory training;

(6) personal business and financial planning matters;

(7) personal development;

(8) personal health and recreation;

(9) personal money management;

(10) politics;

(11) software for office use;

(12) speed reading;

(13) success training;

(14) time management; and

(15) web site development.

Section 4.14 Approval of Continuing Education Programs

Verification Audits The Board may conduct random audits to verify completion of continuing education up to seven years after a license is renewed Upon request by the Board, the licensee shall submit certificates of completion for all programs listed in the licensee's renewal application.

Section 4.15 Approval of Continuing Education Programs

Failure to Meet Active Practice/Continuing Education Requirement A dentist who fails to meet the active practice/continuing education requirement will be refused renewal and must file an application and must successfully complete the examinations required by Rule 44.

Section 4.16 Approval of Continuing Education Programs

Emergency Office Procedures Completion of a course in emergency office procedures as defined in Rule 21(m) is required for license renewal.

Part 5 Sedation, Analgesia, Anesthesia: Special Endorsements, Incident Reports

Section 5.1 Approval of Continuing Education Programs

Preamble The Board seeks to protect the public health, safety and welfare by adopting specific rules in the area of anesthesia and pain reduction The Board recognizes the value of making comfortable dental services available to those who might otherwise postpone or avoid necessary dental care It recognizes that there can be some risk in the use of certain medications By these rules the Board seeks to ensure that practitioners are adequately prepared to use such medications in their practice.

Section 5.2 Incident Reports

(a) Each dentist, whether or not holding a special endorsement provided under these rules, must submit a complete report to the Board within 30 days of any incident which occurs in the dentist's office or outpatient facility during, or as a direct result of the administration of any anesthetic, local or general, anxiolysis, parenteral deep sedation, or parenteral conscious sedation, or sedation regardless of the route of administration, which results in a patient being transported to a hospital, hospitalization, or death.

(b) The incident report shall be submitted whether or not the patient is admitted, and whether or not the incident has the potential for life-threatening consequences. A report of an incident shall include a statement setting forth the names and credentials of those present or participating during the anesthesia, anxiolysis or sedation. Failure to comply with this reporting requirement may result in disciplinary action including loss of a special endorsement.

Section 5.3 Anesthesia Definitions and Guidelines

(a) "Administering nitrous oxide analgesia" means: the dispensing, applying, or offering of nitrous oxide analgesia to a dental patient.

(b) "Anxiolysis" means: the reduction of anxiety through the administration of pharmacological agent or agents. The administered dose should be within the guidelines for dosage on the manufacturer's package insert, or using techniques taught by CODA approved programs. When anxiolysis is achieved, the patient

(1) is conscious;

(2) can and does respond to conversation appropriately without extra stimulation; and

(3) is fully able to independently and continuously maintain an unimpeded airway.

(c) "Conscious Sedation" means a depressed level of consciousness achieved through the administration of a pharmaceutical/pharmacological agent or agents in which:

(1) the patient retains the ability to independently and continuously maintain an airway;

(2) the patient's ability to comprehend questions and conversation and react appropriately is suppressed;

(3) protective reflexes remain active; and

(4) the patient is easily aroused.

(d) Techniques and pharmaceutical or pharmacological agents used to achieve conscious sedation must render unintended consequences unlikely. Doses shall be within the guidelines on the manufacture's package insert or used according to techniques taught by CODA approved programs. Intravenous pharmaceutical or pharmacological agents used to achieve conscious sedation are limited to those for which there is a reversal agent.

(e) Dentists who administer a pharmaceutical/pharmacological agent or agents with the intent to achieve conscious sedation in a patient and who do not possess a General Anesthesia Endorsement must obtain a Conscious Sedation Endorsement from the Board.

(f) " Deep Sedation " - Deep sedation is a controlled state of depressed consciousness accompanied by partial loss of protective reflexes, including the inability to continually maintain an airway independently and/or to respond purposefully to verbal command, and is produced by a pharmacologic or non-pharmacologic method or combination thereof. Deep sedation may not be employed without a General Anesthesia Endorsement issued by the board.

(g) "General Anesthesia" - General anesthesia is a controlled state of unconsciousness accompanied by a partial or complete loss of protective reflexes, including inability to independently maintain an airway and respond purposefully to physical stimulation or verbal command, and is produced by a pharmacologic or non-pharmacologic method or combination thereof.

(h) "Monitoring" - For purposes of these rules, monitoring patients who have received analgesic or anesthetizing drugs or otherwise mind altering drugs means observing the patient and evaluating through clinical evaluation, electronic and mechanical means, recognizing adverse reactions or complications, and reporting any adverse reaction or complication to the supervising dentist, where applicable, immediately. The degree of monitoring necessary depends on the level of sedation or anesthesia achieved.

Section 5.4 Anesthesia Definitions and Guidelines

Subsection Regarding: Authorization to Administer Anesthesia or Certain Pharmaceuticals or Pharmacological Agents.

Section 5.5 Anesthesia Definitions and Guidelines

When No Endorsement Required A dentist needs no special endorsement to employ the following:

(a) Nitrous Oxide: Use of nitrous oxide in a dental office does not require a special license or endorsement.

(1) Under direct supervision of a licensed dentist, registered dental assistants and licensed dental hygienists instructed and trained by the dentist may monitor nitrous oxide analgesia during a dental procedure. Administration of nitrous oxide analgesia, as well as prescription, initiation, and determination of nitrous oxide analgesia levels and release and discharge of the patient after administration of nitrous oxide analgesia, shall be performed by and shall be the responsibility of the supervising dentist.

(2) All individuals administering and monitoring nitrous oxide analgesia must, in addition to required emergency office procedures, have annual CPR training.

(b) Local Anesthesia: Administration of local anesthesia by dentists does not require a special endorsement from the Board.

(c) Anxiolysis: Dentists who administer a pharmaceutical/pharmacological agent or agents with intent to achieve a state of "anxiolysis" as defined in these rules do not require a specific Board endorsement of authority. This includes the prescription of orally-administered, rectally-administered, or nasally-administered sedatives by dentists for anxiolysis before treatment which may be supplemented by nitrous oxide.

Section 5.6 Anesthesia Definitions and Guidelines

Duty for Use of Pharmaceuticals As licensed professionals, dentists employing the above, or any pharmaceuticals, are responsible to assure that they possess sufficient knowledge of the proper use of medications to achieve analgesia, anxiolysis, sedation, or anesthesia They must be able to respond if pharmaceuticals intended to achieve anxiolysis have unintended effects If patients given anxiolysis medications go to the next level beyond anxiolysis, dentists must have the knowledge and resources to manage the effects of the medication.

Section 5.7 Anesthesia Definitions and Guidelines

Endorsements Required A Special Endorsement from the Board is required before use of Conscious Sedation or General Anesthesia.

Section 5.8 Conscious Sedation: Special Endorsement Required

Dentists Who Do Not Have a General Anesthesia Endorsement and Who Wish to Employ Conscious Sedation as Defined by These Rules must Obtain a Conscious Sedation Privilege Endorsement from the Board.

Section 5.9 Conscious Sedation: Special Endorsement Required

Introduction To Conscious Sedation The administration of conscious sedation carries with it inherent risks and added responsibility for care of the patient Titration of oral medication for the purposes of sedation is unpredictable Improper or repeated dosing of orally administered sedative agents can result in an alteration in the state of consciousness beyond the intent of the practitioner The administration of conscious sedation on an outpatient basis by dentists is, with appropriate safeguards, an accepted patient care modality.

Section 5.10 Need for Conscious Sedation Endorsement

(a) Dentists who do not possess a general anesthesia endorsement under rules 5.24 - 5.26 herein and who wish to use pharmaceutical/pharmacological agents to achieve conscious sedation may do so only in compliance with the requirements of these rules.

(b) No Dentist may employ a pharmacological agent or agents with the intent of achieving conscious sedation without first obtaining from the Board an endorsement of authority to employ conscious sedation. The endorsement shall be maintained with the dentist's license.

Section 5.11 Need for Conscious Sedation Endorsement

Application for Conscious Sedation Endorsement A licensed dentist seeking conscious sedation administration privileges shall file an application with the Board, on the form provided by the Office Applicants must submit:

(a) Documentation of satisfactory completion of a conscious sedation training program provided under the auspices of a dental school or program accredited by the Commission on Dental Accreditation of the ADA. The program must:

(1) include a minimum of 60 hours of didactic and clinical study including training in conscious sedation, physical evaluation, venipuncture, technical administration;

(2) include training in recognition and management of complications and emergencies;

(3) include documented clinical experience in managing compromised airways and certification of competency in airway management from the program director;

(4) include training in monitoring patient vital signs to assure expertise in interpretation of those signs and appropriate reaction to them;

(5) contain additionally supervised experience in providing conscious sedation including successful management of parenteral conscious sedation for no fewer than 20 patients;

(6) be given in an organized sequence of study administered by one entity; and

(7) be completed in less than two calendar years or as part of a CODA accredited dental specialty training program; or

(b) Certification by an CODA accredited school showing that the applicant has completed a course of training in conscious sedation while a student in an accredited school of dentistry or through postgraduate training which meets the requirements of the ADA Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry; or

(c) Conscious Sedation Endorsement Based on Endorsement from Another Jurisdiction: documentation showing that he or she is a licensed dentist in good standing in a jurisdiction of the United States or Canada having conscious sedation standards substantially equivalent to those of this state; or

(d) for those treating children under 12 years of age, documentation of appropriate training, in pediatric sedation techniques according to the guidelines of the American Academy of Pediatric Dentistry and in pediatric resuscitation including the recognition and management of pediatric airway and respiratory problems; and

(e) A signed affidavit certifying that the dentist:

understands the requirements of these rules; and
will use a properly staffed and equipped facility as defined in rule 5.13 of this Section for the administration of conscious sedation.

Section 5.12 Issuance of Endorsement

(a) When the applicant has shown compliance with the rules, the Board will issue a conscious sedation endorsement. The endorsement, unless renewed with the biennial renewal, will expire at the end of the licensing period.

(b) The Board, in its discretion, may waive some or all of the Rule 5.11(a) training requirement upon the applicant's showing adequate initial training in conscious sedation in a CODA approved program, and treatment of a minimum of 10 patients in the preceding two years before the application (Rule 5. 19(a)(2)), which assures the Board that the applicant has the current ability to employ conscious sedation with safety.

Section 5.13 Facility and Personnel Requirements

(a) Facility Requirements: A dentist employing conscious sedation may do so only in a properly equipped facility which shall include at a minimum:

Sphygmomanometer, stethoscope, and pulse oximeter,

A positive pressure oxygen delivery system with full face masks and connectors capable of delivering to the sedated patient oxygen under positive pressure, plus a back up system;
emergency drugs and equipment appropriate to the medications administered including drugs appropriate to address emergencies and drugs appropriate for ACLS or PALS;
suction equipment;
an emergency back up light source system that will permit safe termination of any procedure under way; and
a defibrillator.

(b) Staffing Requirements:

(1) In addition to the dentist or other professional permitted under these rules to administer pharmaceuticals to achieve conscious sedation, there must be a minimum of one assistant licensed or registered under Chapter 13 of Title 26 who possesses a current certification in cardio pulmonary resuscitation and is capable of assisting with procedures, problems and emergencies incident to the administration of such sedation.

(2) A licensed or registered dental assistant or dental hygienist trained in airway management must remain with the patient until the patient's escort arrives, and the patient is able to maintain a patent airway unassisted.

Section 5.14 Patient Risk Criteria

(a) Conscious sedation may be provided in a dental office for patients who are Class I and II as classified by the American Society of Anesthesiologists (ASA).

(b) Conscious sedation shall not be provided in a dental office for patients in ASA risk category V.

(1) by an oral and maxillofacial surgeon after performing an evaluation and documenting the ASA risk assessment category and any special monitoring requirements that may be necessary; or

(2) by a dentist with a conscious sedation endorsement after consultation with the patient's primary care physician or other medical specialist regarding potential risk and special monitoring requirements that may be necessary.

Section 5.15 Monitoring Requirements

To minimize risks to patients, a dentist who uses conscious sedation shall:

(a) Ensure that monitoring of a patient under conscious sedation begins prior to the administration of sedation, and takes place continuously during the procedure and recovery from sedation. The person who administers the sedation or another licensed practitioner qualified to administer conscious sedation shall remain on the premises until the patient is responsive and discharged;

(b) Ensure that monitoring includes:

(1) continuous direct clinical observation of the patient;

(2) interval recording of blood pressure and pulse;

(3) continuous evaluation of oxygen saturation; and

(4) additional devices such as EKG for monitoring when dictated by the medical needs of the patient;

Section 5.16 Conscious Sedation Protocols

The dental office shall develop written protocols for sedation of dental patients addressing the following:

(a) preoperative patient evaluation and selection prior to conscious sedation,

(b) informed consent,

(d) sedation record keeping procedures, and

(e) patient discharge assessment.

Section 5.17 Emergency Protocols

(a) The dental office shall develop written protocols for sedation-related emergencies addressing the following:

(1) Laryngospasm,

(2) Bronchospasm,

(3) Aspiration of emesis,

(4) Angina Pectoris,

(5) Myocardial infarction,

(6) Hypotension,

(7) Hypertension,

(8) Cardiac arrest,

(9) Hyperventilation,

(10) Hypoventilation,

(11) Convulsions,

(12) Allergic and toxic reaction, and

(13) Airway occlusion by foreign body.

(b) Training to educate assistants with respect to these protocols must be provided to all sedation team assistants and updated periodically.

Section 5.18 Emergency Protocols

Records of Conscious Sedation Administration The following records shall be made for each administration of conscious sedation:

(a) relevant medical history of the patient;

(b) consent for administration of conscious sedation prior to the performance of any procedure and administration of any drugs;

(c) preoperative, intra operative and pre-discharge monitoring of blood pressure, pulse, respiration and oxygen saturation where the level of patient cooperation and/or medical/physical limitations of the patient allows; and

(d) drugs and dosages of drugs used during the operative procedure, and times of their administration over the course of the procedure.

Section 5.19 Emergency Protocols

Renewal of Conscious Sedation Endorsement: Continued Competence At the time of license renewal, a dentist who wishes to renew the conscious sedation endorsement shall:

(a) provide documentation of:

(1) 6 hours of continuing education in conscious sedation during the licensing period; and

(2) treatment of a minimum of ten patients in the preceding two years. In cases where the renewal occurs less than two years after the conscious sedation endorsement was initially issued, the Board may waive all or part of this requirement.

(b) provide documentation of current, successful completion of an Advanced Cardiac Life Support (ACLS) or Pediatric Advanced Life Support (PALS) training as appropriate. This training may be applied toward the continuing education requirement in this rule.

Section 5.20 Emergency Protocols

Others Permitted to Administer Conscious Sedation: Certified Registered Nurse Anesthetists.

(a) A dentist who holds a valid conscious sedation endorsement from the board may permit a Certified Registered Nurse Anesthetist (CRNA) to administer conscious sedation. Use of a Certified Registered Nurse Anesthetist does not relieve the dentist of responsibility for the patient.

(b) A dentist who does not hold a conscious sedation endorsement may not have a CRNA administer conscious sedation.

Section 5.21 Emergency Protocols

Exemptions from Conscious Sedation Endorsement Requirement A dentist does not need to hold a conscious sedation endorsement when conscious sedation is administered by:

(a) another assisting dentist, who possesses one; or

(b) a physician anesthesiologist.

(c) "Physician" for purposes of this section means a physician who is licensed to practice medicine and all of its branches under the laws of Vermont and is authorized to provide anesthesia services in a licensed hospital or licensed ambulatory surgical treatment center, or is an anesthesiologist.

(d) Administration of conscious sedation under the exemption sections above is permitted only in facilities which meet the equipment and staffing requirements of these rules.

Section 5.22 Incident Reports

(a) Each dentist, whether or not holding a special endorsement provided under these rules, must submit a complete report to the Board within 30 days of any mortality, or other incident which occurs in the dentist's office or outpatient facility during, or as a direct result of, the administration of any anesthesia, local or general, anxiolysis, parenteral deep sedation, or parenteral conscious sedation or sedation regardless of the route of administration, and which results in a patient being transported to a hospital, hospitalization, or death.

Section 5.23 Incident Reports

Conscious Sedation Provisions: Effective Date Effective January 1, 2007 no dentist shall administer a pharmaceutical agent or agents to induce conscious sedation without first obtaining a conscious sedation endorsement or general anesthesia endorsement from the Board.

Section 5.24 Incident Reports

General Anesthesia: Endorsement Required Dentists who employ general anesthesia must obtain a Special Endorsement from the Board.

Section 5.25 Incident Reports

Obtaining a General Anesthesia Endorsement The Board will issue a General Anesthesia Endorsement to authorize qualified dentists to administer general anesthesia, parenteral deep sedation, and parenteral sedation, and parenteral conscious sedation in dental offices.

Section 5.26 Incident Reports

Prerequisites to Approval An applicant must demonstrate that he or she:

(a) has a properly staffed and equipped facility, as set forth in the current edition of the Office Anesthesia Evaluation Manual of the American Association of Oral and Maxillofacial Surgeons; and

(b) has either completed a minimum of 12 months of advanced clinical training in anesthesiology and related academic subjects (or the equivalent) beyond the undergraduate dental school level in a training program, as set forth in Part II of the current edition of the Guidelines for Teaching the Comprehensive Control of Pain and Anxiety in Dentistry of the American Dental Association; or

(c) is a diplomate of the American Board of Oral and Maxillofacial Surgery, is a fellow or member of the American Association of Oral and Maxillofacial Surgeons, or is a fellow of the American Dental Society of Anesthesiology or has successfully completed a CODA accredited oral and maxillofacial surgery residency program.

Section 5.27 Incident Reports

(a) Each dentist, whether or not holding a special endorsement provided under these rules, must submit a complete report to the Board within 30 days of any mortality, or other incident which occurs in the dentist's office or outpatient facility during, or as a direct result of the administration of any anesthesia, local or general, anxiolysis, parenteral deep sedation, or parenteral conscious sedation, or sedation regardless of the route of administration, which results in a patient being transported to a hospital, hospitalization, or death.

(b) The incident report shall be submitted whether or not the patient is admitted, and whether or not the incident has the potential for life-threatening consequences. A report of an incident shall include a statement setting forth the names and credentials of those present or participating during the anesthesia, anxiolysis, or sedation. Failure to comply with this reporting requirement may result in disciplinary action including loss of a special endorsement.

Section 5.28 Incident Reports

Exemption from General Anesthesia Endorsement Requirement The General Anesthesia Endorsement requirement does not apply to dentists administering general anesthesia, parenteral deep sedation, or parenteral conscious sedation in a hospital setting with supervision by an physician or dentist credentialed by the hospital to provide anesthesia services.

Section 5.29 Incident Reports

Renewal of Special Endorsements A special endorsement must be renewed every two years at the same time as license renewal A special endorsement which is not renewed lapses on the expiration date In cases where the renewal occurs less than two years after the general anesthesia endorsement was initially issued, the Board may waive all or part of the renewal requirement.

Section 5.30 Incident Reports

Inspection of Dentist Offices The Board may as it deems appropriate inspect a licensee's facility, equipment, and staff Such inspection shall be conducted by a person or team appointed by the Board or office.

Part 6 Information for Dental Hygienists

Section 6.1 Incident Reports

Dental Hygienist License This license allows a person to practice dental hygiene in Vermont It includes the dental hygienist who is practicing expanded function dental assisting duties or administering local anesthesia by endorsement.

Section 6.2 Incident Reports

How to Become Licensed as a Dental Hygienist There are two ways to qualify for a license as a dental hygienist, licensure by examination, licensure by endorsement.

Section 6.3 Incident Reports

Licensure by Examination To qualify by examination, the applicant must file a written application (obtained from the Office or online), showing that the applicant:

(a) Is at least 18 years old; and

(b) Has graduated from a school of dental hygiene accredited by the Commission on Dental Accreditation of the American Dental Association;

(d) Has completed the emergency office procedure training required in Rule 6. 21; and

(e) Has passed the Northeast Regional Board Examination ("NERB") or the Central Regional Dental Testing Service Examination ("CRDTS") or a successor regional or national examination approved by the board before the examination is taken.

Section 6.4 Testing Information

(a) Information on the NERB may be obtained by writing:

Office of the Secretary

Northeast Regional Board of Dental Examiners

8484 Georgia Avenue, Suite 900

Silver Spring, MD 20910

(b) Information of the CRDTS may be obtained by writing:

Central Regional Dental Testing Service, Inc.

1725 SW Gage Blvd.

Topeka, KS 66604-3333

(c) Should changes occur after adoption of these rules, the Office should be able to provide up-dated contact information.

Section 6.5 Testing Information

Vermont Rules and Statutes Examination The applicant must successfully complete the Vermont dental statutes and rules examination which is available from the office or on line and submit it with the application.

Section 6.6 Testing Information

Licensure by Endorsement To qualify by endorsement, the applicant must file an application (obtained from the Office or online), showing that the applicant:

(a) Is currently licensed in a jurisdiction of the United States or Canada with requirements of education and examination which are substantially equivalent to those currently in effect in Vermont;

(b) Is currently in good standing and has not been disciplined in any jurisdiction where the applicant has been licensed, or has been fully reinstated after having been disciplined;

(d) The applicant must successfully complete the Vermont dental statutes and rules examination which is available from the office or on line and submit it with the application.

Section 6.7 Reserved

Section 6.8 Reserved

Transient Practice Permit A person who is not licensed in Vermont may obtain a transient practice permit from the Board to perform acts constituting the practice of dental hygiene, provided that:

(a) The practice in Vermont does not exceed 10 days in any calendar year;

(b) The person is licensed as a dental hygienist in a jurisdiction of the United States or Canada which, in the opinion of the Board, has regulatory standards substantially equivalent to those currently in effect in Vermont; and

Section 6.9 Reserved

Local Anesthesia Privileges for Dental Hygienists A licensed dental hygienist may qualify for a special endorsement and may undertake the administration of local anesthesia upon:

(a) satisfactorily completing a course of study of at least 24 hours of instruction or three eight-hour days of instruction in a formal program in expanded function dental hygiene sponsored by an institution accredited by the Commission on Dental Accreditation of the American Dental Association. The course must include didactic and clinical studies in the administration of block and infiltration anesthesia. The curriculum must include:

(1) Medical history evaluation procedures,

(2) Understanding pharmacology of local anesthesia and vasoconstrictors,

(3) Anatomy of head, neck, and oral cavity as it relates to administering local anesthetic agents,

(4) Indications and contraindications for administration of local anesthesia,

(5) Selection and preparation of the armamentaria and record keeping for administering various local anesthetic agents,

(6) Medical and legal management of complication,

(7) Recognition and management of post-injection complications and management of reactions to injections,

(8) Proper infection control techniques with regard to local anesthesia and proper disposal of sharps,

(9) Methods of administering local anesthetic agents, with emphasis on:

(A) Technique,

(B) Minimal effective dosage,

(10) A certificate of course completion and a copy of the syllabus must be provided to the Board.

(b) Successfully completing the written examination in the administration of local anesthesia authorized by the Board.

Section 6.10 Reserved

Anesthesia Endorsement A dental hygienist in good standing and who has been licensed and trained to administer local anesthesia in any jurisdiction of the US or Canada having substantially equivalent standards may qualify for a special endorsement to perform that function by presenting written documentation of such licensure and training to the Board.

Section 6.11 Reserved

Maintaining Anesthesia Privileges A dental hygienist may maintain local anesthesia privileges by administering at least 50 local anesthetic injections during the previous five years Otherwise, a dental hygienist must satisfy the Board of competence to administer local anesthesia by successfully completing a course of three or more eighthour days of instruction The course must include didactic and clinical studies in the administration of block and infiltration anesthesia and must meet the curriculum requirements of Rule 69(a) above.

Section 6.12 Dental Hygienists, Expanded Function Duties

(a) A licensed dental hygienist may qualify for registration as an expanded function dental assistant and may perform the expanded function dental assisting duties for which the dental hygienist has been trained in a formal program in expanded function dental assisting accredited by the Commission on Dental Accreditation of the American Dental Association.

(b) A dental hygienist trained as an expanded function dental assistant may be registered by substantiating the adequacy of training.

Section 6.13 Dental Hygienists, Expanded Function Duties

Dental Hygienists, Expanded Functions Duties, Scope of Practice Dental hygienists performing expanded function duties must limit the expanded duties to those for which the dental hygienist is trained within the limits of Vermont rules.

Section 6.14 Dental Hygienists, Expanded Function Duties

Maintaining a Dental Hygienist License To maintain a license as a dental hygienist, the licensee must meet the active practice, continuing education (Rule 616), and emergency office procedures requirements.

Section 6.15 Dental Hygienists, Expanded Function Duties

Active Practice If the applicant has not met the dental hygiene active practice requirement immediately preceding application or renewal, the applicant must successfully complete the NERB or CRDTS or other examination approved by the Board.

Section 6.16 Mandatory Continuing Education for Dental Hygienists

(a) During each full licensing period, licensed dental hygienists must satisfactorily complete 12 hours continuing education as prescribed below. Effective after the 2009 renewal: dental hygienists must satisfactorily complete 18 hours of continuing education as provided below.

(b) Exception: New licensees will not be required to submit evidence of continuing education, except emergency office procedures required by Rule 6. 21, until the first full two-year renewal period following initial licensure.

(d) Types of Education: Nine credits or hours must be taken in clinical or didactic dental or dental hygiene subject areas. Effective after the 2009 renewal: 15 credits or hours must be taken in clinical or didactic dental or dental hygiene subject areas. The remaining three credits or hours may be taken in non-scientific areas appropriate to the practice of dental hygiene.

(e) One hour of continuing education credit shall be given for each hour of attendance at lectures, seminars, or other similar programs. Home study course credit will be determined by the course sponsor based upon the reasonable amount of time necessary to cover course material.

(f) Credit hours obtained during a renewal period shall not be applied to any succeeding renewal period.

(g) Approved course sponsors shall include:

(1) American Dental Hygienist's Association (ADHA),

(2) American Dental Association (ADA),

(3) Constituent and component state dental hygiene associations and constituent and component state dental societies,

(4) Academy of General Dentistry,

(5) Dental or dental hygiene teaching institutions accredited by the Commission on Dental Accreditation (CODA) of the ADA,

(6) Home study courses sponsored by any of the organizations or institutions listed in subparagraphs 1 through 5 above.

Section 6.17 Mandatory Continuing Education for Dental Hygienists

Documentation Licensees must obtain an authenticated document of attendance from the course sponsor The document of attendance shall include:

(a) Participant's name,

(b) Title or subject area of course,

(d) Date and location of course,

(e) Number of lecture and clinical or laboratory participation hours.

Section 6.18 Mandatory Continuing Education for Dental Hygienists

Retention of Continuing Education Records Documents pertaining to continuing education programs attended shall be retained by the licensee for seven years.

Section 6.19 Mandatory Continuing Education for Dental Hygienists

Verification of Compliance Compliance with continuing education requirement shall be verified by the licensee's signature on the license renewal form.

Section 6.20 Mandatory Continuing Education for Dental Hygienists

Audits The Board may audit licensees for compliance with the continuing education requirement The auditing procedure shall be as follows:

(a) A letter will be sent by the Board requesting the licensee to provide within 30 days photocopies of authenticated documents of attendance obtained from course sponsors.

(b) Documentation submitted will be examined by the Board.

(c) If the documentation submitted fulfills all of the requirements of this section, the Board will send a letter confirming compliance to the licensee.

(d) If the documentation submitted does not fulfill all of the requirements of this section, the discrepancy must be justified or corrected within 90 days.

Section 6.21 Emergency Office Procedures

(a) All dental hygienists licensed or registered in the State of Vermont shall as a condition of every biennial license or registration renewal show evidence of having completed a course in emergency office procedures defined in Rule 2.1(m).

(b) Only one emergency office procedure course may count toward continuing education requirements for any licensing period.

Section 6.22 Emergency Office Procedures

Dental Hygienist Licenses: Display Once licensed or registered, the dental hygienist license or a photo copy if the licensee practices at more than one location, must be conspicuously displayed in the licensee's place(s) of practice Licensees may black out or cover their residence address if it appears on the license.

Part 7 Information for Dental Assistants

Section 7.1 Emergency Office Procedures

Dental Assistant Registration This registration allows a person to practice as a dental assistant in Vermont A dental assistant assists the dentist in providing care directly to the patient.

Section 7.2 Emergency Office Procedures

Limitation on Practice A dental assistant may perform duties in the office of any licensed dentist consistent with these rules, and in public or private schools or public or private institutions under the supervision of a licensed dentist The performance of any intraoral tasks by a dental assistant shall be under the direct supervision of a dentist.

Section 7.3 Emergency Office Procedures

Duties of Dental Assistants The specific duties dental assistants may perform are based upon:

(a) Their education;

(b) Their experience; and

(c) An agreement with the employing dentist whose goal as a team is to promote the efficiency and reduce the cost of dental services in the state consistent with the highest possible standards of dental care.

Section 7.4 Emergency Office Procedures

Three categories of dental assistants There are three categories of dental assistants:

(a) Traditional Dental Assistants

(b) Certified Dental Assistants

Section 7.5 Emergency Office Procedures

How to Become Registered as a Traditional Dental Assistant All persons employed as traditional dental assistants in a dental office must register with the Board A person who has not previously registered with the Board and who is hired to be a dental assistant must register within 30 days of the first day of employment Any person employed as a traditional dental assistant in a dental office in this state is subject to these rules immediately upon commencing such employment.

Section 7.6 Emergency Office Procedures

Traditional Dental Assistants, Scope of Practice A traditional dental assistant who is not a graduate of a CODA accredited program may perform all extraoral duties in the dental office or dental clinic which are assigned by the dentist During intraoral procedures, the traditional dental assistant may assist the dentist or clinical staff as assigned by the dentist The traditional dental assistant may take radiographs under a special endorsement of the registration.

Section 7.7 Emergency Office Procedures

Traditional Dental Assistants, Limitations A traditional dental assistant not a graduate of a CODA accredited dental assisting program may not perform coronal polishing or apply dental sealants until the traditional dental assistant has worked as a traditional dental assistant for at least six consecutive months

Section 7.8 How to Become Registered as a Certified Dental Assistant

(a) A person may become registered as a certified dental assistant if the person is certified by the Dental Assisting National Board. A traditional dental assistant who has already obtained radiology privileges may register as a certified dental assistant upon successfully completing the Dental Assisting National Board (DANB) examination.

(b) Certification must be renewed in accordance with DANB requirements. Certified Dental Assistants whose certification status has changed, for any reason, must notify the Board of the change in status within 30 days of the change.

Section 7.9 How to Become Registered as a Certified Dental Assistant

Certified Dental Assistants, Scope of Practice Except as limited by statute, for example 26 VSA § 864, a certified dental assistant may perform all the duties for which the certified dental assistant has received training.

Section 7.10 How to Become Registered as a Certified Dental Assistant

How to Become Registered as an Expanded Function Dental Assistant A certified dental assistant or a licensed dental hygienist who has successfully completed a formal program in expanded function duties at a program accredited by the Commission on Dental Accreditation of the American Dental Association may be registered as an expanded function dental assistant.

Section 7.11 How to Become Registered as a Certified Dental Assistant

Expanded Function Dental Assistants, Training The training program shall have the minimal requirements of 50 hours of didactic training and five weeks of clinical training, followed by six weeks of field training in dental offices, all under supervision of the faculty of the accredited school or its designates.

Section 7.12 Expanded Function Dental Assistants, Scope of Practice

(a) An expanded function dental assistant may perform those functions for which the certified dental assistant or licensed dental hygienist has been trained upon becoming employed by a licensed dentist.

(b) As permitted by statute and these rules an expanded function dental assistant may perform the dental duties for which he or she is trained.

Section 7.13 Expanded Function Dental Assistants, Scope of Practice

Dental Assistants, Radiographic Endorsement The Board will issue a radiographic endorsement to an applicant who:

(a) is at least 18 years of age; and

(b) has within the previous ten years, successfully completed a didactic and clinical or practical radiology course provided by a school accredited by the Commission on Dental Accreditation of the American Dental Association. A student enrolled in a radiology course may take radiographs necessary to course completion, in the office of the employing or supervising dentist, but in no event more than 100 radiographs; and

(d) has a radiography endorsement from another U.S. or Canadian jurisdiction having substantially equivalent standards to those of this state.

Section 7.14 Expanded Function Dental Assistants, Scope of Practice

Radiology Courses, Advisory Potential applicants, especially those new to Vermont, should be aware that acceptable radiology courses are not frequently offered in Vermont Finding and taking an acceptable radiology course in another jurisdiction may shorten or eliminate any delay before a radiologic endorsement can be issued.

Section 7.15 Expanded Function Dental Assistants, Scope of Practice

Dental Assistants, Certificate Display Dental assistant registration certificates or a photo copy if the dental assistant practices at more than one location, must be conspicuously displayed in the registrant's place(s) of practice Dental Assistants may black out or cover their residence address if it appears on the certificate.

Section 7.16 Expanded Function Dental Assistants, Scope of Practice

Emergency Office Procedures All dental assistants, shall complete emergency office procedures training required in Rule 717 within six months of their date of hire.

Section 7.17 Expanded Function Dental Assistants, Scope of Practice

Renewal of Dental Assistant Registration All dental assistants shall as a condition of every registration renewal complete a course in emergency office procedures The Board will accept the following types of courses as satisfying this requirement:

(a) courses in external cardiopulmonary resuscitation which are approved by the Vermont Heart Association or the American Red Cross; or

(b) courses which include a review of health conditions and factors which might produce emergencies. Acceptable courses will be consistent with current educational curricula in schools of dentistry and dental hygiene accredited by the Commission on Accreditation of the American Dental Association.

Section 7.18 Expanded Function Dental Assistants, Scope of Practice

Dental Assistant Transient Practice Permit A person who is not registered in Vermont may obtain a transient practice permit from the Board to perform acts constituting the practice of dental assisting, provided that:

(a) The practice in Vermont does not exceed 10 days in any calendar year;

(b) The person is registered or certified as a dental assistant in another state which, in the opinion of the Board, has regulatory standards substantially equivalent to those currently in effect in Vermont; and

Part 8 License or Registration Renewals, All Professions

Section 8.1 Renewing a License or Registration

(a) Licenses and registrations must be renewed before they expire. The expiration date is stated on the license or registration certificate. Before the expiration date, the Office will mail a renewal application and notice of the renewal fee. Evidence of having taken a course in emergency office procedures as required by these rules must accompany the renewal application. A license or registration which is not renewed will be considered as lapsed as of the expiration date.

(b) Dentists and dental hygienists must verify compliance with license renewal requirements before the license will be renewed.

Section 8.2 Renewing a License or Registration

Dentists A dentist who has not engaged in active practice as defined above will be refused renewal and must successfully complete the examinations for licensure specified in 44 before the renewal is granted.

Section 8.3 Renewing a License or Registration

Dental Hygienists A dental hygienist who has not fulfilled the continuing education requirement above may be required to complete the continuing education requirements for the immediate preceding licensing period before renewal.

Section 8.4 Renewing a License or Registration

Dental Hygienists Expanded Function Scope of Duties, Insufficient Active Practice A dental hygienist with expanded function duties who has not met continuing education requirements must complete the continuing education requirements for the immediate preceding licensing period before renewal, meet all DANB requirements and recertify as a certified dental hygienist.

Section 8.5 Renewing a License or Registration

Traditional Dental Assistants, No Active Practice Traditional dental assistants have no active practice requirement.

Section 8.6 Renewing a License or Registration

Reinstating an Expired License or Registration If a license or registration has expired because it was not renewed on time, the licensee may apply for reinstatement, meet all reinstatement requirements, and pay the renewal fee for the current renewal period and late penalty.

Section 8.7 Renewing a License or Registration

Lapsed Radiography Endorsement A registrant applying to reinstate dental radiography privileges after a lapse of ten years must successfully complete an approved radiography course.

Part 9 Professional Standards, Unprofessional Conduct

Section 9.1 Renewing a License or Registration

Change of Name, Address Licensees and registrants must notify the Office promptly of any changes in name or address Failure to comply with this provision can result in unlicensed practice, late fees, and unprofessional conduct charges.

Section 9.2 Making and Resolving Complaints

(a) The Board follows the complaint procedure of the Office of Professional Regulation. Copies of the procedure and more information about the complaint process may be obtained from the Office or online at http://vtprofessionals.org/.

(b) Under 3 V.S.A. § 127(c), a person may be imprisoned for up to one year or fined up to $ 5,000.00, or both for practicing without a valid license or registration.

Section 9.3 Grounds for Discipline

(a) 3 V.S.A. § 129a defines unprofessional conduct for all professions including those governed by these rules. Whenever its provisions are in conflict or overlap with the statutes specifically governing these professions, or these rules, the provisions which provide greater safety to the public shall apply. Chapter 13 of Title 26 of the Vermont Statutes contains specific definitions of unprofessional conduct for the professions subject to these rules.

(b) 3 V.S.A. § 129a and 26 V.S.A. § 809 specify certain acts which constitute unprofessional conduct. Those statutes are not the only basis of discipline. Failing to comply with provisions of federal or state statutes or rules governing the practice of the profession, 3 V.S.A. § 129a(3), also constitutes unprofessional conduct.

(c) Unprofessional conduct includes failure to practice competently. 3 V.S.A. § 120a(b). Failure to practice competently includes performing treatments or providing services which one is not qualified to perform, or which are beyond the scope of one's education, training, capabilities, experience, or scope of practice. This means that persons subject to these rules, when presented with an unfamiliar or complicated treatment challenge, have a duty to acquire necessary skill or knowledge to treat a patient. This may mean consulting with another professional before treating the patient. If acquiring sufficient skill and knowledge to competently treat the patient is not possible, the professional has a duty to refer the patient to another professional qualified to treat the patient.

Section 9.4 Grounds for Discipline

Ethics Codes The Ethics Codes of the American Dental Association and the American Dental Hygienists' Association can provide guidance to the Board of Dental Examiners as it is called upon to determine the meaning of the statutes and rules governing the profession, as well as unprofessional conduct The Board may refer to the Codes for guidance when possible.

Section 9.5 Grounds for Discipline

Unauthorized Practice The Board also has authority to decide complaints of unauthorized practice as indicated in 3 VSA § 127.

Section 9.6 Grounds for Discipline

Sanctions for Unprofessional Conduct Among the possible disciplinary actions the Board may impose against the license of a dentist, dental hygienist, or dental assistant after a finding of unprofessional conduct are:

(a) denial of licensure or registration or renewal;

(b) warnings or reprimands;

(d) revocation;

(e) limitations on practice;

(f) setting conditions for practice or resumption of practice;

(g) denial of reinstatement; or,

(h) imposition of a civil penalty of up to $ 1,000 for each instance of unauthorized practice, unprofessional conduct, or violation not related to patient care.

Section 9.7 Supervising Dentist: Duty to Inform

(a) It is the responsibility of each supervising dentist to inform each person hired to work of the responsibilities and licensing and registration requirements imposed by these rules and to ensure that all employees are properly licensed or registered.

(b) A copy of these rules shall be readily available to all persons subject to these rules. All persons subject to these rules are reminded that 3 V.S.A. § 129a(6) includes within the definition of "unprofessional conduct" " D elegating professional responsibilities to a person whom the licensed professional knows, or has reason to know, is not qualified by training, experience, education or licensing credentials to perform them."

Section 9.8 Supervising Dentist: Duty to Inform

Public Records All Board decisions on disciplinary complaints are public records Unprofessional Conduct decisions are available online or from the office.

Part 10 Rules for Dental Hygienists Practicing Under General Supervision in Public or Private Schools or Public or Private Institutions

Section 10.1 Supervising Dentist: Duty to Inform

Eligibility Dental hygienists who have a minimum of three years licensed clinical practice experience and have been in good standing for three years before entering the agreement are permitted to provide services as authorized in a General Supervision Agreement between the dental hygienist and dentist licensed and in good standing in Vermont.

Section 10.2 General Supervision Agreement

(a) A general supervision agreement (agreement) is a written document signed by the dental hygienist being supervised and the dentist providing general supervision. Both must be in good standing with the Board of Dental Examiners.

(b) The agreement authorizes the dental hygienist who is providing dental hygiene services in a public or private school or institution under the general supervision of a dentist to provide specific hygiene services agreed to between the dentist and dental hygienist. The agreement sets forth the responsibilities of the dentist and dental hygienist.

(d) The variable terms of the agreement can be modified at any time in writing. Modifications must then be signed by both parties.

(e) A supervision agreement template is available on line at http://vtprofessionals.org.

Section 10.3 General Supervision Agreement

Contents of the Agreement The agreement shall contain the following provisions:

Responsibilities of Supervising Dentist and Dental Hygienist:

"The parties agree that:

(1) The dental hygienist will practice according to the parameters set forth in this agreement.

(2) The dentist providing general supervision must be available for consultation but is not required to be physically present at the site where dental hygiene services are provided.

(3) The dental hygienist working under this agreement and supervising dentist agree to maintain communication and consultation with each other.

(4) The dental hygienist will provide the dentist opportunities to review patient records as requested.

(5) The dentist will review the records of patients treated by the dental hygienist from the beginning of general supervision. Reviews will include records of all patients seen. Reviews must occur no less than once every 6 (six) months at a minimum. The dentist may determine the need for and conduct more frequent reviews. Subsequent reviews of records need only encompass patients seen since the last review.

(6) Limitation on treatment:

(A) When the patient's dental condition requires services beyond what the dental hygienist can provide, the dental hygienist will advise or refer the patient to obtain dental or other care.

(B) For patients who have been treated by a dental hygienist under general supervision and who since treatment began have not been seen or examined by a dentist in 24 months, the hygienist should inform the patient or guardian that an examination by a dentist is strongly recommended.

(7) The dental hygienist will ensure that patient records are properly maintained and comply with applicable state or federal laws.

(8) Authorized services. The agreement must contain a listing of the dental hygiene services that are authorized. The dental hygienist may provide only the services authorized by the agreement. A list of approved dental hygiene services which may be included in the supervision agreement is contained in Rule 10.6.

(9) Consent Form

(a) The dental hygienist will, as appropriate, obtain written consent from the patient, parent or guardian on a form that may include:

"I understand that the records for services provided by the dental hygienist will be reviewed by a Vermont licensed dentist providing the dental hygienist general supervision.

I understand that treatment I receive from the dental hygienist is limited in scope. It does not take the place of a regular dental examination or treatment by a licensed dentist.

I understand that the dental hygienist will refer __________ (me, my child name of patient) for treatment by a dentist or other medical professional when a dental condition requires treatment beyond what the dental hygienist can provide."

(b) If a school or institution uses its own consent form for medical or dental hygiene services provided at its facilities, the dental hygienist shall then document reasonable efforts to ensure that the consent form used by the school or institution provides an equivalent notice, and that patients, parents or guardians are aware of the information in the consent form above.

Section 10.4 General Supervision Agreement

Duration of Agreement Unless modified before, this agreement shall expire on _______ (not more than one year after effective date.)

Section 10.5 Agreement Filing and Retention

(a) A copy of the agreement shall be sent to:

The Board of Dental Examiners

Vermont Secretary of State

Office of Professional Regulation

National Life Bldg., North, FL2

Montpelier, VT 05620-3402

(b) The dentist and dental hygienist shall retain copies of supervision agreements for seven years.

Section 10.6 Approved Services

The following hygiene services are approved by the Board of Dental Examiners for use in public and private schools and institutions and approved for use in the agreement:

The dental hygienist under this agreement is authorized to:

(a) interview patients and record complete medical and dental histories;

(b) take and record the vital signs of blood pressure, pulse and respiration;

(d) perform complete periodontal charting and charting of existing dental restorations;

(e) provide the patient information so that the patient may be referred for or seek necessary follow up dental care;

(f) provide dental health education and oral hygiene instructions;

(g) assess the patient's treatment needs and provide the assessment to the patient;

(h) after determining their necessity;

(1) expose and process radiographs;

(2) apply fluoride varnish and/or fluoride to control caries;

(3) apply desensitizing agents to teeth;

(4) apply sealants;

(i) regardless of periodontal case type classification, provide in appropriate circumstances when there are no medical contra-indications:

(1) prophylaxis adult;

(2) prophylaxis child;

(3) full mouth debridement to enable comprehensive evaluation and diagnosis;

(j) Provide, for patients with mild periodontitis; (Defined as: gingival edema, bleeding upon probing, and/or suppuration, up to 1/4 loss of supporting periodontal tissues and no more than class 1 (incipient) furcation involvement. Pocket depths of 6 mm. or less.)

(1) periodontal maintenance;

(2) periodontal scaling and root planing.

Section 10.7 Approved Services

Additional Information Practitioners are reminded that the Board's web site http://vtprofessionalsorg may have additional information regarding general supervision in public and private schools and institutions

History

STATUTORY AUTHORITY: 26 V.S.A. §§ 767, 804, 810, 853
EFFECTIVE DATE: September 30, 1994 (Secretary of State Rule Log # 94-42)
AMENDED: November 1, 1996 Secretary of State Rule Log # 96-61; November 23, 2000 Secretary of State Rule Log # 00-65; January 1, 2006 Secretary of State Rule Log # 05-051; July 11, 2008 Secretary of State Rule Log #08-027; January 15, 2010 Secretary of State Rule Log #09-042

Chapter 090 ADMINISTRATIVE RULES RELATING TO THE DIETITIAN ADVISORY COMMITTEE

04-090 Code Vt. R. 04-030-090-X ADMINISTRATIVE RULES RELATING TO THE DIETITIAN ADVISORY COMMITTEE

Part 1 GENERAL INFORMATION ON CERTIFICATION DIETITIANS

Section 1.1 THE PURPOSE OF CERTIFICATION

The Secretary of State has been given certain powers by Vermont, law, including the power to protect the public health, safety, and welfare by setting standards, certifying applicants, and regulating certified dietitians and their practices.

Section 1.2 BUSINESS LOCATION

The business location of the Dietitian Advisory Committee (Advisory Committee, advisors) is the Office of the Secretary of State, Office of Professional Regulation, Redstone Office Building, 26 Terrace Street, Montpelier (the office). The mailing address is Office of the Secretary of State, 109 State Street, Montpelier, Vermont 05609-1106. The telephone number is (802) 828-2373. Interested persons may obtain copies of these rules and more information about certification and its requirements and procedures by writing or telephoning the Office.

Section 1.3 ADVISORS TO THE DIRECTOR OF PROFESSIONAL REGULATION

The Secretary of State appoints two certified dietitians for three-year terms to serve as advisors, helping the Director of the office of Professional Regulation (Director) to carry out the certification program.

The Director refers complaints to an investigating team, including at least one advisor. A Special Panel, including the advisors and a public member, holds hearings in disciplinary matters involving charges of unprofessional conduct. In case of disqualification, the Secretary appoints a substitute certified dietitian.

The Advisory Committee also advises the Director on such matters as selecting an examination, setting a passing score, making administrative rules, and approving or denying certification.

Section 1.4 LAWS THAT GOVERN CERTIFICATION

Certification is governed by a specific state law that establishes responsibilities for setting standards, issuing certificates, and regulating the profession. That law is called the Laws Relating To Dietitians, Title 26, Chapter 73, Sections 3381 to 3390. In addition, the Director of the Office of Professional Regulation is obligated to comply with several other state laws, such as the Administrative Procedure Act (Title 3, Vermont Statutes Annotated, Sections 801-849); the Law of Professional Regulation (Title 3, Vermont Statutes Annotated, Sections 121-131); the Open Meeting Law (Title 1, Vermont Statutes Annotated, Sections 311-314), and the Access To Public Records Law (Title 1, Vermont Statutes Annotated, Sections 315-320). These laws spell out the rights of an applicant, dietitian, or member of the public.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 DEFINITIONS

As used in this chapter:

Terms defined in the Dietitians Act have the same meaning when used in these rules. In addition, when used in these rules:

(1) SUPERVISED PRACTICE, by an applicant, means 900 hours of post-baccalaureate dietetics practice that is supervised by a supervisor who is an American Dietetic Association dietitian registered by the Commission on Dietetic Registration. An applicant must have one hour of supervision during each forty hours of supervised practice in a face-to-face setting.

(2) ACCREDITED EDUCATIONAL INSTITUTION means a college or university which has been approved by an institutional accrediting agency recognized by the United States Department of Education.

(3) SUPERVISOR means an American Dietetic Association dietitian registered by the Commission on Dietetic Registration who is responsible for an applicant's work. A supervisor is familiar with the nature of the applicant's activities and monitors the quality of the practice and contributes to the enhancement of self knowledge. "Supervisor" does not include a spouse or family member, or an employer, partner or shareholder in the same enterprise.

Section 2.2 APPLICATIONS

An applicant must submit a completed application form with all supporting documentation and the fee to the Office. Examination applicants must submit the application and the fee by the deadline date in order to be allowed to sit for the examination, although the additional required documentation may be submitted after that date.

The office reviews applications only after the supporting documentation is received, including evidence of a degree, supervised practice and examination results.

Section 2.3 QUALIFICATIONS FOR CERTIFICATION AS A DIETITIAN

As set forth in the Laws Relating to Dietitians, the basic qualifications for certification are (1) a bachelor of arts or science or higher degree in dietetics from an accredited educational institution, (2) 900 hours of supervised practice, and (3) passing the examination. A dietitian registered by the Commission on Dietetic Registration also meets the qualifications for certification as a dietitian.

Section 2.4 SUPERVISED PRACTICE GUIDELINES

The following items, although not all-inclusive, have been determined by the Director to be most relevant to the current practice of the dietetics profession and will be used as a measure of experience objectives and goals to be accomplished through work experience. Failure to list an item does not necessarily mean that it is not relevant or that it cannot be credited toward the experience requirements.

A. Nutritional Services (minimum of 210 hours):

i. Individuals: screening, assessment, and monitoring

ii. Groups: screening, assessment, and monitoring

iii. Normal nutrition/health promotion: planning and intervention

iv. Clinical nutrition: planning and intervention

B. Food Services (minimum of 120 hours):

i. Food planning and production

ii. Service and distribution

iii. Sanitation and safety

iv. Facility management

C. Management (minimum of 90 hours):

i. Human resources

ii. Finance and materials

iii. Products and services

iv. Functions

D. Education & Communication (minimum of 150 hours):

i. Assessment and learner evaluation

ii. Planning

iii. Implementation

E. Evaluation (minimum of 30 hours):

i. Research

ii. Program/services evaluation

iii. Professional standards

The remaining 300 hours are flexible and may be accrued in any category.

Section 2.5 SUPERVISION REPORT

A supervisor must submit a report containing sufficient detail to evaluate an applicant's supervised practice, including:

A. The applicant's name;

B. The supervisor's name, signature, address, certification number, state where granted and date granted;

C. The name and nature of the practice setting, and a description of the client or patient population served;

D. Specific dates of practice covered in the report;

E. Number of practice hours during this period (to include all duties);

F. The applicant's specific duties;

G. Number of face-to-face supervisory hours;

H. Detailed assessment of the applicant's performance;

I. The clinical skills supervised;

J. The ethical practices reviewed; and

K. A verification of status as an American Dietetic Association dietitian registered by the Commission on Dietetic Registration, if the supervisor is certified or licensed in another state. The verification must be provided directly to the Director of Professional Regulation from the other state.

Section 2.6 EXAMINATION

Applicants for certification by examination must pass the Registration Examination for Dietitians administered by the Commission on Dietetic Registration. The examination is administered nationally twice a year, in the spring and fall. Information about the examination may be obtained from the office.

Section 2.7 CERTIFICATION WITHOUT EXAMINATION

To qualify to be certified as a dietitian based on credentials, an applicant must be registered by the Commission on Dietetic Registration. The applicant must provide the information necessary to determine that he or she is registered by the Commission. An applicant who is registered by the Commission does not need to take the dietitian certification examination but must comply with all other eligibility requirements.

Section 2.8 RIGHT TO A WRITTEN DECISION AND APPEAL

If the Director makes the preliminary decision to deny an applicant certification, the Director gives specific reasons in writing and informs the applicant of the right to appeal this preliminary decision to a Special Panel. After giving the applicant an opportunity to present the application and any additional information, the Special Panel affirms, reverses, or modifies the Director's preliminary decision. The applicant may appeal the Special Panel's decision to an appellate officer. Decisions of the appellate officer may be appealed to the Washington Superior Court.

Part 3 INFORMATION FOR CERTIFIED DIETITIANS

Section 3.1 RENEWING CERTIFICATION BIENNIALLY

Certificates expire every two years. Certificants must renew by the expiration date printed on the certificate. Before the expiration date, the office will mail a renewal application and notice of the renewal fee. Certification will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

Section 3.2 CONTINUING EDUCATION REQUIREMENTS

(a) "Continuing education" means the direct participation of a certified dietitian as a learner in a structured educational format as defined by the Commission on Dietitic Registration.

(b) Every certified dietitian must complete 30 continuing education credits in a two-year renewal period in order to renew certification. A certified dietitian who is renewing his or her certificate for the first time after initial certification is not subject to the 30-hour continuing education requirement.

(c) The office will provide a form upon which all credits most be recorded. The name and date of the activity, the number of credits requested, and the name of the instructor and sponsor must be clearly indicated on the form. The form must be submitted with the biennial certification renewal form.

(d) Each certificant must retain records showing proof of attendance at and proof of course contents of the continuing education activities claimed. Proof of attendance includes the certificate of attendance received during instruction or signature of the facilitator. Proof of course content includes pamphlets, program announcements or official course descriptions.

A copy of the continuing education hour statement of the Commission on Dietitic Registration will satisfy the requirements for proof of attendance and course content for Registered Dietitians.

Continuing education records are subject to inspection and verification by the Office upon request.

(e) A certificant who has been unable to complete the required continuing education by the renewal deadline may apply for an extension, showing extreme hardship. The Director may grant an extension of up to six months to complete the remainder of the required credits. Courses may be used only once to satisfy continuing education requirements. An extension does not waive the requirements to accrue the 30 continuing education credits required during a two-year renewal period.

Section 3.3 CONTINUING EDUCATION PROGRAM APPROVAL

Continuing education programs must be approved by the Commission on Dietetic Registration.

Section 3.4 REINSTATING CERTIFICATION

If a certificate has expired because it was not renewed on time, the certificant may apply for reinstatement and pay the renewal fee for the current renewal period and a late renewal penalty. The certificant does not have to pay renewal fees for years during which the certificate was lapsed. The Director of the office of Professional Regulation may also revoke the right to reinstate a certificate, after an opportunity for a formal hearing, if the certificate has lapsed for five years or longer.

Section 3.5 CHANGE OF NAME OR ADDRESS

A certificant is responsible for notifying the Office in writing immediately if he or she changes name, mailing address or business address.

Section 3.6 PROFESSIONAL STANDARDS

Certified dietitians and applicants for certification may be disciplined for any of ten grounds of unprofessional conduct listed in 26 V.S.A. § 3390. In addition, 3 V.S.A. § 129(a)(6) provides a ground for discipline in this state if a certificant or applicant has been disciplined in another state.

Section 3.7 COMPLAINT PROCEDURE

The office has a procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure are available from the office.

Section 3.8 APPEAL RIGHTS

Cases involving charges of unprofessional conduct are heard by the Special Panel. A party may appeal the decision of the Special Panel to an appellate officer. Decisions of the appellate officer may be appealed to the Washington Superior Court.

History

Effective Date: November 1, 1995 (Secretary of State Rule Log #95-66)
- Formerly Rule No. 04 065 001. This rule has not been changed. It has been renumbered and relocated to insure that all rules issued under this Office are properly and uniformly numbered.*
Statutory Authority: 26 V.S.A. §§ 3381-3390

Chapter 100 ADMINISTRATIVE RULES OF THE BOARD OF PROFESSIONAL ENGINEERING

04-100 Code Vt. R. 04-030-100-X ADMINISTRATIVE RULES OF THE BOARD OF PROFESSIONAL ENGINEERING

Part 1 THE BOARD OF PROFESSIONAL ENGINEERING

Part 2 RULES FOR APPLICANTS FOR LICENSURE, LICENSEES, AND ENGINEER INTERNS

History

STATUTORY AUTHORITY: 26 V.S.A. § 1172
EFFECTIVE DATE: July 2, 1990 Secretary of State Rule Log #90-28
AMENDED: November 24, 1994 Secretary of State Rule Log #94-51; January 1, 2000 Secretary of State Rule Log #99-74; August 1, 2017 Secretary of State Rule Log #17-042

Chapter 110 RULES OF THE BOARD OF FUNERAL SERVICE

04-110 Code Vt. R. 04-030-110-X RULES OF THE BOARD OF FUNERAL SERVICE

Part 1 INTRODUCTION

Section 1.1 THE BOARD'S PURPOSE

The Board of Funeral Service (which is referred to as "the Board" in this rule) has been created and given powers by Vermont law. Its purpose is to protect the public health, safety and welfare by setting standards, licensing only qualified applicants and regulating licensees and their practices.

Section 1.2 LAWS THAT GOVERN THE BOARD

The Board is governed by specific state laws that establish its responsibilities for setting standards, issuing licenses and regulating the profession. Those laws are found in 26 V.S.A. §§ 931-998 and 1211-1275 and in 18 V.S.A §§ 5201-5225. In addition, the Board must comply with several other state laws such as the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A §§ 310-314) and the "Right to Know Law" ( 1 V.S.A. §§ 315-320). These laws set forth the rights of an applicant, license holder or member of the public. The complete text of these laws is available at most libraries and town clerks' offices.

Part 2 DEFINITIONS

Part 3 INFORMATION FOR APPLICANTS

Section 3.1 APPLICATIONS

Applications and information about the types of licenses and their requirements are available from the Office. An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office. The Board reviews applications only after the fully completed application and documentation is received, including evidence of any required education, supervision, employment, evidence of a license in another jurisdiction and its licensing standards, or other licensing standards.

An applicant issued an initial license within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full license period. An applicant issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 3.2 EMBALMER LICENSE

Qualifications for embalmer licensure are outlined in 26 V.S.A. § 991.

A. Applicants for embalmer licensure by examination shall either:

have graduated from a two-year school of funeral service or have completed one academic year or its equivalent as determined by the Board from an accredited school of funeral service and 30 credits of instruction from an accredited college or university, and

have served a traineeship of 12 months of full-time employment or its equivalent, and
pass the examination(s) required or approved by the Board.

B. Applicants for embalmer licensure by endorsement shall:

have a valid license from another state with requirements for licensure substantially equivalent to those in this state, and
have held the license for at least three years prior to the date of application, and
pass the examination(s) required or approved by the Board pursuant to Rule 3.4 below.

Section 3.3 FUNERAL DIRECTOR LICENSE

Qualifications for funeral director licensure are outlined in 26 V.S.A. § 1252.

A. Applicants for funeral director licensure by examination shall:

have assisted with 30 funerals, under the direct supervision of a licensed funeral director. (Funeral director trainees do not need to register or report progress but the supervising funeral director shall provide verification of completion of the training at the time the applicant applies for licensure), and
pass the examination(s) required or approved by the Board.

B. Applicants for funeral director licensure by endorsement shall:

have a valid license from another state with requirements for licensure substantially equivalent to those in this state, and
have held the license for at least three years prior to the date of application, and
pass the examination(s) required or approved by the Board pursuant to Rule 3.4 below.

Section 3.4 REMOVAL PERSONNEL REGISTRATION

Qualifications for removal personnel are outlined in 26 V.S.A. § 1252.

A. Applicants for removal personnel registration shall:

show proof of employment by a licensed crematory or funeral establishment in good standing in this state; and
Have successfully completed a course of instruction of at least three clock hours in infectious diseases.

B. The course of instruction in infectious diseases must be approved by the Board. Applicants may contact the Office for a list of approved courses.

C. The Board may waive the course requirement if the applicant has sufficient education or experience with universal precautions and infectious diseases.

Section 3.5 EXAMINATIONS

As set forth in 26 V.S.A. § 1253, examinations are required for embalmers and funeral directors. Applicants shall furnish proof of passing an examination. The Board uses the written examinations of the Conference of Funeral Service Examining Boards (CFSEB) and may approve a subsequent or alternative licensing examination for both embalmers and funeral directors. In addition, embalmers shall take a practical exam. If any part of an exam is failed, the exam shall be completely retaken. The CFSEB exams are given in Vermont at least once a year, but they may be taken in other states if the results are reported to the Vermont Board.

All applicants for licensure, including applicants for licensure by endorsement, shall take and pass an examination on the Vermont laws and rules governing the profession in which he or she is applying for licensure. This examination must be taken in Vermont, even though other examinations such as the CFSEB may be taken elsewhere.

Section 3.6 FUNERAL ESTABLISHMENT LICENSE

Qualifications for a Funeral Establishment license are outlined in 26 V.S.A. § 1252

Applicants for a Funeral Establishment license shall:

present permits showing the building to be used (a) has a water supply and wastewater disposal as required by the Agency of Natural Resources and (b) has the approval of the state fire marshall, and
identify the funeral director to be responsible for the funeral establishment, and
pass an inspection of the establishment by the Board or its designee;

Section 3.7 FUNERAL ESTABLISHMENT PREPARATION ROOM REQUIREMENTS

A funeral establishment, if used for embalming or preparation for final disposition, shall have a preparation room.

A. The preparation room shall have:

electrical service, an outside exhaust fan and hot and cold running water;

walls, floors, ceilings, operating tables, sinks, and other furnishings that can be kept clean and sanitary, cabinets for clean and sanitary storage of instruments and a basin for disinfecting instruments after use;

proper waste disposal and drainage facilities, including a covered receptacle for refuse, bandages, cotton and other waste materials which must be disposed of by burning or placing in a plastic bag according to guidelines provided by the Department of Health;
windows and lockable doors that obstruct public view into the room;
hydro or electric aspirators;
the following items: germicidal soap; paper towels and dispenser; viscera pail; embalming table (enamel or stainless steel); sanitary removal cot; clean sheets; at least one large rubber or plastic disaster pouch; a supply of fluids, powder, disinfectants, cotton, threads, cosmetics, hair and barber needs, and plastic or rubber goods such as stockings, pants and unionalls; and an adequate stock of regularly needed instruments and embalming supplies; and
eyewash station or an eyewash disposable kit conveniently located for emergency use.

In addition, the preparation room shall conform to other applicable local, state and federal requirements, including occupational safety and health regulations, Health Department rules, and public building requirements.

B. The funeral establishment license and all personnel licenses shall be displayed together in a conspicuous public area.

Section 3.8 INSPECTIONS

The Board or the Office of Professional Regulation has the authority to inspect any funeral establishment, equipment, and records related to items 1 through 5 below, at any reasonable time, and the funeral director shall make such records available.

The Board or its designee will inspect for and verify the following:

the preparation room, casket display room (if the funeral establishment has a preparation or casket display room), chemical storage room or other areas used for conducting of funeral business to review for conformance to any statute or rule;
the motor vehicles used for removal of human remains;
working order of any required equipment;
records pertaining to prepaid funeral arrangements and forms used, regardless of the date contracts and forms were developed;
general price lists, casket price lists, vault lists, casket display books or catalogues, and other materials used in the sale of funeral arrangements and any information provided to consumers;

Section 3.9 BRANCH LOCATIONS

Each location of a funeral establishment is subject to Board inspection. However, a location does not require a separate license or fee if there is no casket display room or preparation room. Copies of the principal funeral establishment license and all personnel licenses shall be displayed together in a conspicuous public area. Originals shall be displayed in the principal establishment.

Section 3.10 LICENSE DENIALS, HEARINGS, APPEALS

A. If the Board intends to deny an application for a license, the Board shall send the applicant written notice of the decision by certified mail. The notice shall include a statement of the reasons for the action and shall advise the applicant that the applicant may file a petition with the Board for review of its preliminary decision within 30 days of the date on which the notice is mailed. After the hearing, the Board shall affirm or reverse the preliminary denial, explaining the reason therefor in writing.

B. A party aggrieved by a final decision of the Board may appeal that decision by filing a notice of appeal with the Director who shall assign the case to an appellate officer. The review shall be conducted on the basis of the record created before the Board. Persons wishing to appeal shall give written notice of their decision to appeal within 30 days of receipt of the Board's final decision to; the director of the Office of Professional Regulation.

The appellate officer's decision may be appealed to Washington Superior Court.

Part 4 INFORMATION FOR LICENSEES

Section 4.1 RENEWING LICENSES

The Office has a fixed 24-month licensing schedule. Licensees renew on a fixed biennial schedule: August 1 of the odd-numbered years. A licensee shall renew by the expiration date printed on his or her license. Before the license expiration date, the Office will mail a renewal application and notice of renewal fee. A license will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

A licensee is responsible for notifying the Office promptly if he or she changes name, mailing address or business address.

Section 4.2 REINSTATING LICENSES

A license which expired because it was not renewed on time may be reinstated by submitting an application to the Board and paying a reinstatement fee and the renewal fee for the current renewal period. The Board may require additional training, continuing education hours, or examination as a condition of reinstatement.

Section 4.3 CONTINUING EDUCATION

A. All applicants for renewal or reinstatement of licenses shall successfully complete 10 hours of continuing education per license during the two year period ending on the license expiration date. Continuing education topics shall be directly related to maintaining competence in essential issues of public protection and welfare.

Essential issues of public protection are:

a. chemical handling

b. handling of blood-borne pathogens

c. state and federal statutes related to the funeral industry

d. management of funds

e. fraudulent practices

f. grief management and understanding multicultural beliefs about death and dying

g. other topics approved by the Board

B. Individuals initially licensed for less than one year will not be required to submit evidence of continuing education until conclusion of the first full, two-year renewal period following initial licensure.

C. Applicants for renewal of licenses shall file with their applications a signed Continuing Education Form, provided by the Office, listing continuing education programs for which they claim credit and showing the sponsoring organization, location of program, title of program and description of content, dates attended, and hours claimed.

D. Any person or organization may seek approval of a planned course offering by petitioning the Board 90 days before the educational activity will commence. Advance approval requests shall include the name of the sponsoring organization, location of program, title of program, description of content, dates of the program, and continuing education hours requested. A resume of all instructors shall also accompany the request for approval of a continuing education program.

E. Continuing professional education credit will be given for whole hours only, with a minimum of fifty minutes constituting one hour. Contact hours may not include travel time, lunch or breaks.

F. Credit may be granted for time spent in activities as an instructor, presenter, or supervisor, for up to one-half of the hours (5) of continuing education required.

G. Responsibility for documenting the acceptability of the program and the verification of the hours claimed rests with the applicant. An applicant shall retain documentation for a period of 5 years after the completion of the program. Such documentation may consist of certificates of attendance, receipt of registration, or signature of facilitator provided the signature is accompanied by a parnphlet, program announcement, or brief summary of the program content. Those records are subject to inspection and verification by the Board upon request.

H. Continuing education credits for embalmers may be obtained in any of the categories of essential issues to public protection listed above.

I. The Board may set additional standards for continuing education at its discretion.

Section 4.4 COMPLAINTS OF UNPROFESSIONAL CONDUCT

Part 5 PROFESSIONAL STANDARDS

Section 5.1 PROFESSIONAL STANDARDS FOR FUNERAL DIRECTORS

In addition to any other provisions of law, the following conduct by a licensee violates professional standards and constitutes unprofessional conduct. When that conduct is by an applicant or person who later becomes an applicant, it may constitute grounds for denial of a license or other disciplinary action.

Allowing an unlicensed person to practice funeral directing except for directly supervised trainees allowed by Rule 3. 3;

Refusing to surrender custody of a dead human body or cremated remains to a person lawfully entitled to custody;
Failing to pay, or cause to be paid, to the Board an amount under Rule 7.2 that is less than required by that rule;

Soliciting or accepting a commission, bonus or rebate for disposing a dead human body to any crematory, mausoleum or cemetery;

Violating any state law, municipal ordinance or regulation affecting the handling, custody, care, transportation or documentation relating to dead human bodies;
Using any funeral merchandise previously used in whole or in part without the knowledge of the individual selecting or paying for the merchandise;

Discriminating in services because of race, religion, national origin, age, gender, sexual preference, presence of an infectious disease, or disability;

Soliciting business, or offering any inducement, in money or otherwise, for employing solicitors, agents, canvassers or others for the purpose of securing or attempting to secure business, regarding deceased persons or persons whose death is imminent;
Using improper methods of seeking business, such as using donations, gifts, bonuses or acts of service designed to place the recipient in a position of obligation or indebtedness, or transfer or offer to transfer any property or service as payment for business secured, influenced or otherwise provided or promised.
Soliciting dead human bodies or allowing employees to do so;

Transporting bodies in motor vehicles without shades on the sides or a rigid container or cover to prevent public view of the remains;

Transporting a dead human body for interment or disposal before obtaining a permit for removal or burial as required by 18 V.S.A. § 5201;
Storing dead human bodies anywhere other than in a preparation room or locked room, out of view.
If inexpensive caskets are displayed, failing to display the inexpensive caskets in a manner that does not discourage or disparage purchase and that is equivalent to the display of any other caskets on display.
Failing to make the consumer aware of, by picture catalogue or display book, in a manner which does not disparage or discourage the purchase of, the three least expensive caskets available from wholesalers doing business with the licensee.
Failing to provide consumers, if the establishment sells caskets from a display book or catalogue, an opportunity to review the book or catalogue at home.

Section 5.2 PROFESSIONAL STANDARDS FOR EMBALMERS

Fraudulent or deceptive procurement or use of a license;

Practicing the profession when medically or psychologically unfit to do so;
Failing to comply with provisions of federal or state statutes, municipal ordinance or regulation affecting the handling, custody, care or transportation of dead human bodies;
Using fraud or misrepresentation as an embalmer;
Allowing an unlicensed person to practice embalming, except for directly supervised trainees as per 26 V.S.A. § 991(2);
Preparing for burial or other disposition of a dead human body, without dignity and respect for the deceased person as well as for the privacy of the family;
Storing unmarked receptacles containing embalming fluid or any poisonous or dangerous substance;
Performing embalming, clean-up or disposal of blood and excretions of a dead human body without following the "Universal Precautions for the Prevention of HIV and HBV to Health Care and Public Safety Workers"; and
Embalming in a case of sudden, accidental, or unexplained death, requiring notice to a medical examiner, before obtaining a release from the medical examiner or state's attorney.

Section 5.3 PROFESSIONAL STANDARDS FOR REMOVAL PERSONNEL

In addition to any other provisions of law, the following conduct by a registrant violates professional standards and constitutes unprofessional conduct. When that conduct is by an applicant or person who later becomes an applicant, it may constitute grounds for denial of a registration or other disciplinary action.

Failing to comply with provisions of federal or state statutes, municipal ordinance or regulation affecting the handling, custody, care or transportation of dead human bodies;
Performing a removal of a dead human body, without dignity and respect for the deceased person as well as for the privacy of the family;
Performing removals, clean-up or disposal of blood and excretions of a dead human body without following the "Universal Precautions for the Prevention of HIV and HBV to Health Care and Public Safety Workers";
Refusing to surrender custody of a dead human body or cremated remains to a person lawfully entitled to custody;
Transporting bodies in motor vehicles without shades on the sides or a rigid container or cover to prevent public view of the remains;
Transporting a dead human body for interment or disposal before obtaining a permit for removal or burial as required by 18 V.S.A. § 5201; and
Storing dead human bodies anywhere other than in a preparation room or locked room, out of view;

Section 5.4 INCORPORATION OF FEDERAL TRADE COMMISSION RULES

The requirements of the Federal Trade Commission (FTC) Rule, entitled "Funeral Industry Practices Revised Rule," in effect on July 19, 1994, are incorporated into these rules by reference. Although all requirements of the FTC are not outlined in these rules, licensed personnel under the Funeral Service statutes and rules are required to follow all FTC rules.

Sections of the general price list and all statements of funeral goods and services shall be numbered and follow the following format, except that statements of funeral goods and services need not contain items 17 and 18 below.

Basic services of funeral director and staff;

Embalming;

Other preparation of the body;
Additional services and facility fees;

a. facilities and staff for viewing or visitation

b. facilities and staff for private viewing by the family

c. facilities and staff for a memorial service in the funeral home

d. facilities and staff for a funeral in the funeral home

e. staff for a memorial service in a church or other facility

f. staff and equipment for a funeral in a church or other facility

g. staff and equipment for a graveside service

Transfer of remains to funeral home;

Automotive equipment;

Caskets;

Outer burial containers;
Urns;
Clothing or other merchandise;
Forwarding remains to another funeral firm;
Receiving remains from another funeral home;
Immediate burial;
Direct cremation;
Body donation to a medical school or facility;
A statement that "Our basic service charge includes a $ 6.00 fee that will be sent to the State of Vermont and set aside for the protection of funeral service customers;"
A statement that funds may be available for final disposition through the Vermont Department of PATH, general assistance program, for persons who qualify; and
A disclosure at the bottom of the General Price List with the following wording "The funeral industry is governed by laws defining professional conduct. Consumers who have inquiries or wish to obtain a form to register a complaint may do so by calling 802-828-2367 or by writing the Secretary of State at 109 State Street, Montpelier, Vermont 05609-1106."

A copy of the general price list required by this rule shall be submitted to the Office on request.

Part 6 PREPAID FUNERAL ARRANGEMENTS

Section 6.1 PREPAID FUNERAL CONTRACTS; ESCROW ACCOUNTS

A. A funeral director who sells a prepaid funeral shall prepare a written contract consistent with 26 V.S.A. §§ 1271-1275 and these rules. The contract may take the form of a trust account, insurance policy or annuity. The following contract elements are required and should be included in the body of the contract or in attachments expressly incorporated in the contract by reference and attached to the contract at the time of execution by the purchaser:

disclosure of whether the contract is revocable or irrevocable;

identity of the person expected to be responsible for making funeral arrangements;

all standard provisions required by the Board by rule;
signed and dated statement of goods and services;
itemization of the funeral goods and services to be provided;
a provision describing installment payments (unless payment is in a lump sum at the time of sale), and the provisions if payments are not made as agreed;
the method for the buyer to exercise the right of transfer to another funeral director;
explanation of the funeral director's duty to transfer the contract and assets to another funeral director upon insolvency, bankruptcy, or going out of business;
refund provisions;
the location of the escrow account;
the identity of the escrow agent;
the responsibility for filing tax returns;
disclosure that the purchaser has until midnight of the third day after signing the contract to review and revoke the agreement;
disclosure that if the purchaser has not received notice from the escrow agent that an escrow account has been established within 20 business days, the purchaser many cancel the contract at any time; and

disclosure that in the event goods and services are substituted in a pre-need contract the next of kin or personal representative shall be notified.

B. If the contract may be revoked, it must carry this language or its equivalent conspicuously:

This contract may be revoked by you, the buyer. Simply notify [name of funeral director] in writing that you no longer want the prepaid funeral to be provided. The money you have paid, together with all interest or other earnings, will be refunded, less a transaction fee of $ ___ (not to exceed 5% of the total).

Reasonable limits on the right to revoke may be imposed, such as time limits. The limits shall be explained in the contract with the procedure for revocation.

C. If the contract may not be revoked, it must carry this language or its equivalent conspicuously:

This contract may not be revoked by you, the buyer. When the funeral director has provided the funeral goods and services which are itemized in this contract, (he or she) is entitled to receive the full amount you have paid, together with all interest or other earnings which have accrued.

If the contract is subject to cancellation for a specific time period (for example, a three day cancellation period under 9 VSA § 2454) , the language above must be modified to make clear that the contract may be revoked until the end of the period, and not thereafter.

D. When the prepaid funeral arrangements are complete, the trustee will give a copy of the prepaid funeral contract and general price lists to the buyer or the buyer's personal representative.

Section 6.2 ESCROW ACCOUNTS; APPOINTMENT OF ESCROW AGENTS

A. A funeral director shall establish an escrow account and appoint an escrow agent for each prepaid funeral, or a single escrow agent for a pooled account. The account shall be one customarily maintained in a federally insured depository, insurance company or trust company chartered by the State of Vermont. The depository or company shall have proper authority to do business in Vermont. Notwithstanding any other provision of this rule, an insurance policy for funeral expenses only with an insurance company licensed to do business in Vermont may be considered an escrow account if it is established by the person contracting for the prepaid funeral and names the funeral director as beneficiary.

B. Escrow accounts shall be established within ten business days of receipt of the first payment on each prepaid funeral. Each subsequent payment shall be deposited in the account within ten business days of receipt.

C. An escrow account shall be one of the following: a time deposit, demand deposit, or certificate of deposit; bonds of the United States, its agencies, the State of Vermont, its agencies or municipalities, or bonds in which savings banks chartered by the State of Vermont may invest.

Section 6.3 ESCROW AGENTS; QUALIFICATIONS

A person, other than a federally insured depository, licensed insurance company or licensed attorney, shall apply for Board approval before serving as an escrow agent. Any person, including a local elected official, next of kin or the executor of a buyer's estate, may apply by demonstrating (1) independence from the funeral director selling the prepaid funeral or funerals involved, (2) absence of financial interest in the funeral industry, and (3) absence of conviction for any felony or any misdemeanor involving dishonesty or theft. When approved, the agent shall file a bond in an amount greater than the amount to be held in the escrow account, including interest or other earnings.

Section 6.4 DUTIES OF ESCROW AGENTS

A. The escrow agent shall maintain the funds intact in the escrow account, as instructed by the trustee. The agent shall pay the funds as follows:

to the contracting funeral director upon presentation of a death certificate and affidavit that the contract has been performed, and a copy of the affidavit has been provided to the next of kin, as provided by 26 VSA § 1275(a); or

to the next of kin or designee upon presentation of (a) a death certificate and affidavit from the funeral director who provided the funeral that the funeral has been performed or (b) a death certificate and an affidavit of the next of kin or personal representative stating that the initial contracting funeral director had failed to perform the contract promptly, and that a copy has been provided to the contracting funeral director. When the escrow agent pays the funds under this provision, the agent shall notify the initial contracting funeral director and next of kin or designee;

B. The escrow agent may also transfer the funds to another allowable escrow account upon request of the trustee or may pay allowable costs when directed and certified by the trustee that the costs are allowable under Rules 6.5(C) and (D).

C. When a contract is revoked according to its terms, the escrow agent shall pay the money and transaction fee provided in the contract to the funeral provider, and shall pay the balance in the account to the purchaser.

Section 6.5 DUTIES OF TRUSTEES

A. Unless the prepaid funeral contract specifically provides otherwise, the funeral director shall be the trustee of the account. The contract may provide that the buyer is the trustee or co-trustee of the account, and responsible for filing and paying tax returns. Only the funeral director, the buyer, or a trust company may be a trustee of the account.

B. The trustee shall give a copy of the prepaid funeral contract to the escrow agent.

C. The trustee shall obtain a taxpayer identification number for the trust, shall prepare and file income tax returns, and shall pay all reasonable bank fees and administrative costs charged against the account. Administrative costs may not exceed the lesser of two percent of the account, or one-half of the earnings for the previous year.

D. The trustee may transfer funds from one allowable escrow account to another, when prudent and necessary to protect the funds, by notifying the escrow agent to make the transfer. The trustee may also change escrow agents. The trustee shall notify the buyer of each change of escrow account and escrow agent.

E. The trustee shall instruct the escrow agent to provide the buyer in writing within 10 business days after the establishment of the escrow account the following:

location of escrow account
amount of deposit
type of escrow account established

F. The contract may be revoked and no administrative fees shall be charged to the buyer if the information is not provided within 20 business days from the day of purchase.

G. For revocable trusts, the trustee or escrow agent shall provide annually to the buyer or his or her personal representative, in writing, the following information concerning all escrow accounts:

original deposit
ending balance for the year
interest for the year
debits and credits charged to account for the year

H. For irrevocable trusts, the trustee or escrow agent shall provide, upon request of the buyer or his or her personal representative, in writing, the following information concerning all escrow accounts:

original deposit
ending balance for the year
interest for the year
debits and credits charged to account for the year

Section 6.6 INSURANCE CONTRACTS; ANNUITIES

Licensed funeral directors may sell insurance policies or annuities to fund prepaid funeral services, provided the funeral director complies with all state and federal regulations regarding insurance as set forth by the Commissioner of the Department of Banking, Insurance Securities and Health Care Administration.

Section 6.7 RECORDS

A. A funeral director shall maintain the following records relating to each sale of a prepaid funeral:

a copy of all contracts;
a record of all payments received, and charges made against the account;
a copy of the death certificate and affidavit of performance, and, if applicable, the affidavit of the next of kin or personal representative;
a copy of each tax return filed by the funeral director, and
copies of all correspondence to the buyer or the buyer's designee regarding the status of the escrow account.

B. These records shall be retained for seven years following termination or performance of the contract, and shall be available for inspection and copying, during normal business hours, at the Board's request. The funeral director may delegate the performance of duties and maintenance of records to agents but remains responsible for compliance with these rules.

Part 7 PROTECTION FOR CONSUMERS OF PREPAID FUNERAL ARRANGEMENTS; THE FUNERAL SERVICES TRUST ACCOUNT

Section 7.1 FUNERAL SERVICES TRUST ACCOUNT

A. The Funeral Services Trust Account (FSTA) has been established by the General Assembly for the purpose of protecting purchasers of prepaid funeral arrangements from default in the performance of contractual obligations by a funeral establishment. The FSTA shall be administered by the Secretary of State. The Board will work with the Secretary of State to implement administration of the FSTA.

B. Funds in the FSTA shall be available to persons qualifying under Rule 7.3 to defray costs of funeral services in the event of default upon a contract for a prepaid funeral arrangement.

Section 7.2 ASSESSMENTS FOR THE FUNERAL SERVICES TRUST ACCOUNT

A. Each licensed funeral establishment shall pay to the FSTA an assessment of $ 6 per burial or other disposition. The Board will assess each establishment each year for that establishment's annual obligation to the FSTA.

B. Establishments shall pay their FSTA assessment within 15 days from the close of the assessment period. Each FSTA assessment check shall be made payable to the Secretary of State, State of Vermont, and shall bear on its face the reference notation "For Deposit in the Funeral Services Trust Account." Assessment periods shall end on the last day of December of each year.

C. An establishment shall disclose the per disposition assessment on the general price list.

D. The initial, special assessment shall be due on July 1, 1997. Each establishment shall remit to the Board the assessment set forth in 26 V.S.A. § 1272(9)(a), reproduced in the table below. Thereafter, the rate per disposition shall be $ 6, until changed by statute. Determination of the appropriate amount shall be based on the number of dispositions each establishment conducted during the preceding calendar year.

Establishments performing fewer than 51 dispositions are assessed an FSTA special assessment of $
Establishments performing between 51 and 150 dispositions are assessed an FSTA special assessment of $
Establishments performing between 151 and 350 dispositions are assessed an FSTA special assessment of $
Establishments performing over 350 dispositions are assessed an FSTA special assessment of $

E. When the FSTA balance at the beginning of a fiscal year is at least $ 200,000, principal and interest, no disposition charges will be assessed to funeral establishments during that fiscal year.

F. Dispositions paid for by the Vermont Department of Social Welfare are excluded from the provisions of this rule.

G. In the event more than one establishment is involved with a single disposition, the establishment filing for the burial transit permit is responsible for the assessment for that disposition. In the event that more than one establishment is involved with a single disposition and one of the establishments is not located in Vermont, the establishment that is located in Vermont is responsible for the assessment for that disposition.

Section 7.3 CONSUMER CLAIMS ON THE FUNERAL SERVICES TRUST ACCOUNT

A. In the event a funeral establishment is insolvent, bankrupt, or has ceased to do business, and is therefore incapable of performing the prepaid funeral contract into which it has entered, or will therefore be incapable of performing its prepaid funeral contracts at the time of need, holders of prepaid funeral contracts are eligible for payment from the FSTA if the following steps are completed:

The consumer files a copy of the original prepaid funeral contract with the Board.

The Board then determines the value of the contract. The value of the contract shall consist of the total of the payments made on the contract by the consumer, plus interest accrued on those payments. The value determined by the Board shall not serve to enhance the contract purchased by the consumer.
Within six months of the date the Board receives notice from the consumer, the Board will provide the consumer a determination of the value of the contract and information about goods and services previously purchased and will provide guidance to the consumer for purchasing a new funeral contract for equivalent goods and services with a funeral establishment of the consumer's choice.
The new funeral service contract is filed with the Board within 10 business days of its creation by the consumer or his or her personal representative.

The Board will review and accept or decline to accept the new arrangement according to the value of the contract and information on record about previously-contracted goods and services.

At the time of need, the Board will pay for the newly contracted and Board-approved pre-need funeral from the FSTA.

B. The Board may make exceptions to the requirements of Rule 7.3(A) on a case-by-case basis. Exceptions will be granted if the Board finds the requirements of Rule 7.3(A) either present an undue hardship, or are substantially impossible to meet, such as in the case of an otherwise eligible consumer who never received the notice explaining the requirements or whose prepaid funeral contract was the subject of default at the time it became at-need.

C. A consumer who has purchased a prepaid funeral arrangement is not eligible for payment from the FSTA if the funeral establishment ceases to do business for any reason but the consumer is able to recover all of his or her funds, including principal and interest, in the prepaid funeral arrangement escrow account.

Section 7.4 LIABILITY OF DEFAULTING FUNERAL ESTABLISHMENTS

The owner of a funeral establishment is liable to the State of Vermont for all funds paid out of the FSTA as a result of prepaid funeral contracts upon which the funeral establishment defaulted.

Section 7.5 TERMINATION OF THE FUNERAL SERVICES TRUST ACCOUNT

In the event the General Assembly determines the FSTA is no longer needed for the purposes stated in Rule 7. 1(A), funds in the account shall be dedicated to a use benefitting holders of contracts for prepaid funeral arrangements.

History

EFFECTIVE DATE: December 1, 1993 Secretary of State Rule Log # 93-76
AMENDED: September 15, 1997 Secretary of State Rule Log # 97-43
September 1998 [Renumbered from Rule No. 04 132 001]
August 15, 2003 Secretary of State Rule Log # 03-24

Chapter 111 ADMINISTRATIVE RULES FOR THE OPERATIONS OF CREMATORY ESTABLISHMENTS

04-111 Code Vt. R. 04-030-111-X ADMINISTRATIVE RULES FOR THE OPERATIONS OF CREMATORY ESTABLISHMENTS

Part 1 General Information

Section 1.1 The Purpose of Licensure

The Director of Professional Regulation (referred to as "the Director" in this rule) has been given power by Vermont law to license and inspect crematory establishments to protect the public health, safety and welfare. This is done by setting standards for issuing licenses, licensing only qualified applicants and regulating license holders and their practices.

Section 1.2 Laws That Govern Licensure

The operation of a crematory establishment is governed by a specific state law that establishes responsibilities for setting standards, issuing licenses and regulating the profession. In addition, the Director and the Office of Professional Regulation are obligated to comply with several other state laws, including the Administrative Procedure Act ( 3 V.S.A. §§ 801-849), the Open Meeting law ( 1 V.S.A. §§ 310-314) and the Access to Public Records law ( 1 V.S.A. §§ 315-320). These laws set forth the rights of an applicant, license holder or member of the public. Copies of these laws may be obtained from a town clerk or librarian or from the Office. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us.

Section 1.3 Definitions

(1) "Authorizing Agent(s)" mean a person or persons legally entitled to authorize the cremation of human remains.

(2) "The Act" means The Funeral Services Act, 26 Vermont Statutes Annotated, Chapter 83.

(3) "Cremated Remains" are all the remains of the cremated human body recovered after the completion of the cremation process, including pulverization which leaves only bone fragments reduced to unidentifiable dimensions and may possibly include the residue of any foreign matter including casket material, bridgework or eye glasses that were cremated with the human remains.

(4) "Cremation" means the technical process, using direct flame and heat, that reduces human remains to bone fragments. The reduction takes place through heat and evaporation. Cremation includes the processing and usually includes the pulverization of the bone fragments.

(5) "Cremation Chamber" means the enclosed space within which the cremation process takes place. Cremation chambers covered by these procedures shall be used exclusively for the cremation of human remains.

(6) "Cremation Container" means the container in which the human remains are transported to the crematory and placed in the cremation chamber for a cremation.

(7) "Crematory establishment" or "Establishment" means the legal entity or the authorized representative of the legal entity which is licensed by the state to operate a crematory and perform cremation.

(8) "Crematory" means the building or portion of a building that houses the cremation chamber and the holding facility.

(9) "The Director" means the Director of the Office of Professional Regulation.

(10) "Holding Facility" means an area within or adjacent to the crematory facility designated for the retention of human remains prior to cremation.

(11) "Human Remains" means the body of a deceased person, or part of a body or limb that has been removed from a living person, including the body, part of a body or limb in any stage of decomposition.

(12) "The Office" means the Office of Professional Regulation in the Office of the Secretary of State.

(13) "V.S.A." means Vermont Statutes Annotated: for example 26 V.S.A. § 1211 means section 1211 of Title 26 of the Vermont Statutes Annotated.

Part 2 Information For Applicants

Section 2.1 Where to Get an Application

An application for licensure or more information about the licensing process may be obtained by writing or calling the Office at 26 Terrace Street, Drawer 09, Montpelier, Vermont 05609-1106. Telephone 802-828-2191, e-mail nmorin@sec.state.vt.us. Or visit the profession's website at http: www.vtprofessionals.org.

An applicant issued an initial license within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full licensing period. An applicant issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.2 Applications for Licensure

Applications for new crematory establishments shall be on forms furnished and prescribed by the Director and shall provide the Office with the following information:

(1) The full name and address, both residence and business, of the applicant if the applicant is an individual; the full name and address of each partner and the partnership if the applicant is a partnership; the full name and address of every member of the board of directors and the association if the applicant is an association; and the name and address of every officer, director, and shareholder holding more than 25% of the corporate stock and the corporation and the name of the corporation if the applicant is a corporation.

(2) A detailed statement for each of the individuals listed in the application under (1) above providing any felony or misdemeanor convictions or involvement in civil litigation in which fraud was an essential element of the crime or complaint and any information about the loss or suspension of any license by this state or any other state related to the business of funeral directing, operation of a cemetery or crematory.

(3) The address and location of the crematory.

(4) A description of the type of structure and equipment to be used in the operation of the crematory.

(5) Copies of all applications for any licenses or permits issued for a crematory to operate in a state.

(6) Any further information that the Director may reasonably require.

Section 2.3 Requirements For Licensure as a Crematory Establishment

Qualifications for a crematory establishment license are outlined in 26 V.S.A. § 1252(c). Applicants for a crematory establishment license shall:

(1) identify the designated manager to be responsible for the establishment, and

(2) pass an inspection of the establishment by the Office or its designee.

Section 2.4 Inspections; Establishment Requirements

An establishment shall pass an inspection in compliance with the Funeral Services Act and the minimum standards set forth in these rules. Additionally, a crematory establishment shall be subject to all local, state, and federal health and environmental protection requirements and shall obtain all necessary licenses and permits as may be required from the appropriate local, state or federal agencies.

Section 2.5 Right to a Written Decision And Appeal

An applicant will be notified in writing whether the establishment is qualified to be licensed. If the Director denies an applicant a license, the Director shall give the applicant specific reasons in writing and inform the applicant of the right to request a hearing for review of this decision. The hearing will be held by an administrative law officer appointed by the Secretary of State. After giving the applicant and the Director an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, remand or modify the Director's preliminary decision. The administrative law officer's decision may be appealed to Washington Superior Court.

Part 3 Information For Licensed Establishments

Section 3.1 Renewing Licensure Biennially

The Office has a fixed 24-month licensing schedule. Licenses renew on a fixed biennial schedule: August 1 of the odd-numbered years. A license holder must renew by the expiration date printed on the license. Before the license expiration date, the Office will mail a renewal application and notice of renewal fee. A license will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

A license holder is responsible for notifying the Office promptly if the establishment changes designated managers, ownership, name, mailing address, or business address.

Section 3.2 Reinstating a License

Licenses that have lapsed may be reinstated upon payment of a renewal fee for the current biennium and a late renewal penalty.

Section 3.3 Professional Standards

A license holder may be disciplined for a violation of any of the grounds of unprofessional conduct which are found in 26 V.S.A. § 1257 or 3 V.S.A. § 129a. In addition, a license holder may be disciplined for a violation of any of these administrative rules.

Section 3.4 Complaint Procedure

The Office has a procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Section 3.5 Disciplinary Actions

Hearings on charges of unprofessional conduct are held before an administrative law officer appointed by the Secretary of State. A party aggrieved by a decision of an administrative law officer may, within 30 days of the decision, appeal by filing a written notice with the Director. The appeal shall be decided by Washington Superior Court on the basis of the record before the administrative law officer.

Part 4 Minimum Standards for Crematory Establishments

Section 4.1 Authorizing Agent

(A) The following persons, in the priority listed, shall have the right to serve as the authorizing agent, having the authority to authorize the cremation of human remains:

(1) The individual who was the spouse of the decedent at the time of the decedent's death.

(2) The decedent's surviving adult children. If there is more than one adult child, any adult child who confirms in writing the notification of all other adult children, may serve as the authorizing agent, unless the crematory authority receives a written objection to the cremation from another adult child.

(3) The decedent's surviving parent. If the decedent is survived by two parents, a parent who confirms in writing the notification of the other parent may serve as the authorizing agent, unless the crematory authority receives a written objection to the cremation from the other parent.

(4) The person in the next degree of kinship under the laws of descent and distribution to inherit the estate of the decedent. If there is more than one person of the same degree, any person of that degree may serve as the authorizing agent.

(5) In the case of indigents or any other individual whose final disposition is the responsibility of the state or any of its instrumentalities, a public administrator, medical examiner, coroner, state appointed guardian, or any other public official charged with arranging the final disposition of the decedent may serve as the authorizing agent.

(6) In the case of individuals who have donated their bodies to science or whose death occurred in a nursing home or other private institution, who have executed pre-need cremation authorization forms and the institution is charged with making arrangements for the final disposition of the decedent, a representative of the institution may serve as the authorizing agent.

(7) In the absence of any person under paragraphs (1) through (7), any person willing to assume the responsibility as authorizing agent, as specified in this Act.

(B) In the case of body parts, a representative of the institution that has arranged with the crematory authority to cremate the body parts may serve as the authorizing agent, providing that the person whose body parts are being cremated or an authorizing agent has previously approved the cremation of the body parts.

Section 4.2 Authorization to Cremate

(A) Except as otherwise provided in this section, a crematory authority shall not cremate human remains until it has received:

(1) A cremation authorization form signed by an authorizing agent. The cremation authorization form shall contain, at a minimum, the following information:

(a) The identity of the human remains and the date of death.

(b) The name of the person or establishment that obtained the cremation authorization.

(d) A representation that the authorizing agent does in fact have the right to authorize the cremation of the decedent, and that the authorizing agent is not aware of any living person who has a superior or equal priority right to that of the authorizing agent. In the event there is another living person who has a superior or equal priority right to the authorizing agent, the form shall contain a representation that the authorizing agent has made reasonable efforts to contact that person, has been unable to do so, and has no reason to believe that the person would object to the cremation of the decedent.

(e) Authorization for the crematory authority to cremate the human remains.

(f) A representation that the human remains do not contain a pacemaker or any other material or implant that may be potentially hazardous or cause damage to the cremation chamber or the person performing the cremation.

(g) The name of the person authorized to receive the cremated remains from the crematory authority.

(h) The manner in which disposition of the cremated remains is to take place, if known. If the cremation authorization form does not specify a method of disposition, then the form may indicate that the cremated remains will be held by the crematory for 30 days before they are released, unless they are picked up from the crematory prior to that time, in person, by the authorizing agent. At the end of the 30 days the crematory may return the cremated remains to the authorizing agent if no disposition arrangements are made.

(i) A listing of any items of value to be delivered to the crematory authority along with the human remains, and instructions as to how the items should be handled.

(j) The signature of the authorizing agent, attesting to the accuracy of all representations contained on the cremation authorization form.

(k) The cremation authorization form, other than pre-need cremation forms, shall also be signed by a funeral director or other representative that obtained the cremation authorization. That individual shall execute the cremation authorization form as a witness and shall not be responsible for any of the representations made by the authorizing agent, except the funeral director, establishment or other representative shall warrant to the crematory that the human remains delivered to the crematory authority have been positively identified as the decedent listed on the cremation authorization form by the authorizing agent or a designated representative of the authorizing agent. Such identification shall be made by the authorizing agent or designated representative of the authorizing agent.

(2) A completed and executed burial transit permit, as provided by state law, indicating that human remains are to be cremated.

(3) A medical examiner's permit and any other documentation required by the state, county or municipality.

(B) If an authorizing agent is not available to execute the cremation authorization form in person, that person may execute the form in writing by other reliable means, including a facsimile transmission, telegram, or other electronic transmission.

(C) A crematory shall not accept unidentified human remains. The crematory authority may rely on the identification made before the body was placed in the cremation container. The crematory authority shall place appropriate identification upon the exterior of the cremation container based on the prior identification.

Section 4.3 Permits, documentation and recordkeeping

(A) Medical examiner's permit. Human remains shall not be cremated by the crematory authority until authorization to cremate has been received in writing from the medical examiner.

(B) Cremation log. Each crematory shall maintain a reliable system for recording and tracking cremations. The crematory shall retain a copy of this information in its permanent records. The information shall be easily accessible to inspection by the Director's designee, and shall show the following information, at a minimum:

(1) the date and time of the receipt of human remains;

(2) the type of casket or alternative container in which the body was delivered;

(3) the name of the person or establishment from whom the human remains were received;

(4) the name of the decedent;

(5) the date and time of the cremation;

(6) the date of release of the cremated remains; and

(7) the name of the person or establishment to whom the cremated remains were released.

Section 4.4 Identification of remains

(A) Each crematory establishment shall have a reliable system to ensure that the human remains received by the establishment are properly identified and tracked throughout the cremation process. Immediately prior to being placed within the cremation chamber, the presence of identification of the human remains, as indicated on the cremation container, shall be verified by the establishment and the identification label or paperwork shall be removed from the cremation container and placed near the cremation chamber control panel where it shall remain in place until the cremation process is complete, unless the crematory is using a cremation disk for identification, which may be placed in the chamber.

(B) No unauthorized person shall be permitted in the crematory area while any human remains are in the crematory area awaiting cremation, being cremated or being removed from the cremation chamber. Family members or designated agents of the deceased may witness the cremation.

(C) The unauthorized, simultaneous cremation of the human remains of more than one person within the same cremation chamber is not allowed unless the establishment has received specific written authorization to do so from all authorizing agents for the human remains to be so cremated.

Section 4.5 Handling, containers and holding facilities

(A) A cremation container shall meet all of the following standards:

(1) be composed of readily combustible materials suitable for cremation;

(2) be able to be closed in order to provide a complete covering for the human remains;

(3) be resistant to leakage or spillage;

(4) be rigid enough for handling with ease; and

(5) be able to provide protection for the health, safety and personal integrity of crematory personnel.

(B) An establishment shall not be required to accept for holding a cremation container from which there is evidence of leakage of the body fluids from the human remains therein.

(C) Crematory personnel may come into contact with bodily fluids in the course of their employment. All personnel should be educated regarding blood-borne pathogens and infectious diseases. Universal precautions shall be followed in crematory establishments.

(D) Holding facilities shall:

(1) comply with any applicable public health law;

(2) preserve the dignity of the human remains;

(3) recognize the integrity, health and safety of the crematory personnel operating the crematory; and

(4) be secure from access by anyone other than authorized personnel.

Section 4.6 Pacemakers and Other Implanted Medical Devices

(A) No body shall be cremated with a pacemaker or other potentially hazardous implant in place. The authorizing agent for the cremation of the human remains shall be responsible for informing the funeral director or crematory establishment about a pacemaker or other potentially hazardous implant. The authorizing agent shall be ultimately responsible to ensure that any pacemakers or implants are removed prior to cremation.

(B) Pacemakers shall be removed by an embalmer, medical professional, or other persons appropriately trained in their removal. Removed pacemakers must be treated as medical waste and disposed of accordingly.

Section 4.7 Equipment and maintenance

(A) Establishment floors, walls and other surfaces shall be washable and shall be clean and in good repair. Establishments shall have appropriate ventilation to keep the crematory free from excessive accumulation of ambient dust.

(B) Each establishment shall have at least one properly functioning retort, and equipment for the pulverization or grinding of remains. Equipment shall be maintained according to the manufacturer's instructions.

(C) Upon completion of the cremation, and in so far as is possible, all of the recoverable residue of the cremation process shall be removed from the cremation chamber and all residue from the cremation process shall then be separated from anything other than bone fragments. The bone fragments shall be processed, unless otherwise directed by the authorizing agent, so as to reduce them to unidentifiable particles. Anything other than the particles shall be removed from the cremated residuals in so far as is possible and shall be disposed of by the establishment.

Section 4.8 Sale of Body Parts Prohibited

No establishment shall engage in or otherwise facilitate the illegal sale of bodies or body parts. 26 V.S.A. § 1212

History

EFFECTIVE DATE: August 15, 2003 Secretary of State Rule Log # 03-025

Chapter 112 ALTERNATIVE PREPARATORY PATH FOR FUNERAL DIRECTORS

04-112 Code Vt. R. 04-030-112-X RULE ON ALTERNATIVE PREPARATORY PATHS FOR FUNERAL DIRECTORS AND EMBALMERS

FUNERAL DIRECTORS

Pursuant to 26 V.S.A. § 1252(a)(3), an applicant may qualify for a funeral director license without formal funeral-service schooling or Conference of Funeral Service Examining Boards (CFSEB) examination, by instead completing an Office of Professional Regulation (Office or OPR) approved preparatory program and examination. Participants shall apply for prior approval of a preparatory program, using forms supplied by the Office.

An approved program shall contain the following minimum elements:

(a) Education. In the ten years prior to applying for licensure, the applicant shall have earned at least 26 collegiate credits from a regionally accredited institution of higher learning, or College Board CLEP credit, including coursework with a clear and dominant focus on:

The psychology of death and dying
Human biology
Introductory ethics
Comparative religion
Financial accounting to include internal controls and external reporting to service providers, merchandizers, and corporations
Public speaking and effective communication
Conflict resolution or mediation; and
Business law

(b) Course Content. It is the burden of the applicant to demonstrate that courses offered in satisfaction of subpart (a) have a clear and dominant focus on the enumerated topics. The Director of OPR may require course syllabi and other supporting evidence where content is unclear.

(c) Approved Course Sequences. College credit claimed under this rule may be derived from any qualified educational institution. The Office maintains a list of approved course sequences from qualified educational institutions. The approved course list can be found on the Office's Funeral Service website.

(d) Networking and Continuing Education. During the preparatory program, the applicant shall participate in the same ten hours of continuing professional education undertaken each biennium by all licensed funeral directors, shall earn these hours at live events in the company of practicing Vermont funeral directors, and shall demonstrate active engagement in professional and civic activities related to the practice of funeral service.

(e) Apprenticeship. The applicant shall establish an Office-approved apprenticeship at a Vermont licensed funeral establishment, during which the applicant shall attain practical experience under the supervision of a Vermont-licensed funeral director.

The applicant must document working at least 50 dispositions, competently exercising, under supervision, the essential responsibilities of a funeral director, including removal of the deceased from the place of death; service arrangement meeting with the family; gathering information and writing the obituary; completing the Statement of Goods and Services; completing the demographic information on the VT EDRS website; if requested, coordinating clergy, musicians, cemetery, burial vault, flowers, and reception; conducting the funeral or memorial service; securing permits for burial/cremation; notifying the Social Security Administration; and completing a follow-up visit with the family after services.
The apprenticeship must specifically establish the applicant's proficiency in:

i. all aspects of the Vermont Mandatory Pre-need Contract, including rules for prepaid funeral funds pursuant to 26 VSA § 1272;

ii. VT Advanced Directive and COLST forms as well as using the Advanced Directive online database;

iii. the Federal Trade Commission (FTC) Funeral Services Rule;

iv. complete crematory operations from delivery of deceased through processing cremated remains, through documented onsite review;

v. the use and function of funeral merchandise, including but not limited to caskets, urns, and burial vaults;

vi. practical application of Vermont statutes, rules, and probate procedures controlling disposition of human remains, including 18 V.S.A. § 5227; and

vii. practical application of professional standards and bases for unprofessional conduct set out in Vermont law and regulation.

An apprenticeship supervisor must be a Vermont-licensed funeral director with at least three years of practice and must be in good standing. The supervisor shall be responsible for timely, accurate, and complete filing of evaluative forms supplied by the Office. The Director may limit the number of apprentices a supervisor may oversee simultaneously.

(f) Examination. An applicant shall pass a written examination, specified by the Director, addressing mortuary science, funeral practice, and laws and rules pertaining to the funeral industry.

EMBALMERS

Pursuant to 26 V.S.A. § 1252(b)(3), an applicant may qualify for an embalmer license without formal funeral-service schooling or CFSEB examination, by instead completing an Office approved preparatory program and examination. Participants shall apply for prior approval of a preparatory program, using forms supplied by the Office.

An approved program shall contain the following minimum elements:

(a) Education. In the ten years prior to applying for licensure, the applicant shall have earned at least 18 collegiate credits from a regionally accredited institution of higher learning, or College Board College-Level Examination Program (CLEP) credit, including coursework with a clear and dominant focus on:

Introduction to embalming (human biology, or anatomy and physiology, as a prerequisite)
Advanced embalming
Embalming clinical
Embalming chemistry
Sanitary science; and
Restorative art

(b) Course Content. It is the burden of the applicant to demonstrate that courses offered in satisfaction of subpart (a) have a clear and dominant focus on the enumerated topics. The Director may require course syllabi and other supporting evidence where content is unclear.

(d) Networking and Continuing Education. During the preparatory program, the applicant shall participate in the same ten hours of continuing professional education undertaken each biennium by all licensed embalmers, shall earn these hours at live events in the company of practicing Vermont embalmers, and shall demonstrate active engagement in professional and civic activities related to the practice of funeral service.

The applicant must document competently exercising under supervision the essential responsibilities of an embalmer which include embalming or assisting in the embalming of at least 20 human bodies in addition to those completed during the educational program described in subpart (a), herein. One embalmed body must be an autopsied individual, and one must be a bone and tissue donation. The applicant shall also view an autopsy performed at a medical center by the pathology department.
An apprenticeship supervisor must be a Vermont-licensed embalmer with at least three years of practice and in good standing. The supervisor shall be responsible for timely, accurate, and complete filing of evaluative forms supplied by the Office. The Director may limit the number of apprentices a supervisor may oversee simultaneously. In exceptional circumstances, the Director may authorize supervision by an embalmer licensed and practicing in a state or province bordering Vermont.

(f) Examination. Two types of examination are required:

Practical examination. An applicant shall pass a practical examination which will be administered by an institution of higher learning or a Vermont-licensed embalmer; both of which must be approved by the Office. The examiner shall not be the direct supervisor or employer of the apprentice taking the practical examination.

Written examination. An applicant shall pass a written examination, specified by the Director, addressing laws and rules pertaining to embalming and the funeral industry.

History

EFFECTIVE DATE:
October 7, 2019 Secretary of State Rule Log #19-049
AMENDED:
10/21/2023 Secretary of State Rule Log #23-033
STATUTORY AUTHORITY: 3 V.S.A. § 801; 26 V.S.A. § 1252(a)(3)

Chapter 120 RULES FOR HEARING AID DISPENSERS

04-120 Code Vt. R. 04-030-120-X RULES FOR HEARING AID DISPENSERS

Part 1 GENERAL INFORMATION ABOUT THE LICENSING OF HEARING AID DISPENSERS

Section 1.1 The Purpose of Licensing

The Secretary of State's Office of Professional Regulation has been given certain powers by Vermont law. The purpose is to protect the public health, safety and welfare by setting standards, licensing applicants, and regulating licensed hearing aid dispensers.

Section 1.2 Business Location

The business location for licensing matters is the Office of the Secretary of State, Office of Professional Regulation, Redstone Office Building, 26 Terrace Street, Montpelier (the office). The mailing address is the Office of the Secretary of State, Pavilion Office Building, Montpelier, Vermont 05609-1106. The telephone number is (802) 828 - 2363, or toll-free in Vermont, (800) 439-8683. An interested person may get copies of these rules and more information about licensing and its requirements and procedures by writing or telephoning the office.

Section 1.3 Advisors to the Director of Professional Regulation

The Secretary of State appoints three licensed hearing aid dispensers to serve as advisors to the Director of Professional Regulation in matters related to hearing aid dispensers. One member is an otolaryngologist; one is an audiologist; and the third is a hearing aid dispenser who is neither an otolaryngologist nor an audiologist.

The appointees advise the director on such matters as selecting an examination, setting a passing score, making administrative policies and rules, and denying licenses.

Section 1.4 Laws that Govern Licensing

Licensing of hearing aid dispensers is governed by a specific statute that establishes the responsibilities for setting standards, issuing licenses, and regulating the profession. The law is Title 26, Vermont Statutes Annotated, Chapter 67. In addition, the director is obligated to comply with several other state laws, such as the subchapter on Professional Regulation (Title 3 Vermont Statutes Annotated, sections 121-131), the Administrative Procedure Act (Title 3 Vermont Statutes Annotated, sections 801 - 849); the Open Meeting Law (Title 1 Vermont Statutes Annotated, sections 311 - 314), and the Access to Public Records Law (Title 1 Vermont Statutes Annotated, sections 315-320). These laws spell out the rights of applicants, licensed hearing aid dispensers, and members of the public. The complete text of any of these laws is available from town clerks or libraries, which should have a set of the Vermont Statutes Annotated.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Definitions

Terms defined in the Hearing Aid Dispensers Act, 26 V.S.A. § 3281, have the same meaning when used in these rules. In addition, when used in these rules;

(1) "Cost of service" means the actual cost of the service provided to fit the hearing aid or hearing aids but must not exceed five percent of the sale price or $ 50.00 per sale, whichever is greater.

(2) "Director" means the director of the Office of Professional Regulation.

(3) "Physician" means any medical doctor or osteopath licensed to practice allopathic medicine or osteopathic medicine.

(4) "Special panel" means a panel appointed by the Secretary of State, including a public member and the appointed advisors or substitutes for them.

Section 2.2 Qualifications for a License through Examination

In order to obtain a license to dispense hearing aids in Vermont, the applicant must:

(1) be at least 18 years old;

(2) pass the examination; and

(3) not be guilty of unprofessional conduct, as defined in 26 VSA § 3301

The passing score is set by the use of objective psychometric standards.

The examination is given at least twice a year, and the applicant who does not pass the examination may retake it one or more times. A special panel may waive the requirements of (3) if the applicant shows sufficient rehabilitation.

Section 2.3 Licenses from other Jurisdictions

The director may waive the examination requirement if the applicant is a hearing aid dispenser regulated under the laws of another state, who is in good standing to dispense hearing aids in that state and who was licensed by examination and the examination currently used is equivalent to Vermont's, including the criteria for passing.

Section 2.4 Right to a Written Decision and Appeal

If the director denies an application for a license, he or she shall give the applicant specific reasons in writing and inform the applicant of the right to appeal this decision to a special panel appointed by the secretary. After an opportunity to present the application and any additional information, the special panel shall affirm or reverse the director's preliminary decision. The applicant may appeal the special panel's decision to an appellate officer.

Part 3 INFORMATION FOR LICENSED HEARING AID DISPENSERS

Section 3.1 Renewal of License

Licenses are to be renewed every two years. Biennially, the director shall forward a renewal form to each licensee. When the form is returned with the renewal fee, the office will issue a new certificate. This rule does not apply to lapsed licenses (see 3.2).

Section 3.2 Reinstating a License

A license which has lapsed for a period of three years or less may be renewed upon application and payment of the renewal fee and the reinstatement fee.

A license which has lapsed for more than three years may be reinstated after the applicant passes the examination. The applicant must complete a reinstatement application, which details his or her activities since the last renewal was filed.

Section 3.3 Display of License, Business Address

A licensee must maintain, in Vermont, a business address, an office and a telephone number, at which the licensee can normally be reached, and must conspicuously display a copy of the license at each place of business the licensee maintains for dispensing hearing aids.

Section 3.4 Change of Name or Address

A licensee is responsible for notifying the office promptly if he or she changes name, mailing address or business address. Failure to notify the office may result in not receiving the renewal application.

Section 3.5 Records and Equipment

(a) A licensee must maintain records relating to any sale of a hearing aid or related services and, upon request, must make such records available to the director or the buyer for review. A licensee must maintain the required records by a reasonably reliable method for at least seven years from the date of sale, including:

(1) contracts and retail installment sales agreements;

(2) hearing test results;

(3) waivers signed by the consumer; and

(4) a record of payments and refunds.

(b) Testing equipment used by a licensee must be available for inspection during normal business hours, and must be calibrated annually, as provided in 26 VSA § 3282. A copy of the calibration report must be kept on file and provided to the director's inspector on request.

Section 3.6 Prices to be Disclosed

(a) A licensee must disclose in a clear and conspicuous manner the range of retail prices charged for hearing aids and accessories. The disclosure schedule must include the ten brands of hearing aids most frequently sold, and show the highest and lowest prices for each brand. The most expensive and the least expensive brands sold must be included on the list. The schedule must also show the range of prices for batteries.

(b) The disclosure schedule must be posted in each retail establishment in which the licensee works, in a location which is easily accessible in the waiting area of the dispenser's office at eye level. The price disclosure shall be in not less than fourteen point boldface type and "one and a half" spacing, or the handlettered equivalent.

This sentence is an example of fourteen point boldface type with one and a half spacing.

A typed copy, in twelve point or pica type, must be given to each customer prior to any sale.

Section 3.7 Required Clauses in Contracts

(a) At the time of each sale, immediately before completion, the dispenser shall provide to the buyer a written statement showing the complete terms of sale, including the individual prices of the goods and services sold, the brand, model number, serial number, whether the hearing aid is new or used, the dispenser's telephone number and the date of delivery, to be filled in upon delivery. The written statement shall include or be accompanied by a disclosure in substantially the following form:

NOTICE OF 45 DAY TRIAL PERIOD

YOU HAVE 45 DAYS FROM THE DAY THAT YOU RECEIVE YOUR HEARING AID TO TRY IT OUT AND DECIDE WHETHER YOU WISH TO KEEP IT. THE 45 DAY PERIOD DOES NOT INCLUDE ANY DAYS THAT THE HEARING AID IS IN THE POSSESSION OF THE DISPENSER, MANUFACTURER, REPAIRER OR THEIR AGENTS. IF, IN YOUR OPINION, DURING THE 45 DAY TRIAL PERIOD YOU FEEL THAT THE HEARING AID IS NOT SATISFACTORY FOR YOU, YOU HAVE A RIGHT TO RETURN THE HEARING AID AND RECEIVE A REFUND OF THE FULL PRODUCT PRICE EXCEPT FOR THE COST OF EAR MOLDS AND SERVICE. THIS REFUND WILL BE AT LEAST $ ___. (ENTER PRICE MINUS COST OF EAR MOLD & SERVICE *). HOWEVER, IF YOU HAVE DAMAGED THE HEARING AID, YOUR REFUND WILL BE REDUCED BY THE REASONABLE COST OF DAMAGE.

"COST OF SERVICE" MEANS THE ACTUAL COST OF THE SERVICE PROVIDED TO FIT THE HEARING AID OR HEARING AIDS BUT MUST NOT EXCEED FIVE PERCENT OF THE SALE PRICE OR $ 50.00 PER SALE, WHICHEVER IS OREATER.

IN ORDER TO RETURN THE HEARING AID AND RECEIVE A REFUND, CONTACT

___ AT (ENTER NAME OF DISPENSER)

___, (ENTER ADDRESS OF DISPENSER)

___, NOT LATER THAN 45 DAYS AFTER DELIVERY OF THE HEARING AID.

(b) At the time of delivery, the delivery date shall be entered on the sales contract.

(c) If the hearing aid is delivered at a time other than when a contract is signed, it shall be accompanied by a notice of the 45 day trial period as specified in section (a) above.

(d) At the time of sale, the dispenser shall give the buyer a written copy of any audiometric test performed.

Section 3.8 Refunds

A dispenser shall pay any refund requested during the 45 day trial period within four weeks of receiving a returned hearing aid or, if the hearing aid has not been delivered, within four weeks of the request. Failure to pay the refund within the four weeks shall be considered an unreasonable delay of a refund for purposes of 26 VSA § 3301(14) (unprofessional conduct).

Section 3.9 Complaints, Investigations and Unprofessional Conduct

The Office maintains procedures for the investigation of complaints, holding hearings and taking disciplinary action. Contact the Office for copies of the procedures.

History

Effective Date: December 25, 1991 (Secretary of State Rule Log #91-74)
- Formerly Rule No. 04 063 002. This rule has not been changed. It has been renumbered and relocated to insure that all rules issued under this Office are properly and uniformly numbered.*
Statutory Authority: 26 V.S.A. Chapter 67

Chapter 130 ADMINISTRATIVE RULES OF THE BOARD OF LAND SURVEYORS

04-130 Code Vt. R. 04-030-130-X ADMINISTRATIVE RULES OF THE BOARD OF LAND SURVEYORS

Part 1 General Information

Section 1.1 The Board's Purpose

(a) The Board of Land Surveyors ("the Board") has been created by Vermont law, Title 26 Chapter 45 of the Vermont Statutes Annotated which confers certain powers and duties on the Board. The Board has adopted these rules to aid applicants, licensees, and the general public in understanding the requirements for this profession.

(b) The Board is created to safeguard property and the public welfare by setting standards for issuing licenses, licensing qualified applicants, and regulating the practice of license holders.

(c) The Board maintains a website at http://vtprofessionals.org/ . Practitioners should periodically consult the website for matters of interest to the profession.

Section 1.2 Definitions

As used in these rules:

(a) "ABET" means "ABET, Inc.," the Accreditation Board for Engineering and Technology;

(b) "Board" means the Board of Land Surveyors;

(d) "NCEES" means National Council of Examiners for Engineering and Surveying;

(e) "Office" means the Office of Professional Regulation within the Office of the Secretary of State;

(f) "Supervising land surveyor" means a land surveyor who has been licensed three years or more and who conducts a regular personal review of an applicant's land surveying work during a period of internship.

(g) "V.S.A." means Vermont Statutes Annotated; " 26 V.S.A. § 2501 " means section 2501 of Title 26 of the Vermont Statutes Annotated.

Section 1.3 Business

The Board's mailing address is:

Board of Land Surveyors

Vermont Secretary of State

Office of Professional Regulation

National Life Bldg., North, FL2

Montpelier, VT 05620-3402

Section 1.4 Board

(a) The Board is made up of five licensed land surveyors and two members of the public who have no financial interest in land surveying except as consumers. One of the land surveyor members must have been licensed by examination within five years preceding appointment. The members of the Board are appointed by the Governor and serve staggered five-year terms as set forth in 3 V.S.A. § 129b. Board officers are elected annually.

(b) Officers' duties are as follows:

(1) Chairperson. Calls Board meetings, presides at Board meetings, signs vouchers and official Board papers, and generally supervises the Board's activities.

(2) Vice-Chairperson. Performs the duties of the chairperson when he or she is absent.

(3) Secretary. The Secretary performs such tasks as the Board may determine.

Section 1.5 Meetings

Regular meetings of the Board are scheduled well in advance. Regular meeting dates may be obtained from the Board's web site http://vtprofessionals.org . Special or emergency meetings may be called by the chairperson or any two members of the Board. A majority of Board members constitutes a quorum for all meetings. Formal action may be taken at a meeting if a majority of those present and voting are in favor of the action.

Section 1.6 Laws that Govern the Board

(a) The Board is created by Chapter 45 of Title 26, Vermont Statutes Annotated, which establishes the Board's responsibilities for setting standards, issuing licenses, and regulating the profession. The statutes are online at http://www.leg.state.vt.us/statutes/chapters.cfin?Title=26. Board powers are also conferred by subchapter III of Chapter 5 of Title 3 ( 3 V.S.A. §§ 121-132) "Professional Regulation," the statutes creating and governing the Office of Professional Regulation. In addition to the "Professional Regulation" statutes, the Board is subject to other state laws including the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314), the "Access to Public Records Law" and ( 1 V.S.A. §§ 315-320). In contested cases, the Board follows the Vermont Rules of Evidence, as amended by the Administrative Procedure Act. These laws set forth the rights of applicants, license holders and members of the public. The Office provides legal counsel to help the Board comply with all laws affecting Board business.

(b) Applicants and licensees should be aware that Chapter 5 of Title 3 of the Vermont Statutes contains several statutes which govern regulation of licensed professionals. See among them, 3 V.S.A. § 129a which defines unprofessional conduct.

(c) The complete text of these laws is available at most libraries and town clerk's offices. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us . The Board's statutes and rules may be accessed through the Board's website at http://vtprofessionals.org/ .

Section 1.7 Rules of the Board

(a) The Board is authorized to make these rules under 26 V.S.A. § 2544(a) and 26 V.S.A. § 2592. The rules govern the Board's proceedings. When the Board establishes rules, it follows the Administrative Procedure Act. These rules are approved by the Vermont Legislative Committee on Administrative Rules and are presumed valid. 3 V.S.A. § 845(a).

(b) Copies of these rules may be obtained on line through the Office of Professional Regulation web site. Questions about the Board and its procedures may be addressed to the Office. Email contact information is on the Board's web page at http://vtprofessionals.org.

Part 2 Information for Applicants

Section 2.1 Need for a License

26 V.S.A. § 2503 provides:

"A person who is not licensed by the board shall not:

(1) use the title 'licensed land surveyor' or any substantially equivalent title;

(2) represent himself or herself as licensed by this state or able to perform land surveying; or

(3) practice land surveying or act in responsible charge of another person who practices land surveying."

Section 2.2 How to Become a Licensed Land Surveyor

An application for a license or more information about applying for licensure may be obtained on line at http://vtprofessionals.org or by writing or calling the Office. The application fee is stated on the application form. Checks must be made payable to Vermont Secretary of State. Mail the completed application form and required additional information to the Office.

Section 2.3 Four Routes to Licensure

Under Vermont's land surveying statute, there are four ways of qualifying for a license. They are:

(a) Bachelor's Degree in Land Surveying, Internship, Portfolio, and Examination;

(b) Associate's Degree in Land Surveying, Internship, Portfolio, and Examination;

(d) Endorsement.

Section 2.4 Bachelor

(a) An applicant under this rule must have:

(1) graduated with a bachelor's degree from an ABET-approved surveying program;

(2) completed a 24 month internship as explained in Rule 2. 8;

(3) submitted a complete portfolio as set forth in Part 4 of these rules; and

(4) passed the land surveying examinations designated by the Board.

(b) An application under this rule must be accompanied by:

(1) Certified transcript;

(2) Required documentation from supervising land surveyors as set forth in these rules and;

(3) Application fee.

Section 2.5 Associate' s Degree in Land Surveying, Internship, Portfolio, and Examination

(a) An applicant under this rule must have:

(1) graduated with an associate's degree from an ABET-approved surveying program;

(2) completed a 36 month internship as explained in Section 2.8;

(3) submitted a complete portfolio as set forth in Part 4 of these rules; and

(4) passed the land surveying examinations designated by the Board.

(b) An application under this rule must be accompanied by:

(1) Certified transcript

(2) Required documentation from supervising land surveyors; and,

(3) Application fee.

Section 2.6 Internship, Portfolio, and Examination

(a) An applicant under this rule must have:

(1) completed a 72 month internship as explained in Rule 2. 8;

(2) submitted a complete portfolio as set forth in Part 4 of these rules; and

(3) passed the land surveying examinations designated by the Board.

(b) An application under this section must be accompanied by:

(1) Required documentation from supervising land surveyors; and,

(2) Application fee.

Section 2.7 Licensure

(a) A person holding a land surveying license in good standing issued by another United States or Canadian jurisdiction may apply under this rule. The license may be called a certificate of registration or by another name. The absence of portfolio requirement in another jurisdiction shall not prevent the Board from finding substantial equivalence. The Board must have determined that, the jurisdiction's current licensing requirements are substantially equivalent to Vermont's.

(b) An application under this section must include:

(1) Verification of current licensing status;

(2) Application fee.

Section 2.8 Internship, General Information

An internship in land surveying will combine study with practical work experience as a prerequisite to licensure. An intern should work with his or her supervisor to establish objectives that will lead to licensure. The applicant shall obtain the current version of the statutes and the Administrative Rules of the Board of Land Surveyors. See, Chapter 45 of Title 26, and Chapter 5 of Title 3 and Rule 1.6 above.

Section 2.9 Experience

The Board has determined the following areas to be most relevant to the current practice of the surveying profession. Although not all-inclusive, they will be used as a measure of experience, objectives, and goals to be accomplished through work experience.

(a) Research: A surveyor must have knowledge of legal principles and requirements applicable to surveying and land descriptions. A surveyor researches public and private land records (e.g., municipal clerks' land records and probate court records); federal, state, county, and municipal sources, and records of other surveyors to compile boundary evidence and to establish procedures and background information in accordance with prevailing and applicable professional standards and contract requirements. A surveyor must have knowledge of history of local land survey systems and practices and of sources of surveying records and information.

(b) Reconnaissance: A surveyor must have knowledge of and ability to perform field reconnaissance techniques (e.g., gathering parol evidence, questioning knowledgeable persons, using physical characteristics of areas, and other means of locating markers or monuments). A surveyor performs field reconnaissance for rural and urban surveys to locate boundary evidence and to further establish procedures and background information in accordance with prevailing and applicable professional standards and contract requirements.

(c) Measurement: A surveyor must have knowledge of and ability to perform basic survey measurement techniques (e.g., traverse, triangulation, trilateration, leveling, and error reduction techniques). A surveyor measures units of space, water, land, and structures (e.g., boundaries, areas, shapes, directions, slopes, distances, angles, heights, locations, and alignments) using the equipment of the profession in accordance with prevailing and applicable professional and regulatory standards.

(d) Calculation: A surveyor must have knowledge of and the ability to perform basic survey computational techniques. A surveyor must have knowledge of mathematics including algebra, plane and solid trigonometry, analytical geometry, and statistics.

(e) Evaluation and Verification: A surveyor must have knowledge necessary to recognize and assemble pertinent information and the ability to draw conclusions, set priorities, and otherwise weigh relevant evidence. In order to locate boundaries, a surveyor must have the knowledge and ability to analyze measurement data using the equipment of the profession in accordance with prevailing and applicable professional standards.

(f) Perpetuation

A surveyor establishes monuments, verifies or locates monuments, corners, lines, witness points in accordance with available data in order to comply with contracts, other legal requirements, and to protect the public welfare and property. A surveyor monuments, re-monuments and marks property corners and lines to perpetuate their locations. A surveyor establishes permanent records in order to provide evidence for future surveys, satisfy legal requirements, and provide personal and public protection in accordance with prevailing and applicable professional standards.
A surveyor must have knowledge of and the ability to apply written communication techniques (e.g., writing legal descriptions, surveyors' reports, and field notes). A surveyor compiles final notes in order to comply with contract and other legal requirements including documents (e.g., plats, maps, descriptions, surveyor reports, job narratives, affidavits, photographs, and certifications) in accordance with prevailing and applicable professional standards and regulations. A surveyor communicates with clients to establish the scope of survey services (e.g., boundary, topographic, title insurance, condominium, settlement, plat of subdivision, cemetery survey and plat, retracement, and location) in accordance with client requirements and prevailing and applicable professional standards using available data (e.g., maps, plats, photographs, land descriptions, abstracts, records, affidavits, and other legal documents).

Section 2.10 Taking

(a) The applicant may submit an application and, if approved by the Board, take the Fundamentals of Surveying examination, the Principles and Practice of Surveying examination, and the Vermont State Specific surveying examination.

(b) The Board grades the Vermont State Specific Surveying Examination and sends results to the applicants.

Section 2.11 Failure

A candidate may apply to retake an examination as permitted by the Board and NCEES.

Part 3 Application Process

Section 3.1 Notification of Intent to Deny an Application

(b) The Board, or the Office on behalf of the Board, most often issues a preliminary denial of licensure or renewal when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing by the Board. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the Board issues a final decision in writing.

Section 3.2 Right to Appeal Licensing Decisions

If the applicant is not satisfied with the Board's final decision concerning the denial of a license or renewal, the applicant may appeal the decision to the Director. The appeal must be filed within 30 days of the date of the denial. An appellate officer will review the record made before the Board for legal errors. Information about the appeal process may be obtained from the Office or online at http://vtprofessionals.org/ .

Part 4 Portfolio

Section 4.1 Portfolio

Except for those applying for licensure by endorsement, each applicant, in addition to the requirements above, is required to submit a portfolio.

Section 4.2 Definition

The portfolio is a selection of the applicant's work and work to which the applicant contributed under licensed supervision. Only work of a land surveying nature is creditable. The purpose of the portfolio is to document the applicant's education and experience by showing the acquisition of knowledge, skills, and abilities through experience in critical areas of land surveying necessary to meet minimum standards for licensure.

Section 4.3 Time

The portfolio may be submitted at any time during the last year of supervision. An applicant may begin filling out the portfolio at any time. The Board suggests that as the applicant's internship progresses, he or she make contemporaneous entries. The portfolio can then be used as an educational "road map" showing the applicant which areas of educational experience need to be addressed.

Section 4.4 Contents

It is hoped that the portfolio requirement can be satisfied in three or fewer surveys so long as the surveys submitted show acquisition of education in all of the areas on the portfolio checklist. But an applicant may submit up to six surveys, if necessary.

Section 4.5 Purpose

(a) The portfolio is intended to show exposure to and education of the type typically seen in Vermont land survey work. The portfolio must be submitted in a non-electronic format. The applicant may be asked to provide an explanation of the portfolio if necessary.

(b) The intent of the portfolio is twofold:

It provides applicants and their supervisors with clearly described educational exposure and achievement standards for them to display. And,
it is hoped that supervising Land Surveyors whose apprentices' work is approved by them and shown to the Board in the portfolios will use the checklist as a guide to fulfilling their professional obligations.

Section 4.6 Directions

(a) Each portfolio is to be accompanied by the Board's Portfolio Explanation Form (available on line or from the office). The form contains a check list of educational topics. For each topic, the form contains a space for the applicant to fill in showing where in the portfolio evidence and documentation of that topic can be found. The form also provides space for the applicant to explain how his or her experience contributed to the documentation included in the portfolio. The applicant will complete the checklist, and for each item on it, specify where documentation of education for that requirement is found in the portfolio.

(b) At the end of the portfolio evaluation form, the supervising land surveyors must attest that the work the applicant claims as his or hers was in fact performed under the supervision of that land surveyor.

For example:

"Evaluation of Evidence:

a. Explanation of how the evidence found was evaluated."

| Area of Education | Time / Explanation | Reference to Portfolio page number and section | For Board Use Only | | --- | --- | --- | --- | | Research Rule 2. 9(a) | This land record evidence was analyzed by me from the Vershire Town Clerk's records and approved by my supervising LS in June of 2007. | Found and footnoted in Survey #1 of Portfolio, on pages 7 and 21 | | | Survey Plats- Rule 5.5(c)(1) Descriptions of natural and artificial monuments including whether found or set. | May 2008: Located and described monuments on a survey for a client in Johnson, Vermont. | Found and footnoted in Survey #2 of Portfolio on pages 11 and 13 | |

(c) A sample portfolio and sample completed Portfolio Explanation Form is available at the Board's web site at http://vtprofessionals.org .

Section 4.7 Topics Covered

The specific educational topics to be documented are taken from standards set forth in these rules as well as from Vermont statutes and announced minimum standards governing land surveying.

Section 4.8 Board review

(a) The Board reviews the portfolio to verify that the applicant has obtained sufficient education and training necessary to meet minimum professional competence standards required for licensed land surveying in Vermont.

(b) The Board reviews portfolios to assess the applicant's exposure to, and understanding of principles and practices, and not a specific methodology.

Section 4.9 Written Decision

(a) After reviewing the portfolio, the Board will provide the applicant a written decision indicating approval of the topics appropriately shown in the portfolio, and, if necessary, designating the area(s) where the applicant must still show documentation of experience meeting minimum standards of practice.

(b) If the Board determines that some of the areas on the evaluation form have not been adequately documented, the applicant will be notified. The applicant must then provide additional documentation sufficient to address the deficiencies found. Unless the portfolio is grossly deficient, the applicant will not be required to submit a new portfolio.

Part 5 Standards for the Practice of Land Surveying

Section 5.1 Authority

The Vermont Board of Land Surveyors is authorized by the legislature to adopt rules establishing minimum standards of practice. 26 VSA § 2544(9).

Section 5.2 Purpose

(a) The purpose of these standards is to establish minimum procedural and technical criteria to govern the performance of land surveyors when more stringent standards are not required. Further, the purpose is to protect the inhabitants and property owners in this state from substandard or incompetent surveying, and generally to safeguard property and the public welfare.

(b) These standards are also a guide for land surveyors in their daily practice and for intern surveyors working to enter the profession.

(c) These standards are intended to allow land surveyors flexibility in their surveying methods and the collection and interpretation of evidence necessary for boundary determination.

(d) If possible, the land surveyor shall locate the corners and boundaries of the property under survey. These standards are developed to satisfy that minimum result.

Section 5.3 Definitions

For the purpose of this part:

(a) "Boundary" means: A line of demarcation between adjoining properties and indicating the furthest extent of property.

(b) "Corner" means: A point on a boundary, at which two or more boundaries intersect.

(c) "Document" means: Any instrument which may be used as evidence. A document makes record of letters, figures, marks, or any combination thereof. The term "document" shall be applied broadly to include writings and printed works, maps and plans, photographs and pictures, seals and plates. Documents include record evidence and may be found in a number of locations in addition to the municipal clerks' offices.

(d) "Evidence" means: Information, observations, or objects that may aid the surveyor in locating the position of a boundary.

(e) "Inconsistency" means: An uncertainty; doubtfulness or a want of clearness and definiteness. Inconsistency means also an ambiguity or that which is difficult to comprehend or distinguish. An inconsistency occurs when title to the same property is expressly conveyed to different parties, where a gap exists between descriptions, or when one party has title and another party has possession, or the documents and record evidence contain ambiguities or conflicting terms.

(f) "Key deed" means the deed which originally created the boundary.

(g) "Land Surveying" means: The definition provided by 26 V.S.A. § 2502.

(h) "Land Surveyor" means a person with a legal right to be in responsible charge of a property survey in this State.

(i) "Monument" means: A physical structure, mark or object that serves to perpetuate the location a corner or point on a boundary. Permanence, durability and stability are implied.

(j) "Positional Tolerance" means: The maximum theoretical uncertainty (at the 95% confidence level) of a measurement between any two corners under survey. The positional tolerance allowed is expressed as a constant (base error) plus the indicated ratio (dependent error) applied to said corners.

(k) "Property:" Property includes land, water, land under water, space, improvements and rights, and easements and servitudes attached thereto.

(l) "Survey Abstract" means: A chronological, condensed history of the record documents pertaining to property boundaries including, but not limited to, conveyances and deeds which may control the location of corners and boundaries of the land under survey.

(1) A survey abstract includes legal descriptions that originally created the subject and abutting parcel(s) which control the location of the corners and boundaries of the property under survey and the abutting properties.

(2) A survey abstract includes pertinent documents related to easements or servitudes that may encumber or benefit the property under survey.

(3) A survey abstract shall be sufficient, if possible, to enable the land surveyor to locate the corners and boundaries of the property under survey and to meet the requirements of these standards.

Section 5.4 Procedural

Whenever a land surveyor conducts a survey of property, the surveyor shall, at a minimum, perform the following:

(a) Research and Field Investigation:

(1) Prepare a survey abstract.

(2) Examine, analyze and test consistency of the record evidence. Investigate and document inconsistencies and form preliminary conclusions as to the completeness of the record evidence.

(3) If necessary, obtain and document from knowledgeable and credible persons parol evidence which may control the location of the corners and the boundaries of the property under survey.

(4) Search for physical evidence which may control the location of the corners and the boundaries of the property under survey. Existing monumentation and physical evidence should not be removed or disturbed.

(5) Record and document in detail all physical evidence found or physical evidence of record not found. Descriptions shall include materials, size and shape, identifying marks or numbers, position and stability; cylindrical sizes shall be reported as inside or outside diameter. Position reported shall include the distance above or below ground.

(6) Make, record, and document measurements to ensure the location and perpetuation of pertinent physical evidence.

(b) Computations, Conclusions, and Perpetuation:

(1) Compute, check, and compare field measurements and pertinent information with record evidence.

(2) Investigate, document and, if possible, reconcile inconsistencies.

(3) When necessary, make additional computations and analyses to develop and formalize opinions on the location of the corners and boundaries of the property under survey. Professional opinions shall be based on the best available evidence and in accordance with applicable Vermont boundary law and the established hierarchy of evidence.

(4) A land surveyor who conducts a survey of property shall set monuments and marks to adequately perpetuate the location of unmarked corners and boundaries of the property under survey.

(c) Results: When the land surveyor cannot prepare a professional opinion on the location of a corner or boundary, the surveyor shall:

(1) Search for and recover additional or missing evidence that will enable the surveyor to form a professional opinion on the boundaries; or

(2) Issue a report describing, at a minimum, controlling evidence and conclusions and any inconsistencies, conflicts, or unusual circumstances.

Section 5.5 Technical

Only two measurement standards are acceptable. Either the accuracy standard or precision standard may be used. The surveyor shall determine which standard should be used based on the current and future needs of the project. The surveyor shall select and employ proper field procedures, instrumentation, and personnel to achieve the applicable measurement standard.

(a) Survey Classes Guidelines for selection of survey classes by land use.

(1) Urban - Surveys of more densely settled or developed land lying within or adjoining a city, village or town center. This includes the surveys of commercial and industrial properties, condominiums, town houses, apartments, and other multi-unit developments, regardless of geographic location.

(2) Suburban - Surveys of land lying outside urban areas and used almost exclusively for single family residences or residential subdivisions.

(3) Rural

Surveys of lands such as farms and other undeveloped land outside of suburban areas.

(b) Measurement Standards

(1) Accuracy Standard: The maximum positional tolerance of any point on the subject boundary is;

(A) Urban 0.05 feet plus 1:10,000

(B) Suburban 0.10 feet plus 1:5,000

(2) Precision Standards: Minimum traverse precision ratio after angles are balanced and closure is calculated;

(A) Urban 1:10,000

(B) Suburban 1:10,000

(c) Survey Plats A land surveyor who conducts a survey shall, when contracted for by the client, prepare a plat showing the results of the survey and shall furnish a copy to the client. The plat shall be prepared in accordance with the latest adopted version of 27 V.S.A. § 1403, Filing of Survey Plats, and 26 V.S.A. § 2596(a), Use of Seal, Certification, and shall also include the following information:

(1) A detailed description of natural and artificial monuments, noted as found or set. Descriptions shall include materials, size and shape, identifying marks or numbers, position and stability. Cylindrical sizes shall be reported as inside or outside diameter. Position reported shall include the distance above or below ground.

(2) A delineation of inconsistencies between the survey and the record description and the source of information used as the basis of the survey.

(3) The name and deed references of the title holder and the adjoiners at the time of survey.

(4) Visible encroachments onto or from adjoining property or streets and the extent of such encroachments.

(5) Public and private rights-of-way, easements and rights which are reasonably known or observed that encumber or benefit the land surveyed.

(6) Sufficient boundary survey data to provide a closed geometric figure of a perimeter survey. A survey of a boundary line adjustment shall have sufficient information to tie into the client's adjoining boundary lines.

(7) Inscriptions noting the specific evidence used to locate the corners and land boundaries. List sources of information used as the basis for boundary location. Include key deed references.

(8) The certification statement shall clearly set forth what information was used as the basis of the survey and shall specifically indicate that the survey work identified thereon is consistent with this information. 26 V.S.A. § 2596.

(9) All lettering and data must be clearly legible.

(d) Monuments

(1) Monuments shall be durable and stable.

(2) Monumentation set shall be identified with the license number of the surveyor in responsible charge.

(3) Monuments set replacing inadequate monuments or missing monuments shall conform to this standard, be documented, and the document be recorded in the public land records.

Part 6 Information for Licensed Land Surveyors

Section 6.1 License Certificate and Seal

(a) The Board will issue a license when it has determined that the applicant has met all prerequisites for licensure. The license should be displayed in the land surveyor's principal place of business or employment.

(b) Each land surveyor must have a seal of a type recommended and approved by the Board. The seal shall contain the words "State of Vermont, Licensed Land Surveyor" and the licensee's name and license number. All lettering on the seal must be a minimum of 1/10th inch high. Seals should not be more than 1.5 inches in diameter. An example of an acceptable seal may be found on the Board's web site.

Section 6.2 License Renewal

(a) Licenses are issued according to a two-year licensing and renewal period, and must be renewed by the expiration date printed on the license. The Office mails renewal notices in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not.

(b) A license expires automatically if the renewal application and fee are not returned to the Office by the expiration date.

Section 6.3 Expired Licenses

(a) A license which is not renewed expires.

(b) A person who does not hold a valid active license shall not engage in the practice of land surveying or hold himself or herself out as being a licensed land surveyor. Practicing land surveying without a valid license is punishable as a crime. 26 V.S.A. §§ 2503, 2504. It is also unprofessional conduct. 3 V.S.A. §§ 129a(a)(3). Practicing without a valid license is grounds for disciplinary action which may include permanent revocation of any right to renew a license.

Section 6.4 Renewal of Expired licenses

a) If a license has been expired for a period of less than three years, the person seeking renewal must submit:

(1) A renewal application;

(2) The required fees; and

(3) Verification of successful completion of no fewer than 20 hours of Board approved continuing education.

b) If a license has been expired for three or more years the person seeking renewal must submit the following:

(1) A renewal application.

(2) The required fees.

(3) Verification of successful completion of the Fundamentals of Land Surveying exam and the Principles and Practice of Land Surveying exam administered by The National Council of Examiners for Engineering and Surveying.

(4) Verification of successful completion of the Vermont Land Surveying examination.

(6) The examinations required in this section must have been taken and successfully completed within one year of the renewal application.

c) Exceptions: The Board, in its sole discretion, may, in individual cases involving extreme hardship, grant waivers or extension of the renewal and reinstatement requirements.

Section 6.5 Change of Name or Address

All licensees are responsible for notifying the Office within 30 days of a change in name or address. Lack of notification may result in a renewal notice not being received. Licensees are responsible for ensuring that a renewal application and fee are returned to the Office prior to license expiration.

Part 7 Continuing Education

Section 7.1 Definition

"Continuing Education" - is an educational activity that reinforces, maintains or adds to the skills, knowledge and ability required by a land surveyor to adequately practice land surveying and to maintain minimum competency.

Section 7.2 Requirements

Licensees must complete and document 20 hours of continuing education within the preceding biennium.

Section 7.3 Exception

For applicants granted an initial license, the mandatory continuing education requirement begins with the first day of the first biennial renewal period following the issuance of initial license. The Board recommends, but does not require continuing education for initial licensees during their first licensing period.

Section 7.4 Credit

(a) Credit for formal activities will be granted only for actual time spent as a learner. Business meetings and lunches will not be counted toward continuing education credits.

(b) College Courses - One academic semester credit equals 15 continuing education hours.

(c) Approval for other types of educational activities will be considered by the Board when written requests are submitted to the Board in accordance with Rules 7.9 and 7.10. The Board shall have final authority to approve continuing education activities and to determine how many hours credit each may receive.

Section 7.4 Acceptable Educational Activities

(a) All courses, presentations, instruction, and other educational activities described above must be relevant to the practice of land surveying and must meet the following criteria:

Have a clear purpose and objective for each educational activity which will improve or expand skills and knowledge obtained prior to initial licensure or to develop new and relevant skills;
Contribute meaningfully to the licensee's ability to better serve and meet the needs of the general public;
Be planned, well organized, and presented in a sequential manner;
Engage presenters who are well qualified by education or experience or both and, if applicable, include the opportunity for active participation by the attendees; and
Include a procedure for controlling and verifying attendance.

(b) Credit shall be given only for satisfactory completion of an educational activity in its entirety.

Section 7.5 Reports and Records

(a) Except as above in Rule 7.3 at each renewal, each licensee must certify attendance or participation in 20 hours of continuing education.

(b) Each licensee is responsible for acquiring and maintaining the necessary documents and records to support credits claimed. Records must be maintained for a period of four years after the biennial report on which the credits were claimed, and must be available to the Board for audit if requested.

Section 7.6 Requests for Pre-Approval of Educational Activities

(a) A sponsor, i.e. an individual, organization, association, institution or other entity which provides an educational activity as defined in these rules, or a licensee who desires to have an educational activity considered for pre-approval, shall submit a written request for pre-approval to the Board at least 90 days prior to the desired effective date of approval.

(b) The written request for pre-approval shall be submitted on application forms furnished by or in a format prescribed by the Board.

(c) Failure to meet the prescribed due date for submission may result in delayed consideration of the request for pre-approval.

Section 7.7 Contents of Request

The application shall include, but not be limited to;

(a) The name and address of the sponsor and the licensee, if applicable;

(b) The title or name of the educational activity and the date and location;

(d) A description of the educational activity, program content, hourly schedule, and proposed length of presentation.

(e) A synopsis of materials.

Section 7.8 Changes in Educational Activities

Once an educational activity has been submitted to the Board for approval, any changes, including those in format, instructors or content, shall be promptly reported to the Board in writing. Changes must be reviewed and approved by the Board.

Section 7.9 Continuing Education Approval Process

Immediately after the Board has reviewed and acted upon a written request for pre-approval, the Board shall advise the sponsor or licensee, in writing, of approval or denial of the application. If approval is granted, the Board shall assign a maximum number of continuing education hours that the educational activity may receive.

Section 7.10 Representations by Approved Providers

(a) A sponsor who has obtained approval for an educational activity may represent to the licensees that the Board has approved a certain number of continuing education hours for successful completion of the activity. Only the following reference to Board approval may be stated: "This educational activity has been approved by the Vermont Board of Land Surveyors for x hours of continuing education."

(b) A sponsor shall in no way represent to licensees that the Board has endorsed, recommended, or encouraged enrollment in the educational activity.

(c) A sponsor of a pre-approved educational activity shall furnish each licensee who successfully completes the entire program with a Certificate of Completion or some form of documentation as evidence' of satisfactory completion.

(d) Ninety days after the Board has received a completed request for pre-approval, the program will be deemed approved unless the Board notifies the sponsor that (1) the application is incomplete, or (2) the program is disapproved.

Section 7.11 Post Activity Approval

(a) A sponsor or licensee who did not request pre-approval of a continuing education activity may request, in writing, approval of an educational activity which has already transpired. The request and response from the Board shall conform to the procedures in Rules 7.7 and 7.9 above.

Section 7.12 Audits

(a) Each biennium, the Board shall conduct a random audit of no fewer than ten percent (10%) of the licensees applying for renewal. The Board may also audit currently conditioned licensees, late renewing licensees, and licensees who in any of the preceding 3 renewal cycles were initially found to have not met continuing education renewal requirements.

(b) When a licensee appears on the audit list, the Board shall request documentation from the licensee showing a detailed account of the various credits claimed. The Board shall review the documentation and determine if continuing education requirements have been satisfied.

(c) Under 3 V.S.A. § 129(k) the Board may give licensees 90 days to develop and complete a corrective plan to correct any deficiencies in his or her continuing education requirements.

(d) A licensee who upon audit is found to be deficient in continuing education may be permitted 90 days to develop and complete a corrective plan.

Section 7.13 Noncompliance

If the Board determines that the licensee has not complied with the continuing education requirement, the Board may terminate the active status of the license, and the license shall be treated for all purposes as expired.

Part 8 Discipline

Section 8.1 Unprofessional

3 V.S.A. § 129a and 26 V.S.A. § 2598 define unprofessional conduct for applicants and licensees. Unprofessional conduct as defined in 3 V.S.A. § 129a(a)(3) includes, "Failing to comply with provisions of federal or state statutes or rules governing the practice of the profession."

Section 8.2 Complaint Procedure

The Board follows the Office procedure for processing, investigating, and prosecuting unprofessional conduct and unauthorized practice complaints. A copy of the complaint procedure may be obtained from the Office or online under "Disciplinary Procedures" at http://vtprofessionals.org/.

History

STATUTORY AUTHORITY: 26 V.S.A. § 2544
EFFECTIVE DATE: November 1, 1994 Secretary of State Rule Log # 94-31
AMENDED: January 1, 1996 Secretary of State Rule Log #95-85; October 11, 1999 Secretary of State Rule Log #99-44; January 7, 2013 Secretary of State Rule Log #12-050

Chapter 131 CODE OF ETHICS - BOARD OF LAND SURVEYORS

04-131 Code Vt. R. 04-030-131-X CODE OF ETHICS - BOARD OF LAND SURVEYORS

The board adopts the following code of ethics. The board may take appropriate disciplinary action for violations of the code.

It shall be inconsistent with honorable and proper practice for a land surveyor to:

(1) Act for his client or employer in professional matters other than as a faithful agent or trustee, or to accept any remuneration other than the stated recompense for services rendered;

(2) Attempt to injure falsely or maliciously, directly or indirectly, the professional reputation, prospects or business of another surveyor;

(3) Review the work of a fellow practitioner for the same client, except with the knowledge of the practitioner, unless his or her connection with the work has been terminated; and

(4) Disclose information concerning the business affairs or technical processes of clients or employers without their consent.

History

Effective Date: July 5, 1985 (Secretary of State Rule Log #85-40)
- Formerly Rule No. 04 049 002. This rule has not been changed. It has been renumbered and relocated to insure that all rules issued under this Office are properly and uniformly numbered.*
Statutory Authority: Not Available

Chapter 160 RULES RELATING TO MOTOR VEHICLE RACING COMMISSION

04-160 Code Vt. R. 04-030-160-X RULES RELATING TO MOTOR VEHICLE RACING COMMISSION

Part 1 GENERAL INFORMATION

Section 1.1 INTRODUCTION

The Motor Vehicle Racing Commission (which is referred to as "the Commission") has been created and given powers by Vermont law. Its purpose is to protect the public health, safety and welfare by setting standards, issuing permits to qualified applicants and regulating permit holders and their practices.

Section 1.2 LAWS THAT GOVERN THE COMMISSION

The Commission is governed by specific state laws that establish its responsibilities for setting standards, issuing permits and regulating the profession. Those laws are found in 31 V.S.A. §§ 301-313. In addition, the Commission must comply with several other state laws such as the "Administrative Procedure Act" ( 3 V.S.A. §§ 802-849), the "Open Meeting Law" ( 1 V.S.A. §§ 311-314), the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320) and the blanket Professional Regulation Laws ( 3 V.S.A. §§ 121-131). These laws set forth the rights of an applicant, permit holder or member of the public.

The complete text of any of these laws should be available from any local town clerk or library or the Vermont Statutes Online (www.leg.state.vt.us). Most have copies of the Vermont Statutes Annotated.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 APPLICATION FOR PERMIT

2.1.1 Applications and information about the type of permits and their requirements are available from the Office. An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office. The Commission reviews' applications only after the fully completed application and documentation is received, including a copy of proof of insurance, a copy of a town permit (photocopy showing the town letterhead), copy of a grandstand report from the inspecting entity, copy of a schedule of events (dates and times), copy of the promoters track rules, and a detailed diagram of a track layout, including, but not limited to grandstand location, fences (type, height and location), distances between the track and spectators, location of a pit, location of fire and medical personnel.

2.1.2 An applicant issued an initial permit within 90 days of the renewal date will not be required ro renew or pay the renewal fee. The permit will be issued through the next full permit period. An applicant issued an initial permit more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.2 PERMIT DENIALS, HEARINGS, APPEALS

2.2.1 If the Commission preliminarily denies an application for a permit, the Commission shall send the applicant written notice of the decision by certified mail. The notice shall include a statement of the reasons for the denial and shall advise the applicant that the applicant may request a hearing with the Commission for review of its preliminary decision within 30 days of the date on which the notice is mailed. After the hearing, the Commission shall affirm or reverse the preliminary denial, explaining the reason therefore in writing.

2.2.2 A party aggrieved by a final decision of the Commission may appeal that decision by filing a notice of appeal with the Director who shall assign the case to an appellate officer. The review shall be conducted on the basis of the record created before the Commission. Persons wishing to appeal shall give written notice of their decision to appeal within 30 days of receipt of the Commission's final decision to:

Director, Professional Regulation

Office of the Secretary of State

109 State Street

Montpelier, Vermont 05609-1106

The appellate officer's decision may be appealed to Washington Superior Court.

Part 3 AUTO AND TRUCK RACING TRACKS

Section 3.1 TRACKS AND FENCING

3.1.1 Tracks must be laid out to prevent any soil erosion.

3.1.2 Tracks must comply with the requirements of other state and local agencies.

3.1.3 Track racing areas and surfaces must be laid out with a priority on safety.

3.1.4 Precautions must be taken to restrain unauthorized persons from being on the track.

3.1.5 The track promoter is responsible for providing adequate fencing and other means of crowd control to protect the spectators from injury during the meet.

3.1.6 A positive barrier shall be maintained along the straightaway, consisting of a wall of no less than four feet in height and eight inches thick or six inches thick backed by dirt, or a steel barrier backed by dirt of equal strength. This wall must run the full length of the spectator seating area and continue for a minimum of 50 feet along the track before and after the spectator seating area. If spectators are allowed to sit along both straightaways then a concrete wall will be required on both sides of the track.

3.1.7 A wheel fence shall be maintained between the track and the spectators, consisting of wire fencing made of a minimum of nine gauge fabric, approved by the commission, at least ten feet high from the track surface, attached to steel poles of at least two and a half inches in diameter, set in concrete at least four feet into the ground and spaced no more than ten feet apart. Running horizontally on the track side of the fence along the top of the fence, the bottom, and three feet from the bottom securely fastened with brace bands to the end poles and fastened with hogties to all other poles and to the fence with hogties every 18 inches shall be a 3/4" steel cable. The fence shall be attached to the end poles using a tension bar woven through the fence and attached to the pole using tension bands and bolted to the fabric and tension bar. The fencing shall have signs attached at regular intervals stating, "Spectators, Keep Off."

3.1.8 An overhang shall be affixed to the top of the wheel fence, angled toward the track surface. The overhang shall be at least 24 inches in length and welded or bolted to the posts supporting the fence. Attached to the overhang shall be affixed wire fencing made of a minimum of nine gauge fabric suitable for the deflection of wheels or tires. Running horizontally along the top of the overhang securely fastened with brace bands to the end poles and fastened with hogties to all other poles and to the fence with hogties every 18 inches shall be a 3/4" steel cable.

(a) In addition to the wheel fence there must be a crowd control fence that is a minimum of four feet high made of a minimum of 11 gauge wire fencing at least 18 inches from the wheel fence on poles at least 1/2 inch in diameter, set in concrete at least two feet into the ground and spaced no more than ten feet apart placed between the spectators and the wheel fence.

3.1.9 The use of baled hay, straw, snow fence or any similar material as a protective device or barricade between participating vehicles and spectators is prohibited.

3.1.10 There shall be a crowd control fence around the infield made of woven wire, four feet high and sufficient to keep spectators back, unless all people are prohibited from the infield.

3.1.11 There shall be provided a system of electrically controlled lights, red and yellow in color, and so located high enough to be visible to drivers on all parts of the track; supports are to be so located as not to interfere with normal track movement.

3.1.12 Tracks shall be lighted during any portion of any race held after civil twilight.

Section 3.2 PIT AREA

3.2.1 Pit areas must be designed to prevent spectators from entering the area.

3.2.2 Pit areas must be designed to prevent vehicles from moving on or off the track except at a designated area. The fenced entrance and exit to the pit area does not need to be closed. The fenced opening for vehicles shall be so located that a vehicle leaving the track must travel at least 75 feet from the edge of the track before entering the pit. The fenced opening shall be no more than 24 feet in width.

3.2.3 Drinking of alcohol is to be prohibited within the confines of the race track or the pit area.

3.2.4 Signs stating "NO DRINKING ON THE TRACK OR IN THE PIT AREA" must be situated at all entries and exits to the pit area.

3.2.5 There shall be no spectators allowed in the infield, on the curved portions of the track or by the pit entrance or exit area.

3.2.6 No one under the age of 14 may be allowed in the pit area.

3.2.7 The liability insurance certificate required under 31 V.S.A. § 306 shall cover the pit area as well as all other areas of the race track.

3.2.8 "Spectator" means any person who holds a general admission ticket, special admission ticket, or other kind of ticket or permit purporting to grant that person entrance to any part of the track racing area or pit area.

Section 3.3 FIRST AID

3.3.1 There must be at least one ambulance and one emergency medical technician (EMT) at the track whenever spectators are present and the track is in use. EMT's must be certified by the Vermont Department of Health pursuant to its Emergency Medical Services Rules.

3.3.2 Ambulances and first aid personnel must be located in the pit area where they can either see the entire track or see designated personnel watching areas out of their view. Once an ambulance has left the pit area a race may not be continued until a back-up ambulance is provided or the first ambulance returns.

Section 3.4 FIRE PROTECTION

3.4.1 No race or exhibition of driving skill shall be conducted unless there is available at a suitable location near the track a fire truck with trained fire fighters in attendance.

3.4.2 A "suitable location" shall be defined as an area readily accessible to the track which allows the fire truck to reach all areas of the track in a timely manner while still protecting the fire fighters and truck and fire personnel from the racing participants.

3.4.3 A "fire truck" shall be defined as a vehicle that is adequately equipped with fire fighting equipment, including, but not limited to the following minimum equipment:

a. One (1) 150 pound dry chemical extinguisher, or its equivalent in smaller extinguishers;

b. Three (3) 5 or 10 pound dry chemical extinguishers;

c. Three (3) 2 1/2 pound APW (all purpose water) with cold fire or a foam additive. Extinguishers shall be inspected before every event by the permittee or his designee and shall be inspected at least once per year by a trained professional.

d. A water tank with either a gas driven / hydraulic or "power take off" driven pump; or a pressurized water tank containing at least 50 gallons of water;

e. A complete set of hand extraction tools, including hacksaws and panel cutters, and wire/cable cutters;

f. Hydraulic rescue tools must be on hand or must at least be available within 10 minutes of the event; and

g. Stabilization blocking.

3.4.4 "Trained fire fighters" shall be defined as persons having had Level 1 certification with review of flammable liquids, auto extraction, and fire extinguishers. Fire fighters shall also have familiarity with race car structure, roll cage design, fuel cells, removable steering wheels, harnesses, window nets, and placement of switches.

If not Level 1 certified, fire fighters shall, at a minimum, have had a complete class in fire science, flammable liquids, flammable metals, fire extinguishers, extraction tools both power and hydraulic, stabilization of race car, and familiarity with medical stabilization equipment, in addition to the familiarity with the race car equipment as defined above.

3.4.5 Fire fighters in attendance must be properly equipped, including, but not limited to the following fire retardant items:

a. Suit or regular turnout gear;

b Head covering; and

c. Gloves.

d. At least two of the fire fighters present must be wearing their equipment during the running of the event.

3.4.6 There shall be a fire extinguisher located at all refueling stations.

3.4.7 If any of the above fire truck equipment is rendered inoperable, the event may not proceed until the required equipment is replaced. For the purposes of this rule, an extinguisher is "inoperable" if it is less than 75% charged and must be replaced or recharged.

Section 3.5 POLICE PROTECTION

3.5.1 There must be a minimum of one Security Guard for every five hundred spectators. In addition, there must be a minimum of one Qualified Officer, when the spectator attendance exceeds 1000, for every 1000 spectators. If a town or city requires a more strict ratio that requirement must be met. Security Guards and Qualified Officers must wear a uniform including a jacket and cap, or shirt and cap, or vest and cap that will identify them as security personnel.

3.5.2 "Security Guard" means an individual hired by the track manager for the purpose of duties such as, but not restricted to, crowd control, restraining unauthorized persons from entering restricted areas, keeping aisles clear, etc.

3.5.3 "Qualified Officer" means a police officer of the state or any municipality, sheriff, deputy sheriff, or constable, with arrest powers.

Section 3.6 SPECTATOR AREA

The application for a permit must be accompanied by an inspection report certifying that the spectator seats are built and maintained in a safe manner. The inspection report shall be prepared by:

the building inspector of the municipality in which the track is located,

a registered professional engineer,

a reputable building contractor,
examiner of the insurance company holding the risk on the stands, or
the Department of Labor and Industry. In the event the stands are moved or altered during the racing season or new stands erected, a new inspection report shall be forwarded to the office of the Commission before the stands are used.

Section 3.7 INSPECTIONS

3.7.1 The commission will inspect any race track or place of exhibition permitted by it or for which application for permit has been made to it. The Commission may also utilize the services of the special officer assigned to the Commission by the Department of Public Safety to make such inspections.

3.7.2 Any permit may be revoked at any time for failure of the permittee to comply with the requirements of these rules. A permittee shall be afforded at least seven days notice of revocation, and a reasonable opportunity to be heard prior there to. If, in the opinion of the Commission, the failure to comply with the requirements of these rules constitutes a serious immediate danger to the public, the Commission may order the permittee to immediately suspend racing. Permits which have been revoked may be reinstated by the Commission upon compliance with the requirements of these rules.

Part 4 MOTORCYCLES, ALL TERRAIN VEHICLES (ATV'S) AND CO-KARTS

Section 4.1 TRACKS AND FENCING

4.1.1 Tracks shall not cross any stream of any size.

4.1.2 Tracks must be laid out to prevent any soil erosion.

4.1.3 Tracks must comply with the requirements of other state and local agencies.

4.1.4 Track racing areas and surfaces must be laid out with a priority on safety.

4.1.5 Unauthorized persons must be restrained from being on the race course.

4.1.6 The track promoter must provide adequate fencing as approved by the commission and other means of crowd control to protect the spectators from injury during the meet.

4.1.7 No fencing shall be placed closer than 10 feet to the race surface.

4.1.8 Fencing on a curved portion of the track where spectators are allowed must be at least 20 feet from the track.

4.1.9 Fencing must be a minimum of 48 inches high. Snow fence type, plastic or fiber glass fencing, or steel wire with a mesh of not more than six inches is required. Any damaged fence or posts shall be repaired or replaced immediately. Fence posts must be placed at no more than 20 foot intervals. Only steel fence posts of the standard type used as snow fence posts shall be used. (No steel pipe of any size is allowed). Each post shall have a tire hanging from its top. Tires used either on the track or placed on the fence posts shall not have any wire or steel belting showing.

Section 4.2 PIT AREA

4.2.1 Pit areas must be so designed as to prevent spectators from entering.

4.2.2 Pit areas must be so designed as to prevent cycles or ATV's from moving on or off the track except at a designated area; preferably at the start or finish areas.

4.2.3 No drinking alcohol within the confines of the racing surface itself or pit areas.

4.2.4 Signs stating "NO DRINKING IN THE PIT AREAS" must be placed at all entries and exits to the pit areas.

4.2.5 Pit areas must be designed to prevent vehicles from moving on or off the track except at a designated area. The fenced entrance and exit to the pit area does not need to be closed. The fenced opening for vehicles shall be so located that a vehicle leaving the track must travel at least 75 feet from the edge of the track before entering the pit. The fenced opening shall be no more than 24 feet in width.

4.2.6 The liability insurance certificate required under 31 V.S.A. § 306 shall cover the pit area as well as all other areas of the race track.

4.2.7 "Spectator" means any person who holds a general admission ticket, special admission ticket, or other kind of ticket or permit purporting to grant that person entrance to any part of the track racing area or pit area.

Section 4.3 FIRST AID

4.3.1 There must be at least one ambulance and at least one emergency medical technician (EMT) at the track whenever spectators are present and the track is in use. EMT's must be certified y [by] the Vermont Department of Health pursuant to its Emergency Medical Services Rules.

4.3.2 Ambulances must be located in an area designated by the Commission, so as to afford immediate access to all areas of the event. First aid personnel must be located in an area where they can either see the entire track or see designated personnel watching areas out of their view.

4.3.3 Once an ambulance has left the race track grounds, a race may not be continued until a back-up ambulance is provided or the first ambulance returns. A race must not be allowed to continue if the EMT leaves the race track grounds, unless a back-up EMT is provided.

Section 4.4 FIRE PROTECTION

4.4.1 No race or exhibition of driving skill shall be conducted unless adequate extinguishers are available at suitable locations around the track. The extinguishers must be suitable to put out fires involving flammable liquids and be operated by trained fire fighters. Extinguishers shall be inspected before every event by the permittee or his or her designee and shall be inspected at least once per year by a trained professional.

4.4.2 "Suitable locations around the track" shall be defined as at every flagstand.

4.4.3 "Trained fire fighters" shall be defined as persons having extensive familiarity with flammable liquids and are extinguishers.

4.4.4 Fire fighters in attendance must be properly equipped with fire retardant gloves and eye protection.

4.4.5 There shall be a fire extinguisher located at all refueling stations.

4.4.6 If any of the above extinguishers are rendered inoperable, the event may not proceed until the required extinguisher is replaced. For the purposes of this rule, an extinguisher is "inoperable" if it is less than 75% charged and must be replaced or recharged.

Section 4.5 POLICE PROTECTION

4.5.1 There must be a minimum of one Security Guard for every five hundred spectators. In addition, there must be a minimum of one Qualified Officer, when the spectator attendance exceeds 1000, for every 1000 spectators. If a town or city requires a more strict ratio that requirement must be met. Security Guards and Qualified Officers must wear a uniform including a jacket and cap, or shirt and cap, or vest and cap that will identify them as security personnel

4.5.2 "Security Guard" means an individual hired by the track manager for the purpose of duties such as, but not restricted to, crowd control, restraining unauthorized persons from entering restricted areas, keeping aisles clear, etc.

4.5.3 "Qualified Officer" means a police officer of the state or any municipality, sheriff, deputy sheriff, or constable, with arrest powers.

Section 4.6 SPECTATOR AREA

The application for a permit must be accompanied by an inspection report certifying that the spectator seats are built and maintained in a safe manner. The inspection report shall be prepared by:

the building inspector of the municipality in which the track is located,

a registered professional engineer,

a reputable building contractor,
an examiner of the insurance company holding the risk on the stands, or
the Department of Labor and Industry. In the event the stands are moved or altered during the racing season or new stands erected, a new inspection report shall be forwarded to the office of the Racing Commission before the stands are used.

Section 4.7 INSPECTIONS

4.7.1 The Commission will inspect any race track or place of exhibition permitted by it or for which application for permit has been made to it. The Commission may also utilize the services of the special officer assigned to the Commission by the Department of Public Safety to make such inspections.

4.7.2 Any permit may be revoked at any time for failure of the permittee to comply with the requirements of these rules. A permittee shall be afforded at least seven days notice of revocation, and a reasonable opportunity to be heard prior thereto. If, in the opinion of the Commission, the failure to comply with the requirements of these rules constitutes a serious immediate danger to the public, the Commission may order the permittee to immediately suspend racing. Permits which have been revoked may be reinstated by the Commission upon compliance with the requirements of these rules.

Section 4.8 PARENTAL CONSENT

Each participant under the age of majority shall provide in advance of the race a consent form sworn before a notary by his or her parent or guardian, which the promoter shall retain on file for one year after the race.

Part 5 DEMOLITION DERBY

Section 5.1 EVENT AREAS AND FENCING

5.1.1 References as applied to demolition derbies:

a. Any reference to the "event area" shall be deemed a reference to the participant area or "bull ring" for demolition derbies.

b. Any reference to the "pit area" includes the "holding" or "unloading" areas for demolition derbies.

5.1.2 Event areas must be laid out to prevent any soil erosion.

5.1.3 Event areas must comply with the requirements of other state and local agencies.

5.1.4 Event areas and surfaces must be laid out with a priority on safety.

5.1.5 Precautions must be taken to restrain unauthorized persons from being in the event area.

5.1.6 The permit holder is responsible for providing adequate fencing and other means of crowd control to protect the spectators from injury during the meet. The permit holder is responsible for communicating with the promoter as to the Commission's laws and rules. The permit holder is responsible for ensuring compliance with these laws and rules.

5.1.7 The barriers and fencing for demolition derbies and for special event demolition derbies shall be as follows:

a. Around the circumference of the event area there shall be a barrier which may be constructed from concrete, steel or other material suitable to the Commission that will restrain participating vehicles from leaving the event area. Jersey barriers or cement blocks of equivalent size are the recommended barrier for use at demolition derbies. Barriers constructed of logs will no longer be allowed as of January 1, 2000.

b. A fence shall be placed not closer than 30 feet to the barrier required above, and must restrain spectators. Spectator fences must be properly policed to ensure that spectators do not come inside the spectator fence or come within 30 feet of the barriers at any time.

c. Inadcquate barriers or spectator fences will be cause for the Commission to prevent the event from taking place until such time as proper barriers and/or fences are in place.

d. In the event the topography of the land outside of the event area shall require any deviation from the requirements set forth above, the change must have prior approval of the Commission.

5.1.8 The use of baled hay, straw, or any similar material as a protective device or barricade between participating vehicles and spectators is prohibited.

5.1.9 Event areas shall be lighted during any portion of any meet held after civil twilight.

5.1.10 "Special Events" means events such as fairs, field days, circuses or exhibitions which are held only once a year and last no more than ten consecutive days, at which racing or demolition derbies are held.

Section 5.2 PIT AREA

5.2.1 Pit areas must be designed to prevent spectators from entering the area. This includes proper fencing and policing of the pit area. There shall be only one entrance for foot traffic into the pit area which must be properly policed by a qualified officer (see Rule 5.5.3. below) to prevent spectator entry.

5.2.2 Pit areas must be designed to prevent vehicles from moving on or off the event area except at a designated area. The fenced entrance and exit to the pit area does not need to be closed. The fenced opening for vehicles shall be so located that a vehicle leaving the event area must travel at least 75 feet from the edge of the event area before entering the pit. The fenced opening shall be no more than 24 feet in width.

5.2.3 Drinking of alcohol is to be prohibited within the confines of the event area or the pit area.

5.2.4 Signs stating "NO DRINKING IN THE EVENT AREA OR IN THE PIT AREA" must be situated at all entries and exits to the pit area.

5.2.5 There shall be no spectators allowed by the pit entrance or exit area.

5.2.6 No one under the age of 14 may be allowed in the pit area.

5.2.7 The liability insurance certificate required under 31 V.S.A. § 306 shall cover the pit area as well as all other event areas.

5.2.8 "Spectator" means any person who holds a general admission ticket, special admission ticket, or other kind of ticket or permit purporting to grant that person entrance to any part of the event area or pit area.

5.2.9 Pit crews shall be limited to two persons, not including the driver.

Section 5.3 FIRST AID

5.3.1 There must be at least one ambulance and one emergency medical technician (EMT) at the demolition derby whenever spectators are present and the event area is in use. EMT's must be certified by the Vermont Department of Health pursuant to its Emergency Medical Services Rules.

5.3.2 Ambulances and first aid personnel must be located in the pit area or where they can either see the entire event area or see designated personnel watching areas out of their view. Once an ambulance has left the pit area a demolition derby may not be continued until a back-up ambulance is provided or the first ambulance returns.

Section 5.4 FIRE PROTECTION

5.4.1 No demolition derby shall be conducted unless there is available at a suitable location near the event area a fire truck with trained fire fighters in attendance.

5.4.2 A "suitable location" shall be defined as an area readily accessible to the event area which allows the fire truck to reach all parts of the event area in a timely manner while still protecting the fire fighters and truck from the demolition derby participants.

5.4.3 A "fire truck" shall be defined as a vehicle that is adequately equipped with fire fighting equipment, including, but not limited to the following minimum equipment:

a. One (1) 150 pound dry chemical extinguisher, or its equivalent in smaller extinguishers;

b. Three (3) 2 1/2 pound APW (all purpose water) with cold fire or a foam additive. Extinguishers shall be inspected before every event by the permittee or his designee and shall be inspected at least once per year by a trained professional.

c. A water tank with either a gas driven/hydraulic or "power take-off" driven pump; or a pressurized water tank containing at least 50 gallons;

d. A complete set of hand extraction tools, including hacksaws, panel cutters, and wire/cable cutters;

e. Hydraulic rescue tools must be on hand or at least must be available within 10 minutes of the event; and

f. Stabilization blocking.

5.4.4 "Trained fire fighters" shall be defined as persons having had Level 1 certification with review of flammable liquids, auto extraction, and fire extinguishers.

If not Level 1 certified, fire fighters shall, at a minimum, have had a complete class in fire science, flammable liquids, flammable metals, fire extinguishers, extraction tools both power and hydraulic, stabilization of vehicles and familiarity with medical stabilization equipment.

5.4.5 Fire fighters in attendance must be properly equipped, including, but not limited to the following fire retardant items:

a. Suit or regular turnout gear;

b. Head covering; and

c. Gloves.

d. At least two of the fire fighters present must be wearing their equipment during the running of the event.

5.4.6 There shall be a fire extinguisher located at the refueling station, if applicable.

5.4.7 If any of the above fire truck equipment is rendered inoperable, the event may not proceed until the required equipment is replaced. For the purposes of this rule, an extinguisher is "inoperable" if it is less than 75% charged and must be replaced or recharged.

Section 5.5 POLICE PROTECTION

5.5.1 There must be a minimum of one Security Guard for every five hundred spectators. In addition, there must be a minimum of one Qualified Officer, when the spectator attendance exceeds 1000, for every 1000 spectators. If a town or city requires a more strict ratio that requirement must be met. Security Guards and Qualified Officers must wear a uniform including a jacket and cap, or shirt and cap, or vest and cap that will identify them as security personnel.

5.5.2 "Security Guard" means an individual hired for the purpose of duties such as, but not restricted to, crowd control, restraining unauthorized persons from entering restricted areas, keeping aisles clear, etc.

5.5.3 "Qualified Officer" means a police officer of the state or any municipality, sheriff, deputy sheriff, or constable, with arrest powers.

Section 5.6 SPECTATOR AREA

The application for a permit must be accompanied by an inspection report certifying that the spectator seats are built and maintained in a safe manner. The inspection report shall be prepared by:

the building inspector of the municipality in which the event is located,

a registered professional engineer,

a reputable building contractor,
examiner of the insurance company holding the risk on the stands, or
the Department of Labor and Industry. In the event the stands are moved or altered or new stands are erected, a new inspection report shall be forwarded to the office of the Commission before the stands are used.

Section 5.7 INSPECTIONS

5.7.1 The Commission will inspect any demolition derbies permitted by it or for which application for permit has been made to it. The Commission may also utilize the services of the special officer assigned to the Commission by the Department of Public Safety to make such inspections.

5.7.2 Any permit may be revoked at any time for failure of the permittee to comply with the requirements of these rules. A permittee shall be afforded at least seven days notice of revocation, and a reasonable opportunity to be heard prior there to. If, in the opinion of the Commission, the failure to comply with the requirements of these rules constitutes a serious immediate danger to the public, the Commission may order the permittee to immediately suspend the event. Permits which have been revoked may be reinstated by the Commission upon compliance with the requirements of these rules.

Part 6 OTHER INFORMATION FOR PERMIT HOLDERS

Section 6.1 PERMIT RENEWAL

6.1.1 The Office has a fixed 24-month renewal schedule. Permit holders renew on a fixed biennial schedule. Permits expire on the even number years.

6.1.2 Permit holders shall renew by the expiration date printed on their permit. Before the permit expiration date, the Office will mail a renewal application and notice of a renewal fee. Permits will expire automatically if the renewal application and fees are not returned to the Office by the expiration date. There is a late renewal penalty of $ 25.00 for a renewal submitted less than 30 days late. Thereafter the penalty will increase by $ 5.00 for every additional month or fraction of a month, not to exceed $ 100.00.

6.1.3 A permit holder is responsible for notifying the Office promptly if there a change in name, mailing address or business address.

6.1.4 A "Special Event", as defined by Rule 5.1. 10, shall require a single racing permit only, including demolition derbies.

Section 6.2 COMPLAINTS OF UNPROFESSIONAL CONDUCT

6.2.1 The Commission follows Office procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure, complaint forms and more information about the complaint process may be obtained from the Office.

6.2.2 Grounds for unprofessional conduct complaints may be found in the Commission's statutes at 31 V.S.A. Sections 301-313 and 3 V.S.A. Section 129a.

History

Effective Date: [In effect. First effective date not available.]
AMENDED: September 23, 1991 (Secretary of State Rule Log #Not Available)
April 20, 1994 (Secretary of State Rule Log #94-18)
May 15, 1999 (Secretary of State Rule Log #99-22)
Statutory Authority: 31 V.S.A. §§ 301-313

Chapter 170 ADMINISTRATIVE RULES OF THE BOARD OF NURSING

04-170 Code Vt. R. 04-030-170-X ADMINISTRATIVE RULES OF THE BOARD OF NURSING

PART 1 DEFINITIONS

Section 1 Definitions.

As used in these Rules:

"Advanced Practice Registered Nurse" or "APRN" is defined at 26 V.S.A. § 1572(4).

"Board" or "the Board" means the Vermont Board of Nursing.

"Board website" means the primary Office website assigned to the Vermont Board of Nursing, found at sos.vermont.gov/nursing/ or a designated successor location.

"Compact" means the Nurse Licensure Compact adopted pursuant to 26 V.S.A. § 1647 et seq. The Compact facilitates interstate practice among RNs and LPNs from party states; it is not applicable to APRN or LNA practice.

"Compact State" means a jurisdiction that is a member of the Compact.

"Convert" means to change a multistate license to a single-state license, secondary either to a disqualifying event or to relocation from a Compact State to a non-Compact State; or to change a single-state license to a multistate license when a disqualifying event is eliminated.

"Current Practice Competence" means ongoing competence to practice registered nursing or licensed practical nursing, which may be established by documenting any one of the following:

(1) active practice of the licensed profession totaling at least 50 days (400 hours) in the previous 2 years or 120 days (960 hours) in the previous 5 years, verified by appropriately certified employment records;

(2) satisfactory completion of 20 hours of qualifying continuing education in the two years immediately preceding application; or

(3) current, nationally recognized certification.

"Deactivate" means to change the status of a multistate license or privilege to practice from active to inactive.

"Director" means the Director of Professional Regulation.

"Direct Supervision" means supervision of a licensee's practice by a nurse physically present on the unit.

"Disqualifying Event" means an incident, which results in a person becoming disqualified or ineligible to retain or renew a multistate license. These include but are not limited to the following: any adverse action resulting in an encumbrance, current participation in an alternative program, a misdemeanor offense related to the practice of nursing (which includes, but is not limited to, an agreed disposition), or a felony offense (which includes, but is not limited to, an agreed disposition).

"Executive Director" means the Executive Director of the Board, employed by the Office pursuant to 26 V.S.A. § 1574(b) to carry out the work of the Board.

"Governing Organization" means the agency or institution that has the authority and responsibility for financing a nursing education program, employing the administrator and faculty, graduating students, and granting the nursing diploma, certificate, or degree.

"High-fidelity" refers to simulation experiences that are extremely realistic and provide a high level of interactivity and realism for the learner (International Nursing Association for Clinical Simulation and Learning, 2013). It can apply to any mode or method of simulation; for example: human, manikin, task trainer, or virtual reality

"Licensed Practical Nurse" or "LPN" means licensed practical nurse.

"Licensed Practical Nursing" is defined at 26 V.S.A. § 1572(3).

"Medium-Fidelity Simulation Learning " means the use of low-technology mannequins or actors to demonstrate a condition within a simulated learning environment without automatic or programmed clues.

"Nationally Recognized Certification" means a specialty certification by a national nursing certification board or agency issued based upon a nurse's successful passing of an exam designed to validate a mastery of knowledge and skill within a specific area of nursing practice and/or patient population focus.

"Nursing Assistant" or "LNA" means licensed nursing assistant.

"NCLEX" means National Council Licensure Examination. "Office" means the Office of Professional Regulation

"Office website" means the primary website of the Office of Professional Regulation, found at https://sos.vermont.gov/opr/ or a designated successor location.

"On-Site Supervision" means active oversight and monitoring of a licensee's practice by a specifically assigned nurse who is present on the premises of a facility at all times the supervised licensee is practicing.

"Practice of nursing" is defined at 26 V.S.A. § 1572 and includes using in connection with one's name, words, letters, signs or figures which imply that a person is an RN, LPN, or APRN. See 26 V.S.A. § 1584(a).

"Preceptor" means an Advanced Practice Registered Nurse or Registered Nurse who serves as a facilitator and supervisor of student learning experiences in a practice setting.

"Program" or "Nursing Education Program" means a formal education program, based on a structured curriculum and clinical experience, designed to prepare students to qualify for licensure and to practice as APRNs, RNs, or LPNs.

"Qualifying continuing education" means continuing education that has been approved and assigned a credit value by an organization approved by the American Nurses Credentialing Center's Commission on Accreditation, or by another verifying authority approved by the Board, or directly by the Board.

"Registered Nurse" or "RN" means licensed registered nurse.

"Registered Nursing" is defined at 26 V.S.A. § 1572(2).

"Unencumbered license" means a license that authorizes a nurse to engage in the full and unrestricted practice of nursing without special conditions, limitations, or supervision.

PART 2 ADMINISTRATION

Section 2.1 Applicable Law.

The practice of nursing and "nursing related functions" is regulated pursuant to 26 V.S.A. § 1571 et seq. Copies of these and other statutes are available online at www.legislature.vermont.gov/statutes/. The Office administers licensure in conformity with these and other Vermont laws, to include the Administrative Procedure Act, 3 V.S.A. § 800 et seq.; the Public Records Act, 1 V.S.A. § 315 et seq.; and the Laws of Professional Regulation, 3 V.S.A. § 121 et seq.

Section 2.2 Resources for Applicants and Licensees.

The Office website offers information of general application to Vermont licensed professionals, including policies of the Office, license lookup services, and disciplinary orders. The Board website, available at http://sos.vermont.gov/nursing, offers information specific to the practice of nursing, including policies and minutes of the Board, membership information, and practice guidance.

Section 2.3 U.S. Armed Forces.

The Director may accept toward the requirements of these rules relevant military education, training, or service completed by a member of the U.S. Armed Forces and may expedite licensure of a person who left licensed employment in another state secondary to a spouse's military transfer to Vermont. 3 V.S.A. § 123(g). Service members and the spouses of service members should visit the Office website for details.

Section 2.4 Executive Director.

The Office employs an Executive Director of the Board. 26 V.S.A. § 1574(b). The powers and duties of the Executive Director include those appropriate to carry out the work of the Board and to execute State policy respecting the regulation of nursing practice, including without limitation:

(a) guiding Office staff in the conduct of the Board's affairs, the execution of Board directives, and the administration of applicable laws and policies;

(b) appointing members of committees created by statute, these rules, or directive of the Board;

(c) interpreting policies, making administrative decisions, and providing consultation regarding Board affairs such as nursing education, examination, registration, licensure, renewal, and practice questions;

(d) surveying and monitoring nursing education programs;

(e) preparing agendas, reports, and recommendations to the Board, and attending to official correspondence on the Board's behalf;

(f) orienting new Board members and nursing staff;

(g) monitoring evolving policy and practice issues that may call for Board action;

(h) referring instances of misconduct and hazards to the public health, safety, and welfare to the Office's Enforcement Division and providing expert support to prosecutors as appropriate;

(i) representing the Board at meetings, symposia, conferences, and the like; and

(j) such other lawful duties as may be delegated by the Board or the Director in furtherance of the Board's mission and policies.

Section 2.5 Committees.

(a) The Board shall maintain the following committees:

(1) a Practice Committee, to monitor evolving issues in nursing practice;

(2) an APRN Subcommittee, to study and report to the Board on matters relating to advanced practice registered nurse practice in conformity with 26 V.S.A. § 1615a;

(3) a Disciplinary Alternative Program Committee, to advise the Executive Director and Board on appropriate standards for admission to and administration of a program to serve as an alternative to the disciplinary process for nurses and nursing assistants with substance use disorder or other professional practice issues; and

(4) an Education Committee, to assist the Board with oversight of Vermont nurse education programs.

(b) Committee authority is advisory. In the main, committees study issues, report to the Board, and recommend appropriate courses of action. A committee may exercise binding administrative discretion only if authorized in respect to a specific question or responsibility put to the committee by vote of the Board duly recorded in the Board's minutes.

PART 3 PROCEDURES

Section 3.1 Applications.

Online license applications must be completed through the Office website.

(b) When the Board, or the Office on the Board's behalf, intends to deny an application, notice stating the reasons for the action shall be given to the applicant by certified mail, whereupon the applicant shall have 30 days to petition for a hearing before the Board. 3 V.S.A. 129(e)(1).

(d) The Board may deem expired any application that is left incomplete for six months.

(e) For good cause, the Board may require that any applicant for licensure or relicensure obtain, from an approved, qualified professional, an independent assessment of the applicant's current mental, physical, and professional fitness to practice.

Section 3.2 Complaints.

Complaints against licensees, applicants for licensure, or persons practicing without a license may be submitted through the Office website.

Section 3.3 Contested Cases.

Procedures in contested cases relating to licensure or discipline are governed by the Office of Professional Regulation Administrative Rules of Practice, CVR 04-030- 005, as those rules may from time to time be modified.

Section 3.4 Declaratory Rulings.

Petitions for declaratory rulings as to the applicability of any statutory provision or of any rule or order of the Board or Office may be made pursuant to 3 V.S.A. § 808 and Office procedure.

Section 3.5 Reasonable Accommodation.

The Board complies with applicable provisions of the Americans with Disabilities Act. See the Office website for policies and procedures.

Section 3.6 Conflict of Standards.

Where a standard of unprofessional conduct set forth in statute conflicts with a standard set forth in rule, the standard that is most protective of the public shall govern. See 3 V.S.A. § 129a(e).

Section 3.7 Determination of Equivalency.

Where the Board or Director is permitted by law or rule to accept certain training or experience on the basis of equivalence to a fixed standard, it is the burden of the applicant or licensee to establish equivalence to the Board or Director's satisfaction, by producing credible, clear, and convincing evidence of the same. The Board and the Office have no obligation to research the bona fides of any institution, program, course, degree, certification, practicum, fellowship, or examination.

Section 3.8 Waiver or Variance.

The Board will not grant routine waivers or variances from any provisions of these rules without amending the rules. See 3 V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Board may, upon written request of an interested party, so find, grant a waiver with or without particular conditions and limitations, and record the action and justification in a written memorandum. This rule shall not be construed as creating any administrative hearing right or cause of action.

PART 4 LICENSURE GENERALLY

Section 4.1 Applicants from Other States: Fast Track Endorsement.

An applicant with three or more years of full-time licensed practice, as an LNA, LPN, RN, or APRN, in good standing, in a U.S. jurisdiction outside Vermont, may qualify for expedited licensure in Vermont. See 3 V.S.A. § 136a. An RN or LPN who holds an active multistate license from another Compact State is not required to obtain a Vermont license unless changing primary state of residence to Vermont.

Section 4.2 Applicants Educated Outside the United States.

(a) Canadian Nursing Education. An applicant whose nursing education and initial license to practice was in Canada, who has been duly licensed by a provincial licensing authority, who has passed an acceptable examination and maintained provincial licensure in good standing, may apply for licensure by endorsement. Acceptable examinations are the NCLEX and, for a person licensed prior to December 31, 2015, the Canadian Nurses' Association Testing Service Examination. Applicants who have not completed an acceptable examination must take the NCLEX and should apply by examination as set out in Rule 6-1, for LPNs, or Rule 7-1, for RNs. Endorsement applications must include:

(1) if the nursing education program or licensing exam was not conducted in English, acceptable evidence of oral and written English-language proficiency;

(2) documentation of:

(a) 50 days (400 hours) of practice as a nurse in the two years immediately preceding the application;

(b) 120 days (960 hours) practice as a nurse within five years of the application;

(d) a current nationally recognized certification, and

(3) A completed federal criminal background check.

(b) Other Non-U.S. Nursing Education. An applicant whose nursing education and initial license to practice was in a country other than the United States or Canada shall be authorized to take a licensing examination once the Board has received English-language documentation including:

(1) a completed application for licensure;

(2) a completed federal criminal background check;

(3) a credentials review by an external agency that specializes in international academic credentials review which verifies that the applicant's nursing education meets the requirements of these rules;

(4) satisfactory evidence of eligibility to work lawfully in the United States, to include a social security number or taxpayer identification number;

(5) proof of oral and written English proficiency, if the nursing education program was not conducted in English; and

(6) documentation of a minimum of:

(a) 50 days (400 hours) of practice as a nurse in the two years immediately preceding the application;

(b) 120 days (960 hours) practice as a nurse within five years of the application;

(d) active, nationally recognized certification.

Section 4.3 Biennial Licensing Period.

Licenses are valid for fixed, two-year periods. Expiration dates are printed on licenses. A license expires if not renewed by midnight on the date of expiry. Practice under an expired license is prohibited. A search tool on the Office website may be considered a primary source verification as to license status and expiration.

Section 4.4 Initial License Issuance.

An applicant issued an initial license within 90 days of the end of a licensing period will not be required to renew or pay the renewal fee. The license will be issued through the next full licensure period.

Section 4.5 Provisional Licensure.

The Board is authorized to issue provisional licenses to certain applicants who have met other licensure requirements but whose eligibility for licensure is contingent upon acceptable verification of licensure from another jurisdiction or the results of a required criminal background check. See 3 V.S.A. § 130.

Section 4.6 Telehealth Registration and Licensure.

Effective July 1, 2023, a licensee who is not otherwise licensed in Vermont but is licensed in another US jurisdiction and wishes to provide telehealth care services to a patient or client located in Vermont shall obtain a telehealth registration or license in accordance with 26 V.S.A. chapter 56. RNs and LPNs who hold an active multistate license from a Compact state are not required to obtain Vermont licensure to provide telehealth services.

Section 4.7 License Renewal.

Section 4.8 Requirements of Renewal.

(a) RNs & LPNs shall:

(1) Have practiced for a minimum of 50 days (400 hours) in the two years preceding application or 120 days (960 hours) in the five years preceding application; or

(2) Have completed 20 hours of qualifying continuing education in the two years immediately preceding the application; or

(3) Hold a current nationally recognized certification.

(b) LNAs shall demonstrate, via job description or other appropriate employer verification, at least 50 days (400 hours), in the two years preceding application, of employment as a nurse assistant or in a role, regardless of title or obligation to hold a license, that would reasonably tend to reinforce the training and skills of a licensed nurse assistant. See 26 V.S.A. § 1645.

(1) A licensee who does not meet the active practice requirement shall repeat the nursing assistant education program and competency examination.

(1) Have satisfied LNA renewal requirements;

(2) Have completed 4 hours qualifying continuing education specific to medication administration; and

(3) Have dedicated at least 25% of the qualifying LNA experience (100 hours) to MNA functions.

(d) APRNs shall:

(1) Have satisfied RN renewal requirements;

(2) Have practiced in an APRN role for a minimum of 50 days (400 hours) in the two years preceding application or 120 days (960 hours) in the five years preceding application;

(3) Present current certification by a national APRN certifying organization; and

(4) If required, have a current collaborating provider agreement.

Section 4.9 Late Renewal Penalties.

Late renewal applications are subject to penalty fees, which may be waived in certain circumstances, for example, if the applicant did not practice in Vermont during the period of lapse. See 3 V.S.A. § 127(d). Reinstatement waivers may be requested through the online licensing system.

Section 4.10 Requirements of Reinstatement; Extended License Lapse.

A license expired for more than two years requires reinstatement, including a federal criminal background check.

(a) Two to five years. A license expired for two to five years may be reinstated upon proof of continuous practice elsewhere, or if practice ceased, upon satisfaction of the requirements of renewal set out in Rule 4-8.

(b) More than five years. A license expired for five or more years may be reinstated upon proof of continuous practice elsewhere, or if practice ceased, a licensee's preparation to return to practice will be assessed on a case-by-case basis. After consultation with the Board, the Director may require re-training, testing, or re-application. See 3 V.S.A. § 135. In most circumstances, completion of an approved nursing re-entry program is a minimum prerequisite to reinstatement.

(c) Enhanced APRN requirements. This rule, 4-10, will yield to enhanced requirements for APRN practice refreshment and license reinstatement set out in Part 9, infra.

PART 5 VERMONT NURSING EDUCATION PROGRAMS

Section 5.1 Approval Required.

No person, including a corporation, association, or individual may conduct a nursing education program in Vermont, other than an online-only program approved by the Vermont Agency of Education, unless the program has been approved by the Board. See 26 V.S.A. § 1584.

Section 5.2 Accreditation Required.

Nursing education programs shall be accredited by the Commission on Collegiate Nursing Education (CCNE), the National League for Nursing's (NLN) Commission on Nursing Education Accreditation (CNEA), the Accreditation Commission for Education in Nursing (ACEN), or a national nursing accreditation organization otherwise specifically approved by the Board.

Section 5.3 Nursing Faculty.

Vermont nursing education programs shall be compliant with their accrediting agency's faculty standards regarding educational and experiential requirements for full- time and part-time nursing faculty.

Section 5.4 Operational Oversight; Site Visits.

The Board may at any time request information appropriate to confirm that a Vermont nursing education program is operating in conformity with applicable rules and accrediting standards. The Board may conduct a site visit to any proposed or existing nursing education program during the application review, during any review for extension of approval, or at any time deemed necessary to assess compliance with these rules. A nursing education program shall reimburse the Board for actual and necessary costs incurred for a site visit.

Section 5.5 Duty to Report Site, Administrative, and Curricular Changes.

A program shall copy to the Board any required report made to accrediting authorities concerning significant changes to program curriculum or structure.

Section 5.6 Program Application.

At least nine months before a program proposes to admit its first students, or within 30 days of a request from the Executive Director to an operating program, an authorized representative of the governing organization shall submit the following information or copies of submissions to or from an approved accreditor reflecting the same:

(a) accreditation status of the governing organization;

(b) a statement of mission and purpose;

(d) the identity and qualifications of the Program Administrator;

(e) a description of faculty, including numbers and qualifications;

(f) a chart illustrating the program's administrative and supervisory hierarchy;

(g) evidence of the feasibility of the program and community readiness to accept and support the program;

(h) the certificate(s) or degree(s) to be offered;

(i) a statement of clinical and academic facilities and resources, including classroom, conference room, library, office space, and skills laboratory;

(j) evidence of financial resources sufficient for the planning, implementation and operation of the program;

(k) a description of the anticipated student population; and

(l) any other information showing that the proposed program will meet the requirements of these rules.

Section 5.7 Preliminary Program Approval.

When the Board determines that an application to commence a new program is satisfactory, as indicated by substantial progress toward compliance with prevailing accrediting standards and demonstrated ability to attain full compliance, it will issue a preliminary approval authorizing the applicant to hire faculty, enroll students, develop and implement the program, commence the use of all assigned facilities and resources, and otherwise begin operation of the program.

Section 5.8 Full Program Approval and Reapproval.

A program granted preliminary approval shall notify the Board when it graduates its first class and shall apply for full program approval by submitting such information as the Executive Director or Board may request demonstrating progress toward full accreditation. The Board may condition full program approval upon accreditation.

Section 5.9 Application Denial.

If a program's preliminary application, full-program application, or application for re-approval is found to be deficient, the Board will offer a reasonable opportunity, not to exceed two years, for the program to cure the deficiency before acting on the application. The process for denial of an application is set out at 3 V.S.A. § 129(e).

Section 5.10 Annual Reports.

Approved programs shall submit annual reports on forms available from the Board. Each annual report shall be submitted no later than October 1 and cover the period between August 1 of the preceding year and July 31 of the year the report is submitted. Annual reports to include any new sites or site changes, administrative changes affecting the program, and significant curricular changes, to include changes in, duration, structure, graduation requirements, or core curricular content. Programs shall cooperate with reasonable requests for supplemental information.

Section 5.11 Forms of Approval.

An operating program shall apply for reapproval as determined by the duration of its prior approval, which may be set by the Board but will not in any event exceed the duration of the program's national accreditation. Approvals may be conditioned as appropriate to protect the public health, safety, and welfare, or to ensure ongoing ability to conform to prevailing accrediting standards.

Section 5.12 Intervention for Cause.

If the Board or Executive Director reasonably suspects a program is at risk of falling out of substantial compliance with prevailing accrediting standards, either may require that a program undergo a site visit, apply for reapproval early, or otherwise show cause why its approval should not be conditioned or withdrawn. The Board will give written notice to any program considered for withdrawal of approval and will afford program administrators a reasonable opportunity to be heard before acting upon a motion to terminate or condition a program's approval.

Section 5.13 Voluntary Program Closure.

The governing organization shall advise the Board of a decision to close its program. All Board approval requirements shall be maintained until the last student has transferred or graduated. The governing organization shall notify the Board where permanent program and student records are stored and how they may be retrieved. The program shall:

(a) discontinue student admissions;

(b) assist accepted applicants and current students to transfer to other approved programs; and

Section 5.14 Practical Nurse Program: Duration.

An acceptable practical nurse curriculum shall require no less than one academic year to complete.

Section 5.15 Practical Nurse Program: Curriculum.

In accordance with the standards of a program's accrediting agency, practical nursing programs shall include clinical and theory hours sufficient to establish competency in Adult Nursing, Maternal/Infant Nursing, Pediatric Nursing, and Psychiatric/Mental Health Nursing.

(a) Didactic content will include Anatomy and Physiology, Social/Behavioral Science, Pharmacology and Nutrition

(b) Nursing education programs shall include clinical experience in state approved facilities. Clinical experiences must provide an opportunity for direct care in the promotion, prevention, restoration and maintenance of health in clients across the life span in a variety of settings. No more than 25% of clinical experience may be obtained in a medium- or high- fidelity simulation learning laboratory without prior Board approval or the approval of the program accrediting agency.

Section 5.16 Practical Nurse Re-Entry Programs.

The Board will approve, for a presumptive period of five years, a re-entry program that:

(a) has a written purpose, program and unit objectives, and measurable outcomes;

(b) includes at least 80 hours of theory and 80 hours of clinical experience;

(d) is located within, or if individually designed, is under the direction of, a program providing nursing education.

Section 5.17 Registered Nurse Program Curriculum.

In accordance with a program's accreditation agency standards, a registered nursing program will provide a sound foundation in biological, physical, social and behavioral sciences and include:

(a) Didactic content including prevention of illness and the promotion, restoration and maintenance of health in patients across the lifespan and from diverse cultural, ethnic, social and economic backgrounds.

(b) Didactic and clinical experiences shall include clinical and theory hours sufficient to establish competency in Medical/ Surgical, Obstetrics, Pediatrics, Psychiatric/ Mental Health and Community Health.

(c) No more than 25% of clinical experience may be obtained in a medium- or high-fidelity simulation learning laboratory without prior Board approval or the approval of the program's accrediting agency.

(d) Clinical experiences shall be supervised and occur directly with patients. Clinical experiences and simulation shall include a variety of clinical settings sufficient for meeting program outcomes.

Section 5.18 RN Re-entry Program Design.

(a) Re-entry programs may be individually designed or established by a nursing education program or a nursing service facility. Re-entry programs must be approved by the Board. Program approval is valid for five years unless otherwise specified.

(b) The Board will approve a re-entry program which meets the following requirements:

(1) The re-entry program has a written purpose, program and unit objectives, and measurable outcomes;

(2) consists of a minimum of 120 hours of theory and a minimum of 120 hours of clinical experience;

(3) provides direct RN supervision for re-entry program clinical experience; and

(4) is located within, or if individually designed, is under the direction of a program providing nursing education.

Section 5.19 APRN Refresher Course.

(a) Individuals who have been out of practice for less than five years and who do not meet the practice requirement for initial licensure, or renewal, or reinstatement of an APRN license must take a refresher course as set forth in parts 9-16 through 9-18 of these Rules. Once commenced, the course must be completed within 18 months.

(b) Individuals who have been out of practice for more than five and fewer than ten years may be assigned a case-specific refresher assignment approved by the Board.

(c) Individuals who have been out of practice for more than ten years must complete a new post-masters APRN program that includes a minimum of 500 clinical practice hours.

Section 5.20 Refresher Course Clinical Practice Permit.

The Board may grant a refresher course clinical practice permit, valid in six month increments and renewable not more than twice, to an applicant who:

(a) holds a Vermont RN license; and

(b) holds a national APRN certification.

A person practicing under a permit shall be conspicuously identified as an "APRN Applicant" on name badges, signature blocks, medical record entries, and other locations calling for a professional designation.

Section 5.21 APRN Refresher Course Design.

(a) Refresher programs may be individually designed or established by a nursing education program or a non-accredited nursing service facility. Each must be approved by the Board.

(b) The Board may accept a Nationally Accredited Refresher Program in Vermont or elsewhere which meets the requirements of Parts 9-17 and 9-18 of these rules.

Section 5.22 APRN Refresher Course Approval Criteria

The Board may approve a refresher program that provides on-site supervision by an APRN collaborating provider qualified under Part 9 of these rules who holds an unencumbered Vermont license, or a physician collaborating provider who holds an unencumbered Vermont license. A supervising provider must practice in the same role and population focus. Minimum course hours are:

(a) for a licensee who has been out of practice for less than five years consists of a minimum of:

(1) 150 hours of theory; and

(2) 200 hours of clinical experience; or

(b) for a licensee who has been out of practice for more than five years, but less than ten years consists of a minimum of:

(1) 150 hours of theory and

(2) 400 hours of clinical experience.

Section 5.23 APRN Refresher Program Curricula.

Curricula must include a review and update of:

(a) advanced pharmacotherapeutics;

(b) advanced assessment;

(d) role and population specific clinical practicum; and

(e) advanced practice nursing skills.

PART 6 LICENSED PRACTICAL NURSES

Section 6.1 Licensure by Examination.

To qualify for licensure by examination, an applicant shall:

(a) be a graduate of an approved LPN education program, as verified by an official transcript;

(b) complete a federal criminal background check;

(d) pass the NCLEX-PN examination within five years of nursing program graduation.

Section 6.2 Licensure by Endorsement.

To qualify for licensure by endorsement, based on licensure and experience outside Vermont, an applicant who is not eligible for expedited endorsement under Rule 4-1 shall:

(a) be licensed in a United States jurisdiction with licensing requirements substantially equivalent to those of Vermont, on the basis of a U.S. nursing education program;

(b) complete a federal criminal background check; and

(1) active practice in the jurisdiction of origin totaling at least 50 days (400 hours) in the previous 2 years or 120 days (960 hours) in the previous 5 years, verified by appropriately certified employment records; or

(2) satisfactory completion of 20 hours of qualifying continuing education in the two years immediately preceding application; or

(3) current, nationally recognized certification.

Section 6.3 Scope of Practice.

Refer to Part 11-1. Consistent with 26 V.S.A. § 1572, an LPN's scope of practice is directed by a licensed RN, APRN, MD, DO, physician assistant, or dentist acting within his or her own scope of practice. Direction may occur via direct supervision or through provider orders, forms, guidelines, policies or procedures, protocols, algorithms, or clearly established plans of care.

(a) The LPN, practicing to the extent of their education and training under the supervision of an RN, advanced practice registered nurse (APRN), physician or other authorized licensed health care provider:

(1) Participates in nursing care, health maintenance, patient teaching, counseling, collaborative planning and rehabilitation.

(2) Plans for patient care, including:

(i) Planning nursing care for a patient whose condition is stable or predictable.

(ii) Assisting the RN, APRN, or physician in identification of patient needs and goals.

(iii) Determining priorities of care together with the RN, APRN or physician.

(3) Provides patient surveillance and monitoring, participating with other health care providers and contributing to the development, modification, and implementation of the patient centered healthcare plan.

(4) Implements nursing interventions and prescribed medical regimens in a timely and safe manner.

(5) Documents nursing care provided accurately and timely.

(6) Collaborates and communicates relevant and timely patient information with patients and other health team members to ensure quality and continuity of care, including:

(i) Patient status and progress.

(ii) Patient response or lack of response to therapies.

(iii) Changes in patient condition.

(iv) Patient needs and special requests.

(7) Takes preventive measures to promote an environment that is conducive to safety and health for patients, others and self.

(8) Respects patient diversity and advocates for the patient's rights, concerns, decisions and dignity.

(9) Maintains appropriate professional boundaries.

(10) Participates in systems, clinical practice and patient care performance improvement efforts to improve patient outcomes.

(11) Assigns and delegates nursing activities to assistive personnel. The LPN shall delegate only those nursing measures the delegate has the training, education, and experience to accomplish safely.

Section 6.4 Individual Scope.

The individual scope of practice for each LPN is determined by the individual's education, training, experience, and certification. Each LPN has a responsibility to practice in a manner that protects and promotes the health, safety and rights of the patient. Each nursing activity must be consistent with reasonable and prudent practice. Refer to Part 11-1 of these Rules.

PART 7 REGISTERED NURSES

Section 7.1 Licensure by Examination.

To qualify for licensure by examination, an applicant shall:

(a) be a graduate of an approved RN education program, as verified by an official transcript;

(b) complete a federal criminal background check;

(d) pass the NCLEX-RN examination within five years of nursing program graduation.

Section 7.2 Licensure by Endorsement.

To qualify for licensure by endorsement, based on licensure and experience outside Vermont, an applicant who is not eligible for expedited endorsement under Rule 4-1 shall:

(a) be licensed as an RN in a United States jurisdiction with licensing requirements substantially equivalent to those of Vermont, on the basis of a U.S. nursing education program;

(b) complete a federal criminal background check; and

(2) satisfactory completion of 20 hours of qualifying continuing education in the two years immediately preceding application; or

(3) current, nationally recognized practice-area certification.

Section 7.3 Scope of Practice.

"Registered nursing" means the practice of nursing as defined at 26 V.S.A. § 1572.

Section 7.4 Individual Scope.

The individual scope of practice for each RN is determined by the individual's education, training, experience, and certification. Each RN has a responsibility to practice in a manner that protects and promotes the health, safety and rights of the patient. Each nursing activity must be consistent with reasonable and prudent practice. Refer to part 11-1 of these Rules

PART 8 INTERSTATE PRACTICE PRIVILEGES FOR RNS AND LPNS: THE NURSE LICENSURE COMPACT

Section 8.1 Applicant Responsibilities.

(a) An applicant for a multistate license shall declare Vermont as primary state of residence.

(b) A nurse who changes primary state of residence to another party state shall apply for a license in the new party state when the nurse declares to be a resident of the state and obtains multistate privileges not ordinarily extended to nonresidents of the state.

(c) A nurse shall not apply for a Vermont single state license while the nurse holds a multistate license in another party state.

(d) An applicant must provide evidence of residence in Vermont. This evidence may include, but is not limited to, a current:

(1) driver's license with a home address;

(2) voter registration card with a home address;

(3) federal income tax return with a primary state of residence declaration;

(4) military form no. 2058 (state of legal residence certificate); or

(5) W2 form from the United States government or any bureau, division, or agency thereof, indicating residence.

(e) An applicant who is a citizen of a foreign country, and who is lawfully present in the United States and is applying for multistate licensure in Vermont may declare either the applicant's country of origin or Vermont as the primary state of residence.

(f) If the applicant declares the foreign country as the primary state of residence, they are not eligible for a multistate license, but may apply for a single state license if the applicant meets licensure requirements.

(g) An applicant shall disclose current participation in an alternative program to any party state, whether upon initial application or within ten (10) calendar days of enrollment in the program.

Section 8.2 Change in Primary State of Residence.

(a) A nurse who changes his or her primary state of residence from one party state to another party state may continue to practice under the existing multistate license while the nurse's application is processed, and a multistate license is issued in the new primary state of residence.

(b) Upon issuance of a new multistate license in another party state, the Vermont multistate license will be deactivated/expired.

(c) If a party state verifies that a licensee who holds a multistate license changes primary state of residence to a non-party state, the party state shall convert the multistate license to a single state license within fifteen (15) calendar days and report this conversion to the Coordinated Licensure Information System.

Section 8.3 Temporary Permits and Licenses.

A temporary permit, license, or similar temporary authorization to practice issued by a party state to an applicant for licensure shall not grant multistate licensure privileges.

Section 8.4 Identification of Licenses.

A license issued by a party state shall be clearly identified as either a single state license or a multistate license.

Section 8.5 Credentialing and English Proficiency for Foreign Nurse Graduates.

(a) A party state shall verify that an independent credentials review agency evaluated the credentials of graduates.

(b) The party state shall verify successful completion of an English proficiency examination for graduates.

Section 8.6 Deactivation, Discipline, and Revocation.

(a) The Board of Nursing shall determine whether a disqualifying event will result in adverse action or deactivation of a multistate license or privilege.

(b) Upon deactivation due to a disqualifying event, the Board may issue a single state license.

Section 8.7 Federal Criminal Records.

Communication between Vermont and the Nurse Licensure Compact Commission and communication between party states regarding verification of the nurse's eligibility for licensure pursuant to the Compact shall not include any Criminal History Record Information (CHRI) received from the Federal Bureau of Investigation relating to a federal criminal records check performed by a member board under Public Law 92-544.

Section 8.8 Active-duty Military Personnel and Spouses.

(a) An active-duty service member, or the member's spouse, shall designate a home state where the service member or spouse has a current license in good standing.

(b) The service member may retain the home state designation during the period the service member or spouse is on active duty.

(c) After designating a home state, the service member or spouse shall only change home state through application for licensure in the new state.

PART 9 ADVANCED PRACTICE REGISTERED NURSES

Section 9.1 APRN License Requirements.

To be eligible for licensure as an APRN the applicant must:

(a) hold an unencumbered Vermont registered nursing license or an unencumbered multistate registered nursing license from another Compact state;

(b) meet the education requirements set forth below;

(d) complete a federal criminal background check; and

(e) meet the practice requirements.

Section 9.2 Roles.

The Board may license an individual to practice as an APRN in the following roles:

(a) Certified Nurse Practitioner;

(b) Certified Nurse Midwife;

(d) Clinical Nurse Specialist.

Section 9.3 Identification.

APRNs shall use, at a minimum, the license designation "APRN" for purposes of identification and documentation.

Section 9.4 Population Focus.

Population Focus means that segment of the population, defined by age group or health status to which an APRN provides professional services. Each licensee is assigned a population focus area based on the licensee's certification. Refer to the Board Website for recognized population focus areas.

Section 9.5 Education

To be eligible for an APRN license, an applicant shall:

(a) have a degree or certificate as shown by the official transcripts from the applicant's graduate nursing program in one of the four recognized APRN roles from:

(1) a Vermont graduate nursing program approved by the Board; or

(2) a United States graduate nursing program approved by a state or a national accrediting agency approved by the Board; and

(b) have successfully completed graduate level courses in:

(1) advanced pharmacotherapeutics;

(2) advanced patient assessment; and

(3) advanced pathophysiology.

Section 9.6 APRN Certification Organizations

The Board may accept certification by a certifying organization which:

(a) follows established certification testing and psychometrically sound, legally defensible standards for APRN certification exams;

(b) assesses APRN core and role competencies across a minimum of one population focus of practice;

(c) assesses specialty competencies, when applicable, separately from the APRN core role and population-focused competencies; and

(d) is accredited by a national U.S. or Canadian certification accreditation body.

Section 9.7 Education and Practice Requirement.

To be eligible for initial licensure or to renew or reinstate an APRN license, an applicant must have

(a) For initial licensure and renewals,

(1) Graduated from an APRN program within two years of making the application; or

(2) Practiced as a licensed APRN for a minimum of:

i. 50 days (400 hours) in the previous two years; or

ii. 120 days (960 hours) in the previous five years; and

(3) Maintained certification by a national certification accreditation body; or

(b) For reinstatement, completed a Board approved APRN Refresher Course as set forth in 9-14 through 9-17 of these Rules within two (2) years of making the application.

Section 9.8 Transition to Practice: Collaborative Provider Agreement.

An APRN with fewer than 24 months and 2,400 hours of licensed active advanced nursing practice in an initial role and population focus or fewer than 12 months and 1,600 hours for any additional role and population focus shall have a formal agreement with a collaborating provider as required by 26 VSA § 1613 and these Rules:

(a) An APRN shall maintain signed and dated copies of all collaborative provider agreements, and when the transition to practice is complete, shall retain a copy of the Board form attesting to completion of the transition to practice.

(b) An APRN required to practice under a collaborative provider agreement may not practice in a setting where there are no additional APRNs or licensed physicians to provide mentoring, consultation or advisement.

Section 9.9 Collaborating Providers.

A collaborating provider may be a Vermont APRN, a medical doctor licensed under 26 V.S.A. Ch. 23, or an osteopathic physician licensed under 26 V.S.A. § Ch. 33. An APRN may have more than one collaborating provider. A collaborating provider must be actively licensed in good standing and possess at least four years of practice experience in the same role and population focus or specialty as the APRN.

Section 9.10 Collaborating Provider Responsibilities

A collaborating provider shall establish a written agreement with an APRN to serve as an advisor, mentor, and consultant. A collaborating provider shall participate in quality assurance activities.

Section 9.11 APRN Group Practice.

An APRN group practice must include one or more APRNs who are not required to practice under a collaborative provider agreement.

Section 9.12 APRN Refresher Course

(b) Individuals who have been out of practice for more than five and fewer than ten years may be assigned a case-specific refresher assignment approved by the Board;

(c) Individuals who have been out of practice for more than ten years must complete a new post-masters APRN program that includes a minimum of 500 clinical practice hours.

Section 9.13 Refresher Course Clinical Practice Permit.

The Board may grant a refresher course clinical practice permit, valid in six month increments and renewable not more than twice, to an applicant who:

(a) holds a Vermont RN license;

(b) holds a national APRN certification.

Section 9.14 APRN Refresher Course Design.

(a) Refresher programs may be individually designed or established by a nursing education program or a non-accredited nursing service facility. Each must be approved by the Board.

(b) The Board may accept a Nationally Accredited Refresher Program in Vermont or elsewhere which meets the requirements of Parts 9-17 and 9-18 of these rules.

Section 9.15 APRN Refresher Course Approval Criteria.

The Board will approve a refresher program which:

(a) for a licensee who has been out of practice for less than five years consists of a minimum of:

(1) 150 hours of theory; and

(2) 200 hours of clinical experience; or

(b) for a licensee who has been out of practice for more than five years, but less than ten years consists of a minimum of:

(1) 150 hours of theory and

(2) 400 hours of clinical experience; and

(1) by an APRN collaborating provider qualified under Part 9 of these rules holding a Vermont unencumbered APRN license, or a physician collaborating provider with a Vermont unencumbered license; and

(2) who practices in the same role and population focus.

Section 9.16 APRN Refresher Program Curricula.

Curricula must include a review and update of:

(a) advanced pharmacotherapeutics;

(b) advanced assessment;

(d) role and population specific clinical practicum; and

(e) advanced practice nursing skills.

Section 9.17 Scope of Practice

(a) The individual scope of practice for each APRN is determined by the APRN's education, training, experience, role, population focus, and national certification, consistent with Rule 11-1.

(b) Nurse practitioners providing primary care may be primary care providers of record.

(1) registered nurse scope of practice;

(2) acts of medical diagnosis including, ordering, and interpreting diagnostic tests and procedures;

(3) prescribing medications;

(4) prescribing medical, therapeutic, or corrective measures;

(5) initiating written or verbal orders to other health care providers; and

(6) managing and evaluating care.

Section 9.18 Eligible Colleges or Universities

The Board will approve a Vermont APRN education program which:

(a) is offered by a college or university;

(b) confers a graduate degree with a major in nursing or a graduate degree that prepares nurses to practice advanced practice nursing; and

(c) meets the educational standards set by a national accrediting body and national certifying board approved by the Board.

Section 9.19 Approval Process.

To obtain and maintain Board approval, an APRN education program must follow the processes outlined in Part 5 of these Rules.

PART 10 LICENSED NURSE ASSISTANTS

Section 10.1 Licensure by Examination.

To qualify for licensure by examination, an applicant shall:

(a) have completed, within two years of application, a nursing assistant education program approved by the Department of Disabilities, Aging, and Independent Living or its equivalent in another U.S. jurisdiction, or be a student in an RN or LPN education program who has completed studies equivalent thereto;

(b) complete a federal criminal background check; and

(c) pass a competency examination approved by the Department of Disabilities, Aging, and Independent Living or an equivalent exam acceptable to the Board.

Section 10.2 Examination Attempts.

A candidate who has not passed LNA exams after three attempts must repeat an approved nursing assistant education program.

Section 10.3 Licensure by Endorsement.

To qualify for licensure by endorsement, based on licensure and experience outside Vermont, an applicant who is not eligible for expedited endorsement under Rule 4-1 shall:

(a) be licensed or certified as nursing assistant by another state;

(b) complete a federal criminal background check; and

(c) demonstrate, via job description or other appropriate employer verification, at least 50 days (400 hours), in the two years preceding application, of employment as a nurse assistant or in a role, regardless of title or obligation to hold a license, that would reasonably tend to reinforce the training and skills of a licensed nurse assistant.

Section 10.4 Scope of Practice.

(a) An LNA's scope of practice includes:

(1) Basic Nursing Care;

(2) Personal Care;

(3) Basic Restorative Care;

(4) Psychosocial Support;

(5) Care of the Cognitively Impaired;

(6) Communication; and

(7) Patient Safety.

(b) Additional tasks and skills may be performed by LNAs through the delegation process by APRNs, RNs and LPNs as described in section 11.2

(c) An LNA may not perform activities which exceed the scope defined by the level of licensure. This means that LNAs may not perform, even if directed to do so, an activity not appropriate to their level of licensure or otherwise prohibited by law. Examples of activities not within the LNA scope of practice include nursing assessments, nursing judgments, and development of the plan of care.

Section 10.5 Definition.

A medication nursing assistant (MNA) is a licensed nursing assistant authorized by a specialty designation to administer medications in limited settings set out by 26 V.S.A. § 1641.

Section 10.6 Eligibility for MNA Specialty Designation.

To be eligible for the MNA specialty designation, an applicant must:

(a) hold an unencumbered Vermont LNA license;

(b) be at least 18 years of age;

(d) have two years' experience consisting of no fewer than 4,000 hours of LNA experience, of which at least one year and 2,000 hours were acquired in a long-term care nursing facility;

(e) complete, within the year preceding application, an MNA training program approved by the Board; and

(f) successfully complete MNA competency and math proficiency examinations approved by the Board.

Section 10.7 Nursing Student Eligibility.

The experience and training requirements set out in subparts 10-6(d) & (e) may be waived for a student enrolled in a Board-approved RN or LPN program that has covered MNA training content.

Section 10.8 Training from Other Jurisdictions.

(a) If the Board determines that the program has complied with the requirements of statutes and these rules, it will grant approval to continue the program. Approval will be for a period of time determined by the Board. Approval may not exceed the duration of the national accrediting agency's accreditation, and in no event exceed ten years.

(b) Once approved, a program is considered to be an "existing program" subject to the requirements of Subsection B of this Part.

Section 10.9 Scope of Practice.

(a) An MNA is supervised on-site, on the unit, by an LPN, RN, or APRN.

(b) A medication nursing assistant upon delegation by an LPN, RN, or APRN may:

a. administer medications to individual residents; and

b. administer medication via oral, sublingual, buccal, inhalation, spray (on oral mucosa), topical, nasal, ocular, optic, and suppository (vaginal or rectal) route.

Section 10.10 Limitations.

An MNA may:

(a) administer medications to a newly admitted resident only after the delegating nurse determines that the resident is stable, and then only according to facility policy; and

(b) administer prn medication only after an RN assessment confirms the need for the medication.

Section 10.11 Exclusions.

An MNA may not:

(a) administer injectable medications.

(b) administer medications new to the patient;

(d) take or transcribe orders;

(e) apply medicated dressings;

(f) administer insulin;

(g) administer bladder instillations;

(h) calculate conversions;

(i) dispose of medications; or

(j) administer enteral feedings or medications.

SUBPART B MNA TRAINING PROGRAMS

Section 10.12 Board Approval Required.

Before providing MNA training, an MNA program must receive Board approval. The process for receiving Board approval is set forth in Part 5 of these rules. The Board will approve a program which assures that participants are trained in:

(a) communication and documentation;

(b) ethical and legal responsibilities regarding medication administration;

(c) medication use, side effects, abbreviations, look alike drugs, drug interactions, proper storage, and the need for reporting side effects;

(d) apothecary and metric measurements;

(e) patient safety principles regarding proper medication administration; and

(f) facility policies regarding medication errors.

Section 10.13 MNA Training Program Requirements.

To receive Board approval each MNA training program must:

(a) employ a standardized textbook approved by the Board;

(b) require no fewer than 60 hours of class instruction including lab/simulation instruction; and 40 hours of supervised clinical instruction;

(1) possess unencumbered Vermont RN licenses;

(2) have at least 2 years' full-time practice experience, of which one year was in clinical practice; and

(3) hold a baccalaureate or higher degree in nursing; and

(d) have a program administrator who holds a baccalaureate or higher degree in nursing.

Section 10.14 MNA Program Review.

An annual report shall be submitted to the Board by each MNA program as per Rule 5-9 of these rules and site visits to MNA programs may be conducted by the Board in accordance with Rule 5-3 of these rules.

PART 11 STANDARDS OF NURSING PRACTICE

Section 11.1 Determination of Scope of Practice.

An activity not prohibited by Vermont Administrative Rules or Statues and that is consistent with current national professional nursing organizational standards, accreditation standards and or credible nursing research may be considered within an individual nurse's scope of practice if the following conditions are met:

(a) the nurse has completed the necessary education and possesses adequate knowledge to perform the activity;

(b) there is evidence of the nurse's current competency and skill;

(d) there are institutional policies and /or procedures in place governing the activity, and the activity is consistent with those;

(e) There are adequate resources, equipment and supports in the care setting to ensure patient safety; and

(f) The nurse is prepared to accept and manage the consequences of performing the activity.

In the absence of any of the above, the activity would be considered out of scope for an individual nurse and should not be performed. A nurse may not perform, even if directed to do so, an activity not recognized by the profession as appropriate for that level of licensure or otherwise prohibited by law.

Section 11.2 Delegation.

A licensee shall not delegate tasks to a person the licensee knows, or has reason to know, is not qualified by training, experience, education, or licensing credentials to perform them. See 3 V.S.A. § 129a(a)(6). Decision-making regarding the delegation of nursing care must be focused on the protection of the health, safety, and well-being of the patient/client.

(a) Non-delegable functions. An APRN or RN may never delegate the exercise of nursing judgment, including patient assessment, care planning, and evaluation of care, to a licensee whose scope of practice does not include those functions.

(b) Factors. A nurse delegating tasks shall consider the Five Rights set out in the National Guidelines for Nursing Delegation:

(1) Right task: the activity must be within the delegate's job description and consistent with written policies and procedures;

(2) Right circumstance: the patient's condition must be appropriately stable, and the delegating nurse must be situated to be aware of changes;

(3) Right person: the delegate must have the skills and knowledge to perform the activity;

(4) Right direction and communication: the delegate must be appropriately educated, and understanding must be confirmed by two-way communication and clear understanding and acceptance of the delegated activity; and

(5) Right supervision and evaluation: the delegating nurse must monitor the delegated activity, remain ready and available to intervene, and follow up to evaluate performance, outcomes, and accurate documentation.

Section 11.3 Evidence-based Practice; Competent and Credible Evidence.

(a) Duty of competence. A licensee shall maintain awareness of evolving evidence-based practice guidelines and standards; shall implement these in nursing practice; and shall exercise the critical thinking required to meet the statutory obligation to refrain from "promoting or recommending a therapy or treatment in a manner tending to deceive the public or to suggest a degree of reliability or efficacy unsupported by competent evidence and professional judgment."3 V.S.A. § 129a(a)(17).

(b) Credibility of sources. An APRN considering a therapeutic intervention shall consider whether the therapy is reasonably indicated for the relevant diagnosis, as indicated by FDA approval or support by credible literature, meaning literature upon which a reasonable clinician competent in the prevailing practice would rely.

Section 11.4 Fitness.

A licensee shall practice as a nurse or nurse assistant only when fit to work. Fitness includes the ability to collect data, notice detail, analyze information, solve problems, and respond rapidly to hazards to patient safety or wellbeing. Fitness may be impaired by fatigue, stress, alcohol, drugs, physical impairment, medical condition, or emotional state. Nurse peers, nurse supervisors, and nursing employers share a responsibility to ensure fitness and to intervene if a licensee appears unfit.

(a) A nurse or nurse assistant shall:

(1) Assure his or her ongoing wellness and fitness for work, by such means as such as getting adequate rest, seeking treatment for medical conditions, seeking counseling for emotional problems, managing stress, and avoiding substances and activities that may impair fitness for work;

(2) Notify the manager, supervisor, or responsible person of any concerns regarding his or her fitness for work and request appropriate accommodations, as needed;

(3) Refuse an assignment, if not fit to competently and safely perform the assignment; and

(4) Notify the individual and the manager, supervisor, or responsible person of any concerns regarding another person's fitness for work.

(b) A nurse supervising others shall:

(1) Develop or enforce workplace policies and procedures regarding fitness for work;

(2) Schedule responsibly, allowing adequate time for rest breaks during and between shifts;

(3) Manage the work environment to promote safety and avoid fatigue and hazards;

(4) Educate employees regarding fitness for work concepts and available supports;

(5) Be available to observe and assess the fitness for work of employees on duty, and

(6) if a nurse or nurse assistant appears to be unfit for work, remove the employee from the work environment until the situation has been assessed, appropriate action taken, and the employee is determined to be fit to perform their assigned work.

Section 11.5 Patient Abandonment.

A licensee shall not abandon a patient. Abandonment occurs when a licensee who has accepted a patient assignment or accepted responsibility for care of a patient jeopardizes the safety of that or other patients by improperly disengaging from the assignment or responsibility.

(a) Examples of abandonment include, without limitation:

(1) Leaving the patient care area without transferring responsibility appropriately;

(2) Remaining unavailable for patient care for a duration that compromises patient care;

(3) Inattention or insufficient observation or contact with a patient;

(4) Sleeping while on duty outside supervisor-approved rest consistent with written facility policy;

(5) Failing to timely notify a supervisor or employer if unable to initiate or complete an assignment where the licensee is the sole care provider; or

(6) For an APRN, terminating the nurse-patient relationship without providing reasonable notification to the patient and resources for continuity of care.

(b) The following employment acts generally do not constitute patient abandonment:

(1) Failing to report to work when an assignment has not been assumed or accepted;

(2) Refusing to accept an assignment to a unit when there has been no orientation and no educational preparation or an assignment outside the licensee's scope of practice;

(3) Leaving an assignment after notifying the appropriate personnel and transferring responsibility for patient care;

(4) Leaving an assignment due to circumstances reasonably perceived by the licensee as placing the licensee in imminent danger of serious harm;

(5) Refusing to work beyond a scheduled shift; or

(6) Resigning without giving specific notice.

Section 11.6 Informed Consent.

Each person has a right to determine what shall be done with his or her body and a right to accept or refuse medical treatment. For those determinations to be informed, the person, as patient, must be capable of making relevant decisions, based not only on personal capacity, but also upon the provision of accurate and adequate information by providers of care. If a patient lacks capacity, informed consent is to be obtained from a parent or legal guardian.

(a) An APRN or RN may obtain a patient's informed consent for a treatment or procedure if:

(1) The APRN or RN will perform the treatment or procedure;

(2) The treatment or procedure is within the APRN or RN's scope of practice;

(3) The APRN or RN is able accurately to convey to the patient:

i. A description of the treatment or procedure;

ii. The indications for the treatment or procedure;

iii. Risks and benefits of the treatment or procedure;

iv. Alternatives and their risks and benefits;

v. The probable consequences of declining the recommended treatment or procedure; and

vi. Roles of others who may be involved in executing the treatment or procedure.

Section 11.7 Duty to Update and Self-report.

Applicants and licensees owe a duty of candor to the Board and shall disclose circumstances that may call for further investigation to protect the public. That a matter is reportable does not imply that the matter necessarily is a basis for discipline. A licensee, including an applicant for licensure, shall report to the Office, in writing, within 30 days:

(a) any change of name, e-mail, or mailing address;

(b) any material inaccuracy or change in circumstance relative to any application question, where the changed circumstance arises between submission of a license application and issuance of the license sought;

(d) any conviction for any criminal act;

(e) any injunction or other order of a court or regulatory authority, including any order to cease & desist and any assurance of discontinuance, limiting the licensee's ability to practice;

(f) any legal claim, settlement, or judgment arising from alleged professional negligence, misconduct, or malpractice; and

(g) any adverse action against a professional license in another jurisdiction, where the adverse action relates to an allegation of misconduct, substandard practice, or unethical conduct.

PART 12 ALTERNATIVE TO DISCIPLINE PROGRAM

Section 12.1 Alternative Program.

As authorized by 26 V.S.A. § 1574(a)(10), the Board administers an Alternative Program to serve as an alternative to the disciplinary process for nurses and nursing assistants with substance use disorders or other professional practice issues as designated by the Board. The purpose of the Program is to protect the public safety while encouraging licensees to seek help when necessary and without fear of adverse licensing consequences or undue publicity. The Program reflects the Board's belief that nurse wellness is foundational to safe practice.

Section 12.2 Eligibility.

A person eligible to participate in the Alternative Program shall:

(a) hold a license issued by the Board or be an eligible applicant for one;

(b) voluntarily request to participate;

(c) not be the subject of any unresolved complaint, investigation, or charge, unless specifically approved for participation by the State Prosecuting Attorney authorized to bring disciplinary charges;

(d) acknowledge that a deficiency in some aspect of nursing practice, or a substance use disorder, if not appropriately addressed, may impact the licensee's ability to practice safely and competently;

(e) illustrate that the condition or circumstance is of a type susceptible to successful treatment or remedial training; and

(f) if requested, agree to undergo a comprehensive assessment, at the applicant's expense, from a pre-approved qualified provider based on criteria determined by the Committee.

Section 12.3 Disqualification.

Notwithstanding Rule 12-2, supra., no person shall be eligible to participate in the Program who:

(a) has harmed or endangered a patient through willful, knowing, or reckless or inexcusably negligent conduct, or has exhibited abusive or cruel behavior toward a patient;

(b) presents a danger to the public;

(d) has attempted to conceal a practice error or falsify records; or

(e) in the judgment of the Committee, is not an appropriate candidate for any reason.

Section 12.4 Confidentiality.

Records pertaining to an individual's participation in the Program are not available to the public and shall not be publicized, except:

(a) by order of a court of competent jurisdiction;

(b) when necessary and appropriate to monitor compliance with Program requirements, such as by confirming conditions are followed at a place of employment or that a participant has remained in treatment;

(c) when the Board is required by the terms of the Nurse Licensure Compact to report Program participation to the coordinated licensure information system, pursuant to 26 V.S.A. § 1647f; or

(d) when participation in the Program is considered in a future disciplinary matter.

Section 12.5 Administration and Selection.

The Alternative Program is administered by the Executive Director. The investigative team assigned to a matter may refer a potential participant if the team believes participation would be in the interest of the public health, safety, and welfare; consistent with these Rules and applicable policies of the Alternative Program Committee; and likely to benefit the eligible person's fitness to practice.

Section 12.6 Agreement.

When a participant is approved, the Executive Director or case manager shall propose an Alternative Program Agreement suited to address the underlying conduct or circumstance. The Agreement must be jointly approved by the participant and the Executive Director. The Agreement shall at a minimum specify:

(a) the conduct, circumstance, or condition acknowledged to require treatment or remediation;

(b) that such conduct, circumstance, or condition shall not be the subject of Board discipline if the participant successfully completes the Alternative Program as set out in the Agreement;

(c) the conditions of participation, to include without limitation any supervision, restriction, testing, coursework, treatment or other requirements calculated to aid the participant while appropriately protecting the public;

(d) that the Agreement is voluntary and that the participant agrees to forgo due process rights associated with a contested disciplinary case before the Board;

(e) that the participant shall grant the Program releases as may be reasonably requested to confirm treatment compliance and progress and agrees not to assert patient-provider privilege to frustrate Program oversight; and

(f) that violation of the Agreement shall constitute unprofessional conduct and may result in public disciplinary charges.

Section 12.7 Effect on Multistate Licensure Privilege.

The Board is obligated by the Nurse Licensure Compact to deactivate the multistate licensure privilege of any nurse licensed by the Board, for the duration of the nurse's participation in an alternative program. See 26 V.S.A. § 1647(e)(c).

PART 13 DISCIPLINE

Section 13.1 Unprofessional Conduct.

Unprofessional conduct includes those acts set out at 3 V.S.A. § 129a (applicable to all professional licensees) and 26 V.S.A. § 1582 (applicable to the nursing professions). Violation of these rules is cognizable as unprofessional conduct pursuant to 3 V.S.A. § 129a(a)(3).

Section 13.2 Remedies.

Upon a finding by the Board that a licensee, applicant, or person who later becomes an applicant has committed unprofessional conduct, within or without this State, or has had a license application denied or a license revoked, suspended, limited, conditioned, or otherwise disciplined by a licensing agency in another jurisdiction for conduct which would constitute unprofessional conduct in this State, or has surrendered a license while under investigation for unprofessional conduct, the Board may warn, reprimand, suspend, revoke, limit, condition, deny, or prevent the renewal of a license or privilege to practice. See 3 V.S.A. § 129(a). A license may be summarily suspended pending further proceedings, consistent with 3 V.S.A. § 814(c), upon a finding that public health, safety, or welfare imperatively requires emergency action.

History

EFFECTIVE DATE:
July 13, 1991 Secretary of State Rule Log #91-42
AMENDED:
June 1, 1995 Secretary of State Rule Log #95-35; July 15, 1998 Secretary of State Rule Log #98-42; March 1, 2004 Secretary of State Rule Log #04-06; June 23, 2011 Secretary of State Rule Log #11-024; January 15, 2015 Secretary of State Rule Log #14-054; 5/11/2023 Secretary of State Rule Log #23-010
STATUTORY AUTHORITY: 3 V.S.A. § 123; 26 V.S.A. § 1574

Chapter 180 BOARD OF EXAMINERS FOR NURSING HOME ADMINISTRATORS; ADMINISTRATIVE RULES

04-180 Code Vt. R. 04-030-180-X BOARD OF EXAMINERS FOR NURSING HOME ADMINISTRATORS; ADMINISTRATIVE RULES

Part 1 GENERAL INFORMATION

Section 1.1 The Purpose of Licensure

Vermont Law Title 18 Chapter 46 of the Vermont Statutes Annotated gives the Director of the Office of Professional Regulation (Director) certain powers and duties to protect the public health, safety, and welfare by regulating nursing home administrators. The Director has adopted these rules to aid applicants, licensees, and the general public in understanding the requirements for this profession.

Section 1.2 Business Address

Business Correspondence related to Nursing Home Administrators should be addressed to:

Secretary of State

Office of Professional Regulation

Nursing Home Administrators

National Life Bldg., North, FL2

Montpelier, VT 05620-3402

Section 1.3 Regular, Special and Emergency Meetings

The Director, or the Office on behalf of the Director, may, as necessary, hold public meetings to solicit public input in matters pertaining to this profession.

Section 1.4 Laws That Govern the Regulation of Nursing Home Administrators

(a) The Director is authorized by Chapter 46, Title 18 of the Vermont Statutes Annotated to adopt rules, set standards, issue licenses, and regulate the profession. The statutes are online at http://www.leg.state.vt.us/ statutes/chapters.cfm?Title=18. The Director's authority is also conferred by subchapter III of Chapter 5 of Title 3 "Professional Regulation," the statutes creating and governing the Office of Professional Regulation ( 3 V.S.A. §§ 121-131). In addition to the "Professional Regulation"statutes, the Director is subject to other state laws including the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314), the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320), and the "Law of Professional Regulation" ( 3 V.S.A. §§ 121-131). In contested cases, hearings are conducted using the Vermont Rules of Evidence, as amended by the Administrative Procedure Act. These laws set forth the rights of applicants, license holders and members of the public.

(b) The Secretary of State appoints two advisors to advise the Director as set forth in section 129b of Title 3. The requirements for advisors are set forth in 18 V.S.A. § 2052(a). The Director is required by this statute to seek the advice of the advisors in carrying out the provisions of Chapter 46 of Title 18 regulating this profession.

(c) The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us. The statutes and rules related to nursing home administrators may be accessed through the OPR website at http://vtprofessionals.org/.

Section 1.5 Administrative Rules

The Director is authorized to make these rules under Chapter 46 of Title 18. In making or revising rules, the Director must follow the Administrative Procedure Act ("Act"). These rules are approved by the Vermont Legislative Committee on Administrative Rules and have the force of law. 3 V.S.A. § 845(a).

Section 1.6 Definitions

In addition to the definitions found in 18 V.S.A. § 2051, the following definitions apply to these rules:

(a) "Approved Program or Activity" is a continuing education program or activity which meets the standards set forth in these rules, and which has received approval by the Director.

(b) "Director" means the Director of the Office of Professional Regulation. Where appropriate, the Director may delegate duties regarding the administration of this profession to staff of the Office of Professional Regulation. Therefore, as used in these rules the term "Director" may include staff of the Office of Professional Regulation to whom the Director has delegated specific duties. The Director retains ultimate legal responsibility and authority for those duties.

(c) "Hour" of continuing education means a clock hour spent by a licensee in actual attendance at and completion of an approved continuing education activity. Clock hours may not include travel time, lunch or breaks.

(d) "Licensee" means any person licensed to practice nursing home administration in the State of Vermont.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Applications

(a) Applications for a license and information about the application process are available from the Office. An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office.- Applications are reviewed only after the fully completed application and documentation are received, including evidence of any required education, supervision, employment, training, or evidence of a license in another jurisdiction and its licensing standards.

(b) An applicant issued an initial license within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full license period. An applicant issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.2 License by Examination

(a) To qualify to take the exam, the applicant must meet the following criteria:

(1) be at least 18 years of age;

(2) hold at least a bachelor's degree from an accredited institution;

(3) Violation of 3 V.S.A. § 129a may be grounds for denial or conditioning of a license under these rules;

(4) be mentally and physically able to perform as a licensed nursing home administrator; and

(5) have completed an administrator-in-training program approved by the Director.

(b) The Director may consider experience as a licensed Nursing Home Administrator in lieu of the educational requirements.

Section 2.3 Administrator-in-Training program

(a) The Director has the exclusive authority to determine the qualifications, skill and fitness of any person to serve as a nursing home administrator and shall develop, impose and enforce standards designed to insure that nursing home administrators are, by training or experience in the field of institutional administration, qualified to serve as nursing home administrators. The former Board and the Director have determined that an administrator-in-training program is necessary to protect the public by insuring that nursing home administrators are experienced and qualified.

(b) Administrator-in-training (AIT) program components:

(1) Content: The AIT program shall cover the subjects specified in the National Association of Long Term Care Administrator Boards (NAB) Five Step Program Administrator in Training Internship Manual and AIT, as it may be amended from time to time, which is available from the NAB.

(2) Plan: The applicant must file a proposed plan for the AIT program for approval prior to starting the program. The plan must be submitted on forms provided by the Office and shall include the name and qualifications of the proposed preceptor.

(3) Supervision: The program must be completed under the supervision of a preceptor approved by the Director. "Supervision" means on-site supervision (on the premises of the facility). The supervisor must be readily available to assist and answer questions, but may be off the premises for limited periods of time for vacations, conferences, etc. but still must be available by phone, not to exceed an average of more than one day per week.

(4) Preceptors: To qualify for approval, preceptors must be currently licensed and in good standing as a Nursing Home Administrator in this state and have at least five years of experience as a licensed Nursing Home Administrator.

(5) Hours: The program must cover 1,000 total hours in the areas specified and must be completed within two years.

(6) Report: At the completion of the training program, the applicant must submit a final report, approved by the preceptor, verifying the completion of the training program. The report must be submitted on forms provided by the Office.

(c) Waiver of hours: The director may waive the AIT program requirement or reduce the number of hours needed if in the Director's discretion it is determined that the applicant has gained practical experience that would satisfy the components of the program in the specific program areas. Some examples include, but are not limited to:

(1) A Nursing Home Administrator licensed in another state with relevant experience in a long-term care facility but who has not completed an AIT program.

(2) Relevant experience as a currently licensed registered nurse in a long-term care facility.

(3) Relevant training in a long-term care facility received as part of a practical component of a course of study in long-term care administration.

(4) Participation in an AIT program in another state which is substantially equivalent to Vermont's.

(5) Relevant courses of instruction and training offered in Vermont or elsewhere for persons who wish to become nursing home administrators.

(d) Endorsement: Applicants who have completed an AIT program in another state which the Director determines to be substantially equivalent to Vermont's will not be required to complete an AIT program in Vermont prior to licensure.

Section 2.4 Examinations

(a) Applicants who are approved will be scheduled for examination in Vermont.

(b) Applicants must successfully complete a written examination given by the National Association of Boards of Examiners of Long Term Care Administrators (NAB) and a jurisprudence examination on the laws in the State of Vermont, which may cover these rules, the statutes contained in 18 V.S.A. Chapter 46, 3 V.S.A. Chapter 5, Subchapter 3, and the licensing and operating rules and regulations for nursing homes as per the Department of Disabilities, Aging and Independent Living, as amended.

(c) An applicant who fails the exam given by NAB may retake it as permitted by the NAB. A new application and fee must be submitted each time.

(d) After successful completion of the NAB examination, the applicant may schedule to take the Vermont examination. An applicant who fails the Vermont exam may retake it.

Section 2.5 Licensure by Endorsement

An applicant who is licensed and in good standing in another jurisdiction, whose licensing requirements are substantially equivalent to Vermont's may apply for a license without written examination for proficiency and competence. The applicant must still successfully complete the Vermont jurisprudence examination and meet continuing education requirements. A license may be denied, limited, or conditioned if the applicant has engaged in unprofessional conduct.

Section 2.6 License Denials, Hearings, Appeals

(a) The Director will notify applicants in writing of all decisions to either grant or deny a license or license renewal. If a license or renewal is denied, the Director will give the applicant specific reasons and will also inform the applicant of the right to appeal the decision. This is called a "preliminary denial."

(b) The Director most often issues a preliminary denial of licensure or renewal when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing by an administrative law officer. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the administrative law officer issues a final decision in writing.

(c) A party aggrieved by a final decision of an administrative law officer may appeal that decision to the Washington Superior Court which shall review the matter on the basis of the record created before the administrative law officer.

(d) Information about the appeal process may be obtained from the Office or online at http:// vtprofessionals.org/.

Part 3 INFORMATION FOR LICENSED NURSING HOME ADMINISTRATORS

Section 3.1 Renewal

(a) Licenses are issued for a two year period. Before the license expiration date, the Office will send notice of the upcoming renewal. A license will expire automatically if the complete renewal application, along with proof of completion of the required continuing education and renewal fee are not submitted to the Office by the expiration date.

(b) Those who practice as nursing home administrators after expiration of a license are subject to late fees before renewal and unprofessional conduct prosecution or other penalties.

Section 3.2 Lapsed Licenses

A lapsed license may be reinstated within 5 years of expiration upon payment of the renewal fee and late renewal penalty. and verification of completion of continuing education for the last renewal period. A licensee whose license has lapsed for more than 5 years, must successfully complete the NAB examination and the Vermont jurisprudence examination before a license may be reinstated.

Section 3.3 Continuing Education

(a) Licensed nursing home administrators are required to continue their education in areas directly related to nursing home administration. Continuing education in nursing home administration is defined as specific learning experiences designed to enhance the knowledge and skills of nursing home administrators.

(b) Biennial Renewal Requirements:

(1) First Renewal: If a licensee is first licensed during the first 12 months of the biennium, the licensee shall complete at least 20 hours of continuing education for the first renewal. If a licensee is first licensed during the second year of the biennium, the licensee is not required to complete continuing education for the first renewal.

(2) Subsequent renewals: For each subsequent renewal, a licensee shall accrue 40 hours of continuing education during the two year period immediately preceding the date of license renewal.

(d) Record keeping requirements: Licensees shall maintain and upon request submit copies of certificates of attendance or transcripts which demonstrate completion of the requirements. Evidence of the completion of the total 40 hour requirement shall be submitted before licenses are renewed.

(e) A licensee whose continuing education submissions are not approved shall be given a notice from the Office that the education requirements are not satisfied. The licensee will have 90 days from the date of that notice to develop a corrective plan approved by the Director and complete that plan.

(f) The Director may temporarily waive the continuing education requirements of this policy in cases of extreme hardship.

Section 3.4 Continuing Education: Course Content and Providers

(a) The subject matter of each course shall be directly related to the duties and responsibilities of a nursing home administrator and in one of these areas:

(1) Patient and Resident Care;

(2) Personnel Relations;

(3) Management and Law;

(4) Business and Finance;

(5) Governmental Regulations

(6) Promoting Culture Change.

(b) Approved Courses:

(1) Certain organizations and the continuing education courses they offer are pre-approved by the Director. A list of the currently approved course providers is available from the Office or via the web site http://vtprofessionals.org.

(2) Courses from Providers who have not been pre-approved. Courses of study offered by an education institution, association, professional society, or organization for the purpose of providing continuing education for nursing home administrators, not on the list of approved course providers, shall be submitted for approval on forms provided by the Office. Licensees may avoid the risk of a course not being approved by requesting pre-approval. This is done by submitting course information on the continuing education approval application form which is available from the office or on-line.

(1) Academic Credits The Director shall approve for continuing education credit those courses taken for college academic credit if the content meets the criteria set forth in this rule and a transcript including a passing grade from the college is presented with a course outline. Each college credit may count for 15 hours continuing education.

(2) Distance learning and web based continuing education: Continuing education credits shall be granted for successful completion of Director approved distance learning courses. Proof of completion shall be presented with a course outline.

(3) Workshops, Seminars & Conferences: Attendance at workshops, seminars and conferences related to the role of Nursing Home Administrators in the approved categories of 3.2(a) are considered for approval.

(4) Other categories: No credit will be granted for professional activities, publishing, or serving as an administrator-in-training.

Section 3.5 Change of Name or Address

A licensee shall notify the Office in writing within 30 days of any changes of name, mailing address, or business address. A licensee notifying the Office of a change in his/her name must submit proof of the legal change in name.

Section 3.6 Unprofessional Conduct and Penalties

The Director may refuse to issue or renew a license or may suspend, revoke reprimand or otherwise limit or condition a license if the licensee violates any provisions 3 V.S.A. § 129a, which includes violations of these rules or any other laws or regulations relating to the proper administration and management of a nursing home.

Section 3.7 Complaint Procedure

The Office follows the current investigation and disciplinary procedure adopted by the Office of Professional Regulation, except where these rules provide otherwise. Copies of the procedure, complaint forms and more information about the complaint process may be obtained from the Office.

History

STATUTORY AUTHORITY: 18 V.S.A. § 2053
EFFECTIVE DATE: June 1, 1986
AMENDED: September 1, 1996 Secretary of State Rule Log #96-37; March 9, 1999 Secretary of State Rule Log #99-12; November 13, 2000 Secretary of State Rule Log #00-66; March 15, 2009 Secretary of State Rule Log #09-005

Chapter 190 ADMINISTRATIVE RULES FOR OCCUPATIONAL THERAPISTS AND OCCUPATIONAL THERAPY ASSISTANTS

04-190 Code Vt. R. 04-030-190-X ADMINISTRATIVE RULES FOR OCCUPATIONAL THERAPISTS AND OCCUPATIONAL THERAPY ASSISTANTS

Part 1 GENERAL INFORMATION

Section 1.1 THE PURPOSE OF LICENSURE

The Director of Professional Regulation (who is referred to as "the Director" in this rule) has been given power by Vermont law to license occupational therapists and occupational therapy assistants in order to protect the public health, safety and welfare. This is done by setting standards for issuing licenses, licensing only qualified applicants and regulating license holders and their practices.

Section 1.2 BUSINESS LOCATION

The Director's business location is c/o Secretary of State, Office of Professional Regulation, 26 Terrace Street, Montpelier (the Office). Mailing address:

Secretary of State

Office of Professional Regulation

26 Terrace Street Drawer 09

Montpelier, Vermont 05609

The telephone number is (802) 828-2363.

An interested person may get copies of these rules and more information about licensure and its requirements and procedures by writing or telephoning the Office.

Section 1.3 ADVISORS TO THE DIRECTOR OF PROFESSIONAL REGULATION

The Secretary of State appoints two occupational therapists to serve as advisors who help the Director carry out the program and advise the Director on such matters as selecting an examination, setting a passing score, making administrative rules, and approving or denying licensure. The Director refers disciplinary matters to an administrative law officer.

Section 1.4 LAWS THAT GOVERN LICENSURE

The practice of occupational therapy is governed by a specific state law that establishes responsibilities for setting standards, issuing licenses and regulating the profession. In addition, the Director is obligated to ensure compliance with several other state laws, including the Administrative Procedure Act ( 3 V.S.A. §§ 801-847), the Open Meeting law ( 1 V.S.A. §§ 311-314) and the Access to Public Records law ( 1 V.S.A. §§ 315-320). These laws spell out the rights of applicants, license holders and members of the public. A copy of these laws may be obtained by contacting a town clerk or librarian. Most have copies of these statutes.

Section 1.5 RULES, RULEMAKING AND DECLARATORY RULINGS

(a) Requests for the adoption, amendment or repeal of any of these rules may be sent to the Office. Such requests must be in writing, addressed to the Director. The Director will, within 30 days, initiate rulemaking procedures for the rule's adoption, adopt a procedure, or deny the request in writing.

(b) Requests for declaratory rulings as to the applicability of any statutory provisions or any rule or order may be sent to the Director. Such requests must be in writing, and must show the existence of a real controversy, not just a hypothetical question. A declaratory ruling is binding upon the parties to the ruling and the Director. The requests will be considered at the Advisory Committee's next regular meeting. Within 30 days of a decision, the parties will be notified in writing.

(c) In the absence of real controversy, the Director may issue an advisory opinion, or may decline to address the question presented in a request for declaratory ruling. An advisory opinion is not binding on the requestor, other license holders, or the Director. Within 30 days of a decision the requestor will be notified in writing.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 DEFINITIONS

The definitions in the Act also apply to these rules. In addition, as used in these rules:

(1) "ACOTE" means the Accreditation Council for Occupational Therapy Education of the American Occupational Therapy Association or its successor organization.

(2) "The Act" means the Occupational Therapists Act, 26 Vermont Statutes Annotated, Chapter 71.

(3) "AOTA" means the American Occupational Therapy Association or its successor organization.

(4) "The Director" means the Director of the Office of Professional Regulation.

(5) "The Office" means the Office of Professional Regulation in the Office of the Secretary of State.

(6) "V.S.A." means Vermont Statutes Annotated: for example 26 V.S.A. § 3351 means section 3351 of Title 26 of the Vermont Statutes Annotated.

Section 2.2 WHERE TO GET AN APPLICATION

Applications for licensure and information about the application process are available by calling or writing the Office. Applicants apply on one of three bases: examination, endorsement or certification by a nationally recognized credentialing body approved by the Director.

Section 2.3 LICENSURE AS AN OCCUPATIONAL THERAPIST (BY EXAMINATION)

(1) Education: The applicant must have a bachelor's or higher degree from an educational program for occupational therapists that is accredited by ACOTE, including the required supervised fieldwork.

(2) Examination: The applicant must submit proof of having passed the exam approved by the Director. Information on applying for and scheduling the exam is available from the Office or the national examining body. Candidates who fail the exam must retake the exam and are ineligible to practice until its successful completion.

(3) Application procedure: The instructions for "examination" applicants found on the application form are followed.

Section 2.4 LICENSURE AS AN OCCUPATIONAL THERAPY ASSISTANT (BY EXAMINATION)

(1) Education: The applicant must have an associate's or higher degree from an educational program for occupational therapy assistants which is accredited by the ACOTE, including the required supervised fieldwork.

(2) Examination: The applicant must submit proof of having passed the certification exam approved by the Director. Information on applying for and scheduling the exam is available from the Office or the national examining body. Candidates who fail the exam must retake the exam and are ineligible to practice until its successful completion.

(3) Application procedure: The instructions for "examination" applicants found on the application form are followed.

Section 2.5 TEMPORARY LICENSES

(a) A temporary license may be issued by the Director for a period of up to 90 days to a person who applies for the first time to practice occupational therapy in this state. The temporary license is issued to allow one who meets the licensing requirements of Rules 2.3 or 2.4 above, to practice pending the applicant taking the next exam or pending the Director's receipt of the necessary data for licensure without exam.

(b) Close supervision, as defined in Rule 3.7(a) below, is required of the applicant while practicing under a temporary license.

Section 2.6 LICENSURE WITHOUT EXAMINATION (BY ENDORSEMENT)

(a) To qualify for a license by endorsement, occupational therapist applicants or occupational therapy assistant applicants must be currently certified or licensed in another jurisdiction. The requirements of that jurisdiction must currently be at least equal to Vermont's.

(b) Application procedure: The instructions for "endorsement" applicants found on the application form are followed.

Section 2.7 WAIVER OF EXAMINATION OR EDUCATION REQUIREMENTS

(a) The Director may waive the examination requirement if the applicant is certified or licensed prior to the effective date of the Act as a registered occupational therapist (OTR) or certified occupational therapy assistant (COTA) by a nationally recognized credentialing body approved by the Director, and if, in the opinion of the Director, the standards and qualifications for such certification are at least equal to those required by the Act.

(b) The Director may waive the educational requirement for licensure as an occupational therapist, if the applicant is recognized by a nationally recognized credentialing body approved by the Director as a certified occupational therapist after having qualified for and passed an occupational therapy examination, and the Director determines that the examination so taken meets the requirements of the Act.

Section 2.8 FOREIGN TRAINED GRADUATES [O> CERTIFICATION (a) Applicants trained in countries without accreditation standards similar to those in the United States must have completed an occupational therapy or occupational therapy assistant educational program equivalent to the standards of accredited schools. The Office will evaluate those academic credentials received with completed application in consultation with a credentials evaluation service. The applicant is responsible for the costs of this credential review. The Office will provide a current list of acceptable services and steps for requesting credential review. Upon approval of the applicant's education, the application will be considered under rules 2.3 or 2.4. -

(b) Application procedure: The instructions for "examination" applicants found on the application form are followed.

Section 2.9 RIGHT TO A WRITTEN DECISION AND APPEAL

Applicants are notified in writing whether or not they meet requirements to be licensed. If the Director denies an application he or she shall give specific reasons and inform the applicant of the right to request a hearing for review of this decision. The hearing will be held by an administrative law officer. After an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, remand or modify the Director's preliminary decision. The applicant may appeal the administrative law officer's decision, by sending a written notice of appeal to the Director within 30 days of the decision. Appeals are heard by the superior court of Washington County, on the basis of the record before the administrative law officer

Section 2.10 USE OF TITLE

A person may not use letters, words or insignia indicating or implying that the person is an occupational therapist or occupational therapy assistant unless the person is licensed. See 26 VSA § 3352. However, the use of the terms "occupational therapy student" or "occupational therapy intern" in a manner that is not deceptive or misleading is acceptable.

History

EFFECTIVE DATE: December 29, 1995 Secretary of State Rule Log # 95-87
AMENDED: February 2002 [Not an amendment - correction of statutory authority]; June 1, 2004 Secretary of State Rule Log # 04-16

Chapter 200 RULES OF THE BOARD OF OPTICIANS

04-200 Code Vt. R. 04-030-200-X RULES OF THE BOARD OF OPTICIANS

Part 1 General Information

Section 1.1 The Purpose of Licensure

The Secretary of State and the Director of the Office of Professional Regulation (Office) have been given certain powers under Vermont law to protect the public health, safety, and welfare by setting standards, licensing applicants, and regulating licensed opticians and their practices. Legal authority for oversight of this profession is given to the Director of the Office of Professional Regulation. The Director is assisted by two advisors, licensed opticians residing in Vermont, who are appointed by the Secretary of State. The advisors will meet as needed.

Section 1.2 Business Address

The mailing address for matters concerning opticians is

Secretary of State

Office of Professional Regulation

Optician Licensing

National Life Bldg., North, FL2

Montpelier, VT 05620-3402

The Office is located at the National Life Building North, in Montpelier. Copies of these rules may be obtained on line at http://vtprofessionals.org or by contacting the Office 802-828-2837.

Section 1.3 Laws That Govern Licensure

(a) Licensure is governed by a specific state law that establishes responsibilities for setting standards, issuing licenses, and regulating the profession. The law is in Chapter 47, Title 26 Vermont Statutes Annotated. In addition, the Director of the Office of Professional Regulation is obligated to comply with several other State laws such as the Administrative Procedure Act ( 3 V.S.A. §§ 801-849), the "Law of Professional Regulation" ( 3 V.S.A. §§ 121-131), the "Right to Know Law" ( 1 V.S.A. §§ 311-314), and the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320). These laws spell out the rights of an applicant, license holder or member of the public.

(c) The complete text of these laws may be found in the Vermont Statutes Annotated. Most town clerks and public libraries have copies of the Vermont Statutes Annotated. The laws may be found on line at http://www.leg.state.vt.us/statutes/statutes2.htm.

Section 1.4 Rules

The Director is authorized to make these rules by 26 V.S.A. § 2665. Administrative rules for this profession have the force of law and govern proceedings related to this profession. In making rules, the Director must follow the Administrative Procedure Act ("APA"). The provisions of the Act governing rulemaking are found in 3 V.S.A. §§ 801-808 and 817-849.

Section 1.5 Making and Resolving Complaints

The Office follows the current complaint procedure recommended by the Director of the Office of Professional Regulation. Copies of the procedure and more information about the complaint process may be obtained via the Office of Professional Regulation web site, http://vtprofessionals.org or from the Office.

Part 2 Information for Applicants

Section 2.1 Need for a License

(a) No one is allowed to practice as an optician in Vermont unless he or she is currently licensed by the Office.

(b) A licensed optician, ophthalmologist, or optometrist shall be present when optician services are rendered. An optician's, ophthalmologist's, or optometrist's office or shop which is open to the public when the optician, ophthalmologist, or optometrist is not present shall notify customers that no optician services may be rendered.

(c) When rendering optician services, a licensed optician shall wear a name tag clearly visible to the client stating the licensee's name and bearing the words "Licensed Optician" beneath the name.

(d) During regular business hours, a representative of the Office may inspect the premises where a licensed optician, optometrist, or ophthalmologist is providing optician services, for compliance with statutes and rules of the profession.

Section 2.2 Where to Obtain an Application

An application for a license may be downloaded from the Optician Web page at http://vtprofessionals.org. More information about the application process may be obtained by calling or writing the Office.

Section 2.3 Licensure by Examination

(a) Examination: To qualify for licensure by examination, an applicant must be at least 18 years old and have a high school diploma or its equivalent. In addition, an applicant must meet either requirement (1) or (2) below, and (3):

(1) Complete at least a two-year college level program in ophthalmic dispensing at a school of ophthalmic dispensing which is accredited or a candidate for accreditation by an accreditation agency approved by the United States Department of Education and which agency is also approved by the Director, or

(2) Complete at least three years of practical experience as a registered optician trainee. Specific requirements for optician training are set forth in Part 3 below; and

(3) Successfully complete the National Opticianry Competency Examination (NOCE) sponsored by the American Board of Opticians (ABO). The examination may be taken no sooner than the final year of education in section 1 or 2 above.

(b) The applicant must submit an application and fee as stated on the application. The application must be completed accurately. A check for the correct amount should be made payable to the Vermont Secretary of State.

(c) Take the exam. The exam is given at least once a year. Information on examination scheduling may be obtained online at http://vtprofessionals.org or from the Office. The exam will include, but is not limited to: ophthalmic materials, laboratory, practical and physiological optics, prescription interpretation, dispensing preparation, adjustment of lenses, spectacles, eye glasses, prisms, tinted lenses, appurtenances, use of lensometers or equivalent instruments, adjusting instruments and pupillary and facial measurements.

Section 2.4 Licensure by Endorsement

(a) An applicant who holds a valid current license in good standing in another United States or Canadian jurisdiction where the current requirements for regulating or licensing opticians are substantially equal to Vermont's current requirements may be issued a license.

(b) The completed application and application fee should be sent as directed on the application form.

Section 2.5 Display of Licenses

A licensee or trainee must display his or her license or registration conspicuously in his or her principal place of business.

Part 3 Optician Trainees

Section 3.1 How to Register as an Optician Trainee

(a) An individual may pursue licensure through optician training and experience by working for a licensed optician, ophthalmologist or optometrist. That individual must register as an optician trainee with the Office. The period of traineeship begins on the date the Office determines the registration is complete.

(b) The application for registration must be certified by the trainee's supervisor. The fee as stated on the registration form must also be paid for a trainee's registration certificate.

Section 3.2 Length of Training

(a) A registered optician trainee must complete a minimum of 4,680 hours of practical training in not less than three years and no more than six years approved by the Office under the direct personal supervision of a licensed optician, optometrist, or ophthalmologist within Vermont or another state which requires the supervisor to be licensed.

(b) A detailed description of the proposed training to be received and the supervisor's name and license number must accompany the application for registration. Upon review of this description and any further review it may undertake, the Office may in its discretion approve the training in this manner.

Section 3.3 Supervisor Requirements and Limitations

(a) A licensed supervisor provides direct personal supervision of a trainee; while the trainee is working, by being physically present for consultation or intervention on the premises where the trainee is working. Merely being available at another optical facility for consultation does not constitute direct personal supervision.

(b) The licensed supervisor may not have more than two trainees under his or her direct personal supervision at any time, nor shall any establishment employ more than two trainees per licensed supervisor at any time. Any change in the named supervisor or in the trainee being supervised shall be reported immediately to the Office for approval.

Section 3.4 Content of Training

All optician training must include:

(a) Optical Principals and theory including the theories of light and laws of refraction, reflection and absorption;

(b) Anatomy and physiology of the eye;

(d) Ophthalmic regulations including Vermont Opticians Act, 26 V.S.A. Chapter 47, ANSI Standards, FDA and FTC regulations;

(e) Laboratory, practical and physiological optics prescription interpretation, adjustment of eyeglasses, prisms, tinted lenses, and appurtenances, the use of lensometers or equivalent instruments, adjusting instruments, and pupillary and facial measurements;

(f) Transposition and interpreting prescriptions;

(g) Single vision, Bifocal & trifocal and progressive addition lens types and their uses;

(h) Proper ordering of lenses and frames;

(i) knowledge of frame material and parts;

(j) Identification of common ophthalmic lens materials, designs, coatings, and uses (e.g. CR-39, polycarbonate, glass, trivex, hi-index plastic; scratch resistant, anti-reflective, and mirror coatings.)

(k) Types of specialty lenses and their uses (e.g. fresnel, aspherics, lenticular, cataract, prism, slab-off prism, occupational, safety.)

(l) Absorptive lenses including ultra-violet, infra-red, fixed tint, polarized, and photosensitive.

(m) Methods for obtaining patient measurements related to interpupillary distance, vertical optical center placement, multifocal segment placement, vertex distance.

(n) The use of the lensometer to neutralize, duplicate, and verify prescriptions (including identification of sphere, cylinder, axis, and prism; marking of lens optical centers)

(o) The use of measuring tools such as pupilometer, mm ruler, lens clock, lens thickness gauges;.

(p) Methods for performing standard alignment, custom adjustments, and repairs of frames using fitting tools, pliers, and frame warmers, and;

(q) Resolution of client complaints.

Section 3.5 Verification of Training

Optician training is to be documented by written affidavit from the training supervisor submitted at the completion of the training period or at other times as the Office may direct.

Section 3.6 Renewal of Training Certificate

Every registered optician trainee who continues to act as an optician trainee shall, biennially, renew his or her optician trainee's certificate of registration by paying the renewal fee as stated on the renewal form. After initial registration, a trainee may renew his or her trainee's certificate of registration no more than three times, permitting no more than six years in which to complete the 4,680 hours of practical training required by this rule. Thereafter, a trainee's certificate of registration may not be renewed.

Section 3.7 Identification as Trainee

The registered optician trainee shall wear in a manner clearly visible to the client a name tag stating the registered optician trainee's name and bearing the words "Registered Optician Trainee" beneath the name.

Section 3.8 Inspections

During regular business hours, a representative of the Office may inspect the premises where a licensed optician, optometrist, or ophthalmologist is providing direct personal supervision of a registered trainee, for compliance with this rules.

Part 4 Licensing and Registration Decisions

Section 4.1 Right to a Written Decision

(a) The Office will notify applicants in writing of all decisions to either grant or deny a license, registration, license renewal, or registration renewal. If a license or registration or renewal is denied, the decision is called a "preliminary denial." The Office will give the applicant specific reasons for denying a license or registration and will also inform the applicant of the right to appeal that decision.

(b) The Office most often issues a preliminary denial of licensure or renewal when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing by an administrative law officer acting on behalf of the Director. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the administrative law officer issues a final decision in writing.

Section 4.2 Right to Appeal Licensing and Registration Decisions

An applicant who is not satisfied with the final decision denying a license or registration or renewal may appeal the decision to the Washington County Superior Court which shall review the matter on the basis of the record created before the administrative law officer.

Part 5 Information for Licensed Opticians and Optician Trainees

Section 5.1 License and Registration Renewals

(a) Licenses expire no later than two years after issuance. A licensee must renew his or her license by the expiration date. Before the expiration date, the Office will mail each licensee a renewal application and notice of the renewal fee. However, if a licensee has changed name or address without advising the Office, the licensee may not receive this notice. It is still the licensee's responsibility to renew on time. Failure to report a change of name or address within 30 days is, according to 3 V.S.A. § 129a(14), unprofessional conduct.

(b) A licensee who does not return the completed renewal application and fee to the Office by the expiration date, will be assessed a late renewal fee which must be paid before the license or registration can be reinstated.

(c) Initial licenses issued within 90 days of the renewal date will not be required to renew and pay the renewal fee. Applicants issued an initial license more than 90 days prior to the renewal expiration date are required to renew and pay the renewal fee.

Section 5.2 Reinstating a License

(a) Any person whose license has expired, provided the period of expiration has been less than five years, may reinstate that license by documenting completion of continued education for the previous renewal period and paying the renewal fee plus the late renewal penalty. The licensee shall not be required to pay renewal fees during periods when the license was expired.

(b) Licenses which have lapsed for more than five years may be reinstated by:

(1) demonstrating more than 1,000 hours of licensed practice in another state over the preceding two years; or

(2) successfully completing the national licensing examination within one year prior to applying for reinstatement; and

(3) paying the renewal fee and late renewal penalty.

Section 5.3 Continuing Education (CE) Requirements for Opticians and Registered Trainees

(a) All opticians and trainees must take a minimum of ten (10) CE credit hours during a two-year license renewal period. Credit hours must be obtained during the current renewal period.

(b) Limitations:

(1) Content: C.E. credits may include courses in contact lenses, but contact lens courses may not exceed three credits per renewal period.

(2) Format: CE credits may include home study courses, but such courses may not exceed two credits per renewal period.

(3) Credit may also include live web seminars and interactive television, but such courses may not exceed two (2) credits per renewal period.

(1) Courses approved by the ABO Education Committee or the NCLE Education Committee will be accepted for continuing education credit.

(2) Courses obtained from any of the institutions of higher learning on the list of schools, colleges and universities approved by the Office will be accepted for continuing education credit.

(d) Credits will be accepted at the rate of one credit per hour of instruction. A certificate of course completion must also accompany the credits.

(e) Reporting of CE credits: At the time of license renewal, the applicant must submit documentation of having taken ten acceptable credit hours in the two-year period.

Section 5.4 Exemption for Applicants Granted an Initial License to Practice by the Office

The mandatory continuing education requirement begins with the first day of the first biennial renewal period following the issuance of initial license. The Director recommends, but does not require, continuing education for initial licensees during their first licensing period.

Section 5.5 Failure to Meet Continuing Education Requirement

Licensees whose submissions do not satisfy the continuing education requirement may, absent exceptional circumstances, be denied renewal or may be issued a 90 day temporary license. During that period each person shall submit for approval and once approved, complete a specified corrective action plan. Once the Office determines that the plan has been met, it will issue a license. Otherwise the temporary license will expire.

History

STATUTORY AUTHORITY: 26 V.S.A. § 2665
EFFECTIVE DATE: Original effective date not provided.
AMENDED: January 7, 1991 Secretary of Sate Rule Log #91-3; December 1, 1994 Secretary of State Rule Log #94-48; October 22, 2008 Secretary of State Rule Log #08-045

Chapter 210 RULES OF THE STATE BOARD OF OPTOMETRY

04-210 Code Vt. R. 04-030-210-X RULES OF THE STATE BOARD OF OPTOMETRY

Part 1 General Information

Section 1.1 The Board's Purpose

(a) The State Board of Optometry ("the Board") is created by the Vermont Legislature. Chapter 30 of Title 26 of the Vermont Statutes Annotated confers the Board with specific powers and duties. The Board has adopted these rules to aid applicants, licensees, and the general public in understanding the requirements for this profession.

(b) The Board is created to protect the public health, safety, and welfare by setting standards for issuing licenses, licensing qualified applicants, and regulating the practice of license holders.

(c) The Board maintains a website at http://vtprofessionals.org/.Practitioners should periodically consult the website for matters of interest to the profession.

Section 1.2 Definitions

As used in these rules:

(a) "Board" or "The Board" means the Vermont Board of Optometry.

(b) "C.O.P.E." means Council on Optometric Practitioner Education;

(d) "V.S.A." means Vermont Statutes Annotated, the authorized compilation of Vermont legislative enactments.

Section 1.3 Laws That Govern the Board

The Board is created by Chapter 30, Title 26, Vermont Statutes Annotated, which establishes the Board's responsibilities for setting standards, issuing licenses, and regulating the profession. The statutes are online at http://www.leg.state.vt.us/statutes/chapters.cfm?Title=26. Board powers are also conferred by subchapter III of Chapter 5 of Title 3 "Professional Regulation," the statutes creating and governing the Office of Professional Regulation ( 3 V.S.A. §§ 121-132). In addition to the "Professional Regulation" statutes, the Board is subject to other state laws including the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314), and the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320). In contested cases, the Board follows the Vermont Rules of Evidence, as amended by the Administrative Procedure Act. These laws set forth the rights of applicants, license holders, and members of the public. The Office provides legal counsel to help the Board comply with all laws affecting Board business. Applicants and licensees should be aware that Chapter 5 of Title 3 of the Vermont Statutes contains several statutes which govern regulation of licensed professionals. See among them, 3 V.S.A. § 129a which defines unprofessional conduct.

Section 1.4 Business Address

(a) The Board's business location is in the Office of the Secretary of State, Office of Professional Regulation, (the "Office") in the City Center in Montpelier. Its mailing address is:

Vermont Board of Optometry

Vermont Secretary of State

Office of Professional Regulation

89 Main Street, Fl. 3

Montpelier, VT 05620-3402

(b) Copies of these rules and more information about the Board and its requirements and procedures may be obtained by contacting the Office at 802-828-1505. This information may also be obtained from the Board's website at http://vtprofessionals.org/.

Section 1.5 Board Rules

The Board is authorized to make these rules by Chapter 30 of Title 26. In making or revising rules, the Board must follow the Administrative Procedure Act ("Act"). These rules were approved by the Vermont Legislative Committee on Administrative Rules before adoption and are presumed valid. These rules have the force of law. 3 V.S.A. § 845(a).

Section 1.6 Advisory Opinions

Interpretation of the meaning of Board Rules and statutes often occurs when the Board is deciding an unprofessional conduct case. The Board is not authorized to issue advisory opinions.

Section 1.7 Legislative Changes Affecting Rules

Legislative changes from time to time may create inconsistencies between statutes and administrative rules. When a rule and statute are inconsistent, the statute governs.

Section 1.8 Regular, Special, and Emergency Meetings

(a) The Board holds at least one regular annual meeting. The chair or two members may call a special or emergency meeting if it is necessary. A majority of Board members constitutes a quorum for all meetings. Formal action may be taken at a meeting if a majority of those present and voting are in favor of the action.

(b) Information on meeting times and location can be obtained from the Office or online at http://vtprofessionals.org/.

Part 2 Information for Applicants

Section 2.1 Need for a License

According to the Optometry Act, 26 V.S.A. § 1712, No person may practice optometry in this state who is not licensed under this chapter, and no person may use the title "doctor of optometry," "optometrist," or any substantially equivalent title unless he or she is licensed by the Board.

Section 2.2 Application

An applicant must submit a completed application form with all supporting documentation and applicable fee to the Office. Applications and information about license requirements are available from the Office or online at http://vtprofessionals.org/.

Section 2.3 Licensure by Examination

To be eligible for licensure as an optometrist by examination an applicant must:

(a) have reached the age of majority;

(b) be a graduate of an optometric school or college accredited by a regional or professional accreditation organization approved by the Board; and

Section 2.4 Recent Examination Required

Applicants who have not previously been licensed must successfully have completed the examination no more than 2 years before applying for licensure.

Section 2.5 License by Endorsement

An applicant who is licensed and in good standing in another United States jurisdiction whose licensing requirements are substantially equivalent to Vermont's may apply for a license without written examination.

Section 2.6 Unprofessional Conduct - Effect on Licensure

A license may be denied, limited, or conditioned if the applicant has engaged in unprofessional conduct.

Section 2.7 Right to a Written Decision

(b) The Board, or the Office on behalf of the Board, most often issues a preliminary denial of licensure or renewal when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing by the Board. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the Board issues a final decision in writing. If the decision affirms the preliminary denial of a license, the decision informs the applicant of his or her appellate rights.

Section 2.8 Right to Appeal

A person who is not satisfied with a final decision of the Board may appeal to an appellate officer within 30 days of being sent notice of the Board's decision. The appellate process is governed by Vermont law, 3V.S.A. § 130a, and has its own procedural rules. Information about the appellate process is available from the Office.

Part 3 Information for Licensed Optometrists

Section 3.1 License Renewal

(a) Licenses are issued for a two-year period on a schedule set by the Office of Professional Regulation and must be renewed by the expiration date printed on the license certificate.

(b) A license not renewed by its expiration date expires.

(c) The Office sends licensees a renewal notice in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not.

Section 3.2 Continuing Education Requirements

(a) As a condition of renewal all licensees are required to complete continuing education as set forth below:

(1) Licensees who do not hold an endorsement permitting use of therapeutic pharmaceutical agents must complete 20 hours of continuing education.

(2) Licensees who hold an endorsement permitting use of therapeutic pharmaceutical agents must complete 40 hours of continuing education of which 20 hours shall be in the use of therapeutic pharmaceutical agents, including treating possible complications arising from their use, and the treatment of glaucoma.

(b) "Continuing education" means the direct participation of an optometrist in a structured educational format taught by qualified presenters. Continuing education has significant intellectual and practical content directed at maintaining the professional competence of optometrists. Continuing education as used in this Part does not include practice management courses or programs.

(c) Permitted continuing education programs may include classroom style instruction, educational seminars with substantial written material available, whether conducted by live speakers, lecturers, panel members, video or audio tape presentation, in a classroom setting with a group of not fewer than three individuals, or on line.

Section 3.3 When Continuing Education is Required

(a) For applicants granted an initial license to practice, the mandatory continuing education requirement begins with the first day of the first full biennial licensing period following the issuance of initial license.

(b) For those licensees granted an initial license within 90 days of the end of the licensing period/renewal date and who are not then required to renew their licenses, the continuing education requirement begins with the first day of the biennial licensing period so that all people licensed for two years at the time of their first renewal must show compliance with the continuing education requirements.

Section 3.4 Limitation

No more than ten (10) hours of required continuing education may be taken as on home study or on line study. Of those ten (10) hours, no more than two (2) may be taken as home study. To qualify for approval home study or on line study courses must require verification of successful completion via test or other acceptable means.

Section 3.5 Hardship Variance

The Board, in its sole discretion, may, in individual cases involving extreme hardship, grant waivers or extensions of time to complete continuing education requirements.

Section 3.6 Acceptable Hours

Continuing education hours will be allowed only for actual time spent as a learner. Time spent in activities as an instructor, presenter, or supervisor do not qualify for continuing education credit.

Section 3.7 Continuing Education Records Retention

Continuing education certificates of attendance/documentation must be retained for four years.

Section 3.8 Continuing Education Audits

(a) The Board will conduct continuing education audits of randomly selected licensees as well as licensees whose licenses are conditioned. The Board will also audit reinstating licensees, and licensees who in any of the preceding 2 renewal cycles were initially found to have not met continuing education renewal requirements.

(b) When a licensee appears on the audit list, the Board will request documentation from the licensee showing a detailed account of the various credits claimed. The Board will review the documentation and determine whether the continuing education requirements have been satisfied.

(c) A form upon which all continuing education must be recorded is available on line at the Board's web site. Documentation of continuing education must include the name and date of the programs with certificates of attendance, the number of continuing education hours approved.

(c) Under 3 V.S.A. § 129(k) the Board may give licensees 90 days to develop and complete a corrective plan to cure any deficiencies in his or her continuing education requirements.

(d) Courses taken pursuant to a corrective plan may be counted for only the licensing period being audited.

(e) Failure to comply with a corrective plan may result in disciplinary action. 3 V.S.A. § 129a(a)(4).

Section 3.9 Pre-approved programs or providers

(a) Continuing education programs approved by C.O.P.E. are pre-approved by the Board.

(b) The Board may approve other specific providers or programs. A list of those approvals will be kept by the Board and be available from the Board's website.

Section 3.10 Approval of Continuing Education Programs not Pre-Approved under Rule 3.9

(a) An educational program may be approved by the Board. Applications for approval may be made by submitting a continuing education approval application form. The forms are available from the Board's web site.

(b) Requests for approval must include:

(1) The name of the activity;

(2) the number of credits requested;

(3) an outline of presentation, copies of handouts or slides, if any;

(4) the name of the instructors;

(5) sponsors; and,

(6) whether C.O.P.E. approval has been sought, granted or denied.

(d) An application for advance approval must be filed at least 90 days before the educational activity occurs.

Section 3.11 Post Activity Approval

Applications for approval of continuing education programs which have already occurred must be filed within 30 days of the event or program.

Section 3.12 Approval Process

(a) The Board will approve an activity or program which meets the requirements of these rules.

(b) The Board will determine how many hours credit each approved activity will be awarded.

(d) The sponsor of a program approved by the Board may state that the program is approved for the number of hours of continuing education credit specified by the Board.

Section 3.13 Reinstatement of Expired Licenses

(a) A lapsed license may be reinstated within six (6) years of expiration upon payment of the reinstatement penalty and renewal fee, and meeting all renewal requirements.

(b) If the license has lapsed more than six years, and the licensee does not possess an active license in good standing from another jurisdiction, the applicant is not eligible for reinstatement and must reapply as provided above.

Section 3.14 Inactive Status

Licensees may change their license status to inactive as permitted by law.

Section 3.15 Change of Name or Address

A licensee is responsible for notifying the Office promptly of any change of name, mailing address, or business address within 30 days. Acceptable documentation of change of name includes a notarized copy of a marriage certificate, instrument of change of name from a probate court, or other court order. Acceptable documentation of change of name also includes a notarized copy of current identification, such as a driver's license or Social Security card, in both the former and present names. The Office may require additional documentation at its discretion.

Part 4 Complaint Procedure and Unprofessional Conduct

Section 4.1 Procedure

The Board follows the procedure of the Office of Professional Regulation (Office) for receiving complaints, conducting investigations, and resolving charges of unprofessional conduct. Copies of the procedure are available from the Office telephone 802-828-1505).

Section 4.2 Unprofessional Conduct

A licensee or applicant may be disciplined for unprofessional conduct on any of the grounds listed in 26 V.S.A. § 1719 and 3 V.S.A. § 129a. Violation of these rules can be unprofessional conduct. 3 V.S.A. § 129a(a)(3).

Section 4.3 Confidentiality

The Board follows the confidentiality provisions of 3 V.S.A. § 131. All identifying information related to complaints remains confidential until disciplinary charges are filed.

History

STATUTORY AUTHORITY: 26 V.S.A. §§ 1708, 1716
EFFECTIVE DATE: March 13, 1984 Secretary of State Rule Log #84-7
AMENDED: September 1, 2000 Secretary of State Rule Log #00-43; September 9, 2013 Secretary of State Rule Log #13-025

Chapter 220 ADMINISTRATIVE RULES OF THE BOARD OF OSTEOPATHIC PHYSICIANS AND SURGEONS

04-220 Code Vt. R. 04-030-220-X ADMINISTRATIVE RULES OF THE BOARD OF OSTEOPATHIC PHYSICIANS AND SURGEONS

Part 1 GENERAL

Section 1.1 Purpose

The Board of Osteopathic Physicians and Surgeons, "the Board," has been created and given powers by Vermont law. The Board's purpose is to protect the public health, safety and welfare. The Board does this by setting standards for issuing licenses, licensing qualified applicants, and disciplining and regulating the practices of license holders.

Section 1.2 Business Address

The Board's address is c/o Vermont Secretary of State, Office of Professional Regulation, 89 Main Street, Fl. 3, Montpelier, VT 05620-3402.

Section 1.3 Board Members and Officers

The Board is composed of five members who are appointed by the Governor and serve staggered five-year terms as set forth in 3 V.S.A. § 129b. A list of Board members is available from the Board or by accessing the Board's Web site at http://www.vtprofessionals.org/osteopaths .

Section 1.4 Regular, Special and Emergency Meetings

The Board generally meets quarterly. The chair or two members may call a special or emergency meeting if it is necessary. A majority of Board members constitutes a quorum for all meetings. Formal action may be taken at a meeting if a majority of those present and voting are in favor of the action. Information on meeting times is available from the Office or online at http://vtprofessionals.org/ .

Section 1.5 Laws Governing the Board

(a) The Board is governed by 26 V.S.A. Chapter 33, which establishes the Board's responsibilities for setting standards, issuing licenses and regulating osteopathic physicians. In addition, the Board is obligated to comply with several other state laws such as the Administrative Procedure Act ( 3 V.S.A. §§ 801-847), the Law of Professional Regulation ( 3 V.S.A. §§ 121-132), the Right to Know Law ( 1 V.S.A. §§ 312-313), and the Access to Public Records Law ( 1 V.S.A. §§ 315-320). These laws set forth the rights of applicants, license holders, or members of the public.

(b) The complete text of these laws is available at most libraries and town clerk's offices. "Vermont Statutes Online" are also available on the Internet at http://legislature.vermont.gov/statutes/ . The Board's statutes and rules may be accessed through the Board's website at http://vtprofessionals.org/ .

Section 1.6 Board Rules

The Board is authorized to make these rules under Chapter 33 of Title 26. These rules were approved by the Vermont Legislative Committee on Administrative Rules before adoption and are presumed valid. These rules have the force of law. 3 V.S.A. § 845(a).

Section 1.7 Definitions

As used in these rules:

(a) "ABMS" means the American Board of Medical Specialties.

(b) "ACGME" means the Accreditation Council for Graduate Medical Education;

(d) "Board" means the Board of Osteopathic Physicians and Surgeons created by 26 V.S.A. Chapter 33.

(e) "COMLEX-USA" means the Comprehensive Osteopathic Medical Licensing Examination administered by the NBOME.

(f) "COMVEX" means the Comprehensive Osteopathic Medical Variable purpose Examination administered by the NBOME.

(g) "FCVS" means the Federation Credentials Verification Service administered by the Federation of State Medical Boards.

(h) "FLEX" means the Federation Licensing Examination administered by the Federation of State Medical Boards.

(i) "FSMB" means the Federation of State Medical Boards.

(j) "Limited temporary permit" means a permit issued for the purpose of completing postgraduate training, which allows the holder to practice under the direct supervision and control of a licensed physician in a hospital program of postgraduate training, or in clinics affiliated with that hospital

(k) "National Boards" means the examination given by the National Board of Medical Examiners or the examination given by the National Board of Osteopathic Medical Examiners.

(l) ''NBME" means the National Board of Medical Examiners.

(m) "NBOME" means the National Board of Osteopathic Medical Examiners.

(n) "Office" means the Office of Professional Regulation;

(o) "RRC" means the Residency Review Committee of the ACGME.

(p) "Specialty Board certification" means successfully completing the educational and examination requirements of a specialty board of the American Board of Medical Specialties or , the AOA.

(q) "SPEX" means the Special Purpose Examination administered by the Federation of State Medical Boards.

(r) "USMLE" means the United States Medical Licensing Examination.

(s) "V.S.A." means Vermont Statutes Annotated.

Part 2 OSTEOPATHIC PHYSICIANS

Section 2.1 General Requirements for Licensure

(a) To be eligible for a license to practice osteopathic medicine, the applicant must present evidence satisfactory to the Board that the applicant:

(1) Is at least 18 years of age;

(2) Is a graduate of an accredited school or college of osteopathic medicine;

(3) Has satisfactorily completed one year's post-graduate training in a rotating internship program approved by the AOA or has satisfactorily completed three years of post-graduate training in an AOA or ACGME-approved residency program;

(4) Has taken and passed the COMLEX-USA Level 3 or has taken and passed the National Boards (the former three-part NBOME examination series) or has taken and passed the USMLE-Step 3.

(b) The Board accepts credentials verification from the FCVS. An applicant may obtain information about the FCVS credentials verification procedure by contacting the FSMB directly at its Web site (http://www.fsmb.org).

Section 2.2 Application for COMLEX-USA

(a) Applications for COMLEX-USA are available from the National Board of Osteopathic Medical Examiners, http://www.nbome.org . The address, telephone number, and fax number of the NBOME are available by accessing the Board's Web site.

(b) All three COMLEX-USA examinations. (Levels 1, 2, and 3) must be completed in sequential order within seven years of the successful completion of Level 1/Part 1 ("Seven Year Rule").

Section 2.3 Application for USMLE Examination

To be eligible for licensure by the route of USMLE only, an applicant must successfully complete USMLE Steps 1, 2, and 3 as set forth by USMLE.

Section 2.4 Licensure by Endorsement

An applicant who holds an active license from another United States or Canadian jurisdiction may be licensed in Vermont without further examination if the other jurisdiction has substantially equivalent standards for licensure. The applicant must present a certificate of medical licensure from all jurisdictions in which he or she is licensed.

Section 2.5 Application for Limited Temporary License

(a) A limited temporary license is issued for the purpose of completing postgraduate training, and allows the holder to practice under the direct supervision and control of a licensed osteopathic or allopathic physician in a hospital program of postgraduate training or in clinics affiliated with that program.

(b) The applicant must be enrolled in an AOA, ACGME, or RRC-approved program of postgraduate training, or in a sub-specialty clinical fellowship program in a hospital that has an AOA, ACGME, or RRC-approved program in the parent specialty.

(c) Licenses are issued for one year or less and may be renewed on their expiration date. A maximum of four renewals will be allowed.

Section 2.6 Applications

Application for a limited temporary license must include:

(a) the required fee;

(b) verification that the applicant is at least 18 years of age;

(d) a supervising physician's statement, acknowledging statutory responsibility for the applicant's negligent or wrongful acts or omissions; and

(d) documentation of passage of COMLEX-USA Parts 1 and 2 or USMLE Parts 1 and 2.

Section 2.7 Right to a Written Decision

(a) The Board will notify applicants in writing of all decisions to either grant or deny a license, renewal, or reinstatement. If a license, renewal, or reinstatement is denied, the Board will give the applicant specific reasons and will also inform the applicant of the right to appeal the Board's decision. This is called a "preliminary denial."

(b) The Board, or the Office on behalf of the Board, most often issues a preliminary denial of licensure, renewal or reinstatement when it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure. When this occurs, the applicant is notified of the right to file an appeal which is heard as a formal hearing. At the hearing the burden of proof is on the applicant to show that the preliminary denial was in error. After that hearing the Board issues a final decision in writing. If the decision affirms the preliminary denial of a license, the decision informs the applicant of his or her appellate rights.

Part 3 INFORMATION FOR LICENSED OSTEOPATHIC PHYSICIANS

Section 3.1 Renewing a License

(a) Licenses are issued for a two-year period on a schedule set by the Office of Professional Regulation and must be renewed by the expiration date on the license certificate.

(b) The Office sends licensees a renewal notice in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not.

Section 3.2 Reinstating a License after it Has Expired

(a) A license not renewed by its expiration date expires.

(b) To reinstate an expired license the applicant must:

(1) pay any license renewal fees;

(2) pay any applicable penalty; and

(3) meet renewal and reinstatement requirements in effect at the time.

Section 3.3 Inactive Status

Licensees may change their license status to inactive as permitted by law

Section 3.4 Reinstatement of an Expired or Inactive License

(a) The osteopathic physician must complete a reinstatement application in full and pay the application fee and provide license verification from each state where the physician holds an active license.

(b) An applicant for reinstatement who has not practiced for five years or more shall successfully complete:

(1) either a post-licensure assessment program (which may include SPEX) designed to assess current competence required for general, undifferentiated medical practice; or

(2) COMVEX. COMVEX is an evaluation instrument for license reinstatement candidates who must demonstrate current osteopathic medical knowledge; or

(3) document current board certification in an osteopathic medicine specialty.

Section 3.5 Change of Name or Address

A licensee must notify the office within 30 days of any change of name or address.

Section 3.6 Continuing Medical Education Requirements

(a) With the first renewal application after two years of licensure, and with each subsequent renewal application, documentation of 30 hours of acceptable continuing education is required. Only continuing education taken within two years of the renewal date is counted. 26 V.S.A § 1836 sets the number of continuing education hours which must be osteopathic in nature.

(b) "Continuing medical education" means the direct participation in a structured educational or supervisory program directly related to competency in medicine or protection of patients from harm, or both.

(1) one quarter college credit equals ten continuing medical education hours.

(2) one semester college credit equals fifteen continuing medical education hours.

(d) Credit will be granted only for actual time spent as a learner. Breaks, business meetings, and lunches are not to be counted toward continuing education credits.

(e) The Board requires continuing education which is approved by the AOA or a successor or equivalent organization approved by the Board.

Section 3.7 Continuing Education Audits

(a) The Board will conduct continuing education audits of randomly selected licensees as well as licensees whose licenses are conditioned. The Board may also audit late renewing licensees and licensees who in any of the preceding 2 renewal cycles were initially found to have not met continuing education renewal requirements.

(b) When a licensee appears on the audit list, the Board will require documentation from the licensee showing a detailed account of the hours claimed. The Board will review the documentation and determine whether continuing education requirements have been satisfied.

(c) Under 3 V.S.A. § 129(k) the Board may give licensees 90 days to develop and complete a corrective plan to correct any deficiencies in the licensee's continuing education requirements.

(d) Failure to comply with a corrective plan may result in disciplinary action. 3 V.S.A. § 129a(a)(4).

Part 4 DISCIPLINE

Section 4.1 Disciplinary Procedure

Section 4.2 Grounds for Discipline

(a) Unprofessional conduct includes acts or omissions which violate section 129a of Title 3, violations of these rules, and violations of 26 V.S.A. § 1842. Whenever 3 V.S.A. § 129a conflicts or overlaps with the statutes specifically governing osteopathic medicine, or these rules, the provisions which provide greater safety to the public shall apply.

(b) Unprofessional conduct includes failure to practice competently. 3 V.S.A. § 129a(b). Failure to practice competently includes performing treatments or providing services which one is not qualified to perform or which are beyond the scope of one's education, training, capabilities, experience, or scope of practice.

History

STATUTORY AUTHORITY: 26 V.S.A. § 1792
EFFECTIVE DATE: February 19, 1990 Secretary of State Rule Log #90-08
AMENDED: February 1, 2000 Secretary of State Rule Log #00-03; May 15, 2015 Secretary of State Rule Log #15-012; August 2015 [editor correction to chapter number]

Chapter 230 BOARD OF PHARMACY ADMINISTRATIVE RULES

04-230 Code Vt. R. 04-030-230-X BOARD OF PHARMACY ADMINISTRATIVE RULES

PART 1 GENERAL INFORMATION

Section 1.1. The Board's Purpose.

The Vermont Board of Pharmacy ("the Board") has been created and given powers by Vermont law, 26 V.S.A. Chapter 36. Its purpose is to protect the health, safety, and welfare of the public. The Board does this by, among other authority set forth in Chapter 36 and in Chapter 5 of Title 3, setting standards for examining and licensing qualified applicants, and regulating the practice of pharmacy.

Section 1.2. Board Restrictions.

The Board may not make any rule that is designed or implemented to limit the number of licensees or pharmacies in the state; nor may the Board require that nonprescription drugs be sold only by a pharmacist or under a pharmacist's supervision.

Section 1.3. Business Address.

The Board is located at the Office of the Secretary of State, Office of Professional Regulation, 89 Main St., Fl. 3, Montpelier, VT 05620-3402 ("the Office"). The Board's mailing address is the same. The Office telephone number is 1802-828-1505. Applications, copies of these rules, and additional information about the Board may be obtained by contacting the Office or by accessing the Board's website, http://vtprofessionals.org/.

Section 1.4. Board Members and Officers.

The Board is composed of five licensed pharmacists, each with at least five years' experience as a pharmacist in Vermont, and two members of the public. Public members of the Board shall have no financial interest in the field of Pharmacy, as defined in 26 V.S.A. § 2031 other than as consumers or possible consumers. Members of the Board are appointed by the governor as provided in 3 V.S.A. sections 129b and 2004. The Board elects a chair, a vice chair and a secretary, and other officers from among its members. A list of the names and addresses of Board members and officers may be obtained from the Office or the website.

Section 1.5. Hearings.

The Board conducts hearings in accordance with the Administrative Rules for the Office of Professional Regulation, 3 V.S.A. § 129, and the provisions of the Vermont Administrative Procedure Act for contested cases, 3 V.S.A. §§ 801 -816.

Section 1.6. Regular, Special, and Emergency Meetings.

The Board holds at least two regular meetings a year. The chair or a majority of members may call a special or emergency meeting. A majority of members constitute a quorum for all meetings. Contact the Office for the date, time and location of scheduled meetings.

Section 1.7. Laws that Govern the Board.

(a) The Board is governed by the law in 26 V.S.A. Chapter 36, that establishes its responsibilities for setting standards, issuing licenses, and regulating the profession. The Board is also governed by and exercises authority granted in Chapter 5 of Title 3 of the Vermont statutes. In addition, the Board must comply with several other statutes, such as the "Law of Professional Regulation," ( 3 V.S.A. §§121 - 132), the "Administrative Procedure Act" ( 3 V.S.A. §§ 801 -849), the "Right to Know Law" ( 1 V.S.A. §§ 311 - 314), and the "Access to Public Records Law" ( 1 V.S.A. §§ 315 -320). These laws establish rights for applicants, licensees, and the public. Please note that 3 V.S.A. § 129a also defines unprofessional conduct which can be the basis of disciplinary action.

(b) Most town clerks and libraries have copies of the Vermont Statutes Annotated, which contain the complete text of these laws. The Vermont Statutes Annotated may also be accessed through the Internet at http://www.leg.state.vt.us.

(c) The profession of pharmacy is governed by other state and federal laws among which are the Generic Drug Law; Food, Drug, and Cosmetic Acts; the Health Insurance Portability and Accountability Act of 1996 (HIPAA); laws and regulations governing the use of alcohol; Federal Controlled Substance Act, 21 U.S.C. § 801 et seq.; Vermont Regulated Drug Act, 18 V.S.A. §§ 4201 - 42, and postal regulations to be followed when shipping legend drugs.

Section 1.8. Rules of the Board.

(a) The Board is authorized to make these Rules under 26 V.S.A. §2032. These Rules govern Board proceedings and have the effect of law. The Board reviews these rules periodically and revises them as needed. These rules may be cited as "BOP Rule x.x"

(b) Violation of these rules may result in disciplinary action by the Board or other federal or state authorities.

Section 1.9. Abbreviations Used in These Rules.

As used in these rules:

(a) ACPE: Accreditation Council for Pharmacy Education.

(b) DEA: Drug Enforcement Administration.

(e) FPGEC: Foreign Pharmacy Graduate Examination Committee.

(f) FPGEE: Foreign Pharmacy Graduate Equivalence Examination.

(g) MPJE: Multistate Pharmacy Jurisprudence Examination.

(h) NABP: National Association of Boards of Pharmacy.

(i) NAPLEX: North American Pharmacy Licensure Examination.

(j) OPR: Office of Professional Regulation, or "office."

(k) TOEFL: Test of English as a Foreign Language.

(l) TSE: Test of Spoken English.

(m) VAWD: Verified Accredited Wholesale Distributor.

Section 1.10. Definitions.

(a) As used in these rules:

(1) "Administer" or "Administration" means the direct application of a drug to the body of a patient or research subject by injection, inhalation, ingestion, or any other means.

(2) "AMDS" means automated medication distribution system. An AMDS is an automated device or series of devices operated by an electronic interface with one or more computers that is used to prepare, package, or dispense specified dosage units of drugs for administration or dispensing to a patient or the ultimate user. "AMDS" includes a device that prepares and packages a drug for unit dose dispensing, that prepares and packages a drug into outpatient prescription vials, and that dispenses pre-packaged drugs.

(3) "Alternative evidence of the individual's identity" as referred to in 18 V.S.A. § 4215b means documents which reasonably permit a pharmacist to conclude that the individual is who he or she purports to be.

(4) "Bona fide representative of a patient" as referred to in 18 V.S.A. § 4215b means an individual who is authorized by law, or known to the patient and authorized by the patient to receive drugs dispensed by prescription for the patient.

(5) "Bona fide representative of an animal owner" as referred to in 18 V.S.A. § 4215b means the owner of an animal or a person authorized by the owner to receive drugs dispensed by prescription for the animal.

(6) "Beyond-Use Date" means a date determined by a pharmacist and placed on a prescription label at the time of dispensing that is intended to indicate to the patient or caregiver a time beyond which the contents of the prescription are not recommended to be used.

(7) "Board of Pharmacy" or "Board" means the Vermont Board of Pharmacy, or its designee.

(8) "Collaborative Pharmacy Practice" means that portion of pharmacy practice where a pharmacist may perform certain patient care functions under a protocol of specified conditions or limitations in collaboration with a practitioner. Collaborative practice agreements must be in writing and are valid for up to one year. After one year, a new written agreement is necessary for the collaboration to continue. Each collaborative practice agreement shall include provisions for no less than an annual quality assurance review by the collaborating practitioner. A pharmacist may have collaborative practice agreements with more than one practitioner.

(9) "Compounding" means the preparation of any active ingredients or added substances into a drug product

(A) as the result of a practitioner's prescription drug order or initiative based on the practitioner/patient/pharmacist relationship in the course of professional practice, or;

(B) for the purpose of, or as an incident to, research, teaching, or chemical analysis and not for sale or dispensing. Compounding also includes the preparation of drugs or devices in anticipation of prescription drug orders based on routine, regularly observed prescribing patterns. Compounding does not include mixing, reconstituting, or other such acts that are performed in accordance with directions contained in approved labeling provided by the product's manufacturer.

(10) "Confidential Information" means information accessed, maintained by, or transmitted to the pharmacist in the patient's records or which is communicated to the patient as part of patient counseling, which is privileged and may be released only to the patient or, as the patient directs, to those practitioners, other authorized health care professionals, and other pharmacists where, in the pharmacist's professional judgment, such release is necessary to protect the patient's health and well-being; and to such other persons or governmental agencies authorized or required by law to receive such confidential information, regardless of whether such information is in the form of paper, preserved on microfilm, or is stored on electronic media.

(11) "Deliver" or "Delivery" means the actual, constructive, or attempted transfer of a drug or device from one person to another, whether or not for a consideration.

(12) "Device" means an instrument, apparatus, implement, machine, contrivance, implant, or other similar or related article, including any component part or accessory, which is required under federal law to bear the label, "Caution: Federal or State law requires dispensing by or on the order of a physician."

(13) "Dispense" or "Dispensing" means the interpretation, evaluation, and implementation of a prescription drug order, including the preparation and delivery of a drug or device to a patient or patient's agent in a suitable container appropriately labeled for subsequent administration to, or use by, a patient.

(14) "Distribute" or "Distribution" means the delivery of a drug or device other than by administering or dispensing.

(15) "Drug" means:

(A) articles recognized as drugs in any official compendium, or supplement thereto, designated from time to time by the Board for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in humans or other animals;

(B) articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in humans or other animals;

(C) articles (other than food) intended to affect the structure or any function of the body of humans or other animals; and

(D) articles intended for use as a component of any articles specified in clause (A) (B) or (C) of this definition.

(16) "Drug regimen review and/or "drug utilization review" includes but is not limited to the following activities:

(A) Evaluation of the prescription drug order(s) and patient record(s) for:

(1) known allergies;

(2) rational therapy-contraindications;

(3) reasonable dose and route of Administration; and

(4) reasonable directions for use:

(B) Evaluation of the prescription drug order(s) and patient record(s) for duplication of therapy;

(1) drug-drug;

(2) drug-food;

(3) drug-disease; and

(4) adverse drug reactions.

(D) Evaluation of the Prescription Drug Order(s) and patient record(s) for proper utilization (including over or underutilization), and optimum therapeutic outcomes.

(17) "Electronic Transmission" means transmission of information in electronic form or the transmission of the exact visual image of a document by way of electronic equipment.

(18) "Electronic transmission intermediary" means an entity that provides the infrastructure that connects the computer systems or other electronic devices used by health care providers, prescribers, pharmacies, health care facilities, pharmacy benefit managers, health insurers, third party administrators, and agents and contractors of those persons in order to facilitate the secure transmission of an individual's prescription drug order, refill, authorization request, claim, payment, or other prescription drug information.

(19) "Electronic digital signature" means an electronic signature based upon cryptographic methods of originator authentication, and computed so that the identity of the signer and the integrity of the data can be verified.

(20) "Emergency Situations" for the purposes of authorizing an oral Prescription Drug Order of a Schedule II controlled substance, means those situations in which the prescribing practitioner determines (1) that immediate administration of the controlled substance is necessary for proper treatment of the patient, (2) that no appropriate alternative treatment is available, including administration of a drug which is not a Schedule II controlled substance, and (3) that it is not reasonably possible for the prescribing practitioner to provide a written prescription drug order to be presented to the person dispensing the substance, prior to the dispensing.

(21) "Equivalent Drug Product" means a drug product which has the same active ingredient(s), strength or concentration, dosage form, and route of administration and which is formulated to contain the same amount of active ingredient(s) in the same dosage form and to meet the same compendial or other applicable standards (i.e., strength, quality, purity, and identity), but which may differ in characteristics, such as shape, scoring, configuration, packaging, excipients (including colors, flavors, preservatives), and expiration time.

(22) "Fine/Civil/Administrative Penalty" is a monetary penalty permitted by law assessed against a licensee for violation of federal or state statutes or rules governing the practice of the profession.

(23) "Home Infusion Pharmacy" means a pharmacy which compounds solutions for direct administration to a patient in a private residence, long-term care facility, or hospice setting by means of parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion.

(24) "Labeling" means the process of preparing and affixing a label to any drug container exclusive, however, of the labeling by a manufacturer, packer, or distributor of a non-prescription drug or commercially packaged legend drug or device. Any such label shall include all information required by federal and state law or rule.

(25) "Legend drug" see definition of prescription drug below.

(26) "Long-Term Care Facility" means a nursing home, retirement care, mental care, or other facility or institution that provides extended health care to resident patients.

(27) "Manufacturer" means a person engaged in the manufacture of drugs or devices.

(28) "Manufacturing" means the production, preparation, propagation, conversion, or processing of a drug or device, either directly or indirectly, by extraction from substances of natural origin or independently by means of chemical or biological synthesis, and includes any packaging or repackaging of the substance(s) or labeling or relabeling of its container, and the promotion and marketing of such drugs or devices. Manufacturing also includes the preparation and promotion of commercially available products from bulk compounds for resale by pharmacies, practitioners, or other persons.

(29) "Medical Order" means a lawful order of a practitioner that may or may not include a prescription drug order.

(30) "Medication Therapy Management" means a distinct service or group of services that optimize therapeutic outcomes for individual patients. Medication Therapy Management services are independent of, but can occur in conjunction with, the provision of a medication or a medical device.

(31) "Non-Prescription Drug" means a drug which may be sold without a prescription and which is labeled for use by the consumer in accordance with the requirements of the laws and rules of this state and the federal government.

(32) "Office" means Office of Professional Regulation.

(33) "Patient Counseling" means the oral communication by the pharmacist of information, as defined in the rules of the applicable Board, to the patient or caregiver, in order to ensure proper use of drugs and devices.

(34) "Person" means an individual, corporation, subsidiary, partnership, association, organization, affiliate organization, or any other legal entity, including government.

(35) "Pharmacist Care" is the provision by a pharmacist of medication therapy management services, with or without the dispensing of drugs or devices, intended to achieve outcomes related to the cure or prevention of a disease, elimination or reduction of a patient's symptoms, or arresting or slowing of a disease process, as defined in the Rules of the Board.

(36) "Pharmacist" means an individual currently licensed by this state to engage in the practice of pharmacy.

(37) "Pharmacist-Manager" (also referred to as "Pharmacist in Charge") means a pharmacist currently licensed in this state who has held an unencumbered license in this or another state for at least two years, who accepts responsibility for the operation of a pharmacy in conformance with all laws and rules pertinent to the practice of pharmacy and the distribution of drugs, and who is personally in full and actual charge of such pharmacy and personnel.

(38) "Pharmacy" means any place within this state where drugs are dispensed and pharmaceutical care is provided and any place outside of this state where drugs are dispensed and pharmaceutical care is provided to residents of this state.

(39) "Pharmacy Intern" is a person working toward licensure as a pharmacist as set forth in Part 4 of these rules.

(40) "Pharmacy, Scope Of Practice." See, 26 V.S.A. § 2032(a)(1). Pharmacy is that profession which is concerned with the art and science of preparing, from natural and synthetic sources, suitable and convenient materials for distribution and use in the treatment and prevention of disease. It embraces a knowledge of the identification, selection, preparation, preservation, combination, analysis, standardization of pharmacologic action, and therapeutic use of drugs and medicines. As a health care profession, it also embraces the interpretation, evaluation, and dispensing of prescription drugs or drug orders in the patient's best interest; immunization; participation in drug and device selection, drug administration, drug regimen reviews and drug or drug-related research; provision of patient counseling and the provision of those acts or services necessary to provide pharmaceutical care; and the responsibility for compounding and labeling of drugs and devices, proper and safe storage of drugs and devices and maintenance of proper records for them. It includes the management of drug therapy in collaboration with other health care providers responsible for patient care and the research, consultation, selection of drugs under protocol, and recommendation or provision of information necessary for drug therapy.

(41) "Practice of Telepharmacy" means the provision of pharmaceutical care through the use of telecommunications and information technologies to patients at a distance.

(A) "Practice of Telepharmacy Across State Lines" means the provision of pharmaceutical care through the use of telecommunications and information technologies that occurs when the patient is physically located within the jurisdiction and the pharmacist is located outside the jurisdiction.

(B) Those providing telepharmacy services must register with the Board and meet the requirements set forth in Rules 2.9 and 2.10.

(42) "Practitioner" means an individual currently licensed, registered, or otherwise authorized by the appropriate jurisdiction to prescribe and administer drugs in the course of professional practice.

(43) "Preceptor" means an individual who is currently licensed as a pharmacist by the Board of Pharmacy, who meets the qualifications as a preceptor under the rules of the Board, and participates in the instructional training of pharmacy interns.

(44) "Prescription Drug" or "Legend Drug" means a drug which is required under federal law to be labeled with either of the following statements prior to being dispensed or delivered:

(A) "Caution: Federal law prohibits dispensing without prescription;" or

(B) "Caution: Federal law restricts this drug to use by, or on the order of, a licensed veterinarian;" or

(C) a drug which is required by any applicable federal or state law or rule to be dispensed pursuant only to a prescription drug order or is restricted to use by practitioners only.

(45) "Prescription Drug Order" means a lawful order from an authorized prescriber for a drug or device for a specific patient, including orders derived from collaborative pharmacy practice, that is communicated directly to a pharmacist in a licensed pharmacy. Non-verbal non-electronic prescriptions must bear the signature of the prescriber.

(46) "Tamper resistant prescription form" means a form meeting the requirements of Rule 9.5.

(47) "These Rules" mean the Administrative Rules of the Board of Pharmacy;

(48) "Primary Care" is the first level of contact of individuals, the family, and the community with the health care delivery system, bringing health care as close as possible to where people live and work, and constitutes the first element of a continuing health care process. (Areas of primary care where pharmacists provide pharmaceutical care include, but are not limited to, the following: chronic disease management; smoking cessation; maternal and child health; immunizations; family planning; self-care consulting; drug selection under protocol; treatment of common diseases and injuries; nutrition; and general health education and promotion.)

(49) "Repackage" means changing the container, wrapper, quantity, and labeling of a product or device to further the distribution of the drug or device.

(50) "Repackager" means one who repackages drugs or devices.

(51) "Signature" for purposes of a prescription, means an authorized prescriber's name handwritten by that person on a "hard" prescription, or that person's "electronic digital signature" as part of an electronic prescription sent directly to a pharmacy.

(52) "Significant Adverse Drug Reaction" means any drug-related incident that may result in serious harm, injury, or death to the patient.

(53) "Wholesale Distributor" means any person engaged in wholesale distribution of drugs, including but not limited to manufacturers, repackagers, own-label distributors, private-label distributors, jobbers, brokers, warehouses, including manufacturers' and distributors' warehouses, chain drug warehouses, and wholesale drug warehouses, independent wholesale drug traders, and retail pharmacies that conduct wholesale distributions.

Section 1.11. Acts Which May Affect Licensure, Registration, or Renewal.

The Board may discipline or deny licensure, registration, or renewal under these rules if any applicant, sole proprietor, partner, corporate officer, or owner has engaged in unprofessional conduct violating these rules, 3 V.S.A. § 129a, and 26 V.S.A. § 2051, or acts which directly affect the ability to practice pharmacy.

Section 1.12. Licenses, Registrations, and First Renewal.

An applicant issued an initial license or registration within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full license period. An applicant issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 1.13. Renewals.

All licenses and registrations are renewed biennially on a schedule as determined by the office.

PART 2 REQUIREMENTS FOR PHARMACIST LICENSURE

Section 2.1. Routes to Licensure.

There are two routes to licensure as a pharmacist, licensure by examination and licensure by endorsement.

Section 2.2. Licensure by Examination, Qualifications for Licensure.

To be eligible for licensure as a pharmacist, an applicant must:

(a) Be at least 18 years of age;

(b) Submit an official transcript showing graduation from a pharmacy school approved by ACPE or other accrediting body approved by the Board;

(c) For foreign-trained applicants, have successfully passed the FPGEE, TOEFL, and TSE examinations or their successor examinations and hold an FPGEC certificate or its successor certificate demonstrating that their education was equivalent to the education at a school or college specified in subsection (b) above;

(d) Have completed an internship or demonstrated experience which is equivalent to an internship as set forth in Part 4 of these rules;

(e) Have passed the required examinations as set forth in Rule 2.3 below; and

(f) Have submitted an application form with photograph, and paid the appropriate fee.

Section 2.3. Examinations.

Licensure requires successful completion of the "NAPLEX" and the "MPJE." Contact NABP through its web site http://www.nabp.net/ for the date, time, and place of the examination.

Section 2.4. Required Examination Scores.

A minimum score of 75 must be attained on each component of the exam. An applicant who does not attain the required examination scores may elect to be re-examined. If the required score is not attained within one year, all previous scores shall be forfeited and the applicant must sit for and pass all components of the examination.

Section 2.5. Score Transfer.

Vermont will accept the NAPLEX score attained by an applicant from another state when the following requirements are met:

(a) The score is transferred through the NABP office under the conditions outlined by that Association;

(b) An application is submitted;

Section 2.6. Pre-Graduation Applications.

An applicant who has not yet graduated may submit an official transcript from his or her pharmacy school and arrange for certification of graduation to be sent to the Board under separate cover. Certification must be received by the Board before the applicant may sit for the examination.

Section 2.7. Licensure by Endorsement.

The Board may license an applicant who possesses an active license in a state whose current standards are substantially equivalent to the current standards in Vermont. The applicant shall submit:

(a) The Vermont application form and official NABP form, completed in full and signed by the applicant;

(b) Official verification of original licensure by examination;

(d) The prescribed application fee; and

(e) shall successfully complete the MPJE for Vermont.

Section 2.8. License Renewals.

Applicants for license renewal shall submit:

(a) The completed renewal form;

(b) A statement listing the continuing pharmacy education programs completed since the licensee's latest license was issued showing compliance with continuing education requirements;

(d) Any late fees or penalties required by law.

Section 2.9. Registration for Telepharmacy Across State Lines.

Pharmacy services may be provided via telepharmacy. A pharmacist providing telepharmacy services into the State of Vermont from another state is required to be registered as an "out of state registered pharmacist" with the Board. This registration requirement does not apply to pharmacists practicing in a non-resident licensed pharmacy.

(a) An applicant applying for registration to engage in the practice of telepharmacy across state lines shall:

(1) Present to the Board proof of licensure in another state and proof that such license is in good standing;

(2) Submit an application in the form prescribed by the Board;

(3) Pay the fee(s) specified by the Board for the issuance of the Registration; and

(4) Comply with all other requirements of the Board.

(b) The application required shall request of the applicant, at a minimum, the following information:

(1) Name, address, and current pharmacist licensure information in all other states, including state(s) of licensure and license number(s);

(2) Name, address, phone number, and, if applicable, state of licensure and license number of the site where the practice of telepharmacy will originate;

(3) A statement of the scope of patient services that will be provided;

(4) A description of the protocol or framework by which patient care will be provided;

(5) If applicable, any collaborative practice agreements with other health care practitioners; and

(6) A statement attesting that the applicant understands and will abide by the pharmacy laws and regulations of the State of Vermont.

(c) Registrations under this section shall be for the time period and follow the time schedule used for license and registration renewals.

Section 2.10. Telepharmacy Disclosure Requirements.

A pharmacist whose application for providing telepharmacy services across state lines has been approved shall:

(a) Identify himself or herself to patients as an "out of state registered pharmacist;"

(b) Notify patients of the jurisdiction in which he or she is currently licensed to practice pharmacy; and

Section 2.11. Inactive Status.

Subject to the reinstatement provisions of 26 V.S.A. § 2045, applicants for license renewal may request inactive status as permitted by law. A person who does not possess an active Vermont license may not practice pharmacy in Vermont.

Section 2.12. Reinstatement of an Inactive or Expired License.

(a) Once the expiration date on a license has passed, the license expires, and the license holder may not practice until reinstated. 26 V.S.A. §2045.

(b) To reinstate a license a holder of an inactive or expired license must comply with the continuing pharmacy education requirements set forth in these rules by accumulating a total of 30 hours for each renewal period during which the license was inactive. A person applying for renewal of an inactive or expired license shall not be assessed the renewal fees for the years during which the license was inactive or expired.

Section 2.13. Five Years Expired or Inactive Status.

(a) A pharmacist whose Vermont license has expired for 5 years or more, who is currently licensed in good standing in another US jurisdiction, must, before practicing independently,

(1) complete 60 hours of continuing education within four years preceding the application; and

(2) successfully complete the MPJE.

(b) A pharmacist whose Vermont license has expired for five years or more, and who has not been licensed in more than three years in another United States jurisdiction, must, before practicing independently,

(1) practice as an intern for no less than 200 hours under the direct supervision of a licensed pharmacist preceptor approved by the Board;

(2) complete 60 hours of continuing education within four years preceding the application; and

(3) successfully complete the MPJE.

PART 3 CONTINUING PHARMACY EDUCATION

Section 3.1. Definitions.

(a) ACPE: Accreditation Council for Pharmacy Education

(b) AMA: American Medical Association

(c) Live Programs (didactic sessions): Covers all programs that provide for direct interaction between faculty and participants and may include lectures, symposia, live teleconferences, and workshops.

Section 3.2. Continuing Pharmacy Education (CPE) Requirements.

The licensee must complete a total of 30 CPE hours per renewal period. A minimum of ten hours shall be obtained during participation in live programs (didactic sessions). Continuing pharmacy education participation must be reported every two-year renewal period. For newly-licensed pharmacists, see Rule 3.11 below.

Section 3.3. Limits.

CPE hours may not be transferred or carried over from one renewal period to another.

Section 3.4. Corrective Plan.

A licensee who fails to fulfill the continuing pharmacy education requirements of these rules may be required by the Board to develop and complete a specific corrective action plan within 90 days.

Section 3.5. Hardship Waiver.

Upon a showing a hardship, the Board may in its sole discretion waive the continuing pharmacy education requirement. To apply for a waiver, the licensee must submit a written statement setting forth the conditions of hardship with specificity. After review, the Board shall send written notification of its decision, and the reasons therefore, to the licensee.

Section 3.6. Out of State Licensees.

A licensee residing and licensed in another jurisdiction is required to meet the continuing pharmacy education requirements for license renewal in Vermont.

Section 3.7. Topics and Formats of Study.

Topics and formats of study shall include subject matter designed to maintain the professional competence of pharmacists licensed to practice and to improve their professional skills in order to protect the public health and safety.

Section 3.8. Documentation and Approval.

Providing documentation of continuing pharmacy education in Board-approved programs may be required to maintain licensure.

(a) All ACPE and AMA Category I approved programs and programs approved by pharmacy boards in other states may be approved by this Board.

(b) Organizations or licensees may have a program approved in advance by submitting the program outline, including learning objectives, and the names and qualifications of the presenters to the Board. After review, the Board shall send written notification of its decision to the organization or licensee.

Section 3.9. Verification of Continuing Pharmacy Education.

Pharmacists shall provide the Board with verification of completion of the required continuing pharmacy education programs by such means as designated by the Board. The Board may conduct random audits to verify completion of continuing pharmacy education up to four years after a license is renewed. Licensees must retain continuing education records to cover this period. Upon request by the Board, the licensee shall submit certificates of completion for all programs listed in the licensee's renewal application.

Section 3.10. Audits.

All reinstatements of inactive or expired licenses shall be audited and shall be accompanied by documentation of continuing pharmacy education. During each biennial renewal period, the Board may audit the continuing pharmacy education activities of a random sample of pharmacists. The Board may also audit currently conditioned licensees and licensees who in any of the preceding 3 renewal cycles were initially found to have not met continuing education renewal requirements. Pharmacists shall submit for inspection the documents necessary to verify the reported continuing pharmacy education.

Section 3.11. Newly Licensed Pharmacists.

(a) For applicants granted an initial license to practice by the Board, accumulation of CPE's shall commence on the opening date of the first biennial renewal period following receiving initial Vermont licensure.

PART 4 PHARMACY INTERNS

Section 4.1. Definitions.

(a) Internship: means the practical pre-licensure experience where the intern is provided the knowledge and practical experience needed for licensure. The internship requirement may be fulfilled by postgraduate experience, supervised practice, and experience gained during participation in college-coordinated externship and clerkship programs.

(b) Supervised practice: means experience obtained during participation in Board-approved programs, as an intern under the direct supervision of a qualified preceptor as defined by these rules. The programs shall be designed to give the participant experience in the type of setting in which the preceptor practices.

(c) Externship: experience obtained during participation in college-supervised programs, under the supervision of a Board-approved preceptor. The programs must be conducted outside the classroom, in licensed pharmacies.

(d) Clinical Clerkship or Clerkship: means experience gained during participation in college-supervised programs which involve patient contact in either community or institutional settings. The programs must be designed with an emphasis on monitoring and evaluation of drug therapy. The clinical clerkship or clerkship must:

(1) Be conducted in patient care settings where the student is provided with actual experiences in patient care;

(2) Emphasize all phases of drug therapy relative to the disease states of individual patients;

(3) Involve provision of clinical services on either an outpatient or inpatient basis as a primary activity;

(4) Involve a minimal amount of drug distribution;

(5) Be approved by the state board of pharmacy where the pharmacy school is located; and

(6) Be a component of the college curriculum for which academic credit is given.

(e) Preceptor: means a pharmacist with an active license, who has at least 2,000 hours experience in the actual practice of pharmacy, approved by the Board of Pharmacy in his or her state of licensure to supervise and direct the training of a pharmacy intern. To be a preceptor in Vermont the licensee must possess an unencumbered license. The Board at its discretion upon good cause may permit a licensee with a conditioned license to act as a preceptor.

Section 4.2. Registration of Pharmacy Interns.

(a) Every individual shall be registered with the Board before beginning an internship in this State.

(b) Prior to beginning any period of internship in Vermont, a prospective intern shall submit, on official forms, the following information:

(1) The intern's name and address;

(2) The name and address of the pharmacy where the internship is being served;

(3) The name, address, and license number of each preceptor at the internship site; and

(4) A complete statement of the intern's qualifications, to be provided directly to the Board by the pharmacy school or college.

(c) Forms required for proper registration of interns, along with instructions for their use, are available from the Board.

Section 4.3. Pharmacy Intern Qualifications.

Registration to practice pharmacy as an intern shall be granted only to:

(a) an individual who is currently enrolled the first professional year in an accredited pharmacy program; or

(b) a graduate of an ACPE accredited pharmacy program; or

(c) a graduate of a pharmacy program located outside the United States who has successfully completed the FPGEE, TOEFL, and TSE examinations or their successor examinations, and obtained Foreign Pharmacy Graduate Examination Committee (FPGEC) certification.

Section 4.4. Internship Non-Classroom Hours.

At least 500 hours of internship experience must be outside the classroom in a setting in which the intern provides direct patient care services, as an intern under the direct supervision of a pharmacist. Documentation shall be provided on a form available from the Board.

Section 4.5. Internship Expected Experience.

Experience obtained in hospital or retail settings should include compounding, dispensing, inventorying prescription drugs, and maintaining prescription records.

Section 4.6. Internship Other Possible Experiences.

With approval of the Board, the internship may also include experience obtained in one of the following:

(a) A demonstration project related to pharmacy;

(b) The pharmaceutical industry; or

Section 4.7. Internship Training and Practice Site Requirements.

The pharmacy at which an intern is being trained shall provide an environment that is conducive to the learning of the practice of pharmacy by an intern. The pharmacy must:

(a) Conform to all standards set by governmental agencies;

(b) Provide a broad scope of pharmaceutical services;

(d) Use a patient medication record system;

(e) Provide the opportunity for chart review in a practice setting in which charts are used;

(f) Maintain contact with other health professionals and, when possible, provide pharmaceutical services to institutionalized patients; and

(g) Provide patient counseling services.

Section 4.8. Exposure to Practice Areas.

It is expected that the intern will be exposed to all facets of the practice of pharmacy, including but not limited to, the following:

(a) Evaluation of prescription drug orders;

(b) Preparation and labeling of drugs;

(d) Patient profile update and review;

(e) Drug use review;

(f) Patient counseling; and

(g) Proper and safe storage of drugs.

Section 4.9. Other Conditions Governing Internships.

Interns enrolled in a pharmacy school approved by ACPE may participate in cooperative plans or other suitable arrangements developed by the pharmacy school and approved by the Board. Internship programs in non-traditional practice sites (e.g., industry-sponsored programs) must be approved by the Board prior to granting of internship credit.

Section 4.10. Armed Forces Members.

Members of the armed forces who served under conditions fulfilling internship requirements may submit documentation for approval by the Board. Participation in activities equaling or exceeding Vermont internship requirements shall be recognized on an hour-for-hour basis.

Section 4.11. Out of State Credit.

The Board will give credit for out-of-state or Canadian internship experience upon presentation of an affidavit or certificate of approval indicating the internship was approved in the state or province where the experience was obtained. The intern shall abide by all the provisions of the internship rules in that state or province and shall provide evidence from that state's or province's board of pharmacy of the number of clock-hours of experience actually participated in by the intern. Documentation may be provided on a form available from the Board.

Section 4.12. Responsibilities of Intern.

The intern may perform only those duties assigned by the pharmacist.

Section 4.13. Internship: No Supervisory Duties.

The intern shall not be in charge of the pharmacy department at any time.

Section 4.14. Pharmacy Interns Identified.

(a) The Board shall issue a confirmation letter or registration certificate to the intern for purposes of identification and verification of his or her role as an intern.

(b) A pharmacy intern shall wear a name tag bearing in a clearly legible font the individual's name and title "Pharmacy Intern."

(c) An individual who is not properly registered with the Board as an intern shall not take, use, or exhibit the title of intern, or any other similar term.

Section 4.15. Change of Information.

All interns shall notify the Board immediately upon change of name or address.

Section 4.16. 1,740 Internship Hours Required.

Applicants for licensure as pharmacists shall submit evidence on Board-approved forms that they have satisfactorily completed no fewer than 1,740 hours of internship credit under the instruction and supervision of a preceptor.

Section 4.17. End of Registration.

Without Board approval on a showing of extenuating circumstances Registration ends upon:

a) dismissal from pharmacy school, or

b) one year after graduation or until licensed, whichever occurs first.

Section 4.18. Board Jurisdiction over Interns.

Interns are subject to the disciplinary authority of the Board. Interns must report a conviction of any felony or any offense related to the practice of the profession in a Vermont district court, a Vermont superior court, a federal court, or a court outside Vermont within 30 days.

Section 4.19. Preceptor, Primary Responsibility.

The preceptor shall have the primary responsibility for the training of the intern. This includes ensuring that the pharmacy intern is registered with the Board.

Section 4.20. Preceptor Duties.

(a) The preceptor may allow other pharmacists to aid in the training process.

(b) The preceptor may permit an intern to provide services normally provided by a pharmacist provided that the services performed are under the direct supervision of a pharmacist.

(c) A pharmacist shall be in continuous personal contact with and actually give instructions to the intern during all professional activities throughout the entire internship period. The pharmacist shall physically review the prescription drug order and the dispensed product before the product is delivered to the patient or the patient's agent. The pharmacist is responsible for the work of the intern.

Section 4.21. Preceptor Intern Information Required.

The preceptor shall submit, on approved forms, such information as the Board requires.

Section 4.22. Preceptor Limitation.

A pharmacist may not act as a preceptor of more than two interns working at a pharmacy at any one time.

PART 5 PHARMACY TECHNICIANS

Section 5.1. Definition of Pharmacy Technician.

A pharmacy technician is "an individual who performs tasks relative to dispensing and only while assisting and under the supervision and control of a licensed pharmacist." 26 V.S.A. § 2022(13).

(a) Effective July 1, 2017: These rules create two categories of pharmacy technicians, "certifies pharmacy technicians" and pharmacy technicians who are not certified. The latter group are referred to as "pharmacy technicians."

(b) Cashiers, and delivery people who enter or have access to the prescription department must register as pharmacy technicians.

Section 5.2. Certified Pharmacy Technician.

Certified pharmacy technician means personnel registered with the Board who have completed a pharmacy technician certification program approved by the Board.

(a) Effective July 1, 2017 each individual performing the acts in subsection (b) below must be registered with the Board as a "certified pharmacy technician."

(b) A certified pharmacy technician may, under the supervision of a Pharmacist, perform certain activities involved in the Practice of Pharmacy, such as:

(1) receiving new written or electronic Prescription Drug Orders, prescription data entry;

(2) compounding;

(3) assisting in the dispensing process; and

(4) performing all functions allowed to be performed by pharmacy technicians.

(1) drug utilization review (DUR);

(2) clinical conflict resolution;

(3) receipt of new oral prescription drug orders

(4) prescriber contact concerning prescription drug order clarification or therapy modification;

(5) patient counseling;

(6) prescription transfer;

(7) dispensing process validation; or

(8) any act requiring the exercise of professional judgment by a pharmacist.

Section 5.3. Certified Pharmacy Technician Registration.

(a) To be registered as a certified pharmacy technician, an applicant shall:

(1) submit a completed application showing that the applicant is certified by a national pharmacy technician certification authority approved by the Board;

(2) pay the fee specified in statute;

(3) not have engaged in acts which affect the ability of the applicant to practice as a pharmacy technician;

(4) have attained the age of 18 years and be a high school graduate or equivalent.

(b) An individual who has held a pharmacist license that has been revoked or suspended for unprofessional conduct, or whose application for licensure as a pharmacist has been denied for unprofessional conduct, shall not be eligible to be registered as a certified pharmacy technician unless the Board, in its sole discretion, determines that good cause exists to register than individual.

(c) A certified pharmacy technician while working in the prescription department shall wear a name tag bearing in a clearly legible font, at a minimum, the individual's first name and title "Certified Pharmacy Technician."

(d) A person whose application for registration has not been approved may not act as a certified pharmacy technician.

Section 5.4. Maintaining Certification.

An individual registered with the Board as a certified pharmacy technician must maintain national certification. A person whose national certification has lapsed or has in any other way not met the requirements for continued national certification shall not practice as a registered certified pharmacy technician.

Section 5.5. Pharmacy Technician.

Pharmacy Technician means an individual registered with the Board as a pharmacy technician.

(a) A pharmacy technician may, under the supervision of the pharmacist, assist in the pharmacy and perform such functions as:

(1) receiving requests for refills of current prescriptions;

(2) processing of medical coverage claims;

(3) inventory responsibilities; and

(4) cashiering.

(b) A pharmacy technician may not perform such functions as:

(1) assisting in the dispensing work flow;

(2) drug utilization review (DUR);

(3) clinical conflict resolution;

(4) prescriber contact concerning prescription drug order clarification or therapy modification;

(5) patient counseling;

(6) prescription transfer;

(7) receipt of new prescription drug orders; or

(8) any act requiring the exercise of professional judgment by a pharmacist.

(c) A pharmacy technician in training to become a certified pharmacy technician may, after registering with the Board, under the direct supervision of a pharmacist, engage in certified pharmacy technician acts for up to 18 months. A pharmacy technician who has not successfully completed the requirements to become a registered certified pharmacy technician in 18 months may apply to the board for an extension. The Board shall, in its sole discretion, determine whether such an extension is appropriate.

Section 5.6. Pharmacy Technician Registration.

(a) To be registered as a pharmacy technician, an applicant shall:

(1) submit a completed application;

(2) not have engaged in acts which affect the ability of the applicant to practice as a pharmacy technician.

(c) A pharmacy technician while working in the prescription department shall wear a name tag bearing in a clearly legible font, at a minimum, the individual's first name and title "Pharmacy Technician."

(d) A person whose application for registration has not been approved may not act as a pharmacy technician.

Section 5.7. Renewals.

Certified pharmacy technician registrations and pharmacy technician registrations shall be renewed biennially on a schedule as determined by the Office.

Section 5.8. Jurisdiction.

Certified pharmacy technicians and pharmacy technicians are subject to the disciplinary authority of the Board.

Section 5.9. Transitional Provision Grandfather Clause.

Effective July 1, 2017. A person who has not completed a national pharmacy technician program approved by the Board may be registered as a Vermont certified pharmacy technician if:

a) As of July 1, 2017 the person has been a Vermont registered pharmacy technician in good standing with an unencumbered registration continuously since July 1, 2014;

b) The person currently engages in the tasks reserved for certified pharmacy technicians under Rule 5.2(b);

c) The person pays the applicable fee and submits an application for transition from a Vermont Registered Pharmacy Technician to a Vermont Certified Pharmacy Technician which application shall include a verification by oath or affirmation containing:

a detailed description of the certified pharmacy technician tasks set forth in these rules and that the applicant has engaged in, signed by both the applicant and the pharmacist-manager or supervising pharmacist; and

verification by the pharmacist manager or supervising pharmacist that the applicant/pharmacy technician currently performs those certified pharmacy technician tasks competently to the satisfaction of the pharmacy manager or supervising pharmacist, and a statement by the pharmacist-manager or supervising pharmacist that the applicant/pharmacy technician is qualified to serve as a certified pharmacy technician in that pharmacy practice location.

d) A person registered as a Vermont certified pharmacy technician under this Rule is not as a condition of renewal required to obtain or maintain certification from a national certification program approved by the Board.

e) An individual who becomes a Vermont certified pharmacy technician under this Rule may continue to practice as a certified pharmacy technician only in that person's current practice pharmacy location and employer. Registration with the Board as a Vermont certified pharmacy technician under this rule will terminate with the cessation of practice at the registrant's current practice location. To be hired to practice at any other pharmacy location will require that the individual obtain and maintain certification from a national certification program approved by the Board.

f) A person registered as a Vermont Certified Pharmacy technician under this rule must notify the Board within 10 days of terminating employment at his or her current location.

g) Registration as a certified pharmacy technician under this rule is available between July 1, 2017 and July 1, 2018. The Board will permit applications to be submitted in March of 2017 in hopes that successful candidates will be able to receive their certified pharmacy technician registrations and be ready to practice under them on July 1, 2017. Unsuccessful applicants will be advised of the appeal process.

h) The intent of this grandfather clause is to ensure that after July 1, 2017 all newly hired certified pharmacy technicians in Vermont are certified by a national certification program approved by the Board.

PART 6 PHARMACIST-MANAGER

Section 6.1. Pharmacist-Manager Required.

No pharmacy may operate unless its designated pharmacist-manager has been approved by the Board.

Section 6.2. General Duties and Limitations.

The pharmacist-manager shall be responsible for the direct management, supervision, and control of the pharmacy department.

(a) After the effective date of these rules, to serve as a pharmacist manager a pharmacist shall have been licensed and in good standing as a pharmacist in this state or in another state with substantially similar requirements for licensure for at least two years. Unless granted written permission by the Board, a licensee is required to possess an unencumbered license while serving as a pharmacist-manager.

(b) A pharmacist may not serve as pharmacist-manager unless he or she is physically present in the pharmacy a sufficient amount of time (30% of the hours the prescription department is open or at least 40 hours per week, whichever is less), to provide supervision and control.

(c) A pharmacist may not serve as pharmacist-manager for more than one pharmacy at any one time except as specifically allowed by written permission from the Board.

Section 6.3. Duties Included.

The pharmacist-manager shall:

(a) be responsible for proper closing of the drug outlet; or if a foreclosure or bankruptcy, the official in charge shall obtain the services of a pharmacist to serve as acting pharmacy-manager.

(b) be responsible for required record keeping of drugs and devices that are destroyed, surrendered to the Board, or returned to the wholesaler or manufacturer for disposal.

(d) ensure that all policies and procedures are in computerized form or if written shall be collected in a format such as a three-ring binder that can be easily accessed, updated and revised as necessary.

(e) assure that the automated pharmacy dispensing system is in good working order and accurately dispenses the correct strength, dosage form, and quantity of the drug prescribed while maintaining appropriate record keeping and security safeguards.

(f) implement an ongoing quality assurance program that monitors performance of the automated pharmacy dispensing system, which is evidenced by written policies and procedures adopted by the pharmacy.

(g) assure that all pharmacists employed at the pharmacy are properly licensed, all pharmacy technicians are properly registered and Health Insurance Portability and Accountability Act (HIPAA) trained, and that all pharmacy interns employed at the pharmacy are properly registered with the Board of Pharmacy.

(h) report to the Board within 10 days, along with supporting information and evidence, any disciplinary action taken by it or its staff, after an initial investigation, or hearing in which a pharmacist, pharmacist intern, or pharmacy technician has been afforded the opportunity to participate, which limits or suspends, conditions, or terminates that person's employment for drug diversion or violations of the rules and statutes governing pharmacy practice. If the pharmacy manager is disciplined, the pharmacy owner shall report the action to the board. See, 3 V.S.A. § 128.

(i) Notify the Board of Pharmacy immediately of any of the following changes on forms provided by the Board:

(1) Any theft or significant loss of prescription drugs shall be reported to the Board immediately by telephone, email or fax. Within three days, a written report shall be made on forms available from the Board and on line for this purpose;

(2) Change of ownership of the pharmacy, including the filing of a new application for licensure by the owner, corporate officer of partner;

(3) Change of address of the pharmacy, or if change of location, including the filing of a new application;

(4) In the event of bankruptcy or foreclosure, the official in charge shall obtain the services of a pharmacist to serve as acting pharmacist-manager;

(5) Permanent closing of the pharmacy; and

(6) Disasters, accidents and emergencies which may affect the strength, purity or labeling of drugs, medications, devices or other materials used in the diagnosis or the treatment of injury, illness and disease shall be immediately reported to the Board;

(j) Make or file any reports required by state or federal laws and rules;

(k) Respond to the Board of Pharmacy regarding any violations brought to his or her attention;

(l) Establish policies and procedures for maintaining the integrity and confidentiality of prescription information and patient health care information, or verifying the existence thereof and ensuring that all employees of the pharmacy read, sign, and comply with the established policies and procedures;

(m) Provide the Board with prior written notice of the installation or removal of automated pharmacy systems. The notice must include, but is not limited to:

(1) The name and address of the pharmacy;

(2) The name and location of the automated equipment; and

(3) The identification of the responsible pharmacist.

Section 6.4. Pharmacy Technicians, When Required.

The pharmacist-manager shall be assisted by a sufficient number of pharmacists and pharmacy technicians as may be required to competently and safely provide pharmacy services.

Section 6.5. Pharmacy Technician Training Manual.

The pharmacist-manager shall develop or adopt, implement, and maintain a pharmacy technician training manual for that pharmacy. The training manuals of the National Community Pharmacists' Association (NCPA) and National Association of Chain Drug Stores (NACDS), or others as approved by the Board may be used as guides.

Section 6.6. Implementing a Procedure for Drug Recalls.

The pharmacist-manager shall develop and implement a written procedure for proper management of drug recalls which may include, where appropriate, contacting patients to whom the recalled drug product(s) have been dispensed.

Section 6.7. Change of Pharmacist-Manager.

When a pharmacist-manager changes employment or responsibilities, he or she shall do the following:

(a) Within 5 days, the outgoing and incoming pharmacist-managers shall notify the Board, in writing, regarding his or her change in employment.

(b) The outgoing pharmacist-manager shall conduct a physical written inventory of all controlled drugs, explain any discrepancies in full, certify the inventory as true and correct, and retain a copy for his or her records.

(c) The inventory shall be certified as true and correct, by the incoming pharmacist-manager, and filed with the permanent records of the drug outlet.

(d) The inventory shall be signed by both the incoming and outgoing pharmacist-managers, and a copy submitted to the Board as an attachment to the forms provided.

(e) A new license, indicating the name of the new pharmacist-manager will be issued upon approval.

PART 7 RULES FOR OPERATION OF DRUG OUTLETS

Section 7.1. Forms of Ownership.

Retail drug outlets may be owned by a sole proprietor, partnership, corporation or professional corporation.

Shareholders of a professional corporation shall be considered individual pharmacists for disciplinary purposes.

Section 7.2. Application and Procedure for Opening a Retail Drug Outlet.

Applicants shall use the standard form available from the Office or via the website. Completed applications shall include:

(a) The Office application form, completed in full and signed by an owner, corporate officer or partner;

(b) A scale drawing of the outlet, indicating space utilization and security arrangements in detail, and showing in detail the patient counseling area, attached to the application;

(d) A list of all stockholders of a parent corporation owning five percent or more of the corporation's assets;

(e) Affirmation by the sole proprietor, or all partners, or corporate officers and directors, and the pharmacist-manager, that they have not been convicted of, and are not under indictment for, any felony or misdemeanor arising from the violation of any drug or pharmacy related law; and,

(f) If the applicant is a corporation:

(1) A copy of the corporate charter; and

(2) If non-publicly traded, a list of all stockholders owning five percent or more of the corporation's assets.

(g) The approximate date of completion, if a new drug outlet.

Section 7.3. Inspection before Licensure.

(a) A Board representative shall make an on-site inspection within 20 days of a request for inspection. The pharmacist-manager must be present for this inspection.

(b) If deficiencies are found:

(1) The Board representative shall send written notification to the applicant and the Board, noting all unremedied deficiencies.

(2) If the Board receives evidence of correction of the deficiencies, or upon order of the Board, an on-site inspection shall be made by a Board representative within 30 days. If an unremedied deficiency remains after a re-inspection, the procedures outlined in this rule shall apply. A denial of licensure based on an unsatisfactory inspection may be appealed as provided by 3 V.S.A. § 129(e).

Section 7.4. Successful Inspection, License Issued, Time of Opening.

(a) If there are no deficiencies, or deficiencies noted above have been corrected, a license shall be issued.

(b) The pharmacy may not open until it has provided the Board:

(1) confirmation of the its DEA license; and

(2) confirmation of an adequate supply of drugs.

Section 7.5. Pharmacist-Manager Required.

No pharmacy shall be operated without a designated pharmacist-manager approved by the Board. The pharmacistmanager of a pharmacy shall be designated in the application of the pharmacy for license, and in each renewal thereof. Requirements for pharmacist-managers and their responsibilities are set forth in Part 6 of these rules. Additional pharmacist-manager duties are specified elsewhere in these rules.

Section 7.6. Opening Date Notice Required.

The applicant shall give at least 10 days' notice to the Board prior to opening for public business.

Section 7.7. Changes in Corporation.

A non-publicly traded corporation shall immediately notify the Office, in writing, of any changes in officers, or stockholders owning five percent or more of the corporation.

Section 7.8. Change or Transfer of Ownership.

Business may continue uninterrupted when ownership of the retail drug outlet is changed or transferred to an individual or entity required to be listed as an owner in an application for initial licensure if the new owner:

(a) Notifies the Board within 48 hours after the transfer;

(b) Submits a completed application within 15 business days after the transfer;

(d) States the date of transfer on the application.

Section 7.9. Change of Mailing Address or Location.

(a) The licensee shall submit immediate written notification of any change in mailing address of a drug outlet.

(b) A licensee shall notify the Board within 48 hours after changing the location of a drug outlet, and shall not open for business in the new location until after successful completion of an inspection.

(c) In order to continue business without interruption, the licensee shall, at least 60 days prior to a change in location of a drug outlet, submit an application for a new license. All equipment and library materials approved for use in the new location must be transferred prior to opening for public business.

Section 7.10. Renovations.

Before reopening for business after remodeling or relocation which affects the security of a pharmacy, the drug outlet must successfully complete an inspection. In order to continue business, the licensee shall notify the Board 60 days prior to the changes, submitting a scale drawing of the outlet, indicating space utilization and security arrangements in detail. The pharmacist-manager shall notify the Board in writing when renovations are completed.

Section 7.11. Natural Disaster, Fire, or Other Catastrophe.

(a) Upon written request after a natural disaster or fire, the Board may issue an immediate 60 day emergency license for operation of the drug outlet at a new location.

(b) A Board representative shall conduct an on-site inspection at the proposed location. The Board shall issue the emergency license if security conditions are satisfactory.

(c) No equipment, supplies, or drug inventory from the old location shall be used in the new location without Board approval.

(d) Upon application, prior to the expiration of the emergency license, the Board may continue the emergency license up to a period of two years from the original date of the emergency license.

Section 7.12. Death of Owner.

(a) Following death of a sole proprietor or partner, the Board may issue a temporary license only if the legally appointed representative of the decedent's estate has named a licensed pharmacist-manager to operate the drug outlet.

(b) The temporary license shall be effective until:

(1) The drug outlet has been properly reorganized; or

(2) Ownership has been transferred; or

(3) The drug outlet has been closed; or

(4) One year has elapsed since death of the owner.

PART 8 DRUG OUTLET CLOSURE

Section 8.1. Voluntary Surrender of Drug Outlet License.

The Board may accept a license to operate a drug outlet that has been surrendered voluntarily, if:

(a) The licensee submits, in writing, a signed statement setting forth the reasons the license is being surrendered; and

(b) All prescription legend drugs are properly disposed of under these rules; and

Section 8.2. Termination of License to Operate a Drug Outlet.

Unless a temporary license has been applied for within 5 business days of the following, a license to operate a drug outlet is immediately terminated:

(a) If a sole proprietorship: death of owner, change of location, change in ownership, or change in business name.

(b) If a partnership: death of a partner, change of location, change in partners or other change in ownership, change in business name, or other factors as provided in statutes governing partnerships.

(d) Failure to register a change in pharmacist-manager.

Section 8.3. Drug Outlet Closing.

If the closing of a drug outlet is not planned, the licensee shall notify the Board of the closing within 48 hours. The licensee shall notify the general public of the intent of the licensee and the future location of prescription files by advertising in a newspaper with a general circulation in the area served, and by posting signs in a conspicuous place at or near the drug outlet.

(a) The licensee shall arrange for a responsible agent to maintain all prescription drug outlet records for three years from the date the outlet is closed.

(b) If the closing of a drug outlet is planned, the licensee shall, at least 15 days prior to the closing, send the Board written notification of the following:

(1) The date the outlet will close for public business;

(2) The name(s) and address(es) of the person(s) with custody of prescription, bulk compounding, repackaging, and controlled drug inventory records;

(3) The names and addresses of all persons who will acquire legend drugs when the drug outlet closes.

(1) The licensee voluntarily surrendered the license to operate a drug outlet;

(2) All legend drugs were transferred to another authorized drug outlet, or returned to wholesalers or manufacturers, or destroyed, and the name(s) and address(es) of the drug outlet(s) receiving the legend drugs;

(3) All labels and blank prescription pads were destroyed;

(4) All signs indicating the presence of a drug outlet were removed; and

(5) Confirmation that the DEA registration and all unused DEA 222 forms were returned to the DEA.

(d) The licensee shall, at least 30 business days in advance, notify the general public of the date of closing and the future location of prescription files, in the following manner:

(1) Advertise in a newspaper with a general circulation in the area served; and

(2) Post signs in a conspicuous place in the drug outlet.

PART 9 STANDARDS FOR PHARMACIES

Section 9.1. Facility.

Minimum requirements for a pharmacy:

(a) No pharmacy may operate without a designated pharmacist-manager.

(b) Each dispensing pharmacy shall be of sufficient size (minimum of 200 square feet) to allow for the safe and proper storage of prescription drugs and for the safe and proper compounding and preparation of prescription drug orders.

(c) If the store is open at times when the prescription department is closed, the prescription area must be permanently enclosed by a partition or Board-approved barrier device at least nine feet six inches in height, except where the ceiling is less than nine feet six inches, in which case the partition or Board-approved barrier device shall be from floor to ceiling.

(d) The prescription department must contain no less than 12 feet of counter space two feet in width. If two or more pharmacists are on duty at the same time, the counter shall be four feet longer for each additional pharmacist. The prescription counter shall be kept free of any items not being used in the practice of pharmacy. No television monitors shall be located in the prescription department, and no such equipment shall be placed to as to distract the pharmacist from the practice of pharmacy. The aisle space behind the prescription counter shall be wide enough to allow free movement and shall be kept free of obstructions. The prescription department shall have a sink of appropriate size, exclusive of drain board area, necessary to fulfill the needs of the pharmacy. The sink shall be connected to hot and cold running water, shall have a working drain, and shall be convenient to the compounding area for the purpose of hand scrubs prior to compounding.

(e) Each pharmacy shall provide internet access as needed for compliance with the prescription monitoring system.

Section 9.2. Counseling Area Required.

Each pharmacy providing outpatient prescriptions directly to the public or employees, shall maintain an area designated for the provision of patient counseling services. This area shall be designed to provide reasonable privacy.

Section 9.3. 24 Hour Access.

The pharmacist-manager, or a pharmacist designated by him or her, shall have 24 hours access to the pharmacy department.

Section 9.4. Signs and Names.

(a) The only name(s) used to identify the drug outlet at the site or in advertisements shall be the name(s) registered with the Board.

(b) The drug outlet shall display pharmacy business hours and the name of the pharmacist on duty in a conspicuous manner visible to the public.

(c) Use of words "drugs," "medicines," "drugstore," "pharmacy," or similar term or combination of terms shall be restricted to the area registered by the Board. Nothing in this restriction shall prevent the placement of signs on the outside of the establishment, indicating the presence of a drug outlet inside.

Section 9.5. Display of Licenses.

(a) The drug outlet's current license shall be displayed in a conspicuous manner visible to the public.

(b) All pharmacists, pharmacy interns, and pharmacy technicians shall display their current licenses or registrations in a conspicuous manner visible to the public.

(c) Pharmacists employed in more than one drug outlet may elect to have their current license displayed at either drug outlet. The wallet portion of the license must be available for examination by any consumer, Board inspector, or law enforcement officer upon demand.

Section 9.6. Name Tags and Identification.

(a) A pharmacist shall wear a name tag bearing in a clearly legible font the individual's name and title "Pharmacist."

(b) No pharmacist may verbally or by other means, identify his or her self as a "doctor" unless he or she possesses a doctoral level degree in pharmacy from an accredited school of pharmacy and clarifies that he or she is not a medical doctor.

Section 9.7. Security.

(a) Each pharmacist, while on duty, shall be responsible for the security of the pharmacy, including provisions for effective control against theft or diversion of drugs or devices.

(b) The pharmacy shall be secured by a physical barrier with suitable locks and an electronic barrier to detect entry and report the entry to appropriate persons at a time when the pharmacy is not open. The prescription department shall be secure from access by unauthorized personnel at all times. Only support personnel directly involved in the prescription dispensing process, non-pharmacist management, maintenance personnel, law enforcement personnel, or emergency services personnel shall be allowed entry into the prescription department only with the consent of the pharmacist who is present in the pharmacy.

(c) Prescription and other patient health care information shall be secure from access by the public, and the information shall be kept confidential. Prescriptions, orders, records, and stocks of regulated drugs shall be open for inspection to authorized agents of the Board ( 18 V.S.A. § 4211). A person who gives information to specifically authorized agents of the Board concerning the use of regulated drugs, or the misuse by other persons or regulated drugs, shall not be subject to any civil, criminal or administrative liability or penalty for giving such information ( 18 V.S.A. § 4218(c)).

Section 9.8. Hygiene Standards.

The drug outlet shall:

(a) comply with all federal, state, and local health laws;

(b) have walls, ceilings, windows, and floors kept clean and in good repair;

(d) have equipment kept clean and stored in an orderly manner;

(e) be well lighted;

(f) be dry and well ventilated;

(g) have adequate restroom facilities for employees.

Section 9.9. Drugs and Devices, Definitions.

(a) Adulterated: means consisting, in whole or in part, of any filthy, putrid, decomposed substance; or does not meet FDA standards.

(b) Misbranded: means outdated, or label is false or misleading, or does not meet FDA standards.

Section 9.10. Drugs Removed from Inventory.

Any drug or device that is misbranded, adulterated, or expired shall not be sold or given away and shall be removed from inventory and stored for no more than one year from the date of expiration in a separate location within the prescription drug area until processed for return or destruction.

Section 9.11. Recalled Drugs.

There shall be a system to monitor drug recalls and, where appropriate, to notify patients to whom the recalled drug products have been dispensed.

Section 9.12. Disposal of Controlled and Non-Controlled Substances.

The Board accepts Drug Enforcement Administration (DEA) approved reverse distribution organizations. A list may be obtained by contacting the Diversion Unit at the regional DEA office in Boston, Massachusetts. Telephone 888-2725174; fax 617-557-2126. The DEA list is compiled from applications for registration and is amended periodically.

Section 9.13. Drug Storage Areas.

All areas where drugs and devices are stored shall be dry, well-lighted, well-ventilated, and maintained in a clean and orderly condition. Storage areas shall be maintained at temperatures which will ensure the integrity of the drugs prior to their dispensing as stipulated by the USP or the manufacturer's or distributor's labeling unless otherwise indicated by the Board.

Section 9.14. Equipment.

The pharmacy shall carry and utilize the equipment and supplies necessary to conduct a pharmacy in a manner that is in the best interest of the patients served and comply with all state and federal laws. The pharmacy must have at a minimum the following equipment:

(a) A refrigerator with a temperature control and thermometer;

(1) The refrigerator shall have a thermometer and maintain temperature between 36 degrees F and 46 degrees F (+2 to + 8 Celsius). Unless electronically monitored on a continual basis, a logged compliance check at least monthly is required.

(2) Non- pharmacy related items may not be stored in the pharmacy refrigerator intended for medications.

(b) If the facility carries drugs which require storage in a freezer: the freezer temperature must be maintained at or below minus 15 degrees Celsius;

(d) An automated data processing system;

(e) At least one telephone in the prescription area, with the same number as the telephone number printed on the drug outlet prescription labels;

(f) A tablet and capsule counting tray;

(g) Containers which meet official compendia standards, available with closures that meet Federal Poison Prevention Packaging Act of 1970 requirements, as well as regular closures;

(h) Prescription labels imprinted or computer-generated with the name, address, and telephone number of the drug outlet that do not contain any symbol or background logo that interferes with the reading and interpretation of any information written by the pharmacist on the label;

(i) Auxiliary labels;

(j) equipment and supplies sufficient for the scope of practice; If needed for compounding: One class A prescription balance with metric weights from 10 milligrams to 50 grams or automatic sensitivity requirement of six mg. with no load, or an electronic balance.

(k) Any drug outlet involved in the preparation of sterile pharmaceutical products must meet the requirements of the Sterile Pharmaceuticals rules.

Section 9.15. Reference Library.

Each pharmacy shall maintain on file at least one reference in each of the categories listed below. Computerized, online versions are acceptable instead of a hard copy of the current manual only if made known and accessible to every pharmacist at the pharmacy. Whether in hard copy or computerized, this reference work must be complete and must include an explanation of drug interactions, either in the form of a manual or otherwise:

(a) State and federal drug laws relating to the practice of pharmacy, including a current copy of these statutes and rules, and the legal distribution of drugs and any rules or regulations adopted pursuant thereto;

(b) Current manual of drug interactions equivalent to Hansten's or Drug Facts, with quarterly updates, which has been pre-approved by the Board.

(d) Current reference on pediatric dosages;

(e) Pharmacies offering for sale herbal or alternative medicines, must possess a current reference for such; computerized version or hard copy.

Section 9.16. Inspection of Drug Outlets.

(a) Biennially, a Board member, a representative appointed by the Board, or an employee of or contractor with the Office of Professional Regulation, shall inspect a drug outlet in Vermont during regular business hours, for compliance with these rules. Deficiencies shall be handled in the manner set forth in Rule 7.2(i).

(b) The Board shall not authorize any inspection that extends to financial data, sales data other than shipping data or pricing data of the drug outlet.

Section 9.17. Persons Authorized to Prescribe.

Pharmacists may accept prescription legend drug orders from authorized practitioners within the United States and Canada. At the time these rules are adopted, authorized prescribers include:

(a) Dentist;

(b) Naturopathic physician, as authorized by law;

(d) Optometrist;

(e) Osteopath;

(f) Physician;

(g) Physician's assistant, as authorized by law;

(h) Podiatrist;

(i) Scientific investigator;

(j) Veterinarian;

(k) Certified Nurse Midwife as permitted by law; and

(l) Others as permitted by Vermont and federal law.

Section 9.18. Prescription Pick-Up and Delivery.

(a) A licensee may, upon request by the patient, accept or deliver a drug or device to the patient or licensed facility in which patient resides. Upon a showing of special circumstances, the Board may approve delivery to and pick up from a secure site in a medical facility under conditions set by the Board.

(b) The licensee may delegate the pick-up and delivery of prescription drugs and devices to an employee of the drug outlet, or the U.S. mail, or a common carrier. The drug or device shall be properly labeled as a finished dispensed prescription product.

Section 9.19. Advertising Prescription Drugs.

Prescription legend drug and device advertising shall be truthful, reasonable, informative, and understandable to the consumer. Advertisements for drugs at special prices for a limited time must state the termination date of the special price, and that prices may change after that date.

Section 9.20. Sale of Prescription Legend Drugs.

(a) Legend drugs may be sold or transferred to a licensed pharmacist, or practitioner qualified to prescribe, or drug outlet, or drug outlet owner, or manufacturer, wholesaler, or distributor of such drugs.

(b) The transaction shall be recorded on a written invoice or appropriate form and kept in the drug outlet. See, 26 V.S.A. §§ 2067 - 2076 (wholesale drug distributors) for requirements relating to wholesalers and 26 V.S.A. § 2022(16) for the definition of "wholesale distribution."

(c) The invoice shall contain the name, strength, form, and quantity of the drug, the date of sale, and the name and address of the seller and purchaser.

(d) If the product is a controlled substance, the invoice shall also include the DEA registration number of both the purchaser and seller. If the product is a Schedule II controlled substance and is sold or transferred, the purchaser or transferee must give a DEA 222 or its successor form to the supplier before the transfer/sale can proceed.

(e) Receipt, dispensing, and distribution records. Except as provided in this sub rule, a coordinating pharmacy shall maintain a record of all drugs received, dispensed, and distributed from the coordinating pharmacy and from each remote dispensing site.

Section 9.21. Pharmacist Meal/Rest Breaks.

(a) Whenever the prescription department is staffed by a single pharmacist, the pharmacist may take a meal/rest break for a period of up to 30 minutes without closing the pharmacy and removing support personnel from the pharmacy, provided that the pharmacist reasonably believes that the security of the prescription drugs will be maintained in the pharmacist's absence.

(b) No pharmacist shall work more than 8 hours without a meal/rest break. Breaks should be scheduled as close as possible to the same time each day, so that patients may become familiar with the approximate time of the breaks

(c) The pharmacist shall remain on the premises of the drug outlet during the meal/rest break and shall be available for emergencies.

(d) If two or more pharmacists are on duty in the prescription department, the pharmacists shall stagger their meal/rest breaks so that the prescription department is not left without a pharmacist on duty.

(e) Whenever the pharmacist temporarily leaves the prescription department for a meal/rest break, a sign indicating that there is no pharmacist on duty shall be conspicuously displayed.. The sign shall also indicate the time when the pharmacist will return.

(f) Only support personnel directly involved in the prescription dispensing process and authorized by the pharmacist on duty may remain in the prescription department while the pharmacist is on a meal/rest break.

(g) When the pharmacist is temporarily absent from the prescription department, support personnel authorized by the pharmacist on duty may continue to perform non-discretionary duties as delineated by the pharmacist. All such duties performed by support personnel shall be reviewed by the pharmacist upon return from the meal/rest break.

(h) When a pharmacist is not in the prescription department, there shall be no dispensing of new prescriptions that the pharmacist has checked and that are waiting to be picked up, nor shall counseling be provided by support personnel.

(i) New, written prescriptions presented by the patient or the patient's agent may be accepted by support personnel. The processing of such prescriptions, up to the final check, may occur in the absence of the pharmacist. However, no prescription may be dispensed until the final check is completed by the pharmacist after return to the prescription department.

(j) New prescriptions conveyed by telephone shall not be accepted by support personnel. The caller should be instructed to call back, or a telephone number should be obtained for the pharmacist to call upon return to the prescription department.

(k) During the pharmacist's absence, prescription refills which have been previously prepared and checked by a pharmacist may be picked up by the patient or the patient's agent. Support personnel must offer the patient counseling by the pharmacist. If the patient has no questions, dispensing may proceed as usual, with the patient signing for the counseling refusal. If the patient desires counseling, the patient should be asked to wait for the pharmacist to return from the meal/rest break. Alternatively, the patient may be asked to leave a telephone number for the pharmacist to call later the same day.

(l) Telephone refill orders and refill requests presented in person by the patient or the patient's agent may be accepted by support personnel. Such refill orders may be processed by support personnel up to the final check. However, no such refill orders shall be dispensed until the final check is completed by the pharmacist after return from the meal/rest break.

(m) Under this rule, the pharmacist-manager remains responsible for the direct management, supervision, and control of the prescription department.

(n) If, for security reasons or otherwise, the pharmacist determines that the prescription department should close during the pharmacist's absence, the pharmacist shall close the prescription department and remove all support personnel from the prescription department during the pharmacist's absence. A sign informing the public of the pharmacist's temporary absence and time of return shall be conspicuously posted.

(o) Using this rule as a guide, the pharmacist-manager, in conjunction with the pharmacy license holder, should develop written policies and procedures regarding operation of the prescription department while the pharmacist is temporarily absent on a meal/rest break.

(1) The policies and procedures should include authorized duties of support personnel and should define the pharmacist's responsibilities for checking all work performed by support personnel and for maintaining security of the prescription department. The pharmacist-manager should review the policies and procedures with support personnel.

(2) After review, each support person should be requested to initial the policies and procedures to indicate that the policies and procedures are understood.

PART 10 PHARMACY PRACTICE

Section 10.1. Prescription Drug Orders.

A Prescription drug order shall contain the following information at a minimum:

(a) Full name and street address of the patient (which may appear on the back of the prescription drug order);

(b) Name, address, facility or practice name where applicable, and telephone number, and, if a controlled substance, address and DEA registration number of the prescribing practitioner;

(d) Name, strength, dosage form, quantity or stop date, and route of administration of drug prescribed;

(e) Directions for use by patient;

(f) Number of authorized refills or specified time limit; if number of refills or time limit is not specified, prescription is non-refillable; and

(g) If a manually written prescription drug order, the prescribing practitioner's handwritten signature.

Section 10.2. Legitimate Prescriptions.

A prescription or drug order for a legend drug is not valid unless it is issued for a legitimate medical purpose arising from a prescriber-patient relationship which includes a documented patient evaluation adequate to establish diagnoses and identify underlying conditions and/or contraindications to the treatment. Treatment, including issuing a prescription or drug order, based solely on an online questionnaire or consultation outside of an ongoing clinical relationship does not constitute a legitimate medical purpose.

Section 10.3. End of Prescriber's Practice.

If a practitioner as defined in 26 V.S.A. § 2022(15) ceases to practice for any reason, a pharmacist may, pursuant to a prescription written by that practitioner, dispense all remaining refills up to a 90-day supply of the drug prescribed, to enable the patient to obtain the services of another practitioner.

Section 10.4. Allowed Forms of Prescription Drug Orders.

Prescription drug orders must be communicated directly to a pharmacist. This may be accomplished in one of the following ways.

(a) A prescription drug order, including that for a controlled substance listed in Schedules II through V, may be communicated in written, oral, or electronic form.

(b) A prescription drug order, including that for a controlled substance listed in Schedules III through V, and, in certain situations, that for a controlled substance listed in Schedule II, may be communicated orally (including telephone voice communication) or by way of electronic transmission as permitted by federal law provided the vendor of the software meets the requirements set forth by the DEA for authentication.

Section 10.5. Tamper Resistant Prescription Forms.

(a) Prescriptions shall be written so as to:

(1) prevent unauthorized copying of a completed or blank prescription form,

(2) prevent erasure or modification of information written on the prescription by the prescriber; and

(3) prevent the use of counterfeit prescription forms.

(b) Handwritten prescriptions must be written on a tamper resistant pad.

(c) Computer generated printed prescriptions must be printed on tamper resistant paper or other tamper proof methods as defined by the Centers for Medicaid and Medicare Services, including micro-printing and/or printing a "void" pantograph accompanied by a reverse "Rx," which causes a word such as "Void," "Illegal," or "Copy" to appear when the prescription is photocopied.

(d) Prescriptions written which comply with Medicaid rules will satisfy this rule.

(e) Prescription form features which will satisfy this rule could, for example, include the following properties:

(1) a colored background with a watermark;

(2) when photocopied read "void" in the background;

(3) have printed on the form the name of the prescriber or hospital identification and batch numbering with serially numbered pages for prescriptions;

Section 10.6. Loss of Prescription Pads or Forms.

Loss of any prescription pads or forms should be immediately reported to local law enforcement officials and the Board of Pharmacy.

Section 10.7. Prescriptions Not Hand Written.

If communicated orally or by way of electronic transmission, the prescription drug order shall be immediately reduced to a form by the pharmacist that shall be maintained for the time required by laws or rules.

Section 10.8. Schedule II Prescriptions.

(a) Except as provided below, a prescription drug order for a Schedule II controlled substance may be communicated in written form or electronically prescribed, provided the prescriber has proper software as certified by the DEA for this purpose. The electronic prescription order shall be maintained in accordance with the section below on patient records.

(b) A prescription drug order for a Schedule II controlled substance may be communicated by the practitioner by facsimile, provided the original written, signed prescription drug order is presented to the pharmacist for review prior to the actual dispensing of the controlled substance, except as noted in sub-sections or (c), (d) or (e) below in this section. The original, written prescription drug order shall be maintained in accordance with the section below on patient records.

(c) A prescription drug order for a Schedule II narcotic substance to be compounded for the direct administration to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion may be communicated by the practitioner or the practitioner's agent to a home infusion pharmacy by way of electronic transmission if permitted by federal law.

(d) A prescription drug order for a Schedule II controlled substance for a resident of a long term care facility may be communicated by the practitioner or the practitioner's agent by way of electronic transmission if permitted by federal law.

(e) A prescription drug order for a Schedule II narcotic substance for a resident under hospice care, no matter where provided, may be communicated by the practitioner or the practitioner's agent by way of electronic transmission as provided by federal law. The practitioner or the practitioner's agent must note on the prescription that the patient is a hospice patient.

(f) In an emergency situation, a prescription drug order for a Schedule II controlled substance may be communicated by the practitioner orally, provided that:

(1) The quantity prescribed and dispensed is limited to the amount adequate to treat the patient during the emergency period (dispensing beyond the emergency period must be pursuant to a written prescription drug order signed by the prescribing practitioner);

(2) The orally communicated prescription drug order shall be immediately reduced to writing by the pharmacist, and shall contain the information required in Rule 9.1 above on prescription drug orders;

(3) If the prescribing practitioner is not known to the pharmacist, he or she must make a reasonable effort to determine that the oral authorization came from a legal practitioner, which may include a callback to the practitioner using the practitioner's phone number as listed in the telephone directory or other good faith efforts to insure the practitioner's identity; and

(4) Within 7 days after authorizing an emergency oral prescription drug order, the prescribing practitioner shall cause a written prescription drug order for the emergency quantity prescribed to be delivered to the dispensing pharmacist. In addition to conforming to the requirements of the sub-section above on prescription drug orders, the prescription drug order shall have written on its face "Authorization for Emergency Dispensing," and the date of the orally or electronically transmitted prescription drug order. The written prescription drug order may be delivered to the pharmacist in person or by mail, but if delivered by mail, it must be postmarked within the 7 day period. Upon receipt, the dispensing pharmacist shall attach this written prescription drug order to the emergency oral prescription drug order which had earlier been reduced to writing or to the hard copy of the electronically transmitted prescription drug order. The pharmacist shall notify the nearest office of the U.S. Drug Enforcement Administration if the prescribing practitioner fails to deliver a written prescription drug order.

Section 10.9. Electronic Transmission.

All prescription drug orders communicated by way of electronic transmission shall:

(a) Be transmitted directly to a pharmacist in a licensed pharmacy of the patient's choice with no intervening person having access to the prescription drug order. This does not apply to the electronic transmission intermediary.

(b) Provide the transmitter's phone number for verbal confirmation, the time and date of transmission, and the identity of the pharmacy intended to receive the transmission, as well as any other information required by federal or state law;

(d) Be deemed the original prescription drug order, provided it meets the requirements of Rule 10.1 herein.

Section 10.10. Authorized Agents for Oral Transmission.

Designated employees of practitioners qualified to prescribe drugs may transmit an order for a prescription via telephone. The practitioner shall be responsible for record keeping and the accuracy of the prescription information. Any new prescription drug order being transmitted by a practitioner or his or her agent by telephone and the identity of the person calling in the prescription must be received and documented by a pharmacist or sufficiently trained pharmacy intern.

Section 10.11. Electronic Signatures Required.

An electronic prescription transmission to a pharmacist in a licensed pharmacy requires the electronic signature of the prescriber.

Section 10.12. No Carbon or Duplicate Prescriptions.

Carbon or duplicate written prescriptions are not valid prescriptions. A written prescription must bear the original signature of the prescriber, not a copy or photo copy or stamp of the signature of the prescriber.

Section 10.13. Use of Independent Professional Judgment.

The pharmacist shall exercise professional judgment regarding the accuracy, validity, and authenticity of the prescription drug order communicated by way of electronic transmission consistent with existing federal or state laws and rules.

Section 10.14. Security of Electronic Equipment.

All electronic equipment for receipt of prescription drug orders communicated by way of electronic transmission shall be maintained in the pharmacy area so as to ensure against unauthorized access or observation.

Section 10.15. Unauthorized Access.

Persons other than pharmacists, pharmacy technicians, pharmacy interns and others specifically authorized by law shall have no access to pharmacy records containing confidential information or personally identifiable information concerning the pharmacy's patients.

Section 10.16. Filling Time Limits, Future Fill Dates.

(a) No prescription for a Schedule II controlled substance written without a future fill date may be filled more than 30 days after the date the prescription was issued.

(b) An individual practitioner may issue multiple prescriptions authorizing the patient to receive a total of up to a 90-day supply of a Schedule II controlled substance. Each prescription must contain both the original date of issue and the future fill date. For guidance, refer to regulations implementing the federal Controlled Substances Act.

(c) No prescription for a Schedule II controlled substance written to be filled at a future date may be filled more than 90 days after the date the prescription was issued.

Section 10.17. One Year Limit.

No prescription for a non-controlled drug may be filled or refilled more than one year after the prescription was written.

Section 10.18. Transfer of a Prescription Drug Order.

(a) Pharmacies utilizing automated data processing systems shall satisfy all information requirements of a manual mode for prescription drug order transferal, except as noted in subsection (d) below. The transfer of original prescription drug order information for the purpose of refill dispensing is permissible between pharmacies subject to the following requirements:

(1) The information is communicated directly between two pharmacists and the transferring pharmacist records the following information:

(A) Write the word "Transferred" on the face of the invalidated prescription drug order;

(B) Record on the reverse side of the invalidated prescription drug order the name and address of the pharmacy to which it was transferred and the name of the pharmacist receiving the prescription drug order;

(D) A computerized prescription record which contains all of the elements of (A), (B), and (C) above is acceptable.

(b) The pharmacist receiving the transferred prescription drug order information shall reduce to writing the following:

(1) Write the word "TRANSFER" on the face of the transferred prescription drug order;

(2) Provide all information required to be on a prescription drug order pursuant to state and federal laws and rules, and include:

(A) Date of issuance of original prescription drug order;

(B) Original number of refills authorized on original prescription drug order;

(D) Number of valid refills remaining and date of last refill;

(E) Pharmacy's name, address, telephone number, and original prescription number from which the prescription drug order information was transferred; and

(F) First and last name of transferring pharmacist.

(G) A computerized prescription record which contains all of the elements of (A) through (F) above is acceptable.

(3) Systems providing for the electronic transfer of information shall not infringe on a patient's freedom of choice as to the provider of pharmaceutical care.

(c) Both the original and transferred prescription drug order shall be maintained for a period of three (3) years from the date of last refill.

(d) Pharmacies accessing a common electronic file or database used to maintain required dispensing information are not required to transfer prescription drug orders or information for dispensing purposes between or among pharmacies participating in the same common prescription file, provided, however, that any such common file shall contain complete records of each prescription drug order and refill dispensed, and, further, that a hard copy record of each prescription drug order transferred or accessed for purposes of refilling shall be generated and maintained at the pharmacy refilling the prescription drug order or to which the prescription drug order is transferred. A hard copy is not necessary as long as the electronic information is readily available and hard copies can be generated immediately upon request.

(e) Pharmacies with automated systems that are unable to meet the transfer requirements of this section may transfer prescriptions and document such transfers using a manual method.

(f) A pharmacist may transfer an unfilled prescription order to another pharmacy.

Section 10.19. Drug Product Selection by the Pharmacist.

(a) When a pharmacist receives a prescription for a drug which is listed either by generic name or brand name in the U.S. Department of Health and Human Services publication Approved Drug Products With Therapeutic Equivalence Evaluations (the "Orange Book"), the pharmacist shall select the lowest priced drug from the list which in his or her professional judgment is an generically equivalent drug product and which he or she has in stock, unless otherwise instructed by the purchaser or prescriber.

(b) The purchaser shall be informed by the pharmacist or his or her representative that an alternative selection as provided under subsection (a) of this section will be made unless the purchaser chooses to refuse the substitution.

(c) Any pharmacist substituting a generically equivalent drug shall charge no more than the usual and customary retail price for that selected drug. This charge shall not exceed the usual and customary retail price for the prescribed brand.

(d) If the prescriber does not wish substitution to take place, he or she shall clearly indicate "brand necessary" or "no substitution" on the prescription. In the case of an unwritten prescription, there shall be no substitution if the prescriber expressly indicates to the pharmacist that the brand name drug is necessary and substitution is not allowed. Pharmacists are advised to monitor changes to 18 V.S.A. §§ 4605 and 4606.

Section 10.20. Hospital/Health Care Facility Labeling Requirements.

All drugs dispensed for use by inpatients of a hospital or other health care or institutional facility, where the drug is not in the possession of the ultimate user prior to administration, shall meet the following requirements:

(a) The label of a single-unit package of an individual-dose or unit-dose system of packaging of drugs shall include:

(1) The non-proprietary or proprietary name of the drug;

(2) The route of administration, if other than oral;

(3) The strength and volume, where appropriate, expressed in the metric system whenever possible;

(4) The control number and expiration date;

(5) Identification of the re-packager by name or by license number shall be clearly distinguishable from the rest of the label; and

(6) Special storage conditions, if required.

(b) When a multiple-dose drug distribution system exceeding a 24 hour supply is utilized, including dispensing of single unit packages, the drugs shall be dispensed in a container to which is affixed a label containing the following information:

(1) Identification of the dispensing pharmacy;

(2) The patient's name;

(3) The date of dispensing;

(4) The non-proprietary or proprietary name of the drug dispensed; and

(5) The strength, expressed in the metric system whenever possible.

(d) Whenever any drugs are added to parenteral solutions, such admixtures shall bear a distinctive label indicating:

(1) Name of solution, lot number, and volume of solution;

(2) Patient's name;

(3) Infusion rate;

(4) Bottle sequence number or other system control number;

(5) Name and quantity of each additive;

(6) Date of preparation;

(7) Beyond-use date and time of parenteral admixture; and

(8) Ancillary precaution labels.

Section 10.21. Pharmacy Dispensed Drugs: Labels.

All drugs, except those dispensed under Rule 10.20 above shall be dispensed in a container whose label shall include:

(a) The name and address and telephone number of the pharmacy;

(b) The name of the patient, or, if the patient is an animal, the first and last name of the owner, name of animal, and species of animal;

(d) directions for use;

(e) The date of dispensing;

(f) Any cautions which may be required by federal or state law;

(g) The serial number of the prescription drug order;

(h) The name or initials of the dispensing pharmacist;

(i) The proprietary or generic name of the drug dispensed and its strength;

(j) The name of the manufacturer or distributor of the drug and;

(k) The expiration date of the drug, if it is less than one year from the date of dispensing.

See, 18 V.S.A. § 4064a(a)(2)(B).

Section 10.22. Centralized Prescription Processing.

(a) "Centralized prescription processing" means the processing by a pharmacy of a request from another pharmacy to fill or refill a prescription drug order or to perform processing functions such as dispensing, drug utilization review, claims adjudication, refill authorizations, and therapeutic interventions.

(b) A pharmacy may perform or outsource centralized prescription processing services provided the parties:

(1) have the same owner; or

(2) have a written contract outlining the services to be provided and the responsibilities and accountabilities of each party in fulfilling the terms of the contract in compliance with federal and state laws and regulations; and

(3) share a common electronic file or have appropriate technology to allow access to sufficient information necessary or required to fill or refill a prescription drug order.

(c) The parties performing or contracting for centralized prescription processing services shall maintain a policy and procedures manual and documentation that implementation is occurring in a manner that shall be made available to the Board for review upon request and that includes, but is not limited to, the following:

(1) a description of how the parties will comply with federal and state laws and regulations;

(2) the maintenance of appropriate records to identify the responsible pharmacist(s) in the dispensing and counseling process;

(3) the maintenance of a mechanism for tracking the prescription drug order during each step in the dispensing process;

(4) the maintenance of a mechanism to identify on the prescription label all pharmacies involved in dispensing the prescription drug order;

(5) the provision of adequate security to protect the confidentiality and integrity of patient information;

(6) the maintenance of a quality assurance program for pharmacy services designed to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, pursue opportunities to improve patient care, and resolve identified problems.

(d) Pharmacies using centralized processing shall post a notice to the public advising that:

(1) the pharmacy employs centralized processing;

(2) the pharmacist who dispenses a prescription to a patient may not be the pharmacist who prepared it, and;

(3) that upon request, the pharmacy shall provide a further explanation of how centralized processing works.

Section 10.23. Drugs Compounded in a Pharmacy.

Except for sections (c) and (e) below which do not apply to compounded drugs for veterinary clinic use, parenteral and sterile product prescriptions shall be compounded as follows: (See, Part 13 for requirements for Sterile Pharmaceuticals.)

(a) For all compounded prescriptions, the pharmacist shall be responsible for all compounding records and the proper maintenance, cleanliness and use of all equipment used in compounding.

(b) Every pharmacist who engages in non-sterile drug compounding shall be proficient, in the art of compounding and shall maintain that proficiency through participation in seminars, studying appropriate literature and/or becoming certified by a compounding certification program. Also, every pharmacist who engages in drug compounding must practice in accordance with NABP's Good Compounding Practices.

(c) A prescription shall be compounded and dispensed only pursuant to a specific order for an individual patient issued by a prescriber. A limited quantity may be compounded in anticipation of prescription drug orders based on routine, regularly observed prescribing patterns.

(d) A Pharmacist may not compound a drug that appears on the FDA List of Drugs Withdrawn or Removed from the Market for Safety Reasons or on the FDA List of Drug Products that Present Demonstrable Difficulties in Compounding.

(e) Pharmacists shall not offer compounded drug products to other State-licensed persons or commercial entities for subsequent resale, except in the course of professional practice for a practitioner to administer to an individual patient, in limited quantities.

(f) In addition to the requirements in Rules 10.20 and 10.21, the label of compounded prescriptions shall also contain an expiration or beyond-use date.

(g) Pharmacists shall maintain a compounding record that contains at least the following information:

(1) the name, strength, quantity, and dosage form of the drug product compounded;

(2) the formula to compound, including mixing instructions, all ingredients and their quantities, and any additional information needed to prepare the compound;

(3) the prescription number or assigned internal identification number;

(4) the date of preparation;

(5) the manufacturer and lot number of each ingredient;

(6) beyond-use date;

(7) the name of the person who prepared the compound; and

(8) the name of the pharmacist who approved the compound;

(h) These records must be kept for 3 years and shall be readily available for Board inspection.

Section 10.24. Radiopharmaceuticals.

No radiopharmaceutical may be dispensed unless a label is affixed to the immediate container bearing the following information:

(a) The standard radiation symbol;

(b) The words "Caution - Radioactive Material"; and

(d) The radionuclide and chemical form;

(e) The activity and date and time of assay;

(f) The volume, if in liquid form;

(g) The requested activity and the calibrated activity;

(h) Patient name or space for patient name.

(1) Where the patient's name is not available at the time of dispensing, a 72-hour exemption is allowed to obtain the name of the patient.

(2) No later than 72 hours after dispensing the radiopharmaceutical, the patient's name shall become a part of the prescription drug order to be retained for a period of three years;

(i) The name and address of the nuclear pharmacy;

(j) The name of the practitioner; and

(k) The lot number of the prescription.

Section 10.25. Patient Records.

A patient record system shall be maintained by all pharmacies for patients for whom prescription drug orders are dispensed. The patient record system shall provide for the immediate retrieval of information necessary for the dispensing pharmacist to identify previously dispensed drugs at the time a prescription drug order is presented for dispensing. The pharmacist shall make a reasonable effort to obtain, record, and maintain the following information:

(a) Full name of the patient for whom the drug is intended;

(b) Street address and telephone number of the patient;

(d) Patient's gender;

(e) A list of all prescription drug orders obtained by the patient at the pharmacy maintaining the patient record during the three years immediately preceding the most recent entry showing:

(1) the name of the drug;

(2) prescription number;

(3) name and strength of the drug;

(4) the quantity and date received; and

(5) the name of the prescriber.

(f) Pharmacist comments relevant to the individual's drug therapy, including any other information peculiar to the specific patient or drug.

Section 10.26. Allergy and Health Information.

The Pharmacist or certified pharmacy technician or intern shall make a reasonable effort to ascertain from the patient or the patient's representative the patient's known allergies, drug reactions, idiosyncrasies, chronic conditions, or disease states and current use of other drugs which may relate to prospective drug review. The information shall be recorded in the patient profile. It shall be updated periodically, but not less than once per year.

Section 10.27. Patient Records Retention.

A patient record shall be maintained for a period of not less than three years from the date of the last entry in the profile record. This record may be maintained either on paper or on electronic media.

Section 10.28. Records of Dispensing.

Records of dispensing for original and prescriptions for all drugs or devices are to be made and kept by pharmacies for three years. Records of dispensing for refill prescriptions may be kept in either hard copy or electronic format. Records of dispensing for new and/or refill prescriptions shall include, but not be limited to:

(a) Quantity dispensed for original and refills, if different from original;

(b) Date of dispensing;

(d) Identification of the pharmacist dispensing;

(e) Name and manufacturer of drug dispensed if drug product selection occurs and more than a 24-hour supply is dispensed; and

(f) Records of refills to date.

Section 10.29. Confidential Information.

Confidential information is to be handled in conformance with HIPAA federal regulations. Confidential information or personally identifiable information may be released to the patient or the patient's authorized representative, the prescriber or other licensed practitioner then caring for the patient, another licensed pharmacist, the Board or its representative, or any other person duly authorized by law to receive such information. Confidential information or personally identifiable information in the patient medication record may be released to others only on written release of the patient.

Section 10.30. Prospective Drug Review.

(a) A pharmacist shall review the patient record and each prescription drug order presented for dispensing for purposes of promoting therapeutic appropriateness by identifying:

(1) Over-utilization or under-utilization;

(2) Therapeutic duplication;

(3) Drug-disease contraindications;

(4) Drug-drug interactions (including serious interactions with non-prescriptive or over-the-counter drugs);

(5) Incorrect drug dosage or duration of drug treatment;

(6) Drug-allergy interactions; and

(7) Clinical abuse or misuse.

(b) Upon recognizing any of the above, the pharmacist shall take appropriate steps to avoid or resolve the problem which shall, if necessary, include consultation with the practitioner.

Section 10.31. Patient Counseling.

(a) Patient counseling is the effective oral consultation by the pharmacist, in the exercise of his or her professional judgment and consistent with state statutes and Board rules regarding confidential information, with the patient or caregiver, in order to improve therapy by ensuring the proper use of drugs and devices.

(b) Upon receipt of a new prescription drug order and following a review of the patient's record, a pharmacist, pharmacy technician, or pharmacy intern shall offer counseling with the pharmacist or pharmacy intern of matters which will enhance or optimize the patient's drug therapy. The discussion with the pharmacist or intern shall be in person, whenever practicable, or by telephone and shall include appropriate elements of patient counseling which may include the following:

(1) The name and description of the drug;

(2) The dosage form, dose, route of administration, and duration of drug therapy;

(3) Intended use of the drug and expected action;

(4) Special directions and precautions for preparation, administration, and use by the patient;

(5) Common severe side or adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance, and the action required if they occur;

(6) Techniques for self-monitoring drug therapy;

(7) Proper storage;

(8) Prescription refill information;

(9) Action to be taken in the event of a missed dose; and

(10) Pharmacist comments relevant to the individual's drug therapy..

(c) Alternative forms of patient information may be used to replace patient counseling when verbal face-to-face counseling is not possible. Alternative forms of patient information may be used to supplement patient counseling when appropriate. Examples include written information leaflets, pictogram labels, video programs, etc.

(d) Each pharmacy shall post a notice advising, "You have the right to confidential consultation with a pharmacist about your prescription. If you wish, a confidential consultation will be provided."

(e) Patient counseling, as described above and defined in these rules, shall not be required for inpatients of a hospital or institution where other licensed health care professionals are authorized to administer the drug(s).

(f) A pharmacist shall not be required to counsel a patient or caregiver when the patient or caregiver refuses such consultation and such refusal is documented.

Section 10.32. Adverse Drug Reactions.

Unless already reported by the patient to the practitioner, significant adverse drug reactions shall be reported by the pharmacist to the practitioner and, in either case, an appropriate entry on the patient's record shall also be made.

Section 10.33. Perpetual Inventory.

A perpetual inventory shall be maintained for at least two years for all Schedule II controlled substances. Electronic versions may be permitted if they provide a secure audit trail of entries.

Section 10.34. Schedule II Inventory.

All Schedule II controlled substances must be physically inventoried and documented at least once every thirty (30) days.

Section 10.35. Immunizations.

For patients 18 or older: A pharmacist or intern may administer a vaccine pursuant to a written protocol including emergency measures e.g., epinephrine and/or diphenhydramine based on a collaborative practice agreement or a patient-specific prescription from a licensed prescriber.

(a) A properly trained pharmacist or intern may administer vaccines to a patient 18 years of age or older.

(1) A pharmacist or intern must take an accredited training course on immunizations and keep proof of training on file in the pharmacy. The immunization course must, at a minimum, meet U.S. Center for Disease Control and Prevention (CDC) Guidelines and be accredited by the Accreditation Council for Pharmacist Education (ACPE) or AMA (American Medical Association) Category I approval or a similar health authority or professional body, and include preadministration education and screening, vaccine storage and handling, administration of medication, record-keeping, emergency response and reporting of adverse reactions.

(2) A pharmacist or intern must maintain current training in Basic Cardiac Life Support.

(b) In an emergency related to an immunization a pharmacist or intern may administer epinephrine and/or diphenhydramine without a practitioner's prescription.

(c) A pharmacist administering immunizations shall complete a minimum of two (2) hours of continuing education related to immunizations in each licensing period.

(d) Recording keeping and reporting requirements: Unless specifically required by federal or state law. a pharmacist shall maintain for ten (10) years the following documentation regarding each immunization administered:

(1) The name, address, and date of birth of the patient;

(2) Any known allergies;

(3) The date of administration and site of injection;

(4) The name, dose, manufacturer's lot number, and expiration date of the vaccine or, in an emergency, epinephrine or diphenhydramine;

(5) The name and address of the patient's primary health care provider;

(6) The name and address of the prescriber, if different from the patient's primary provider;

(7) The name of the pharmacist administering the immunization;

(8) A record of the pharmacist's consultation with the patient determining that the patient is eligible for immunization.

(e) The pharmacist shall provide:

(1) a notification to the patient's primary health care provider of the immunization administered; and,

(2) to comply with the 18 V.S.A. § 1129 's immunization registry, notice as required to the Vermont Department of Health.

Section 10.36. Independent Practice of Pharmacists.

A pharmacist may provide pharmacist care services outside of a licensed pharmacy if all the following conditions are met:

(a) the pharmacist has access to prescription records, patient profiles, or other relevant medical information for purposes of pharmacist care services and appropriately reviews such information before performing any such functions;

(b) access to the information described in paragraph (a) of this rule is secure from unauthorized access and use, and all access by pharmacists is documented; and

(c) a pharmacist providing pharmacist care services outside the premises of a licensed pharmacy shall maintain the records or other patient-specific information used in such activities in a readily retrievable form in a system that is secured and managed by the pharmacy with whom the pharmacist is providing such services or, if acting independent of a pharmacy, a secure system maintained by the pharmacist. Such records or information shall:

(1) provide accountability and an audit trail;

(2) be provided to the Board upon request; and

(3) be preserved for a period of at least three years from the date relied upon or consulted for the purposes of performing any such function.

PART 11 INSTITUTIONAL PHARMACY

Section 11.1. Introduction.

In addition to requirements set forth in other parts of these rules, the rules in this Part are specifically applicable to all institutions and institutional pharmacies as defined below..

Section 11.2. Definitions.

(a) "Institutional facility" means any organization whose primary purpose is to provide a physical environment for patients to obtain health care services, including but not limited to a(n):

(1) Hospital;

(2) Convalescent home;

(3) Nursing home;

(4) Extended or long-term care facility;

(5) Mental health facility;

(6) Rehabilitation center;

(7) Psychiatric center;

(8) Developmental disability center;

(9) Drug abuse treatment center;

(10) Family planning clinic;

(11) Penal institution or correctional facility;

(12) Hospice;

(13) Public health facility;

(14) Athletic facility; and

(15) Residential care home.

(b) "Institutional pharmacy" means any drug outlet licensed by the Board which provides pharmaceutical care to current residents or patients in an institutional facility where drugs, devices, and other materials used in the diagnosis and treatment of injury, illness, and disease (hereinafter referred to as "drugs") are dispensed, compounded, and distributed and pharmaceutical care is provided. A pharmacy that provides services to patients who do not reside in institutional settings (with the exception of a one-time dispensing upon discharge from an institution) cannot be classified as an "institutional pharmacy."

Section 11.3. Personnel.

The institutional pharmacy shall:

(a) Be under the direct supervision of a full-time Vermont licensed pharmacist-manager;

(b) Employ support personnel to perform technical and secretarial duties appropriate to their training and skill level;

(d) Employ registered pharmacy technicians as needed to perform appropriate tasks.

Section 11.4. Responsibilities of the Pharmacist-Manager.

The pharmacist-manager shall be responsible for:

(a) The safe and efficient distribution and control of all pharmaceutical products;

(b) Preparation, sterilization, and admixture of parenteral medications;

(d) Compounding within the institutional pharmacy;

(e) Participation in developing a formulary for the institution;

(f) Correct filling and labeling of containers;

(g) Supply and inventory of emergency antidote drugs, if not kept in the emergency room;

(h) Record keeping;

(i) Participation in the institution's patient care evaluation program;

(j) Cooperation with teaching and research programs in the institution;

(k) Implementation of the institution's policies and procedures;

(l) Efficient and effective messenger and delivery service within the institution regarding medication use;

(m) Setting quality assurance standards;

(n) Development and implementation of written policies and procedures; and

(o) Inspections of medication storage areas.

Section 11.5. Written Policies.

The pharmacist-manager shall develop and implement written policies and procedures for the safe and efficient distribution of drugs and for the provision of pharmaceutical care. An annual updated copy of such procedures shall be on hand for inspection by the Board. Written policies and procedures shall include:

(a) Duties of support personnel;

(b) Night cabinets;

(d) Distribution of pharmaceutical products;

(e) Disposition of adulterated, misbranded or discontinued drugs;

(f) Recall of drugs; and

(g) Storing and returning drugs brought into the institution by patients.

Section 11.6. Absence of Pharmacist.

During such times as an institutional pharmacy may be unattended by a pharmacist, arrangements shall be made in advance by the pharmacist-manager for provision of drugs to the medical staff and other authorized personnel of the institutional facility by use of night cabinets and, in emergency circumstances, by access to the pharmacy. A pharmacist must be "on call" during all absences.

Section 11.7. Night Cabinets/Temporary Storage.

In the absence of a pharmacist, drugs for distribution to patients shall be stored in a locked cabinet ("night cabinet") or other enclosure constructed and located outside of the pharmacy area, to which only specifically authorized personnel may obtain access by key or combination, and which is sufficiently secure to deny access to unauthorized persons. The pharmacist-manager shall, in conjunction with the appropriate committee of the institutional facility, develop inventory listings of those drugs to be included in the night cabinet(s) and determine who may have access, and shall insure that:

(a) Drugs are properly labeled;

(b) Only prepackaged drugs are available, in amounts sufficient for immediate therapeutic requirements until a pharmacist is available;

(c) Whenever access to the cabinet occurs, date and time of access, written practitioner's orders and proofs-of-use are provided;

(d) All drugs in the night cabinet are inventoried by a pharmacist or designee no less than once per week;

(e) A pharmacist reviews all medication orders for drugs removed from the night cabinet within 24 hours of their removal;

(f) A complete audit of all activity concerning the night cabinet is conducted no less than once per month; and (g) Written policies and procedures are established to implement the requirements of this section.

Section 11.8. Access to Pharmacy during Emergency.

The institutional pharmacy shall be secure from access by unauthorized persons at all times. Whenever any drug is not available from floor supplies or night cabinets, and the drug is required to treat the immediate needs of a patient whose health would otherwise be jeopardized, the drug may be obtained from the pharmacy in accordance with the requirements of this section.

Section 11.9. Designated Nurse Access.

(a) One supervisory nurse in any given eight-hour shift is responsible for obtaining drugs from the pharmacy.

(b) The responsible nurse shall be designated in writing by the appropriate committee of the institutional facility.

Section 11.10. Nurse Removal of Drugs.

Removal of any drug from the pharmacy by an authorized nurse must be recorded on a suitable form showing:

(a) patient name;

(b) room number;

(d) strength, amount,

(e) date and time of removal, and

(f) signature of nurse.

Section 11.11. Doses.

Doses should be in unit-of-use (unit-dose) packaging whenever possible. The physician order shall be left in the institutional pharmacy with the container from which the drug was removed, as notice to the next pharmacist on duty. The amount should be sufficient only for the patient's emergency needs.

Section 11.12. Emergency Kits.

An institutional facility lacking an institutional pharmacy may provide drugs from emergency kits. The drugs may be administered by authorized personnel, provided that such kits meet the following requirements:

(a) Emergency kits contain those drugs which may be required to meet the immediate therapeutic needs of patients;

(b) The drugs are not available from any other authorized source in sufficient time to prevent risk of harm to patients;

(d) All emergency kit drugs are equipped with a breakable seal, are sealed by a pharmacist, and are secure from access by unauthorized personnel;

(e) The supplying pharmacist, nursing staff, and the medical staff of the institutional facility shall jointly determine the drugs, by identity and quantity, to be included in emergency kits;

(f) The emergency kits shall be stored in secured areas to prevent unauthorized access and to ensure a proper environment for preservation of drugs in the kits;

(g) The exterior of each emergency kit shall be labeled so as to clearly indicate that it is an emergency drug kit and that it is for use in emergencies only.

(h) The label on the emergency kit shall contain a listing of the drugs contained in the kit, including name, strength, quantity, earliest expiration date and the name, address(es) and telephone number(s) of the supplying pharmacist;

(i) Drugs shall be removed from emergency kits pursuant to a valid prescription drug order only;

(j) Whenever an emergency kit is opened, the supplying pharmacist shall be notified within 24 hours, and the pharmacist shall ensure that the kit is restocked and resealed within a reasonable time so as to prevent risk of harm to patients;

(k) The expiration date of an emergency kit shall be the earliest date of expiration of any drug supplied in the kit. Upon the occurrence of the expiration date, the supplying pharmacist shall replace the expired drug; and

(l) The pharmacist and medical staff shall develop and implement written policies and procedures for using emergency drug kits.

Section 11.13. Emergency Kits in Non-Federal Registered Long-term Care Facilities (LTCF).

(a) An LTCF may obtain controlled substances for emergency kits from a DEA-registered hospital, clinic, pharmacy, or practitioner.

(b) An LTCF must have security safeguards for each emergency kit stored in the LTCF which include the designation of individuals who may have access to the emergency kits and a specific limitation of the type and quantity of controlled substances permitted to be placed in each emergency kit.

Section 11.14. Emergency Kit Records.

The LTCF and the providing registered DEA hospital, clinic, pharmacy, or practitioner must maintain complete and accurate records of the controlled substances placed in the emergency kits and the disposition of these controlled substances, and must take periodic physical inventories.

Section 11.15. Authorized Emergency Kit Users.

Controlled substances in emergency kits may be administered to patients in an LCTF only by personnel expressly authorized by an individual practitioner and in compliance with federal regulations on controlled substances.

(a) It is the Board's intent that the last person to inspect and seal an emergency drug kit must be a pharmacist. This task may not be delegated to a technician or a nurse. To further clarify this point, if the emergency drug kit is to be exchanged in its entirety and leaves the pharmacy after being sealed by a pharmacist, the intent of the rules has been met.

(b) If the drugs in the emergency drug kit are individually sealed in tamper proof containers, such as plastic cubes which are sealed either by plastic locks or tamper evident tape, then individual drugs may be "swapped" out of kits as long as they are properly labeled and it is done by authorized personnel.

(c) A nurse or technician at the long term care facility may replenish emergency drug kits with a drug item, provided the drug item is pre-sealed in an individual container and placed in a pre-designated part of the kit. This requirement is to prevent loose unit-dosed medications from being placed in the wrong locations in an emergency drug kit.

Section 11.16. Physical Requirements.

The institutional pharmacy shall meet the same standards as a retail drug outlet.

(a) Prescription area: The pharmacist-manager, or the pharmacist designated by him or her, shall have 24 hour access to the institutional pharmacy. The prescription area shall be large enough to properly store and prepare a prescription. The Board recommends 200 square feet.

(b) If the institutional facility is open at times when the institutional pharmacy is closed, the pharmacy must be permanently enclosed by a partition or Board-approved barrier device from floor to ceiling, or at least nine feet six inches in height, whichever is less.

(c) The institutional pharmacy must be secure from access when the institutional facility is closed. It must be secure from access by unauthorized personnel at all times. Only support personnel directly involved in the prescription dispensing process and non-pharmacist management shall be allowed entry into the institutional pharmacy and then only when a pharmacist is present in the institution.

(d) The prescription counter shall be kept free of any items not being used in the practice of pharmacy. No television monitors shall be located in the institutional pharmacy, and no such equipment shall be placed so as to distract the pharmacist from the practice of pharmacy. The aisle space behind the prescription counter shall be wide enough to allow free movement and shall be kept free of obstructions. The institutional pharmacy shall have a sink of appropriate size, exclusive of drain board area, necessary to fulfill the needs of the pharmacy. The sink shall be connected to hot and cold running water and shall have a working drain.

Section 11.17. Hygiene Standards.

The institutional pharmacy shall:

(a) comply with all federal, state, and local health laws;

(b) have walls, ceilings, windows, and floors kept clean and in good repair;

(d) have equipment kept clean and stored in an orderly manner;

(e) be well lighted;

(f) be dry and well ventilated; and

(g) have adequate restroom facilities for employees.

Section 11.18. Equipment.

The following equipment and miscellaneous supplies shall be present:

(a) One class A prescription balance with weights or automatic sensitivity requirement of six mg. with no load;

(b) One set of metric weights from 10 milligrams to 50 grams;

(d) Distilled and/or sterile water;

(e) An automated data processing system;

(f) At least one telephone in the prescription area, with the same number as the telephone number printed on the drug outlet prescription labels;

(g) A tablet and capsule counting tray;

(h) Containers which meet official compendia standards, available with closures that meet Federal Poison Prevention Packaging Act of 1970 requirements, as well as regular closures;

(i) Prescription labels imprinted or computer-generated with the name, address, and telephone number of the institutional pharmacy that do not contain any symbol or background logo that interferes with the reading and interpretation of any information written by the pharmacist on the label;

(j) Auxiliary labels;

(k) Prescription filing devices for record keeping;

(l) Sufficient equipment, graduates, mortars, funnels, etc., to maintain the scope of practice;

(m) A current copy of the Vermont Pharmacy Laws and Rules and Regulations;

(n) Any institutional pharmacy involved in the preparation of sterile pharmaceutical must meet the requirements of the "Sterile Pharmaceuticals" provisions of these rules; and

(o) Telephone number of a poison control center.

Section 11.19. Reference Materials.

Each pharmacy shall maintain on file at least one reference in each of the following categories. Computerized, on-line versions are acceptable instead of a hard copy of the current manual. Whether in hard copy or computerized, this reference work must be complete and must include an explanation of drug interactions, either in the form of a manual or otherwise:

(b) Current manual of drug interactions equivalent to "Hansten's" or "Drug Facts," with quarterly updates, which has been pre-approved by the Board.

(d) Current reference on pediatric dosages;

(e) IV admixture compatibility reference (such as "King's Guide to Parenteral Admixtures");

(f) Injectable Drug Handbook ("Trissel's"); and

(g) American Hospital Formulary Service Drug Information text.

Section 11.20. Storage.

All drugs shall be stored in designated areas within the institutional pharmacy, at temperatures recommended by the U.S. Pharmacopoeia.

Section 11.21. Security.

The institutional pharmacy shall be locked by key or combination when unattended.

Section 11.22. Labeling.

All drugs dispensed for use within the institution shall:

(a) Be in appropriate containers; and

(b) Be labeled with the patient's name, patient's location, brand or generic name, strength, quantity of drug, and expiration date.

Section 11.23. Dispensed Drugs.

All drugs dispensed for use outside the institution shall comply with standards set for a retail drug outlet.

Section 11.24. Unit Dose Packaging.

All drugs shall be in unit dose packaging specifying drug name, strength, and expiration date. Either the drug manufacturer and lot number must be labeled on the package, or there must be a system that allows for retrieval of such information.

Section 11.25. Discontinued Drugs.

All discontinued, outdated, or misbranded drugs shall be returned to the institutional pharmacy and properly disposed of by the pharmacist-manager or his or her authorized designee.

Section 11.26. Physician's Orders.

Drugs may be dispensed from the institutional pharmacy if:

(a) Ordered by an authorized practitioner;

(b) The drug order includes the name and location of the patient, name and dosage of the drug, directions for use, date of order, and signature of the physician or his or her authorized designee;

(c) Telephone or verbal orders are transcribed into the patient record and noted as a telephone or verbal order. Telephone or verbal orders shall be countersigned by the prescribing physician within 30 days. The authority to receive telephone or verbal orders must be officially granted in the institutions' rules and regulations or medical staff bylaws.

(d) All abbreviations and symbols used in written orders are approved for use by the institution.

(e) Pharmacists may adjust medication doses if the order is part of a medication or dosing protocol that has been approved by the medical staff of the institution. This section should not be construed as giving prescribing privileges to pharmacists.

Section 11.27. Telephone Orders.

Prescription orders issued by an authorized practitioner may be telephoned to a retail drug outlet by a licensed registered or practical nurse.

Section 11.28. Controlled Drug Accountability.

The following information must be recorded each time a controlled drug is administered;

(a) Name of drug;

(b) Dosage;

(d) Date and time the drug was administered;

(e) Name of person administering the drug; and

(f) Name of prescriber.

Section 11.29. Recall.

All recalled drugs and pharmaceutical devices shall be retrieved from within the institution for safe and proper disposal in the institutional pharmacy.

Section 11.30. Adverse Drug Reactions.

All adverse drug reactions shall be reported to the patient's physician and documented in the patient chart and shall also be entered into the patient profile.

Section 11.31. Medications Brought into the Institution by Patients.

Drugs brought into an institutional facility by a patient shall not be administered unless they can be identified and the quality of the drug assured. If such drugs are not to be administered, then the pharmacist-manager shall, according to procedures specified in writing, have them turned in to the pharmacy, which shall package and seal them and return them to an adult member of the patient's immediate family, or store and return them to the patient upon discharge.

Section 11.32. Investigational Drugs.

Investigational drugs shall be stored in and dispensed from the pharmacy only. Investigational drugs may be administered if:

(a) Prior approval of the protocol has been granted by the institution's investigational drug review board or committee;

(b) Informed consent to treatment with these drugs has been given in writing by the patient or authorized representative;

(c) Administered under the direct and personal supervision of the principal physician-investigator, or his or her authorized clinician, or a nurse educated and trained in administration of investigational drugs;

(d) All essential information pertaining to the investigational drug is maintained, stored, updated, and dispensed by the institutional pharmacy;

(e) The institution participating in investigational studies assures that such studies contain adequate safeguards for the patient, the institution, and the scientific integrity of the study;

(f) The institution participating in investigational studies has written policies and procedures for the approval, management, and control of these studies; and

(g) The pharmacist is responsible to the institution and to the principal investigator for seeing that procedures for the control of investigational drug use are developed and maintained.

Section 11.33. Records and Reports.

The following records and reports shall be kept on file for three years and submitted to the Board upon request:

(a) The practitioner's orders, or direct copies. The ability to retrieve these orders from a patient's medical record is acceptable;

(b) Records of medications dispensed;

(d) Inventories of night cabinets, emergency kits, the institutional pharmacy, and controlled substances;

(e) Alcohol and flammables reports;

(f) Authorized removal of drugs from the institutional pharmacy by a nurse.

Section 11.34. Inspection of Medication Areas.

Every month, the pharmacist-manager or his or her qualified designee shall inspect all matters for which he or she is responsible, to verify compliance with these rules, and document the following:

(a) Drugs are dispensed only under the direct supervision of a licensed pharmacist;

(b) Support personnel are properly directed and supervised;

(d) Compliance with all special storage conditions for each drug;

(e) Outdated drugs are not stocked in the institution or the institutional pharmacy;

(f) Distribution and administration of controlled substances are adequately documented by pharmacy, medical, and nursing personnel;

(g) There is an adequate supply of emergency drugs;

(h) All security and storage standards are met;

(i) Metric-apothecary weight and measure conversion tables and charts are reasonably available to all medical and nursing personnel; and

(j) Compliance with policies and procedures pertaining to the pharmacy.

PART 12 COMPUTER SYSTEMS AND AMDS USAGE

Section 12.1. Permitted Practices.

Computer systems for data processing may be used for record keeping in licensed pharmacies, if:

(a) Patient records may be viewed at any time on the computer screen;

(b) Patient records are available as printed documents;

(d) An auxiliary record keeping system is established for use when the computer system is temporarily inoperable, and such records are entered into the system when operations are restored;

(e) A backup copy must be kept off-site or in fire-proof storage;

(f) A software provision must be implemented that will flag or otherwise warn of allergies or medication interactions.

Section 12.2. Common Files or Data Bases.

Pharmacies accessing a common electronic file or database used to maintain required dispensing information are not required to transfer prescription drug orders or information for dispensing purposes between or among pharmacies participating in the same common prescription file. Provided, however, that any such common file shall contain complete records of each prescription drug order and refill dispensed and further, that a hard copy record of each prescription drug order accessed for purposes of refilling shall be generated and maintained at the pharmacy refilling the prescription drug order.

Section 12.3. Printouts.

The computerized system shall have the capability of producing a printout of any prescription drug order data. The system shall provide a refill-by-refill audit trail for any specified strength and dosage form of any drug. Such an audit trail shall be by printout, and include the name of the prescribing practitioner, name and location of the patient, quantity dispensed on each refill, date of dispensing of each refill, name or identification code of the dispensing pharmacist, and unique identifier of the prescription drug order.

Section 12.4. Retrievability.

Any facility maintaining centralized prescription records shall be capable of sending a requested printout to the pharmacy within 72 hours.

Section 12.5. Sight Readable Information.

The system shall have the capability of producing sight-readable information on all original and refill prescription drug orders. The term "sight-readable" means that an authorized individual shall be able to examine the record and read the information from the computer monitor, microfiche, microfilm, printout, or other method acceptable to the Board.

Section 12.6. On-Line Retrieval.

The system shall provide on-line retrieval (via computer monitor or hard-copy printout) of original prescription drug order information. The information shall include, but not be limited to, the prescription drug order requirements and records of dispensing as indicated in these rules.

Section 12.7. Daily Records.

Each pharmacist responsible for dispensing shall create a retrievable record of each day's prescription drug order information. The pharmacist shall in a log book sign a daily verification that prescription information in the record is correct. The verification shall be dated and signed in the same manner as signing a check or legal document (e.g., J.H. Smith or John H. Smith) by the individual pharmacist. Daily records shall be retained for three years.

Section 12.8. Automated Systems.

If an automated pharmacy system is used the pharmacist-manager shall have the ultimate responsibility to:

(a) Assign, discontinue, or change access to the system;

(b) Ensure that access to the medications comply with state and federal regulations;

(c) Ensure that the automated pharmacy system is filled and stocked accurately and in accordance with established, written policies and procedures.

(d) If an automated dispensing system is utilized in the LTCF, only those systems that are designed to prevent improper placement of medications may be utilized.

Section 12.9. Personnel.

The filling and stocking of all medications in the automated pharmacy system shall be accomplished by qualified personnel under the supervision of a licensed pharmacist.

Section 12.10. Records.

A record of medications filled or stocked into an automated pharmacy system shall be maintained and shall include identification of the persons filling or stocking and checking for accuracy. These records shall be maintained for three (3) years.

Section 12.11. Dispensing and Distributing.

(a) All drugs stored in an AMDS shall be packaged and labeled as required by federal and state statutes and regulations.

(b) All aspects of handling controlled substances dispensed via an AMDS shall comply with applicable state and federal statutes and regulations.

Section 12.12. Confidentiality.

To maintain the confidentiality of patient records, the system shall have adequate security and systems safeguards designed to prevent and detect unauthorized access, modification, or manipulation of patient records. Once the drug has been dispensed, any alterations in prescription drug order data shall be documented, including the identification of the pharmacist responsible for the alteration.

Section 12.13. Automated Pharmacy System Records in Institutions.

Records and electronic data kept by the automated pharmacy system shall meet the following requirements:

(a) All events involving the contents of the automated pharmacy system must be recorded electronically.

(b) Records must be maintained by the pharmacy and must be readily available to the Board or its agent. Such records shall include:

(1) Identity of system accessed;

(2) Identification of the individual accessing the system;

(3) Type of transaction;

(4) Name, strength, dosage form, and quantity of the drug accessed; and

(5) Name of the patient for whom the drug was ordered.

Section 12.14. AMDS Records.

(a) Records and/or electronic data kept by Automated Pharmacy Systems shall be maintained at the AMDS site and must be readily available to the Board. Such records shall include:

(1) identification of the individual accessing the system;

(2) the date the AMDS was accessed,

(3) the name, strength, dosage form, and quantity of the Drug accessed;

(4) the name of the patient for whom the Drug was ordered; and

(5) A record of medications filled/stocked into an AMDS and identification of the persons filling/stocking and checking for accuracy.

(6) such additional information as the coordinating pharmacist may deem necessary.

(b) Records must be maintained and retrievable a minimum of three years.

Section 12.15. System Backup.

(a) Routine backup systems and procedures (hard copy, copy, disk, etc.) shall be in place and operational to ensure against loss of patient data.

(b) In the event that permanent dispensing information is lost due to unscheduled system interruption, the Board of Pharmacy shall be notified within 72 hours.

Section 12.16. Policies and Procedures.

(a) A remote pharmacy must be operated pursuant to policies and procedures adopted by the coordinating pharmacy.

(b) The policies and procedures shall require on-going documentation by the coordinating pharmacist manager to assure:

(1) that access to the AMDS is available to registered or licensed pharmacy personnel or AMDS maintenance personnel only;

(2) that the automated pharmacy dispensing system is in good working order and accurately dispenses the correct strength, dosage form, and quantity of the drug prescribed

(3) appropriate record keeping and security safeguards, and

(4) a mechanism for securing and accounting for medications removed from and subsequently returned to the AMDS; and

(5) a mechanism for securing and accounting for wasted medications or discarded medications; and

(6) patient confidentiality.

Section 12.17. Oral Communication of Prescriptions.

Designated employees of practitioners qualified to prescribe drugs may transmit an order for a prescription via telephone.

PART 13 STERILE PHARMACEUTICALS

Section 13.1. Purpose and Scope.

The purpose of this section is to assure positive patient outcomes through the provision of standards for (1) pharmaceutical care, (2) the preparation, labeling, and distribution of sterile pharmaceuticals by pharmacies, pursuant to or in anticipation of a prescription drug order, and (3) product quality and characteristics, such as sterility and potency, that would be associated with environmental quality, preparation activities, and checks and tests carried out in the pharmacy.

Section 13.2. Applicability.

These standards are intended to apply to all sterile pharmaceuticals, notwithstanding the location of the patient (e.g., home, hospital, nursing home, hospice, doctor's office). All requirements of this rule shall apply to any pharmacy engaged in the preparation of sterile pharmaceutical products.

Section 13.3. Definitions.

(a) "Compounding Aseptic Containment Isolator" also known as "biological safety cabinet" means a containment unit suitable for the preparation of low to moderate risk agents where there is a need for protection of the product, personnel, and environment, according to National Sanitation Foundation (NSF) Standard 49.

(b) "ISO 5" (International Organization for Standards) means an atmospheric environment which contains less than 100 particles 0.5 microns in diameter per cubic foot of air, according to Federal Standard 209E.

(d) "Enteral" means within or by way of the intestine.

(e) "Parenteral" means a sterile preparation of drugs for injection through one or more layers of the skin.

(f) "Positive patient outcomes" include the cure or prevention of disease, elimination or reduction of a patient's symptoms, or arresting or slowing of a disease process so as to improve the patient's quality of life.

(g) "Product quality and characteristics" include: sterility, potency associated with environmental quality, preparation activities, and checks and tests.

(h) "Sterile pharmaceutical" means any dosage form devoid of viable microorganisms, including, but not limited to, parenterals, injectables, and ophthalmics.

(i) "USP 797" means the current version of USP-NF General Chapter 797 Pharmaceutical Compounding - Sterile Preparations published annually by the U.S. Pharmacopeial Convention.

Section 13.4. Policy and Procedure Manual.

A policy and procedure manual shall be prepared and maintained for the compounding, dispensing, delivery, administration, storage, and use of sterile pharmaceutical prescription drug orders.

(a) The policy and procedure manual shall include a quality assurance program for the purpose of monitoring patient care and pharmaceutical care outcomes, adverse drug reactions, personnel qualifications, training and performance, product integrity, equipment, facilities, infection control, and guidelines regarding patient education.

(b) The policy and procedure manual shall be current and available for inspection by a Board-designated agent.

Section 13.5. Physical Requirements.

The pharmacy shall have a designated area with entry restricted to designated personnel for preparing parenteral products. This area shall be:

(a) structurally isolated from other areas with restricted entry or access;

(b) be designed to avoid unnecessary traffic and airflow disturbances from activity within the controlled facility;

(d) of sufficient size to accommodate a laminar airflow hood and to provide for the proper storage of drugs and supplies under appropriate conditions of temperature, light, moisture, sanitation, ventilation, and security.

Section 13.6. ISO 5 Compliance.

The pharmacy preparing parenteral products shall have:

(a) appropriate environmental control devices capable of maintaining at least ISO 5 conditions in the workplace where critical objects are exposed and critical activities are performed; furthermore, these devices are capable of maintaining ISO 5 conditions during normal activity. Examples of appropriate devices include laminar airflow hoods and zonal laminar flow of high efficiency particulate air (HEPA) filtered air;

(b) Appropriate disposal containers for used needles, syringes, etc., and if applicable, for cytotoxic waste from the preparation of chemotherapy agents and infectious wastes from patients' homes;

(c) When cytotoxic drug products are prepared, appropriate environmental control also includes appropriate biohazard cabinetry;

(d) Temperature-controlled delivery container if products are to be stored unrefrigerated for more than two hours; and

(d) Infusion devices, if appropriate.

Section 13.7. Supplies.

The pharmacy shall maintain supplies adequate to maintain an environment suitable for the aseptic preparation of sterile products.

Section 13.8. Reference Materials.

The pharmacy shall maintain on file at least one current reference related to preparation of sterile products, equivalent to "Trissel's" or "King's."

Section 13.9. Records and Reports.

In addition to standard record and reporting requirements, the following additional records and reports must be maintained for sterile pharmaceuticals:

(a) A policy and procedure manual, including policies and procedures for cytotoxic or infectious waste, or both, if applicable, and

(b) Lot numbers of the components used in compounding sterile prescriptions, except for preparations made for a specific patient and which will be used within 30 days.

Section 13.10. Delivery Service.

The pharmacist-manager shall assure the environmental control of all products shipped. Any compounded, sterile pharmaceutical must be shipped or delivered to a patient in appropriate temperature-controlled (as defined by USP Standards) delivery containers and stored appropriately in the patient's home.

Section 13.11. Emergency Kit.

When sterile pharmaceuticals are provided to home care patients, the dispensing pharmacy may supply the nurse or patient with emergency drugs, if the physician has authorized the use of these drugs by a protocol, in an emergency situation (e.g., anaphylactic shock).

Section 13.12. Cytotoxic Drugs.

In addition to the minimum requirements for a pharmacy established by rules of the Board, the following requirements are necessary for those pharmacies that prepare cytotoxic drugs to insure the protection of the personnel involved:

(a) All cytotoxic drugs should be compounded in a vertical flow, Class II, Compounding Aseptic Containment Isolator. Other products should not be compounded in this cabinet.

(b) Protective apparel shall be worn by personnel compounding cytotoxic drugs. This shall include disposable masks, gloves, and gowns with tight cuffs.

(c) Appropriate safety and containment techniques for compounding cytotoxic drugs shall be used in conjunction with the aseptic techniques required for preparing sterile products.

(d) Disposal of cytotoxic waste shall comply with all applicable local, state, and federal requirements.

(e) Written procedures for handling both major and minor spills of cytotoxic agents must be developed and must be included in the policy and procedure manual.

(f) Prepared doses of cytotoxic drugs shall be dispensed, labeled with proper precautions inside and outside, and shipped in a manner to minimize the risk of accidental rupture of the primary container.

Section 13.13. Disposal of Cytotoxic or Hazardous Wastes.

The pharmacist-Manager is responsible for assuring that there is a system for the disposal of cytotoxic or infectious waste in a manner so as not to endanger the public health.

Section 13.14. Patient Education and Training.

If appropriate, the pharmacist must document the patient's training and competency in managing this type of therapy provided by the pharmacist to the patient in the home environment. A pharmacist must be involved in the patient training process in any area that relates to drug compounding, labeling, administration, storage, stability, compatibility, or disposal. The pharmacist must be responsible for seeing that the patient's competency in the above area is reassessed on an ongoing basis.

Section 13.15. Quality Assurance for Compounding and Preparation of Sterile Pharmaceuticals.

There shall be a documented, ongoing quality assurance control program that monitors personnel performance, equipment, and facilities. Appropriate samples of finished products shall be examined to assure that the pharmacy is capable of consistently preparing sterile pharmaceuticals meeting specifications.

Section 13.16. Sanitation Standards - Certification of Compliance.

All clean rooms and laminar flow hoods shall be certified by an independent contractor according to ISO Standard 14644 for operational efficiency at least every six months. Appropriate records shall be maintained.

Section 13.17. Written Protocol.

There shall be written procedures developed requiring sampling if microbial contamination is suspected.

Section 13.18. End Product Testing.

If bulk compounding of parenteral solutions is performed using non-sterile chemicals, extensive end-product testing must be documented prior to the release of the product from quarantine. This process must include appropriate tests for particulate matter and testing for pyrogens.

Section 13.19. Beyond Use Dates.

There shall be written justification of the chosen beyond-use dates for compounded products.

Section 13.20. Quality Assurance Audits.

There shall be documentation of quality assurance audits at regular, planned intervals, including infection control and sterile technique audits.

Section 13.21. Pharmaceutical Care Outcomes.

There shall be a documented, ongoing quality assurance control program that monitors patient care and pharmaceutical care outcomes, including but not limited to the following:

(a) Routine performance of prospective drug use review and patient monitoring functions by a pharmacist;

(b) Patient monitoring plans that include written outcome measures and systems for routing patient assessment (examples include infection rates, rehospitalization rates, and the incidence of adverse drug reactions);

(d) Appropriate collaboration with other health care professionals.

Section 13.22. USP 797 Compliance for Compounded Sterile Products.

(a) All pharmacies, either in state or out of state, dispensing or distributing compounded sterile products as defined by USP 797 to Vermont patients, institutions or providers shall meet all requirements of USP 797.

(b) Such pharmacies shall file with the Board proof of USP 797 compliance or an affidavit describing their procedures for quality assurance, sterilization methods, environmental controls, sterility and pyrogen testing, and maintenance of the quality of sterile products throughout packaging, handling, and distribution. The Board may conduct audits of any licensee.

PART 14 LICENSING OF INVESTIGATIVE AND RESEARCH PROJECTS

Section 14.1. Licenses Required.

Licensing of Investigative and Research Projects is required by 26 V.S.A. § 2061 (5). A legitimate institution or entity which possess prescription drugs in the course of conducting research or investigation shall apply to the Board for a license. The Board may issue a license when it determines that:

(a) The entity requesting the license is a legitimate research entity, recognized by state or national licensing or accreditation organizations approved by the Board;

(b) The entity explains with its application;

(1) where and how regulated drugs used for research or investigation will be stored, secured, and accounted for,

(2) who will be responsible for ensuring compliance with the requirements of this rule and;

Section 14.2. Conditions.

The Board may set reasonable conditions on licenses granted under this section.

The license holder will notify the Board within 5 working days if there is a change in the person responsible for compliance.

Section 14.3. Exemptions.

Medical facilities such as clinics and physicians' offices which are otherwise legally entitled to possess prescription drugs or are otherwise licensed by this Board are not required to be licensed under this Part 13 of the rules.

PART 15 NUCLEAR/RADIOLOGIC PHARMACY

Section 15.1. Purpose and Scope.

The practice of nuclear/radiologic pharmacy is a specialty of pharmacy practice regulated by the Board. Nuclear/radiologic pharmacy practice refers to a patient-oriented service that embodies the scientific knowledge and professional judgment required to improve and promote health through the assurance of the safe and efficacious use of radiopharmaceuticals and other drugs.

Section 15.2. Definitions.

(a) "Authentication of product history" means, but is not limited to, identifying the purchasing source, the ultimate fate, and any intermediate handling of any component of a radiopharmaceutical.

(b) "Internal test assessment" means, but is not limited to, conducting those tests of quality assurance necessary to ensure the integrity of the test.

(c) "Nuclear pharmacy" means a pharmacy providing radiopharmaceutical services or, as provided in Rule 14.3 below, the appropriate area of any institutional facility.

(d) "Qualified licensed professional" means a non-pharmacist individual (such as a physician, nurse, or technologist) who possesses a current state license, if applicable, and who has sufficient training and experience to safely handle and dispense radiopharmaceuticals as defined by the Board.

(e) "Qualified nuclear pharmacist" means a currently licensed pharmacist in Vermont who is certified as a nuclear pharmacist by a certification board recognized by the Board, or who meets the following standards:

(1) Minimum standards of training for "authorized user status" of radioactive material, as defined by the Vermont Department of Health (VDH).

(2) Completed a minimum of 200 contact hours of instruction in nuclear pharmacy and the safe handling and use of radioactive materials from a program approved by the Board, with emphasis on the following areas:

(A) Radiation physics and instrumentation;

(B) Radiation protection;

(D) Radiation biology; and

(E) Radiopharmaceutical chemistry.

(3) Attain a minimum of 500 hours of clinical nuclear pharmacy training under the supervision of a qualified nuclear pharmacist.

(f) "Radiopharmaceutical quality assurance" means, but is not limited to, the performance of appropriate chemical, biological, and physical tests on potential radiopharmaceuticals and the interpretation of the resulting data to determine their suitability for use in humans and animals, including internal test assessment, authentication of product history, and the keeping of proper records.

(g) "Radiopharmaceutical service" means, but shall not be limited to, the procurement, storage, handling, preparation, labeling, quality assurance testing, dispensing, delivery, record keeping, and disposal of radiopharmaceuticals and other drugs.

(h) "Radiopharmaceuticals" are radioactive drugs as defined by the FDA.

Section 15.3. General Requirements for Pharmacies Providing Radio-Pharmaceutical Services.

(a) A license to operate a pharmacy providing radio-pharmaceutical services shall be issued only to a qualified nuclear pharmacist.

(b) All personnel performing tasks in the preparation and distribution of radioactive drugs shall be under the direct supervision of a qualified nuclear pharmacist.

(c) A qualified nuclear pharmacist shall be responsible for all operations of the pharmacy and shall be in personal attendance at all times that the pharmacy is open for business.

(d) In emergency situations when a qualified nuclear pharmacist is not present, designated qualified licensed professionals may have access to the licensed area. These individuals may prepare single doses of radiopharmaceuticals for the immediate emergency, and must document such activities.

Section 15.4. Physical Requirements.

Nuclear pharmacies shall have adequate space and equipment, commensurate with the scope of services required and provided, meeting minimal space requirements established for all pharmacies in Vermont or as otherwise defined by the Board.

Section 15.5. Security.

The nuclear pharmacy area shall be secured from unauthorized personnel.

Section 15.6. Records.

Nuclear pharmacies shall maintain records of acquisition, inventory, and disposition of all radioactive drugs and other radioactive materials in accordance with the requirements of the Vermont Department of Health.

Section 15.7. Radioactive Storage.

All pharmacies handling radiopharmaceuticals shall provide a radioactive storage and product decay area. Detailed floor plans shall be submitted to the Board and the Vermont Department of Health before approval of the certification to practice nuclear pharmacy.

Section 15.8. Prescriptions.

Radiopharmaceuticals are to be dispensed only upon a prescription drug order from a practitioner authorized to possess, use, and administer radiopharmaceuticals.

Section 15.9. Permit Prerequisites.

The permit to operate a nuclear pharmacy is conditioned upon an approved Vermont Department of Health (VDH) or Nuclear Regulatory Commission (NRC) license. Copies of the VDH or NRC inspection reports shall be made available upon request for Board inspection.

Section 15.10. Other Requirements.

All nuclear/radiologic pharmacies shall also adhere to the rules for pharmaceutical care as they pertain to the practice of nuclear pharmacy.

PART 16 NON-RESIDENT PHARMACY

Section 16.1. Definitions.

(a) "Non-resident pharmacy" means a drug outlet or business located outside of Vermont which dispenses prescription drugs or devices for Vermont residents or residents of other states and which mails, ships, or delivers such prescription drugs or devices into this state, or which provides any type of pharmacy services.

(b) "Pharmacy services" as defined in this section includes consulting or medication therapy management. Nonresident pharmacies include pharmacies operating by means of the Internet.

(c) "Medication Therapy Management" as used in this section means a distinct service or group of services that optimize therapeutic outcomes for individual patients. Medication Therapy Management services are independent of, but can occur in conjunction with, the provision of a medication or a medical device.

Section 16.2. Licensure.

An applicant for initial licensure must provide to the Board:

(a) evidence that the applicant holds a pharmacy license, registration, or permit issued by the state in which the pharmacy is located that is valid and in good standing;

(b) the location, names, and titles of all principal corporate officers and all pharmacists who are dispensing drugs to residents of this state, including the pharmacist-manager in charge of the non-resident pharmacy license;

(1) If a person: the name, business address, and date of birth;

(2) If a partnership: the name, business address, and date of birth of each partner, and the name of the partnership;

(3) If a sole proprietorship: the full name, business address, social security number, and date of birth of the sole proprietor and the name of the business entity; and

(4) If a corporation: the federal identification number of the corporation, the name, business address, date of birth, and title of each corporate officer and director, the corporate names, the name of the state of incorporation, and the name of the parent company, if any; the name, business address of each shareholder owning five percent or more of the voting stock of the corporation, including over-the-counter stock, unless the stock is traded on a major stock exchange and not over-the-counter;

(d) affirmation by the sole proprietor, or all partners, or corporate officers and directors, and the pharmacist-manager, that they have not been convicted of, and are not under indictment for, any felony or misdemeanor arising from the violation of any drug or pharmacy related law;

(e) evidence of the applicant's ability to provide to the Board a record of a prescription drug order dispensed by the applicant to a resident of this state not later than 72 hours after a request for the record by the Board;

(f) an affidavit by the pharmacist-manager which states that he or she has read and understands the Vermont laws and rules relating to a non-resident pharmacy;

(g) evidence that during its regular hours of operation, but not fewer than five days per week, for a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate communication between patients in this state and a pharmacist at the pharmacy who has access to the patients' records. The toll-free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this state; and evidence that during its regular hours of operation, but not fewer than six days per week, for a minimum of 40 hours per week, a toll-free telephone service is provided to facilitate communication between patients in this state and a pharmacist at the pharmacy who has access to the patients' records. The toll-free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this state;

(h) a copy of the most recent inspection report from the state in which the pharmacy is located; and

(i) For internet non-resident pharmacies, a copy of an inspection report not more than three years old by either:

(1) the state in which the pharmacy is located; or

(2) Verified Internet Pharmacy Practice Sites (VIPPS) certification.

Section 16.3. Change of Information.

Changes of information required in Rule 16.2 above shall be submitted to the Board within 30 days.

Section 16.4. Personnel.

A non-resident pharmacy shall be under the continuous on-site supervision of a pharmacist and shall designate one pharmacist licensed to practice pharmacy by the regulatory or licensing agency of the state in which the non-resident pharmacy is located to serve as the pharmacist-manager in charge of the non-resident pharmacy license.

Section 16.5. Prescription Records.

A non-resident pharmacy shall maintain for three years prescription records available for review if required by the Board. Such records shall provide the following information concerning each prescription for a drug or device that is shipped, mailed, or delivered to a resident of Vermont:

(a) the name of the patient;

(b) the name of the prescriber;

(d) the date of the prescription;

(e) the name of the drug;

(f) the strength and quantity of the dose; and

(g) name or other identification of the dispensing pharmacist.

Section 16.6. Substitution of Drug.

A non-resident pharmacy which provides mail order service to a resident of Vermont may substitute a drug as required by the substitution provisions of Title 18 Chapter 91 and as set forth in Rule 10.19 herein.

Section 16.7. Toll-Free Telephone Service.

A non-resident pharmacy that is located outside this state and which provides mail order service to Vermont residents shall provide during its regular hours of operation, but not fewer than six days per week, for a minimum of 40 hours per week, a toll-free telephone service to facilitate communication between patients in this state and a pharmacist at the pharmacy who has access to the patients' records. The toll-free number must be disclosed on the label affixed to each container of drugs dispensed to residents of this state.

Section 16.8. Disciplinary Action.

In addition to any other provisions of law, the Board may initiate disciplinary action when:

(a) a violation of these rules pertaining to non-resident pharmacies is alleged;

(b) a violation affecting a resident of this state is alleged and the state where the non-resident pharmacy is located has taken no action within 45 days from the date the violation was reported;

(c) an emergency arises that would constitute an immediate threat to the health and safety of the residents of this state.

PART 17 WHOLESALE DISTRIBUTORS

Section 17.1. Minimum Required Information for Licensure.

The Board of Pharmacy requires the following from each wholesale distributor as part of the initial licensing procedure and as part of any renewal of such license:

(a) Name, full business address, and telephone number of the licensee;

(b) All trade or business names used by the licensee;

(c) Addresses, telephone numbers, and the names of contact persons for the facility used by the licensee for storage, handling, and distribution of drugs;

(d) Type of ownership or operation (i.e., partnership, corporation, or sole proprietorship); and

(e) Name(s) of the owner and the operator of the licensee, including:

(1) If a person: the name, address, and social security number and date of birth;

(2) If a partnership: the name, address, and social security number and date of birth of each partner, and the name of the partnership;

(3) If a corporation: the federal identification number of the corporation, the name, address, and date of birth, and title of each corporate officer and director, the corporate names, the name of the State of incorporation, and the name of the parent company, if any; the name, and address of each shareholder owning five percent or more of the voting stock of the corporation, including over-the-counter stock, unless the stock is traded on a major stock exchange and not over-the-counter;

(4) If a sole proprietorship: the full name, address, social security number and date of birth of the sole proprietor, and the name of the business entity.

(5) Affirmation by the sole proprietor, or all partners, or corporate officers and directors, and the pharmacist-manager, that they have not been convicted of, and are not under indictment or under investigation for, any felony or misdemeanor arising from the violation of any drug or pharmacy related law.

Section 17.2. Required Forms.

The information required for initial licensure or renewal of a license of a wholesale distributor shall be submitted on forms prepared by the Board, and shall be submitted to the Board accompanied by the applicable fee as directed on such form.

Section 17.3. Change of Information.

Changes of information required in Rule 17.1 above shall be submitted to the Board within 30 days.

Section 17.4. Acts Which May Affect Licensure.

Among the factors the Board of Pharmacy will consider when deciding whether to grant a license to a wholesale distributor are:

(a) Any conviction of the applicant under any federal, state or local laws relating to drug samples, wholesale or retail drug distribution or distribution of controlled substances;

(b) Any felony convictions of the applicant under federal, state, or local laws;

(c) The applicant's past experience in the manufacture or distribution of prescription drugs, including controlled substances;

(d) The furnishing by the applicant of false or fraudulent material in any application made in connection with drug manufacturing or distribution;

(e) Suspension or revocation by federal, state, or local government of any license currently or previously held by the applicant for the manufacture or distribution of any drug, including controlled substances;

(f) Compliance with licensing requirements under previously granted licenses, if any;

(g) Compliance with the requirements to maintain or make available to the Board or to federal, state, or local law enforcement officials those records required to be maintained or made available by wholesale drug distributors;

(h) Any other factors or qualifications the Board considers relevant to and consistent with the public health and safety. Section 17.5. Personnel.

The licensed wholesale distributor shall employ adequate personnel with the education and experience necessary to safely and lawfully engage in the wholesale distribution of drugs.

Section 17.6. Minimum Requirements for the Storage and Handling of Drugs.

All facilities at which drugs are stored, warehoused, handled, held, offered, marketed, or displayed shall:

(a) be of suitable size and construction to facilitate cleaning, maintenance, and proper operations;

(b) have storage areas big enough to provide adequate lighting, ventilation, temperature, sanitation, humidity, space, equipment, and security conditions;

(c) have a quarantine area for storage of drugs that are outdated, damaged, deteriorated, misbranded, or adulterated, or that are in immediate or sealed secondary containers that have been opened; and

(d) be maintained in a clean and orderly condition.

Section 17.7. Security.

All facilities used for wholesale drug distribution shall be secure from unauthorized entry.

(a) Access from outside the premises shall be kept to a minimum and be well-controlled.

(b) The outside perimeter of the premises shall be well-lighted.

(d) All facilities shall be equipped with an alarm system to detect entry after hours.

Section 17.8. Diversion Prevention.

All facilities shall be equipped with a security system that will provide suitable protection against theft and diversion. When appropriate, the security system shall provide protection against theft or diversion that is facilitated or hidden by tampering with computers or electronic records.

Section 17.9. Storage.

All drugs shall be stored at appropriate temperatures and under appropriate conditions in accordance with requirements, if any, in the labeling of such drugs, or with requirements in the current edition of an official compendium.

(a) If no storage requirements are established for a drug, the drug may be held at "controlled" room temperature, as defined in an official compendium, to help ensure that its identity, strength, quality, and purity are not adversely affected.

(b) Appropriate manual, electromechanical, or electronic temperature and humidity recording equipment, devices, and/or logs shall be utilized to document proper storage of drugs.

Section 17.10. Inspections.

All wholesalers must submit proof with initial and renewal applications that they have successfully passed and have maintained a current inspection (not more than three years old) certification by the Pharmacy Board in the state in which they reside, or have successfully obtained and maintained VAWD certification, or from inspection certification from another similar body approved by the Board.

Section 17.11. Examination of Materials.

Upon receipt, each outside shipping container shall be visually examined for identity and to prevent the acceptance of contaminated drugs, or drugs that are otherwise unfit for distribution. This examination shall be adequate to reveal container damage that would suggest possible contamination or other damage to the contents.

Section 17.12. Examination of Outgoing Shipments.

Each outgoing shipment shall be carefully inspected for identity of the drug products and to ensure that there is no delivery of drugs that have been damaged in storage or held under improper conditions.

Section 17.13. Returned, Damaged, and Outdated Drugs.

Drugs that are outdated, damaged, deteriorated, misbranded, or adulterated shall be quarantined and physically separated from other drugs until they are destroyed or returned to their supplier.

Section 17.14. Compromised Packaging.

Any drug whose immediate or sealed outer or sealed secondary containers have been opened or used shall be identified as such, and shall be quarantined and physically separated from other drugs until they are either destroyed or returned to the supplier.

Section 17.15. Drug Safety/Quality Questions.

(a) If the conditions under which a drug has been returned cast doubt on the drug's safety, identity, strength, quality, or purity, then the drug shall be destroyed, or returned to the supplier, unless examination, testing, or other investigation proves that the drug meets appropriate standards of safety, identity, strength, quality, and purity.

(b) In determining whether the conditions under which a drug has been returned cast doubt on the drug's safety, identity, strength, quality, or purity, the wholesale drug distributor shall consider, among other things, the conditions under which the drug has been held, stored, or shipped before or during its return and the condition of the drug and its container, carton, or labeling, as a result of storage or shipping.

Section 17.16. Record Keeping.

(a) Wholesale distributors shall establish and maintain inventories and records of all transactions regarding the receipt and distribution or other disposition of drugs. This includes:

(1) stored drugs;

(2) all incoming and outgoing drugs; and

(3) all outdated, damaged, deteriorated, misbranded, or adulterated drugs.

(b) These records shall include the following information:

(1) The source of the drugs, including the name and principal address of the seller or transferor, and the address of the location from which the drugs were shipped;

(2) The identity and quantity of the drugs received and distributed or disposed of; and

(3) The dates of receipt and distribution or other disposition of the drugs.

Section 17.17. Availability of Records.

Inventories and records shall be made available for inspection and photocopying by any authorized official of any governmental agency charged with enforcement of these rules for a period of two years following disposition of the drugs.

Section 17.18. Record Retention.

(a) Records described in this section that are kept at the inspection site or that can be immediately retrieved by computer or other electronic means shall be readily available for authorized inspection during the retention period.

(b) Records kept at a central location apart from the inspection site and not electronically retrievable shall be made available for inspection within two working days of a request by an authorized official of any governmental agency charged with enforcement of these rules.

Section 17.19. Reporting Thefts.

Any theft or significant loss of prescription drugs shall be reported to the Board within 5 days. The report should be made on forms available from the Board for this purpose.

Section 17.20. Written Policies and Procedures.

Wholesale distributors shall establish, maintain, and adhere to written policies and procedures, which shall be followed for the receipt, security, storage, inventory, and distribution of drugs, including policies and procedures for identifying, recording, and reporting losses or thefts, and for correcting all errors and inaccuracies in inventories.

Section 17.21. Written Policies, Contents.

Wholesale distributors shall include in their written policies and procedures the following:

(a) A procedure whereby the oldest approved stock of a drug product is distributed first. The procedure may permit deviation from this requirement if such deviation is temporary and appropriate.

(b) A procedure to be followed for handling recalls and withdrawals of drugs. Such procedure shall be adequate to deal with recalls and withdrawals due to:

(1) any action initiated at the request of the Food and Drug Administration or other federal, state, or local law enforcement or other government agency, including the Board of Pharmacy;

(2) any volunteer action by the Manufacturer to remove defective or potentially defective drugs from the market; or

(3) any action undertaken to promote public health and safety by the replacing of existing merchandise with an improved product or new package design.

(4) A procedure to ensure that wholesale distributors prepare for, protect against, and handle any crisis that affects security or operation of any facility in the event of a strike, fire, flood, or other natural disaster, or other situations of local, state, or national emergency.

(5) A procedure to ensure that any outdated drugs shall be segregated from other drugs and either returned to the manufacturer or destroyed.

(A) This procedure shall provide for written documentation of the disposition of outdated drugs.

(B) This documentation shall be maintained for two years after disposition of the outdated drugs.

Section 17.22. Responsible Individuals.

Wholesale distributors shall establish and maintain lists of officers, directors, managers, and other individuals in charge of wholesale drug distribution, storage, and handling, including a description of their duties and a summary of their qualifications.

Section 17.23. Compliance with Federal, State, and Local Laws.

Wholesale distributors shall operate in compliance with applicable federal, state, and local laws and rules.

Section 17.24. Inspections Authorized.

Wholesale distributors shall permit the Board of Pharmacy and authorized federal, state, and local law enforcement officials to enter and inspect their premises and delivery vehicles, and to audit their records and written operating procedures at reasonable times and in a reasonable manner to the extent authorized by law.

Section 17.25. Controlled Substances Compliance Requirements.

Wholesale distributors that deal in controlled substances shall register with the Drug Enforcement Administration (DEA), and shall comply with all applicable state, local, and DEA requirements.

Section 17.26. Salvaging and Reprocessing.

Wholesale distributors shall be subject to the provisions of any applicable federal, state, or local laws or rules that relate to drug product salvaging or reprocessing, including Title 21, parts 207, 210, and 211 subpart K of the Code of Federal Regulations.

PART 18 COMMUNITY BASED LONG TERM CARE PHARMACIES

Section 18.1. Community Based Long Term Care Pharmacies.

Community based long term care pharmacies are those pharmacies that are closed to retail trade and only provide services to patients who may or may not reside in institutional settings, but who require a higher level of service than that typically provided by retail pharmacies. These would include unit dose or multi dose packaging promoting compliance with drug treatment regimens, and higher levels of medication therapy management.

Section 18.2. Applicable Rules.

Community Based Long Term Care Pharmacies shall comply with Part 9 herein, Pharmacy Practice Rules.

Section 18.3. Community Based Long Term Care Pharmacies versus Institutional Long Term Care Pharmacies.

Community based long term care pharmacies are distinguished from Institutional Long Term Care Pharmacies which are addressed in 10.2(b) of these Rules.

PART 19 REMOTE PHARMACIES

Section 19.1. General Purpose.

(a) This Part is enacted pursuant to 26 V.S.A. § 2032 which in 2006 initially authorized the Board of Pharmacy to conduct pilot remote pharmacy experiments and to then propose rules governing remote pharmacy and remote pharmacy practice.

(b) The Board's experiment shows that residents of identified under-served areas of Vermont can benefit from having access to remote pharmacies. Vermonters in under-served areas are significantly restricted in their ability to obtain needed prescription drugs. Remote pharmacies enable Vermonters to obtain prescription drugs in their own communities while still being able to consult with a pharmacist in a manner where public health, safety and welfare can be assured.

(c) Remote pharmacies should be located only in those areas where residents require basic pharmacy services and do not have a reasonably accessible retail pharmacy nearby. Remote pharmacies are designed to allow patients to, as closely as possible, receive the basic care, attention, and services that they would expect from a traditional retail pharmacy. Because a pharmacist is not required to be on the premises at all times however, the remote pharmacy cannot provide the full range of services normally provided by a retail pharmacy.

(d) Remote pharmacies are not intended to be a substitute for retail pharmacies where a pharmacist is present whenever prescription drugs are dispensed.

Section 19.2. Definitions.

(a) "Certified pharmacy technician" means an individual who is:

(1) registered with the Board as a pharmacy technician;

(2) whose registration is unencumbered;

(3) who has obtained and maintains current certification from a national technician certification authority approved by the Board; and

(4) who has a minimum of 2,000 hours experience as a registered pharmacy technician.

(b) "Coordinating pharmacist" means a Vermont licensed pharmacist with an unencumbered license who provides remote pharmacy services and who has no less than three years licensed practice experience.

(c) "Coordinating pharmacist manager" means a Vermont licensed pharmacist who has full responsibility for all aspects of one or more remote pharmacies.

(d) "Coordinating pharmacy" as used in this Part means a licensed pharmacy located within the State of Vermont or a Vermont licensed pharmacist not affiliated with a pharmacy. The "coordinating pharmacy," as permitted by the Board, provides remote pharmacy services at one or more licensed remote dispensing/pharmacy sites.

(e) "Remote pharmacy" means a licensed pharmacy facility where pharmacy services are provided by a coordinating pharmacist. The remote pharmacy is designed so that a pharmacist at a different location provides pharmacy services electronically via a computer system and via video and audio communication system approved by the Board.

(f) "Remote pharmacy practice" means the provision of pharmaceutical care services, including the storage and dispensing of prescription drugs, drug regimen review, and patient counseling, at a staffed remote dispensing site.

Section 19.3. Coordinating Pharmacist Manager.

(a) The Coordinating pharmacist manager is a Vermont licensed pharmacist who:

has no less than three years licensed practice experience;
possesses an unencumbered license; and
has been specifically designated and registered with the Board to serve as a coordinating pharmacist manager.

(b) When the remote pharmacy is affiliated with a Vermont retail pharmacy, the retail pharmacy's pharmacist manager shall be the coordinating pharmacist manager.

Section 19.4. Coordinating Pharmacist Manager Responsibilities.

The coordinating pharmacist manager shall be responsible for, at a minimum, the following:

(a) Submitting for Board approval the operational plan for the remote pharmacy service, including:

(1) justification of the need for the remote pharmacy service as provided in this Part.

(2) identification of the coordinating site;

(3) identification of the remote dispensing site;

(4) the names and titles of key personnel at both locations;

(5) the quality assurance and improvement plan;

(6) a policies and procedure manual; and

(7) explanation of the remote dispensing process to be utilized at the remote dispensing site;

(b) Ensuring that the practice of pharmacy performed at the remote pharmacy and the supervision of pharmacy technicians complies with applicable federal and state statutes and regulations and these rules;

(1) any automated pharmacy system is in good working order;

(2) the AMDS accurately dispenses the correct strength, dosage form, and quantity of the prescribed drug and accurately prints the prescription label while maintaining appropriate record-keeping, security, and quality assurance safeguards;

(d) Ensuring that all pharmacists and pharmacy technicians authorized to provide remote pharmacy services at the managing pharmacy or the remote site:

(1) maintain current licensure or registration with the Board;

(2) are trained in the operation of any automated pharmacy system; and

(3) are familiar with policies and procedures relating to the remote pharmacy practice.

Section 19.5. Change of Coordinating Pharmacist Manager.

A change in the coordinating pharmacist manager shall be reported in the manner a change of a pharmacist manager is reported under Part 6 of these Rules.

Section 19.6. Coordinating Pharmacist Duties.

Only the coordinating pharmacist may perform the activities listed in this rule. These activities may not be delegated to a pharmacy technician at a remote site.

(a) Receiving an oral prescription drug order from a prescriber or the prescriber's agent for dispensing to a patient at the remote site;

(b) Interpreting a prescription drug order;

(d) Interpreting the patient's drug record and conducting a drug utilization review;

(e) Authorizing any AMDS to dispense a prescription drug and print a prescription label at the remote site;

(f) Performing the final verification of a dispensed prescription;

(g) Counseling the patient or the patient's care-giver; and

(h) Completing and documenting the weekly inspection of the remote site.

Section 19.7. License Required for Remote Pharmacy Services - General Requirements.

(a) To be eligible for a remote pharmacy license, the applicant shall comply with the application process set forth in Rules 7.2 and Rule 7.3 herein and demonstrate to the Board that there is limited access to pharmacy services in the community where the remote site is proposed.

(b) In determining whether a community has limited access to pharmacy services, the Board may consider, but is not limited to the following factors:

(1) the proximity of a licensed retail or remote pharmacy;

(2) the geographical location of the community and proximity or ease of access to a retail pharmacy; and

(3) the nature of the community and its demographics.

(c) In no event will the Board approve a remote pharmacy if a retail pharmacy is located within a ten (10) mile drive by motor vehicle.

(d) Notwithstanding subsection (c) above, a remote pharmacy approved by the Board as part of the pilot project before adoption of these rules may, so long as it remains in compliance with these rules, continue to operate at its present locations.

Section 19.8. Laws Applying to Remote Pharmacies.

(a) Each remote pharmacy shall, in addition to meeting the requirements of these rules, comply with all applicable federal and state laws.

(b) If controlled substances are dispensed from the remote pharmacy, the remote pharmacy must obtain its own DEA registration.

(c) Where remote pharmacy rules conflict with the other rules governing retail pharmacies, the requirements of this Part shall apply. Space requirements for retail pharmacies do not apply to remote pharmacies.

Section 19.9. Policy and Procedure Manual.

The coordinating pharmacy and remote pharmacy shall operate pursuant to a written policy and procedure manual that is established by the coordinating pharmacy. The policy and procedure manual shall include, but is not limited to the following:

(a) a current list containing the name and business address of the coordinating pharmacist and personnel designated by the coordinating pharmacist manager to have access to the area where drugs are stored at the remote pharmacy;

(b) duties that may only be performed by a pharmacist; and

(1) operation of the video/auditory communication system;

(2) security;

(3) sanitation;

(4) storage of drugs;

(5) dispensing;

(6) supervision; and

(7) drug procurement, receipt of drugs, and delivery of drugs.

Section 19.10. Record Keeping.

The coordinating pharmacist manager shall, at least annually, review and revise as necessary the written policies and procedures, and document such review.

Section 19.11. Remote Pharmacy Staffing.

(a) A pharmacist, pharmacy technician, or pharmacy intern performing services in support of a remote pharmacy, whether those services are performed at the coordinating pharmacy or the remote pharmacy, must be licensed by or registered with the Board.

(b) Remote pharmacies shall be staffed by certified pharmacy technicians under the continuous supervision of a Pharmacist. A remote pharmacy where the sole operation is limited to an AMDS dispensing pre-packaged medications in a secure dispensing unit may be staffed by a certified pharmacy technician, licensed practical nurse, registered nurse, or authorized prescriber any of whom shall register as a pharmacy technician with the Board and shall be under the continuous supervision of a Pharmacist.

(d) A pharmacist who is engaged in the operation of a retail, institutional, or mail order pharmacy shall not simultaneously operate more than one remote pharmacy.

(e) A coordinating pharmacist who is also engaged in retail or institutional pharmacy may supervise the interpretation, evaluation, and implementation of a prescription drug order, including the preparation of a drug or device to a patient or patient's agent, to an average of 125 prescriptions at the remote pharmacy per work day in any one week or a peak of 150 prescriptions on any one day. This supervision limit does not apply to central filled or refill prescriptions dispensed at the remote pharmacy.

(f) A pharmacist who is not engaged in the operation of a retail, institutional or mail order pharmacy may operate no more than three simultaneously open Remote Pharmacies. A coordinating pharmacist providing only remote pharmacy services may supervise the interpretation, evaluation, and implementation of a prescription drug order, including the preparation of a drug or device to a patient or patient's bona fide representatives to an average of 250 prescriptions per work day in any one week or a peak of 300 prescriptions per day.

(g) A coordinating pharmacy providing remote pharmacy services shall provide sufficient staffing to meet the prescription work load. In an emergency, a temporary exception to this limit may, in the Board's discretion, be granted where the Coordinating Pharmacy has documented a need to supervise additional remote pharmacies and has demonstrated that appropriate safeguards are in place to ensure proper supervision of each.

Section 19.12. Notices and Displays.

(a) Each remote pharmacy shall have a notice clearly visible to the public stating: "This is a licensed remote pharmacy. A pharmacist may not be physically present. A pharmacist from the pharmacy in reviews every prescription dispensed here. Whether physically present here or at the pharmacy, the pharmacist is required to speak with you before your prescription will be dispensed."

(b) The license, or a copy thereof, of any pharmacist providing remote pharmacy services must be prominently displayed at the remote pharmacy.

(c) The registration and national certification, or copy thereof, of any pharmacy technician at a remote pharmacy shall be prominently displayed.

(d) Remote pharmacies must display all signs required by state or federal law for any retail pharmacy.

Section 19.13. Storage Security.

Drugs stored at Remote pharmacy shall be stored in an area that is:

(a) separate from any other drugs at a health care facility; and

(b) locked by key or combination, so as to prevent access by unauthorized personnel.

(c) Access to the area where drugs are stored at the remote pharmacy must be limited to registered or licensed pharmacy personnel.

Section 19.14. Audiovisual Link.

(a) There must be a continuously accessible, two-way audiovisual link between the coordinating pharmacist and the remote pharmacy. The transmission of information through the computer link must make information available to the coordinating pharmacist and the remote pharmacy simultaneously. The video camera used for the certification of prescriptions must be of sufficient quality and resolution so that the coordinating pharmacist can visually identify the markings on tablets and capsules. No prescription may be dispensed if the audio/visual link is not fully operational.

(b) Audio/video and IT communications disruptions shall be documented and retained for three years.

(c) The audio/visual link shall be recorded while the remote pharmacy is in operation. The recording shall be retained for 30 days.

(d) Each remote pharmacy shall have security cameras which shall capture movement within the remote pharmacy at all times. The coordinating pharmacist shall be able to monitor the security cameras at all times.

Section 19.15. AMDS Requirements.

An AMDS used in a remote pharmacy must comply with AMDS provisions contained in Part 11 of these rules.

Section 19.16. Remote Pharmacy Operation.

(a) A remote pharmacy may utilize an AMDS located in an area accessible only to registered or licensed pharmacy personnel.

(b) The coordinating pharmacist shall have access to the remote pharmacy's automated data processing system to perform a prospective drug utilization review (DUR) prior to dispensing. The pharmacist shall ensure, through the use of the video/auditory communication system, that the certified pharmacy technician has accurately and correctly prepared the drug for dispensing according to the prescription drug order.

(c) The remote pharmacy may be open only if the computer link, video link, and audio link with the coordinating pharmacy are functioning properly. If any link is not functioning properly, the remote pharmacy must be closed unless a pharmacist is working at the remote pharmacy.

(d) Any prescription filled at the remote pharmacy must be reviewed and interpreted by a pharmacist before the prescription is dispensed.

(e) A remotely dispensed prescription must have a properly prepared label attached to the final drug container before the pharmacist approves the prescription for dispensing.

(f) The computer must be capable of carrying the initials of the technician preparing the prescription and the pharmacist verifying the prescription.

(g) No compounding may occur at a remote pharmacy unless a pharmacist is physically present.

Section 19.17. Written or Electronic Prescription Drug Orders.

(a) A remote dispensing site may receive only written, faxed, or electronic prescription drug orders. The pharmacy technician at the remote site shall either transmit the prescription drug order or refill request to the coordinating pharmacy. The pharmacy technician may input the prescription drug order or refill request so that coordinating pharmacist may perform a prospective drug utilization review and verify the prescription information prior to authorizing dispensing from the remote site.

(b) A pharmacy technician at a remote pharmacy shall not receive oral prescription drug orders from a practitioner or practitioner's agent. Oral prescription drug orders shall be communicated directly to a coordinating pharmacist.

Section 19.18. Schedule II Prescriptions.

Schedule II prescriptions shall be dispensed as follows:

(a) patient presents original hard copy of Schedule II prescription to the remote pharmacy; (faxed prescriptions are not permitted)

(b) after verifying that the prescribed drug is in stock, technician dates, cancels, and signs the original hard copy;

(d) the coordinating pharmacist prints and reviews scanned prescription;

(e) the coordinating pharmacist dates, cancels, and signs the printed scanned prescription;

(f) the coordinating pharmacist re-scans the prescription to the patient file;

(g) the technician at the remote site prints the pharmacist's cancelled prescription and attaches it to the original prescription.

(h) No less than once per week, the original prescription must be reviewed in person by a pharmacist who then cancels, signs, and dates the original prescription.

Section 19.19. Counseling.

Unless the patient affirmatively refuses counseling, which refusal shall be documented, counseling is required for all new prescriptions.

Section 19.20. No Returned Drugs.

A remote pharmacy may not receive "take backs" except drugs returned due to a prescription dispensing error made at that site.

Section 19.21. Inspections and Board of Pharmacy Access to Records.

(a) All policies and procedures for any remote pharmacy must be maintained both in the coordinating pharmacy and the remote pharmacy and be available for inspection by the Board. The Board may physically inspect a remote pharmacy as it deems appropriate.

Section 19.22. Quality Assurance.

The coordinating pharmacist manager must:

(a) conduct an inspection of the remote pharmacy at weekly intervals or more frequently if necessary. Inspection must be documented and kept on file at the remote pharmacy and available upon request by the Board;

(b) implement and conduct a quality assurance plan that provides for on-going review of dispensing errors, with appropriate action taken, if necessary, to assure patient safety;

(d) Maintain records of all controlled substances stocked by the remote pharmacy through a daily perpetual inventory. Controlled substance perpetual inventory records must be available for Board inspection;

(e) conduct an inventory of all controlled substances at least monthly to verify accuracy; and

(f) maintain a record of medication errors.

Section 19.23. Reports to the Board.

(a) Initial Report After 180 days of operation the coordinating pharmacist manager for each remote pharmacy shall submit a report to the Board. The report shall:

(1) summarize identified errors by category and shall include the total number of errors identified, the reasons for the errors, the corrective actions taken to prevent the recurrence of those errors.

(2) state the number of prescriptions dispensed each month.

(b) Subsequent reports, annually. Within 15 days of the anniversary of the opening date, the coordinating pharmacist manager for each remote pharmacy shall submit a report to the Board. The report shall contain all the information required in subsection (a) of this rule.

Section 19.24. Renewal Requirements.

(a) Before a remote pharmacy license will be renewed, the licensee must demonstrate a continuing need for the remote pharmacy addressing the criteria upon which the initial license was granted. The Board's renewal form may contain questions to assist the renewal evaluation process so that the Board can determine whether there is a continuing need for the remote pharmacy.

(b) Remote renewals applications must be submitted using forms approved by the board.

(c) The Board will not renew a remote pharmacy license if a retail pharmacy is granted a license to operate within ten (10) miles by motor vehicle of the remote pharmacy's location. The remote pharmacy may apply to the Board for a pharmacy license for that location.

Section 19.25. Remote Pharmacy Closing.

A remote pharmacy which is to close shall comply with the drug outlet closing provisions of these Rules.

PART 20 UNPROFESSIONAL CONDUCT AND DISCIPLINARY INFORMATION

Section 20.1. Definitions.

The Board may take disciplinary action against a licensee, former licensee, or applicant for any of the grounds of unprofessional conduct set forth in 26 V.S.A. § 2051 or in 3 V.S.A. § 129a. 3 V.S.A. § 129a(a)(3) includes within the definition of unprofessional conduct, "(3) ailing to comply with provisions of federal or state statutes or rules governing the practice of the profession." Unprofessional conduct includes:

(a) Giving or receiving improper assistance in connection with any part of the examinations for licensure.

(b) Failing to provide, or false documentation of, continuing pharmacy education.

(d) Participating in, or agreeing to, activities whereby prescription orders, or prescription drugs and devices may be regularly delivered, or received, or solicited, or accepted by or to any non-licensed person.

(e) Providing prescription pads or blanks inscribed with the pharmacist's name, or the name and address of the drug outlet, for office use by a prescriber.

(f) Any disciplinary action in any jurisdiction by a licensing authority regulating the practice of a health-related profession.

(g) Dealing with drugs or devices that the licensee knows or should know are stolen drugs or devices or that the licensee knows or should know were obtained through distribution channels that do not comply with licensing requirements.

(h) Attempting to circumvent the patient counseling requirements, or discouraging the patient from receiving patient counseling concerning his or her prescription drug order.

(i) Divulging or revealing to unauthorized persons patient or practitioner information or the nature of professional pharmacy services rendered without the patient's express consent, or without order or direction of a court. The following are considered authorized persons:

(1) Patient or patient's agent, or another pharmacist acting on behalf of a patient;

(2) Practitioner who issued the prescription drug order;

(3) Certified or licensed health care personnel who are responsible for the care of the patient;

(4) A member, inspector, agent, or investigator of the Board or any federal, state, county, or municipal officer whose duty is to enforce the laws of this State or the United States relating to drugs or devices or both and who is engaged in a specific investigation involving a designated person or drug; and

(5) An agency of government charged with the responsibility of providing medical care for the patient, upon a written request by an authorized representative of the agency requesting such information.

(j) Selling, giving away, or otherwise disposing of accessories, chemicals, or drugs or devices found in illegal drug traffic when the pharmacist knows or should have known of their intended use in illegal activities.

(k) Selling a drug for which a prescription drug order from a practitioner is required, without having received a prescription drug order for the drug.

(l) Willfully and knowingly failing to maintain complete and accurate records of all drugs received, dispensed, or disposed or in compliance with the federal laws and regulations and state laws and rules.

(m) Obtaining any remuneration by fraud, misrepresentation, or deception, including but not limited to, receiving remuneration for amending or modifying, or attempting to amend or modify, a patient's pharmaceutical care, absent a clear benefit to the patient, solely in response to promotion or marketing activities.

Section 20.2. Independent Judgment.

3 V.S.A. § 129a(b) requires practitioners to practice competently. This includes conforming to essential standards of acceptable and prevailing practice. Part of a pharmacist's responsibilities is the duty to use independent professional judgment.

(a) A licensed pharmacist must comply with federal and state statutes and rules including the rules of the Vermont Board of Pharmacy. The nature of contemporary pharmacy practice may from time to time place a pharmacist in a position where adherence to legal requirements may conflict with the expectation of prescribers, employers or others.

(b) When such conflicts arise, the pharmacist's obligation is to exercise independent professional judgment. This may require a pharmacist to tell patients, prescribers, employers or others that his or her legal obligations prevent him or her from taking a certain course of action or complying with the wishes of others.

Section 20.3. Initiating a Complaint.

Anyone wishing to make a complaint of unprofessional conduct against a licensed professional should file a written complaint with the Office of the Secretary of State, Office of Professional Regulation, 89 Main St., Fl. 3, Montpelier, VT 05620-3402. The telephone number is (802) 828-1505. A complaint form may also be accessed from the Office Web site http://www.vtprofessionals.org.

Section 20.4. Investigations.

The Board may receive complaints from any source. 3 V.S.A. § 129(b).

Section 20.5. Disciplinary Process.

The Board follows the current complaint procedure recommended by the Office of Professional Regulation. A copy of the procedure and more information about the complaint process can be obtained from the Office.

Section 20.6. Confidentiality.

Confidentiality of disciplinary matters is governed by 3 V.S.A. § 131.

Section 20.7. Appeals.

Appeals from Board decisions are governed by 3 V.S.A. § 130.

Section 20.8. Reinstatement after Revocation.

(a) Unless the Board orders otherwise in a disciplinary decision, a licensee whose license has been revoked may apply for reinstatement at any time after one year has elapsed from the effective date of the revocation, or the date of the last application for reinstatement, if more than one application has been made.

(b) An application for reinstatement must show, among other requirements, that the licensee is fully rehabilitated from the conduct which produced the revocation, and should include supporting recommendations from pharmacists who have personal knowledge of the applicant's activities since the revocation. Information about other requirements and necessary documentation may be obtained from the Director of the Office of Professional Regulation.

Section 20.9. Modification of Orders.

(a) A licensee whose license has been suspended, restricted, or placed under supervision may apply for modification of the Board's order at any time after six months have elapsed from the effective date of the order, or the date of the last application, if more than one application has been made, unless an order of the Board provides otherwise.

(b) An application for reinstatement of an unrestricted license must show, among other requirements, that the licensee is fully rehabilitated from the conduct which produced the disciplinary action, and should include supporting recommendations from pharmacists or other relevant persons who have personal knowledge of the applicant's activities since the action. Information about other requirements and necessary documentation may be obtained from the Director of the Office of Professional Regulation.

History

EFFECTIVE DATE:
December 25, 1992 Secretary of State Rule Log #92-65; September 15, 2015
AMENDED:
September 1998; August 15, 2003 Secretary of State Rule Log #03-28; October 1, 2009 Secretary of State Rule Log #09-029; June 1, 2014 Secretary of State Rule Log #14-017 (cite as B.O.P. Rule x.x.); September 15, 2015 Secretary of State Rule Log #15-038; December 2015; October 2018 [correction to Section 10.23]
STATUTORY AUTHORITY: 26 V.S.A. §§ 2032, 2042b, 2061, 2062, 2063

Chapter 231 INSTITUTIONAL PHARMACIES

04-231 Code Vt. R. 04-030-231-X INSTITUTIONAL PHARMACIES

Section 1 DEFINITIONS

For purposes of these Rules and Regulations, the following definitions apply.

1.1 Institutional Facility. Institutional Facility is defined as:

a. Hospital;

b. Convalescent Home;

c. Nursing Home;

d. Extended Care Facility; or,

e. Any other such organization whose primary purpose is to provide a physical environment for patients to obtain health care services, except those places where physicians, dentists, veterinarians, osteopaths and other practitioners of the healing arts, who are duly licensed, engage in private practice.

1.2 Institutional Drug Outlet Pharmacy.

Institutional Drug Outlet Pharmacy is defined as that portion of an Institutional Facility which is engaged in the practice of pharmacy and which is registered with the Vermont Board of Pharmacy pursuant to Subchapter V. of the Vermont Pharmacy Act. Institutional Drug Outlet shall be hereinafter referred to as Institutional Pharmacy.

Section 2 PURPOSE

The purpose of the following Rules and Regulations is to accomplish the purposes of the Vermont Pharmacy Act, as specified in Section 2021 of Vermont Pharmacy Laws thereof, by implementing the provisions of that portion of the Act concerning Registration of Facilities, as specified in Section 2061 of Vermont Pharmacy Laws thereof.

Section 3 APPLICABILITY

The following Rules and Regulations are applicable to all Institutions and Institutional Pharmacies as defined by Section 1 hereinabove.

Section 4 PERSONNEL

4.1 Director. Each Institutional Pharmacy shall be directed by a Pharmacist, hereinafter referred to as the Director of Pharmacy, who has no fewer than 1500 hours experience in an Institutional Pharmacy. The Director shall be a full-time employee of the Institutional Facility in which the Institutional Pharmacy is located, except that the Director may be a part-time employee and may be exempt from the education and experience requirements above with express permission of this Board upon written application by the person responsible for all activities of the Institutional Pharmacy and for meeting the requirements of the State of Vermont Pharmacy Act and these Rules and Regulations.

4.2 Supportive Personnel

a. Trained technical personnel may be employed provided they have been approved by the Director. Up to a one to one ratio of one registered pharmacist to one trained technical person may be employed. At any given time should additional technical personnel be required the Director may petition the board for a variance. The Director shall develop and implement written policies and procedures to specify the duties to be performed by such technical personnel. These policies and procedures shall at a minimum, specify that ancillary technical personnel are under the direction and supervision of a registered pharmacist and that ancillary technical personnel are not assigned duties which may be performed only by registered pharmacists.

b. Secretarial and clerical assistance and support should be provided as required to assist with record keeping, report submission and other administrative duties; provided however, such personnel does not perform any technical duties.

4.3 Supervision. All of the activities and operations of each Institutional Pharmacy shall be under the direction and supervision of its Director or his designee. All functions and activities of ancillary personnel shall be under the Direction and supervision of a sufficient number of registered pharmacists to insure that all such functions and activities are performed competently, safely and without risk of harm to patients.

Section 5 ABSENCE OF PHARMACIST

5.1 General. During such times as an Institutional Pharmacy may be unattended by a registered pharmacist, arrangements shall be made in advance by the Director for provision of drugs to the medical staff and other authorized personnel of the Institutional Facility by use of night cabinets and in emergency circumstances, by access to the Pharmacy.

5.2 If night cabinets are used, The following should prevail: absence of a registered pharmacist, shall be by locked cabinet(s) or other enclosure(s) constructed and located outside the Pharmacy area, to which only specifically authorized personnel may obtain access by key or combination, and which is sufficiently secure to deny access to unauthorized persons by force or otherwise. The Director shall, in conjunction with the appropriate committee of the Institutional Facility, develop inventory listings of those drugs to be included in such cabinet(s) and shall insure that:

a. Such drugs are available therein, properly labeled;

b. Only prepackaged drugs are available therein, in amounts sufficient for immediate therapeutic requirements.

c. Whenever access to such cabinet(s) shall have been gained, written physician's orders and proofs of use, if applicable are provided;

d. This cabinet(s) shall be inspected by the Pharmacy each day that there is a Pharmacist on duty.

e. Written policies and procedures are established to implement the requirements of this Subsection .2.

5.3 Access to Pharmacy. Whenever any drug is not available from floor supplies or night cabinets, and such drug is required to treat the immediate needs of a patient whose health would otherwise be jeopardized, such drug may be obtained from the Pharmacy in accordance with the requirements of this Subsection .3. One supervisory registered nurse in any given shift is responsible for removing drugs therefrom. The responsible nurse may, in times of emergency, delegate this duty to another nurse. The responsible nurse shall be designated by position in writing by the appropriate committee of the Institutional Facility, and shall prior to being permitted to obtain access to the Pharmacy, recieve thorough education and training in the proper methods of access, removal of drugs, and records and procedures required. Such education and training shall be given by the Director of Pharmacy who shall require, at a minimum, the following records and procedures:

a. Removal of any drug from the Pharmacy by an authorized nurse must be recorded on a suitable form showing name of patient and room number, name of drug, strength, amount date, time and signature of nurse. This record shall be

b. Such form shall be left with container from which the drug was removed, both placed conspicuously so that it will be found by a pharmacist and checked properly and promptly.

5.4 Emergency Kits. For an Institutional Facility which does not have an Institutional Pharmacy, drugs may be provided for use by authorized personnel by emergency kits located at such Facility, provided, however, such kits meet the following requirements:

a. Emergency Kit Drugs Defined. Emergency kit drugs are those drugs which may be required to meet the immediate therapeutic needs of patients and which are not available from any other authorized source in sufficient time to prevent risk of harm to patients by delay resulting from obtaining such drugs from such other source.

b. Supplying Pharmacist. All emergency kit drugs shall be provided by a registered pharmacist.

c. Drugs Included. The Supplying pharmecist and the Nursing and Medical staffs of the Institutional Facility shall jointly determine the drugs, by identity and quantity, to be included in emergency kits.

d. Storage. Emergency Kits shall be stored in secure areas, suitable to prevent unauthorized access by force or otherwise, and to insure a proper environment for preservation of the drugs within them.

e. Labeling -- Exterior. The exterior of emergency kits shall be labeled so as to clearly and unmistakably indicate that it is an emergency drug kit and it is for use in emergencies only; and in addition, such label shall also contain a listing of the drugs contained therein, including name, strength, quantity and expiration of the contents, and the name, address(es) and telephone number(s) of the supplying pharmacist.

f. Labeling -- Interior. All drugs contained in emergency kits shall be labeled in accordance with Subsection 7.3.a. of these Rules and Regulations, and shall also be labeled with such other and further information as may be required by the medical staff of the Institutional Facility to prevent misunderstanding or risk of harm to the patients of the Facility.

g. Removal of Drugs. Drugs shall be removed from emergency kits only pursuant to a valid physician's order by authorized personnel, or by the supplying pharmacist. The kit shall have a breakable seal which indicates access.

h. Notifications. Whenever an emergency kit is opened the supplying pharmacist shall be notified and the pharmacist shall restock and reseal the kit within a reasonable time so as to prevent risk of harm to patients. In the event the kit is opened in an unauthorized manner, the pharmacist and other appropriate personnel of the Facility shall be notified.

i. Expiration Dates. The expiration date of an emergency kit shall be the earliest date on any drugs supplied in the kit. Upon the occurence of the expiration date, the supplying pharmacist shall open the kit and replace expired drugs with current dated drugs and reseal it.

j. Procedures. The supplying pharmacist shall, in conjunction with the medical staff of the Institutional Facility, develop and implement written policies and procedures to insure compliance with the provisions of this Subsection .3

Section 6 PHYSICAL REQUIREMENTS

6.1 Area. An Institutional Pharmacy shall have within the Institutional Facility its services, sufficient floor space allocated to it to insure that drugs are propared in sanitary, well lighted and enclosed places, and which meet the other requirements of this Section.

6.2 Equipment and Materials. Each Institutional Pharmacy shall have sufficient equipment and physical facilities for proper compounding, dispensing and storage of drugs, including parenteral preparations, and where appropriate, the following:

a. United States Pharmacopoeia;

b. American Hospital Formulary Service;

c. Periodicals on drug therapy such as American Journal of Hospital Pharmacy, Drug Intelligence and Clinical Pharmacy or Journal of Parenteral and Enteral Nutrition;

d. Remington's Practice of Pharmacy;

e. Compatibility charts;

f. Drug interaction references;

g. Antidote information;

h. Current editions of text and reference works covering theoretical and practical pharmacy;

i. Reference materials on general, organic, pharmaceutical and biological chemistry;

j. Reference materials on toxicology, pharmacology, bacteriology, sterilization and disinfection and,

k. Sufficient drugs to meet the needs of the patients of the Institutional Facility.

l. Vermont Pharmacy laws, rules and regulations and Institutional rules and regulations.

6.3 Storage. All drugs shall be stored in designated areas within the Institutional Pharmacy which are sufficient to insure proper sanitation, temperature, light, ventillation, moisture control, segregation and security.

6.4 Security. All areas occupied by an Institutional Pharmacy shall be locked by key or combination when unattended, so as to prevent acces: by unauthorized personnel. The Director shall designate those person: who shall have access to particular areas within the Pharmacy.

Section 7 DRUG DISTRIBUTION AND CONTROL

7.1 General. The Director of Pharmacy Services shall establish written procedures for the safe and efficient distribution of pharmaceutical products. An annual updated copy of such procedures shall be on hand for inspections.

7.2 Responsibility. The Director shall be responsible for the safe and efficient distribution of, control of and accountability for drugs. The other professional staff of the Institutional Facility shall cooperate with the Director in meeting this responsibility and in ordering, administering and accounting for pharmaceutical material so as to achieve this purpose. Accordingly, the Director shall be responsible for the following:

a. Preparation and sterilization of parenteral medications manufactured within the Institutional Facility:

b. Admixture of parenteral products, including education and training of nursing personnel concerning incompatibility and provision of proper incompatibility information when the admixture of parenteral products is not accomplished within the Institutional Pharmacy;

c. Manufacture of Drugs, if applicable

d. Participation in development of a formulary for the Institutional Facility;

e. Filling and labeling all containers to which drugs are transferred or from which drugs are to be administered;

f. Maintaining and making available a sufficient inventory of antidotes and other emergency drugs, both in the Pharmacy and patient care areas;

g. Records of all transactions of the Institutional Pharmacy as may be required by applicable law, state and federal and as may be necessary to maintain accurate control over and accountability for all pharmaceutical materials;

h. Participation in those aspects of the Institutional Facility's patient care evaluation program which relate to pharmaceutical material utilization and effectiveness

i. Fullest cooperation with teaching and/or research programs in the Institutional Facility, if any;

j. Implementation of the policies and decisions of the appropriate committee(s) of the Institutional Facility;

k. Effective and efficient messenger and delivery service to connect the Pharmacy with appropriate parts of the Facility on a regular basis throughout the normal workda of the Facility; and,

l. Meeting all inspection and other requirements of the Vermont Pharmacy Act and all applicable Rules and Regulations.

7.3 Labeling.

(a.) For Use Inside the Institutional Facility. All drugs dispensed by an Institutional Pharmacy, intended for use within the Facility, shall be dispensed in appropriate containers and adequately labeled so as to identify, at a minimum, brand name or generic name, strength, quantity. Whenever possible drugs should be dispensed in unit of use packaging which specifies the drug name, strength, manufacture, lot number and expiration date.

(b.) For use outside the Institutional Facility. All drugs dispensed by an Institutional Pharmacy for use outside of the Institutional Facility shall be packaged and labeled according to Federal and State Laws and Regulations.

c. Drugs added to Parenteral Admixtures. Whenever any drugs are added to parenteral admixtures, whether within or outside the direct and personal supervision of a registered pharmacist, such admixtures shall be labeled with a distinctive supplementary label indicating the name and amount of the drug added, date and time of addition, expiration time, and name of person so adding. Standards for dating, record keeping and a quality assurance program for admixtures shall be established by the Director of Pharmacy.

7.4 Discontinued Drugs. The Director shall develop and implement policies and procedures to insure that discontinued and outdated drugs and containers with worn, illegible, or missing labels are returned to the Pharmacy for proper disposition, or that the Director or his or her designee make proper disposition or dispose of such drugs at the storage site.

7.5 Physician's Orders. Drugs may be dispensed for an individual patient from the Institutional Pharmacy only upon an original or direct copy of an authorized physician's order.

a. Authorization. The appropriate committee of the Institutional Facility shall, from time to time as appropriate, designate those physicians who are authorized to issue orders to the Pharmacy.

b. Telephoned orders. Orders which are telephoned in should be immediately transcribed into the patient's chart with the individual transcribing the order indicating that it is a "Telephoned" order and needs to be countersigned by the attending Physician. The Physician should co-sign the order within 2 hours. Only an RN and LPN should receive the telephone order and they should indicate their name after the transcription.

c. Abbreviations. Orders employing abbreviations and chemical symbols shall be utilized and filled only if such abbreviations and symbols appear on a published list of accepted abbreviations developed by the appropriate Committee of the Institutional Facility.

d. Requirements -- Orders for Drugs for Use by Inpatients. Orders for use by inpatients shall, at a minimum, contain patient name and location, drug name, dose directions for use, date and physician's signature or that of his or her authorized representative.

7.6 Controlled Drug Accountability. The institutional facility shall establish effective procedures and maintain adequate records regarding use and accountability of controlled substances and such other drugs as the appropriate institutional committee may designate which may specify at least the following.

A. Name of drug,

B. Dose,

C. Physician,

D. Patient,

E. Date and time of administration,

F. And person administering the drug.

7.7 Recall. The Director shall develop and implement a recall procedure that can be readily activated to assure the medical staff of the Institutional Facility and the Pharmacy staff and the Director that all drugs included on the recall, whether within or outside the Facility, are returned to the Pharmacy for proper disposition.

7.8 Suspected Adverse Drug Reactions.

Any and all suspected adverse drug reactions shall be reported orally immediately to the ordering physician and in writing to the Pharmacy. Appropriate entry on the patient's record shall also be made.

7.9 Records and Reports.

The Director shall maintain and submit, as appropriate, such records and reports as are required to insure patient health, safety and welfare and, at a minimum, the following:

a. Physician's orders or direct copies thereof

b. Proofs of use;

c. Reports of suspected adverse drug reactions;

d. Inventories of night cabinets and emergency kits;

e. Inventories of the Pharmacy;

f. Bi-annual controlled substances inventories;

g. Alcohol and flammables reports;

h. Removal of drugs from the pharmacy by an authorized nurse;

i. Such other and further records and reports as may be required by law and these Rules and Regulations.

7.10 Brought by Patients.

Whenever patients bring drugs into an Institutional Facility, such drugs shall not be administered unless they can be precisely identified by the pharmacy; administration shall be pursuant to a specific physican's order for each drug only. If such drugs are not to be administered then the Director of Pharmacy shall, develop procedures to store and return them to the patient upon discharge or destroy as appropriate.

Section 8 INVESTIGATIONAL DRUGS

Investigational drugs shall be administered only under the person and direct supervision of the principal physician-investigator or his or her authorized clinician(s) with prior approval of the appropriate Committee(s) of the Institutional Facility. Nurses may administer such drugs only after they have been educated and trained concerning relevant pharmacologic information about such drugs by the clinician or the Pharmacy. The pharmacy shall store, dispense and maintain essential information on such drugs. Patients or representatives informed consent must be obtained prior to investigational drug therapy.

Section 9 INSPECTION

9.1 Monthly. The Director of Pharmacy shall no less than once per month, personally or by qualified designee, inspect all matters within his or her jurisdiction and responsibility and make appropriate written records and notations of such inspections. Such inspections shall, at a minimum verify that:

a. Drugs are dispensed only under direct supervision of registered pharmacists;

b. Ancillary Pharmacy personnel are properly directed and supervised;

c. Disinfectants and drugs for external use are stored separately and apart from drugs for internal use or injection;

d. Drugs requiring special storage conditions to insure their stability are properly stored;

e. No outdated drugs are stocked in the Institutional Pharmacy or the Facility it serves;

f. Distribution and administration of controlled substances are properly and adequately documented and reported by both Pharmacy and medical personnel;

g. Emergency drugs designated pursuant to Section 5 hereinabove are in adequate and proper supply both within the Pharmacy and at outside storage locations;

h. All necessary and required security and storage standards are met;

i. Metric-apothecariest weight and measure conversion tables and charts are reasonably available to all medical personnel; and,

j. All policies and procedures of the Director and of Appropriate Committees of the Institutional Facility relevant to Pharmacy are followed.

History

Effective Date: July 22, 1979 (Secretary of State Rule Log #79-52)
- Formerly Rule No. 04 057 002. This rule has not been changed. It has been renumbered and relocated to insure that all rules issued under this Office are properly and uniformly numbered.*
Statutory Authority: Not Available

Chapter 240 ADMINISTRATIVE RULES FOR PHYSICAL THERAPISTS

04-240 Code Vt. R. 04-030-240-X ADMINISTRATIVE RULES FOR PHYSICAL THERAPISTS

Part 1 General Information

Section 1.1 The Purpose of Licensure

The Director of the Office of Professional Regulation (referred to as "the Director" in this rule) is responsible, pursuant to Vermont law, for licensing physical therapists and physical therapist assistants in order to protect the public health, safety and welfare. The Director's responsibilities include setting standards for issuing licenses, regulating the practice of physical therapy and enforcing Vermont's professional conduct laws.

Section 1.2 Laws that Govern Licensure

Chapter 38, Title 26 V.S.A. contains the enabling statutes that govern professional physical therapy practice. Among the laws governing the regulation of professional practice are: the Professional Regulation law ( 3 V.S.A. §§ 121-131); the Administrative Procedure Act ( 3 V.S.A. §§ 801-849); the Open Meeting law ( 1 V.S.A. §§ 310-314); and the Access to Public Records law ( 1 V.S.A. §§ 315-320). These laws set forth the rights of an applicant, license holder or member of the public. The complete "Vermont Statutes" are at www.leg.state.vt.us . These rules implement and interpret the statutory laws governing the profession. Law libraries and the offices of most Town Clerks maintain volumes of the Vermont Statutes Annotated. The Office posts the most recent statutes and administrative rules governing the practice of the profession at www.vtprofessionals.org and http://vtprofessionals.org/oprl/p_therapists/ .

Section 1.3 Business Address

The Board's mailing address is the Office of the Secretary of State, Office of Professional Regulation, Director, National Life Bldg., North, FL2, Montpelier, VT 05620-3402 (the "Office"). Copies of these rules and more information about the profession and its requirements can be obtained by contacting the Office at 1-802-828-2363. This information may also be obtained from the Office's web site at http://vtprofessionals.org/.

Part 2 Information for Applicants

Section 2.1 Definitions

(a) "The Act" means The Physical Therapists Act, 26 Vermont Statutes Annotated, Chapter 38.

(b) "The Office" means the Office of Professional Regulation in the Office of the Secretary of State.

(c) "V.S.A." means Vermont Statutes Annotated: for example 26 V.S.A. § 2081 means section 2081 of Title 26 of the Vermont Statutes Annotated.

(d) "Physical therapy" is defined in 26 V.S.A. § 2081a(6).

(e) "Practice of physical therapy" is defined in 26 V.S.A. § 2081a(8).

(f) "Physical therapist" is defined in 26 V.S.A. § 2081a(4).

(g) "Physical therapist assistant" is defined in 26 V.S.A. § 2081a(5).

(h) "Physical therapy aide" is defined in 26 V.S.A. § 2081a(7).

(i) "General Supervision" means the supervising physical therapist must be available at least by telecommunications.

(j) "Direct Supervision" means the supervising physical therapist must be on-site and present in the department facility where the services are provided, is immediately available to the person being supervised, and maintains continued involvement in the aspects of each treatment session which are beyond the scope of practice of a physical therapist assistant or aide.

(k) "Unprofessional Conduct" is defined by 26 V.S.A. § 2121 and 3 V.S.A. § 129a.

(l) "Continuing competence" refers to the licensee's obligation to acquire and maintain the minimum necessary education, training, experience and/or expertise to practice with reasonable skill and safety and within the essential standards of acceptable and prevailing practice. It also involves the process of maintaining and documenting competence through ongoing self-assessment, development and implementation of a personal learning plan and subsequent reassessment.

(m) "Distance Consultation" is defined in 26 V.S.A. § 2081a(3).

Section 2.2 Where to Get An Application

An application for licensure or more information about the application process may be found on the Office's web site or by contacting the Office at the address found in Rule 1.3 above. Applicants must submit a completed application with all supporting documentation and fee to the Office. Supporting documentation may include, but is not limited to, evidence of required education, supervised practice, examination results, evidence of a license in any and all jurisdictions and their respective licensing standards, or other licensing standards. An initial license issued to an applicant within 90 days of the current expiration date will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.3 Qualifications for Licensure As a Physical Therapist

(a) Physical Therapist Qualifications. An applicant for a license as a physical therapist shall:

(1) be a graduate of a professional physical therapy education program accredited by the Commission of Accreditation in Physical Therapy Education (CAPTE), or accredited by a national accreditation agency approved by the Director;

(2) pass the Federation of State Boards of Physical Therapy (FSBPT) examination, or an equivalent examination approved by the Director; and

(3) pass an approved English proficiency exam if the applicant's native language is not English.

(b) Foreign Trained Physical Therapist Qualifications. An applicant who has been educated outside the United States and graduated from an education program not accredited by a national accreditation agency approved by the Director shall:

(1) undergo a credentials evaluation which demonstrates the candidate has met uniform criteria for educational requirements. The Office will provide applicants with a current list of acceptable services. Applicants are responsible for the costs of this evaluation; and

(2) pass an approved English proficiency examination if the applicant's native language is not English; and

(3) pass the FSBPT examination, or an equivalent examination approved by the Director.

Section 2.4 Qualifications for Licensure as a Physical Therapist Assistant

An applicant for licensure as a physical therapist assistant shall:

(a) be a graduate of a professional physical therapist assistant education program accredited by the Commission of Accreditation in Physical Therapy Education (CAPTE), or accredited by a national accreditation agency approved by the Director;

(b) pass an approved English proficiency examination if the applicant's native language is not English; and

(c) pass the Federation of State Boards of Physical Therapy (FSBPT) examination, or an equivalent examination approved by the Director.

Section 2.5 Licensure by Endorsement

An applicant licensed in good standing in another jurisdiction may be eligible for a license in Vermont if the requirements for licensure in the other jurisdiction are substantially equivalent to those of this state.

Section 2.6 How to Get a Temporary License

(a) A temporary license to practice, for a period not to exceed 90 days, may be issued to a physical therapist or physical therapist assistant currently licensed in another jurisdiction who has applied for licensure by endorsement in Vermont.

(b) A temporary license allows an applicant to practice while the application is being considered. An applicant for temporary license must submit the application, proof of other state licensure, verification of supervision, and fee.

(c) Practice of a PTA applicant with a temporary license must be under the daily, direct, on-site supervision of a physical therapist currently licensed in Vermont. Practice of a PT applicant with a temporary license must be under the daily, general supervision of a physical therapist currently licensed in Vermont.

(d) A temporary license shall not be renewed, and becomes null and void upon the issuance of a Vermont license, or upon the denial of the application.

Section 2.7 Right to a Written Decision and Appeal

An applicant will be notified in writing whether he or she is qualified to be licensed. If the Director denies an applicant a license, the Director shall give the applicant specific reasons and inform the applicant of the right to request a hearing for review of this decision. The hearing will be held by an administrative law officer appointed by the Secretary of State. After giving the applicant and the Director an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, remand or modify the preliminary decision. The administrative law officer's decision may be appealed to Washington Superior Court.

Part 3 Information for Physical Therapists and PT Assistants

Section 3.1 Renewing a License Biennially

Licenses renew on a fixed biennial schedule, September 30 [th ]of the even numbered years, and must be renewed before they expire. Before the expiration date, the office will mail a renewal notice to the licensee. Licensees must pay a renewal fee, and must have completed at least 24 hours of continuing competence activities for physical therapists and 16 hours of continuing competence activities for physical therapist assistants during the two years immediately preceding their respective renewal.

Section 3.2 Reinstatement of a License that has been Expired for Less than Five Years

Licenses that are expired may be reinstated upon meeting all requirements under 3.1 above, and payment of the late renewal penalty.

Section 3.3 Reinstatement of a License that has been Expired for More than Five Years

Pursuant to 26 V.S.A. § 2108, if a license has been expired for more than five consecutive years, that person may have his or her license reinstated upon payment of all applicable renewal, late penalty, and reinstatement fees, and demonstration of competence to practice by one or more of the following, as determined by the Director:

(a) acceptable "practice" under § 2108(1) means practice for at least one year containing 1200 work hours within that year under a supervisor licensed in Vermont as a physical therapist who has been practicing clinically for a period of at least one year prior thereto. If there is more than one individual supervising the person seeking reinstatement, only one supervisor at a time shall bear responsibility for the supervisee. Supervision must be direct supervision for at least 80% of the 1200 total hours. The remaining 20% may be performed under general supervision. After completion of the 1200 work hours, a letter shall be submitted to the Director from the applicant's most recent supervisor indicating supervisory approval and that the applicant has the requisite evaluation, treatment, management and professional interaction skills to be reinstated.

(b) completion of a "remedial course" and "continuing competence requirements" under § 2108(2) & (3), meaning 24 Continuing Competency Units ("CCUs") for PTs plus 10 CCUs per year for the period greater than 5 years in which the license has been expired. For PTAs, § 2108(2) & (3) means 16 CCUs plus 5 CCUs per year for the period greater than 5 years in which the license has been expired.

Section 3.4 Supervision Standards

(a) Physical therapist assistants shall work under a PT's supervision. The supervising physical therapist shall make regular visits at reasonable frequency to the place where the assistant is providing service and adjust the plan of care as needed. The physical therapist shall document the visits in the patient's medical record. The physical therapist shall re-evaluate and render treatment to a patient at least every fifth visit or every 30 days, whichever occurs first, or if the treatment is performed more than once a day, at least once per week. The PT shall communicate all plan of care changes to the PTA.

(b) A physical therapist or a physical therapist assistant practicing under a temporary license shall have daily, direct, on-site supervision by a licensed physical therapist for the duration of the temporary license. The supervising physical therapist shall be available for advice and intervention, and shall sign all notes entered in the patient's medical record.

(c) Physical therapy aides must have direct on-site supervision by a licensed physical therapist. The supervising physical therapist must:

(1) be continuously on-site and present in the department or facility where the aide is performing supervised tasks that do not require the knowledge and skill of a licensed physical therapist or licensed physical therapist assistant;

(2) be immediately available to assist the person being supervised in the tasks being performed; and

(3) maintain continued involvement in appropriate aspects of each treatment session in which a component of treatment is assigned to an aide.

(d) Supervisor to supervisee ratio:

(1) All PTAs: The supervising physical therapist may not supervise more than four physical therapist assistants at one time; or

(2) Non-PTAs or Mixed Group: The supervising physical therapist may not supervise more than three persons at one time, if said three person group includes aides, physical therapist students, physical therapist assistant students, and/or temporary licensees.

(e) The following physical therapy services may be performed only by, and are the sole responsibility of, the supervising physical therapist:

(1) Interpretation of referrals;

(2) Initial examination, problem identification, and diagnosis for physical therapy;

(3) Development or modification of a plan of care that is based on the initial examination and includes the goals for physical therapy intervention;

(4) Determination of which tasks require the expertise and decision-making capacity of the physical therapist and must be personally rendered by the physical therapist, and which tasks may be assigned;

(5) Assurance of the qualifications of all physical therapist assistants and physical therapy aides to perform assigned tasks through written documentation of their education or training that is maintained and available at all times;

(6) Assignment and instruction of the services to be rendered by the physical therapist assistant, or aide, including but not limited to, specific treatment program, precautions, special problems and contraindicated procedures;

(7) Timely review of documentation, re-examination of the patient and revision of the plan of care when indicated; and

(8) Establishment of a discharge plan and documentation of discharge summary or status.

(f) All supervisors shall be in good standing with an unencumbered license during the period of supervision.

Section 3.5 Complaint Procedure

The Office has a procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the complaint form and the procedure are available on the web at: www.vtprofessionals.org or by contacting the Office.

Section 3.6 Disciplinary Actions

Part 4 Continuing Competence

Section 4.1 Continuing Competency Activities Required

(a) A physical therapist licensee must document completion of a total of 24 CCUs during the two-year licensing period preceding renewal. A physical therapist assistant licensee must document completion of 16 CCUs during the two-year licensing period preceding renewal. This provision shall apply to all renewal periods.

(b) CCUs must be obtained in subjects related to either the professional practice of physical therapy or patient/client management.

(1) The professional practice of physical therapy includes but is not limited to professional accountability, professional behavior and professional development.

(2) Patient/client management includes but is not limited to examination, evaluation and diagnosis and prognosis; plan of care; implementation; education; and discharge.

Section 4.2 Standards for Continuing Competence Activities

(a) They have intellectual or practical content based on best available scientific evidence and the primary objective is to increase the participant's professional competence and proficiency as a licensee.

(b) They constitute learning experiences dealing with matters directly related to the practice of physical therapy or patient welfare.

(c) Live instruction mechanically or electronically recorded, reproduced or transmitted material, other electronic media, or a computer website accessed via internet may be used.

(d) Continuing competence materials shall be prepared, and activities conducted, by an individual or group qualified by practical or academic experience in a setting physically suitable to the educational activity of the program or clinical experience and, with sufficient space.

(e) Written materials must be distributed to all attendees at or before the time a course is presented. A syllabus/outline, learning objectives, and reference list with citations for pertinent evidence based practice information shall be provided.

(f) For activities that are directed to more than one discipline, or are directed primarily to another health care discipline, a determination by OPR would be made regarding whether the content of the activity would sufficiently enhance physical therapy knowledge and skills or aid in the practice of physical therapy.

Section 4.3 Approval of Providers

Providers must adhere to the following requirements:

(a) Topics and subject matter for each course shall be pertinent to the practice of physical therapy.

(b) Instructors for each course shall be competent in the subject matter and shall be qualified by appropriate education, training, experience, and scope of practice or licensure.

(c) Each course shall have a syllabus that includes learning objectives, reference list and either a schedule, for courses offered in-person, or an outline, for courses offered online.

(d) Each course shall have written educational goals and specific learning objectives which are measurable and which serve as a basis for an evaluation of the effectiveness of the course.

(e) Each participant shall be given the opportunity to evaluate each course and offer feedback to the approved provider. The approved provider shall consider any such evaluations for the purpose of updating or revising courses.

(f) Each approved provider shall maintain records regarding course content and licensee attendance for a minimum of two years.

(g) Each approved provider shall provide a certificate of completion to attendees.

Section 4.4 Approval for Continuing Competence Activities

(a) The Director shall approve a provider if the Director is satisfied that the provider's activities meet the standards set forth in Rule 4.3.

(b) Once a provider is approved, the continuing competence activity sponsored by that provider is approved for credit and no application to the Director must be made for approval. The Office shall maintain a PT CCU Table that sets forth the specific units/credits, documentation requirements, and the unit limitations for activities sponsored by an approved provider, as well as a list of approved providers. The CCU Table for Activities Sponsored by Approved Providers, as well as the List of Approved Providers, may be obtained from the Office's web site at http://vtprofessionals.org/.

(c) The Office shall also maintain a PT CCU Table that sets forth a list of continuing competence activities, their corresponding units/credits, documentation requirements, and unit limitations for activities that are not sponsored by an approved provider. The CCU Table for Activities Not Sponsored by Approved Providers may be obtained from the Office's web site at http://vtprofessionals.org/. Any licensee may seek individual approval of an activity not sponsored by an approved provider by applying to the Office at anytime but no later than 90 days before licensing renewal.

(d) The requirements related to maintaining records and the random audit provision set forth in Rule 4.5 apply to both activities sponsored by approved providers and activities not sponsored by approved providers.

Section 4.5 Evidence of Compliance

(a) Each licensee shall keep and maintain records showing that each course or activity for which credit is claimed has been completed.

(b) The Office shall perform a random audit of licensees' continuing competency activity requirements. An Audit Notice will be sent to the audited licensees. Within 30 days from receipt of an Audit Notice from the Office, the licensee must furnish the Office with the documentary evidence showing completion of the CCUs required for the audited reporting period.

History

STATUTORY AUTHORITY: 26 V.S.A. §§ 2091(7), 2107(d)
EFFECTIVE DATE: August 7, 1990 Secretary of State Rule Log #90-34
AMENDED: September 1, 1998 Secretary of State Rule Log #98-31; June 1, 2013 Secretary of State Rule Log #13-012

Chapter 250 ADMINISTRATIVE RULES FOR THE BOARD OF PRIVATE INVESTIGATIVE AND SECURITY SERVICES

04-250 Code Vt. R. 04-030-250-X ADMINISTRATIVE RULES FOR THE BOARD OF PRIVATE INVESTIGATIVE AND SECURITY SERVICES

PART 1 DEFINITIONS AND CLARIFICATION OF TERMS

Section 1-1. Agency.

"Agency" means a business organization that employs, intends to employ, or holds itself out as employing two or more persons licensed as private investigators or security guards.

Section 1-2. Director.

"Director" means the Director of Professional Regulation.

Section 1-3. Employee of an Agency.

"Employee of an agency" means a person engaged directly by the agency and compensated through its regular, W-2 payroll. "Employee of an agency" does not mean an independent contractor, subcontractor, or employee of another corporate entity.

Section 1-4. Office.

"Office" means the Office of Professional Regulation.

Section 1-5. Office Website.

"Office website" means sos.vermont.gov/opr/.

Section 1-6. Private Investigator.

"Private investigator" is defined by 26 V.S.A. § 3151(3) and limited by specific exclusions at id. § 3151.a(a).

Section 1-7. Qualifying Agent.

"Qualifying Agent" means a licensed security guard or licensed private investigator who is designated by an agency to be professionally responsible for monitoring the agency's compliance with regulatory requirements. See Rule 4 - 5(a)(3).

Section 1-8. Security or Security Guard.

"Security" or "security guard" is defined by 26 V.S.A. § 3151(4) and limited by specific exclusions at id. § 3151.a(b).

Section 1-9. Supervision.

"Supervision" and the verb "to supervise" mean having and maintaining regular and substantial familiarity with the conduct and work performance of another, and being readily available to consult telephonically or in person where necessary to address unexpected events, including questions of professional judgment.

PART 2 ADMINISTRATION

Section 2-1. Applicable Law.

The practice of private investigation and security is defined and regulated pursuant to 26 V.S.A. § 3151 et seq. Copies of these and other statutes are available online at legislature.vermont.gov/statutes/. The Office administers licensure in conformity with these and other Vermont laws, to include the Administrative Procedure Act, 3 V.S.A. § 800 et seq.; the Public Records Act, 1 V.S.A. § 315 et seq.; and the Laws of Professional Regulation, 3 V.S.A. § 121 et seq.

Section 2-2. Resources for Applicants and Licensees.

The Office maintains a website at sos.vermont.gov/opr/ with information and links relevant to all licensed professionals. Information specific to security guards, private investigators, and agencies, including links to forms and online applications, is available from sos.vermont.gov/private-investigative-security-services/.

Section 2-3. Military Status.

Relevant education, training, and service completed as a member of the United States Armed Forces may be credited toward the requirements of licensure under these rules, and special procedures apply to expedite licensure for spouses of service members subject to a military transfer to Vermont. See the Office website for details.

PART 3 PROCEDURES

Section 3-1. Applications.

Electronic applications for licensure are available from the Office website.

(b) When the Director intends to deny a completed application, notice stating the reasons for the action shall be given to the applicant by certified mail, whereupon the applicant shall have 30 days to petition for a hearing before an administrative law officer.

Section 3-2. Complaints.

Complaints against licensees, applicants for licensure, or persons practicing without a license may be submitted online at sos.vermont.gov/opr/complaints-conduct-discipline/.

Section 3-3. Contested Cases.

Section 3-4. Declaratory Rulings.

Petitions for declaratory rulings as to the applicability of any statutory provision or of any rule or order of the Office may be made pursuant to 3 V.S.A. § 808 and Office policy and procedure.

Section 3-5. Conflict of Standards.

Where a standard of unprofessional conduct set forth in statute conflicts with a standard set forth in rule, the standard that is most protective of the public shall govern, pursuant to 3 V.S.A. § 129a(e).

Section 3-6. Determination of Equivalency.

Where the Director is permitted by law or rule to accept certain training or experience on the basis of equivalence to a fixed standard, it is the burden of the applicant or licensee to establish equivalence to the Director's satisfaction, by producing credible, clear, and convincing evidence of the same. The Office has no obligation to research the bona fides of any institution, program, course, degree, certification, practicum, or fellowship and may resolve all inferences in favor of withholding a credential or approval.

Section 3-7. Waiver or Variance Policy.

The Office will not grant routine waivers or variances from any provisions of its rules without amending the rules. See 3 V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Director may, upon written request of an interested party, so find, grant a waiver with such limitations as it deems appropriate, and record the action and justification therefor in writing. This rule shall not be construed as creating any hearing right or cause of action.

Section 3-8. Contacting the Office.

See the Office website for contact details. Send mail to:

Office of Professional Regulation, ATTN: Private Investigative and Security Services, 89 Main Street, 3rd Floor, Montpelier, VT 05620-3402.

PART 4 LICENSES AND PERMITS

Section 4-1. Licensed Security Guard.

A licensed security guard may provide security services as a sole proprietor or as the employee of an agency. Pursuant to 26 V.S.A. § 3174, eligible applicants shall:

(a) be at least eighteen years old;

(b) have satisfactorily completed 40 hours of approved training in private security;

(d) demonstrate two or more years of experience in security work, as determined by the Director, which may include employment as a security guard licensed in another state; as a security guard for a security agency licensed in this or another state; or as a sworn member of a federal, state, or municipal law enforcement agency;

(e) meet a high standard as to character, integrity, and reputation and otherwise demonstrate fitness to practice, the assessment of which may be informed by the results of a criminal background check, verified employment history, and references from at least two professional peers.

Section 4-2. Registered Security Employee.

A registered security employee may provide private security services as the employee of an agency licensed under these rules, supervised by a licensed security guard employed by the same agency.

(a) An eligible registered security employee shall:

(1) be at least eighteen years old;

(2) have satisfactorily completed eight hours of approved training in private security; and

(3) meet a high standard as to character, integrity, and reputation and otherwise demonstrate fitness to practice, the assessment of which may be informed by the results of a criminal background check, employment history, and references from professional peers.

(b) When a registered security employee is not employed and supervised by an agency, his or her license shall be active but inoperative, and he or she is not authorized to provide private security services. Violation of this requirement is cognizable as unprofessional conduct and unauthorized practice pursuant to 3 V.S.A. § 127. An inoperative license returns to operative status when the licensee is registered by a firm.

Section 4-3. Licensed Private Investigator.

A licensed private investigator may practice private investigation as a sole proprietor or as the registered employee of an agency. Pursuant to 26 V.S.A. § 3173, eligible applicants shall:

(a) be at least eighteen years old;

(b) have satisfactorily completed 40 hours of approved training in private investigation;

(d) demonstrate two or more years of experience in investigative work, as determined by the Director, which may include employment as a private investigator licensed in another state; an investigator for a private investigator licensed in this or another state; or as a sworn member of a federal, state, or municipal law enforcement agency; and

Section 4-4. Registered Investigative Employee.

A registered investigative employee may provide private investigative services as the employee of an agency licensed under these rules, supervised by a licensed private investigator.

(a) An eligible investigative employee shall:

(1) be at least eighteen years old;

(2) have satisfactorily completed eight hours of approved training in private investigation; and

(b) When a registered investigative employee is not employed and supervised by an agency, his or her license is deemed active but inoperative, and he or she is not authorized to provide private investigative services. Violation of this requirement is cognizable as unprofessional conduct and unauthorized practice pursuant to 3 V.S.A. § 127. An inoperative license returns to operative status when registered by a firm.

Section 4-5. Agency.

An agency must be licensed prior to offering private investigative or security services to the public.

(a) An eligible agency shall:

(1) supply evidence of current Vermont business entity registration;

(2) identify those having an interest in the agency, or in the case of a publicly traded company, the company's officers and structure; and

(3) designate one or more full-time agency employees, each licensed in good standing as a licensed security guard or licensed private investigator, who shall be the Office's designated contact at the agency and professionally responsible for monitoring the agency's compliance with regulatory requirements.

(b) The Office may deny an agency application made by, on behalf of, or with the involvement of principals who have been disciplined for unprofessional conduct or who have a substantial connection to another agency disciplined for unprofessional conduct or unauthorized practice, or in any case where the Director finds that licensing the applicant agency would tend to undermine regulatory oversight or public accountability.

(c) An agency that employs one or more registered security employees must have on staff a licensed security guard responsible for the supervision of those registered security employees. An agency that employs one or more registered investigative employees must have on staff a licensed private investigator responsible for the supervision of those registered investigative employees.

Section 4-6. Out-of-State Licensee Temporarily Working in Vermont, Transitory Permit Required.

Upon application and payment of the applicable fee, the Office may grant a transitory permit to practice as a private investigator to a person who is not a resident of Vermont and has no established place of business in this state, if that person is legally qualified by license to practice as a private investigator in any state or country that regulates such practice. A transitory permit authorizes the reasonable continuation in this state of an investigative engagement or assignment initiated in or emanating from another. Practice under a transitory permit shall not exceed 30 days in any calendar year. A person so practicing is accountable for unprofessional conduct in like manner to a licensee. By applying for a transitory permit, an applicant agrees that the Office may accomplish service of process by transmitting first-class mail to his or her address of record.

Section 4-7. Firearms/Guard Dog Instructor.

Persons providing training to licensees in the use of firearms or guard dogs must be registered with the Office.

(a) The Office will not recognize firearms or guard-dog training provided by an unregistered instructor.

(b) To become registered as an instructor, an applicant must submit the information required by 26 V.S.A. § 3175a.

(c) Each course taught by a registered instructor must be approved by the Office. Course approval policies are available from the Office website.

PART 5 SPECIALTY DESIGNATIONS: FIREARMS, GUARD DOG HANDLING

Section 5-1. Specialty Designation Required.

No person may, in connection with private investigative or security services, carry or use firearms, nor handle or use guard dogs, unless he or she holds an appropriate license under Part 4 and an appropriate specialty designation under this Part. The Office construes this requirement strictly, such that, regardless of intent, the possession and control of a firearm or canine while working in any capacity as a licensee requires an active specialty designation. Violation of this requirement is cognizable as unprofessional conduct and unauthorized practice under 3 V.S.A. § 127.

Section 5-2. Special Responsibility.

Specialty designations authorize licensees to undertake activities requiring enhanced judgment and responsibility. The Office may apply a heightened standard as to character, integrity, and reputation for peaceful and responsible conduct and sound judgment to applicants for firearms and dog-handler specialties.

Section 5-3. Firearms Specialty Designation.

(a) To obtain a firearms specialty designation, a person shall:

(1) be licensed in good standing under Part 4;

(2) satisfactorily complete approved classroom instruction of at least twelve hours in safe handling and proper use of firearms, and legal responsibility for improper or negligent use;

(3) satisfactorily complete approved classroom instruction of at least four hours on safety and use of the particular weapon to be carried while working;

(4) satisfactorily complete range qualification appropriate to the weapon to be used.

(b) To renew a firearms specialty designation, a licensee shall possess a valid firearms recertification certificate recognized by the Office.

Section 5-4. Guard Dog Handler Specialty Designation.

(a) To obtain a guard dog handler specialty designation, a person shall:

(1) be licensed in good standing under Part 4;

(2) satisfactorily complete approved classroom instruction in basic guard dog safety, use, and legal responsibility;

(3) pass an approved field examination testing proficiency in guard dog handling.

(b) To renew a guard dog handler specialty designation, a licensee shall, at the time the Part 4 license is timely renewed, demonstrate that he or she has in the preceding six months:

(1) repeated and refreshed the classroom training required by Part 5-4(a)(2)

(2) re-qualified at field examination as required by Part 5-4(a)(3).

PART 6 LICENSE RENEWAL

Section 6-1. Biennial Licensing Period.

Licenses and specialty designations are valid for fixed, two-year periods and lapse if not renewed before the end of each biennial period. An initial license issued fewer than 90 days prior to the beginning of the fixed biennial period shall be valid through the end of full biennial licensing period following initial licensure. Expiration dates are printed on licenses. A lookup tool on the Office website may be considered a primary source verification as to the license status and expiration date of all Office licensees.

Section 6-2. License Renewal.

License renewal applications are available from the Office website. The Office transmits email reminders to licensees at the end of each biennial licensing period; however, non-receipt of such reminders shall not excuse a licensee from the obligation to maintain continuous licensure or the consequences of failing to do so. Practicing while a license is lapsed is a violation of 3 V.S.A. § 127.

Section 6-3. Cardiopulmonary Resuscitation.

Within three months of hire by an agency, all security personnel shall have acquired certification in cardiopulmonary resuscitation and the use of an automated external defibrillator from the American Red Cross, the American Heart Association, or an equivalent source approved by the Office. The Office may require that valid certification be documented or attested-to as a condition of license renewal. An agency shall keep records of employee certification and shall produce the same upon request of the Office.

Section 6-4. Late Renewal Penalties.

Late renewal applications are subject to reinstatement fees pursuant to 3 V.S.A. § 127(d). Late reinstatement fees are waivable at the discretion of the Director where a licensee has fully and completely removed himself or herself from practice for a period and has ceased holding himself or herself out as licensed. Licensees planning extended absence from practice are advised to document such intentions in advance to eliminate any subsequent question as to waiver eligibility.

PART 7 DUTIES AND STANDARDS

Section 7-1. Duty to Update and Self-Report.

Applicants and licensees owe a duty of candor to the Office and shall disclose circumstances that may call for further investigation to protect the public. That a matter is reportable does not imply that the matter necessarily is a basis for discipline. A licensee or applicant; and an agency in respect to its partners, corporate officers, agents, and employees; shall report to the Office, in writing, within 30 business days:

(b) any arrest, charge, or conviction for a criminal act;

(d) any adverse action against a foreign professional license, where the adverse action relates to an allegation of misconduct, substandard practice, or unethical conduct.

Section 7-2. Mandated Reporters.

Section 7-3. Professional Standards.

An administrative law officer may consider agency codes of conduct, practice guidelines, and training materials when determining "the essential standards of acceptable and prevailing practice" for purposes of 26 V.S.A. § 129a(b). All licensees should be familiar with these materials, where applicable, and the bases for discipline identified in Part 8.

Section 7-4. Identification to the Public.

A licensee must at all times when working carry his or her license or registration, or a true copy thereof, on his or her person. A licensee shall produce the same upon request of any law enforcement officer, Office investigator or inspector, or member of the public, unless doing so would create an unwarranted risk to the licensee's safety. Uniforms, badges, and insignia must not suggest law enforcement authority or otherwise mislead the public as to the licensee's authority, identity, or employer. Unauthorized retention or off-duty use of agency uniforms, badges, or insignia is unprofessional conduct.

Section 7-5. Agencies: De-Registration.

An agency shall notify the Office within 72 hours of terminating the employment of any employee licensed under Part 4 of these rules. A person licensed as an agency security guard under Part 4 shall be deemed registered with the agency when the Office confirms the registration.

Section 7-6. Inspection.

At work sites, no licensee may impede an investigation or unreasonably fail to reply, cooperate, or produce lawfully requested records in relation to an investigation or inspection. See 3 V.S.A. § 129a(a) (16(A).

PART 8 DISCIPLINE

Section 8-1. Unprofessional Conduct.

Unprofessional conduct includes those acts set out at 3 V.S.A. § 129a (applicable to all professional licensees) and 26 V.S.A. § 3181 (applicable to private investigators and security guards). Violation of these rules is cognizable as unprofessional conduct pursuant to 3 V.S.A. § 129a(a)(3).

Section 8-2. Remedies.

Section 8-3. Procedures.

Disciplinary proceedings are contested cases for purposes of Rule 3-3, above, and therefore are governed by the Office of Professional Regulation Administrative Rules of Practice, CVR 04-030-005.

PART 9 TRAINING PROGRAMS

Section 9-1. Training Approval.

The Office will credit toward Part 4 license requirements the satisfactory completion of programs of training, examination, and testing that have been duly approved under this Part. An agency or other organization seeking program approval shall apply in writing, on forms provided by the Office. Training must be structured and cannot involve allowing an unlicensed person to provide licensed activities without active guidance and supervision by a responsible licensee. Approvals will be granted for a defined period of time and will relate to the specific instructor or instructors identified in the application. The Office may at any time require that an approved training program re-verify its compliance with the requirements of this Part and may verify that training is carried out as approved by sending observers, requesting training materials or records, or interviewing participants.

Section 9-2. Licensed Security Guard Training - 40 Hours.

(a) An instructor or course organizer must be a licensed security guard in good standing, with five years' experience in security or law enforcement. The Director may waive instructor qualifications on a case-by-case basis where an instructor can demonstrate substantially equivalent preparation to train others.

(b) A 40-hour course shall address the following components at the following minimum durations:

| 1. Role of the security guard | 2 hours | | --- | --- | | 2. Ethics and conduct | 4 hours | | 3. Legal powers and limitations | 4 hours | | 4. Communication and public relations | 4 hours | | 5. Patrolling/investigation | 4 hours | | 6. Emergency response | 4 hours | | 7. Observation and note taking | 4 hours | | 8. Statements | 2 hours | | 9. Evidence | 2 hours | | 10. Access control | 2 hours | | 11. Report writing | 4 hours |

Section 9-3. Registered Security Employee Training - 8 Hours.

(a) An instructor or course organizer shall be qualified as required by Rule 9-2.

(b) An 8-hour course shall address the following components at the following minimum durations:

| 1. Role of the agency security guard | 2 hours | | --- | --- | | 2. Ethics and conduct | 3 hours | | 3. Legal powers and limitations | 3 hours |

Section 9-4. Licensed Private Investigator Training - 40 Hours.

(a) An instructor or course organizer must be a licensed private investigator in good standing, with five years' experience in security or law enforcement. The Director may waive instructor qualifications on a case-by-case basis where an instructor can demonstrate substantially equivalent preparation to train others.

(b) A 40-hour course shall address the following components at the following minimum durations:

| 1. Role of the private investigator | 2 hours | | --- | --- | | 2. Ethics and conduct | 4 hours | | 3. Legal powers and limitations | 6 hours | | 4. Communication and public relations | 4 hours | | 5. Investigative tools and applications | 6 hours | | 6. Observation and note taking | 4 hours | | 7. Statements | 2 hours | | 8. Evidence | 4 hours | | 9. Report Writing | 6 hours |

Section 9-5. Registered Investigative Employee Training - 8 Hours.

(a) An instructor or course organizer shall be qualified as required by 9-4(a)

(b) An 8-hour course shall address the following components at the following minimum durations:

| 1. Role of the agency private investigator | 2 hours | | --- | --- | | 2. Ethics and conduct | 3 hours | | 3. Legal powers and limitations | 3 hours |

History

EFFECTIVE DATE:
August 2, 1993 Secretary of State Rule Log #93-46
AMENDED:
October 15, 1998 Secretary of State Rule Log #98-64; July 1, 2005 Secretary of State Rule Log #05-009; April 1, 2015 Secretary of State Rule Log #15-007; 1/1/2022 Secretary of State Rule Log #22-003

Chapter 260 ADMINISTRATIVE RULES FOR PSYCHOANALYSTS

04-260 Code Vt. R. 04-030-260-X ADMINISTRATIVE RULES FOR PSYCHOANALYSTS

Part 1 INTRODUCTION

Section 1.1 The Purpose of Regulating Psychoanalysts

The Secretary of State has been given certain powers by Vermont law, the purpose of which is to protect the public health, safety, and welfare by setting standards, certifying applicants, and regulating certified psychoanalysts and their practices.

Section 1.2 Laws That Govern Regulation of Psychoanalysts

Certification is governed by a specific state law that establishes responsibilities for setting standards, issuing certificates, and regulating the profession. The law is the Psychoanalysts Act, 26 V.S.A. §§ 4051-4062. In addition, the Director is obligated to comply with several other state laws such as the Administrative Procedure Act, 3 V.S.A. §§ 801-849, the Open Meeting Law, 1 V.S.A. §§ 310-314, the Law of Professional Regulation, 3 V.S.A. §§ 121-131, and the Access To Public Records Law, 1 V.S.A. §§ 315-320. These laws set forth the rights of an applicant, certified psychoanalyst, or member of the public. The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us.

Part 2 INFORMATION FOR APPLICANTS FOR INITIAL CERTIFICATION

Section 2.1 Applications

Applications and information about certification requirements are available from the Office of Professional Regulation. An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office. The Director of the Office of Professional Regulation reviews applications only after the fully completed application and documentation are received, including evidence of any required education, supervision, or training.

Section 2.2 Psychoanalyst Certification

Qualifications for certification are set forth in 26 V.S.A. § 4057. Applicants for psychoanalyst certification shall have:

(1) Degree requirement: A master's (or equivalent) degree in any discipline,

and

(2) Psychoanalysis institute requirement: A graduate certificate or doctoral degree in psychoanalysis from a government-chartered psychoanalytic institute, accredited by a national psychoanalytic association.

Section 2.3 Certification Denials, Hearings, and Appeals

If the Director intends to deny an application for certification, the Director shall send the applicant written notice of the decision by certified mail. The notice shall include a statement of the reasons for the action and shall advise the applicant that the applicant may file a petition with the Director for review of the Director's preliminary decision within 30 days of the date on which the notice was mailed. The review shall be conducted by an administrative law officer.

After giving the applicant an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, or modify the Director's preliminary decision and shall explain the reasons in writing. At the hearing, the applicant has the burden of proving that he or she is eligible for certification. Decisions of the administrative law officer may be appealed to the Washington Superior Court.

Part 3 INFORMATION FOR CERTIFIED PSYCHOANALYSTS

Section 3.1 Certification Renewal

Certifications renew on a fixed biennial schedule: November 30 of the odd-numbered years. Initial certifications issued within 90 days of the renewal date will not be required to renew and pay the renewal fee. The certificate will be issued through the next full license period. Applicants issued an initial certification more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee. Before the expiration date, the Office will mail a renewal application and notice of the renewal fee. Certification will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

Section 3.2 Reinstating Certification

If a certificate has expired because it was not renewed on time, the certificant may apply for reinstatement and pay a late fee and the renewal fee for the current renewal period.

If a certificate has lapsed for five or more years, the Director may revoke the person's right to renew certification after giving the person notice and opportunity for a hearing.

Section 3.3 Change of Name or Address

A certificant is responsible for notifying the Office promptly if he or she changes name, mailing address, or business address. Acceptable documentation of change of name includes a notarized copy of a marriage certificate, instrument of change of name from a probate court, or other court order. Acceptable documentation of change of name also includes a notarized copy of current identification, such as a driver's license or Social Security card, in both the former and present names. The Director may require additional documentation at his or her discretion.

Section 3.4 Continuing Educational Requirements

All persons certified to practice psychoanalysis must earn a minimum of 20 hours of continuing education during the two-year renewal period and must report these hours at the time of license renewal.

The continuing education requirement does not apply for the renewal period during which a person initially obtained certification. It will begin with the first full two-year renewal period.

"Continuing education" means the direct participation of a certified psychoanalyst in a structured educational or supervisory program directly related to competency in psychoanalysis or protection of clients from harm, or both. Continuing education hours are calculated in the following manner:

(1) one contact hour equals one continuing education hour.

(2) one semester college credit equals fifteen continuing education hours.

(3) one quarter college credit equals ten continuing education hours.

(4) one hour spent in a workshop equals one continuing education hour.

At the time of certificate renewal, each certificant must certify on the Office renewal form that he or she has complied with the continuing education requirements. The Director or the Director's designee may randomly audit certificants to ensure compliance.

A certificant who is audited will be notified in writing by the Director or the Director's designee and will be required to produce written documentation verifying successful completion of the 20 hours of continuing education during the two-year period at issue.

Section 3.5 Failure to Meet Continuing Education Requirement

A certificant who fails to comply with the continuing education requirement may be required to develop and complete a specific corrective action plan prior to certificate renewal.

Section 3.6 Complaint Procedure

The Director has a procedure for receiving, investigating, and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Section 3.7 Disclosure of Information

Each certified psychoanalyst shall disclose to each client the following information, printed or typed in easily readable format:

(1) The certified psychoanalyst's professional qualifications and experience, including (A) all relevant graduate programs attended and all graduate degrees and certificates earned, including the full legal name of the granting institution, and (B) a brief description of any special qualifications and areas of practice.

(2) A copy of the statutory definition of unprofessional conduct ( 26 VSA § 4062) .

(3) Information on the process for filing a complaint with, or making a consumer inquiry to, the Director. Sample information cards are available from the Office.

Disclosure means, at a minimum, (A) posting the information and informing the client where the information is posted, or (B) having the information printed, displaying the printed information in an easily accessible location, and informing the client where the information is displayed, or (C) having the information printed and directly handing a copy of the information to the client.

Not later than the third office visit, the certified psychoanalyst shall present to the client for signature a document stating that the information required to be disclosed in paragraphs (1), (2), and (3) above has been disclosed to the client. The psychoanalyst shall also sign the document and shall retain the signed original. If, by the third visit, disclosure cannot be made or the client declines to sign, the psychoanalyst shall prepare and sign a written statement explaining the omission, which shall be retained in place of the signed copy.

When the client is not able to understand the disclosure, as in the case of an institutionalized person, a minor, or an adult who is under the supervision of guardian, the disclosure shall be made to a suitable parent or guardian.

The Director may audit a certified psychoanalyst's records of information disclosure. Individuals to be audited may be selected at random.

History

Effective Date: March 1, 1998
- Formerly Rule No. 04 100 002. This rule has not been changed. It has been renumbered and relocated to insure that all rules issued under this Office are properly and uniformly numbered.*
Statutory Authority: 26 V.S.A. §§ 4051-4062

Chapter 270 ADMINISTRATIVE RULES OF THE BOARD OF PSYCHOLOGICAL EXAMINERS

04-270 Code Vt. R. 04-030-270-X ADMINISTRATIVE RULES OF THE BOARD OF PSYCHOLOGICAL EXAMINERS

Part 1 GENERAL INFORMATION about THE BOARD

Section 1.1 The Board's Purpose

The Board of Psychological Examiners (referred to as "the Board" in this Rule) has been created and given certain powers by Vermont law. Its purpose is to protect the public health, safety, and welfare. It does this by setting standards, licensing applicants, and regulating licensed psychologists and those engaged in supervised practice toward licensure as psychologists and their practices.

Section 1.2 Business Location

The business location of the Board is the Office of the Secretary of State, Office of Professional Regulation, in the City Center 89 Main St., Fl. 3, Montpelier, VT 05620-3402, (the Office). the mailing address is Board of Psychological Examiners, Office of Secretary of State, Office of Professional Regulation, 89 Main St., Fl. 3, Montpelier VT 05620-3402. the telephone number is (802) 828-1505.

Section 1.3 Information Sources

Copies of these rules and more information about the Board and its requirements and procedures are available by contacting the Office or through the OPR website at http://vtprofessionals.org. Practitioners and applicants should periodically consult the website for matters of interest to the profession.

Section 1.4 Regular, Special, and Emergency Meetings

(a) The Board is required to hold at least two regular meetings a year, although it usually meets more often, as dictated by the volume of business to be conducted. If necessary, the Chair or any two members may call a special or emergency meeting.

(b) Three members of the Board constitute a quorum for all meetings. the Board may not take any formal action at any meeting unless a majority of the members present vote in favor of the action.

(c) Meeting dates and locations may be obtained from the Office. Notice of meetings may usually be found online at http://vtprofessionals.org.

Section 1.5 Laws that Govern the Board

(a) The Board is governed by Title 26, Chapter 55 of the Vermont Statutes Annotated that establishes its responsibilities for setting standards, issuing licenses, and regulating the profession. Board powers are also conferred by subchapter III of Chapter 5 of Title 3 "Professional Regulation," the statutes creating and governing the Office of Professional Regulation ( 3 V.S.A. §§ 121-132).

(b) In addition, the Board is obligated to comply with several other state laws, including the Administrative Procedure Act ( 3 V.S.A. §§ 801-849); the "Vermont Open Meeting Law" ( 1 V.S.A. §§ 311-314), and the "Public Records Law" ( 1 V.S.A. §§ 315-320). in contested cases, the Board follows the Vermont Rules of Evidence, as amended by the Administrative Procedure Act. These laws spell out the rights of an applicant, licensed psychologist, or member of the public. "The Vermont Statutes Online" are available on the Internet at http://www.leg.state.vt.us/statutesMain.cfm.

Section 1.6 The Rules

The Board is authorized to make these rules by 26 VS.A. § 3009a. These rules were approved by the Vermont Legislative Committee on Administrative Rules before adoption and are presumed valid. These rules have the force of law. 3 V.S.A. § 845(a). Violation of these rules can be unprofessional conduct. 3 V.S.A. § 129a(a)(3).

Section 1.7 Need for a License

26 V.S.A. § 3002 states: "(a) a person who is not licensed under the Act shall not engage in the practice of psychology. (b) a person who is not licensed under the Act shall not use the title 'psychologist' or any title which contains that word."

Section 1.8 Temporary License

A person licensed with no disciplinary history and in good standing to practice psychology in another United States or Canadian jurisdiction may apply to the Board for a temporary license to practice in Vermont for no more than 10 days or 80 hours in any 12-month period. Information about temporary licenses and associated fees may be obtained from the Office. No applicant may be issued more than two temporary licenses.

Section 1.9 Emergency License

The Board may issue temporary emergency licenses during a declared state of emergency. the psychologist issued a temporary emergency license must be currently licensed, in good standing, and not subject to disciplinary proceedings in any other United States or Canadian jurisdiction. the temporary emergency license shall authorize the holder to practice in Vermont until the termination of the declared state of emergency or 90 days, whichever occurs first, as long as the licensee remains in good standing. There is no fee for an emergency licensure under this rule.

Section 1.10 School Psychologists

School psychologists are licensed by the Vermont Department of Education. a school psychologist who practices outside of his or her scope of school psychology practice may be considered to be engaged in the unauthorized practice of psychology and be subject to administrative penalties, civil action, and criminal prosecution.

Section 1.11 Definitions

Unless otherwise indicated, all words and phrases used in these rules have the same meaning as the terms defined in 26 V.S.A. Chapter 55. as used in these rules:

(a) "APA" means the American Psychological Association.

(b) "CAMPP" means the Council of Applied Master's Programs in Psychology.

(d) "Good standing" means that the professional holds a current, unrestricted license.

(e) "Jurisprudence Examination" means the examination of Vermont Statutes and Board Administrative Rules regarding the regulation of psychologists given by the Board as part of the registration and licensure process.

(f) "National Register" means the National Register of Health Service Providers in Psychology.

(g) "The Office" or "Office" means the Office of Professional Regulation.

(h) "Supervised practice" as used in these rules means post degree clinical work toward licensure as a psychologist. It is supervised by a licensed psychologist who is familiar with the nature of the individual's clinical activities and who monitors the quality of the work and contributes to the enhancement of the individual's knowledge of self and of clinical work. Both the supervisor and supervisee in Vermont are subject to the disciplinary authority of the Board.

(i) "Unprofessional Conduct" means conduct defined by statute for which an applicant or licensee may be held accountable.

(j) "V.S.A." means the Vermont Statutes Annotated, the authorized compilation of Vermont legislative enactments.

Part 2 DOCTORAL LEVEL LICENSURE

Section 2.1 Routes to Licensure

(a) There are five ways to become licensed in Vermont as a psychologist at the doctoral level.

(1) Examination: An applicant may apply on the basis of education, licensing examination, and supervision;

(2) Endorsement: An applicant who is licensed in another jurisdiction may seek licensure on the basis of that license or certification.

(3) Diplomate status;

(4) Certification from an individual certification program; and

(5) "Up-grade" from master's level licensure.

(b) Statutes and rules examination All applicants must successfully complete the Board's jurisprudence (statutes and rules) examination before a license will be issued.

Section 2.2 Licensure by Examination

To be eligible for licensure by examination, an applicant must:

(a) have attained the age of 18 years;

(b) hold a doctoral degree in psychology as defined below;

(d) have completed 4,000 hours of supervised practice, of which no fewer than 2,000 hours were completed after the doctoral degree in psychology was received; and

(e) complete the Board's jurisprudence examination.

Section 2.3 Degree Requirement

An applicant must hold a doctoral degree in psychology from:

(a) a professional psychology training program regionally accredited by a body approved by the Council on Postsecondary Accreditation and the United States Office of Education, or

(b) a Canadian institution which is a member of the Association of Universities and Colleges of Canada, and is a doctoral program designated by the Joint Designation Committee of the Association of State and Provincial Psychology Boards and the National Register of Health Service Providers in Psychology; or

(c) a doctoral program accredited by the American Psychological Association or the Canadian Psychological Association; or

(d) "other acceptable degree programs" as defined below.

Section 2.4 Other Acceptable Degree Programs - Accreditation

A doctoral degree from a program, other than the ones specified in subsections (a) through (d) of Rule 2.3 must be:

(a) from an American institution regionally accredited by a body approved by the Council on Postsecondary Accreditation and the United States Office of Education and meet the requirements of Rule 2.6 below; or

(b) from a Canadian institution which is a member of the Association of Universities and Colleges of Canada, and meet the requirements of Rule 2.6 below; or

(c) from an institution outside the United States or Canada whose educational requirements are equivalent to the standards of a professional psychology training program as defined by these rules; and,

(1) The institution must be accredited by the respective official organization having such authority.

(2) The Board will evaluate an applicant's academic credentials after the Board receives a report from a Board-approved credentials evaluation service.

(A) Applicants should consult the Board's Web page or contact the Board for a current list of acceptable services.

(B) Applicants are responsible for the costs of this evaluation.

Section 2.5 Other Acceptable Degree Programs - Structure

A doctoral degree from a program other than the ones specified in subsections (a) through (c) of Rule 2.3 must, in the sole determination of the Board, be:

(a) from a program that:

(1) wherever it may be administratively housed, is clearly identified and labeled as a psychology program;

(2) has an identifiable psychology faculty and a licensed psychologist responsible for the program;

(3) is directed and taught predominantly by psychologists;

(4) offers both training in the practice of psychology and a degree in psychology;

(5) is specified in pertinent institutional catalogs and brochures that it is intended to educate and train professional psychologists in the area of psychology; and,

(b) the degree must be based on substantial course work that is primarily psychological in nature, meaning courses which:

(1) are taught in the Department of Psychology or by an instructor with a graduate degree in psychology or with psychological training and experience appropriate to the content of the course;

(2) include a review of the scholarly literature in the particular area of psychology involved; that is, a review of psychological theory, research methods, and applications, as distinguished from practice and field experience; and

(3) are psychological in content, as distinguished from courses which ordinarily are the subject matter of another discipline that may incidentally draw on psychological theory or research.

(c) To qualify for consideration under this rule, degrees from programs, including acceptable foreign degree programs, must require a minimum of 400 hours in program and clinical courses, exclusive of internship, to be in person on campus.

Section 2.6 Courses Required from "Other Acceptable Degree Programs" - Approval

To be eligible for licensure an applicant must have successfully completed the following. An applicant whose degree does not meet these requirements may supplement as set forth in Rule 2.9.

(a) Assessment 9 credit hours

(1) Assessment refers to psychological theory, research, and methods concerning the measurement and assessment of an individual's behavioral or psychological functioning. This section must include 3 credit hours of general foundation course(s) providing a general overview of the subject area. General foundation courses may include, but are not limited to:

(A) Psychological Testing/Assessment;

(B) Intellectual (Cognitive) Assessment;

(D) Introduction to Psychometrics.

(2) Assessment course(s) may cover areas such as the assessment of psychopathology, personality characteristics, intellectual functioning, skills and interests, and neuropsychological functioning. Assessment courses may include, but are not limited to:

(A) Specialized courses:

(i) Projective Testing;

(ii) Neuropsychological Testing;

(iii) Diagnostic Interviewing;

(iv) Minnesota Multiphasic Personality Inventory (MMPI); and

(v) Tests and Measurements.

(b) Intervention 9 credit hours. Intervention courses relate to psychological theory, research, and methods concerning the remediation, treatment, or prevention of behavior disorders, adjustment problems, and psychopathology, or other disturbances in psychological functioning. Examples of relevant courses may include, but are not limited to the following:

(1) Cognitive Psychotherapy;

(2) Family Therapy;

(3) Group Therapy;

(4) Psychoanalytic/Psychodynamic Therapy;

(5) Community Psychology;

(6) Prevention of Psychopathology.

(1) Psychopathology courses relate to psychological theory, research, and methods concerning the descriptive characteristics, diagnosis, and etiology of psychopathology, or mental and behavioral disorders of children and adults. This section must include 3 credit hours of foundation course(s) providing a general overview of the subject area. General foundation courses may include, but are not limited to:

(A) Advanced Abnormal Psychology;

(B) Child Psychopathology;

(D) DSM (Diagnostic and Statistical Manual of Mental Disorders) / ICD (International Classification of Diseases);

(2) Examples of relevant specialized courses in psychopathology may include, but are not limited to the following:

(A) Mood Disorders;

(B) Substance Abuse;

(D) Mental Retardation; and

(E) Attention Deficit Hyperactivity Disorder (ADHD).

(d) Statistical Methods (Statistics or Research Methodology) 3 credit hours; and

(e) Professional Ethics 3 credit hours.

Section 2.7 Interpretation

In determining whether an applicant's training program has met course distribution requirements, the Board will accept a course as fulfilling the requirement of one area only. the Board will not accept subdivision of the credit hours of a course into two or more areas.

Section 2.8 Documentation

Applicants bear the responsibility to submit to the Board official or primary source documentation. This documentation permits the Board to determine whether an applicant's degree and education meet the requirements of these rules.

Section 2.9 Permitted Supplementation

Applicants whose transcripts show that they have not met all the requirements of Rule 2.6 may supplement their education as set forth herein.

(a) A doctoral degree in psychology which has not met all the requirements set forth in sections (a) - (e) of Rule 2.6 may be supplemented by up to six (6) hours of course work.

(b) No more than three credit hours of course work may be taken to supplement the requirements of any one section. Example: An applicant cannot take 2 courses (six hours) in intervention to supplement courses lacking in that category.

(d) Undergraduate courses and work experiences may not be substituted for course work under this section.

Section 2.10 Examination

Applicants must successfully complete the Examination for Professional Practice in Psychology (EPPP), prepared by the Association of State and Provincial Psychology Boards (ASPPB), or other examination(s) approved by the Board and made known through its website in advance. See, Application Process for timing of the examination. More information about the examination is available from the Office or by accessing the Board's Web page at http://vtprofessionals.org/opr1/psychologists/.

Section 2.11 Recent Examination Required

For applications received after the effective date of these rules: Applicants who have not previously been licensed must successfully complete the EPPP or other examination approved by the Board within 5 years of applying for licensure.

Section 2.12 Examination Report

(a) The passing score is set by the ASPPB who reports the score to the Board.

(b) The Board will tell an applicant whether he or she successfully completed the examination.

Section 2.13 Retaking the Examination

Unsuccessful candidates may retake the examination as permitted by the examination provider.

Section 2.14 Supervised Practice

(a) The post-doctoral degree supervised practice may not be completed in less than one (1) year.

(b) The specific supervised practice requirements are contained in Part 4 of these rules.

Section 2.15 Exceptional Cases

The Board may waive the education, experience, or examination requirement in exceptional cases when the applicant demonstrates appropriate qualification. Only one of the three requirements may be waived. in general, this section applies to individuals who by reason of research, teaching, or practice are nationally or internationally recognized as exceptional; that is, those individuals who, in the sole judgment of the Board, are generally recognized by the profession at large as having made a major contribution to the practice of psychology. in all other instances, success or failure in attaining a license shall depend on meeting the requirements of these rules and not on any waiver of educational or other requirements.

Section 2.16 Vermont Licensure Based on License from Another Jurisdiction

Psychologists licensed in another United States or Canadian Jurisdiction may be eligible for licensure in Vermont as set forth in the following rules.

Section 2.17 Licensure by Endorsement

(a) Applicants who are licensed doctoral level psychologists in good standing in another jurisdiction in the United States or Canada may be licensed in Vermont upon showing that the jurisdiction's current licensing requirements are substantially equivalent to Vermont's. in determining substantial equivalence of supervised practice requirements, the Board will consider a state whose standards require no fewer than 1,500 hours of post-degree supervised practice to be substantially equivalent.

Section 2.18 Vermont Licensure Based on Current Diplomate Status

Applicants licensed in another United States or Canadian jurisdiction who demonstrate that they are diplomates in good standing in one of the academies of the American Board of Professional Psychology (ABPP) may be granted a license.

Section 2.19 Vermont Licensure Based on Certification Programs

Applicants licensed in another United States or Canadian jurisdiction who present evidence of professional qualification from an individual certification program acceptable to the Board may be granted a license. Applicants may contact the Board by accessing its Web page for a list of acceptable individual certification programs.

Section 2.20 Change to Doctoral Level Licensure from Master's Level Licensure

(a) a psychologist currently licensed by this Board as a psychologist-master, who has since earned a doctoral degree in psychology from a doctoral program meeting the requirements of these rules, may be eligible to upgrade the license to a psychologist-doctorate. to do so, the licensee must file a new application and submit certified copies of transcripts.

(b) Note: Licensees who change their level of licensure from the master's to doctoral level in this manner may not meet licensure requirements of other jurisdictions.

Section 2.21 Jurisprudence Examination

Applicants who have not previously taken the jurisprudence examination must also successfully complete the jurisprudence examination.

Section 2.22 Change to Doctoral Level Licensure from Master's Level Licensure

(a) A psychologist currently licensed by this Board as a psychologist-master, who has since earned a doctoral degree in psychology from a doctoral program meeting the requirements of these rules, may be eligible to upgrade the license to a psychologist- doctorate. To do so, the licensee must file a new application and submit certified copies of transcripts.

(b) Note: Licensees who change their level of licensure from the master's to doctoral level in this manner may not meet licensure requirements of other jurisdictions.

Section 2.23 Change to Doctoral Level Licensure from Master's Level Licensure

Jurisprudence Examination Applicants who have not taken the jurisprudence examination to become registered for Vermont supervised practice or for licensure at the master's level must also successfully complete the jurisprudence examination.

Part 3 MASTER'S DEGREE LEVEL LICENSURE

Section 3.1 Routes to Licensure

There are two ways to become licensed in Vermont as a psychologist at the master's level:

(a) Examination An applicant may apply on the basis of education, licensing examination, and supervision; or

(b) Endorsement An applicant who is licensed in another jurisdiction may seek licensure on the basis of that license or certification.

Section 3.2 Licensure by Examination

To become licensed at the master's level an applicant must:

(a) be at least 18 years of age;

(b) hold a master's degree in psychology ( 26 V.S.A. § 3011a(a)(3)(B)) as defined below;

(d) have completed 4,000 hours of supervised practice, of which no fewer than 2,000 hours were completed after the master's degree in psychology was received; and

(e) complete the Board's jurisprudence examination.

Section 3.3 Degree Requirement

Applicants must possess a master's degree in psychology obtained through a professional psychology training program awarded by an institution of higher education. to qualify under this rule, the psychology training program must be offered by a full member of the Council of Applied Master's Programs in Psychology (CAMPP).

Section 3.4 Equivalent Programs

The Board may grant a master's level license to an applicant who has received a master's degree which is determined by the Board to be equivalent to that described in Rule 3.3 above.

Section 3.5 Equivalence Determinations

To be considered equivalent the degree must be from a university, professional school, or other institution of higher learning that:

(a) in the United States, is regionally accredited by bodies approved by the Council on Postsecondary Accreditation and the United States Office of Education;

(b) in Canada, holds a membership in the Association of Universities and Colleges of Canada; or

(1) The institution must be accredited by the respective official organization having such authority.

(2) The Board will evaluate an applicant's academic credentials after the Board receives a report from a Board-approved credentials evaluation service.

(A) Applicants should consult the Board's Web page or contact the Board for a current list of acceptable services.

(B) Applicants are responsible for the costs of this evaluation.

(d) In addition, the graduate training program must be a planned program of study which reflects an integration of the science and practice of psychology and includes courses in assessment, intervention, psychopathology, statistical methods, and professional ethics, as well as a supervised practicum and internship; and

(e) the program:

(1) wherever it may be administratively housed, is clearly identified and labeled as a Psychology program;

(2) has an identifiable psychology faculty and a licensed psychologist responsible for the program;

(3) is directed and taught predominantly by psychologists;

(4) offers both training in the practice of Psychology and a degree in Psychology; and,

(5) is specified in pertinent institutional catalogs and brochures that it is intended to educate and train professional psychologists in the area of Psychology; and,

(f) the degree is based on substantial course work that is primarily psychological in nature, meaning courses which:

(1) are taught in the Department of Psychology or by an instructor with a graduate degree in Psychology or with psychological training and experience appropriate to the content of the course;

(2) include a review of the scholarly literature in the particular area of Psychology involved; that is, a review of psychological theory, research methods, and applications, as distinguished from practice and field experience;

(3) are psychological in content, as distinguished from courses which ordinarily are the subject matter of another discipline that may incidentally draw on psychological theory or research; and

(4) the program is the equivalent to two years of full time academic study, no fewer than sixty (60) credit hours; and

(g) To qualify for consideration under this rule, degrees from programs, including acceptable foreign degree programs, must require a minimum of 275 hours in program and clinical courses, exclusive of internship, to be in person on campus.

Section 3.6 Documentation Needed

Section 3.7 Courses Required for Licensure for Applicants Whose Degrees Are Approved under Rules 3.4 - 3.6 above

To qualify for consideration under this rule, degrees from programs meeting the requirements of Rules 3.4 through 3.6 must include six (6) credit hours in each of the following areas:

(a) Assessment 6 credit hours

(1) Assessment refers to Psychological theory, research, and methods concerning the measurement and assessment of an individual's behavioral or psychological functioning. This section must include 3 credit hours of general foundation course(s) providing a general overview of the subject area. General foundation courses may include, but are not limited to:

(A) Psychological Testing/Assessment;

(B) Intellectual (Cognitive) Assessment;

(D) Introduction to Psychometrics.

(A) Specialized courses:

(i) Projective Testing;

(ii) Neuropsychological Testing;

(iii) Diagnostic Interviewing;

(iv) Minnesota Multiphasic Personality Inventory (MMPI);

(v) Tests and Measurements.

(b) Intervention 6 credit hours. Intervention courses relate to psychological theory, research, and methods concerning the remediation, treatment, or prevention of behavior disorders, adjustment problems, and psychopathology, or other disturbances in psychological functioning. Examples of relevant courses may include, but are not limited to the following:

(1) Cognitive Psychotherapy;

(2) Family Therapy;

(3) Group Therapy;

(4) Psychoanalytic/Psychodynamic Therapy;

(5) Community Psychology; and

(6) Prevention of Psychopathology

(1) Psychopathology courses relate to psychological theory, research, and methods concerning the descriptive characteristics, diagnosis, and etiology of psychopathology, or mental and behavioral disorders of children and adults. This section must include 3 hours of foundation course(s) providing a general overview of the subject area. General foundation courses may include, but are not limited to:

(A) Advanced Abnormal Psychology;

(B) Child Psychopathology;

(D) DSM (Diagnostic and Statistical Manual of Mental Disorders) / ICD (International Classification of Diseases).

(2) Examples of relevant specialized courses in psychopathology may include, but are not limited to the following:

(A) Mood Disorders;

(B) Substance Abuse;

(D) Mental Retardation; and

(E) Attention Deficit Hyperactivity Disorder (ADHD).

(d) Statistical Methods (Statistics or Research Methodology) 3 credit hours; and

(e) Professional Ethics 3 credit hours.

(f) Undergraduate courses and work experiences may not be substituted for course work.

(g) A master's degree in psychology which has not met all the requirements set forth in sections (a) - (e) of Rule 3.7 may be supplemented by up to six (6) credit hours of course work.

Section 3.8 Permitted Supplementation

A master's degree in psychology which has not met all the requirements set forth in sections (a) - (e) of Rule 3.7 may be supplemented by up to six (6) hours of course work.

Section 3.9 Interpretation

Section 3.10 Examination

(a) Applicants must successfully complete the Examination for Professional Practice in Psychology (EPPP), prepared by the Association of State and Provincial Psychology Boards (ASPPB), or other examination(s) approved by the Board and made known through its website in advance.

(b) More information about the examination is available from the Office or by accessing the Board's Web page at http://vtprofessionals.org/opr1/psychologists/.

Section 3.11 Recent Examination Required

Section 3.12 Examination Score Report

(a) The passing score is set by the ASPPB which reports the score to the Board.

(b) The Board will tell an applicant his or her score, and whether he or she successfully completed the examination.

Section 3.13 Re-taking the Examination

Unsuccessful candidates may retake the examination as permitted by examination service.

Section 3.14 Supervised Practice

(a) The post master's degree supervised practice may not be completed in less than one (1) year.

(b) The specific supervised practice requirements are contained in Part 4 of these rules.

Section 3.15 Licensure by Endorsement

Applicants who are licensed psychologists at the master's level in another jurisdiction in the United States or Canada may be licensed in Vermont upon showing that the jurisdiction's current licensing requirements are substantially equivalent to Vermont's.

Part 4 POST GRADUATE DEGREE: SUPERVISED PRACTICE FOR APPLICANTS FOR LICENSURE BY EXAMINATION

Section 4.1 Explanation

"Supervised practice" means post graduate degree clinical work that is supervised by a licensed psychologist who is familiar with the nature of the individual's clinical activities and who monitors the quality of the work and contributes to the enhancement of the individual's knowledge of self and of clinical work. Supervised practice is always in person.

Section 4.2 Mandatory Registration for Supervised Practice in Vermont

Any person in the State of Vermont who wishes to engage in post degree supervised practice toward licensure as a psychologist must, if not licensed as a clinical mental health counselor, marriage and family therapist, licensed independent clinical social worker, or licensed master social worker:

(a) be registered on the roster of psychotherapists who are nonlicensed and noncertified. Those who are currently registered as psychological trainees, instead of renewing registration with the Board, shall register on the roster of nonlicensed and noncertified psychotherapists. Registration forms are available from the Office or on line;

(b) pay the applicable registration fee.

(d) No supervised practice may occur within the State of Vermont until the supervisee is registered.

Section 4.3 Failure to Register, Penalties

(a) Unregistered supervised practice is unauthorized practice and may subject the individual and the supervisor to disciplinary sanctions.

(b) Unregistered supervised practice in Vermont will not be counted toward the supervised practice requirement.

Section 4.4 Supervisor Prerequisites

A supervisor of anyone engaged in supervised practice toward licensure as a psychologist must:

(a) possess a valid unencumbered psychologist's license for the state in which the supervised practice occurs, and

(b) for supervision commencing after the effective date of these rules have a minimum of three years licensed practice in good standing before supervision begins and be in good standing at all times during the period of supervision.

(c) Clinical supervision must be limited to areas in which the supervisor has sufficient education, training, and experience to provide meaningful guidance and be consistent with ethical standards for practice.

(d) Applicants and supervisors share responsibility for ensuring that supervision provided meets the requirements of these rules.

Section 4.5 Supervisor Responsibilities

A clinical supervisor assumes full professional and legal responsibility for the supervised individual's work. the clinical supervisor maintains a level of supervision and practice consistent with professional standards.

Section 4.6 Nature of Supervision

The supervisor may provide both administrative and clinical supervision. Both are necessary to ensure professional standards are maintained, however, only clinical supervision counts toward the supervised practice required by these rules.

Section 4.7 Situations Limiting Supervision

(a) Successful supervision requires that the future licensee and supervisor have a full and candid exchange regarding all aspects of the supervised practice. Treatment issues, for example, issues of sexual attraction and other matters between practitioner and client, and work conditions affecting practice, should be fully explored. Because full candor is needed, conflicts of interest between supervisor and future licensee must be avoided.

(b) Applicants and supervisors must avoid any situation that suggests a "multiple relationship," as defined in the APA Code of Conduct. Exploitive relationships or a potential or demonstrable conflict of interest may disqualify supervision from being credited.

(c) A licensee who personally financially gains from the practice of the supervisee is disqualified from providing clinical supervision to the trainee. Receipt of compensation for supervision is not barred by this rule.

Section 4.8 Identification of Those in Supervised Practice

Persons engaged in supervised practice toward licensure shall identify themselves to clients as "psychological trainees" or "psychological interns." They may not hold themselves out as psychologists before becoming licensed by the Board. They must comply with the disclosure requirements for rostered psychotherapists.

Section 4.9 Number of Supervisors Required

The applicant must have no fewer than two supervisors during the course of supervised practice training. Each supervisor shall supervise no fewer than 500 hours of clinical practice for the supervision to be accepted.

Section 4.10 Type and Frequency of Supervision

(a) No person engaged in supervised practice toward licensure may practice more than forty hours without receiving 2 hours of supervision.

(b) One of the two hours of the supervision must be in a formal, individual, in person setting.

Section 4.11 Part Time Clinical Practice

Applicants who document less than 20 hours per week of clinical practice require individual supervision and may not count group supervision as satisfying the supervision requirement.

Section 4.12 Supervised Practice - Completion Time

(a) Supervised practice, whether toward master's or doctoral level licensure, may not be completed in less than one (1) year.

(b) Absent exceptional unforeseen circumstances, a year which contains fewer than 700 hours of supervised practice will not count toward the supervised practice requirement.

(c) For applications received after the effective date of these rules: to ensure that an applicant's supervised practice reflects a current competence for licensure, only supervised practice hours acquired within 5 years of completion of the application for licensure will be counted.

Section 4.13 Insufficient Supervision

A ratio of one hour of supervision to 20 or fewer practice hours must be maintained. a trainee who receives more than one but less than two hours of supervision for 40 hours supervised practice may count only 20 hours toward the number of supervised hours required.

Section 4.14 Limits on Supervised Hours

No more than 40 hours of practice may count as "supervised practice" in any one week period.

Section 4.15 Board Jurisdiction

Persons engaged in supervised practice are subject to the jurisdiction of the Board and may be sanctioned for unprofessional conduct.

Section 4.16 Documentation of Supervision

(a) In addition to the Supervision Report in Rule 4. 17, the supervisor shall create and maintain a record of the number and dates of one-to-one supervision hours and group supervision hours.

(1) This record shall be retained by the supervisor for four years and kept available for the Board's review.

(2) As part of the application process the Board may request that the supervisor submit the record to the Board for review.

(3) The Board may request this record as part of a random audit of supervision documents.

(b) The supervisor is not obligated to send this record to the Board unless and until it is requested.

Section 4.17 Supervision Reports

Each clinical supervisor must submit a supervision report. Supervision report template forms are available on line or from the Office. the report must contain the following and be sufficiently detailed to permit the Board to evaluate the trainee's supervised experience. Supervision reports shall include, but are not limited to:

(a) The supervisee's name;

(b) The supervisor's name, signature, address, license number, jurisdiction(s) where granted, date granted, and areas of specialization;

(c) The name and nature of the supervisee's supervised practice setting, and a description of the client population served;

(d) The specific dates of practice covered in this report;

(e) The number of practice hours during this period (to include all duties);

(f) The trainee's specific duties;

(g) A detailed description and assessment of the trainee's performance which shall include, but is not limited to:

(1) The clinical skills supervised;

(2) The ethical practices reviewed; and

(3) The professional readings covered.

(h) A photocopy of the supervisor's license or licenses and;

(i) the supervisor's opinion of whether the applicant is prepared to meet the responsibilities of independent practice.

Section 4.18 Applicant's Summary of Supervised Experience

Each applicant shall submit as part of the application for licensure, on a form available from the Board, a "Summary of Supervised Experience." the summary shall document:

(a) the practice setting and how the practice was supervised;

(b) the number of hours of supervised practice;

(d) the number of individual and group supervision hours acquired.

Part 5 APPLICATION PROCESS

Section 5.1 Application

(a) Applications for a license, or registration on the roster of nonlicensed and noncertified psychotherapists for those who will engage in supervised practice, and information about the application process are available through the OPR website or from the Office. An applicant must file a completed application in sufficient time to allow the Board at least 60 days to review the application before the candidate sits for the examination.

(b) The Board will review an application following receipt of transcripts and other documentation to determine if the applicant's education meets the requirements of the rules.

Section 5.2 Applications Expire

For applications received after the effective date of these rules: An application is deemed to have expired, if after five years the applicant does not provide the Board any report on progress towards licensure. If no updated information is provided to the Board within five years, the applicant must begin the application process anew. This will require a new application and application fee. the Board will then consider the application a new application.

Section 5.3 Approval to Sit for Examination

Once an applicant's education is approved, the applicant may sit for the examination. the applicant bears the responsibility of scheduling his or her examination.

Section 5.4 Procedure for Processing Applications

When the Board receives a completed application, the application is reviewed. Sometimes during the review process questions about the meaning or adequacy of some documents may arise. Rather than deny the application, the Board may request that the applicant submit additional or clarifying information. When that information is provided, the Board can, then make a full assessment of the application. by asking for additional or clarifying information, the Board can avoid unnecessary denials of applications.

Section 5.5 Right to a Written Decision

When it appears from the application and accompanying documents that the applicant does not meet all of the requirements for licensure, the office on behalf of the Board will notify the applicant. This is called a preliminary denial. the preliminary denial letter will specify why the application is not approved. the applicant is notified of the right to file an appeal which is heard as a formal hearing by the Board. at the appeal hearing the burden of proof is on the applicant to show that the preliminary denial was in error. after that hearing the Board issues a final decision in writing.

Section 5.6 Right to Appeal

A person who is aggrieved by a final decision of the Board may appeal to an appellate officer within 30 days of the Board's decision. the appellate process is governed by Vermont law, 3 V.S.A. § 130a, and has its own procedural rules. Information about the appellate process is available from the Office.

Part 6 INFORMATION FOR LICENSED PSYCHOLOGISTS

Section 6.1 Change of Name or Address

Licensees are responsible for notifying the Office within 30 days of any name or address change.

Section 6.2 Complete Title

Under 26 V.S.A. § 3016(2) a licensee is required to indicate a complete title (that is, psychologist-doctorate, or psychologist-master) on all signs, business cards, letterhead, promotional materials, and other professional uses. a licensee whose name appears in an advertisement listing individuals in a practice must include his or her full professional title in the listing, clearly indicating licensure as a psychologist-doctorate or psychologist-master. This rule applies wherever the professional listing occurs.

Section 6.3 Code of Ethics

(a) It is the licensee's responsibility to become familiar with the "Ethical Principles of Psychologists and Code of Conduct," of the American Psychological Association, Inc., and the "ASPPB Code of Conduct" as guides to conduct and practice. Conduct which violates these ethical principles and codes, or their successor principles and codes, constitutes unprofessional conduct under 26 V.S.A. § 3016(9) and § 3016(10).

(b) Copies of the "Ethical Principles" are available on line through the American Psychological Association and may be obtained from the American Psychological Association directly. Copies of the "ASPPB Code of Conduct" may be obtained from the Association of State and Provincial Psychology Boards or on line. However, licensees are responsible for staying current with any successor versions of either code.

Section 6.4 Telepractice

(a) Telepractice is governed by statute, 26 V.S.A. § 3018. Professionals who provide service via the Internet or other electronic means should provide as much information as possible to individuals who access their services.

(b) Psychologists from other jurisdictions providing telepractice services to persons in Vermont are deemed to be practicing in Vermont. They must be licensed by the Board and must comply with the disclosure requirements of Rule 6.8.

(c) Vermont licensed psychologists who provide telepractice services to clients outside of Vermont remain under the jurisdiction of the Board. They shall comply with the disclosure requirements of Rule 6.8 and shall specifically disclose:

(1) Name, location, and telephone number of the psychologist;

(2) What the psychologist is licensed and trained to do; and

(3) The limits and limitations of Internet practice and service delivery.

Section 6.5 Medication Recommendations to Prescribing Providers

A psychologist may offer a medication recommendation to the prescribing provider about a patient the psychologist has evaluated when such recommendation is an informed opinion based on the psychologist's education, training, and professional experience. the psychologist's opinion may inform the physician's medication decision.

Section 6.6 Duty to Warn

Supervisees and licensees must be aware of and comply with Vermont mandatory reporting requirements. Among them are 33 V.S.A. § 4913 (Reporting Child Abuse and Neglect) and 33 V.S.A. § 6903 (Reporting suspected abuse, neglect, and exploitation of vulnerable adults). Practitioners should also be aware that common law imposes a duty to warn in certain circumstances. See, e.g. Peck v. Counseling Service of Addison County, Inc., 146 Vt. 61, 499 A.2d 422, 425 (1985). the Board cannot provide legal advice to practitioners. Those with questions regarding their duty to report should consult their legal advisors.

Section 6.7 Responsibility to Cooperate with Investigations

(a) Each licensed psychologist has a responsibility to cooperate with investigations by the Board.

(b) When an investigation seeks confidential client information, the psychologist, whether or not the subject of the investigation, has a duty to request that the client release the information to the Board's investigators.

Section 6.8 Disclosure of Information

(a) Each psychologist shall disclose to each client, whether residing in Vermont or elsewhere, the following information, printed or typed in easily readable format:

(1) The psychologist's professional qualifications and experience, including:

(A) all relevant graduate programs attended and all graduate degrees and certificates earned, including the full legal name of the granting institution;

(B) a brief description of any special qualifications and areas of practice; and

(C) if providing direct human services in a service or technique that is new to the profession, clear and concise information about the innovative nature of and known risks associated with the services, so that the client can exercise freedom of choice concerning such services.

(D) A psychologist providing services under subsection (C) above shall also provide the Board with a copy of the written information provided to the client.

(2) A copy of the statutory definitions of unprofessional conduct ( 26 V.S.A. § 3016 and 3 V.S.A. § 129a); and,

(3) Information on the process for filing a complaint with, or making a consumer inquiry to, the Director of the Office of Professional Regulation. Sample disclosure forms are available from the Office.

(b) Disclosure means, at a minimum,

(1) posting the information and informing the client where the information is posted, or

(2) having the information printed, displaying the printed information in an easily accessible location, and informing the client where the information is displayed, or

(3) having the information printed and directly handing a copy of the information to the client.

(c) Not later than the third professional contact, the psychologist shall present to the client for signature a document stating that the information required to be disclosed in paragraphs (1), (2), and (3) above has been disclosed to the client. the psychologist shall also sign the document and shall prepare and shall retain the signed original. If, by the third professional contact, disclosure cannot be made, or the client declines to sign, the psychologist shall prepare and sign a written statement explaining the omission, which shall be retained in place of the signed copy.

(d) When the client is not able to understand the disclosure, as in the case of a minor or an adult who is under the supervision of a guardian, the disclosure shall be made to a suitable parent or guardian.

(e) If no guardian has been appointed, but a guardianship application has been made, the disclosure should be to the person named in the petition. If the guardianship petition is contested or soon to be awarded, the licensee may either wait or have the client sign and then subsequently, if a guardian is appointed, have the guardian sign.

(f) When the client is a patient or resident in an institution, including a hospital, nursing home, school, correctional facility, or community mental health center, psychologists providing care are excused from obtaining a signed receipt of disclosure so long as the information required in (a) above is readily available from the institution. the psychologist must make individual disclosure as provided in (a) and (b) above in cases where the institution's disclosure is inadequate.

(g) Psychologists employed by or belonging to a private practice group (partnership or corporation) or managed care group (corporation or other form of business organization) are considered to be practicing independently and subject to the disclosure requirements of these rules.

(h) Employees or persons under contract with an institution which is under the oversight of a governmental agency are exempt from the disclosure requirements of these rules but must inform clients that the information listed in Rule 6.8 above is available upon request.

(i) At its discretion, the Board may inspect and audit a licensee's records of information disclosure. the Board will inspect only general materials relating to information disclosure and will not inspect individual client records or notes, unless a complaint has been filed by or concerning a particular client. Individuals to be audited are selected on a random basis or in response to a complaint.

Section 6.9 Record Retention

(a) 3 V.S.A. § 129a requires that client records be retained for seven (7) years.

(b) Non-regulatory considerations may dictate retaining client records for longer than the seven years required for licensing purposes. Licensees and supervisees should consult with their legal advisors or insurers to determine how long they should retain client records.

Part 7 LICENSE RENEWAL AND REINSTATEMENT

Section 7.1 Renewing Licenses Biennially

Licenses are renewed on a two year cycle set by the Office. before the expiration date, the Office will send a renewal notice. If the renewal application and fee are not received by the Office by the expiration date, the license will expire automatically.

Section 7.2 Reinstatement of an Expired License

An expired license can be reinstated by applying to the Board for reinstatement and paying the appropriate fees. as a condition of reinstatement, applicants must meet all renewal requirements and document that they have acquired 60 hours of continuing education as required by these rules within 24 months of the application.

Section 7.3 Lapses of Five Years or More

(a) A person whose Vermont license has lapsed for more than five years and who has not practiced under a license from another U.S. or Canadian jurisdiction during that time must, in addition to submitting the application and paying the required fees:

(1) complete the jurisprudence examination;

(2) complete the continuing education required for license renewal;

(3) obtain Board approval and be registered on the roster of nonlicensed and noncertified psychotherapists; and

(4) complete 1,000 hours of supervised practice as set forth in Part 4 of these rules.

(b) upon completion and Board approval of the completed supervised practice, the applicant's license will be fully reinstated.

Part 8 CONTINUING EDUCATION

Section 8.1 Continuing Education Renewal Requirements

At each renewal, each licensee must document attendance or participation in 60 hours of continuing education.

(a) No fewer than 6 of those hours must be specially devoted to professional psychologist ethics.

(b) No more than 30 hours may be dedicated to any one topic.

(c) Self-help activities and programs or activities that are designed to increase income or office efficiency will not be counted toward the continuing education requirement.

(d) No license will be renewed until the licensee submits a verification of compliance with the continuing education requirements

Section 8.2 Exemption

With the first renewal application after two years of licensure, and with each subsequent renewal application, documentation of completion of 60 hours of acceptable continuing education is required. Only continuing education taken within two years of the renewal date is counted.

Section 8.3 Content Goals and Requirements

Continuing education is required so the public can be assured that psychologists maintain continued competence to practice. It permits the public to benefit from practitioners who are exposed to the most current and effective standards of professional practice. Specifically:

(a) Continuing education is the study and review of psychological concepts and techniques, and the acquisition of new knowledge or skills relevant to the practice of psychology.

(b) Continuing education should contribute to the growth of professional knowledge and practice competence.

Section 8.4 Acceptable Continuing Educational Activities

Continuing education may be obtained via:

(a) large group and formal presentations;

(b) small group activities; and

Section 8.5 Large Group Activities and Formal Presentations

Continuing education may be obtained via group activities such as:

(a) Formal academic courses and in-person live lectures which may include attendance at professional or scientific meetings relevant to the practice;

(b) Interactive programs such as symposia, presentations, workshops, institutes, formal panel discussions, invited speaker sessions, webinars, or other formats that allow for a live exchange among participants.

Section 8.6 Small Group Activities

Small group activities means in-person meetings or meetings conducted via electronic visual media of small groups, 3 to 8 people, of professional peers. to be counted toward continuing educational requirements, these networking activities must be pre-planned meetings among psychologists and other mental health professionals which:

(a) review current issues in psychology; or

(b) discuss the practice of psychology; or

(d) which may include group professional book or journal clubs.

Section 8.7 Small Group Activities - Documentation

Each participant claiming credit for small group activities must document each session or meeting. Licensees are encouraged to use the small group activity documentation forms available from the Board's website.

Documentation must include:

(a) list or number of participants;

(b) hours of attendance;

(d) the way in which the meeting was conducted; and

(e) an assessment of how the meeting contributed to professional development.

Section 8.8 Individual Activities

Continuing education may be obtained via individual activities such as:

(a) independent study, e.g. professional readings, audiotapes, videotapes, CD's, DVD's, on line continuing education courses, professional writing, or speaking (including preparation of courses and formal presentations) not more than once for the subject matter covered);

(b) scholarship research;

(d) the study of alternative paradigms in the field of psychology. Documentation for alternative paradigm study will include a thorough critique (two or three pages) of the new paradigm.

(e) During any 2 year licensing period, the Board may determine that successful completion of the Vermont Jurisprudence Examination may be counted for one hour of continuing education credit.

(f) No minimum number of individual activities is required, but no more than 24 hours of the 60 hours may be obtained via individual activities.

Section 8.9 Documentation

Licensees are responsible for proper documentation of all continuing education activities. Documentation must show hours of attendance and participation, process and product including relevant readings, activities, research procedures, and products. for small group and individual activities documentation shall include a brief critique of the material.

Section 8.10 Forms

Licensees are encouraged to use the continuing educational documentation forms available from the Board's website. Licensees shall be prepared to provide supporting documentation to enable a full review of the continuing educational activity claimed.

Section 8.11 Pre-Approved Programs and Providers

Continuing education programs sponsored by the American Psychological Association and the Vermont Psychological Association are pre-approved by the Board. the Board may pre-approve other specific providers or programs. a list of those approvals will be kept by the Board and be available from the Board's website.

Section 8.12 Retention of Continuing Education Records

Documents pertaining to continuing education programs shall be retained by the licensee for four years.

Section 8.13 Compliance Audits

(a) The Board will conduct continuing education audits of currently conditioned licensees and randomly selected licensees. the Board may also audit late renewing licensees and licensees who in any of the preceding 2 renewal cycles were initially found to have not met continuing education renewal requirements.

(b) If an audit shows that the licensee has not acquired 60 hours of acceptable continuing education, the Board will inform that licensee. the licensee will be given 90 days to develop and complete a corrective plan to correct the deficiencies. Failure to comply with a corrective plan may lead to disciplinary action.

Part 9 DISCIPLINE

Section 9.1 Complaint Procedure

(a) Unprofessional conduct is defined by 3 V.S.A. § 129a and 26 V.S.A. § 3016. Unprofessional conduct includes "(3) Failing to comply with provisions of federal or state statutes or rules governing the practice of the profession." 3 V.S.A. § 129a(a)(3).

(b) The Board follows the Office procedure for receiving complaints, conducting investigations, and resolving charges of unprofessional conduct against psychologists, and those who have applied for licensure or who are engaged in supervised practice toward licensure as a psychologist. Copies of the procedure are available from the Office and on the website http://vtprofessionals.org.

History

STATUTORY AUTHORITY: 26 V.S.A. § 3009a
EFFECTIVE DATE: September 30, 1987 Secretary of State Rule Log #87-52
AMENDED: February 1, 1997 Secretary of State Rule Log #96-79; June 1, 2001 Secretary of State Rule Log #01-28; November 19, 2012 Secretary of State Rule Log #12-039; January 15, 2015 Secretary of State Rule Log #14-053

Chapter 280 BOARD OF RADIOLOGIC TECHNOLOGY RULES

04-280 Code Vt. R. 04-030-280-X BOARD OF RADIOLOGIC TECHNOLOGY RULES

Part 1 GENERAL INFORMATION

Section 1.1 The Board's Purpose

The Board of Radiologic Technology ("the Board") has been created by Vermont law, Title 26 Chapter 51 of the Vermont Statutes Annotated which confers certain powers and duties on the Board. The Board is created to protect the public health, safety, and welfare by setting standards for issuing licenses, licensing qualified applicants, and regulating the practice of license holders. The Board maintains a website at www.sec.state.vt.us/professional-regulation/professions/radiologic-technology. Practitioners should periodically consult the website for matters of interest to the profession.

Section 1.2 Business Address

The Board's business location and mailing address can be found on the Board's website. Copies of these rules and more information about the Board and its requirements and procedures may be obtained by contacting the Office of Professional Regulation (the "Office") at 802-828-1505. This information also may be obtained from the Board's website.

Section 1.3 Board Members and Officers

The Board's composition is set forth in 26 V.S.A. § 2811. Board Members shall meet at least annually and elect a Chair, Vice-Chair, and Secretary. This election shall be in September or at the next meeting thereafter.

Section 1.4 Laws Governing the Board

The Board is created by Chapter 51, Title 26, Vermont Statutes Annotated, which establishes the Board's responsibilities for setting standards, issuing licenses, and regulating the profession. In addition to the "Professional Regulation" statutes, the Board is subject to other state laws including the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314), the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320), and the "Law of Professional Regulation" ( 3 V.S.A. §§ 121-132).

Section 1.5 Board Rules

The Board is authorized to make these rules under Chapter 51 of Title 26. In making or revising rules, the Board must follow the Administrative Procedure Act. These rules are approved by the Vermont Legislative Committee on Administrative Rules and have the force of law. 3 V.S.A. § 845(a).

Part 2 COMPETENCY REQUIREMENTS OF CERTAIN LICENSED PRACTITIONERS

Section 2.1 Requirements under 26 V.S.A. section 2804

No persons, as defined in Section 2804, shall apply ionizing radiation to human beings without first being certified as competent by the Board. The Board shall maintain an online compendium of courses, course sequences, or qualifying exams approved to demonstrate a practitioner's competency for purposes of certification or biennial recertification. Approved courses, course sequences, or exams shall address: radiation biology, radiation physics, exposure reduction, radiation safety, safe equipment operation, image processing, image evaluation, quality control, and patient consideration. Details are available from the Board's website at www.sec.state.vt.us/professional-regulation/professions/radiologic-technology.

Section 2.2 Renewal of Competency Certification

(a) The competency certification must be renewed under 26 V.S.A. § 2804 every two years by satisfactory completion of the competency course and payment of the renewal fee.

(b) The practitioner is responsible for notifying the Office promptly of any change in name or address. If the practitioner has moved without giving the Office their new address, they may not receive a renewal application. It is the practitioner's responsibility to renew on time.

(c) If a practitioner does not renew their competency certification by the expiration date, it will expire automatically. To have the competency certification reinstated after it has expired, the practitioner must re-apply.

Section 2.3 Fluoroscopy Users

Those practitioners defined under 26 V.S.A. § 2804 who receive a competency certification from the Board and who utilize fluoroscopy must keep a log of procedures and exposure times and document fluoroscopy exposure times for each procedure in the patient's medical records.

Section 2.4 Delegation Prohibited

No person authorized by the Board to apply ionizing radiation to human beings may delegate to any person not so authorized any professional responsibilities in relation thereto, including any role in actuating the application of ionizing radiation.

Part 3 CONTINUING EDUCATION

Section 3.1 Guidelines for Continuing Education Credit Courses

(a) The 24 credit hours earned during each two-year period must be obtained from educational activities which follow the guidelines for acceptable course content as described by the American Registry of Radiologic Technologists (ARRT) and the Nuclear Medicine Technologist Certification Board (NMTCB).

(b) During any biennial renewal period, the Board may randomly audit licensees to ensure compliance with continuing education rules. A licensee who is audited will be notified in writing by the Board and will be required to produce written documentation showing successful completion of 24 hours of continuing education during the two-year period at issue.

Section 3.2 Failure to Meet Continuing Education Requirement

A licensee who fails to comply with the continuing education requirement may be subject to investigation and possible charges of unprofessional conduct.

Part 4 REINSTATEMENT

Section 4.1 Qualifications for Reinstating an Expired License

The Board recognizes and follows the American Registry of Radiologic Technologists (ARRT) and the Nuclear Medicine Technologist Certification Board (NMTCB) reinstatement requirements and procedures.

History

EFFECTIVE DATE: January 20, 1995 Secretary of State Rule Log #95-10
AMENDED: July 1, 2017 Secretary of State Rule Log #17-024

Chapter 290 REAL ESTATE COMMISSION; ADMINISTRATIVE RULES

04-290 Code Vt. R. 04-030-290-X REAL ESTATE COMMISSION; ADMINISTRATIVE RULES

Part 1 General Information

Section 1.1 The Commission's Purpose

The Vermont Real Estate Commission ("Commission") is responsible for enforcing Vermont's real estate licensing laws. The purpose of the Commission is to protect the public health, safety and welfare. The Commission does this by, among other things, setting standards for issuing licenses and registrations, licensing and registering only qualified applicants, approving education and continuing education courses and regulating license and registration holders and their practices.

Section 1.2 Business Address

Vermont Real Estate Commission

Office of Professional Regulation

89 Main Street, 3rd Floor

Montpelier, VT 05620-3402

These rules and more information about the Commission and its requirements and procedures are available at www.sec.state.vt.us/professional-regulation or by contacting the office.

Section 1.3 Commission Members

The Commission is composed of seven members, including three licensed brokers, one licensed salesperson, one attorney, and two public members. The Governor appoints each member, 26 V.S.A. § 2251.

Section 1.4 Regular, Special and Emergency Meetings

The Commission usually meets monthly. The chair or two of the members may call a special or emergency meeting. A majority of the Commission constitutes a quorum for all meetings. No formal action at any meeting is valid unless a majority of those present and voting concur.

Meeting dates and locations can be obtained from the Commission's website at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission.

Section 1.5 Laws That Govern the Commission

(a) The Commission is created by law, Title 26, V.S.A., Chapter 41, which establishes its responsibilities for setting standards, issuing licenses and regulating the profession. In addition, the Commission is subject to several other state laws such as the Administrative Procedure Act (Title 3, V.S.A., Chapter 25), the "Law of Professional Regulation" (Title 3, V.S.A., Sections 121-131), the "Right to Know Law" (Title 1, V.S.A., Sections 311-314), and the "Access to Public Records Law" (Title 1, V.S.A., Sections 315-320). These laws spell out the rights of applicants, licensees, and members of the public.

(b) The Vermont Statutes Annotated contain the complete text of these laws. They can usually be found in any Town Clerk's office or public library. The Vermont Statutes Online are also available at legislarure.vermont.gov. The Commission's statutes and rules maybe accessed through the Commission's website at sec.state.vt.us/professional-regulation/profession/real-estate-commission.

Section 1.6 Rules

(a) The Commission is authorized to make these rules under Title 26, V.S.A., Section 2252. These rules are approved by the Vermont Legislative Committee on Administrative Rules and have the effect of law and govern the Commission's proceedings. Rules are made following the Administrative Procedure Act ("APA"). The Office of Professional Regulation ("OPR") helps the Commission to comply with the Act. Rules are reviewed and revised periodically.

(b) Legislative changes from time to time may create inconsistencies between statutes and administrative rules. When rules and statutes conflict, the statutes govern.

Section 1.7 Making and Resolving Complaints

(a) Any person may make a complaint against a broker or salesperson by contacting OPR or obtaining a copy of the complaint form from the Commission's website at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission.

(b) The Commission follows the current investigation and disciplinary procedure adopted from time to time by OPR, except where the Commission's published procedures provide otherwise. Copies of the procedure, complaint forms, and more information about the complaint process may be found at www.sec.state.vt.us/professional-regulation.

Section 1.8 Definitions

As used in these rules:

(a) "Advertising" includes print ads of any type, internet, email, or electronic media, stationery, business cards, individual "For Sale" signs and other audio, visual or print depictions or notices of real estate offered for sale or brokerage services.

(b) "Broker in Charge" means the individual broker responsible for a single office.

(c) "Broker Prelicensing Course" means a course of instruction to become a broker, at least 40 hours long, which has been approved by the Commission.

(d) "Brokerage Services" means those activities requiring a license, specifically listed in 26 V.S.A. § 2211(a)(4).

(e) "Brokerage Firm" means a business entity which is engaged in brokerage services.

(f) "Buyer" includes a person who buys, offers to buy, intends to buy, or is interested in buying real estate.

(g) "Client" means the person(s) with whom a brokerage firm and its licensees, or designated licensees, has an agency relationship related to the negotiation, sale, purchase, or exchange of an interest in real estate. Licensees owe a fiduciary duty to their clients.

(h) "Continuing Education" means instruction approved by the Commission.

(i) "Designated Agency" means the practice by which one or more licensees affiliated with a brokerage firm is appointed to act as an agent of the brokerage firm's buyer or seller client. Designated Agents owe the client the duties of a fiduciary.

(j) "Exclusive Agency Marketing Agreement" means a seller service agreement which expressly reserves to the owner the right to sell or market the property himself or herself without liability to the brokerage firm for a commission or fee, and which grants the brokerage firm the right to market the property, but which prohibits the owner from listing the property with any other brokerage firm for the term of the agreement.

(k) "Exclusive Buyer Agency Agreement" means a buyer service agreement by which a buyer engages a single brokerage firm to provide brokerage services, and by which the buyer agrees not to obtain services from any other broker, but which expressly reserves to the buyer the right to purchase property himself or herself without liability to the brokerage firm for a commission or fee.

(l) "Exclusive Right to Market Agreement" means a seller service agreement which grants to the brokerage firm the exclusive right to market the property, and which recognizes a liability on the part of the owner for a commission or fee to the brokerage firm, even if the property is sold by the owner.

(m) "Exclusive Right to Represent Buyer Agreement" means a buyer service agreement which grants to the brokerage firm the exclusive right to act on behalf of the buyer in a real estate purchase, and which recognizes a liability on the part of the buyer for a commission or fee to the brokerage firm, even if a property is purchased without assistance by the brokerage firm.

(n) "Fiduciary Duty" means the duty to act for the benefit of the client in all matters relating to the agency relationship. A fiduciary must put the interest of the client ahead of the interests of the agent and any third party. Fiduciaries must disclose all material facts the fiduciary learns about the transaction, must disclose any knowledge gained from other parties to the client's transaction, must protect the client's confidences and act with reasonable care, loyalty, and obedience toward the client. Unless otherwise agreed, the duty to protect a client's confidences continues after the brokerage service agreement expires or is otherwise terminated.

(o) "Licensee" means a person holding any license issued by the Commission.

(p) "Material Fact" means a fact that might cause a buyer or seller to make a different decision with regards to entering into or remaining in a contract or affect the price paid or received for real property.

(q) "Net Listing" means a brokerage service agreement in which, at some point, the benefit of negotiating a higher price for the seller or a lower price for the buyer accrues only to the agent or brokerage firm and not to the client. Net listing is a prohibited practice. See Rule 4.8(e).

(r) "Non-Designated Agency" means the practice by which all licensees affiliated with a brokerage firm act as the agent of the brokerage firm's clients. All licensees affiliated with the brokerage firm owe the client the duties of a fiduciary.

(s) "Nonexclusive" or "Open" with respect to a seller service agreement means a seller service agreement which expressly reserves to the owner the right to list the property with other brokerage firms or to sell the property himself or herself. It shall also mean a buyer service agreement that allows the buyer to obtain brokerage services from other brokerage firms or purchase a property himself or herself.

(t) "OPR" means the Office of Professional Regulation.

(u) "Principal Broker" means the individual broker responsible for the brokerage firm and all associated branch offices.

(v) "Salesperson Prelicensing Course" means a course of instruction to become a salesperson, at least 40 hours long, which has been approved by the Commission.

(w) "Salesperson Post-Licensure Education" means a course of instruction, which has been approved by the Commission, which satisfies, or counts toward satisfying, the hours of required education after obtaining an initial salesperson license.

(x) "Seller" includes a person who sells, offers to sell, intends to sell, or is interested in selling real estate.

(y) "Supervising Licensee" in a designated agency firm means a licensee of the brokerage firm who is selected by the brokerage firm's principal broker or broker in charge to act in a supervisory capacity for different licensees within the brokerage firm whose clients wish to participate in the same transaction. This individual shall not be a licensee who represents one of the clients in the transaction.

(z) "Vicariously Responsible" means accountability of a principal broker or broker in charge for unprofessional conduct by a licensee.

(aa) "V.S.A." means Vermont Statutes Annotated.

Part 2 Information for Applicants

Section 2.1 Need for a License

(a) A person shall not engage in the business of a real estate broker or salesperson without a license. Broker and salesperson services are defined by statute. See 26 V.S.A. § 2211(a)(4) & (5).

(b) Examples of activities that require a license include: These activities, and others, require a license when a person engages in them for others, for a fee or other compensation, as a continuing course of conduct. This list is not exclusive.

(1) listing, offering, attempting or agreeing to list real estate or any interest therein for sale or exchange;

(2) selling, exchanging or purchasing real estate or any interest therein;

(3) offering to sell, exchange or purchase real estate or any interest therein;

(4) negotiating, offering, attempting or agreeing to negotiate, the sale, exchange or purchase of real estate or any interest therein;

(5) buying, selling, offering to buy or sell, or otherwise dealing in options on real estate or any interest therein;

(6) advertising or holding oneself out as being engaged in the business of buying, selling or exchanging real estate or any interest therein; or

(7) assisting or directing in the procuring of prospects, calculated to result in the sale or exchange of real estate or any interest therein; however, a non-licensed employee of a licensee shall be allowed to respond to inquiries from members of the public, so long as the employee makes it clear that he or she is not licensed and that any information provided should be confirmed by a licensed person.

(1) offering property for lease; and

(2) offering mobile homes or businesses for sale or lease, without also offering real property. See 26 V.S.A. § 2211(b).

Section 2.2 Where to Get An Application

Applications for a license or registration can be found at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission or by contacting:

Vermont Real Estate Commission

Office of Professional Regulation

89 Main Street, 3rd Floor

Montpelier, VT 05620-3402.

Section 2.3 Types of Licenses and Registrations

(a) The Commission issues the following licenses:

(1) Broker;

(2) Salesperson; and

(3) Temporary Broker ( 26 V.S.A. § 2299) .

(b) The Commission issues the following registrations:

(1) Brokerage firm; and

(2) Branch office.

(c) Every licensee must be associated with a single registered brokerage firm, except that a broker who also holds a temporary license under 26 V.S.A. § 2299 may be associated with a second firm.

Section 2.4 How to Become Licensed as a Salesperson

A license as a salesperson shall be granted to a person who satisfies all of the following:

(a) is at least 18 years old;

(b) has completed the salesperson prelicensing course;

(c) has passed the national and state examinations required by the Commission within the two years immediately preceding application;

(d) has been employed by or become associated with a brokerage firm and that firm's principal broker;

(e) is not precluded from licensure pursuant to 3 V.S.A. § 129a; and

(f) meets other requirements mandated by law.

The Commission may waive all or a part of the national examination requirement for a salesperson if the applicant is a real estate salesperson regulated under the laws of another jurisdiction, is licensed and in good standing to practice in that jurisdiction, and in the opinion of the Commission, the other jurisdiction's licensure requirements are substantially equal to Vermont's. All applicants are required to complete the Vermont examination.

Section 2.5 How to Become Licensed as a Real Estate Broker

A license as a broker shall be granted to a person who satisfies all of the following:

(a) has completed the broker prelicensing course;

(b) has passed the national and state examinations as required by the Commission, within the two years immediately preceding application;

(c) has gained at least two years experience as a licensed salesperson, including at least eight separate and unrelated closed transactions among buyers and sellers bearing no familial or contemporaneous business relation to the applicant.

The Commission may waive all or a part of the national examination requirement and experience requirement for brokers if the applicant is a real estate broker regulated under the laws of another jurisdiction, and is licensed and in good standing to practice in that jurisdiction, and in the opinion of the Commission, the other jurisdiction's licensure requirements are substantially equal to Vermont's. All applicants must complete the Vermont examination.

Section 2.6 How to Register Real Estate Brokerage Firms

To obtain a brokerage firm or branch office registration a person must file a written application and must:

(a) designate a principal broker for the main office and a broker in charge for each branch office;

(b) register the firm with the Corporations Division of the Office of the Secretary of State, if required by law; and

(c) specifically designate the brokerage firm name under which the firm will conduct business, register licensees, and advertise.

Section 2.7 Examinations

All examinations for real estate broker's licenses and for salesperson's licenses are administered through OPR and information is available through the Commission's website at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission. A candidate who fails one part of the exam may retake that part within the next six months. After six months or two failures, the candidate must retake the full exam.

Section 2.8 Display of Licenses for Brokers and Salespersons

A license issued by the Commission must be conspicuously displayed in the office where the licensee is associated.

Section 2.9 Applicant's Right to a Written Decision and Personal Appearance

The Commission will notify applicants in writing of all decisions concerning the granting or denial of a license or registration. If a license or registration is denied, the applicant will be given specific reasons and informed of the right to request a review and personal appearance before the Commission before the decision becomes final.

Section 2.10 Applicant's Right to Appeal

If the applicant is not satisfied with the Commission's final decision, the applicant may appeal within 30 days of the Commission's decision, to an appellate officer, by filing a notice of appeal with the Office of Professional Regulation, 89 Main Street, 3rd Floor, Montpelier, Vermont 05620-3402 Attention: Appeal. The appellate process is governed by 3 V.S.A. § 130a.

Part 3 Information for Licensed Brokers and Salespersons

Section 3.1 Renewing a License or Registration

(a) Licenses and registrations renew on a fixed biennial schedule and must be renewed before they expire. The expiration date is stated on the license or registration. Before the expiration date, OPR will provide notification for renewal to the licensee's electronic mail address of record; however, failure to receive such notice shall not excuse any licensee from the obligation to maintain continuous licensure. Evidence of having completed the required hours of continuing and/or post-licensure education must be provided with license renewal applications. Prior to expiration, a licensee may request that the license be placed in an inactive status by paying the fee to transfer the license to inactive status. No continuing education is needed to become inactive. Unless a licensee requests to be placed on inactive status prior to expiration, the license shall be designated as "expired."

(b) When the license of a principal broker ceases to be active for any reason, all licensees associated with that brokerage firm shall lose authority to transact business in the firm's name.

(c) When the license of a broker in charge ceases to be active for any reason, all licensees associated with that branch office shall lose authority to transact business in the brokerage firm's name.

Section 3.2 Reinstating An Expired or Inactive License or Registration

(a) A license that has been expired for less than five years may be reinstated by the licensee by paying the renewal fee and late renewal penalty, and providing proof of the required hours of continuing and/or post-licensure education taken within the previous 24 months.

(b) A licensee who requested the license be inactive, and reactivates during the same renewal period, may be reinstated by paying the reinstatement fee, renewal fee, and providing proof of the required hours of continuing and/or post-licensure education taken within the previous 24 months. A licensee who does not request reactivation during the same renewal period may not renew under this section and must qualify under 3.2(a).

(c) A brokerage firm whose registration has expired because it was not renewed by the expiration date may be reinstated by paying the renewal fee and late renewal penalty. When the registration of the brokerage firm is not renewed prior to expiration, all licensees associated with that brokerage firm shall lose authority to transact business in the brokerage firm's name.

Section 3.3 Requests for Declaratory Rulings

(a) Requests for declaratory rulings as to the applicability of any statutory provisions or any rule or order of the Commission may be sent to the Commission office. Requests must be in writing, and must show the existence of a real controversy, not just a hypothetical question. A declaratory ruling is binding upon the parties to the ruling and the Commission. The requests will be considered pursuant to the Administrative Procedure Act, 3 V.S.A. Chapter 25 and the Administrative Rules of the Office of Professional Regulation. The Commission may call witnesses in addition to those presented by the parties.

(b) In the absence of a real controversy, the Commission may, in its discretion, elect to issue a non-binding advisory opinion, or may decline to address the question presented. An advisory opinion is not binding on the requestor, other licensees, or the Commission.

Section 3.4 Change of Name or Address

(a) A principal broker or broker in charge must notify OPR in writing within 30 days of any change in name, address, phone number or email address of the brokerage firm or any licensee associated with that brokerage firm.

(b) Each licensee shall notify OPR in writing within 30 days of any change of the licensee's principal business location, phone number or email.

Section 3.5 Modifications of Conditions and Reinstating a Suspended License

The Commission may set forth a specific process in a disciplinary order for modification of that order or for reinstatement after suspension. A licensee who receives a warning, reprimand, suspension, or condition to continued practice, shall specifically refer to the Commission's order for the process for modification of that order or reinstatement after suspension.

Part 4 Conduct of Licensees

Section 4.1 Offices and Branch Offices

(a) A principal broker shall be in charge of a brokerage firm. The principal broker must maintain his or her place of business at the brokerage firm's main office. The principal broker must notify the Commission of the brokerage firm's main office location.

(b) A brokerage firm which desires more than one office shall register a branch office. A branch office shall use the same name as the main office and shall designate a broker in charge. The broker in charge of a branch office must maintain his or her place of business at the branch office.

(c) The firm's licensees must have a primary place of business at one of the brokerage firm's locations but may work out of any of the brokerage firm's offices.

(d) A principal broker or broker in charge may not serve as principal broker or broker in charge for more than one office or brokerage firm at any one time, except that a broker who also holds a temporary license under 26 V.S.A. § 2299 may be associated with a second brokerage firm.

Section 4.2 Broker Supervision

(a) A principal broker may be vicariously responsible for the professional conduct of licensees and employees of the brokerage firm, including all branches; a broker in charge may be vicariously responsible for the professional conduct of all licensees and employees of the branch office.

(b) Licensees must work under the supervision and training of the principal broker or broker in charge.

(c) In a Designated Agency Firm, a principal broker or broker in charge who is the designated licensee for a client has the opportunity to create a conflict of interest if their client enters into a transaction with another client of the brokerage firm. In these instances, the principal broker or broker in charge must delegate their supervisory responsibilities, for the other licensee in the transaction, to a qualified supervising licensee.

Section 4.3 Brokerage Firms Practicing Non-Designated Agency

(a) All brokerage firms that are not under an election to practice Designated Agency are governed by this Rule as practicing Non-Designated Agency (see Rule 1.8 (r)). Any such brokerage firm shall be known as a Non-Designated Agency Firm and disclosure of this status shall be included in seller and buyer service agreements as required under Rule 4.8(c).

(b) A Non-Designated Agency Firm is the agent of each client of the firm and on its behalf all licensees of the firm represent all clients of the firm pursuant to written agreements for brokerage services (see Rule 4. 8). The firm and all its licensees owe the client the duties of a fiduciary (see Rule 1.8 (n)).

(1) take ordinary and necessary care to protect all client confidences from disclosure to third parties, except disclosure may occur pursuant to authorization of all clients affected thereby;

(2) until closing, submit all offers to or from the client, with or without a deposit, whether oral or written, whether above or below the listed price; and

(3) if true, disclose the fact that the brokerage firm provides brokerage services to both buyers and sellers in the market. The disclosure shall be part of any seller or buyer service agreement executed on behalf of the brokerage firm.

(d) A Non-Designated Agency Firm and all its licensees shall not:

(1) practice dual or limited agency, acting as agent for both a buyer and seller in the same transaction. The firm may act as an agent for one party in a transaction where the other party is an unrepresented customer;

(2) practice Designated Agency; or

(3) provide or offer to provide services as an Intermediary, a Transactional Broker, a Facilitator or any other form of representation not involving an agency relationship for which fiduciary duties are owed. This provision does not preclude the right to make referrals as provided in Rule 4.13.

(e) A Non-Designated Agency Firm may retain and compensate another brokerage firm to assist it in providing services to its clients without thereby creating an agency relationship between the client and the other firm. This practice shall be known as broker agency and the relationship shall be governed by the provisions of Rule 4.11.

(f) A Non-Designated Agency Firm shall terminate the seller service agreement prior to a licensee associated with the brokerage firm entering into negotiations on his or her own behalf to purchase a property listed by the brokerage firm. In addition, the brokerage firm shall provide an opportunity for the client to seek outside representation, and disclose in writing that a conflict of interest is automatically created due to the competing interests of the client and the licensee. Prior to entering into negotiations for the sale of property owned by a licensee of the Non-Designated Agency Firm to a buyer under a buyer service agreement with the brokerage firm, the brokerage firm must terminate the buyer service agreement to provide the client an opportunity to seek outside representation, and disclose in writing that a conflict of interest is automatically created due to the competing interests of the client and the licensee. In these instances, a Non-Designated Agency Firm cannot advance the interests of the client and provide undivided loyalty while negotiating with a licensee associated with the brokerage firm. The client may elect to remain an unrepresented customer of the Non-Designated Agency Firm, and not seek outside representation, if the client provides informed written consent. A Non-Designated Agency Firm and its associated licensees must show affirmatively that they acted in good faith in the transaction.

Section 4.4 Brokerage Firms Practicing Designated Agency

(a) If a brokerage firm has more than two licensees, the brokerage firm may elect to practice Designated Agency (see Rule 1.8 (i)). Any such brokerage firm shall be known as a Designated Agency Firm and disclosure of this status shall be included in seller and buyer service agreements as required under Rule 4.8(c).

(b) A Designated Agency Firm shall delegate to its individual licensees all brokerage firm agency and fiduciary responsibilities for specific clients of the firm pursuant to written agreements for brokerage services (see Rule 4. 8). Delegations may be made to a single licensee or to multiple licensees associated with the brokerage firm. The licensee(s) so delegated shall be known as designated agent(s). Only the designated agent(s) owe the client the duties of a fiduciary (see Rule 1.8 (n)).

(c) A Designated Agency Firm shall at all times ensure that there is a supervising licensee within the firm to provide guidance to the designated agent(s) in the event of a conflict where the principal broker and/or broker in charge is acting as a designated agent for one of the parties to the transaction (e.g. "in-house transaction").

(d) A Designated Agency Firm and the designated agent(s) with respect to a specific client shall:

(1) obtain written consent of the client to the appointment of the initial and any subsequent designated agent(s) at the time the seller or buyer service agreement is executed or amended;

(2) take ordinary and necessary care to protect all client confidences from disclosure to third parties, except disclosure may occur pursuant to authorization of all clients affected thereby;

(3) take ordinary and necessary care to protect all client confidences from disclosure to other licensees of the firm who are not designated agents for the client, except disclosure may occur pursuant to authorization of all clients affected thereby;

(4) until closing, submit all offers to or from the client, with or without a deposit, whether oral or written, whether above or below the listed price; and

(5) if true, disclose the fact that the firm provides brokerage services to both buyers and sellers in the market. The disclosure shall be part of any seller or buyer service agreement executed on behalf of the firm.

(e) A Designated Agency Firm and its designated agent(s) for a particular client shall not:

(1) practice dual or limited agency by acting as agent for both a buyer and seller in the same transaction. The designated agent(s) may act as an agent for one party in a transaction where the other party is an unrepresented customer;

(2) practice Non-Designated Agency;

(f) A Designated Agency Firm may retain and compensate another brokerage firm to assist it in providing services to its clients without thereby creating an agency relationship between the client and the other firm. This practice shall be known as broker agency and the relationship shall be governed by the provisions of Rule 4.11.

(g) A Designated Agency Firm may permit one of its licensees with a customer who may be interested in buying from or selling to a client of the firm to practice broker agency with the designated agent(s) of the client. No written cooperation agreement is required. In such case the licensee with a customer owes the designated agent(s), but not the firm's client, the duties of a fiduciary.

(h) All confidential information of the seller or buyer client may not go beyond the designated agent(s) or the supervising licensee, except with the client's prior authorization. A designated agent may reveal confidential information of a client to the extent reasonably necessary to obtain proper guidance from the supervisor in charge of such agent, as long as that supervisor is not acting as an agent for another party in a transaction with the client. The supervisor shall protect from further disclosure any confidential information received in a supervisory capacity. All seller and buyer service agreements shall contain clear language that notifies the client that this can occur.

(i) When a designated agent is appointed, information known to or acquired by the designated agent shall not be imputed to the brokerage firm or to other licensees within the same brokerage firm.

(j) The principal broker and broker in charge shall remain vicariously responsible for breach of duty in his or her supervisory capacity as provided in Rule 4. 2, however, they do not by virtue thereof become dual agents.

(k) A Designated Agency Firm shall terminate the seller service agreement prior to a designated agent associated with the brokerage firm entering into negotiations on his or her own behalf to purchase a property in which he/she is a designated agent for the property listed by the brokerage firm. In addition, the brokerage firm shall provide an opportunity for the client to seek outside representation, and disclose in writing that a conflict of interest is automatically created due to the competing interests of the client and the licensee. Prior to entering into negotiations for the sale of property owned by a licensee of the brokerage firm who is the designated agent of the buyer under a buyer service agreement with the brokerage firm, the Designated Agency Firm must terminate the buyer service agreement. In addition, the brokerage firm shall provide an opportunity for the client to seek outside representation, and disclose in writing that a conflict of interest is automatically created due to the competing interests of the client and the licensee. In these instances, a Designated Agency Firm cannot advance the interests of the client and provide undivided loyalty while negotiating with a licensee associated with the brokerage firm. The client may elect to remain an unrepresented customer of the brokerage firm, and not seek outside representation, if the client provides informed written consent. A Designated Agency Firm and its associated licensees must show affirmatively that they acted in good faith in the transaction.

Section 4.5 Duty to Customers and the Public

(a) A licensee working for a brokerage firm employed by a seller or seller's agent must fully and promptly disclose to a prospective buyer all material facts within the licensee's knowledge concerning the property being sold. This obligation continues until the sale is closed or has been cancelled. Some examples of material facts (See Rule 1. 8(p)) include, but are not limited to, the following:

(1) a defect that could significantly diminish the value of the land, structures, or structural components such as the roof, wiring, plumbing, heating system, water system, or sewage disposal system;

(2) a limitation in the deed that could substantially impair the marketability or use of the property and thereby diminish its value;

(3) a recognized or generally accepted hazard to the health or safety of a buyer or occupant of the property; or

(4) facts a licensee reasonably believes may directly impact the future use or value of the property.

(b) If the client refuses to consent to disclosure after being informed that the licensee considers disclosure to be necessary, then the licensee must withdraw from the agency relationship.

(c) A licensee, before showing real property, must disclose any known significant limitations on the seller's ability to convey a fee simple interest in the property, such as options, rights of first refusal, or being subject to prior closings.

(d) A licensee buying or selling on his or her own account shall disclose the existence of his or her real estate license and that the property under consideration belongs to the licensee or will be purchased for the licensee's use. These disclosures are to be made on initial contact with the seller, buyer, or their representatives.

(e) A licensee shall comply with all federal, state and local requirements related to the marketing, transfer or development of real estate.

Section 4.6 Duty to Provide Mandatory Consumer Disclosure

(a) At the time of first contact with a member of the public who expresses an interest in buying or selling real property, a licensee shall give an oral or written disclosure informing the person that there is no confidentiality between the licensee and the person until and unless there is a signed brokerage service agreement.

(b) A brokerage firm, and its licensees, shall provide to any unrepresented person with whom a licensee of the brokerage firm has substantial contact, including via electronic communication, a true copy of the most recent consumer disclosure form adopted by vote of the Commission. The disclosure shall occur at the first reasonable opportunity, and it must occur before:

(1) entering into a brokerage service agreement; or

(2) showing a property.

(c) If it has been more than twelve (12) months since the consumer disclosure form was given, a new consumer disclosure form must be given.

(d) The current consumer disclosure form adopted by the Commission can be accessed through the Commission's website at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission.

(e) For purposes of this rule, an unrepresented person means any person who:

(1) is under a brokerage service agreement for representation, but is not at the time in the presence of their agent; or

(2) is not under contract with a brokerage firm for representation.

(f) If the person required to receive the written disclosure form does not sign the form, the licensee shall:

(1) note that information on the form;

(2) sign and date the form; and

(3) provide a copy of that form to the person.

(g) The licensee's signature in 4. 6(f)(2) above shall constitute a certification by the licensee that the form was provided to the person with the recommendation to read the disclosure.

(h) The disclosure form is not required for unrepresented persons in the following instances:

(1) for an open house where the host brokerage firm conspicuously displays a poster containing a replica of the disclosure form, with copies available on request;

(2) for any Vermont broker or salesperson licensee; or

(3) for any customer of a cooperating firm brought to a principal firm pursuant to a cooperation agreement between brokerage firms (see Rule 4.11) when that customer has already received the disclosure form from the cooperating firm.

Section 4.7 Trust Accounts

(a) Every brokerage firm shall maintain a pooled interest-bearing trust account in a bank or other regulated financial institution licensed in Vermont, so long as the firm holds the funds of others in the course of its real estate business, and shall establish individual interest-bearing trust accounts as needed to comply with these rules. Interest on the pooled trust account shall be remitted as provided by 26 V.S.A. § 2214.

(b) All deposits in the possession of a brokerage firm to be held as an escrow agent under a Purchase and Sale Agreement shall be deposited in the firm's trust or escrow account not later than five (5) banking days after the Purchase and Sale Agreement is executed by both seller and buyer. Any licensee affiliated or associated with that brokerage firm is required to utilize the brokerage firm's accounts in the discharge of his or her responsibility under this rule and under 26 V.S.A. § 2214. Unless otherwise agreed to in writing, all deposits held by any licensee shall be placed in the account of the brokerage firm with which the seller has a seller service agreement, or, if there is no listing broker, in the account of the buyer's brokerage firm. No earnings of the accounts shall be made available to the brokerage firm or any associated licensee.

(c) If a deposit is reasonably expected to earn more than $ 100, it shall be transferred to or placed in an individual interest-bearing trust account, if requested by the person making the deposit, specifying the Social Security account number or taxpayer identification number of the person who paid the money or is entitled to receive the interest. A deposit which is not reasonably expected to earn more than $ 100 shall be placed in the brokerage firm's pooled trust account.

(d) Disputed deposits--When the brokerage firm learns of a dispute concerning the proper party to receive a deposit held in a trust account, the broker shall notify the parties, in writing, that the deposit will remain in the trust account until (1) the parties to the disputed deposit give written authority to the broker to disburse the funds, or (2) a court of competent jurisdiction determines the proper party entitled to the proceeds of the disputed deposit.

(e) Augmented deposit--When a person making a deposit increases the amount of the deposit for any reason, it shall be deposited in the firm's trust account not later than five (5) banking days after receipt thereof. If the recalculated interest is reasonably expected to exceed $ 100, the brokerage firm shall transfer the principal amount of the total deposit to an individual interest bearing trust account, if requested by the person making the deposit.

(f) When a payment is made out of an individual interest bearing trust account to the person entitled to it, any interest accrued on that account shall be paid out simultaneously to that person or to such other person designated in the contract.

(g) The brokerage firm shall keep accurate records of all deposits held by it. Such records shall include:

(1) the name(s) from whom the money was received and to whom it was disbursed;

(2) the amount of each deposit;

(3) the amount of each disbursement;

(4) the date each amount was received, the date disbursed and the amount of any interest earned on an individual interest bearing trust account; and

(5) all contracts, documents and other records related to a trust account and all its activity, including copies of all related brokerage service agreements, deposit receipts, withdrawal receipts and sales agreements.

(h) The responsibility for the account and all transactions concerning the account remains with the principal broker or broker in charge.

(i) A brokerage firm may deposit its own funds in the account to cover bank service charges or meet a minimum balance to avoid bank service charges. Check printing charges, wire transfer charges, overdraft charges, and other charges for specialized services are a business expense of the brokerage firm. Ordinary bank service charges may be offset against the interest in the account, but the brokerage firm shall not permit the principal amount of the trust funds to be depleted.

Section 4.8 Agreements for Brokerage Services

(a) Before rendering any brokerage services, a brokerage firm must have:

(1) a written seller service agreement; or

(2) a written buyer service agreement; or

(3) a written cooperation agreement between brokerage firms.

(b) Agreements for brokerage services shall contain a specific expiration date not to exceed one (1) year from the effective date of the agreement. A brokerage service agreement shall not contain any provision for automatic extension or renewal. All information in a brokerage service agreement shall be current as of the date signed, and shall be current as of the date of the most recent extension or renewal. Any limitation on the scope of services to be provided shall not compromise any of the duties required under Rules 4.3, 4.5 and/or 4.6.

(c) All seller and buyer service agreements shall contain clear language that states whether the firm is a Designated or Non-Designated Agency Firm. If the firm elects to practice designated agency, the designated agent(s) must be named in the seller or buyer service agreement. Any changes to the designated agent(s) shall be in writing and approved by the client. Brokerage service agreements must contain a provision indicating that a designated agent may reveal confidential information of the client to the extent reasonably necessary to obtain proper guidance from any supervising licensee in charge of such agent, as long as that supervising licensee is not acting as an agent for another party in a transaction with the client. The supervising licensee shall protect from further disclosure any such confidential information received in a supervisory capacity.

(d) Copies of all agreements for brokerage services shall be given to all parties to the agreements at the time of execution, or as soon as possible thereafter.

(e) Use of a net listing or any variation is prohibited.

Section 4.9 Seller Service Agreements

(a) Each type of seller service agreement shall be on a separate form and identified with only one of the titles below in boldface type at the top of the agreement:

NONEXCLUSIVE (Open) AGENCY MARKETING AGREEMENT;

EXCLUSIVE AGENCY MARKETING AGREEMENT; or

EXCLUSIVE RIGHT TO MARKET AGREEMENT

(b) A seller service agreement shall contain:

(1) a clear description of the property and its location;

(2) the price, terms and conditions upon which the brokerage firm has authorization to market the property;

(3) the specific brokerage services the firm will provide, including any limitation on services;

(4) the agreement date, specific expiration date and the effective date if different from the agreement date;

(5) a provision for avoiding dual agency and other conflicts with respect to the brokerage firm's buyer service agreements, including the requirements of subsection 4.3(e) and 4.4 applicable to representation of sellers;

(6) a statement of the amount of transaction fee or other compensation to be paid the brokerage firm, the method of computation and the person who will pay it;

(7) the signatures of all owners or their authorized agents and a licensee associated with the brokerage firm;

(8) a clear description of whether, and how, cooperating brokerage firms will be compensated; and

(9) a clear description of whether, and how, a brokerage firm representing the buyer will be compensated.

(c) A seller service agreement may contain a clause which provides for compensation following expiration or termination when:

(1) a purchase and sale agreement is signed, a closing held, or the property is otherwise conveyed, within a specified number of months following the expiration or termination date of the seller service agreement, but not to exceed twelve months;

(2) the brokerage firm, during the term of the seller service agreement, was procuring cause of the sale;

(3) the brokerage firm provided the name of the purchaser to the seller in writing not later than 10 days after the expiration or termination date of the seller service agreement; and

(4) the property has not been listed with another brokerage firm under a valid, exclusive right to market agreement with terms and conditions similar to those contained in the expired or terminated seller service agreement.

(d) No other provision for compensation following expiration or termination is authorized.

Section 4.10 Buyer Service Agreements

(a) Each type of buyer service agreement shall be on a separate form and identified with only one of the titles below in boldface type at the top of the agreement:

NONEXCLUSIVE (Open) BUYER AGENCY AGREEMENT;

EXCLUSIVE BUYER AGENCY AGREEMENT; or

EXCLUSIVE RIGHT TO REPRESENT BUYER AGREEMENT

(b) A buyer service agreement shall contain:

(1) the agreement date, specific expiration date, and the effective date if different from the agreement date;

(2) all terms of the agency authorized;

(3) a description of the services that the brokerage firm will perform under the agreement, including any limitations on services;

(4) a provision for avoiding dual agency and other conflicts with respect to the brokerage firm's seller service agreements, including the requirements of subsection 4.3(e) and 4.4 applicable to representation of buyers;

(5) a statement of the amount of transaction fee or other compensation to be paid the brokerage firm, the method of computation and the person who will pay it;

(6) the signatures of all parties to the buyer service agreement and a licensee associated with the brokerage firm; and

(7) a clear description of whether, and how, cooperating agents will be compensated.

(c) A buyer service agreement may contain a clause which provides for compensation following expiration or termination when:

(1) a purchase and sale agreement is signed, a closing held, or a property is otherwise purchased, within a specified number of months following the expiration or termination date of the buyer service agreement, but not to exceed twelve months;

(2) the brokerage firm, during the term of the buyer service agreement, was procuring cause of the purchase;

(3) the brokerage firm provided the name of the seller and identification of the property to the buyer in writing not later than 10 days after the expiration or termination date of the buyer service agreement; and

(4) the buyer has not retained another brokerage firm under a valid exclusive right to represent buyer agreement with terms and conditions similar to those contained in the expired or terminated buyer service agreement.

(d) No other provision for compensation following expiration or termination is authorized.

Section 4.11 Cooperation Agreements between Brokerage Firms

(a) A cooperation agreement between brokerage firms shall contain:

(1) identification of the brokerage firm acting as principal and the brokerage firm acting as agent;

(2) the agreement date and a provision for termination, however it need not have a specific expiration date;

(3) a description of the services which the cooperating firm will perform under the agreement, including any limitation on services;

(4) a statement of the amount of transaction fee or other compensation to be paid the brokerage firm and the method of computation;

(5) a provision for avoiding dual agency conflicts with respect to each brokerage firm's other brokerage service agreements; and

(6) signatures of each party.

(b) The cooperating firm under a cooperation agreement is the agent of the principal's firm, and not the agent of the buyer or seller for whom the principal is working.

(d) A cooperating firm which has accepted an offer of broker agency with respect to a particular property must notify the principal firm before representing a buyer with respect to the same property.

(e) Participation agreements in multiple listing services are an acceptable broker cooperation agreement for creating an agency relationship between brokerage firms.

(f) In a designated agency firm, when a licensee is representing a client and another licensee of the brokerage firm has a customer interested in participating in a transaction with the client, the licensee with the customer is a broker agent for the first agent. No cooperation agreement is required in this scenario.

Section 4.12 Advertising

(a) Every real estate advertisement shall conspicuously display the brokerage firm's registered name. This is the name that appears on the brokerage firm's registration issued by OPR. The brokerage firm's registered name shall be the most prominent and largest identifier. This means the brokerage firm's registered name shall be larger than items such as the agent's name, phone number, team name and web address.

(b) When properly in which a licensee has an ownership interest is marketed, all advertisements shall disclose the fact that said owner is a Vermont licensee.

(c) Signs used in advertising must comply with Vermont state and municipal sign laws, including but not limited to the following:

(1) a "for sale" sign, or multiple signs on the same premises taken together, shall not have an area of more than six (6) square feet, including panel, frame and riders (See also 10 V.S.A. § 493(2));

(2) signs attached to "for sale" signs which state "sold," "sale pending," "sale under contract," or similar messages shall not be permitted (See also 10 V.S.A. § 493(2));

(3) a "for sale" sign may only be erected and maintained on the same premises that is for sale and may not be erected or maintained off-premise (See also 10 V.S.A. § 493); and

(4) a "for sale" sign may not be erected and maintained along a highway and visible from the highway which is located upon a tree, or painted or drawn upon a rock or other natural feature (See also 10 V.S.A. § 495(a)(5) ).

(d) Advertisements of properties listed by another brokerage firm shall also conspicuously display that listing brokerage firm's registered name and listing agent's name.

Section 4.13 Compensation

(a) A licensee shall not pay or otherwise compensate an unlicensed person, either directly or indirectly, for the performance of brokerage services. This section shall not prohibit a licensee from reducing or sharing a portion of a commission otherwise owed to the licensee in the transaction, to the benefit of the seller or buyer, so long as it is not compensation for the performance of brokerage services.

(b) A referral fee may be paid or received for referring a prospect to another brokerage firm licensed in Vermont or another jurisdiction. A referral fee agreement must be in writing. A referral does not create an agency relationship. A licensee making a referral is not a sub-agent. A licensee from another jurisdiction may observe, but not perform, brokerage services in Vermont.

(1) a written brokerage service agreement signed by the brokerage firm and its client; or

(2) an agency agreement with a brokerage firm that has a written agreement described in (1). A brokerage firm shall not collect any compensation for brokerage services except as provided by these rules.

(d) The brokerage firm representing a seller may compensate a brokerage firm representing a buyer out of the brokerage fee without thereby creating an agency relationship. The brokerage firm representing a buyer may compensate a brokerage firm representing a seller out of the brokerage fee without thereby creating an agency relationship. Consent of the client is not required in either case.

Section 4.14 Records

(a) A brokerage firm shall maintain for at least seven years at its usual place of business all records (paper or electronic) of brokerage services provided and they shall be available to the Commission and its agents during regular business hours.

(b) The principal broker, broker in charge, or a designee must cooperate in good faith with the Commission's agent during any inspection, and the principal broker, broker in charge, or a designee may remain present during any inspection. The Commission's agent may not be denied access to the records if the principal broker, broker in charge, or a designee is not present.

Section 4.15 Timely Response to Commission Inquiry

As soon as reasonably practicable or within 30 days, whichever is sooner, a licensee shall respond in good faith when contacted regarding any matter related to the regulation of the licensee's profession by the Commission, or the Office of Professional Regulation acting on behalf of the Commission.

Part 5 Education

Section 5.1 Initial Salesperson and Broker Education

All applicants for a salesperson or broker license must complete the salesperson or broker prelicensing course, which will consist of at least forty hours of instruction approved by the Commission. A list of approved courses can be found at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission.

Section 5.2 Continuing Education for Renewals

(a) Salespersons renewing for the first time must provide evidence of having completed the required hours of post-licensure education, approved by the Commission, within ninety (90) days of obtaining their initial salesperson's license. A real estate salesperson regulated under the laws of another jurisdiction, licensed and in good standing to practice in that jurisdiction, and who has been licensed for at least twenty-four months in that jurisdiction, is not required to complete the required post-licensure education.

(b) Salespersons or brokers applying for renewal of licenses must complete the required hours of continuing education during the two-year period immediately preceding renewal. Four hours of the instruction required of brokers and salespersons must be in a subject designated by the Commission for that licensing period. The courses taken must be approved by the Commission as continuing education courses. A list of approved continuing education courses can be found at www.sec.state.vt.us/professional-regulation/profession/real-estate-commission.

(c) Any person may seek individual approval of a course by petitioning the Commission no later than 90 days before licensing renewal.

(d) The Commission may appoint an education committee to advise the Commission on standards for approval of courses and the application of those standards.

Section 5.3 Compliance Audits

(a) The Commission will conduct continuing education audits of randomly selected licensees and licensees whose licenses are conditioned. The Commission may also audit late renewing licensees and licensees who in any of the preceding 2 renewal cycles were initially found to have not met continuing education renewal requirements.

(b) If an audit shows that the licensee has not acquired the required hours of acceptable continuing education, the Commission will inform that licensee. The licensee may be given an opportunity to develop and complete a plan to correct the deficiencies. An opportunity to correct continuing education deficiencies, however, does not preclude disciplinary action against the licensee for unprofessional conduct during the renewal process, including fraudulent or deceptive procurement of a license.

History

STATUTORY AUTHORITY: 26 V.S.A. § 2252
EFFECTIVE DATE: January 31, 1987
AMENDED: December 19, 1991 Secretary of State Rule Log #91-76; July 1, 1995 Secretary of State Rule Log #95-13; April 1, 2002 Secretary of State Rule Log #01-72; April 15, 2008 Secretary of State Rule Log #08-012; September 1, 2013 Secretary of State Rule Log #13-024; December 1, 2015 Secretary of State Rule Log #15-048

Chapter 300 BOARD OF REAL ESTATE APPRAISERS; ADMINISTRATIVE RULES

04-300 Code Vt. R. 04-030-300-X BOARD OF REAL ESTATE APPRAISERS; ADMINISTRATIVE RULES

Part 1 GENERAL INFORMATION

Section 1.1 The Board's Purpose

(a) The Board of Real Estate Appraisers ("the Board") has been created and given powers by Vermont law. A federal law enacted in 1989 required states to establish licensing and certification programs for real estate appraisers who intended to perform appraisals in federally related transactions. The Board was created in response to this federal law by a Vermont statute, which directed the Board to meet federal criteria. The federal law created the Appraisal Subcommittee of the Federal Financial Institutions Examination Council (ASC) as the federal agency responsible for monitoring the establishment of state programs for compliance with federal law. The Appraiser Qualifications Board of the Appraisal Foundation has identified the minimum qualifications for licensure needed to meet the requirements of the federal law, and the Board adopts those minimums as its requirements.

(b) Only individuals licensed by the Board may perform appraisals in a federally related transaction for a fee or may represent themselves as certified real estate appraisers in Vermont. No license is required to perform real estate appraisals in other transactions. However, a certified appraiser is subject to the Board's disciplinary authority when performing all real estate appraisals, whether or not the appraisal could have been performed by an unlicensed person.

Section 1.2 Business Address

The business location is the Office of the Secretary of State, Office of Professional Regulation, 89 Main Street, 3 rd Floor, Montpelier, Vermont ("the Office"). The mailing address is Board of Real Estate Appraisers, Office of Professional Regulation, 89 Main Street, 3 rd Floor, Montpelier, Vermont 05620-3402. Copies of these rules and more information about the Board and its requirements and procedures are available by contacting the Office or on the Board's web site at: http://vtprofessionals.org .

Section 1.3 Laws That Govern the Board

The Board is governed by the Vermont Real Estate Appraisers Act. 26 Vermont Statutes Annotated (V.S.A.) Chapter 69. The Board also enforces the Professional Regulation statutes found in 3 V.S.A. §§ 121-131. In addition, the Board is obligated to comply with several other state laws such as the Administrative Procedure Act (3 V.S.A. Chapter 25), the "Open Meeting Law" ( 1 V.S.A. §§ 312-313) and the "Access to Public Records Law" ( 1 V.S.A. §§ 315-320). These laws explain the rights of an applicant, license holder or member of the public.

Section 1.4 Board Rules

The Board is authorized to make these administrative rules. 26 V.S.A. § 3315.

Section 1.5 Definitions

As used in these rules:

(a) "AQB" means the Appraiser Qualifications Board or its successor institution.

(b) "Complex appraisal" means one in which the property to be appraised, the form of ownership, or market conditions are atypical.

(1) Characteristics similar to the following may suggest that an appraisal is complex:

(i) Ownership rights that are atypical. This may include life estates or situations in which a residence is constructed on land leased for a term of years or where there are subterranean and air rights involved.

(ii) Unusual deed restrictions, easements, encroachments and other similar factors could influence the complexity of the assignment.

(iii) Changes in neighborhood characteristics, which suggest that a residence is no longer the highest and best use for the site. This may include interim use-type situations.

(iv) Actual or suspected environmental hazards.

(v) Architectural style that is atypical for the neighborhood. Examples might include a dome or earth home in a neighborhood of traditional residences. A residence, which is exceptionally large or small for the neighborhood, might also pose a difficult valuation challenge.

(vi) Unstable market conditions including such things as out-of-balance supply and demand relationships may lead to extraordinary complexity.

(2) This list is not intended to be all inclusive but rather representative of situations that may lead to extraordinary complexity of a transaction or an appraisal assignment.

(c) "FIRREA" means the Financial Institutions Reform, Recovery, and Enforcement Act of 1989, Public Law 101-73, as amended.

(d) "License" means a license as a certified general real estate appraiser, a license as a certified residential real estate appraiser, a license by reciprocity, or a temporary license.

(e) "Office" means the Office of Professional Regulation.

(f) "Residential" means an appraisal of vacant or improved property whose highest and best use is residential.

(g) "Transaction value" means the principal amount of the loan application, which will include any extension of credit under consideration.

(h) "USPAP" means the "Uniform Standards of Professional Appraisal Practice" as published by the Appraisal Standards Board of the Appraisal Foundation.

Section 1.6 Making and Resolving Unprofessional Conduct Complaints

The Board follows the complaint procedure used by the Office. Copies of the procedure and more information about the complaint process can be obtained from the Office or on the Board's web site at: http://vtprofesionals.org .

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Appraiser Trainee Registration

A person who wishes to be registered as an appraiser trainee may obtain an application from the Office. Appraiser trainees can be registered in two categories: certified residential appraiser trainee; or certified general appraiser trainee. Education, orientation and continuing education requirements for each category of registration are all set by the AQB.

Section 2.2 Certified Residential Real Estate Appraiser License

Education, experience and continuing education requirements, as well as examination specifications for each category of licensure are all set by the AQB.

Section 2.3 Certified General Real Estate Appraiser License

Education, experience and continuing education requirements, as well as examination specifications for each category of licensure are all set by the AQB.

Section 2.4 Certified Appraisers Supervising Registered Trainee

Supervision requirements during training are set by the AQB.

Section 2.5 Examination

Examination specifications for each category of licensure are set by the AQB.

Section 2.6 Education

Education requirements for each category of licensure are set by the AQB.

Section 2.7 Experience

Experience requirements for each category of licensure are set by the AQB.

Section 2.8 Education Program Approval

(a) In order to be approved by the Board, a program must satisfy the education guidelines set by the AQB.

(b) A program may be approved by the Board by filing an application form that indicates the name of the program, the number of classroom hours requested and the sponsor and instructors. An application may be filed by the sponsor or a participant. For advance approval, applications must be filed at least 90 days before the program commences.

(d) The Board may deny approval of any program which is otherwise eligible if it finds that the program is led by an instructor without sufficient experience in teaching or in the subject matter being taught; is sponsored by a group or individual lacking the ability or intention to produce a program of sufficient quality to improve or establish an appraiser's professional competence; or the program is not sufficiently organized or adequate to fulfill the objectives of these rules. The Board follows the Course Approval Program - Policies, Procedures and Criteria - published by the AQB.

(e) A program sponsor may state that a program has been approved by the Board and may also state the number of credits approved by the Board.

(f) The Board may audit any course it has approved for compliance with this rule and the AQB requirements.

Part 3 INFORMATION FOR LICENSED APPRAISERS

Section 3.1 License Renewal

A license must be renewed before it expires. The expiration date is printed on the license; expiration dates are occasionally adjusted by the Office but are normally two years after the previous renewal date.

Section 3.2 Continuing Education Requirements

Continuing education requirements for each category of licensure are set by the AQB.

Section 3.3 Continuing Education Program Approval

(a) A program must satisfy the continuing education guidelines set by the AQB.

(b) A program may be approved by the Board upon filing an application form, which indicates the name of the program, the number of classroom hours requested and the sponsor and instructors. The sponsor or a participant may file an application. For advance approval, applications must be filed at least 90 days before the program commences. For other programs, sponsors' applications must be filed within 30 days after the educational activity has commenced. Individual applications must be filed by the time of renewal.

(d) The Board may deny approval of any program which is otherwise eligible for accreditation if the Board finds the program is led by an instructor without sufficient experience in teaching or in the subject matter being taught; is sponsored by a group or individual lacking the ability or intention to produce a program of sufficient quality to improve or establish an appraiser's professional competence; or is not sufficiently organized or adequate to fulfill the objectives of these rules. The Board follows the Course Approval Program - Policies, Procedures and Criteria published by the AQB.

(e) A program sponsor may state that a program has Board approval and may also state the number of credits approved by the Board.

Section 3.4 Change of Name or Address

The Office must be immediately notified of any change of name or address.

Section 3.5 Standards of Practice

All licensees shall follow and adhere to the USPAP published by the Appraisal Foundation, as amended, for all appraisals of real property.

Section 3.6 Interpretations and Clarifications

The Board follows the interpretations and clarifications issued by the AQB and the Appraisal Standards Board of the Appraisal Foundation for guidance in administering these rules, in order to maintain uniformity and consistency with FIRREA.

Section 3.7 Scope of Practice

(a) State Licensed Appraiser: A state licensed appraiser may perform non-complex 1-4 unit residential appraisals up to a transaction value of $ 1,000,000; and complex 1-4 unit residential appraisals up to a transaction value $ 250,000. If a state licensee is performing appraisals of more than four units, or appraisals of non-residential properties, the licensee must be in association with a certified residential or certified general licensee who takes responsibility for the licensee's work and that person must sign the report.

(b) Certified Residential Appraiser: A certified residential appraiser may perform 1-4 unit residential appraisals without regard to transaction value or complexity. A certified residential appraiser may also perform non-residential appraisals up to a transaction value of $ 250,000 without regard to complexity. If a certified residential licensee is performing appraisals of non-residential properties over a transaction value of $ 250,000 the licensee must be in association with a certified general licensee who takes responsibility for the licensee's work and that person must sign the report.

(c) Certified General Appraiser: A certified general appraiser may perform appraisals of all types of real property without regard to transaction value or complexity.

(d) Appraiser Trainee: An appraiser trainee may perform activities within the scope of practice of the license sought provided that the supervising appraiser reviews and signs all resulting appraisals, is present with the trainee during the inspection process, is familiar with the market data used in the appraisal report and takes full responsibility for the appraisal. The appraiser trainee may sign the report but must be clearly identified as a "trainee" in all areas of the report in which the trainee's name appears.

(e) Appraisers may employ and utilize the assistance of those who are not registered trainees under these rules. These assistants shall not be referred to or otherwise identified as "trainees" unless registered as such. When assisted by such unlicensed or unregistered employees, the appraiser shall be present during the inspection of the property, be familiar with the market data used in the appraisal report and take full responsibility for the appraisal.

Section 3.8 Inspecting Records

Copies of all records and any other pertinent memoranda concerning an appraisal shall be available for inspection by the Board and its duly authorized agents upon request during regular business hours.

History

STATUTORY AUTHORITY: 26 V.S.A. § 3315
EFFECTIVE DATE: February 9, 1993 Secretary of State Rule Log #93-29
AMENDED: April 15, 1995 Secretary of State Rule Log #95-27; April 15, 2000 Secretary of State Rule Log #00-19; January 1, 2008 Secretary of State Rule Log #07-045; March 1, 2014 Secretary of State Rule Log #14-003

Chapter 310 ADMINISTRATIVE RULES FOR TATTOOING AND BODY PIERCING

04-310 Code Vt. R. 04-030-310-X ADMINISTRATIVE RULES FOR TATTOOING AND BODY PIERCING

Part 1 GENERAL INFORMATION ON REGISTRATION OF TATTOOISTS AND BODY PIERCERS

Section 1.1 THE PURPOSE OF REGISTRATION

The Secretary of State has been given powers by Vermont law to protect the public health, safety, and welfare by setting standards, registering applicants, and regulating registered tattooists and body piercers and their practices.

Section 1.2 LAWS THAT GOVERN REGISTRATION

Registration is governed by a specific state law that establishes responsibilities for setting standards, issuing registrations, and regulating the occupation. The law is the Tattooists and Body Piercers Act, 26 V.S.A. §§ 4101-4109. In addition, the Director of Professional Regulation ("the Director") is obligated to comply with several other state laws such as the Administrative Procedure Act, 3 V.S.A. §§ 801-849, the Open Meeting Law, 1 V.S.A. §§ 310-314, the Access To Public Records Law, 1 V.S.A. §§ 315-320, and the Law of Professional Regulation, 3 V.S.A. §§ 121-131. These laws set forth the rights of an applicant, registered tattooist, or member of the public.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 APPLICATION

A. Applications and information about registration requirements are available from the Office of Professional Regulation ("the Office"). An applicant shall submit a fully completed application form with all supporting documentation and the fee to the Office. The Office reviews applications only after the fully completed application and documentation is received, including evidrence of any registration or license in another jurisdiction and its registration or licensing standards.

B. An applicant issued an initial registration within 90 days of the required renewal date will not be required to renew or pay the renewal fee. The registration will be issued through the next full registration period. An applicant issued an initial registration more than 90 days prior to the required renewal date will be required to renew and pay the renewal fee.

Section 2.2 QUALIFICATIONS FOR REGISTRATION AS A TATTOOIST OR BODY PIERCER

To be eligible for registration as a tattooist or body piercer, an applicant must be 18 years of age or older and have completed a three-hour course in infectious diseases and universal precautions and the 1,000 hour apprenticeship required by 26 V.S.A. § 4105(b) and further described below. Information on course providers and locations may be obtained from the office.

Section 2.3 APPRENTICESHIPS

A. Apprentices shall register with the Office on forms provided by the Director prior to accumulating apprentice hours for the experience to count toward the hourly requirement. The hourly requirement shall be completed within one calendar year of registering with the Office. An applicant may receive no more than 40 hours per week of apprenticeship credit. The applicant shall provide proof of successful completion of the apprenticeship on forms provided by the Director which shall include a weekly record of attendance, including hours worked, dates, and subject areas covered, including a notarized statement of the supervisor attesting to completion of the apprenticeship.

B. Competencies - At a minimum, an apprenticeship shall cover the following basic areas of practice:

Sanitation;
Sterilization;
Personal Health and Hygiene;
Dealing with the Public;
Hands-on Practice; and
Vermont Law.

C. Supervisors - An apprentice supervisor shall have been actively practicing for at least three years and shall not have a record of disciplinary action. A supervisor may supervise no more than three apprentices at any one time and must directly supervise each apprentice. "Direct supervision" means that the supervisor is on the premises and available to the apprentice at all times.

D. The Director may allow certain related education, training or experience of the applicant on a case by case basis for substitution of all or part of the apprenticeship requirement, depending on the quality and nature of that education, training or experience and whether it addressed some or all of the competencies listed above.

Apprenticeship equivalents - The Director may allow the following in lieu of the apprenticeship and course requirements:

a. An applicant who is licensed and in good standing in another state with substantially similar requirements;

b. An applicant with at least three years verifiable tattooing or body piercing experience working in a shop.

Partial apprenticeship equivalents - On a case by case basis, the Director may consider related education, training or experience, allowing credit toward all or part of the apprenticeship requirement dependent upon the quality and nature of that education, training or experience. Examples: formal tattooing or body piercing classroom instruction or experience in related fields such as electrology, nursing or other medical or medical-related professions.
Universal precautions and infectious diseases course - The Director may accept a previously undertaken three hour universal precautions and infectious disease course if the applicant has taken it within the two years immediately preceding the application.

Section 2.4 QUALIFICATIONS FOR REGISTRATION AS A TATTOO OR BODY PIERCING SHOP

Applicants for a shop registration shall:

A. submit a completed application with the required fee;

B. submit a floor plan of the shop showing separate areas for piercing and tattooing, if applicable;

C. pass an inspection of the shop; and

D. designate a registrant responsible for the overall cleanliness and sanitation of the shop.

Section 2.5 INSPECTIONS

An initial inspection will take place prior to operation as a registered shop to ensure compliance with the sanitation and sterilization standards set forth in these rules. After initial inspection, the Director has the authority to inspect any shop during regular business hours.

Section 2.6 RIGHT TO A WRITTEN DECISION AND APPEAL

If the Director denies an applicant registration, the Director must give specific reasons in writing and inform the applicant of the right to appeal this decision to an administrative law officer. After giving the applicant an opportunity to present the application and any additional information, the administrative law officer must affirm, reverse, or modify the Office's preliminary decision. The applicant may appeal the administrative law officer's decision to the Washington Superior Court.

Part 3 INFORMATION FOR REGISTERED TATTOOISTS AND BODY PIERCERS

Section 3.1 RENEWING REGISTRATION BIENNIALLY

The Office has a fixed 24-month registration schedule. Registrants renew on a fixed biennial schedule: October 1 of the even-numbered years. A registrant shall renew by the expiration date printed on his or her registration. Before the registration expiration date, the Office will mail a renewal application and notice of renewal fee. A registration will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

Section 3.2 GENERAL INFECTION CONTROL PROCEDURES AND PUBLIC HEALTH PRACTICES FOR ALL SHOPS, TATTOOISTS AND BODY PIERCERS

The practices of tattooing and body piercing involves the puncture of skin and exposure to blood. Both the client and the tattooist or body piercer are at risk for a skin- or blood-carried infection, including bacterial infections of the skin or underlying tissues and viral diseases, most significantly hepatitis B, C and D and HIV. To decrease the risk of these infections, tattooists and body piercers are required to follow the infection control procedures, public health practices, and sanitation standards contained in these rules. The following sections apply to both tattooists and body piercers and are then followed by rules more specific to each profession.

See Appendix A for a list of current references relative to tattooing, body piercing and infection control.

A. DEFINITIONS

Disinfection - The use of a chemical agent or physical process to destroy all disease-causing microorganisms on objects.
Infectious body fluids

Blood, semen, vaginal secretions and any body fluid that contains visible blood are considered potentially infectious body fluids. Cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids are also potentially infectious.

Invasive procedure - Any procedure that requires a puncturing or cutting of the skin or tissue.
Mucous membranes - Mucous membranes line body cavities such as mouth, nose, throat, urethra, rectum and vagina. Also includes eyes.
Non-intact skin - Skin that is damaged or broken in some way so that it does not provide optimal protection against infection. This might include skin that is chapped or abraded, or has cuts, sores, inflammation, infection, dermatitis, or an area that is the site of a recent procedure that pierces the skin.
Sharp objects (sharps) - Needles, razors, or other objects that can puncture skin.

B. PREVENTING SPREAD OF INFECTION

When performing procedures on clients that might result in contact with open skin, mucous membranes, blood, and other body fluids it is necessary to take measures to prevent infection. Infections can be passed from client to practitioner, practitioner to client, client to client, and practitioner to practitioner. Diseases can be spread by contaminated hands, objects, or body fluids and tissue.

Hand hygiene: hand washing and hygiene are extremely important in preventing the spread of infection.

a. Wash hands with soap (liquid soap is preferred to bar) and water by:

wetting hands with running water;
applying soap and distributing over all surfaces of hands and fingers;
rubbing hands together for 10-15 seconds; and
rinsing hands with running water to remove remaining soap.

b. Alcohol-based waterless handrubs may be used instead of soap and water only if hands are not visibly soiled.

c. Hands must be washed:

before and after contact with a client;
before putting on and after removing gloves;
after contact with body fluids, mucous membranes, skin that is not intact, and soiled inanimate objects such as bandages;
after using the rest room; and
whenever hands are visibly soiled.

d. For invasive procedures, scrub hands and wrists with antimicrobial soap or alcohol-based waterless antiseptic for one minute.

e. Liquid soaps and lotions are kept in closed containers.

f. Reusable soap containers are washed and dried before refilling and are not topped off.

g. Paper (not cloth) towels or hand blowers are within an arm's reach of the sink used for washing hands. If paper towels are used, they are dispensed from holders that do not require pushing a lever or turning a handle.

h. Nails are short enough to be kept clean underneath and not puncture gloves.

Gloves and protective barriers:

a. Use medical gloves in the following instances:

performing invasive procedures;
making contact with genitals or mucous membranes;
making contact with skin that is not intact; and
before disinfecting a work area or equipment that might be soiled with blood, semen, vaginal secretions, other infectious body fluids or any body fluid that might contain blood.

b. Use disposable gloves only once.

c. Do not touch your eyes, nose, mouth, or hair with gloves on.

d. Check gloves periodically for tears.

e. Do not smoke, eat, or drink with gloves on.

f. Wear a mask and protective eyewear or a face shield when performing procedures that are likely to generate droplets of blood or other body fluids that might contain blood.

g. Wear a gown or apron when performing procedures that are likely to generate splashes of blood or body fluids containing blood.

h. Use disposable lap cloths. They are preferred to cloth lap cloths, which can harbor bacteria.

i. Any broken skin on the practitioner must be covered with a semi-occlusive or waterproof bandage.

Blood Spills and Exposure Incidents:

a. Blood spills on inanimate objects shall be cleaned according to the following guidelines:

wear gloves;
disinfect area with a freshly prepared solution of 1:10 household bleach applied for at least 30 seconds; and
wipe up spill and bleach solution.

b. Exposure Incidents: A blood exposure incident has occurred if there has been a piercing of the skin with a sharp object that has been contaminated with blood or other potentially infectious body fluids from another person. A blood exposure may also be eye, mouth or non-intact skin exposure to blood or other potentially infectious body fluids from another person through splashes or contaminated instruments or materials. If an exposure to blood occurs follow the procedures below:

Wash injuries caused by needles and other sharp objects with soap and water.
Rinse splashes to the nose, mouth, or skin with water.
Flush eyes with water, saline, or sterile irrigant.
Contact a health care provider immediately. In some instances, postexposure treatment may be indicated.
Get contact information from the client whose blood you were exposed to. Testing of their blood may be necessary to determine exposures.
Keep a record of the incident, including how the incident occurred and who was exposed.

Disposal of Sharp Objects:

a. Sharps (needles, scalpels, etc.) shall be disposed of in a sharps disposal container as soon as possible after each use. The container shall meet the following criteria:

Durable, closable, puncture resistant, and leak resistant on the sides and bottom.
Clearly identifiable to practitioners with appropriate hazard warning labels.
Allows visualization to the degree to which the sharps container is full.
Secure from client or visitor tampering.
Easy to use and simple to place and remove from a mounting system.

b. The following practices shall be followed to avoid sharps injury:

Provide at least one sharps disposal container at each workspace where sharps will be used.
Place containers within arm's reach of the practitioner. The practitioner should not need to travel across the room or move around furniture to dispose of the sharp.
Place containers at a vertical height that allows the practitioner to see the opening of the container.
Dispose of the sharp as soon as possible after use is complete (preferably do not put the sharp down in between use and disposal).
Secure container in place and keep container upright throughout use to avoid spillage.
Do not recap needles by hand.
Do not overfill sharps container.
Completely close the container before removing or replacing it. Put in a second container for transport if leakage is possible (the second container should be closable and leak proof).

C. CLIENT PROTECTION AND CONSIDERATIONS

Explain risks and complications of the procedures to the client. Have clients sign a consent form.
No procedure shall be performed on a person obviously under the influence of intoxicating beverages or chemical substances. No intoxicating beverages or chemical substances shall be consumed on the premises. This rule includes, but is not limited to, the tattooist or piercer, who may not perform piercing while under the influence of intoxicating beverages or chemical substances.
Neither the practitioner nor the client shall use tobacco in any form while the procedure is being performed.
Do not tattoo a minor without written consent of the parent or guardian of the minor. Keep the signed consent for your records.
Obtain information from the client for your records (name, address, phone number, date of procedure, medical conditions, description of procedure, name of the tattooist or piercer). If a complication occurs during the procedure, make note of it in your records after the client has been cared for.
Give the client instructions for care of the tattoo site after the procedure.
Make sure the client is comfortable before starting the procedure.
Assess the skin to be tattooed. Do not perform if any abnormality of the skin or underlying tissues exists (for example, skin infection, dermatitis or other lesion).
Pre-procedure skin care:

a. If it is necessary to remove hair, remove it immediately before the procedure, preferably using a depilatory or electric clippers. If a razor is used, a single-use disposable razor should be used and discarded appropriately.

b. Clean grossly soiled skin around the procedure site by washing with soap and water.

c. After cleaning with soap and water, prepare the skin at the procedure site using an antiseptic agent. Common antiseptics are iodine and alcohol.

d. Apply antiseptic to skin starting in the middle of the procedure site and moving outward in concentric circles, so as not to re-contaminate an area that has already been cleaned. Allow antiseptic to dry.

e. Antiseptic bottles should be dated and discarded if not used within 3 months of opening. Do not refill or top off antiseptic bottles.

f. Do not use a product labeled as "disinfectant" on the skin. Disinfectants are for inanimate objects and can burn or damage skin.

Post-procedure skin care:

a. Protect procedure site with appropriate dressing.

b. Educate client about care of the procedure site and signs of infection such as redness, swelling, drainage, and fever.

c. Provide written instructions that the client can refer to at home. Direct the client to contact you and a health-care professional if infection occurs.

D. DECONTAMINATION OF RE-USABLE OBJECTS

All objects used more than once on a client or on more than one client must be cleaned and disinfected or sterilized between each use. The level of cleaning, disinfection and sterilization depends on the object and how it is used. All bottles should be labeled.

Cleaning:

a. Cleaning is the physical removal of tissue, blood or other visible matter from an object using soap and water.

b. Take instruments apart before cleaning.

c. Objects should be pre-cleaned before being disinfected or sterilized.

d. Wear gloves when cleaning objects contaminated with blood or other body fluids or tissue.

e. Store cleaned instruments in a clean covered container until disinfected or packaged for sterilization.

Disinfection:

a. Disinfection is the use of a chemical agent or physical process to destroy all disease-causing microorganisms on objects (some forms of microorganisms are not destroyed). Disinfection should not be used in place of cleaning and sterilizing objects that require sterilization.

b. There are three levels of disinfection: low, intermediate, and high.

Low - Kills some microorganisms. Registered as a hospital disinfectant by the Environmental Protection Agency. Used for items that do not come into contact with mucous membranes (for example, table tops).
. Intermediate - Kills most microorganisms. Registered as a "tuberculocide" by the Environmental Protection Agency.
High - Kills all microorganisms except spores. A chemical germicide labeled as a sterilant by the Food and Drug Administration is used.

Sterilization:

a. Sterilization is the use of a physical procedure or chemical agent to destroy all microorganisms, including spores.

b. Some devices may be purchased sterile and are used only once (for example, needles). Other devices may be re-usable and must be sterilized before each use.

c. Re-usable items must be cleaned with soap and water to remove debris before being sterilized.

d. All devices that enter a normally sterile body site (any site through which blood flows) or that touch non-intact skin must be sterile immediately before use.

e. Any device that comes into contact with blood, semen, vaginal fluids, other infectious body fluids, any body fluid containing visible blood, or non-intact skin must be pre-cleaned and then sterilized after use.

f. Sterilization can be achieved by specially manufactured machines which use a combination of pressure and steam or heat. Always follow manufacturer instructions for operation.

g. Steam autoclave:

uses distilled water;
temperature must reach 121 [degrees] - 132 [degrees] Celsius; and
exposure time is 30 min for small packs.

h. Dry heat:

use only for items that cannot be steam autoclaved;
temperature must reach 170 [degrees] Celsius; and

exposure time is 1 hour.

i. Conduct an indicator test to ensure that the machine is working correctly. The manufacturer may recommend one or more of the following indicators:

Manual indicator (pressure and temperature gauges).
Chemical indicators (indicates that a wrapped package has been sterilized).
Biological indicators or spore tests (the best method to ensure sterility - should be conducted weekly).
Spore tests must be conducted at least once per month.

j. Label, date and store sterilized packs in a clean dry area. Plastic wrapped packs can be stored safely for 1 year.

k. Keep a record of sterilization equipment and operation, including indicator test results, maintenance, and repair.

Workspace decontamination:

a. Wear gloves when appropriate (see section on gloves and protective barriers). General purpose (household rubber) gloves can be used for housekeeping chores. They may be decontaminated and reused, but should be replaced if peeling, cracked, discolored, or torn.

b. Clean visibly soiled area before using disinfectant.

c. Use a detergent or low-level disinfectant (hospital disinfectant) for work surfaces and equipment that do not come in direct contact with a client (for example, tables, machines, lamps) and are not grossly soiled with blood or other body fluids that may contain blood.

d. Use an intermediate-level disinfectant (hospital disinfectants that are labeled tuberculocidal / virucidal) according to manufacturer instructions to disinfect items contaminated with blood or other body fluids that may contain blood. 1/4 cup bleach to 1 gallon water prepared daily can be used (contact time must be at least 30 seconds), but it is corrosive to metals and should not be used on instruments with metal parts.

e. Start decontamination in the center of a workspace and work outward in a circular manner, so as not to re-contaminate areas that have just been cleaned

Waste disposal:

a. Most shop waste can be disposed of in closed bags with regular trash.

b. Sharp items such as needles should be disposed of in a sharps container. They should be removed by or sent to medical waste removal companies for processing.

c. Blood and body fluids may be carefully poured down a drain connected to a sanitary sewer (city sewer or septic system).

Laundry:

a. Place all soiled linens in bags or containers at the location where they are used.

b. Transport soiled linens to the laundry area before sorting or rinsing.

c. Persons handling linens contaminated with blood or other body fluids should wear gloves and clothing to cover skin such as forearms that may come into contact with the linens.

d. Wash soiled linens at at least 160 [degrees] F with detergent for at least 25 minutes Water temperature may be lower than 160 [degrees] F if detergents suitable for low-temperature washing are used according to the manufacturer's instructions.

E. SHOP SET-UP AND PROCEDURES

Premises in general.

a. Facilities shall be well-lit.

b. Separate areas for tattooing and body piercing shall be maintained, where applicable.

c. Adequate separation and screening shall be available for the privacy and dignity of clients.

d. No animals are allowed in the shop. In addition to traditional pets, this also includes, but is not limited to: rodents, birds, fish, reptiles and insects. Guide dogs are permitted.

e. All floors, walls, chairs and other furniture which may come into contact with the client, registrant, instruments or equipment shall be easily cleanable and smooth.

f. All shop floors, walls and furniture shall be kept clean and in good repair.

Toilet facilities.

a. A sink with hot and cold running water shall be located in the tattooing or piercing area and shall be accessible to the licensee but separate from any lavatory to be used by the general public.

b. Hand cleanser and single use, disposable towels shall be provided.

Do not conduct financial transactions during the procedure.
Procedure room walls, floors, counters, furniture, and other equipment should be smooth and easy to clean.
Maintain an area for clean items and work station set-up that is separate from the area where dirty / contaminated items are placed.
Keep soiled linens and non-sterile contaminated items away from the areas where a procedure will occur.
Provide infection control guidelines for all employees.
Offer hepatitis B vaccine to all employees likely to be exposed to blood (required by the Occupational Safety and Health Administration).
Records shall be maintained for each client for no less than two years. In the event of change of ownership or closing of the business, all records shall be made available to the Director, Records are subject to inspection at any time by the Director or his or her designee.

F. CLIENT CONSENT FORMS

Consent form: Consent forms should contain the following about tattooing or piercing procedures, with a place for the client to sign and date the form:

a. for tattooing:

an explanation of the procedure;
that tattooing is permanent;
that removal of tattooing may not be complete and may leave scarring; and
that complications of tattooing may include bruising, scarring, bleeding, skin and/or blood infection, allergic reactions to inks, and nerve and tissue damage.

b. for piercing:

an explanation of the procedure;
the complications of body and facial piercing include bruising, scarring, bleeding, skin and/or blood infection, allergic reactions to jewelry, and nerve and tissue damage; and
the complications of oral piercing include bleeding, infection, tooth damage.

The form must include the following questions:

a. Have you used alcohol or drugs within the last 8 hours? (Clients who have used alcohol or drugs within the last 8 hours should consider having the procedure some other day as they are at increased risk for loss of consciousness and they might regret their decision later.)

b. Has it been more than 2 hours since you last ate? (Clients should have eaten within the last 2 hours before the procedure to avoid increased risk of fainting.)

c. Questions about the following medical conditions that put a client at increased risk for complications:

Mitral valve prolapse and other heart valve abnormalities - Persons with these conditions are usually advised to receive antibiotics during dental procedures. Antibiotics might also be recommended by the client's health care provider prior to having the procedure.
Herpes - Persons with a history of herpes in the procedure area are at increased risk of a reoccurrence of herpes in that area. Antiviral medication taken before and after the procedure can reduce the likelihood of a reoccurrence.
Allergies to latex - Persons with allergies to latex can react to latex gloves used by the practitioner. Allergic reactions vary in severity, but can be severe and life-threatening. Vinyl gloves should be used for clients with latex allergies.
Allergies to antibiotics - Persons with allergies to antibiotics can react to antibiotic ointment applied to the skin. Allergic reactions vary in severity, but can be severe and life-threatening. Non-medicated ointments should be used for clients with allergies to antibiotics.
Diabetes - Persons with diabetes, especially those who must take insulin, have impaired healing. They should be cleared by a physician before having the procedure.
Hemophilia, other bleeding disorders, and use of anticoagulant medications - Persons with these conditions can bleed excessively during and after the procedure.
Medications - Blood thinners (Coumadin, Warfarin, and aspirin) affect bleeding.
Autoimmune disorders - Persons with these disorders might have impaired healing. They should be cleared by a physician before receiving a tattoo.

Pregnancy or plans to become pregnant - Complications may result from nipple, navel or genital piercings.

G. INFECTIOUS DISEASES

Immunizations: Close contact with clients can put practitioners at risk for communicable diseases. The following vaccines can protect you and your clients from some diseases. All persons with potential for exposure to blood should be vaccinated with Hepatitis B vaccine. Other vaccines may be recommended for persons with certain health conditions. Check with a health-care professional.

| Vaccine | Disease | Recommendations | | --- | --- | --- | | Hepatitis B | Hepatitis B | This vaccine is recommended for persons who may be exposed to blood. Three shots over 6 months are required. | | Td | Tetanus, Diphtheria | Receive this vaccine every 10 years. If you did not have or don't know if you had childhood shots, a series of 3 shots is needed. | | MMR | Measles, Mumps, Rubella | At least one dose of this vaccine is recommended for all persons born in or after 1957. | | Varicella | Chicken pox | This vaccine can be given to adults who have never had chicken pox. Two shots are required. | | Influenza | Influenza ("flu") | This vaccine is given every year in October through December for persons wishing to protect themselves from flu. Consider this vaccine yearly if vaccine supplies are sufficient. |

Exclusions from work: To avoid spread of disease to clients, refrain from client and equipment contact if you have the following conditions. Contact a health-care professional as medication may be necessary.

| Disease/problem | Example | Restriction | | --- | --- | --- | | Conjunctivitis | Eye infection (e.g. pink eye) | Until symptoms/discharge stop | | Gastroenteritis | Diarrhea (with other symptoms such as fever, vomiting, stomach cramps) | Until symptoms stop | | Skin infections | Open sores, weeping dermatitis, blisters, ulcers, scabies | Until infections heal. May require antibiotics or other medications. | | Fever and Rash | Measles, rubella, chicken pox, other | See a health professional -- for most diseases restriction continues until a number of days after rash disappears or crusts over | | Prolonged cough illness | Pertussis, tuberculosis | See a health professional -- restriction until 5 days after start of antibiotics (pertussis) or until proved noninfectious by a health professional (tuberculosis) | | Respiratory infection | "Flu"-like illness, colds (e.g. fever, headache, runny nose, sore throat, sneezing) | Until symptoms resolve. Strep throat requires antibiotics. |

Section 3.3 STANDARDS FOR TATTOOISTS AND TATTOOING SHOPS

A. PREPARATION OF THE WORK AREA

Cover work surfaces (trays, table tops) with paper towels.
Cover the tattoo machine, clipcord, spray and ink bottles, lamp handle, and any other surface that is touched during tattooing with plastic bags or film. Plastic coverings should be removed after each client and replaced with new plastic coverings for the next client.

Place a sharps container within reach of the workstation so that sharps can be disposed of immediately after use.

Use a waste bin lined with plastic for non-sharp waste items.
Keep a container with water in it at the workstation to hold used (contaminated) instruments and to keep them separate from clean instruments. Do not use an instrument again after it has been placed in the container until it has undergone proper cleaning, disinfection, and/or sterilization.
Keep all necessary items for tattooing within reach of the tattooist. Items within arm's reach will help prevent accidental spills and contamination of clean items.
Tissues or wipes to be used in the tattoo process should be kept in a place that is convenient to the tattooist, but in an area where they cannot become contaminated by other objects.
Set up equipment and open sterile items (needles, autoclave bags) in front of the client to show that sterile instruments are being used.
Wash hands and forearms before each procedure.
Prepare a lap cloth and other personal protective equipment.
Assemble tattoo machine (needlebar, grip, tube) with gloved hands.
Before an instrument is used, it shall be examined for burrs.

B. INFECTION CONTROL PRACTICES SPECIFIC TO TATTOOING

A spray bottle containing a mixture of soap and water can be used to clean the skin and for lubrication for shaving the area. Spray bottles should not be topped off and should be cleaned daily.
Use an antiseptic (for example, 70% isopropyl alcohol) on the skin in the area to be tattooed. Antiseptics should be wiped on in a circular manner using gauze or a swab. To saturate the swab or gauze, use a pump pack or pour antiseptic from its storage container into a disposable cup. The antiseptic must dry on the skin before penetration of the skin can begin. Use water instead of antiseptic around the eye.
Lubricating jelly in pump containers should be dispensed onto a clean single-use applicator. If more jelly is needed, a new applicator should be used. Never remove jelly from the pump using fingers or gloves. Alternatively, use single-use packages of jelly. Do not use deodorant sticks to moisten the skin.
Inks, dyes, and pigments should be non-toxic and need to be sterilized before use. Inks, dyes, and pigments used should be poured into clean single use plastic caps or disposable cups for each client.
Single-use disposable supplies and equipment should be used whenever possible.
Sterilized needles and similar instruments temporarily set down during tattooing shall be handled and placed so as not to become contaminated.
All substances shall be dispensed from containers in a manner to prevent contamination of the unused portion. Single-use tubes, containers, or applicators shall be discarded immediately following the procedure.
The use of styptic pencils, alum blocks, or other solid or liquid styptics to check the flow of blood is prohibited.
Stencils should be single-use (hectographic or tissue). Do not use acetate or other reusable stencils.
Tattoo needles and razors should be used only once and then discarded.
Discard needles and other sharps immediately after their use and in front of the client into an impervious needle disposal box.
Check gloves periodically for pinhole tears during the procedure.
Do not allow tip of pigment bottle to come into direct contact with previously poured pigment in tray or other objects that might contaminate the supply bottle.
When rinsing tubes for color change, do not blow excess water out of the tube. Use a tissue to pat it dry.
After the tattoo is applied, blot excess blood and body fluid and apply a thick layer of ointment or antibacterial cream to the tattooed area.
Apply a nonstick sterile gauze bandage or dressing to the area held in place with skin tape. Do not use plastic wrap. A thin layer of sterile petroleum jelly or antibiotic cream may be applied before covering with the dressing.

C. BREAKDOWN OF THE WORK AREA

Breakdown the workstation immediately after the client leaves the area.
Remove tube and needle set from the machine and immediately place in water or ultrasonic tank for rinsing. Properly dispose of all sharps.
Soak reusable instruments in preparation for cleaning.
Remove and dispose of elastic bands from the tattoo machine.
Left over ink and containers (ink caps and rinse cups) should be discarded after each client.
All left-over wipes in the working area should be discarded after each client.
All single-use items placed on the procedure tray should be discarded after each client.
Disinfect all surfaces that might have been contaminated. Everything to uched during tattoo application is contaminated and must be disinfected (for example, drawer pulls, pigment bottles, lamps, clipcord, power supply) unless there is a barrier protecting it which can be thrown away (for example, plastic bag or film).
The tattoo machine should be wiped down with a disinfectant (for example, 70% isopropyl alcohol)
Bag and discard waste after each client.

D. EQUIPMENT CLEANING AND STERILIZATION

Storage: All clean and ready-to-use needles and instruments shall be kept in sterile packets and stored in a closed glass, metal or rigid plastic case or storage cabinet while not in use. Such cabinet shall be maintained in a sanitary manner at all times.
Sterilization:

a. An autoclave shall be used for sterilizing all needles, needles bars and similar instruments that enter the body or touch a sterile item that enters the body before use on any client.

b. All instruments must be thoroughly pre-cleaned and washed via an ultrasonic to remove dyes, blood clots and other foreign matter, then dried and packaged for sterilization. Packages must then be dated and sterilized by autoclave.

c. Autoclaves must be properly maintained and spore-tested at monthly intervals, at a minimum. Weekly testing is recommended. Testing records shall be maintained and available for inspection for at least the previous two year period. Information on sterilization, cleaning supplies, autoclaves, and spore-testing may be obtained from medical supply companies.

Needles should be used only once and NOT sterilized for re-use.
Needle bars and tubes should be sterilized after each use on a client.

Solder new sterile needles onto a sterile needle bar. Clean and re-sterilize before using on a client.

Use a brush to clean grooved metal grips.

E. AFTERCARE INSTRUCTIONS FOR CLIENTS

Aftercare shall be administered to each client following a procedure. Aftercare consists of both verbal and written instructions concerning proper care for the tattooed area. Aftercare instructions shall include, at a minimum:

a. How long to leave the bandage on and how to remove the bandage if it sticks.

b. What the tattoo site will look and feel like over the next few days (for example, it might itch, look like a sunburn, peel and/or scab)

c. Instructions for keeping the tattoo clean and application of ointment to the tattoo until it has healed. Clients should be sure that they wash their hands before caring for their tattoo.

d. Client activity restrictions. For example, clients should avoid scratching, rubbing or picking the scab. Clients should also avoid swimming, baths, hot tubs, and sunbathing until the skin had healed.

e. Alternatives for cleaning if irritation to original cleaning products occurs.

f. Directions on use of sunscreen on healed tattoos to prevent fading.

g. Possible side effects.

h. Signs and symptoms of infection. These include excessive redness, swelling, severe itching, or pus at the tattoo site. Fever is also a sign of infection. Clients should be instructed to contact you and their health-care provider if signs and symptoms of infection occur.

i. Shop phone number for client questions.

Section 3.4 STANDARDS FOR BODY PIERCERS AND PIERCING FACILITIES

A. PREPARATION OF THE WORK AREA

Cover work surfaces (trays, table tops) with paper towels.
Place a sharps container within reach of the workstation so that sharps can be disposed of immediately after use.
Use a waste bin lined with plastic for non-sharp waste items.
Keep a container with water in it at the workstation to hold used (contaminated) instruments and to keep them separate from clean instruments. Do not use an instrument again after it has been placed in the container until it has undergone proper cleaning, disinfection, and/or sterilization.
Keep all necessary items for piercing within reach of the piercer. Items within arm's reach will help prevent accidental spills and contamination of clean items.
Set up equipment and open sterile items (needles, autoclave bags) in front of the client to show that sterile instruments are being used.
Wash hands and forearms before each procedure.
Prepare personal protective equipment.
Assemble instruments with gloved hands.

B. INFECTION CONTROL PRACTICES SPECIFIC TO PIERCING

Wash hands thoroughly with hand cleanser and water and dry them with single-use, disposable towels before piercing.
Use single use impervious gloves on both hands before beginning the piercing.
Cleanse the client's skin by washing with an antiseptic solution applied with a clean, single-use, disposable paper or gauze product before and after performing the procedure.
All substances shall be dispensed from containers in a manner to prevent contamination of the unused portion. Single-use tubes, containers, or applicators shall be discarded immediately following the procedure.
The use of styptic pencils, alum blocks, or other solid or liquid styptics to check the flow of blood is prohibited.

Marking should be done after skin cleaning with a sterile instrument. Piercers shall not use a reusable marker or pen for marking the area to be pierced. Marking shall be done with a toothpick and ink well or by some other single use, disposable method.

Use an antiseptic (for example, 70% isopropyl alcohol) on the skin in the area to be pierced. Antiseptics should be wiped on in a circular manner using gauze or a swab. To saturate the swab or gauze, use a pump pack or pour antiseptic from its storage container into a disposable cup. The antiseptic must dry on the skin before penetration of the skin can begin. Use water instead of antiseptic around the eye.
For oral piercings, have the client rinse for 30 seconds or more with an antimicrobial mouthwash.
For oral / facial piercings (lip), the clients should use mouthwash and the facial skin should be cleansed.
A sterilized single-use needle should be used for each client and each procedure.
Discard needle immediately after use into the sharps container.

Single-use disposable items that should be discarded after each client include but are not limited to:

. Needles

. Corks

. Rubber bands

. Skin prepping materials

. Marking devices

. Dental bibs

. Tray covers

. Sterile gauze

. Applicators

Reusable items that must be cleaned and disinfected using a high-level disinfectant include:

. Calipers used on mucous membranes

. Needle pushers

Re-usable items that must be cleaned and sterilized after each use include:

. Forceps

. Insertion tapers

. Connectors

. Receiving tubes

. Pliers

Sterilize all needles (not already sterilized) and jewelry prior to use.
Piercing needles shall not be re-used.
Single-use disposable supplies and equipment are used whenever possible.
Disposable items used for the piercing procedure should be sterile (for example, rubber bands, cotton swabs, toothpicks, gauze).
All jewelry brought in by a client should be considered contaminated. Do not let customers place jewelry on a shop surface. Provide small cups for placement of jewelry brought in by clients.
Jewelry should be smooth polished (to avoid skin irritation and ease of cleaning / sterilizing).
Jewelry should be made from one of the following: surgical implant grade stainless steel; surgical implant grade titanium; niobium; tantalum; solid 14k or 18k yellow or white gold; platinum; high-density, low-porosity no-toxic plastics; PTFE (inert plastic; Tygon (S-54-HL); or other materials found to be equally bio-compatable. Before using any of the preceding metals, the piercer should be familiar with each and how they react to different piercing locations.
Provide hand-washing facilities and/or hand sanitizers for clients (to decontaminate their own hands).
Discard needles and other sharps immediately after their use and in front of the client.
Gloves should be changed between skin preparation and the piercing procedure.
Flashlight or transdermal illuminators (used to illuminate tissue to avoid piercing blood vessels) should be covered with a fresh plastic sheath before each use. The instrument should be cleaned and disinfected with a low-level disinfectant after each use.
Do not use marking pens on more than one client, as they cannot be properly cleaned.
Do not dip tooth picks and other object into the ink container. Instead, place a few drops of ink on a clean surface (for example, the inner surface of the sterilization packet wrapper).
Forceps should be cleaned and sterilized after use on each client.

Needles and piercing devices should be the same gauge or slightly larger than the jewelry to be inserted.

If rubber bands are used on clamps, the rubber bands should be removed and disposed before the clamps are cleaned and sterilized.

C. PIERCING GUNS

Piercing guns should not be used on any part of the body except for the ear lobe (fleshy part). Use of the piercing gun on other body parts can lead to tissue damage and increase the risk of infection. See Rule 3.5, below, for recommendations on the use of piercing guns.

D. BREAKDOWN OF THE WORK AREA

Breakdown the workstation immediately after the client leaves the area.
Soak reusable instruments in preparation for cleaning.
All single-use items placed on the procedure tray should be discarded after each client.
Disinfect all surfaces that might have been contaminated. Everything touched during the procedure is contaminated and must be disinfected unless there is a barrier protecting it which can be thrown away (for example, plastic bag or film).
Bag and discard waste after each client.

E. EQUIPMENT CLEANING AND STERILIZATION

Storage: All clean and ready-to-use needles and instruments shall be kept in sterile packets and stored in a closed glass, metal or rigid plastic case or storage cabinet while not in use. Such cabinet shall be maintained in a sanitary manner at all times.
Sterilization:

a. An autoclave shall be used for sterilizing all needles and similar instruments before use on any client.

b. All instruments must be thoroughly pre-cleaned and washed via an ultrasonic to remove blood clots and other foreign matter, then dried and packaged for sterilization. Packages must then be dated and sterilized by autoclave.

c. Autoclaves must be properly maintained and spore-tested monthly, at a minimum. Weekly testing is recommended. Testing records shall be maintained and available for inspection for at least the previous two year period. Information on sterilization, cleaning supplies, autoclaves, and spore-testing may be obtained from medical supply companies.

Needles should be used only once and NOT sterilized for re-use.
Store clean items in a covered container when not in use.

F. AFTERCARE INSTRUCTION FOR CLIENTS

Aftercare shall be administered to each client following a procedure. Aftercare consists of both verbal and written instructions concerning proper care for the piercing. Aftercare instructions shall include, at a minimum:

a. What the site will look and feel like over the next few days (for example, there might be some bruising or swelling)

b. Instructions for cleaning the site and application of cleaning solutions and sea salt soaks until the piercing has healed. Clients should be sure that they wash their hands before caring for their piercing.

c. Advise against using band-aids or other bandages that limit air circulation.

d. Client activity restrictions. For example, clients should avoid:

Over-cleaning the piercing site
Submerging the piercing in water such as pools, lakes, jacuzzis, etc.
Tight waistbands (for naval piercing)
Hair spray and make-up (for ear and facial piercing)

Use of condoms (for genital piercing)

e. Signs and symptoms of infection. These include excessive redness, swelling, severe itching, or pus at the piercing site. Fever is also a sign of infection. Clients should be instructed to contact you and their health-care provider if signs and symptoms of infection occur. If an infection is suspected, jewelry should be left in until the client can be seen by a health provider.

f. Shop phone number for client questions.

Aftercare instructions for oral piercings should also include the following information:

a. Rinsing with cleaning solutions and sea salt mixtures after eating.

b. Suck on ice to reduce swelling.

c. Removal of plaque from tongue jewelry.

d. client activity restrictions. For example, clients should avoid:

Oral sex
Chewing gum, tobacco, and other objects
Smoking
Aspirin
Salty, spicy, acidic, alcohol, and hot foods (for the first few days)

Section 3.5 USE OF EARPIERCING GUNS BY UNLICENSED PERSONS

A. No person shall practice body piercing without first obtaining a registration in accordance with these rules. "Body piercing" is defined by statute at 26 V.S.A. § 4101(4) to include ear piercing, except when performed on the lower lobe of the ear:

by the individual himself or herself;
by a parent or guardian when the subject of the piercing is a minor;
by a household member when the subject of the piercing is an adult; or

with an instrument approved by the director, by rule.

B. Instruments approved by the director include piercing guns which:

utilize a single-use (disposable) sterile cartridge or capsule containing the studs and butterflies;
do not allow contact between the gun and the ear. The cartridge or capsule is discarded after each use;
are capable of being loaded without touching the studs or stud holders; and
have piercing gun bodies disinfected with at least 70% isopropyl alcohol or a high-level disinfectant after each use.

Section 3.6 TATTOOING OR BODY PIERCING A MINOR

A tattooist may not tattoo a person under the age of 18 without the written consent of the minor's parent or guardian.

The written consent form must be signed by the parent or guardian in the presence of the tattooist and must contain a certification by the parent or guardian that the information provided in the consent form is true and accurate, under pains and penalties of perjury.

Before the parent or guardian signs the written consent form, the tattooist must disclose to the parent or guardian the information required to be disclosed in these rules. Copies of a sample written consent form are available from the Office.

The body piercer laws are silent on the issue of minors. Registered body piercers are cautioned to use sound judgment in deciding whether to perform piercings on a minor for possible liability reasons, both criminal and civil.

No tattooist or body piercer is required to perform tattoos or piercings on a minor and may decline to do so.

Section 3.7 CHANGE OF NAME OR ADDRESS

A registrant is responsible for notifying the Office promptly in writing of a legal name change if he or she changes name, mailing address or business address. A registrant requesting a change in his/her name must submit proof of the legal change in name.

Section 3.8 PROFESSIONAL STANDARDS

Registered tattooists and body piercers may be disciplined for any of the categories of unprofessional conduct listed in 26 V.S.A. § 4108. In addition, 3 V.S.A. § 129a provides grounds for discipline in this state, including grounds for discipline if a registrant or applicant has been disciplined in another state for any offense which would constitute unprofessional conduct in Vermont.

Section 3.9 COMPLAINT PROCEDURE

The Office has a procedure for receiving, investigating, and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Part 4 DISCLOSURE OF INFORMATION

Section 4.1 DISCLOSURE OF INFORMATION

Each registered tattooist and body piercer shall disclose to each new client the following information, printed or typed in easily readable format:

(1) The registrant's professional qualifications and experience.

(2) The infection control procedures and public health practices to be followed to protect the public from communicable diseases.

(3) A copy of the statutory definition of unprofessional conduct ( 26 V.S.A. § 4108 and 3 V.S.A. § 129a).

(4) Information on the process for filing a complaint with, or making a consumer inquiry to, the Director. Sample information cards are available from the Office.

Disclosure means, at a minimum:

(a) posting the information and informing the client where the information is posted; or

(b) having the information printed, displaying the printed information in an easily accessible location, and informing the client where the information is displayed; or

Before the first treatment, the tattooist or body piercer shall present to the client for signature a document stating that the information required to be disclosed in paragraphs (1), (2), (3), and (4) above has been disclosed to the client. The tattooist shall also sign the document and shall prepare and shall retain the signed original. If, before the first treatment, disclosure cannot be made or the client declines to sign, the tattooist or body piercer shall prepare and sign a written statement explaining the omission, which shall be retained in place of the signed copy.

For tattooists, if the client is a person under the age of 18, the information required to be disclosed in this rule shall be disclosed to the minor's parent or guardian, in connection with obtaining written consent for treatment, as provided in rule above.

Effective date: July 1, 2004

History

EFFECTIVE DATE: February 26, 1998
AMENDED: July 1, 2004 Secretary of State Rule Log # 04-24

Chapter 320 BOARD OF VETERINARY MEDICINE ADMINISTRATIVE RULES

04-320 Code Vt. R. 04-030-320-X BOARD OF VETERINARY MEDICINE ADMINISTRATIVE RULES

Part 1 Definitions.

1-1 "Client" means a person seeking veterinary care on behalf of a patient.

1-2 "Companion animal" means an animal for which a client has assumed responsibility and ownership as an individual companion or service animal.

1-3 "Direct Supervision" means oversight by a licensed veterinarian available to physically intervene in the care of an animal.

1-4 "Director" means the Director of Professional Regulation.

1-5 "Foreign" means emanating from or existing within a governmental jurisdiction other than the State of Vermont.

1-6 "License" or "licensure" refers to any credential issued by the Office under these rules, including a certification or registration, except where context clearly indicates reference to a foreign or other professional license.

1-7 "Licensee" means a person or entity seeking or holding a license under these rules.

1-8 "Non-companion animal" means an animal raised for economic or agricultural purposes.

1-9 "Office" means the Office of Professional Regulation.

1-10 "Office website" means sos.vermont.gov/opr.

1-11 "Patient" means an animal that is the subject of veterinary care.

1-12 "Veterinarian-Client-Patient Relationship" or "VCPR" is defined at 26 V.S.A. § 2433. See Rule 8-3, infra.

Part 2 Administration.

2-1 Applicable Law. The practice of veterinary medicine is defined and regulated pursuant to 26 V.S.A. § 2401 et seq. Copies of these and other statutes are available online at www.legislature.vermont.gov/statutes/. The Office administers licensure in conformity with these and other Vermont laws, to include the Administrative Procedure Act, 3 V.S.A. § 800 et seq.; the Public Records Act, 1 V.S.A. § 315 et seq.; and the Laws of Professional Regulation, 3 V.S.A. § 121 et seq.

2-2 Resources for Applicants and Licensees. The Office maintains a website at sos.vermont.gov/opr with information and links relevant to all licensed professionals. Information specific to veterinarians is available from sos.vermont.gov/veterinary-medicine/statutes-rules-resources/.

2-3 U.S. Armed Forces. The Director may accept toward the requirements of these rules relevant military education, training, or service completed by a member of the U.S. Armed Forces and may expedite licensure of a person who left licensed employment in another state secondary to a spouse's military transfer to Vermont. 3 V.S.A. § 123(g). Service members and the spouses of service members should visit the Office website for details.

Part 3 Procedures.

3-1 Applications. Online license applications must be completed through the Office website.

(d) The Board may deem expired any application that is left pending for six months.

3-2 Complaints. Complaints against licensees, applicants for licensure, or persons practicing without a license may be submitted through the Office website, at sos.vermont.gov/opr/complaints-conduct-discipline/.

3-3 Contested Cases. Procedures in contested cases relating to licensure or discipline are governed by the Office of Professional Regulation Administrative Rules of Practice, CVR 04-030- 005, as those rules may from time to time be modified.

3-4 Declaratory Rulings. Petitions for declaratory rulings as to the applicability of any statutory provision or of any rule or order of the Board or Office may be made pursuant to 3 V.S.A. § 808 and Office procedure.

3-5 Conflict of Standards. Where a standard of unprofessional conduct set forth in statute conflicts with a standard set forth in rule, the standard that is most protective of the public shall govern. See 3 V.S.A. § 129a(e).

3-6 Determination of Equivalency. Where the Board or Director is permitted by law or rule to accept certain training or experience on the basis of equivalence to a fixed standard, it is the burden of the applicant or licensee to establish equivalence to the Board or Director's satisfaction, by producing credible, clear, and convincing evidence of the same. The Board and the Office have no obligation to research the bona fides of any institution, program, course, degree, certification, practicum, fellowship, or examination.

3-7 Waiver or Variance. The Board will not grant routine waivers or variances from any provisions of these rules without amending the rules. See 3 V.S.A. § 845. Where, in extraordinary circumstances, application of a rule would result in manifest unfairness, an absurd result, unjustifiable inefficiency, or an outcome otherwise inimical to the public health, safety, and welfare, the Board may, upon written request of an interested party, so find, grant a waiver with or without particular conditions and limitations, and record the action and justification in a written memorandum. This rule shall not be construed as creating any administrative hearing right or cause of action.

3-8 Inspection. All veterinary hospitals and other non-residential premises used by licensees in relation to the provision of veterinary services shall be open to announced or unannounced visits by Office inspectors during regular business hours.

3-9 Contacting the Board. See the Office website for contact details. Send mail to: Office of Professional Regulation, ATTN: Board of Veterinary Medicine, 89 Main Street, 3rd Floor, Montpelier, VT 05620-3402.

Part 4 Administration.

4-1 Core requirements. An applicant is eligible for licensure who has:

(a) reached the age of majority;

(b) graduated from a school of veterinary medicine accredited by the American Veterinary Medical Association or the Canadian Veterinary Medical Association; and

(c) passed the North American Veterinary Licensing Examination (NAVLE), or any subsequent licensing examinations prepared under the authority of the National Board of Veterinary Medical Examiners (NBVME) or its successor organization, within two years preceding application.

4-2 International Veterinary Graduates not Licensed in the United States or Canada. In lieu of the graduation requirement of Rule 4-1(b), an applicant may present a certificate issued by the Educational Commission for Foreign Veterinary Graduates (ECFVG), its successor organization, or an organization acceptable to the Board.

4-3 Veterinary Graduates Licensed Elsewhere in the United States or Canada. A person licensed or certified in good standing under the laws of another jurisdiction may be eligible for licensure without examination as specified by 26 V.S.A. § 2424.

4-4 State Laws & Rules. Examination on Vermont-specific laws and rules is not required. All veterinarians are responsible to maintain ongoing familiarity with State and Federal laws and rules governing the practice of the profession, just as all veterinarians are responsible to follow evolving practice standards. Ignorance of regulatory requirements does not excuse noncompliance. Means of ensuring orientation to regulatory obligations include participation in professional associations, consultation with qualified legal counsel, subscription to professional publications, and periodic online monitoring of legislative and regulatory developments.

4-5 Consultation Exemption. Board licensure is not required of a veterinarian regularly licensed in another jurisdiction consulting with a licensed veterinarian in this State. Accord 26 V.S.A. § 2403(5). Exempt consultation is limited to the provision of specialized professional advice or assessment, or the demonstration of clinical practices. A consulting veterinarian is, for purposes of professional responsibility, a delegate of the Vermont veterinarian with whom he or she consults and may provide veterinary services only to animals with which the Vermont veterinarian has a valid VCPR and as requested by the Vermont veterinarian.

4-6 Livestock Management and Husbandry Exemption. Board licensure is not required of persons engaged in accepted livestock management practices and animal husbandry practices. See 26 V.S.A. § 2403(2). Embryo transfer is not exempt as an accepted livestock management practice and may be performed only by or under the direct supervision of a Vermont-licensed veterinarian.

Part 5 License Renewal.

5-1 Biennial Licensing Period. Licenses are valid for fixed, two-year periods. Expiration dates are printed on licenses. A license expires if not renewed by midnight on the date of expiry. Practice under an expired license is prohibited. An initial license issued fewer than 90 days prior to the beginning of the fixed biennial period shall be valid through the end of full biennial licensing period following initial licensure. A lookup tool on the Office website may be considered a primary source verification as to license status and expiration.

5-2 License Renewal. Online license renewal applications must be completed through the Office website. The Office transmits email reminders to licensees at the end of each biennial licensing period; however, non-receipt of such reminders shall not excuse a licensee from the obligation to maintain continuous licensure or the consequences of failing to do so. Practicing while a license is lapsed is a violation of 3 V.S.A. § 127.

5-3 Late Renewal Penalties. Late renewal applications are subject to reinstatement fees, which may be waived in certain circumstances. See 3 V.S.A. § 127(d). Reinstatement waivers may be requested through the online licensing system.

5-4 Extended License Lapse. A license expired for five or fewer years may be reactivated as of right upon proof of continuous veterinary practice elsewhere, or if veterinary practice ceased, upon completion of the continuing education required in the preceding biennial licensing period. When a license has been expired for five or more years, a licensee's preparation to return to practice will be assessed on a case-by-case basis. After consultation with the Board, the Director may require re- training, testing, or re-application. See 3 V.S.A. § 135; 26 V.S.A. § 2426.

Part 6 Continuing Veterinary Medical Education.

6-1 Continuing Education

(a) Requirement. All licensees have a duty to maintain professional competence through conscientious pursuit of professional learning opportunities, interaction with peers, and continual review of relevant scientific and professional literature. In each biennial licensing period, a licensee shall devote at least 24 hours to such pursuits and shall attest to having done so as a condition of renewal.

(b) Relevance. Licensees are expected to identify and pursue appropriate learning opportunities in good faith. Activities claimed under this rule shall be reasonably calculated to improve the particular professional practice of the licensee, shall be relevant, and shall be oriented toward evidence-based practice or the improvement of technical skill. Express approval of continuing learning opportunities is not required.

(c) Documentation. A licensee shall document participation in professional learning activities. For courses, a licensee shall retain completion certificates. For non-course activities, such as reading, research, presentation, or curriculum development, a licensee shall maintain a contemporaneous log of pertinent details, such as journal citations; presentation titles, locations, dates, sponsors, and host institutions; the length of time spent on the activity; and a brief, written summary of the substantive reading, research, presentation, or curriculum developed. A form log is available at the Board website. Certificates and logs must be retained for four years. The Board may audit continuing education compliance at any time.

Part 7 Reporting Duties.

7-1 Duty to Update and Self-Report. Applicants and licensees owe a duty of candor to the Board and shall disclose circumstances that may call for further investigation to protect the public. That a matter is reportable does not imply that the matter necessarily is a basis for discipline. A licensee, including an applicant for licensure, shall report to the Office, in writing, within 30 days:

(a) any change of name, e-mail, or mailing address;

(c) any arrest or charge for conduct occurring in the course of, or in direct relation to, the practice of veterinary medicine;

(d) any conviction for any criminal act;

(e) any injunction or other order of a court or regulatory authority, including an assurance of discontinuance, limiting the licensee's ability to practice;

(f) any legal claim, settlement, or judgment arising from alleged professional negligence, misconduct, or malpractice; and

(g) any adverse action against a foreign professional license, where the adverse action relates to an allegation of misconduct, substandard practice, or unethical conduct.

7-2 Duty to Report Disease.

(a) Pursuant to 6 V.S.A. § 1162, a veterinarian shall immediately report to the State Veterinarian:

the discovery of any domestic animal that is infected with, is suspected of being infected with, or has been exposed to a disease reportable under 6 V.S.A. ch. 102;
any sudden unexplained morbidity or mortality in a herd or flock.

(b) A veterinarian shall report to the Secretary of Agriculture, Food & Markets any horse that has tested positive for equine infectious anemia and shall see that the animal is quarantined if required by 6 V.S.A. § 1182(c).

(c) A veterinarian shall report to the Commissioner of Health any animal or animals having or suspected of having any disease that can result from bioterrorism, epidemic or pandemic disease, or novel and highly fatal infectious agents or biological toxins, and those that might pose a risk of a significant number of human and animal fatalities or incidents of permanent or long-term disability. 13 V.S.A. § 3504(d).

Part 8 Practice Rules & Standards.

8-1 Ethical Conduct. The Board may consider the Principles of Veterinary Medical Ethics of the AVMA a recognized source of professional standards when determining "the essential standards of acceptable and prevailing practice" for purposes of 26 V.S.A. § 129a(b). This section shall not be construed as imposing any mandatory-reporting obligation not otherwise present under Vermont law.

8-2 Compliance with Other Law. Licensees must comply with all federal, state and local laws, governing the practice of the profession. 3 V.S.A. 129a(a)(3).

8-3 The Veterinarian-Client-Patient Relationship. The three elements of a VCPR--assumption of responsibility for care, sufficient knowledge of the patient, and availability--are defined more particularly at 26 V.S.A. § 2433, together with important related principles not restated in these Rules. A valid VCPR:

(a) must exist prior to the provision of any veterinary care, other than in a rabies clinic or an emergency; and

(b) must exist prior to issuance of a veterinary feed directive or any activity relative to the provision, administration, authorization, or prescribing of veterinary prescription drugs.

8-4 Telepractice. When determining whether a valid VCPR has been established, the Board will inquire into the sufficiency, reliability, and validity of the veterinarian's knowledge, not the means or modality by which that knowledge was obtained. Veterinarians are authorized to use their reasoned clinical judgment to determine when and how telemedicine modalities may be used.

(a) Common standard of care. A Veterinarian using telemedicine must take appropriate steps to establish a VCPR, obtain informed consent from the client, and conduct all necessary patient evaluations consistent with currently acceptable standards of care. Some patient presentations are appropriate for the use of telemedicine as a component of, or in lieu of, hands-on medical care, while others are not.

(b) Federal laws and rules. This rule shall not be construed as superseding any contrary law or rule of the United States Food & Drug Administration.

8-5 Veterinary Records: Companion Animals. For each companion animal with which a veterinarian has a VCPR, the veterinarian shall retain a distinct file including:

(a) client and patient information;

(b) a competent history;

(c) individualized entries recording each assessment, treatment, consultation, procedure, intervention, diagnosis, and plan; and

(d) the identity of each person providing such service.

8-6 Veterinary Records: Non-companion animals. Group records are acceptable for non- companion animals; provided, however, that an individual record shall be initiated when indicated by the health status of the animal.

8-7 Records Retention and Production. A veterinarian shall retain patient records for not fewer than seven years from last contact with an animal, or in contexts where other law requires longer retention, for the longer period. Failure to keep appropriate records may constitute unprofessional conduct. 3 V.S.A. § 129a(a)(3). Records shall be typed when practicable under the circumstances, legible, reasonably protected from inadvertent destruction, and fit to transmit relevant content to a subsequent provider of care. Records shall be made available promptly upon written request of a client and may not be withheld for non-payment; provided, however, that a veterinarian may require that a client pay actual costs of production of transmission, such as copying and postage. See 3 V.S.A. § 129a(a)(8).

8-8 Records Disposition. A veterinarian shall have in place a plan for responsible disposition of patient veterinary records in the event the veterinarian should become incapacitated or unexpectedly discontinue practice. 3 V.S.A. § 129a(a)(25). Group practices may satisfy this requirement through a written agreement among partners that contemplates dissolution of the partnership or separation of a partner. Any veterinarian may satisfy this requirement through written agreement with a professional peer, attorney, or other person or organization credibly capable of seeing to appropriate disposition of records. A veterinarian's records-disposition plan shall be available upon request of a client or the Board, but need not be filed with the Board unless requested.

8-9 Delegation. A licensee shall delegate professional responsibilities only to those whom the licensed professional knows, or has reason to know, is qualified by training, experience, education, or licensing credentials to perform them. Diagnosis, prescription, and surgery are not delegable by a veterinarian to a non-veterinarian.

8-10 Alternative Therapies. Alternative therapies may be provided in conformity with accepted principles of veterinary ethics; provided, however, that a veterinarian shall not advertise, promote, or recommend a therapy or treatment in a manner tending to deceive the public or to suggest a degree of reliability or efficacy unsupported by competent evidence and professional judgment. See 26 V.S.A. § 129a(a)(17).

8-11 Integration of Complementary Care Providers. Vermont law does not authorize any non- veterinarian licensed under Title 26 to undertake any act within the scope of veterinary medical practice. Non-veterinarian providers may be skilled in certain modalities that may be safely applied for therapeutic benefit to animals under the supervision of a veterinarian. A veterinarian may delegate veterinary treatments to such providers if:

(a) the veterinarian has a valid VCPR;

(b) the requirements of Rule 8-9 are satisfied;

(c) the veterinarian has verified that the provider is oriented to the unique anatomy, physiology, and behavior of the animal to be treated by documented training additional to that required for the provider to practice his or her care modality on humans;

(d) the veterinarian has a competent clinical and evidential basis to believe the service will be of therapeutic benefit;

(e) the veterinarian has prescribed in writing the treatment or act to be performed;

(f) the veterinarian and delegate provider have established a written plan of care recorded in the veterinary record;

(g) an appropriately qualified veterinarian is available to consult and arrange for intervention in the event of complications; and

(h) the informed consent of the client is obtained and recorded in the veterinary record, including as to any compensation exchanged between veterinarian and delegate provider.

8-12 Rabies Vaccination; VCPR Not Required; Minimal Recordkeeping. It is in the interest of the public health, safety, and welfare that veterinarians participate in rabies vaccination clinics and offer office-based rabies vaccination. A VCPR is not required. A veterinarian participating in a vaccination clinic may do so in conformity with the Agency of Agriculture, Food & Markets' Rabies Vaccination Clinic Rule, CVR 20-022-018, or successor rules. For purposes of those rules, "examination" means such assessment as may be necessary to determine whether the animal is fit for vaccination and does not mean a comprehensive evaluation of health. A veterinarian participating in a rabies vaccination clinic, who complies with records requirements specified in CVR 20-022-018 or successor rules, is excused from the patient recordkeeping requirements in these Rules

Part 9 Discipline.

9-1 Unprofessional Conduct. Unprofessional conduct includes those acts set out at 3 V.S.A. § 129a (applicable to all professional licensees). Violation of these rules is cognizable as unprofessional conduct pursuant to 3 V.S.A. § 129a(a)(3).

9-2 Remedies. Upon a finding by the Board that a licensee, applicant, or person who later becomes an applicant has committed unprofessional conduct, within or without this State, or has had a license application denied or a license revoked, suspended, limited, conditioned, or otherwise disciplined by a licensing agency in another jurisdiction for conduct which would constitute unprofessional conduct in this State, or has surrendered a license while under investigation for unprofessional conduct, the Board may warn, reprimand, suspend, revoke, limit, condition, deny, or prevent the renewal of a license. See 3 V.S.A. § 129(a). A license may be summarily suspended pending further proceedings, consistent with 3 V.S.A. § 814(c), upon a finding that public health, safety, or welfare imperatively requires emergency action.

History

EFFECTIVE DATE:
July 15, 1992 Secretary of State Rule Log #92-24
AMENDED:
June 15, 1999 Secretary of State Rule Log #99-24; July 1, 2012 Secretary of State Rule Log #12-017; July 15, 2022 Secretary of State Rule Log #22-023
STATUTORY AUTHORITY: 3 V.S.A. § 123; 26 V.S.A. § 2413

Chapter 330 ADMINISTRATIVE RULES FOR ATHLETIC TRAINERS

04-330 Code Vt. R. 04-030-330-X ADMINISTRATIVE RULES FOR ATHLETIC TRAINERS

Part 1 GENERAL INFORMATION

Section 1.1 The Purpose of Licensure

The Director of Professional Regulation (referred to as "the Director" in this rule) has been given power by Vermont law to license athletic trainers, to protect the public health, safety and welfare. This is done by setting standards for issuing licenses, licensing only qualified applicants and regulating licensees and their practices.

Section 1.2 Business Location

The Director's business location is c/o Secretary of State, Office of Professional Regulation, 26 Terrace Street, Montpelier (the Office). Mailing address:

Secretary of State

Office of Professional Regulation

26 Terrace Street

Montpelier, Vermont 05609-1101

The telephone number is (802) 828-2363.

An interested person may get copies of these rules and more information about licensure and its requirements and procedures by writing or telephoning the Office or visiting the profession's Web Page at http: www.vtprofessionals.org.

Section 1.3 Advisors to the Director

The Secretary of State appoints two athletic trainers to serve as advisors who help the Director carry out the program and advise the Director on such matters as selecting an examination, setting a passing score, making administrative rules, and approving or denying licenses. The Director refers disciplinary matters to an administrative law officer.

Section 1.4 Laws That Govern Licensure

The practice of athletic training is governed by a specific state law that establishes responsibilities for setting standards, issuing licenses and regulating the profession ( 26 V.S.A. §§ 4151-4160). In addition, the Director and the Office of Professional Regulation are obligated to comply with several other state laws, including the Administrative Procedure Act ( 3 V.S.A. §§ 801-849), the Open Meeting law ( 1 V.S.A. §§ 310-314) and the Access to Public Records law ( 1 V.S.A. §§ 315-320). These laws set forth the rights of an applicant, licensee or member of the public. Copies of these laws may be obtained from a town clerk or librarian or from the Office. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Definitions

In addition to the definitions found at 26 V.S.A. § 4151, the following definitions apply to these rules:

"The Act" means The Athletic Trainers Act, 26 Vermont Statutes Annotated, Chapter 83.

"BOC" means the Board of Certification for the Athletic Trainer, or its successor organization as the national governing board of certification for athletic trainers.

"CAAHEP" means the Committee on Accreditation of Allied Health Education Programs.

"Direct supervision" means the supervisor is on the premises and immediately available at all times.

"NATA" means the National Athletic Trainers' Association.

"The Office" means the Office of Professional Regulation in the Office of the Secretary of State.

" V.S.A. " means Vermont Statutes Annotated: for example 26 V.S.A. § 2081 means section 2081 of Title 26 of the Vermont Statutes Annotated.

Section 2.2 Where to Get an Application

An application for licensure or more information about the application process may be obtained by writing or calling the Office at 26 Terrace Street, Drawer 09, Montpelier, Vermont 05609-1101. Telephone 802-828-2191 or e-mail to lrollins@sec.state.vt.us [File Link Not Available]. Applications are also available online at http: www.vtprofessionals.org.

Applicants must submit a fully completed application form with all supporting documentation and the fee to the Office. Applications are reviewed only after the fully completed application and documentation are received, including evidence of any required education, supervision, employment, or evidence of licensure in another jurisdiction and its standards.

An applicant issued an initial license within ninety (90) days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full licensing period. An applicant issued an initial license more than ninety(90) days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.3 Qualifications For Licensure as an Athletic Trainer,

A. Education:

Prior to January 1, 2004, obtain certification through the internship or accredited educational program route.
After January 1, 2004, have graduated from an athletic training program accredited by CAAHEP or its successor organization.

B. Examination: Pass the BOC examination, and;

C. Furnish proof of certification with the BOC.

Section 2.4 Licensure Without Examination

To qualify for licensure without taking an exam, an applicant must be currently licensed in another state. The requirements in that state must be substantially equal to Vermont's requirements.

Section 2.5 Temporary Permit

A temporary permit may be issued by the Director for a period of up to sixty (60) days to a person who meets the licensing requirements of Rules 2.3 or 2.4 above, to practice pending the applicant taking the next exam and receiving the results of that exam, or pending the Director's receipt of the necessary data for licensure without exam. Direct supervision is required of the applicant while practicing under a temporary permit and the terms of that permit expire immediately upon receipt of notice of having failed the exam.

Section 2.6 Waiver of Examination of Education Requirements

The Director may waive the examination and education requirements if the applicant was BOC certified prior to January 1, 2004 as an athletic trainer.

Section 2.7 Right to a Written Decision And Appeal

An applicant will be notified in writing whether he or she is qualified for licensure. If the Director denies an applicant a license, the Director shall give the applicant specific reasons in writing and inform the applicant of the right to request a hearing for review of this decision. The hearing will be held by an administrative law officer appointed by the Secretary of State. After giving the applicant and the Director an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, remand or modify the Director's preliminary decision. The administrative law officer's decision may be appealed to Washington Superior Court.

Part 3 INFORMATION FOR LICENSED ATHLETIC TRAINERS

Section 3.1 Renewing Licenses Biennially

A. The Office has a fixed 24-month licensing schedule. Licensees renew on a fixed biennial schedule: September 30 of the even-numbered years. A licensee must renew by the expiration date printed on his or her license. Before the license expiration date, the Office will mail a renewal application and notice of renewal fee. A license will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

B. As a condition of renewal, the licensee must show proof of current certification by the BOC.

C. A licensee is responsible for notifying the Office promptly if he or she changes name, mailing address, or business address.

Section 3.2 Reinstating a License

Licenses that have lapsed may be reinstated upon proof of certification in good standing with the BOC, payment of a renewal fee for the current biennium and a late renewal penalty. Licensees who have been lapsed for a period of greater than five (5) years may be required to submit a new application and re-take the examination or may show proof of continuing education or work experience demonstrating current competency.

Section 3.3 Professional Standards

A licensee may be disciplined for a violation of any of the grounds of unprofessional conduct which are found in 26 V.S.A § 4159. In addition, a licensee may be disciplined for a violation of any of the grounds of unprofessional conduct which are found in 3 V.S.A. § 129a.

Section 3.4 Complaint Procedure

The Office has a procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Section 3.5 Disciplinary Actions

Hearings on charges of unprofessional conduct are held before an administrative law officer appointed by the Secretary of State. A party aggrieved by a decision of an administrative law officer may, within thirty (30) days of the decision, appeal by filing a written notice with the Director. The appeal shall be decided by Washington Superior Court on the basis of the record before the administrative law officer. 26 V.S.A. § 4154(b)

History

EFFECTIVE DATE: April 1, 2000 Secretary of State Rule Log # 00-20
AMENDED: October 4, 2005 Secretary of State Rule Log # 05-037

Chapter 340 ADMINISTRATIVE RULES FOR LICENSED ACUPUNCTURISTS

04-340 Code Vt. R. 04-030-340-X ADMINISTRATIVE RULES FOR LICENSED ACUPUNCTURISTS

Part 1 GENERAL INFORMATION ON LICENSURE OF ACUPUNCTURISTS

Section 1.1 THE PURPOSE OF LICENSURE

The Secretary of State and the Director of the Office of Professional Regulation (Office) have been given certain powers by Vermont law to protect the public health, safety, and welfare by setting standards, licensing applicants, and regulating licensed acupuncturists and their practices.

Section 1.2 LAWS THAT GOVERN LICENSURE

Licensure is governed by a specific state law that establishes responsibilities for setting standards, issuing licenses, and regulating the profession. The law is the Acupuncturists Act, 26 V.S.A. §§ 3401-3411. In addition, the Director of Professional Regulation is obligated to comply with several other state laws, such as the Administrative Procedure Act, 3 V.S.A. §§ 801-849, the Open Meeting Law, 1 V.S.A. §§ 311 - 314, the Law of Professional Regulation, 3 V.S.A. §§ 121131, and the Access To Public Records Law 1 V.S.A. §§ 315-320. These laws set forth the rights of an applicant, licensed acupuncturist, or member of the public. The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 DEFINITIONS

Terms defined in the Acupuncturists Act have the same meaning when used in these rules. In addition, when used in these rules:

A. SUPERVISED CLINICAL PRACTICE, by an applicant, means acupuncture practice under the supervision of a licensed acupuncturist who is a qualified preceptor and who is present in the clinic at all times in which supervisees are engaged in the practice of acupuncture. No more than eight students may be supervised at one time. A minimum of 250 student-performed treatments must be included in the 800 hours of supervised clinical practice.

B. ACCREDITED EDUCATIONAL INSTITUTION means a school which has been approved by the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine or its successor organization.

C. PRECEPTOR means a licensed acupuncturist, licensed in the State of Vermont, or a person licensed in another state or country with standards substantially equivalent to Vermont standards. "Preceptor" does not include a spouse or family member, or an employer, partner or shareholder in the same enterprise.

D. EDUCATION AND SUPERVISED PRACTICE REQUIREMENTS FOR PRECEPTORS PRIOR TO JANUARY 1, 1996 means the preceptor must furnish satisfactory proof that his or her training is equivalent to qualifications for Vermont licensure. For supervision provided prior to January 1, 1996, by an acupuncturist, no license is required at the time of supervision if the supervising acupuncturist had met the education and supervised practice requirements of these rules and subsequently passed the examination and was granted licensure.

E. SUPERVISION REPORT means a report submitted by a supervisor containing sufficient detail to evaluate an applicant's supervised practice, including:

Applicant's name;
Supervisor's name, signature, address, certification or license number, state where granted, date granted, and area of specialization;
Name and nature of the practice setting, and a description of the client population served;
Specific dates of practice covered in the report;

Number of practice hours during this period (to include all duties);

Applicant's specific duties;
Number of one-to-one supervisory hours and student-performed treatments;

Detailed assessment of the applicant's performance;

Skills supervised;
Ethical practices reviewed; and
Verification of certification or licensure of the supervisor if the supervisor is certified or licensed in another state. The verification must be provided directly to the Director of Professional Regulation from the other state.

Section 2.2 APPLICATION FOR LICENSURE

An applicant for licensure must:

A. submit a completed application form with all supporting documentation; and

B. pay the required fee.

Examination applicants must submit the application and the fee by the deadline date in order to be allowed to sit for the examination, although the additional required documentation may be submitted after that date. The Office reviews applications only after the supporting documentation is received, including evidence of a certificate or diploma, supervised practice and examination results, as required in Rule 2. 3, or evidence of a license in another jurisdiction and its licensing standards, as required in Rule 2.4. Application forms may be downloaded from the Acupuncturists Web site at http:www.vtprofessionals.org.

Section 2.3 QUALIFICATIONS FOR LICENSURE AS AN ACUPUNCTURIST

As set forth in the Acupuncturists Act, the basic qualifications for licensure are (1) completing a program in acupuncture and Oriental medicine, or (2) completing a training program, and (3) passing the examination.

A. Program in Acupuncture: Certificate or diploma from a school or college of acupuncture or oriental medicine accredited by the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine or as approved by the Director. That education must:

be able to document at least a three-year comprehensive curriculum providing a minimum of 1725 hours of entry-level acupuncture education. The program must include a minimum of 800 hours of supervised clinical practice in which there must be a minimum of 250 student-performed treatments. The program must also include 700 hours of oriental medical theory and 225 hours of biomedical sciences and
consist of no less than 27 months of attendance in classroom and clinic. The diploma must be awarded only after attendance in classroom and clinic. Correspondence programs do not qualify. A year of school is defined as 450 clock-hours in nine months. This may be extended over a period of more than one calendar year. Points will then be given for study equivalent to one year of school. Formal schooling must be documented through the Verification of Education form provided by the Office.

B. Training Program: Completion of a training program which must include earning a minimum of 40 points in any one of the following categories or combination of categories.

apprenticeship -- 10 points for each 1,000 documented contact hours, up to a maximum of 13.5 points per year.

a. An applicant must have completed an apprenticeship of at least 4,000 contact hours with a minimum of 250 student-performed treatments and complete the program in no less than three years and no more than six years.

b. Apprenticeship is defined as on-going work with a tutor or preceptor who assumes responsibility for the theoretical and practical education and training of the apprentice. "Contact hours" is the time the apprentice spends under the direct supervision of the preceptor. Off-site supervision is not included.

c. During the apprenticeship, the preceptor's practice must have included a minimum of 500 acupuncture patient visits with no less than 100 different patients per year during the program. Patient visits must be in general health care practice. Specialized limited practice such as smoking withdrawal, alcoholism, etc., may be included in the practice, but must be in addition to the basic 500 visits of general practice per year. After the first year, the apprentice must have been given increasing responsibilities in patient contact up to and including the final stage of complete diagnosis and treatment under the preceptor's supervision. This increasing responsibility must be documented through the Verification of Training form provided by the Office.

completed academic work -- five points for each half-semester (minimum of 250 hours) completed with at least a C or passing grade in the field of acupuncture or oriental medicine, up to a maximum of four periods or 20 points.

a. Ten (10) points may be earned for each full year (450 hours) of schooling.

b. An official transcript is required, showing academic and clinical work completed, the number of class hours for every class taken in the entire program, and the number of months in the program.

self-directed study -- 10 points for study equivalent to one year of full-time academic work in acupuncture and oriental medicine, for a maximum of two years or 20 points. Self-directed study is limited to certified correspondence courses that are approved by the Director and that grant certificates of completion.

C. Examination: Successful completion of the "Acupuncture Portion" (ACP) of the Comprehensive Written Examination (CWE) in Acupuncture administered by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) or its successor organization, or a substantially equivalent examination approved by the Director, and the "Clean Needle Technique" (CNT) course offered by the Council of Colleges of Acupuncture and Oriental Medicine (CCAOM) or its successor organization.

Section 2.4 LICENSURE WITHOUT EXAMINATION

A. To qualify to be licensed as an acupuncturist based on credentials, an applicant must be licensed or certified in good standing in another jurisdiction in which the standards and qualifications required for regulation in that jurisdiction are at least equal to those required by this chapter.

B. An applicant must also complete the application and send it to the Office with the correct fee.

Section 2.5 FOREIGN-TRAINED APPLICANTS

An applicant must have completed an acupuncture and oriental medicine educational program equivalent to the standards of accredited educational institutions, as defined in Rule 2.1(B). The Director may use a credentials evaluation service to establish academic standing. Applicants should contact the Office of Professional Regulation for a current list of acceptable services. Applicants are responsible for the costs of this evaluation. Upon approval, an applicant may then be eligible for licensure under Rules 2.3 or 2.4.

Section 2.6 RIGHT TO A WRITTEN DECISION AND APPEAL

If the Director denies an applicant licensure, the Director will give specific reasons in writing and inform the applicant of the right to appeal this decision to an administrative law officer. After giving the applicant an opportunity to present the application and any additional information. the administrative law officer will affirm, reverse, or modify the Director's preliminary decision. Decisions of the administrative law officer may be appealed to the Washington Superior Court.

Part 3 INFORMATION FOR LICENSED ACUPUNCTURISTS

Section 3.1 RENEWING LICENSURE BIENNIALLY

Licenses renew on a fixed biennial schedule: January 31 of the even-numbered years. Initial licenses issued within 90 days of the renewal date will not be required to renew and pay the renewal fee. The license will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee. Before the expiration date, the Office will mail a renewal application and notice of the renewal fee. Licensure will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

Section 3.2 CONTINUING EDUCATIONAL REQUIREMENTS

A. "Continuing education" means the direct participation of a licensed acupuncturist as a learner in a structured educational program directly related to competency in acupuncture and oriental medicine or protection of clients from harm, or both.

B. Every licensed acupuncturist must complete 30 continuing education credits in the two years immediately preceding the renewal period in order to renew licensure. The continuing education requirement does not apply for the renewal period during which a person initially obtained licensure. It will begin with the first full two-year renewal period.

C. The Office will provide a form upon which all credits must be recorded. The name and date of the activity, the number of credits requested, and the names of the instructors and sponsor must be clearly indicated on the form. The form must be submitted with the biennial licensure renewal forms. The Director or the Director's designee may randomly audit licensees to ensure compliance.

D. Credits will be granted only for actual time spent as a learner. Breaks and lunches must be deducted.

E. Licensees must maintain records showing attendance and participation in the continuing education activities claimed, such as pamphlets, certificates of attendance received during the instruction, registration receipts, program announcements, facilitators, or brief summaries of work content. These records are subject to inspection and verification by the Office upon request during reasonable business hours. A licensee who is audited will be notified in writing by the Director or the Director's designee and will be required to produce written documentation verifying successful completion of the 30 hours of continuing education during the two-year period at issue.

F. Continuing education credits are calculated in the following manner:

Research and Writing for Publication - one credit for each two hours of documented research. Acceptable research projects include those that relate to the knowledge and/or practice of acupuncture and oriental medicine. No more than 10 credits in this category may be applied toward the continuing education requirement in a single renewal period. Ten credits for each acupuncture and oriental medicine-related article; 15 credits for an acupuncture and oriental medicine-related book or major work. Credit for publication includes any book, or article, study, report, etc., published in a generally recognized journal which relates to the knowledge or practice of acupuncture and oriental medicine. No more than 10 credits in this category may be applied toward the continuing education requirement in a single renewal period except that 15 credits may be applied toward an acupuncture and oriental medicine related book or major work that is published.
Teaching - One credit for each clock hour of instruction. Teaching means the on- going responsibility for the theoretical and/or practical education of acupuncturists. No more than 10 credits in this category may be applied toward the continuing education requirement in a single renewal period. Credit for teaching a course will be granted for a first-time instructor teaching a course. This does not apply to a preceptor.
Continuing Education - One credit for each clock hour of continuing education. Continuing education includes programs or courses which directly enhance an acupuncturist's knowledge and/or practice of acupuncture and oriental medicine. A minimum of 15 credits must be earned in this category for each renewal period.
Distance Learning Programs - Distance learning programs may be eligible for continuing education credits. Such programs are subject to review by the Director. Requirements for eligibility include:

A. Course is accepted for NCCAOM continuing education hours, or

B. Course meets the following criteria:

Certified instructors.

Written course outline and goals for completion submitted for approval before completion of the coursework.

Course includes material that is corrected or reviewed by the instructor.

Course format contains audio or videotapes or other media presented by instructor that follow the outline of the course.

Course credit hours apply based on the actual number of hours of mediabased instruction presented by instructor.

Student keeps records of all coursework and related instructional material.

G. Continuing education courses must be comparable to those that are offered during acupuncture and oriental medicine training by acupuncture and oriental medicine schools and colleges or relevant to the practice of acupuncture and oriental medicine, as determined by the Director.

H. Points will be granted for courses ranging from Oriental medical theory and techniques such as massage, nutrition, and herbology to western sciences such as anatomy, physiology, pathology, biochemistry, microbiology, psychology, nutrition, medical terminology and medical ethics.

Section 3.3 CONTINUING EDUCATION PROGRAM APPROVAL

A. An educational activity shall be eligible for approval as satisfying the continuing education requirements of these rules if it has significant intellectual and practical content directed at increasing the professional competence of acupuncturists, and the activity consists of classroom style instruction, clinical and hands-on style of instruction, or educational seminars with substantial written material available, whether conducted by speakers, lecturers, or panel members, in an approved classroom setting. Seminars, classes, and other learning experiences must be planned around a well-documented lesson plan to qualify for continuing education credit.

B. The activity may be approved by the Office upon filing an application form. The name of the activity, the number of credits requested and the names of the instructors and sponsors must be clearly indicated on the form. An application may be filed by the sponsoring agency or group or by any participant. An application for advance approval must be filed 90 days before the educational activity has commenced. All applications for approval must be filed within 30 days after the activity is completed.

C. The Office shall assign a maximum number of credit hours to each approved activity.

D. The Office may refuse to approve any activity which it finds is not eligible for accreditation pursuant to paragraphs (A) or (B) of this section or which it finds is sponsored by a group or individual lacking the ability or intention to produce a continuing educational activity of sufficiently high quality to improve or maintain an acupuncturist's professional competence, or which it finds is not offered in a sufficiently organized fashion or under otherwise adequate circumstances to fulfill the objectives of these rules.

E. When the Office has approved an activity, the sponsor may so state and may include the number of credits for which the activity has been approved.

Section 3.4 FAILURE TO MEET CONTINUING EDUCATION REQUIREMENT

A licensee who fails to comply with the continuing education requirement may be required to develop and complete a specific corrective action plan of remedial coursework within 90 days, prior to license renewal. The Office will extend the license during the 90-day corrective period but will not renew it if the licensee fails to complete the plan and associated coursework.

Section 3.5 REINSTATING LICENSURE

If a license has expired because it was not renewed on time, the license may be renewed if the applicant meets the renewal requirements and pays the renewal fee for the current renewal period and a late fee.

If a license has lapsed for more than three years, the applicant must apply for reinstatement on forms provided by the Office and demonstrate, to the satisfaction of the Director, that he or she is professionally qualified for (censure.

Section 3.6 CHANGE OF NAME OR ADDRESS

A licensed acupuncturist is responsible for notifying the Office immediately if he or she changes name, mailing address or business address. Acceptable documentation of change of name includes a notarized copy of a marriage certificate, instrument of change of name from a probate court, or other court order. Acceptable documentation of change of name also includes a notarized copy of current identification, such as a driver's license or Social Security card, in both the former and present names. The Director may require additional documentation at his or her discretion.

Section 3.7 COMPLAINT PROCEDURE

The Director has a procedure for receiving, investigating and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Section 3.8 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

Each licensed acupuncturist shall disclose to each client before the first treatment the following information, printed or typed in easily readable format:

A. The licensed acupuncturist's professional qualifications and experience, including (1) all relevant formal education programs attended and all degrees and certificates earned, including the full legal name of the granting institution, (2) all relevant training programs completed and all credentials awarded, including the full legal name of the granting institution, and (3) a brief description of any special qualifications and areas of practice.

B. A copy of the statutory definition of unprofessional conduct ( 26 V.S.A. § 3410) .

C. Information on the process for filing a complaint with, or making a consumer inquiry to, the Director. Sample information cards are available from the Office.

Disclosure means, at a minimum, (1) posting the information and informing the client where the information is posted, or (2) having the information printed, displaying the printed information in an easily accessible location, and informing the client where the information is displayed, or (3) having the information printed and directly handing a copy of the information to the client.

Not later than the third office visit, the licensed acupuncturist shall present to the client for signature a document stating that the information required to be disclosed in paragraphs A, B, and C above has been disclosed to the client. The acupuncturist shall also sign the document and shall retain the signed original. If, by the third visit, disclosure cannot be made or the client declines to sign, the acupuncturist shall prepare and sign a written statement explaining the omission, which shall be retained in place of the signed copy.

When the client is not able to understand the disclosure, as in the case of an institutionalized person, a minor, or an adult who is under the supervision of a guardian, the disclosure shall be made to a suitable patient or guardian.

The Director may audit a licensed acupuncturist's records of information disclosure. Individuals to be audited may be selected at random.

Administrative Rules for Certification and Supervision of Acupuncture Detoxification Technicians.

These Rules implement Chapter 75 of Title 26 which authorizes the Office of Professional Regulation to adopt rules and regulations and perform all acts necessary in carrying out the provisions of that chapter. 26 V.S.A. § 3403(b). Legislative amendments to Chapter 75 in 2002 permit an exception from the licensing requirement for practicing acupuncture. The exception permits special certification for Acupuncture Detoxification Technicians (ADT's). The statute, 26 V.S.A § 3412, confers upon those so certified the privilege of practicing Auricular Detoxification Therapy. These rules establish the standards for certification of persons to practice auricular (ear) detoxification therapy and for the enforcement of such standards through disciplinary action. 26 V.S.A. § 3412 sets the standards approved by the National Acupuncture Detoxification Association as the minimum qualifications for the practice of acupuncture detoxification therapy.

Certification of acupuncture detoxification technicians is recognition that acupuncture detoxification, based in oriental medicine, can lead to significant benefits in recovery from all forms of drug addictions as well as alcoholism.

The Rules and Relating to the Profession of Acupuncture are amended to Add Part 4, Certification of Acupuncture Detoxification Technicians.

Part 4 Certification of Acupuncture Detoxification Technicians

Section 4.1 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

The titles "Acupuncture Detoxification Technician" ("ADT") and "Certified Acupuncture Detoxification Technician" (CADT") may only be used by persons certified pursuant to the Act and these rules who practice auricular (ear) detoxification therapy. Certification as an ADT does not entitle a person to use the title "Acupuncturist" or "Licensed Acupuncturist."

Section 4.2 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

As used in these rules "Auricular Acupuncture" means the insertion of disposable single use acupuncture needles at a specified combination of points, on the surface of the outer ear, according to the protocol of the National Acupuncture Detoxification Association, for the purpose of facilitating the detoxification treatment and rehabilitation of substance abusers.

Section 4.3 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

An acupuncture detoxification technician shall insert disposable single use acupuncture needles in the auricle of the ear only. Under no condition is any needle to be used more than one time. These rules prohibit the use of reusable needles which have been re-sterilized. The points where a technician shall insert needles are limited specifically to the points known as Shen Men, Lung, Liver, Kidney, and Sympathetic as described and located by the National Acupuncture Detoxification Association (NADA) or other national entity approved by the Director of the Office of Professional Regulation ("Director").

Section 4.4 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

A certified acupuncture detoxification technician (ADT)shall provide auricular detoxification acupuncture services only in state, federal or Director approved sites. For purposes of these rules, a state or federal "approved site" is an alcoholism, drug or chemical dependency treatment program which receives federal or state funds. Acupuncture detoxification technicians may practice acupuncture detoxification therapy only under the supervision of an acupuncturist licensed under this chapter and certified by the National Acupuncture Detoxification Association.

Section 4.5 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

Practitioners certified as ADT's shall keep records of patient care which at a minimum shall include the dates of treatment, the purpose for the treatment, the name of the patient, the points used, and the name, signature, and title of the certificate-holder.

Section 4.6 DISCLOSURE STATEMENTS FOR LICENSED ACUPUNCTURISTS

An alcoholism, substance abuse, or chemical dependency program which receives federal or state funds, or is approved by the Vermont Department of Health for treatment of alcoholism, substance abuse, or chemical dependency, or which works in collaboration with any of the aforementioned programs will be acceptable to the Director as a site where acupuncture detoxification may be performed.

Section 4.7 Supervision

(a) No Acupuncture Detoxification Technician shall practice acupuncture detoxification therapy except under the supervision of an acupuncturist who is:

(1) licensed and in good standing under Chapter 75 of Title 26 and;

(2) certified by the National Acupuncture Detoxification Association.

(b) Supervision. The Director may approve a Vermont licensed acupuncturist to supervise a certified ADT if the acupuncturist:

(1) Has been a licensed acupuncturist for at least 2 years;

(2) Is certified by the National Acupuncture Detoxification Association;

(3) Submits to the Director a completed supervision agreement on a form provided by the Director.

Section 4.8 Supervision of Acupuncture Detoxification Technicians

(a) A licensed acupuncturist supervising an ADT shall be available in person, by phone, or electronically during normal working hours, and shall meet onsite with certificate holders as appropriate to assess compliance with these laws and rules.

(b) The licensed acupuncturist must exercise professional judgment when determining the number of technicians he or she can safely and effectively supervise to ensure that quality care is provided at all times.

(c) The licensed supervising acupuncturist is responsible for the professional conduct of a technician functioning in the acupuncture setting and performing procedures as permitted by these rules.

Section 4.9 Limitations

Duties or functions that an acupuncture detoxification technician may not perform include, but are not limited to:

(A) Interpretation of referrals or prescriptions for acupuncture services;

(B) Evaluative procedures;

(D) Acting on behalf of the acupuncturist in any matter related to direct patient care that requires judgment or decision making; and

(E) Any acupuncture service performed independently for any purpose, or detoxification therapy for the treatment of alcoholism, substance abuse or chemical dependence performed with no supervision from a licensed acupuncturist.

Section 4.10 Application for Acupuncture Detoxification Technician Certificate

(a) To qualify as an acupuncture detoxification technician, an applicant shall work in, or in collaboration with, a comprehensive addiction treatment program, and have successfully completed the NADA acupuncture protocol or one which meets or exceeds NADA standards of training.

(b) To be certified as an acupuncture detoxification technician to provide auricular acupuncture detoxification therapy in alcoholism, substance abuse, or chemical dependency programs, an applicant shall submit an application packet to the Director which shall include:

(1) An application, on a form provided by the Director;

(2) A Supervision Agreement on a form provided by the director containing the name, address, telephone number and Vermont license number of the licensed acupuncturist in good standing who will supervise the applicant, signed by the supervising Acupuncturist indicating acceptance of the terms of supervision according to these rules and acupuncture statutes,

(3) The appropriate application fees prescribed by subsection 125(b) of Title 3; (4) Documentation of successful completion of a Director-approved training program in auricular acupuncture for the treatment of alcoholism, substance abuse, or chemical dependency which meets or exceeds standards of training established by the National Acupuncture Detoxification Association.

Section 4.11 Denial of Certification

If the Director denies an application for acupuncture detoxification certification, the Director will give specific reasons in writing and inform the applicant of the right to appeal this decision to an Administrative Law Officer. After giving the applicant an opportunity to present the application and any additional information, the Administrative Law Officer will affirm, reverse, or modify the Director's preliminary decision. Decisions of the Administrative Law Officer may be appealed to the Washington Superior Court.

Section 4.12 Certificate

(a) The certificate shall be posted in a conspicuous place accessible to the public.

(b) The certificate holder shall notify the Office prior to any change in the facility name or change in the ADT's name, address or telephone number.

(c) The certificate holder shall notify the Office in writing of any proposed change of site at least 30 days prior to the effective date of such proposed change.

(d) Every person who holds an ADT certificate shall inform the Office of any change of address or any other change of information, including but not limited to a change of employment, required for certification pursuant to the Act and these Rules.

(e) No person certified under these rules shall practice acupuncture detoxification therapy until the Director has approved the ADT's supervisor and program.

Section 4.13 Disclosure of Information Before Treatment

(a) An Individual practicing as an ADT under the provisions of this chapter shall ensure that any patient receiving such treatment is notified in writing of

(1) the qualifications of the individual providing the acu-detox treatment, and

(2) the process for filing complaints with the Office of Professional Regulation.

(b) The ADT shall ensure that a copy of the notification is retained in the patient's record.

(c) Any person who undergoes auricular (ear) detoxification must indicate in writing prior to such a procedure that he or she has been advised of the following:

(1) that the acupuncture detoxification technician is not licensed to practice medicine in the State of Vermont;

(2) that the acupuncture detoxification technician is not licensed to practice acupuncture in the State of Vermont;

(3) that the acupuncture detoxification technician is not making a diagnosis of the person's disease or medical condition; and

(d) An acupuncture detoxification technician is strictly limited to five ear points treatment for detoxification for substance abuse, chemical dependency, or both.

(e) Persons licensed to practice acupuncture or auricular (ear) detoxification must use a Director approved, standardized "disclosure of information" form for each person treated. The form shall be signed and dated by both practitioner and patient prior to the rendering of services.

Section 4.14 Unauthorized Practice of Acupuncture and Auricular Detoxification Therapy Prohibited Exemptions

(a) No person shall:

(1) Practice acupuncture in Vermont without a license or practice auricular detoxification therapy without a certificate issued under Chapter 75 of Title 26; or

(2) Represent himself or herself to be an Acupuncture Detoxification Technician if he or she is not certified under the Act.

(b) The following persons are exempt from licensure to practice acupuncture or auricular detoxification therapy in Vermont:

(1) Persons who are licensed or certified to perform acupuncture in any other jurisdiction where such persons are doing so in Vermont in the course of regular instruction in a Director-approved educational program of acupuncture or in an educational seminar of a Director-approved professional organization of acupuncture; provided that in the latter case, the practice is supervised directly by a person licensed to practice acupuncture pursuant to the Act;

Section 4.15 Disposal of Biohazard Material and Clean Needle Inventory Records and Used Needle Inventory Records

(a) Disposable single use acupuncture needles are to be used in all acupuncture detoxification therapy. Disposable single use acupuncture needles are considered biohazard waste materials and must be disposed of in accordance with all applicable federal and state laws, rules and regulations. To further ensure the public health and safety of the citizens of Vermont, persons certified under these rules must keep accurate medical and office records that reflect the following detailed information:

(1) Documented disposal of all needles and method of disposal.

(b) Acupuncture detoxification technicians shall ensure that disposable single use needles are stored safely and disposed of in compliance with state and federal laws.

Section 4.16 Renewal of Certification Biennially

Certificate holders renew on a fixed biennial schedule: January 31 of the even-numbered years. Initial certificates issued within 90 days of the renewal date will not be required to renew and pay the renewal fee. The certificate will be issued through the next full license period. Applicants issued an initial certificate more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee. Before the expiration date, the Office will mail a renewal application and notice of the renewal fee. Certification will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

Section 4.17 Unprofessional Conduct and Complaints

(a) No person certified under this section shall engage in unprofessional conduct as defined in 26 V.S.A.' 3410 and 3 V.S.A. § 129a, or as defined elsewhere in Vermont Statutes which may apply to him or her, through another professional license, certification or registration.

(b) The Office of Professional Regulation will investigate any complaint filed against an ADT or the supervising licensed acupuncturist.

Section 4.18 Other Resources and Suggestions

In addition to familiarity with Exposure Control Procedures which are part of ADT training, practitioners should to refer to the Centers for Disease Control's "Exposure to Blood: What Every Health Care worker needs to know" found at http://www.cdc.gov/ncidod/hip/Blood/Exp_to_Blood.pdf [File Link Not Available] for the most up to date information on exposure procedures. Note: If information differs from information contained in the NADA protocol, follow these guidelines.

Suggestion from the Department of Health: Gloves shall be worn when it can be reasonably anticipated that the employee may have hand contact with blood, other potentially infectious materials, mucous membranes, and non-intact skin. 26 V.S.A. § 3403(b)

History

EFFECTIVE DATE: September 1, 2000 Secretary of State Rule Log # 00-46
AMENDED: May 24, 2003 Secretary of State Rule Log # 03-12

Chapter 350 ADMINISTRATIVE RULES FOR CLINICAL MENTAL HEALTH COUNSELORS, MARRIAGE AND FAMILY THERAPISTS, AND PSYCHOTHERAPISTS

04-350 Code Vt. R. 04-030-350-X ADMINISTRATIVE RULES FOR CLINICAL MENTAL HEALTH COUNSELORS, MARRIAGE AND FAMILY THERAPISTS, AND PSYCHOTHERAPISTS

Part 1 GENERAL INFORMATION

Section 1.1 Introduction

(a) The Board of Allied Mental Health Practitioners has been created by Vermont law, which gives the Board certain powers and duties. The Board has adopted these rules to aid applicants, licensees, and the general public to understand the requirements for obtaining a license or entry on the roster, and the practice requirements of the professions regulated by this Board.

(b) The Board is created to protect the public health, safety, and welfare by setting standards for issuing licenses, licensing qualified applicants, and regulating the practice of license holders.

(c) The rules contain individual sections for Clinical Mental Health Counselors, Marriage and Family Therapists, and Nonlicensed and Noncertified Psychotherapists.

(d) These rules have been approved by the Vermont Legislative Committee on Administrative Rules. They have the force of law.

(e) Legislative changes from time to time may create inconsistencies between statutes and administrative rules. If a statutory change does produce an inconsistency, the statute governs, not the rule.

(f) The Board maintains a website at http://vtprofessionals.org/ . Practitioners should periodically consult the website for updated information and matters of interest to the profession.

Section 1.2 Definitions

(a) "Office" means the Office of Professional Regulation.

(b) "Board" means the Board of Allied Mental Health Practitioners.

(1) A school, college, university or other institution of higher learning in the United States which, at the time the applicant was enrolled and graduated, was accredited or in candidacy toward accreditation by a regional accrediting commission recognized by the United States Department of Education or the Council on Post-secondary Accreditation (COPA); or

(2) A school, college, university or other institution of higher learning outside the United States which, at the time the applicant was enrolled and graduated, maintained a standard of training substantially equivalent to the standards of training of those institutions accredited by one of the regional accrediting commissions recognized by the United States Department of Education or COPA.

(d) "Clinical practice" means providing direct and indirect clinical counseling services to clients.

(e) "Degree in counseling or a related field" means a degree meeting the requirements of Part 3 of these rules.

(f) "Direct service" means time spent with a client directly, or consulting with another professional about the client, for example, the client's physician or psychiatrist. It may include any phone time or emergency time with the client, but over all it involves being with the client or the client's other service providers.

(g) "Graduate credit" means credit computed in a semester hour system.

(g) "Indirect services" means creating case notes, staff meetings, supervision, workshops and conferences, general consultation, teaching, case management activities, and any other mental health counselor related work other than direct client contact.

Section 1.3 Laws That Govern the Board

(a) The licensure and roster entry statutes are:

Clinical Mental Health Counselors, 26 V.S.A. §§ 3261-3274;
Marriage and Family Therapists, 26 V.S.A. §§ 4031-4042;
Roster of Psychotherapists Who Are Nonlicensed and Noncertified, 26 V.S.A. §§ 4082-4093.

(b) In addition, the Board is subject to several other state laws. Among them are the Administrative Procedure Act, 3 V.S.A. §§ 801-849, the Open Meeting Law, 1 V.S.A. §§ 310-314, the Law of Professional Regulation, 3 V.S.A. §§ 121-132, and the Access to Public Records Law, 1 V.S.A. §§ 315-320. These laws set forth the rights of an applicant, regulated professional, or member of the public. The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" are also available on the Internet at http://www.leg.state.vt.us . The Board's statutes and rules may also be accessed through the Board's Web site at http://vtprofessionals.org/ .

Section 1.4 General Information for Applicants

Applications and information about licensure or roster entry requirements are available from the Board or online at http://vtprofessionals.org/. No decision on an application can be made until an applicant has paid the required fee, submitted all required documentation to the Board, and the Board has received verification of education, passing examination scores, and completed supervised practice.

Section 1.5 Applications Expire

If after five years an applicant does not provide the Board any report on progress towards licensure, the application expires. If the applicant wishes to pursue licensure, the applicant must begin the application process anew under the rules in effect at the time.

Section 1.6 Decisions on Licensure: Applicant's Right to a Written Decision

(a) Once the Board makes a decision on whether to approve an application, renewal, or reinstatement application, it will notify the applicant in writing. When the Board determines that the applicant does not meet the requirements for licensure, it issues a "preliminary denial." The Board sends a letter to the applicant giving specific reasons for the decision. The letter informs the applicant of the right to appeal the Board's denial and request a formal appeal hearing in front of the Board. An appeal must be filed within 30 days of the Board's denial notice. If the applicant does not request a hearing within 30 days, the denial becomes final.

(b) The Board conducts formal appeal hearings for license denials and renewal denials. The applicant bears the burden to show that the preliminary denial was in error.

Section 1.7 Applicant's Right to Appeal a Final Licensing Decision

After the formal hearing the Board issues a written final decision. If the decision is to deny licensure, the applicant is notified in writing of statutory appeal rights. Appeals must be filed within 30 days of the date of the decision in the manner prescribed in Chapter 5 of title 3 ( 3 V.S.A. § 129) . Further information about the appeal process may be obtained from the Office or online at http://vtprofessionals.org/ .

Section 1.8 Change of Name or Address

(a) Each licensee or roster entrant shall notify the Office within 30 days, if he or she changes name, mailing address, or business address.

(b) Acceptable documentation of change of name includes a notarized copy of a marriage certificate, instrument of change of name from a probate court, or other court order. Acceptable documentation of change of name also includes a notarized copy of current identification, such as a driver's license or Social Security card, in both the former and present names. The Board may require additional documentation at its discretion.

Part 2 DISCLOSURE OF INFORMATION (GENERAL)

Section 2.1 Disclosure Requirements Apply to All

Each member of the professions governed by these rules has specific substantive disclosure requirements. They are specified in that profession's individual section in these rules.

Section 2.2 Disclosure Statements: Form and Timing

Each licensed clinical mental health counselor, licensed marriage and family therapist, or rostered psychotherapist must provide a disclosure statement, printed or typed in easily readable format.

Section 2.3 Definition of Disclosure

Disclosure means, at a minimum:

(a) Posting the information and informing the client where the information is posted; or

(b) Having the information printed, displaying the printed information in an easily accessible location, and informing the client where the information is displayed; or

Section 2.4 Timing of Disclosure

No later than the third office visit, the regulated professional must present to the client for signature a document stating that the information required to be disclosed as described above has been disclosed to the client. Note: rostered psychotherapists have additional requirements in Part 5. The regulated professional must also sign the document and must retain the signed original. If, by the third visit, disclosure cannot be made or the client declines to sign, the regulated professional must prepare and sign a written statement explaining the omission, which must be retained in place of the signed copy.

Section 2.5 Disclosure to Parent or Guardian

Section 2.6 Inspection of Disclosure Statements

At its discretion, the Board may inspect and audit a licensee's or roster entrant's disclosure records. The Board will inspect only general materials relating to information disclosure, and will not inspect individual client records or notes, unless a complaint has been filed. The Board will select individuals to be audited on a random basis or in response to a complaint.

Part 3 CLINICAL MENTAL HEALTH COUNSELORS

Section 3.1 Apply Early

Applicants for licensure as Clinical Mental Health Counselors are advised to apply as soon as they have met their graduation requirements so that they may qualify for the licensing examination at the earliest time. In addition to the application form and other required documents referred to on the application form, applicants must send course descriptions and/or syllabi to the Board for review.

Section 3.2 Apply before Supervised Practice

Applicants should not wait to complete supervised practice requirements before applying for licensure. In fact, early application can help the Board provide applicants a clear understanding of any remaining licensure requirements.

Section 3.3 Requirements for Licensure as a Clinical Mental Health Counselor

There are two ways to become licensed in Vermont as a Clinical Mental Health Counselor.

(a) Examination: An applicant may apply on the basis of education, licensing examination, and supervised practice, or

(b) Endorsement: In certain circumstances, depending on licensing standards of other jurisdictions or duration of licensure, an applicant who is licensed or certified in another jurisdiction may be granted licensure in Vermont on the basis of that license or certification. This is called "licensure by endorsement." See, Rule 3.23.

(c) In addition, in either case: Statutes and Rules Examination: All applicants must successfully complete, after one is adopted, the Board's jurisprudence examination before a license will be issued.

Section 3.4 Those not Qualified for Endorsement

Applicants who do not qualify for licensure by endorsement must meet the requirements for licensure by examination.

Section 3.5 Licensure by Examination

To be eligible for licensure as a clinical mental health counselor, an applicant must satisfy:

(a) the educational requirements;

(b) the examination requirements; and

Section 3.6 Educational Requirements

Educational prerequisites for licensure as a clinical mental health counselor are set forth below. The applicant must:

(a) have earned an "acceptable degree;"

(b) complete no less than 60 credits of graduate level course work including the additional specific courses specified below, if those courses were not taken as part of an acceptable degree.

Section 3.7 Acceptable Degrees

As used in this Part an "acceptable degree" is one which may be used toward licensure. Two categories of degrees are acceptable:

(a) A degree in clinical mental health counseling conferred by a program accredited by the Council for Accreditation of Counseling and Related Educational Programs (CACREP) is an acceptable degree which may be used toward licensure; and

(b) A non-CACREP program degree which meets the requirements set forth below is an acceptable degree which may be used toward licensure.

(c) Reminder: Each applicant who has an acceptable degree is still required to successfully complete 60 credits of graduate level course work in mental health counseling to qualify for licensure.

Section 3.8 Essential Course: Diagnosis, Assessment and Treatment

(a) To be considered an "acceptable" master's or higher degree in "counseling or a related field," the degree must contain no fewer than 3 graduate credits in "Diagnosis, Assessment and Treatment."

(b) Diagnosis, Assessment and Treatment means: studies that provide an understanding of psychopathology. Studies in this area include the Diagnostic and Statistical Manual and its use in counseling, and assessing psychopathology. The course shall also include the development of treatment plans and the use of related services, and the role of assessment, intake interviews, and reports, if that material is not covered in another treatment course.

(c) If the degree does not contain 3 graduate credits in Diagnosis, Assessment and Treatment, the degree does not qualify as a degree in "counseling or a related field" and cannot be used as the basis for licensure as a clinical mental health counselor. The course work in Diagnosis, Assessment and Treatment must be completed within the degree conferred. This deficiency cannot be remedied by taking post degree course work. It cannot be supplemented.

(d) The degree must contain course work from no fewer than five of the seven areas (1) through (7) below:

(1) Human Growth and Development: 3 Graduate credits. Studies that provide an understanding of the nature and needs of individuals at all developmental levels throughout the life span. Studies in this area would include theories of individual and family development and transitions across the life span, and theories of learning and personality development.

(2) Theories: 3 Graduate credits. Studies that survey counseling theories (e.g., Psychodynamic, Humanist, Behavioral, Transpersonal) and their historic and functional relationship to specific counseling approaches (e.g., Cognitive Behavior Therapy, Psychoanalysis, Family Systems, Solution Focused Therapy, Rational Emotive Therapy).

(3) Counseling Skills: 3 Graduate credits. Studies that provide an understanding of the counseling and consultation processes, development of student self-awareness, and the skills necessary for developing a positive therapeutic relationship.

(4) Groups : 3 Graduate credits. Studies that provide an understanding of group development and group dynamics. Studies in this area would include group counseling theories, group counseling methods and skills, group leadership styles, and other group work approaches.

(5) Measurement: 3 Graduate credits. Studies that provide an understanding of group and individual educational and psychometric theories and approaches to measurement. Course work would cover data and information-gathering methods, validity, reliability, psychometric statistics, factors influencing measurements, and use of measurement results in the counseling process.

(6) Professional Orientation and Ethics: 3 Graduate credits. Studies that provide an understanding of the professional counselor's roles and functions. Course work would cover professional counseling organizations and associations, history and trends within the counseling profession, ethical and legal standards, and counselor preparation standards and credentialing.

(7) Treatment Modalities: 3 Graduate credits. Studies that provide an understanding of specific treatment approaches such as Cognitive Behavioral Therapy, Feminist Therapy, Narrative Therapy, and Psychoanalytic Psychotherapy. Studies will focus on one or more modalities. Emphasis will be placed upon the application of theories to practice, including case conceptualization and corresponding therapeutic interventions.

(e) If the degree does not contain the required credits in 5 of the 7 areas, the degree does not qualify as a "degree in counseling or a related field." It cannot be used as the basis for licensure as a clinical mental health counselor. This deficiency cannot be remedied post degree. It cannot be supplemented.

(f) The degree must contain a supervised internship of at least 600 hours, as set forth below.

(g) A degree based from a program with fewer than 600 hours of supervised internship does not qualify as a degree in "counseling or a related field" and cannot be used as the basis for licensure as a clinical mental health counselor. This deficiency cannot be remedied post degree. It cannot be supplemented.

Section 3.9 Courses Required for Licensure

60 credits of graduate level course work are required for licensure. These courses, if not taken as part of the master's or higher degree may be supplemented post-degree.

(a) An applicant who has an acceptable degree qualifying as one in "counseling or a related field" but who has not completed all 7 courses in part (d) of Rule 3. 8, must successfully complete the remaining two courses to qualify for licensure.

(b) An applicant who has an acceptable degree must have at least three graduate credits in each of the following areas of study to qualify for licensure:

(1) Multi-cultural Studies: Studies that provide an understanding of issues and trends in a multi-cultural and diverse society. Course work would cover attitudes and behaviors based on such factors as age, role, religion, physical disability, sexual orientation, ethnicity and culture, family patterns, gender, socioeconomic status, and intellectual ability.

(2) Research and Evaluation: Studies that provide an understanding of research in the field of clinical mental health counseling. Course work would cover the types of research, basic statistics, research report development, research implementation, program evaluation, needs assessment, and ethical and legal considerations associated with research and evaluation.

(3) Career Development and Lifestyle Appraisal: Studies that provide an understanding of career development theories, occupational and educational information services, career counseling, and career decision making.

(c) Additional courses required for licensure: At least three graduate credits in at least two of the five following areas of study (for a minimum of six graduate credits) are necessary for licensure. These courses, if not taken as part of the master's or higher degree may be supplemented post-degree.

(1) Marriage, Couples, and Family Counseling: Studies that provide an understanding of the structure and dynamics of the family, and methods of marital and family intervention and counseling.

(2) Human Sexuality for Counselors: Studies that provide an understanding of human sexual function and dysfunction, the relationship between sexuality, self-esteem, sex and gender roles and life styles over the life cycle, and counseling treatment approaches and techniques.

(3) Crisis Intervention: Studies that provide an understanding of the theory and practice of crisis intervention, short-term crisis counseling strategies, and the responsibilities of all those involved in the intervention.

(4) Addictive Disorders: Studies that provide an understanding of the stages, processes, and effects of addiction, social and psychological dynamics of chemical dependency, and the professional's role in prevention, intervention, and aftercare.

(5) Psychopharmacology: Studies that provide an understanding of the basic classifications, indications, and contraindications of commonly prescribed psychopharmacological medications for the purpose of identifying effective dosages and side effects of such medications.

Section 3.10 Transcripts and Course Descriptions: Required Documentation

(a) Applicants must have the educational program from which they obtained a degree send official transcripts directly to the Board.

(b) Applicants shall provide course descriptions and/or syllabi for all course work appearing on the transcript(s); and

Section 3.11 Board Review of Transcripts

The Board will recognize a course as satisfying the requirements of these rules if it is seen as a "stand alone course," that is one which clearly from its course description covers required subject matter. The Board will not grant credit for "embedded content" that is an element or elements of study of an area which is only part of a larger course concentrating on a different area of study. For example: A course on "marriage and family treatment modality" may include discussion or examination of the ethical issues involved in marriage and family treatment. The Board will not grant credit for ethics content "embedded" within this course. The Board will grant ethics credit only from a course which, standing alone, clearly focuses on ethics.

Section 3.12 Supervised Internship

Each applicant must complete a 700 hours supervised internship. The internship may include no more than 100 hours of practicum/field experience. An applicant who as part of the degree in counseling or related field has completed an internship of 600 or more hours but fewer than 700 hours must make up the difference by:

(a) adding those hours to those required for post degree supervised practice; or

(b) acquiring the remaining hours in an internship which occurs in conjunction with a formal internship seminar class from an accredited graduate program.

Section 3.13 Internship Description

A supervised internship, requires a student to work in a "clinical mental health counseling" practice setting, 26 V.S.A. § 3261(2). The internship provides an opportunity for the student to perform the activities that a regularly employed clinical mental health counselor would be expected to perform.

Section 3.14 Examination

(a) Recent Examination Required - Effective January 1, 2016

For applicants who have not previously been licensed, only examination results obtained within five (5) years of the final decision on licensure may be accepted.

(b) Applicants must successfully complete both the National Clinical Mental Health Counseling Examination (NCMHCE) and the National Counselor Examination (NCE) or their Board approved successor examination or examinations on clinical mental health counseling theory and practice. Once an applicant's education is approved, applicants are given examination registration information.

(c) More information: Applicants may obtain information about the examinations by contacting the examination providers directly. Contact information is available on the Board's web site.

Section 3.15 Post Degree Supervised Practice

(a) "Supervised practice" by an applicant, means post-master's practice of clinical mental health counseling that is supervised by a clinical supervisor. An applicant must complete 3,000 hours of supervised practice over a period of no less than 2 years.

(b) Recent supervision required: Effective January 1, 2016: To ensure that an applicant's supervised practice reflects a current competence for licensure, only supervised practice hours acquired within 5 years of a final decision on licensure may be accepted.

Section 3.16 Post Degree Supervised Practice: Entry on Roster of Nonlicensed and Noncertified Psychotherapists is Required

No supervised practice may occur within the State of Vermont until the prospective licensee has been entered on the roster of nonlicensed and noncertified psychotherapists.

Section 3.17 Distribution of Practice Hours

Of the 3,000 practice hours, 2,000 hours must be direct service, with the remaining 1,000 hours in either continued clinical practice or related services. The supervised practice must take place in a "clinical mental health" practice setting or settings. 26 V.S.A. § 3261(2).

Section 3.18 Supervised Practice, Face-to-Face Supervision

(a) A clinical supervisor must be familiar with the nature of the applicant's clinical activities, monitor the quality of the counseling and contribute to the enhancement of self-knowledge and clinical mental health counseling skills. The supervisor is responsible for monitoring and assessing the applicant's work and compliance with statutes and rules.

(b) Frequency: Supervised practice must be accompanied by no fewer than 100 hours of face-to-face supervision. Under no circumstances may any person in supervised practice accumulate more than thirty hours practice without a minimum of one hour face-to-face supervision. The supervisor and the supervised person are both responsible for ensuring that face-to-face supervision complies with this rule.

(c) Nature and Location Face-to-face supervision is conducted in the formal setting of an office, clinic, or institution, and may be either in an individual setting, between the supervisor and the applicant, or in a group setting, including the supervisor and up to six trainees. Of the 100 hours, at least 50 must be in an individual setting. The applicant must submit satisfactory supervision reports on forms provided by the Office.

(d) The Board recommends that the supervised practice experience include at least two supervisors with diverse theoretical orientations. Supervision focuses on the raw data from the supervisee's continuing clinical practice which may consist of direct observation, co-therapy, written clinical notes, and audio and video recordings. Supervision is a process clearly distinguishable from personal psychotherapy, and is conducted to serve professional or vocational goals.

Section 3.19 Supervisor Qualifications

(a) Supervision shall be by: an individual who possesses an unencumbered license in one of the following professions in the jurisdiction where the supervised practice occurs:

(1) a physician or a licensed osteopathic physician who has been certified in psychiatry by the American Board of Medical Specialties; or

(2) a psychiatric nurse practitioner; or

(3) a psychologist; or

(4) a clinical mental health counselor; or

(5) a clinical social worker; or

(6) a marriage and family therapist; or

(7) a member of a licensed profession which is in the opinion of the Board is a substantial equivalent.

(b) A person who commences supervision must have possessed an unencumbered license for no fewer than three years in a permitted supervisory profession listed above.

Section 3.20 Excluded from Supervising

(a) Preface: Successful supervision requires that the future licensee and supervisor have a full and candid exchange regarding all aspects of the supervised practice. Treatment issues, including issues of sexual attraction and other matters between practitioner and client, and work conditions affecting practice should be fully explored. Because full candor is needed, conflicts of interest between supervisor and future licensee must be avoided.

(b) Certain persons are excluded from being supervisors. A "clinical supervisor" does not include a spouse, life partner, former spouse, or family member. A clinical supervisor does not include an employer, financial partner, or shareholder in the same counseling enterprise, or other person who gains financially from the practice of the applicant.

(1) meets the requirements to be a supervisor; and

(2) is an employee of the same employer as the applicant, and

(3) does not personally financially gain from the practice of the applicant, is not disqualified from providing clinical supervision.

(d) The following arrangements do not constitute clinical supervision:

(1) Supervision by current or former family members or any other person where the nature of the personal relationship prevents or makes difficult the establishment of a professional relationship;

(2) Administrative supervision (for example, clinical practice performed under administrative rather than clinical supervision of an institutional director or executive);

(3) Classes, workshops, or seminars;

(4) Consultation, staff development, or orientation to a field or program, or role-playing of family interrelationships as a substitute for current clinical practice.

Section 3.21 Verification of Supervisor Licensure

If the supervisor is certified or licensed in another jurisdiction, verification of his or her licensure must be provided directly to the Board from the licensing or certifying authority of the other jurisdiction before the Board will review the supervision reports.

Section 3.22 Supervision Reports

A supervision report must be submitted by a clinical supervisor. Supervision Forms are available from the Office or online at http://vtprofessionals.org/. The supervision report shall contain sufficient detail to permit the Board to evaluate an applicant's supervised practice. The supervision report must contain, at a minimum:

(a) Applicant's name;

(b) Supervisor's name, signature, address, certification or licensure number, state where granted, date granted, and area of specialization;

(d) Specific beginning and ending dates of practice covered;

(e) The specific number of hours the applicant spent providing direct and indirect services;

(f) Number of one-to-one supervisory hours;

(g) Number of group supervision hours with a maximum of six people in a group supervised by at least one clinical supervisor;

(h) Applicant's specific duties;

(i) Detailed assessment of the applicant's performance;

(j) Clinical skills supervised;

(k) Ethical practices reviewed; and

(l) A statement of the supervisor's belief that the applicant is competent and qualified to practice independently.

Section 3.23 Licensure by Endorsement

(a) Applicants from a jurisdiction with substantially equivalent standards: The Board may grant a license to an applicant licensed or certified as a clinical mental health counselor in another United States or Canadian jurisdiction whose licensing requirements are in the opinion of the Board, substantially equivalent to those in Vermont.

(b) Applicants from a jurisdiction with substantially equivalent standards except for national competency examinations: If the applicant is licensed or certified as a clinical mental health counselor in a United States or Canadian jurisdiction whose regulatory standards are, in the opinion of the Board, substantially equivalent except for requiring only one exam, the NCMHCE or NCE, the applicant may be licensed upon successful completion of the examination the applicant was not required to take for licensing in the other jurisdiction; or

(c) Applicants in active practice in a United States or Canadian jurisdiction regardless of licensing standards: The Board may grant a license to an applicant:

(1) who is licensed or certified to practice as a clinical mental health counselor in another United States or Canadian jurisdiction notwithstanding the jurisdiction's current licensing requirements;

(2) who has no disciplinary history; and

(3) who has been in "active practice" no fewer than five years. "Active practice" as used in this section means the applicant has practiced clinical mental health counseling more than an average of 20 hours per week for 48 weeks per year.

Section 3.24 Final Review of Applications

Final review of any application will not occur until all requested documents have been received.

Section 3.25 Mandatory Disclosure Statements for Licensed Clinical Mental Health Counselors

Disclosure statements for licensed clinical mental health counselors must include the mental health counselor's professional qualifications and experience, including:

(a) all relevant graduate programs attended and all graduate degrees and certificates earned, including the full legal name of the granting institution;

(b) a brief description of any special qualifications and areas of practice;

(c) a copy of the statutory definition of unprofessional conduct ( 3 V.S.A. § 129a and 26 V.S.A. § 3271 for licensed clinical mental health counselors);

(d) information on the process for filing a complaint with, or making a consumer inquiry to the Board; and

(e) the statement: "My practice is also governed by the Rules of the Board of Allied Mental Health Practitioners. It is unprofessional conduct to violate those rules. A copy of the rules may be obtained from the Board or online at http://vtprofessionals.org/ ."

(f) The form and timing of disclosure is contained in Rules 2.2 through 2.4.

Section 3.26 Continuing Education: Maintaining a License

With the first renewal application after two years of licensure, and with each subsequent renewal application, documentation of completion of 40 hours of continuing education is required. Only continuing education taken within two years of the renewal date is counted. Continuing education is calculated in the following manner:

(a) One academic semester credit equals 15 hours of continuing education.

(b) One quarter academic year credit equals 10 hours of continuing education.

Section 3.27 Continuing Education Ethics Requirement, Supervision

(a) A minimum of four of the 40 hours must be specifically designated as continuing education in professional ethics in the clinical fields of marriage and family therapy, clinical mental health counseling, psychiatry, psychology, or social work.

(b) The remaining 36 hours must be in the theory and practice of clinical mental health counseling.

Section 3.28 Continuing Education: Record Retention

(a) Each licensee must maintain records showing attendance and participation in the continuing education activities claimed. Examples of acceptable records include certificates of attendance received during the instruction, receipt of registration and the activity's time schedule, signature of facilitator, or brief summary of the work content. These records are subject to inspection and verification by the Board upon request.

(b) Licensees must retain records of all continuing education courses and activities for a period of four years. The Board does conduct audits to ensure compliance with continuing education requirements. Submitting documentation of the content of the activities is required only upon specific request of the Board.

Section 3.29 Continuing Education Audits

(a) The Board will conduct continuing education audits of randomly selected licensees as well as licensees whose licenses are conditioned. The Board may also audit licensees seeking reinstatement, and licensees who in any of the preceding 2 renewal cycles were initially found to have not met continuing education renewal requirements. Submitting documentation of the content of the activities is required only upon specific request of the Board.

Section 3.30 Limitations on Credit

Credit for formal activities will be granted only for actual time spent as a learner. Breaks, business meetings and lunches are not to be counted toward continuing education credits.

Section 3.31 Hardship Extension

A licensee who will be unable to complete the required continuing education by the renewal deadline may apply for an extension which the Board may grant only in cases of extreme hardship. The Board may grant an extension to complete the remainder of the required credits. See, 3 V.S.A. § 129(1).

Section 3.32 Continuing Education Acceptable Types

(a) Formal Activities:

(1) Graduate academic courses including on line graduate courses in areas supporting development of skill and competence in counseling at an institution which meets accreditation standards will be acceptable to the Board.

(2) Institutes, workshops, seminars and conferences approved by the Board must clearly relate to maintaining skills for the safe and competent practice of counseling and be conducted by persons qualified within their respective professions.

(b) Individualized Learning Activities: No more than 28 of the 40 hours may be accrued in this category. Home study programs including online or interactive training approved by the National Board of Certified Counselors (NBCC), the American Counseling Association, or the American Mental Health Counselors Association will be accepted. Completion of home study programs must be documented by a certificate of completion or other appropriate documentation. Individualized learning activities subject to the 28 hour limitation include:

(1) Teaching or Consultation: In programs such as institutes, workshops, seminars, and conferences. Documentation must, include relevant readings, activities, research procedures, products, and a brief critique of the material.

Limitation: Not more than five continuing education hours may be granted during any two-year license renewal period for time spent in activities as an instructor or presenter in the field of clinical mental health counseling. Continuing education hours will be allowed only one time per subject taught, and will not be granted for teaching a program which is within the licensee's regular employment: Credit for teaching is given for actual presentation time, not preparation time.

(2) Supervision: received by the licensee and provided by a licensed mental health professional in an individual or group setting. Documentation is required from both the supervisee and the supervisor or colleagues as to general topic and approach as well as assessed professional development of the supervisee.

(c) Continuing education provided by or approved by the National Board for Certified Counselors, the American Counseling Association, the American Mental Health Counseling Association, the American Psychological Association, or the American Association of Marriage and Family Therapists is approved without prior review by the Board.

Section 3.33 Continuing Education Program Approval

(a) The Board may approve programs sponsored by departments of accredited institutions, by national, regional, state or local professional organizations or associations, by public or private human service organizations, or by private consultants or individuals. To be approved, a continuing education program's objectives must relate directly to counseling theory or the application of counseling theory or practice.

(b) Sponsoring organizations may apply to the Board for program approval. The name of the program, a description of the program content, program schedule, the number of hours requested, and the names and qualifications of the instructor(s) and sponsors must be clearly indicated on the application form. Application for advance approval should be filed at least 60 days before the education program is scheduled to commence.

(d) When the Board has approved a program, the sponsor may so state in its publicity and may state the number of hours for which the program has been approved.

Section 3.34 Denial of Continuing Education Approval

(a) The Board may refuse to approve any activity which does not meet the requirements of these rules, or for the following reasons:

(1) Fraud or misrepresentation on the part of the sponsoring organization or licensee regarding continuing education information submitted for approval to the Board;

(2) Program objectives or content do not relate to the theory or clinical application of theory pertaining to the practice of mental health counseling;

(b) A sponsor may claim Board approval of an activity only after the Board has approved it and assigned it a number of continuing education hours.

Section 3.35 License Renewal

(a) Licenses are issued for a two-year period on a schedule set by the Office of Professional Regulation and must be renewed by the expiration date printed on the license certificate.

(b) The Office sends licensees a renewal notice in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not.

Section 3.36 Reinstatement of an Expired License

An applicant for reinstatement of a license which has expired may be eligible for reinstatement upon:

(a) submission of the renewal application form;

(b) payment of the applicable fees;

(d) if the licensed has lapsed more than five years, and the applicant has not practiced under a license from another U.S. or Canadian jurisdiction, reinstatement may not occur before the applicant has:

(1) has registered on the roster of nonlicensed and noncertified psychotherapists;

(2) successfully completed six months with no fewer than 750 hours of supervised practice with supervision as required by these rules for pre-licensure supervised practice; and

(3) successfully completed the Vermont statutes and rules examination.

(e) Upon completion and Board approval of the completed supervised practice, the applicant's license will be fully reinstated.

Section 3.37 Inactive Status

Licensees may change their license status to inactive as permitted by law.

Part 4 MARRIAGE AND FAMILY THERAPISTS

Section 4.1 Apply Early

Applicants for licensure as marriage and family therapists are advised to apply as soon as they have met their graduation requirements so that they may be qualified for the licensing examination at the earliest time. In addition to the application form and other required documents referred to on the application form, applicants should send course descriptions and syllabi to the Board for review.

Section 4.2 Apply before Supervised Practice

Applicants should not wait to complete supervised practice before applying for licensure. In fact, early application can help the Board provide applicants a clear understanding of any remaining licensure requirements.

Section 4.3 Explanation of Licensing Requirements for Marriage and Family Therapists

(a) To ensure that all who are licensed as marriage and family therapists have a sufficiently broad and thorough preparation for licensure, these rules require not only a degree focusing on marriage and family therapy, but for those who have not completed COAMFTE (Commission on Accreditation for Marriage and Family Therapy Education) programs, successful completion of a specific list of courses.

(b) The rules:

(1) permit licensure of graduates of COAMFTE accredited programs; and

(2) permit licensure of graduates from other programs whose curricula meet the requirements set forth below;

(3) require that applicants complete specific course requirements.

Section 4.4 Requirements for Licensure as a Marriage and Family Therapist

There are two ways to become licensed in Vermont as a marriage and family therapist.

(a) Examination: An applicant may apply on the basis of education, successful completion of supervised practice, and passage of licensing examination. See below.

(b) Endorsement: In certain circumstances depending on the licensing standards of other jurisdictions or duration of licensure, an applicant who is licensed or certified in another jurisdiction may seek licensure on the basis of that license or certification. See, Rule 4.25.

Section 4.5 Those Not Qualified for Endorsement

Applicants who do not qualify for licensure by endorsement must meet the requirements for licensure by examination.

Section 4.6 Licensure by Examination

To be eligible for licensure by examination as a marriage and family therapist, an applicant must satisfy:

(a) the educational requirements;

(b) the examination requirements; and

Section 4.7 COAMFTE Programs

A degree from a COAMFTE approved program is an acceptable degree which may be used toward licensure.

Section 4.8 Non-COAMFTE Program Accreditation

Programs or institutions which are not COAMFTE accredited must be accredited by a national or regional accreditation body which is approved by the Board. For purposes of these rules, "accredited" includes candidacy toward accreditation.

Section 4.9 Non-COAMFTE Programs: Credits Required

(a) Degrees from Non-COAMFTE programs must contain 36 graduate credits.

(b) Within the 36 graduate credits, a minimum of 18 must be primarily dedicated to and clearly identified as being from a marriage, couple, or family therapy/systems/relational perspective.

Section 4.10 Supervised Internship

(a) A supervised internship requires a student to work in a marriage and family therapy focused setting. The internship provides an opportunity for the student to perform the activities that a regularly employed marriage and family therapist would be expected to perform.

(b) A minimum of 500 hours of internship within the degree conferred is required for the degree to be accepted toward licensure. Applicants from non-COAMFTE programs must provide documentation of direct and indirect hours completed during the internship.

(d) An applicant who did not provide 500 hours of direct service during the internship must add to the 3,000 hours of post-degree supervised practice the difference between the direct service hours provided and 500 direct service hours required for licensure.

Section 4.11 Notice Regarding Insufficient Internship

A degree based on a program of fewer than 500 hours of supervised internship is not an acceptable degree for licensure. This deficiency cannot be remedied post degree. It cannot be supplemented.

Section 4.12 Credit Hours Required for Licensure

(a) Applicants must complete a minimum of 48 credits of graduate level courses in marriage and family therapy and related areas of study as set forth in these rules.

(b) Some applicants may find they have to take more than 48 graduate credits to satisfy the specific course requirements. Successful completion of all courses or study area requirements listed below is required for licensure. Degrees must contain a minimum of 36 graduate credits.

Section 4.13 Board Review of Transcripts

The Board will recognize a course as satisfying the requirements below if it is seen as a "stand alone course," that is one which on its face fills the requirement. The Board will not grant credit for "embedded content," that is an element or elements of study of an area which is only part of a larger course concentrating on a different area of study. For example: A course on "marriage and family treatment modality" may include discussion or examination of the ethical issues involved in marriage and family treatment. The Board will not grant credit for ethics content "embedded" within this course. The Board will grant ethics credit only from a course which, standing alone, and on its face, focuses on ethics.

Section 4.14 Curriculum Required for Licensure

Each applicant for licensure must have completed the following course work:

(a) 3 credit hours of course work in diagnosis and treatment (DSM); If a non COAMFTE degree does not contain 3 graduate credits in diagnosis, assessment and treatment, the degree does not qualify as a "graduate degree focusing on marriage and family therapy" 26 V.S.A. § 4037 and cannot be used as the basis for licensure as a marriage and family therapist. The course work in diagnosis, assessment and treatment must be completed within the degree conferred. This deficiency cannot be remedied by taking post degree course work. It cannot be supplemented.

(b) Six graduate credits in course work from a marriage and family therapy/systems perspective; these areas shall provide a comprehensive survey and substantive understanding of the major models of marriage and family therapy. A course must include course work in the following areas: historical development, theoretical and empirical foundations, and contemporary conceptual directions of the field of marriage and family therapy.

(c) 3 graduate credits in marriage and family therapy skills; a graduate level course that provides an understanding of the counseling process and the skills necessary for developing a positive therapeutic relationship.

(d) 3 graduate credits in a marriage and family therapy treatment modality; a comprehensive survey and substantive understanding of the major models of marriage, couple, and family therapy;

(e) 3 graduate credits in human growth and development; graduate level course in any aspect of human development across the life span from a marital and family therapy perspective, including but not limited to theories of individual development, theories of learning, theories of personality, theories of normal and abnormal behavior, gender, human sexuality and psychopathology;

(f) 3 graduate credits in diversity/social and cultural foundations; a graduate level course that explores diversity/social and cultural foundations with particular attention paid to the function of relational and family systems;

(g) 3 graduate credits in research; graduate level course in research design, methods and statistics with particular attention paid to research in the field of marriage and family therapy.

(h) 3 graduate credits in professional ethics; means a graduate level course in professional ethics, legal responsibilities and liabilities, standards of practice, licensure regulation, and professional socialization relevant to the practice of marriage and family therapy, utilizing the MFT code of Ethics;

(i) At least three graduate credits in at least two of the nine following areas of study (for a minimum of six graduate credits) are necessary for licensure and may be taken post-degree:

(1) Human sexuality; Studies that provide an understanding of human sexual function and dysfunction, the relationship between sexuality, self-esteem, sex and gender roles and life styles over the life cycle, and counseling treatment approaches and techniques.

(2) Psychopharmacology; Studies that provide an understanding of the basic classifications, indications, and contraindications of commonly prescribed psychopharmacological medications for the purpose of identifying effective dosages and side effects of such medications.

(3) Domestic violence; studies that provide a systemic approach to assessment and treatment of family violence, child, spousal, and parental abuse;

(4) Sexual abuse; studies that provide an overview of skills and interventions in treating sexual abuse, sexual assault

(5) Gender and sexuality; studies that provide a systemic approach to sexual identity and family therapy theory and clinical applications including sexual dysfunction, sex and disability, and nontraditional sexual relationships;

(6) Groups: studies that provide cognitive and affective awareness of group process through didactic and experiential instruction, as well as Group techniques for the treatment of family issues;

(7) Crisis intervention; studies that provide an understanding of the theory and practice of crisis intervention, short-term crisis counseling strategies, and the responsibilities of all those involved in the intervention;

(8) Addictions/chemical dependency; Studies that provide an understanding of the stages, processes, and effects of addiction, social and psychological dynamics of chemical dependency, and the professional's role in prevention, intervention, and aftercare.

(9) Appraisal and assessment; studies that support the Design and execution of research in human service settings. Proposal development, creation of quantitative and qualitative instruments, coding of data, computer-based data analysis, and production of research reports. Individual, couple, and family assessment utilizing a family systems perspective. Overview of family assessment techniques. Issues and procedures in family therapy process and outcome research.

(j) Supervised internship: A 500 hour supervised internship obtained as part of the degree is required for licensure.

Section 4.15 Examination Requirement

(a) Applicants must successfully complete the written examination on marriage and family therapy approved by the Board.

(b) Recent Examination Required - Effective January 1, 2016 For applicants who have not previously been licensed, only examination results obtained within five (5) years of the final decision on licensure may be accepted.

Section 4.16 Post Degree Supervised Practice Requirement

(a) Before a license may be issued, the applicant must complete 3,000 hours of supervised practice with individual, couple, family or group therapy from a systems perspective over a minimum two year period.

(b) Recent supervision required: Effective January 1, 2016 To ensure that an applicant's supervised practice reflects a current competence for licensure, only supervised practice hours acquired within 5 years of a final decision on licensure may be accepted.

Section 4.17 Post Degree Supervised Practice: Entry on the Roster of Nonlicensed and Noncertified Psychotherapists Required

No supervised practice may occur within the State of Vermont until the prospective licensee has been entered on the Roster of Psychotherapists who are Nonlicensed and Noncertified .

Section 4.18 Distribution of Practice Hours

2,000 hours must be direct service, 50 per cent of which must be with couples and/or families. The remaining 1,000 hours must be continued clinical practice or indirect services related to or supporting clinical services.

Section 4.19 Face-to-Face Supervision

(a) A clinical supervisor must be familiar with the nature of the applicant's clinical activities, monitor the quality of the counseling and contribute to the enhancement of self-knowledge and marriage and family therapy clinical skills. The supervisor is responsible for monitoring and assessing the applicant's work and compliance with statutes and rules.

(c) Nature and Location: Face-to-face supervision is conducted in the formal setting of an office, clinic, or institution, and may be either in an individual setting, between the supervisor and the applicant, or in a group setting, including the supervisor and up to six trainees.

(d) Of the 100 hours, at least 50 must be in an individual setting. The applicant must submit satisfactory supervision reports on forms provided by the Office.

Section 4.20 Supervisor Qualifications

(a) A supervisor must have no fewer than three years unencumbered licensure before supervision begins.

(b) A supervisor must possess at all times an unencumbered license in one of the following professions in the jurisdiction where the supervised practice occurs:

(1) marriage and family therapist;

(2) clinical social worker;

(3) clinical mental health counselor;

(4) psychologist;

(5) licensed physician certified in psychiatry by the American Board of Medical Specialties.

Section 4.21 Verification of Supervisor

If the supervisor is certified or licensed in another jurisdiction, verification of his or her licensure or certification must be provided directly to the Board by the licensing or certifying authority of the other jurisdiction before the Board will review the supervision reports.

Section 4.22 Supervision Requirements

(a) A supervisor is familiar with the nature of the applicant's therapy activities, monitors the quality of the therapy, and contributes to the enhancement of self-knowledge and practice of therapy.

(b) The Board recommends that the supervised practice experience include at least two supervisors with diverse marriage and family therapy theoretical orientations. Supervision focuses on the raw data from the supervisee's continuing clinical practice, which may consist of direct observation, co-therapy, written clinical notes, and audio and video recordings, Supervision is a process clearly distinguishable from personal psychotherapy, and is conducted to serve professional or vocational goals.

Section 4.23 Excluded from Supervising

(a) Preface: Successful supervision requires that the future licensee and supervisor have a full and candid exchange regarding all aspects of the supervised practice. Treatment issues, issues of sexual attraction, and other matters between practitioner and client, and work conditions affecting practice should be fully explored. Because full candor is needed, conflicts of interest between supervisor and future licensee must be avoided.

(b) Certain persons are excluded from being supervisors. A clinical supervisor does not include a spouse, life partner, former spouse, or family member. A clinical supervisor does not include or any employer, financial partner, or shareholder in the same counseling enterprise, or other person who gains financially from the practice of the applicant.

(1) meets the requirements to be a supervisor; and

(2) is an employee of the same employer as the applicant, and

(3) does not personally financially gain from the practice of the applicant, is not disqualified from providing clinical supervision.

(d) The following arrangements do not constitute clinical supervision:

(1) Supervision by current or former family members or any other person where the nature of the personal relationship prevents or makes difficult the establishment of a professional relationship;

(2) Administrative supervision (for example, clinical practice performed under administrative rather than clinical supervision of an institutional director or executive);

(3) Classes, workshops, or seminars;

(4) Consultation, staff development, or orientation to a field or program, or role-playing of family interrelationships as a substitute for current clinical practice.

Section 4.24 Supervision Reports

A supervision report submitted by a supervisor shall contain sufficient detail to evaluate an applicant's supervised practice. The report shall include, at a minimum:

(a) Applicant's name;

(b) Supervisor's name, signature, address, certification or license number, state where granted, date granted, and area of specialization;

(d) Specific beginning and ending dates of practice covered in the report;

(e) The specific number of hours the applicant spent providing direct and indirect services,

(f) Number of one-to-one supervisory hours;

(g) Number of group supervision hours, with a maximum of six people in a group supervised by at least one supervisor;

(h) Applicant's specific duties;

(i) Detailed assessment of the applicant's performance;

(j) Clinical skills supervised;

(k) Ethical practices reviewed; and

(l) A statement of the supervisor's belief that the applicant is competent and qualified to practice independently.

Section 4.25 Licensure by Endorsement (Without Examination)

The Board may license without requiring all professional competency examination(s) as follows:

(a) Applicants from a jurisdiction with substantially equivalent standards:

(1) If the applicant is licensed or certified as a marriage and family therapist in another United States or Canadian jurisdiction which currently has, in the opinion of the Board, regulatory standards and qualifications substantially equivalent to those in Vermont, the Board may issue a license.

(2) Applicants from jurisdictions whose requirements are otherwise substantially equivalent but which do not require the national marriage and family therapist examination may be issued a license to practice upon successful completion of that examination.

(b) Applicants in active practice in another U.S. or Canadian jurisdiction, regardless of licensing standards: If the applicant has been licensed or certified to practice with no encumbrance in a U.S. or Canadian jurisdiction, notwithstanding the jurisdiction's current licensing requirements, and has been in "active practice" no fewer than five years, the Board may issue a license. "Active practice" as used in this section means practicing marriage and family therapy more than an average of 20 hours per week for 48 weeks per year.

Section 4.26 Application Process for Licensure of Marriage and Family Therapists

(a) Application by Examination: Before the Board will approve an applicant to sit for the examination, the applicant must submit the following for review:

(1) Official transcripts sent directly to the Board of Allied Mental Health Practitioners by the educational institution;

(2) Other documentation specifically requested by the Board to determine the applicant's eligibility. For applicants from non-COAMFTE programs, this shall include course descriptions and syllabi.

(b) An applicant may sit for the examination at any time following the approval of his or her education credentials provided the applicant has registered for the examination and paid the fee by the deadline dates. Once an applicant's education is approved, the applicant will be given examination registration information.

(c) Final review of any application will not occur until the Board has received all supervision reports and any other requested documents.

Section 4.27 Mandatory Disclosure Statements for Licensed Marriage and Family Therapists

(a) Each marriage and family therapist is required to make a disclosure as provided in Rules 2.2 through 2.6.

(b) Substance: Disclosure statements for licensed marriage and family therapists must include the following information:

(1) The licensee's qualifications and experience, including:

(A) all relevant graduate programs attended and all graduate degrees and certificates earned, including the full legal name of the granting institution, and

(B) a brief description of any special qualifications and areas of practice;

(2) A copy of the statutory definition of unprofessional conduct ( 3 V.S.A. § 129a and 26 V.S.A. § 4042 for licensed marriage and family therapists);

(3) The statement: "My practice is also governed by the Rules of the Board of Allied Mental Health Practitioners. It is unprofessional conduct to violate those rules. A copy of the rules may be obtained from the Board or online at http://vtprofessionals.org/ ";

(4) Information on the process for filing a complaint with, or making a consumer inquiry toe Board.

Section 4.28 Continuing Education

(a) Continuing educational requirements are designed to assure that marriage and family therapists maintain and improve the quality of professional services provided to the public, to keep the marriage and family therapists knowledgeable about current research, techniques, and practice, and to provide other resources which will improve skill and competence in marriage and family therapy.

(b) With the first renewal application after two years of licensure, and with each subsequent renewal application, documentation of completion of 20 hours of continuing education is required. Only continuing education taken within two years of the renewal date is counted.

(c) Continuing Education, Ethics Requirement A minimum of four of the 20 hours must be specifically designated as continuing education in professional ethics in the clinical fields of marriage and family therapy, clinical mental health counseling, psychiatry, psychology, or social work.

(d) Those who serve as supervisors are encouraged to take some continuing education training related to supervision.

(e) "Continuing education" means the direct participation of a marriage and family therapist as a learner in a structured educational format. Hours of continuing education are calculated as set forth below:

(1) One semester credit equals 15 hours of continuing education.

(2) One quarter credit equals 10 hours of continuing education.

(3) One workshop hour equals one continuing education credit.

(f) Continuing education credits will be granted only for actual time spent as a learner. Breaks and lunches cannot be included.

Section 4.29 Maintaining Continuing Education Records

(b) Licensees must retain records of all continuing education courses and activities for a period of four years. The Board conducts audits to ensure compliance with continuing education requirements. Submitting documentation of the content of the activities is required only upon specific request of the Board.

Section 4.30 Continuing Education Audits

(a) The Board will conduct continuing education audits of randomly selected licensees as well as licensees whose licenses are conditioned. The Board will also audit reinstating licensees and licensees who in any of the preceding two renewal cycles were initially found to have not met continuing education renewal requirements. Submitting documentation of the content of the activities is required only upon specific request of the Board.

(c) A form upon which all continuing education may be recorded for audit purposes is available on line at the Board's web site. Documentation of continuing education must include the name and date of the programs with certificates of attendance and the number of continuing education hours approved.

(d) Under 3 V.S.A. § 129(k) the Board may give licensees 90 days to develop and complete a corrective plan to cure any deficiencies in his or her continuing education requirements.

(e) Courses taken pursuant to a corrective plan may be counted for only the licensing period being audited.

(f) Failure to comply with a corrective plan may result in disciplinary action. 3 V.S.A. § 129a(a)(4).

Section 4.31 Hardship Extension

Section 4.32 Credit for Continuing Education, Acceptable Types

(a) Acceptable Formal Activities include:

(1) graduate academic courses in areas supporting development of skill and competence in marriage and family therapy at an institution which meets accreditation standards acceptable to the Board;

(2) institutes, workshops, seminars and conferences approved by the Board that clearly relate to maintaining skills necessary for the safe and competent clinical practice of marriage and family therapy and are conducted by persons qualified within their respective professions;

(b) Individualized Learning Activities: No more than 10 of the 20 hours may be accrued in this category. Home study programs including online or interactive training approved by board which may include programs sponsored by the American Association of Marriage and Family Therapists, the National Board of Certified Counselors (NBCC), the American Counseling Association, or the American Mental Health Counselors Association. Completion of home study programs must be documented by a certificate of completion or other appropriate documentation. Activities permitted may include:

(c) Instructing: No more than five hours of continuing education consisting of activities as an instructor or presenter in the field of marriage and family therapy may be counted. Continuing education credit will be allowed only one time per subject taught, and will not be granted for teaching a program which is within the licensee's regular employment.

Section 4.33 Provider Approval

Section 4.34 Approval of Continuing Education Activities

(a) Approval of the activity may be obtained from the Board. The name of the activity, a description of the program content including a published brochure or handout showing the schedule of the hours spent in instruction, the number of credits requested, and the names and qualifications of the instructors and sponsors must be clearly indicated on the application form. An application may be filed by the sponsoring agency or group, or by any participant. Application for advance approval should be filed 60 days before the educational activity is scheduled to commence.

(b) The Board will assign a maximum number of credit hours to each approved activity.

Section 4.35 Denial of Continuing Education Approval

(a) The Board may refuse to approve any activity which does not meet the requirements of these rules, or for the following reasons:

(1) Fraud or misrepresentation on the part of the sponsoring organization or licensee regarding continuing education information submitted for approval to the Board;

(2) Program objectives or content do not relate to the theory or clinical application of theory pertaining to the practice of marriage and family therapy.

(b) A sponsor may claim Board approval of an activity only after the Board has approved it and assigned the number of continuing education hours.

Section 4.36 License Renewal Process

(a) Licenses are issued for a two-year period on a schedule set by the Office of Professional Regulation and must be renewed by the expiration date printed on the license certificate.

(b) A license not renewed by its expiration date expires.

(c) The Office sends licensees a renewal notice in advance of the expiration date. A licensee is responsible for renewal whether a notice is received or not.

Section 4.37 Reinstatement of Expired License

(a) A license may be reinstated upon payment of the reinstatement penalty and renewal fee, and meeting all renewal requirements.

(b) If the license has lapsed more than five years, and the applicant has not practiced under a license from another U.S. or Canadian jurisdiction, reinstatement may not occur before the applicant has:

(1) after registering on the roster of nonlicensed and noncertified psychotherapists;

(2) successfully completed six months with no fewer than 750 hours of supervised practice with supervision as required by these rules for pre-licensure supervised practice; and

(3) successfully completed the Vermont statutes and rules examination.

(c) Upon completion and Board approval of the completed supervised practice, the applicant's license will be fully reinstated.

Part 5 NONLICENSED AND NONCERTIFIED PSYCHOTHERAPISTS

Section 5.1 Introduction

Vermont law requires that unlicensed persons who practice psychotherapy disclose their training and qualifications. Psychotherapists who are not licensed or certified are held to established standards of professional conduct contained within statutes and these rules. They are subject to discipline by the Board if they fail to adhere to those standards.

Section 5.2 Entry on the Roster of Nonlicensed and Non-Certified Psychotherapists

All nonlicensed and non-certified psychotherapists who practice in Vermont must apply for entry on the roster. A psychologist, clinical social worker, clinical mental health counselor, marriage and family therapist, psychoanalyst, or any other allied mental health practitioner whose license is suspended or revoked in Vermont or any other jurisdiction is not eligible for entry on the roster. See, 3 V.S.A. § 4086.

Section 5.3 Application Information

Applications and information about licensure or roster entry requirements are available from the Board or online at http://vtprofessionals.org/. An applicant must submit a fully completed application form with all supporting documentation and the fee to the Board.

Section 5.4 Mandatory Disclosure Statements for Rostered Psychotherapists

(a) Substance: Disclosure statements for rostered psychotherapists must include the following information, submitted in the format outlined below:

(1) Statement of formal education:

(A) Name of institution;

(B) Dates attended;

(2) Training (must include the following information for each area of training):

(A) Title of training program;

(B) Name and address of trainer and or training institute;

(D) Content of program;

(E) Credentials awarded (if any);

(3) Experience in the practice of psychotherapy (must include the following information for each practice setting):

(A) Description of practice;

(B) Location;

(D) Part-time or full-time practice:

(E) Whether supervision or peer consultation occurs and, if so, how often;

(4) Scope of practice, including:

(A) Therapeutic orientation;

(B) Area of specialization;

(5) A copy of the statutory definitions of unprofessional conduct ( 3 V.S.A. § 129a and 26 V.S.A. § 4093);

(6) The statement: "My practice is also governed by the Rules of the Board of Allied Mental Health Practitioners. It is unprofessional conduct to violate those rules. A copy of the rules may be obtained from the Board or online at http://vtprofessionals.org/."; and

(7) Information on the process for filing a complaint with, or making a consumer inquiry to the Board.

(b) Filing: A dated copy of the disclosure statement used must be sent to the Office of Professional Regulation when it is first printed and when revised. Rostered psychotherapists must retain printed and dated copies of all their disclosure forms should any revisions occur.

Section 5.5 Roster Renewal

(a) Registrations are issued for a two-year period on a schedule set by the Office of Professional Regulation and must be renewed by the expiration date printed on the registration certificate.

(b) The Office sends a renewal notice in advance of the expiration date. A registrant is responsible for renewal whether a notice is received or not.

(d) Roster entries issued within 90 days of the renewal date will not be required to renew or pay the renewal fee. The roster entry will be issued through the next full registration period. Applicants issued an initial license or roster entry more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 5.6 Reinstating a Roster Entry

If a roster entry has expired because it was not renewed on time, the roster entrant may apply for reinstatement and pay applicable penalty and the renewal fee for the current renewal period.

Section 5.7 Continuing Education for Rostered Psychotherapists

Vermont law does not mandate continuing education for psychotherapists. Psychotherapists are encouraged to expand their professional education and skills by participating in continuing education, both formal and informal. Practitioners are reminded that providing services which one is not qualified to provide, or which are beyond the scope of his or her education, training, capabilities, experience, or scope of practice is unprofessional conduct.

Part 6 DISCIPLINE

Section 6.1 Complaint Procedure

The Office of Professional Regulation (Office) has a procedure for receiving, investigating, and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office and on line.

Section 6.2 Unprofessional Conduct, Clinical Mental Health Counselors

Unprofessional conduct includes acts or omissions which violate section 129a of Title 3, violations of these rules, and violations of 26 V.S.A. § 3271.

Section 6.3 Unprofessional Conduct, Marriage and Family Therapists

Unprofessional conduct includes acts or omissions which violate section 129a of Title 3, violations of these rules, and violations of 26 V.S.A. § 4042.

Section 6.4 Unprofessional Conduct, Rostered Psychotherapists

Unprofessional conduct includes acts or omissions which violate section 129a of Title 3, violations of these rules, and violations of 26 V.S.A. § 4093.

Section 6.5 Range of Disciplinary Sanctions

Possible disciplinary sanctions the Board may impose for violation of the statutes or rules of the various professions may include but are not limited to:

(a) denial of licensure or roster entry;

(b) warnings or reprimands;

(d) revocation;

(e) limitations on practice;

(f) setting conditions for practice or resumption of practice;

(g) denial of reinstatement or renewal;

(h) imposition of a civil penalty of up to $ 1,000 for each instance of unauthorized practice or unprofessional conduct.

Section 6.6 Codes of Ethics (General)

The Board may refer to the National Board for Certified Counselors (NBCC) "Code of Ethics" as amended, the American Counseling Association (ACA) "Code of Ethics and Standards of Practice," and the American Association for Marriage and Family Therapy (AAMFT) "Code of Ethics," as guides to the standards of practice for the professions subject to these rules. Although not in themselves additional grounds of unprofessional conduct, these ethical codes establish the standard of practice and fitness within the profession and are incorporated by reference into these rules. Copies of the NBCC "Code of Ethics" may be obtained from the NBCC's web site at http://www.nbcc.org . Copies of the ACA "Code of Ethics and Standards of Practice" may be obtained from the ACA's Web site at http://www.counseling.org . Copies of the AAMFT "Code of Ethics" may be obtained from the AAMFT's Web site at http://www.aamft.org . Copies of these codes may also be obtained from the Office upon written request.

Section 6.7 Disciplinary Actions, Public Records All

Board disciplinary actions are public records available online or from the Office.

Effective Date: February 16, 2015

History

STATUTORY AUTHORITY: 26 V.S.A. § 3263
EFFECTIVE DATE: October 15, 2001 Secretary of State Rule Log #01-56
AMENDED: June 1, 2006 Secretary of State Rule Log #06-013; February 16, 2015 Secretary of State Rule Log #15-001

Chapter 360 ADMINISTRATIVE RULES FOR LICENSED MIDWIVES

04-360 Code Vt. R. 04-030-360-X ADMINISTRATIVE RULES FOR LICENSED MIDWIVES

Part 1 GENERAL INFORMATION ON LICENSURE OF MIDWIVES

Section 1.1 THE PURPOSE OF LICENSURE

The Director of the Office of Professional Regulation has been given powers by Vermont law to protect the public health, safety, and welfare by setting standards, licensing applicants, and regulating licensed midwives and their practices.

Section 1.2 LAWS THAT GOVERN LICENSURE

Licensure is governed by a specific state law that establishes responsibilities for setting standards, issuing licenses, and regulating the profession. The law is the Midwives Act, Title 26, Vermont Statutes Annotated, Chapter 85. In addition, the Director of Professional Regulation is obligated to comply with several other state laws, such as the Administrative Procedure Act ( 3 V.S.A. §§ 801-849), the Open Meeting Law ( 1 V.S.A. §§ 311-314), the Access To Public Records Law ( 1 V.S.A. §§ 315-320), and the Law of Professional Regulation ( 3 V.S.A. §§ 121-131).

These laws set forth the rights of an applicant, licensed midwife, or member of the public. The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" are also available on the Internet at www.leg.state.vt.us. The text of laws and rules governing midwives may be found at www.vtprofessionals.org/midwives [File Link Not Available].

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 APPLICATION

Applications and information about licensure requirements are available from the Office of Professional Regulation (Office). An applicant must submit a completed application form with all supporting documentation and the fee to the Office. The Office reviews applications only after the supporting documentation is received.

Section 2.2 QUALIFICATIONS FOR LICENSURE AS A MIDWIFE

To be eligible for licensure as a midwife, an applicant must (1) have obtained certification as a certified professional midwife (CPM) from the North American Registry of Midwives (NARM), (2) have earned a high school degree or its equivalent, and (3) have agreed to practice according to the scope and standards of practice set forth in these rules.

Section 2.3 RIGHT TO A WRITTEN DECISION AND APPEAL

If the Director of the Office of Professional Regulation (Director) denies an applicant licensure, the Director will give specific reasons in writing and inform the applicant of the right to appeal this decision to an administrative law officer. After giving the applicant an opportunity to present the application and any additional information, the administrative law officer must affirm, reverse, or modify the Director's preliminary decision. Decisions of the administrative law officer may be appealed to the Washington Superior Court.

Part 3 INFORMATION FOR MIDWIVES

Section 3.1 RENEWING LICENSURE BIENNIALLY

Licenses renew on a fixed biennial schedule: January 31 of the odd-numbered years. Initial licenses issued within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Before the expiration date, the Office will mail a renewal application and notice of the renewal fee. A license will expire automatically if the renewal application and fee are not returned to the Office by the expiration date.

See also Rules 3.3 (continuing education requirements), 3.8 (peer reviews), 3.9 (individual practice data), and 3.10 (CPR certification) for additional license renewal requirements.

Section 3.2 LAPSED LICENSES

A license that has lapsed for three years or less will be renewed if the applicant submits the renewal fee, late renewal penalty, and renewal application showing:

(1) That the applicant still meets the eligibility requirements for licensure.

(2) That all requirements for renewal have been met, including continuing education of not less than 20 hours accrued during the two years immediately preceding application for license renewal. See Rule 3.3 (continuing education requirements).

An applicant is not required to pay renewal fees for years during which the license was lapsed.

A license that has lapsed for more than three years for reasons other than professional discipline may be renewed, but only if the applicant files an application for license reinstatement on a form approved by the Director and pays the required fee. An applicant for license reinstatement must show to the Director's satisfaction:

(1) That the applicant still meets the eligibility requirements for licensure.

(2) That the applicant has met the continuing education requirement of not less than 20 hours accrued during the two years immediately preceding application for license reinstatement.

(3) That no fewer than three persons, including at least one midwife licensed in Vermont, who have knowledge of the applicant's professional activities since the license lapsed recommend and support license reinstatement.

An applicant is not required to pay renewal fees for years during which the license was lapsed.

Section 3.3 CONTINUING EDUCATION REQUIREMENTS

All midwives licensed and residing in this state must complete a minimum of 20 hours of continuing education during the two-year renewal period and must so certify at the time of license renewal. The continuing education requirement does not apply for the renewal period during which a midwife initially obtained licensure. It will begin with the first full two-year renewal period.

A continuing education program means classes, institutes, lectures, conferences, workshops, midwifery journals, scientific journals, audio- or videotaped presentations, and preceptorships. A program must consist of study covering new, review, experimental, research, and specialty subjects within the scope of practice of midwifery in this state. Excluded are programs that promote a company, individual, or product and programs whose subject is practice economics.

Programs offered by the following organizations, agencies, or institutions are approved by the Director for continuing education credit:

(1) The American College of Nurse Midwives.

(2) The Midwives Alliance of North America.

(3) A midwifery school or program accredited by the Midwives Education Accreditation Council.

(4) North American Registry of Midwives (NARM)

(5) The Vermont Medical Society or the American Medical Association (programs which qualify for Category I credit).

(6) The Vermont Midwives Alliance when accredited by any other approved organization, agency or institution.

(7) The National Health Service Corps.

(8) The American College of Obstetricians and Gynecologists.

(9) The American Association of Nurse Practitioners.

(10) International Board of Lactation Consultants

A course will be approved for the hours the provider assigns to the course. All other programs will be evaluated and may be eligible for credit if they meet the following criteria and comply with other provisions of these rules: the material is relevant to a midwifery practice (presenting a modality used by midwives), and the sponsoring organization is credible (able to verify attendance and course content).

No more than ten hours will be credited in a single subject area towards the 20-hour biennial continuing education requirement. No more than five hours will be granted for informal study or self-study of midwifery or scientific journals, audio- or videotaped presentations, or preceptorships.

The amount of credit to be allowed for correspondence and formal individual study programs (including taped study programs) will be that which is recommended by the program sponsor. Licensees claiming credit for such correspondence or formal individual study courses are required to obtain evidence of satisfactory completion of the course from the program sponsor. Credit will be allowed in the renewal period in which the course is completed.

A licensee residing in another jurisdiction who has met the continuing education requirements for the current biennial renewal period in that jurisdiction will be deemed by the Director to have met the continuing education requirements for license renewal in Vermont, provided that the other jurisdiction's requirements are reasonably equivalent to those in Vermont. A licensee who holds a current certification as a CPM from the NARM will also be deemed by the Director to have met the continuing education requirements for license renewal in Vermont, provided that NARM's continuing education requirements are reasonably equivalent to those in Vermont.

At the time of license renewal, each licensee must certify on the official renewal form that he or she has complied with the continuing education requirements. The Office may randomly audit licensees to ensure compliance. A licensee who is audited will be notified in writing by the Office and will be required to produce written documentation verifying successful completion of the 20 hours of continuing education during the two-year period at issue. A licensee must maintain such written documentation for a period of three years following the renewal period at issue. The Director may require a licensee who cannot produce such documentation to develop and complete a specific corrective action plan within 90 days, prior to renewal.

Section 3.4 CONTINUING EDUCATION PROGRAM APPROVAL

An educational activity will be eligible for approval as satisfying the continuing education requirements of these rules if it has significant intellectual and practical content directed at increasing the professional competence of midwives, and the activity consists of classroom-style instruction, educational seminars, or self-directed study with substantial written material available, whether conducted by live speakers, lecturers, panel members, video or audiotape presentation, or in written format. If the educational activity consists of classroom-style instruction or seminar, it must be conducted in a classroom or similar setting with a group of not fewer than three individuals. If the educational activity consists of a scientific journals, each journal article for which credit is sought must provide for a written examination and answer sheet, to be completed and mailed to the journal for correction and grading.

The activity may be approved by the Director upon a written request for approval. The name of the activity, the number of credits requested, and the names of the instructors and sponsors must be clearly indicated in the written request. Application may be filed by the sponsoring agency or group, or by any participant. Application for advance approval must be filed at least 120 days before the educational activity has commenced. All applications for approval must be filed within 30 days after the activity is completed. The Director will assign a maximum number of credit hours to each approved activity.

The Director may refuse to approve or may limit the number of hours to be accredited for any activity if the Director finds the activity:

(1) Is not eligible for accreditation pursuant to the criteria set forth above;

(2) Is sponsored by an individual or group lacking the ability or intention to produce a continuing education activity of sufficiently high quality to improve or maintain a midwife's professional competence; or

(3) Is not offered in a sufficiently organized fashion or under otherwise adequate circumstances to fulfill the objectives of these rules.

When the Director has approved an activity, the sponsor may so state, including the number of credits for which the activity has been approved.

Section 3.5 CHANGE OF NAME OR ADDRESS

A licensee is responsible for notifying the Office promptly in writing if the licensee changes name, mailing address, or business address. For purposes of these rules, all initial licensure or renewal applications, notices, or other correspondence mailed to a licensed midwife by the Director or the Office at the licensed midwife's address on file with the Office will be considered as having been received by the licensed midwife.

Section 3.6 UNPROFESSIONAL CONDUCT

Licensed midwives may be disciplined for unprofessional conduct under 26 V.S.A. § 4188 and 3 V.S.A. § 129a. In addition, 3 V.S.A. § 129(a)(6) provides a ground for discipline in this state if a licensee or applicant has been disciplined in another jurisdiction for any offense which would constitute unprofessional conduct in Vermont.

Section 3.7 COMPLAINT PROCEDURE

The Office has a published procedure for receiving, investigating, and acting on complaints of unprofessional conduct. Copies of the procedure are available from the Office.

Section 3.8 PEER REVIEWS

A midwife licensed in this state must participate in at least four separate peer review meetings evaluating the midwife's practice during each two-year renewal period as a condition of license renewal. Peer reviews must be conducted in peer review meetings or in conjunction with professional organization meetings. Each peer review must be conducted by at least two other licensed midwives who have no personal, professional, or financial interest in the birth being reviewed. Peer reviews of the licensed midwife's practice must include but not be limited to process of care, outcome data, referral patterns, and discussion of specific cases and obtaining feedback and suggestions regarding care. Attendance at peer review sessions must be documented in writing on report forms approved by the Director and must be made available to the Director as required.

In addition to the four peer reviews required during each two-year renewal period, a licensed midwife must request and participate in peer review in the following specific situations:

(1) When there has been a death, significant morbidity to client or child, or transfer to hospital.

(2) When the midwife has acted outside the standards set forth in these rules.

Attendance at any peer review session conducted regarding a specific situation listed in paragraph (1) or (2) above must be documented in writing on report forms approved by the Director and must be filed with the Director within 30 days of the peer review session. Reports filed under paragraphs (1) or (2) above will be kept confidential by the Director, unless they result in the filing of charges of unprofessional conduct.

Section 3.9 INDIVIDUAL PRACTICE DATA

As a condition of license renewal, a midwife licensed in this state must submit to the Office, on a form approved by the Director, individual practice data covering each two-year renewal period. Information must not include any data that would identify the client. Such individual practice data must include, at a minimum, the following information about each home birth attended during the renewal period:

(1) Client demographics.

(2) Previous pregnancies.

(3) Present pregnancy concerns.

(4) Prenatal care.

(5) Reasons why client stopped using midwife for primary care before labor at term began.

(6) Reasons why home birth was not or could not have been initiated or was outside midwife's home birth protocol.

(7) Intended and actual place of birth and gestational age.

(8) Encouragement, induction, and augmentation.

(9) Birth data.

(10) Hospital or birth center procedures.

(11) Transport from planned home or birth center birth.

(12) Complications of labor and delivery.

(13) Perineal, labial, cervical, and vaginal trauma.

(14) Newborn data.

(15) Immediate neonatal complications.

(16) Infant's health problems in first six weeks.

(17) Infant in hospital in first six weeks.

(18) Infant died in first six weeks of life.

(19) Client's health and stay in hospital.

(20) Postpartum care, breastfeeding, and health by six weeks.

Section 3.10 CPR CERTIFICATION

A midwife licensed in this state must show proof of current cardiopulmonary resuscitation certification for adults and newborns and for neonatal resuscitation as a condition of initial issuance of license and of license renewal. The Director will accept courses in external cardiopulmonary resuscitation which are approved by the Vermont Heart Association or the American Red Cross and courses in neonatal resuscitation approved by the American Academy of Pediatrics (AAP).

Section 3.11 STUDENT MIDWIVES IN TRAINING AND ASSISTANTS

When providing midwifery care, student midwives in training and assistants must be under the direct on-site supervision of a licensed midwife.

Section 3.12 INFORMED CONSENT

Before accepting a client for care, a licensed midwife must first obtain written informed consent.

Informed consent must be shown by a written statement, in a form prescribed by the Director and signed by the licensee and the client to whom care is to be given, in which the licensee certifies that full disclosure of the following information has been made and acknowledged by the client:

(1) The midwife's educational background and credentials.

(2) Whether the midwife has professional liability insurance coverage.

(3) A description of the procedures, benefits and risks of home birth, primarily those conditions that may arise during delivery.

(4) The fact that the client has been advised to consult with a physician at least once during the pregnancy.

(5) A copy of the written plan for consultation and for emergency transfer and transport of client and newborn required by Rule 3.14 (written plan for consultation and for emergency transfer and transport).

(6) A copy of the written plan for non-emergency transfer and transport of client and newborn.

(7) The address and telephone number of the Office of Professional Regulation where complaints may be filed.

The signed informed consent form must be filed in the client's record, and a copy must be provided to the client.

Throughout the care process, the midwife must continue to inform the client and obtain consent.

Section 3.13 SCOPE AND PRACTICE STANDARDS

Role of the Midwife: The midwife is a person who provides well-woman care, support and education to healthy women during the childbearing cycle, including normal pregnancy, labor, childbirth and the postpartum period. Midwifery care emphasizes education, health promotion, shared responsibility, and mutual participation in decision making. The midwife works with each client and the client's family to identify their unique physical, social, cultural, and emotional needs. When the care required extends beyond the midwife's abilities, the midwife continues involvement and arranges for consultation, referral, and collaboration with appropriate health care providers.

Prenatal Care:

(A) Information: Each midwife must present to each client accurate information conforming to the requirements of Rule 3.12 (informed consent) and also including but not limited to:

(1) Financial charges for services.

(2) Services the midwife provides, advantages and disadvantages of home birth, legal status of midwifery in Vermont, mutual expectations, and responsibilities of the client and the client's family.

(3) Values and ethics of practice.

(4) Choices regarding prenatal lab testing, including but not limited to sexually transmitted diseases, blood type and antibody screen, hematocrit, HIV, rubella, gestational diabetes screening, Group B Strep, urinalysis.

(5) Information regarding community well child care resources available to client and baby.

(B) History and Physical Assessment: At the initiation of prenatal care, a health and personal history must be completed. History taking is an interactive process during which the midwife and the client focus upon emotional, philosophical, and social responses of the client and her family to health issues and problems, as well as on the details of the events themselves. It is also an opportunity for mutual education. This history must include:

(1) Past medical history, including gynecological and previous pregnancy histories.

(2) Relevant family history.

(3) Social history.

(4) Current pregnancy history.

(5) Physical assessment.

(C) On-going Prenatal Care: The purpose of on-going prenatal care is to promote the health of the client and baby, screen for problems, develop a relationship between family and midwife which create the trust and compatibility important to good labor support, exchange information pertinent to the childbearing cycle of the individual client and empower the client with trust in the birthing capabilities of her body. Prenatal visits should occur not less than (1) every four weeks through 32 weeks, (2) every two weeks until 36 weeks, and (3) weekly thereafter. This care includes:

(1) Education and self-care: diet, exercise, enhancement of emotional and physical environment, birth preparation, breast feeding preparation.

(2) Evaluation of maternal nutrition, blood pressure, fetal heart tones, fetal growth, position and presentation of the baby.

(3) Baseline weight; abnormal weight gain or loss.

(4) Screening for signs and symptoms of edema, bleeding, headache, visual disturbances, or unusual vaginal discharge.

(5) Discussion of any recent illnesses, symptoms, social or emotional problems, diet, supplements, reading suggestions, exercise, rest and sleep requirements, sexuality, nipple and perineal preparation, partner's role, birth preparation, newborn care, parenting, and transport arrangements.

(6) Obtaining appropriate lab testing.

(7) Use of aseptic techniques and universal health precautions.

(D) Record Keeping: Each midwife must keep accurate records and make them available as provided in Rule 3.15 (record keeping and report requirements). Records must otherwise be kept confidential.

(E) Birth Preparation: If prenatal course is normal and home birth is planned, the following preparations must be made and are the midwife's responsibility:

(1) Alert parents to signs of complications that necessitate immediate contact with midwife as well as signs of labor and when to call.

(2) Be on call or make specific arrangements for on-call coverage with another licensed health care professional whose scope of practice includes birth.

(3) Arrange for assistance from another licensed midwife or trained assistant to attend the birth, unless declined by the family.

(4) Make a home visit before the 37th week of pregnancy.

(5) Maintain appropriate equipment for assessing maternal, fetal, and newborn well-being; carry oxytocic drugs (Rule 3. 16), supplies to maintain asepsis, and emergency resuscitation equipment.

(6) Midwife must:

(a) Have an accessible phone.

(b) Have transportation readily available.

(c) Make appropriate arrangements for consultation and for emergency and non-emergency transfer and transport of client and newborn.

(7) Midwife insures that parents will:

(a) Have all necessary supplies on hand several weeks prior to due date.

(b) Have adequate light, heat, water, cleanliness, and accessibility.

(d) Make child care arrangements for siblings.

(e) Arrange for help after the birth.

(F) Discontinuation of Services: During prenatal care the midwife must evaluate a client and her baby and determine continuing appropriateness for home birth and midwifery services. All concerns must be shared with the client and documented in the chart. In addition to circumstances outlined in Rule 3.14. 1, it is the right of the midwife to refuse or discontinue service. Before refusing or discontinuing service, the midwife must notify the client in writing, provide the client with names of other licensed maternity care practitioners, and offer to provide copies of medical records promptly, regardless of whether copying costs have been paid by the client.

Labor, Birth, and Immediate Postpartum:

(A) Labor: During labor and birth, the midwife must use all of the resources available to the midwife to assure and enhance the well-being of the client and baby. The midwife recognizes that emotional and spiritual well-being are essential to normal healthy labor and birth and must offer a full spectrum of support.

(1) When the midwife arrives, the midwife must determine well-being of client and baby, the quality and progress of labor, fetal heart tones, position and presentation of the baby, client's energy, attitude and ability to cope with labor.

(2) When indicated, the midwife must perform a vaginal exam to assess progress of labor and position and presentation of the baby.

(3) When the membranes rupture, the midwife must check for meconium, signs of maternal or fetal infection, and cord prolapse.

(4) The midwife must continue to assess the progress of labor and the well-being of client and baby.

(5) The midwife must observe aseptic technique and use universal health precautions.

(B) Care of the Client: The midwife must:

(1) Use the home environment as a valuable resource in helping the client go through labor as comfortably as possible.

(2) Assure adequate nutrition and fluid intake throughout labor.

(3) Periodically assess well-being of the client and the fetus in relation to the progress of labor.

(4) Provide support and encouragement to the client during the birth process.

(5) Assist the client with the delivery of the placenta.

(6) If abnormal bleeding occurs respond appropriately.

(1) Maintain a warm environment for the newborn.

(2) Assess the newborn and provide appropriate care.

(3) Continue to evaluate newborn vital signs.

(4) Encourage and support breast feeding.

(5) Conduct a newborn exam and make a referral if necessary.

(6) Administer eye prophylaxis and vitamin K, unless declined by client and documented by midwife in chart.

(D) Immediate Postpartum Care: Following the birth, the midwife must remain with client and baby until both are stable and secure, and at least two hours have passed since the birth. During this time the midwife must perform the following and document in the chart:

(1) Observe the client's general well-being.

(2) Assess the amount of maternal bleeding, size and consistency of the uterus, and take maternal blood pressure and pulse if indicated.

(3) Examine the client's perineum and vagina and repair lacerations when appropriate.

(4) Assess the client's ability to urinate.

(5) Inspect the umbilical cord, placenta, and membranes.

(6) Assess the client's ability to ambulate and take nutrition.

(E) Instructions: Before leaving, the midwife must discuss with the client and must leave with the client information about:

(1) Normal amount of bleeding and appropriate size and consistency of uterus.

(2) Perineal care and hygiene.

(3) Rest and nutrition requirements of the client.

(4) Signs of a healthy baby and care of the newborn.

(5) Breast/bottle feeding.

(6) Indications that warrant contacting the midwife or consulting a physician.

Follow-up Care:

(A) Visits: Recommended follow-up visits are on the first and third day, one week, three weeks and six weeks or as needed. Phone consultation when necessary. During these visits the midwife must assess the client for:

(1) Over-all well-being.

(2) Status of breast feeding.

(3) Uterine involution, amount and color of lochia, and condition of the perineum.

(4) Vital signs when indicated.

(5) Bowel and urinary continence and output.

(6) Nutritional status and amount of rest.

(7) Emotional status.

(B) Baby Care: The midwife must observe the baby during this period for and document the observations in the chart:

(1) Over-all well-being.

(2) Ability to nurse.

(3) Jaundice.

(4) Activity level, respirations, heart rate, color and body temperature maintenance.

(5) Weight

(6) Bowel movements and urination.

(6) Condition of cord.

(7) Condition of eyes.

(8) Obtain specimens for newborn screening.

(9) Encourage and facilitate referral to a child health care provider for ongoing well-baby services.

(1) Make inquiries concerning bleeding, condition of perineum, breast feeding, family adjustment, sexual activity, and bowel and urinary output and continence.

(2) Discuss client's return to fertility/family planning.

At the final visit, the midwife may:

(1) Perform a pelvic exam, including a pap smear.

(2) Obtain a hematocrit or hemoglobin.

(3) Perform a breast exam.

(4) Obtain other labs as needed, with abnormal findings referred to a physician for consult.

Section 3.14 WRITTEN PLAN FOR CONSULTATION AND FOR EMERGENCY TRANSFER AND TRANSPORT

The licensed midwife recognizes that there are certain conditions when medical consultations or transfers, or both, are advisable.

Each licensed midwife must develop a written plan (1) for consultation with physicians (M.D. or D.O.) and other health care providers and (2) for emergency transfer and for transport of an infant or a client, or both, to an appropriate health care facility. The written plan must be submitted to the Director on an approved form with the initial license application and with every subsequent license renewal.

3.14.1 HISTORY OF DISORDERS OR SITUATIONS FOR WHICH MIDWIFE MUST NOT ASSUME OR CONTINUE TO TAKE RESPONSIBILITY

If a history of any of the following disorders or situations is found to be present at the initial interview or if any of the following disorders or situations becomes apparent through history, examination, or laboratory report as prenatal care proceeds, the midwife must not assume or continue to take responsibility for the client's pregnancy and birth care. For clients already under care, it is the responsibility of the midwife to arrange for orderly transfer of care to a licensed M.D. or D.O.

(1) Diabetes mellitus

(2) Hyperthyroidism currently treated by medication

(3) Uncontrolled hypothyroidism

(4) Epilepsy with seizures or anti-epileptic drug use during the previous 12 months

(5) Coagulation disorders

(6) Chronic pulmonary disease

(7) Heart disease in which there are arrhythmias or murmurs except when, after evaluation, it is the opinion of an M.D. or D.O. that midwifery care may proceed

(8) Hypertension including pregnancy-induced hypertension (PIH)

(9) Renal disease

(10) Rh sensitization with positive antibody titer, except as in R. 3.14.2 below.

(11) Previous caesarean delivery, except as in R. 3.14.2.1 below.

(12) Indications that the fetus has died in utero and there is evidence of DIC or infection

(13) Premature labor (gestation less than 36 weeks)

(14) Multiple gestation

(15) Breech presentation at 38 weeks or after

(16) Transverse lie or other abnormal presentations at 38 weeks or after

(17) Placenta previa or abruption

(18) Preeclampsia

(19) Severe anemia, defined as hemoglobin less than 10

(20) Uncommon diseases and disorders such as Addison's disease, Cushing's disease, systemic lupus erythematosus, anti-phospholipid syndrome, scleroderma, rheumatoid arthritis, periarteritis nodosa, Marfan's syndrome, and other systemic and rare diseases and disorders.

(21) AIDS/HIV

(22) Hepatitis A, B, C, D, E, F, G, and Non A-G

(23) Acute Toxoplasmosis infection, where the client is currently symptomatic

(24) Acute Rubella infection, where the client is currently symptomatic

(25) Acute Cytomegalovirus infection, where the client is currently symptomatic

(26) Acute Parvovirus infection, where the client is currently symptomatic

(27) Drug abuse or continued alcohol use either daily or binge behavior into the second trimester

(28) Thrombosis

(29) Inflammatory bowel disease that is not in remission

3.14.2 SITUATIONS OR CONDITIONS REQUIRING CONSULTATION

If the following situations or conditions are present or become apparent during prenatal care, the midwife must consult with a licensed M.D. or D.O, must document such consultation and the consultant's recommendations, and must document discussion of the consultation with the client.

(1) Significant mental disease such as depression, bipolar disorder, schizophrenia, and other conditions which impair the ability of the client to participate effectively in her care or which require current use of psychotropic drugs to control the condition

(2) Postmaturity (gestational age greater than 42 weeks)

(3) Second or third trimester bleeding

(4) Herpes simplex virus, primary infection or active infection at time of delivery

(5) Continued daily tobacco use into the second trimester

(6) Intermittent use of alcohol into the second trimester

(7) Asthma

(8) Gestational diabetes, diet controlled

(9) History of genetic problems, or intrauterine death after 20 weeks gestation, or stillbirth due to a situation which might recur

(10) Previous uterine surgery including myomectomy, LEEP, cone biopsy

(11) Abnormal Pap smear (greater than ASCUS)

(12) Past obstetrical problems, including but not limited to uterine abnormalities, placental abruption, significant congenital anomalies, placenta accreta and incompetent cervix

(13) Possible ectopic pregnancy

(14) Inflammatory bowel disease, in remission

(15) Tuberculosis

(16) Controlled Hypothyroidism, on thyroid replacement and euthyroid, i.e., the thyroid test numbers are normal

(17) Morbid obesity (body mass index (BMI) greater than 34 at initial pregnancy visit)

(18) Rh sensitization with positive antibody titer

(19) Breech presentation between 35 and 38 weeks

(20) Transverse lie or other abnormal presentation between 35 and 38 weeks

(21) Premature rupture of membranes at 37 weeks or less, unless the client has been shown to be GBS (group B strep) negative by rectovaginal swab or the midwife is following CDC guidelines. See Appendix B.

3.14.2.1 PREVIOUS CESAREAN DELIVERY

The following requirements must be met for vaginal birth after cesarean (VBAC). In addition, prenatal consultation is advised when available.

(1) The midwife must consult with a licensed M.D. or D.O. to ascertain that the client had only one documented previous lower uterine segment cesarean section with uterine closure of more than one layer.

(2) There must be at least 18 months from the client's cesarean to the due date of the current pregnancy.

(3) The client must obtain ultrasound documentation to determine that the location of the placenta is not previa or is not low and anterior.

(4) Signed informed consent must be present in the client's chart. See Appendix A.

(5) The midwife must perform fetal auscultation at least every 15 minutes during active labor and more frequently if necessary and at least every five minutes during the second stage of labor and more frequently if necessary.

(6) The birth site must be located within 30 minutes' transport time from a hospital emergency room.

(7) Two licensed midwives must be present during the birth.

(8) No labor induction or augmentation of any kind must be done, including use of any chemical or herbal medication or nipple stimulation.

(9) Pre-admission forms must be completed for the client before labor, for the hospital to which the client may possibly be transferred.

(10) Prenatal records for the client must be sent before labor to the back-up system for the birth (hospital, labor and delivery unit, or physician practice).

No later than one year from the effective date of these rules or earlier upon written request, the Director, in consultation with the advisor appointees and the Commissioner of Health, will review current scientific research on vaginal birth after cesarean (VBAC), for the purpose of seeking amendment of this rule to reflect current scientific research findings, provided the Director concludes after consultation that amendment is necessary.

3.14.3 CONDITIONS REQUIRING FACILITATION OF TRANSFER, IF POSSIBLE, OR CONSULTATION

If the following conditions become apparent during the labor, birth, or immediate postpartum period, the midwife must facilitate transfer to a hospital setting if time allows. If transfer is not possible, the midwife must consult with a licensed M.D. or D.O. to determine whether and when transfer may become advisable:

(1) Unforeseen malpresentation

(2) Unforeseen multiple fetuses

(3) Non-reassuring fetal heart rate or pattern including but not limited to tachycardia, bradycardia, significant change in baseline, persistent late or severe variable decelerations

(4) Client request

(5) Prolapsed cord

(6) Uncontrolled maternal hemorrhage or retained placenta

(7) Signs of fetal or maternal infection

(8) Client with a fourth degree laceration or a laceration beyond the midwife's repair ability

(9) Apgar of less than seven at 10 minutes

(10) Obvious congenital anomalies

(11) Infants with persistent central cyanosis

(12) Infants with persistent grunting and retractions

(13) Infants with abnormal vital signs

(14) Gross or thick meconium staining

Decision-making Conflicts:

Pre-natal, Birth Not Imminent: If a client chooses to give birth at home in a situation deemed higher- risk or potentially more complicated by the midwife or prohibited by these rules, the midwife must refer the client and her family to alternative care providers. The midwife must cease to take responsibility for the client's pregnancy care no later than one week after providing the referral.

Birth Imminent: If the birth is imminent, the midwife must not leave the client until the ambulance has arrived.

Section 3.15 RECORD KEEPING AND REPORT REQUIREMENTS

A licensed midwife must establish and maintain a record of the care provided and data gathered for each client. Each client's record must contain the following information, as applicable:

(1) Client identification sheet, including name, address, date of birth, next of kin, spouse or other designated person, directions to the client's home, telephone number, and marital status.

(2) Health history sheet including pre-existing conditions or surgeries, previous pregnancies, physical examination, nutritional status, and a written assessment of risk factors with a plan to transfer care to an M.D. or D.O. when risk factors that require termination of the agreement are present.

(3) Progress notes of all encounters with the midwife and other health care consultants, in chronological order, documenting any actions, guidance, and consultations, with copies if appropriate.

(4) Laboratory and diagnostic reports.

(5) Written informed consent on the approved form, which is signed by the client.

(6) Evidence of medical evaluation and physician visits, consisting of either a report signed by the physician, a copy of the medical and physician notes, or other documentation received from the physician or medical provider.

(7) Documentation of all medications administered to the client.

(8) A date for each entry in the prenatal record and the postpartum record, and a date and time for each entry in the labor record. Each entry must be initialed or signed by the midwife. If initials are used, the midwife must also sign on the same page.

A licensed midwife must make records available upon request to the client, to the client's representative, to other health care providers engaged in the care and treatment of the client, for peer reviews required by Rule 3.8 (peer reviews), or upon request by the Director for periodic quality review. For other persons or entities, information in the client's record may be released by the midwife only with the written consent of the client, legal guardian, or as otherwise provided by law.

Section 3.16 PROTOCOL AND FORMULARY FOR DRUG AND EQUIPMENT USE

A licensed midwife may purchase and use the legend devices listed below which are deemed integral to providing safe care to the public.

(1) Dopplers

(2) Syringes

(3) Needles

(4) Phlobotomy Equipment

(5) Sutures

(6) Urinary catheters

(7) Intravenous equipment

(8) Amnihooks

(9) "DeLee type" mucous traps

(10) Equipment and supplies listed in the American heart Association Cardiopulmonary Resuscitation Guidelines and the American Academy of Pediatrics Neonatal Resuscitation Guidelines for the administration of oxygen

(11) Diaphragms and cervical caps for postpartum women

A licensed midwife may obtain (by purchase or by prescription written by a Vermont-licensed MD or DO) and administer the legend drugs listed in Table A, for the purposes listed in that table. The routes of administration listed in the table are the only approved routes. Abbreviations used to define the routes of administration are defined as follows:

| PO | = | by mouth | | --- | --- | --- | | IM | = | intramuscular | | IV | = | intravenous | | SQ | = | subcutaneous | | Topical | = | applied to skin | | Blow-by | = | oxygen blown at the nose and mouth |

The client's records must contain documentation of all medications administered.

A licensed midwife may administer any other medication prescribed by a licensed physician (MD or DO) for a specific client and with the intent that the licensed midwife administer the medication. The licensed midwife must administer such medication consistent with the scope of midwifery practice as defined in Rule 3.13 (scope and practice standards).

TABLE A

| Legend Drug | Indication | Dose | Route of Administration | Duration of Treatment | Comments | | --- | --- | --- | --- | --- | --- | | Oxygen | Fetal distress | Blow-by or Mask | 20 minutes or until EMT arrives | | | | 1% Silver Nitrate Solution or | Neonatal Ophthalmia | 2 drops in each eye from unit dose package | Topical | Single dose | | | 0.5% Erythromycin | 1 cm ribbon in each eye from unit | | | | | | Ophthalmic | dose | | | | | | Ointment or 1% Tetracycline | package 1 cm ribbon in each eye from unit | | | | | | Ophthalmic | dose | | | | | | Ointment | package | | | | | | Oxytocin 10 units/ml | Postpartum hemorrhage | 10 units | IM only | 1-2 Doses | | | Methyl-ergo novine 0.2 mg/ml or 0.2 mg tabs | Postpartum hemorrhage | 0.2 mg | IM or PO | 3-4 times daily for 30 days | Do not use in patients with Raynaud's Disease | | Vitamin K 2 mg/ml | Prophylaxis of Hemorrhagic Disease of the Newborn | 0.5 ml 1 ml | IM PO | Single Dose | Infants with active bleeding must be referred to a licensed physician (MD or DO) | | RH[o] (D) Immune Globulin | Prevention of RH[o] (D) Sensitization in RH[o] (D) negative women | Unit dose | IM Only | Single dose at 26-28 weeks gestation for RH[o] (D) negative, antibody negative women And Single dose given within 72 hours of delivery of RH[o] (D) positive infant | May administer an additional dose approximately 12 weeks after the initial dose if delivery is not imminent. | | Lidocaine HCI Injection 0.5 or 1% And Lidocaine HCI and epinepherine Injection 0.5 or 1% | Local anesthetic for use during postpartum repair of lacerations , tears or episiotomy | Maximum 50 ml | Percutaneous infiltration only | | | | Epinepherine HCI 1:1000 solution | Treatment or post-exposure prevention of severe allergic reactions | 0.3 ml | SQ or IM | Every 10-15 minutes until EMT arrives | Administer first dose then immediately contact emergency services by telephoning 911 | | Rubella Virus Vaccine, Live | Prevention of Rubella in susceptible women in the immediate postpartum period | Unit dose | SQ only | Single dose | Must be in compliance with Federal-law regarding vaccine record keeping | | 5% Dextrose in Ringer =s Lactate, or Ringer = s Lactate | To prevent or correct dehydration complicating labor and delivery | Consult with licensed MD or DO for dose | IV | | |

Effective date: December 1, 2001

History

Effective Date: December 1, 2001 (Secretary of State Rule Log # 01-63)
Statutory Authority: 26 V.S.A. § 4185(b)

Chapter 370 ADMINISTRATIVE RULES FOR ELECTROLOGISTS

04-370 Code Vt. R. 04-030-370-X ADMINISTRATIVE RULES FOR ELECTROLOGISTS

Part 1 General Information

Section 1.0 PROTOCOL AND FORMULARY FOR DRUG AND EQUIPMENT USE

These rules are promulgated in compliance with Chapter 86 of Title 26 of the Vermont Statutes Annotated. 26 V.S.A. § 4404(c) provides: "The director, after consultation with the advisor appointees, may adopt rules necessary to perform the director's duties under this chapter." This authority includes making rules regarding the offices in which electrology is performed, cleanliness and sanitation requirements, education, continuing education requirements, certification of applicants, denial or renewal of certification, and inspection of offices.

Section 1.1 THE PURPOSE OF LICENSURE

Section 1.2 BUSINESS ADDRESS

The Director's mailing address is: Director of the Office of Professional Regulation, Office of the Secretary of State, Office of Professional Regulation, 89 Main Street, FL3, Montpelier, Vermont 05620-3402 (the "Office"). Copies of these rules and more information about the requirements and procedures regarding electrology, including application forms, may be obtained by contacting the Office at 1-802-828-1134. Information about the practice of electrology including application forms and renewal forms also may be obtained from the Office's web site at www.sec.state.vt.us/professional-regulation/professions/electrologists.

Section 1.3 LAWS THAT GOVERN LICENSURE

The practice of electrology is governed by statutes which establish the responsibilities of the Director of the Office for setting standards, issuing certificates and regulating the profession. Those laws are found in Chapter 86 of Title 26 of the Vermont Statutes Annotated, specifically 26 V.S.A. §§ 4401-4412. In addition, the Director's regulation of electrology must comply with several other state laws such as the "Administrative Procedure Act" ( 3 V.S.A. §§ 801-849), the "Open Meeting Law" ( 1 V.S.A. §§ 310-314) and the "Right to Know Law" ( 1 V.S.A. §§ 315-320). These laws set forth the rights of applicants, regulated professionals, and members of the public. The complete "Vermont Statutes" are available at legislature. vermont.gov.

Part 2 Information for Applicants

Section 2.1 APPLICATIONS

Applications shall be submitted to the Office on a form furnished by the Director. The application shall be accompanied by the fee set forth in subsection 125(b) of Title 3. Application forms are available from the Office and on its website at www.sec.state.vt.us/professional-regulation/professions/electrologists.

Section 2.2 EXAMINATION

The standardized national examination approved by the Director shall be the American Electrology Association's International Board of Electrologist Certification examination. An applicant who fails to achieve a passing score on the examination may repeat the examination only three times, upon submitting the appropriate forms and paying the required fee with each application.

Section 2.3 SPECIAL LICENSE ENDORSEMENT FOR LASER USE

In order to obtain the special license endorsement required by 26 V.S.A. § 4404(d) for an electrologist to use a laser for hair removal, an otherwise qualified electrologist shall satisfactorily complete a comprehensive laser hair removal course approved by the Director. An acceptable course shall be not fewer than sixty (60) hours long and shall include the following laser safety topics: laser and Intense Pulse Light ("IPL") physics; classifications of lasers; skin classifications; principles of laser and IPL hair removal; effects of laser light on human tissue; safe equipment operation; and indications and contraindications. At least twenty-four (24) hours of the course shall be dedicated to hands-on, supervised clinical training with both lasers and IPLs on actual patients. The clinical training shall encompass review of pertinent medical histories and treatment of patients in all stages of laser and IPL hair removal from initial to final treatment. A list of courses that meet these requirements and are pre-approved by the Director is available from the Office's website at www.sec.state.vt.us/professional-regulation. Approval for a course not specifically listed on the Office's website may be obtained by applying to the Director at any time but no later than 90 days before the alternate course begins.

Section 2.4 EXAMINATION

A. The director shall examine applicants for certification as electrologists at such times and places as the director may determine.

B. Examinations and examination procedures shall be fair and reasonable and shall be designed to ensure that all applicants are granted certification if they demonstrate that they possess the minimal occupational qualifications which are consistent with the public health, safety and welfare.

C. Standardized national examinations will be administered. They shall not be designed or implemented for the purpose of limiting the number of certified persons.

Section 2.5 REEXAMINATION

An applicant who fails to achieve a passing score on the certification examination may repeat the examination three times, upon submitting the appropriate forms and paying the required fee with each application.

Section 2.6 DENIAL OF CERTIFICATION, RIGHT TO WRITTEN DECISION

An applicant will be notified in writing whether he or she is qualified to be certified. If the Director denies an applicant certification, the Director shall give the applicant specific reasons and inform the applicant of the right to request a hearing for review of the decision. The hearing to review a denial will be conducted by an administrative law officer appointed by the Secretary of State. After giving the applicant and the Director an opportunity to present the application and any additional information, the administrative law officer shall affirm, reverse, remand or modify the Director's preliminary decision. The administrative law officer's decision may be appealed to Washington Superior Court.

Part 3 General Definitions

Section 3.1 As used in these rules

As used in these rules:

A. "Electrologist" means any person who for compensation, practices electrology.

B. "Electrology" is defined at 26 V.S.A. § 4402(3).

C. "Invasive procedures" for purposes of these rules include, but are not limited to, the following:

(1) Application of electricity which contracts the muscle;

(2) Application of topical lotions, creams, or other substances which affect living tissue;

(3) Penetration of the skin by metal needles, except electrolysis needles;

(4) Abrasion of the skin below the non-living, epidermal layers;

(5) Removal of skin by means of a razor-edged instrument.

D. "Electrology experience" means practicing electrology without supervision.

E. "Electrology office" is defined at 26 V.S.A. § 4402(4).

F. "Electrology training" means satisfactory completion of a course of study of at least 600 hours at a school of electrolysis approved by the Director in consultation with the advisors which meets or exceeds the standards set by the American Electrology Association, and passing the examination described in § 4407 and these rules.

G. "Continuing education" means the direct participation of an electrologist in an educational program directly related to competency in electrology.

Part 4 Practice Rules

Section 4.1 DISCLOSURE OF INFORMATION

A. Prior to initiating any treatment, an electrologist must provide the patient with an explanation of:

(1) the nature of the treatment or procedure to be performed;

(2) the potential benefits and risks of undergoing said treatment;

(3) the nature of any after-treatment care to be provided;

(4) the cost of said treatment; and

(5) any other information reasonably necessary to allow the patient to make a decision intelligently about whether or not to undergo electrology treatment.

B. Following such explanation, the electrologist shall obtain, and document in writing, the consent of the patient before initiating any treatment.

Section 4.2 DISPLAY OF CERTIFICATE

A certificate authorizing the holder to practice electrology shall be conspicuously displayed in the place of business, and evidence of current validation shall be in the possession of the certificate holder at all times of practice.

Section 4.3 ELECTROLOGISTS' OFFICES

A. Electrology shall be practiced in an office which provides at minimum the following:

(1) Separate treatment and waiting room or rooms;

(2) Each treatment room shall be at least 48 square feet;

(3) One sink with hot and cold running water in each treatment room, which is separate from other businesses or residential rooms;

(4) Adequate lighting;

(5) Adequate ventilation;

(6) Sanitary conditions;

(7) Toilet facilities must be made available;

(8) Residential areas shall not be used for treatment rooms.

B. Electrologists shall notify the Office 30 days before opening an office or branch office.

C. A professional lamp will be focused on the treatment area at all times.

D. Professional type forceps shall be used in the treatment of patients.

E. Smoking is prohibited by electrologists or patients during treatment and in the treatment area.

F. Every electrology office shall be open for inspection by any investigator of the Director during regular business hours, or upon notice.

Section 4.4 INSPECTION FEE

The Director may waive the fee for inspection permitted under 26 V.S.A. § 4404(b) if the inspection reveals substantial compliance with the rules and statutes governing electrologists.

Section 4.5 SPECIFIC DEFINITIONS AND PRACTICE STANDARDS

A. As used in these rules, the Director employs the following definitions adopted from the American Electrology Association standards to mean:

(1) "anaphoresis/cataphoresis rollers" means stainless steel rollers used to apply current to skin before or after electrology treatment. Anaphoresis/cataphoresis rollers are considered semi-critical items and require sterilization.

(2) "antiseptic" means a chemical used on or in living tissue to inhibit or destroy microorganisms. The chemicals and concentrations used for antisepsis are not typically the same as those used for disinfection; therefore, antiseptic products are not appropriate in any instance for use in cleaning or disinfecting inanimate substances. Antiseptics are regulated by the Food and Drug Administration (FDA).

(3) "aseptic technique" means, from Greek, asepsis, meaning "without sepsis (putrefaction/infection)." Aseptic technique is the combined range of motions and procedures conducted by practitioners to limit the transfer of microorganisms among inanimate surfaces, the patient/client and the practitioner. For example, appropriately timed hand washing, disinfection/sterilization of inanimate surfaces or instruments, appropriate use of personal protective clothing or barriers, proper containment and disposal of waste, consistent personal and instrument/surface manipulations to minimize cross contamination.

(4) "assessment" means the process of collecting, verifying, organizing, interpreting, and documenting data about the patient/client's health status and skin condition.

(5) "autoclave (steam sterilizer)" means a vessel used for sterilization by application of saturated steam under pressure and heat. Autoclaves are regulated by the FDA.

(6) "biological indicator" means a commercially prepared device with a known population of highly resistant bacterial spores to test the method of sterilization being monitored. The indicator is used to demonstrate that conditions necessary to achieve sterilization were met during the cycle being monitored. Biological indicators are regulated by the FDA.

(7) "chemical disinfectant/germicide" means a chemical agent that is applied to inanimate objects to kill microbes. Chemical disinfectants are classified as "high-level," "intermediate-level," and "low-level" according to their comparative levels of potency and their intended uses. Chemical disinfectants are regulated either by the FDA (medical instrument uses) or the Environmental Protection Agency (EPA) (environmental surface uses). Intended uses and directions for use are found both on the labels of the products and/or in package inserts. Material Safety and Data Sheets (MSDS) for each product are available from the manufacturer.

(8) "chemical indicator" means the item used to monitor certain parameters of a heat sterilization process by means of a characteristic color change, usually chemically treated paper strips. A chemical indicator does not indicate that sterilization has been achieved, and most indicate only that the temperature needed has been attained. Other types of chemical indicators are capable of "integrating" time at a particular temperature before color change. Chemical indicators are regulated by the FDA.

(9) "cleaning" means the removal of all visible residual material from objects. Thorough cleaning is an absolute must prior to disinfection and sterilization procedures. A process using friction, detergent, and water to remove organic debris.

(10) "critical items" means the instruments or objects that will come in direct contact with the bloodstream or other normally sterile areas of the body. Needles and forceps are examples of critical items used in electrology.

(11) "decontamination" means a process that renders a medical device, instrument, or environmental surface reasonably safe to handle. In the case of medical instruments or devices, a decontamination process or treatment does not necessarily mean that the item is safe for patient reuse. A decontamination procedure can range from cleaning with soap and water to disinfection or sterilization.

(12) "disinfection" means a process that reduces the level of microbial contamination. A disinfectant is a chemical or physical agent that is applied to inanimate objects to kill microbes. A thorough cleaning of the item in question is essential prior to any disinfection/sterilization process.

(13) "dry heat sterilizer" means a forced air oven-type device specifically designed to sterilize items by exposure to high temperatures for designated exposure periods. Dry heat sterilizers are regulated by the FDA.

(14) "environmental surfaces" means surfaces in the electrology work setting. This surface area may potentially contribute secondary cross-contamination by hands of the electrologist or by contact with instruments that will subsequently come into contact with patient/clients and should therefore be properly maintained to minimize their potential role in disease transmission. Environmental surfaces are "non-critical" (see definition below) and may be divided into at least two major subdivisions according to decreasing risk of disease transmission:

(a) medical equipment surfaces such as frequently touched epilator surfaces, magnifying lamps, and epilator carts; and

(b) housekeeping surfaces such as floors, walls, tabletops, window sills, and so forth.

(15) "epilator cords" means insulated plastic covered cords used to complete current circuit between the epilator and the epilator needle or the indifferent electrode. Epilator cords are non-critical items and require cleaning.

(16) "forceps" means the instrument used in electrology treatment to lift the hair from the follicle. Forceps are critical items and require sterilization.

(17) "gloves" means medical grade hand protection made of latex or vinyl and worn by a practitioner during electrology treatment and cleaning procedures. Medical grade gloves are regulated by the FDA.

(18) "hand washing" means the process for the removal of soil and transient microorganisms from the hands by a vigorous brief rubbing together of all surfaces of lathered hands for 10 to 15 seconds, followed by rinsing under a stream of water.

(19) "high-level disinfection" means the disinfection process that inactivates some, but not necessarily all, bacterial spores. This powerful process will also kill M. tuberculosis var. bovis, (a resistant laboratory test organism used to classify the potencies of disinfectant chemicals), as well as other bacteria, fungi, and viruses. High-level disinfection is the minimum treatment recommended by the CDC in guidelines for the reprocessing of semi-critical instruments or devices. Examples of high-level disinfectants includes glutaraldehyde-, chlorine dioxide-, hydrogen-peroxide, orthophthaldehyde-, and peracetic acid-based formulations. These are commercially available germicides that have been cleared by the FDA as sterilants/disinfectants (all but one product to date) or simply as "high level disinfectants." Items must be properly cleaned before disinfection is performed with these solutions.

(20) "hospital disinfectant" means a chemical germicide with label claims for effectiveness against Salmonella choleraesuis, Staphylococcus aureus and Pseudo-monas aeruginosa. Hospital disinfectants may be classed as either low-level or intermediate-level in their spectrum of activity as indicated by label claims. These classes of germicides are regulated by the EPA and are appropriate for environmental or medical device surfaces but not as a final step in reprocessing of medical instruments.

(21) "indifferent electrode" means a stainless steel bar, which is held by the patient/client during electrology treatment to complete current circuit with galvanic/electrolysis modality or with the use of a timer delay switch in automatic delivery epilators. The indifferent electrode is a non-critical item.

(22) "instruments" means tools or devices designed to perform a specific function, such as grasping, holding, or retracting. Forceps are an example of instruments in electrology.

(23) "intact skin" means skin in which the natural protective barrier has not been altered by infection or trauma.

(24) "intermediate-level disinfection" means a disinfection process capable of killing M. tuberculosis var. bovis, but not bacterial spores. When using a process that kills M. tuberculosis var. bovis, you will also inactivate organisms with a lesser degree of intrinsic resistance, such as most vegetative bacteria and fungi as well as viruses such as hepatitis B virus (HBV) and HIV. Examples of intermediate-level disinfectants include alcohols (70 to 90% ethanol or isopropanol), chlorine compounds (free chlorine, i.e., hypochlorus acids derived from sodium or calcium hypochlorite), and certain phenolic or iodophor preparations, depending on formulation. As with all other disinfection procedures, thorough cleaning is essential to the effectiveness of the process. Intermediate-level germicides are regulated by the EPA.

(25) "invasive procedure" means the surgical entry into tissues, cavities, or organs during a medical treatment. In electrology, the entry of the needle into the hair follicle which can make contact with blood or other normally sterile areas of the body. However, the depth of penetration of electrology instrumentation is limited mostly to the skin tissue layer and never below the subcutaneous tissue layer, i.e., electrology is "superficially invasive" as compared to hospital surgical procedures which typically penetrate to deep soft tissue (facia and muscle) and organ spaces. Similar to subcutaneous injection of medication, the electrology instruments are sterile at time of use.

(26) "latex allergy" means a systemic or local allergic response to various latex proteins to which the individual has been sensitized.

(27) "low-level disinfection" means a process capable of inactivating most bacteria, some viruses and fungi but not bacterial spores or My cobacterium tuberculosis var. bovis. Examples of low-level disinfectants are quaternary ammonium compounds and certain iodophors or phenolics. Like intermediate-level products, low-level disinfectants are regulated by the EPA and are appropriate for disinfecting environmental or medical equipment (non-instrument) surfaces.

(28) "mechanical/visible indicators" means monitoring devices built into a sterilizer, such as indicating thermometers, recording thermometers, pressure gauges and automatic controls, which are used to assist in identifying and preventing malfunctions and operational errors and for record keeping purposes.

(29) "needle" means the wire filament which is inserted into the hair follicle for application of current in electrology. Needles are critical items and are single-use, pre-sterilized and disposable.

(30) "non-critical items" means instruments or environmental (equipment and housekeeping) surfaces that will come in contact only with intact skin. Indifferent electrode and epilator cords are examples of non-critical instruments used in electrology. If properly cleaned and maintained, these surfaces carry relatively little risk of transmitting infection directly or indirectly to patients/clients.

(31) "non-intact skin" means skin in which there is a break in the skin's natural integrity (e.g., post epilation of hair, needle stick, etc.).

(32) "packaging" means a generic term including all types of containment, such as woven or non-woven wraps, paper or film pouches or rigid container systems.

(33) "plain soap" means a detergent-based cleanser without antimicrobial additives used for the primary purpose of physical removal of dirt and transient microorganisms. Soap is used in hand washing to suspend microorganisms and allows them to be rinsed off.

(34) "protective disposable barriers" means a disposable, moisture-resistant covering, which reduces the potential for contaminating environmental or medical device surfaces that may be difficult or inconvenient to clean and disinfect routinely, e.g., tables and pillows, or hard-to-clean surfaces such as light handles and epilator surfaces.

(35) "reprocessing" means the process of cleaning, disinfecting or sterilizing a reusable instrument that has been used or contaminated in order that it be made safe for its intended use.

(36) "semi-critical items" means instruments that may come in contact with mucous membranes and non-intact skin, but do not ordinarily penetrate body surfaces. Tips for epilator needle and anaphoresis/cataphoresis rollers are an example of semi-critical items used in electrology.

(37) "sharps container" means a specially manufactured and labeled, leak-proof, rigid, puncture-resistant, durable plastic container into which needles are placed after use and designed to be disposed of as an item of regulated medical waste.

(38) "sterility assurance file" means the record which contains the sterilizer maintenance and use log and culture reports from each biological monitor.

(39) "sterilization" means the process which destroys all forms of microbial life. The recommended methods of sterilization of instruments and items used in the practice of electrology are the dry heat sterilizer or the autoclave. These methods are standardized and can be routinely monitored for effectiveness.

(40) "tips for epilator needle" means the cap or plastic tip that surrounds the base of the needle and covers the pin device where the needle shank is seated. Tips for epilator needle holders are semi-critical items.

(41) "ultrasonic cleaner" means a processing unit that transmits ultrasonic waves through the cleaning solution in a mechanical process known as cavitation. The sound waves produce tiny air bubbles on instrument surfaces. Ultrasonic cleaning is particularly effective in removing soil deposits from hard-to-reach areas.

Section 4.6 OVERVIEW OF STANDARDS

A. Electrology should be viewed as a superficially invasive procedure when developing standards for patient/client safety. Needles used in electrology treatments penetrate the skin and can become contaminated with blood, serum, or other material. Electrology procedures do not routinely penetrate to sterile tissue although there are occasions where the needles and other devices make contact with blood. Therefore, all needles used in electrology procedures should be single-use, pre-sterilized, and disposable.

B. Other procedures, such as removing ingrown hair, result in blood contamination of instruments and can result in contamination of related surfaces. All reusable critical instruments shared between the patient/clients are sterilized using a standard method that can be routinely monitored for effectiveness (e.g., dry heat sterilizer or autoclave). The intended use of the instrument or equipment will dictate whether or not sterilization is needed, or if disinfection is needed, which level of disinfection is appropriate.

C. Thorough cleaning of instruments and other surfaces must precede either sterilization or disinfection procedures. Instruments that do not encounter blood or sterile tissue during use do not routinely require sterilization. A fresh pair of non-sterile, medical grade, disposable examination gloves should be worn by the electrologist during the treatment procedure of each patient/client. A proper hygienic environment should be maintained and infection control procedures followed to minimize the risk of transmission of infectious diseases between the practitioner and the patient/client.

Part 5 Infection Control Standards and Recommended Procedures

Section 5.1 STANDARDS FOR HAND WASHING

Hand Washing is one of the most important procedures for preventing the transmission of infections.

A. Hands are washed:

(1) Before and after treatment of each patient/client.

(2) Before donning gloves and immediately after gloves are removed.

(3) Immediately if accidental bare-handed contact with blood, body fluids, secretions, excretions, non-intact skin, mucous membranes or contaminated equipment occurs.

B. Hand washing technique includes:

(1) Use of plain soap and water; Reusable liquid containers are cleaned and dried before being refilled with fresh soap;

(2) A vigorous rubbing together of all surfaces of lathered hands, especially between fingers and fingernail areas, for 10 to 15 seconds;

(3) A thorough rinsing under a stream of water;

(4) Hands are dried thoroughly with a clean disposable paper towel;

(5) Faucets are turned off with the paper towel;

(6) Paper towel is disposed of in the appropriate receptacle located in the treatment room.

C. Alcohol based waterless handrubs may be used instead of soap and water only if hands are NOT visibly soiled.

Section 5.2 USE OF GLOVES

A. A fresh pair of non-sterile, medical grade, disposable examination gloves is worn during the treatment of each patient/client. Gloves are disposed of in the appropriate receptacle located in the treatment room.

B. Hands are washed in accordance with the above hand washing standards before putting on gloves and immediately after gloves are removed.

C. Power-free, reduced protein latex gloves or vinyl gloves are worn.

Section 5.3 DETERMINE PATIENT/CLIENT ALLERGIES BEFORE WEARING LATEX GLOVES

Several factors have been linked with latex sensitization, including the presence of allergic conditions (e.g., asthma, eczema, hay fever), allergy to cosmetic powders or foods, and frequency or duration of glove use/exposure.

Section 5.4 COORDINATION OF INSTRUMENTS

Coordinate necessary sterilized instruments and supplies needed for each treatment in a manner whereby adherence to aseptic technique is maintained with minimal modes and sources of contamination. Caution should be taken to avoid puncture injuries from instruments.

Section 5.5 CLEANING AND STERILIZING INSTRUMENTS/ITEMS AND OTHER SAFETY PRECAUTIONS

A. Needles are critical items and are:

(1) Single-use, pre-sterilized, and disposable.

(2) Stored in a manner that will maintain sterile condition of contents, away from wetness or humidity extremes.

(3) Not recapped, bent, or otherwise manipulated by hand prior to disposal to avoid accidental puncture injury.

(4) Placed in a sharps container:

(a) immediately after use;

(b) when opened and found damaged; and

(5) The sharps container is securely sealed and disposed of as specified by state and local health regulations.

B. Forceps and other instruments that are critical items are cleaned and then sterilized before initial use and after use on the patient/client to make safe for use during the next patient/client encounter. Unused instruments in packaging or containers that have been opened are reprocessed after a 24-hour period. Instruments contaminated before use (e.g., dropping or touching an unsterile surface) are reprocessed before use. For processing:

(1) Forceps and other instruments are accumulated in a covered holding container by submersion in a solution of a protein-dissolving enzyme detergent and water, following manufacturer's instructions for dilution.

(2) The holding container is held under warm running water to rinse off detergent and debris and drained.

(3) Forceps and other instruments are placed in the basket of an ultrasonic cleaning unit containing a fresh solution of protein-dissolving enzyme detergent, following manufacturer's instructions for dilution and immersion time.

(4) Basket is removed from ultrasonic unit, rinsed under running water and drained. Forceps and other instruments are dried with disposable paper towels.

(5) Forceps and other instruments are packaged individually or in small multiples for the sterilization process.

(6) Place packaged instruments in an autoclave or dry heat sterilizer with chemical indicator. Sterilize according to manufacturer's instructions.

(7) After processing, packaged instruments are stored in a clean, dry, covered container which prevents the contents from coming into contact with dust, moisture, unnecessary touching and soil.

C. Transfer forceps and their holding containers are cleaned and dried daily and whenever visibly contaminated.

D. Tips for epilator needle holders are semi-critical items and are processed before initial use and after use on the patient/client to make safe for use during the next patient/client encounter. Tips for epilator needle holders contaminated before use (e.g., dropping or touching an unsterile surface) are reprocessed before use.

E. For processing:

(1) Accumulate tips in a covered holding container by submersion in a solution of a protein-dissolving enzyme detergent and water.

(2) The holding container is held under warm running water to rinse off detergent and debris and drained.

(3) Place tips in the basket of an ultrasonic cleaning unit containing a fresh solution of protein-dissolving enzyme detergent, following manufacturer's instructions for dilution and immersion time.

(4) Basket is removed from ultrasonic cleaning unit, rinsed under running water and drained. Tips are dried with disposable paper towels.

(5) Package tips individually or in small multiples for sterilization; or submerse in a freshly made solution of 1 part household bleach to 99 parts water for 10 minutes and rinse under running water if damaged by heat. Dry bleach treated tips with disposable paper towels.

(6) After processing, tips are stored in a clean, dry, covered container which prevents the contents from coming into contact with dust, moisture, unnecessary touching and soil.

F. Anaphoresis/cataphoresis rollers are semi-critical items and are stainless steel. Between each treatment, anaphoresis/cataphoresis rollers are cleaned, dried and sterilized in the same manner as forceps.

G. Indifferent electrodes are non-critical items and are cleaned, dried and subjected to low-level disinfection after each treatment.

H. All containers and their removable parts, used during the cleaning procedure, are cleaned and dried daily and whenever visibly contaminated. The interior chamber of the ultrasonic cleaning unit is emptied, washed and dried daily. Follow manufacturer's instructions for cleaning and maintenance of equipment.

I. Cleaned, dried instruments and items are sterilized by either of the following methods:

(1) Dry heat. The following time-temperature relationships are recommended, or other time-temperature relationships recommended by the manufacturer of the unit:

a) 340 [degrees] F (170 [degrees] C) - 1 hour.

b) 320 [degrees] F (160 [degrees] C) - 2 hours.

(2) Autoclave (steam under pressure). The following time-temperature-pressure relationship is recommended, or other time-temperature-pressure relationships recommended by the manufacturer of the unit:

a) 15-20 minutes at 121 [degrees] C (250 [degrees] F); 15 psi (pounds per square inch) for packaged instruments and items.

b) The above temperature and exposure times for dry heat sterilizers and autoclaves relate only to the time of exposure after attainment of the specific temperature and do not include a penetration or heat-up lag time. Exposure time does not include drying and cool-down time. Follow the manufacturer's instructions for the unit used if times and temperatures differ from those given above.

J. Autoclaves and dry heat sterilizers are loaded, operated and maintained according to manufacturer's instructions. The interior of these devices is cleaned according to the manufacturer's instructions. Sterilizers must have visible physical indicators (e.g., thermometers, timers). Chemical (i.e., color change) indicators are used on each package, and optionally, placed inside packages containing multiple instruments. Chemical indicators should be visible on the outside of each package sterilized. This only indicates items have been exposed to a sterilization process, it does not guarantee sterility. Biological indicators are used no less than once a month (per sterilizer) according to manufacturer's instructions to ensure proper mechanical function. Lab reports with testing results are filed in a permanent Sterility Assurance file.

K. Each office where electrology is practiced shall have a blood spill kit readily available.

Section 5.6 CONTROL MEASURES FOR STERILIZATION

To assure the highest level of patient/client safety, needles must be single use, pre-sterilized, and disposable. All instruments that will penetrate tissue should be either pre-sterilized disposable or thoroughly cleaned and then sterilized before reuse to reduce the risk of transmission of infection and disease.

Section 5.7 CONTROL MEASURES FOR STERILIZATION

The endodontic dry heat sterilizer (glass bead sterilizer) is no longer cleared to market by the Food and Drug Administration (FDA). The FDA Dental Device Classification Panel has stated that the glass bead sterilizer presents "a potential unreasonable risk of illness or injury to the patient because the device may fail to sterilize dental instruments adequately." The endodontic dry heat sterilizer (glass bead sterilizer) should not be used in the practice of electrology.

Section 5.8 CONTROL MEASURES FOR STERILIZATION

Some highlevel disinfectants, including glutaraldehydebased germicides, are not recommended as an applicable method of sterilization of instruments and items, based on their toxicity level, instability, and impracticality Sterilization with liquid chemical germicides is not capable of being biologically monitored If a medical device is heatstable, the proper method of reprocessing is by using a heatbased method such as a steam autoclave or dry heat oven.

Carbon rollers are porous and cannot be sterilized or disinfected, therefore, they should not be used.

Section 5.9 CONTROL MEASURES FOR CLEANING

A meticulous physical cleaning is always done before sterilization or disinfection. For sterilization or disinfection, refer to the manufacturers' instructions for exposure times and conditions as well as recommendations for rinsing and subsequent handling of processed items.

Section 5.10 CONTROL MEASURES FOR DISINFECTING

Low-level and intermediate-level disinfectants used in the practice of electrology should be registered with the Environmental Protection Agency (EPA), whereas high-level disinfectants/liquid chemical sterilants are cleared by the Food and Drug Administration (FDA) for use in sterilizing or disinfecting medical and dental instruments. Disinfectants are to be used according to the manufacturer's instructions.

Section 5.11 USE OF CHLORINE SOLUTION

Bleach solutions used to process tips for epilator needle holders are freshly made by mixing one tablespoon household bleach to one quart tap water. Discard bleach solution after each use. See, appendix: Practice Considerations for rationale.

Section 5.12 STANDARDS FOR ENVIRONMENTAL CONTROL AND HOUSEKEEPING

A proper hygienic environment should be the goal of the electrologist and electrology instructor. A variety of microorganisms are normal contaminants of environmental surfaces, therefore, routine cleaning and removal of soil are recommended. Most microorganisms found on environmental surfaces are non-pathogens, but conscientious sanitation and disinfection techniques control cross-infection.

Section 5.13 ENVIRONMENTAL CONTROL

A. When a treatment session is interrupted, gloves are removed and discarded, and hands are washed before touching items or surfaces (i.e., telephone, computer, door knobs). Hands are washed and re-gloving with a fresh pair of gloves is done before resuming treatment.

B. Gloves are worn during the procedures of soaking, cleaning, rinsing, and drying of forceps and other instruments.

C. Torn or perforated gloves are removed immediately; hands are washed after gloves are removed and then re-gloved with fresh gloves.

Section 5.14 ENVIRONMENTAL CONTROL: DRAPES AND DISPOSABLES

A. Fresh, clean drapes are used on the treatment table or chair for each patient/client.

B. Drapes are stored in a closed cabinet.

C. Soiled disposable items are discarded into a container lined with a plastic bag, securely fastened when ready for disposal, and disposed daily into the regular trash, unless otherwise specified by state and local health regulations.

D. Reusable containers used for dispensing antiseptics and other solutions and products are not refilled before being cleaned and dried. Creams, lotions, and ointments that are dispensed from original containers, are to be used in a sanitary manner, then disposed of when empty.

E. Epilator needle holders and any cords in direct contact with the patient/client and/or practitioner are cleaned with detergent and water, and treated with a low-level disinfectant after each treatment. Follow manufacturer's instructions for use of chemical disinfectants.

F. Any surfaces that are touched during treatment, such as magnification lamps, lighting devices and epilator controls are covered with a protective disposable barrier or disinfected after each treatment according to manufacturer's instructions. The protective disposable barrier is removed, discarded and replaced between each patient/client.

G. After each use, patients/client eyeshields are cleaned with detergent and water, then rinsed and dried.

Section 5.15 HOUSEKEEPING

A. A hospital-grade disinfectant registered with the Environmental Protection Agency (EPA) is used for cleaning environmental surfaces.

B. All other environmental surfaces in the treatment room are kept in a state of visible cleanliness by using a hospital-grade disinfectant/detergent designed for general housekeeping purposes as indicated on the product label after initial cleaning with water and detergent.

Section 5.16 CONTROL MEASURES FOR ENVIRONMENTAL CONTROL AND HOUSEKEEPING

A. Adequate levels of safety for surfaces of medical equipment (non-critical surfaces) may be achieved by simple washing or scrubbing with detergent and warm water or, depending on the equipment surface and the nature and degree of contamination, cleaning followed by an application of an intermediate- to low-level chemical germicide. Follow manufacturer's instructions for application and exposure times of disinfectant products.

B. Cleaning schedules and methods vary according to the type of surface to be cleaned and the amount and type of soil present. Counter tops should be of smooth, non-porous material and should be cleaned daily, taking special care in the areas where the procedures of cleaning and sterilizing instruments and items takes place. Items on counter tops should be maintained in a sanitary manner. Sinks and toilet facilities should be cleaned daily. Environmental surfaces in the treatment room should be cleaned on a regular basis. Equipment surfaces, doorknobs, telephones, and treatment tables should be cleaned on a regular basis. Floors and carpets should be vacuumed and cleaned regularly. Walls, blinds and curtains should be cleaned when visibly soiled.

Section 5.17 STANDARDS FOR PATIENT/CLIENT CONSIDERATIONS

A. Standard Precautions are consistently used for all patient/clients.

B. A complete past and current health history assessment is obtained from each patient/client prior to treatment. The patient/client's health status should be updated and evaluated on an on-going basis and referred to an appropriate physician as indicated. See, limitations listed in section 5.25.

C. The patients/client's skin is evaluated prior to each treatment and referred to an appropriate physician if indicated.

Section 5.18 PRE AND POST-TREATMENT OF SKIN SITE

A. Before treatment, the skin site is cleansed using soap and water then wiped with an antiseptic skin preparation.

B. After treatment, the skin site is wiped with an antiseptic product.

C. Patient/clients are instructed on appropriate post-treatment care to promote healing of the treated skin site.

Section 5.19 CONTROL MEASURES FOR PATIENT/CLIENT CONSIDERATIONS

An assessment of the skin site and examination for signs of infection or rashes should take place prior to each treatment. Treatment should be delayed if actual or potential signs or symptoms of infection are present. The practitioner should refer the patient/client to an appropriate physician when evaluation of health history or skin assessment indicates.

The general health status of the patient/client may be a predisposing factor in susceptibility to infection and normal healing. Professional interpretations require careful observation and good judgment.

Section 5.20 HEPATITIS B VIRUS (HBV) VACCINATION

A. Practitioners and electrology students should be immunized against hepatitis B virus (HBV).

B. Practitioners should contact their personal physician for appropriate immunization against hepatitis B.

Section 5.21 FOLLOW-UP PROCEDURES FOR POTENTIAL EXPOSURES TO HEPATITIS B AND C HIV, AND OTHER BLOODBORNE PATHOGENS

A. Health care workers who have percutaneous or mucous membrane exposure to blood and other body fluids are at risk for infection, including HBV, HCV and HIV infection. The Centers for Disease Control and Prevention (CDC) concludes in a continuing study that, while HIV infection is a real risk to health care workers, the risk is low and can be minimized by taking appropriate precautions.

B. Identified risk factors for HIV and HCV transmission are almost identical to those for HBV transmission. Despite the similarities in modes of transmission, the risk of HBV infection in health care settings far exceeds that for HIV or HCV infection.

Section 5.22 PUNCTURE INJURY PROTOCOL

A. Remove and discard gloves.

B. Wash exposed surface with running water and soap. If wound is bleeding, allow to bleed.

C. After thoroughly cleaning the wound, apply an antiseptic product.

D. Immediate contact is made to practitioner's personal physician for appropriate consultation, and for necessary post-exposure strategies.

E. Documentation of the exposure is made including: date, route of exposure, circumstance under which exposure occurred, name of source patient/client, HIV and/or hepatitis status of source patient/client, status of practitioner's testing, follow-up testing and any necessary post-exposure prophylaxis.

Section 5.23 CONTROL MEASURES FOR FOLLOW UP PROCEDURES

A. Careful clinical skills should be practiced and Standard Precautions followed to prevent puncture injury or mucous membrane exposure to blood.

B. Proper management of exposures is necessary including first-aid measures, medical follow-up including, where possible, collection and testing of blood of source person and exposed person, necessary prophylaxis and written documentation.

C. In the event of exposure to blood and body fluids containing visible blood, the steps recommended in Rule 5.24 should be followed. See, appendix: Practice Considerations for discussion of precautions rationale.

Section 5.24 STANDARD PRECAUTIONS ARE APPROPRIATE FOR THE CARE OF ALL PATIENT/CLIENTS DURING ELECTROLOGY TREATMENTS

Wash hands BEFORE and AFTER each patient/client contact.

Wear gloves when touching blood, body fluids, secretions, excretions, contaminated items, mucous membranes and non-intact skin.

Take care to prevent puncture injuries when using instruments during and after procedures; when cleaning instruments; and when disposing of used needles.

Use adequate procedures for routine care, cleaning, and disinfection of environmental surfaces, and other frequently touched surfaces.

Section 5.25 LIMITATIONS ON PRACTICE

A. An electrologist may not perform treatments or provide services which the electrologist is not qualified to perform or which are beyond the scope of the electrologist's education, training, capabilities, experience, and scope of practice.

B. An electrologist shall obtain additional training, information, and supervision as needed to perform a new electrology technique or service in a new specialty area, or when employing a new treatment modality.

C. An electrologist shall maintain current qualifications to practice electrology and satisfy continuing education requirements established in these rules.

D. Areas of the body which shall not be treated by electrolysis are:

Mucous membranes;
External auditory canal of the ear;
Areolae and nipples of the breasts;
Breasts of nursing women;
Tissues of the nostrils.
Eyelids.

E. Electrologists shall not treat conditions where electrology procedures are contraindicated by current accepted standards of practice. Such conditions include:

Warts;
Moles;
Ingrown eyelashes;
Spider telangiecrasias and angiomas;
Cutaneous papilloma (skin tags);
Impetigo or any other contagious skin disease;

Skin malignancy;

Any area which appears to be infected or inflamed.

F. An electrologist may treat patients with certain conditions if he or she first obtains written authorization to do so from the patient's physician. Such conditions include:

Hair in moles;
Cardiac disorders for which the patient has a pacemaker;
Coagulation disorders and/or disorders which are treated with drugs having anti-coagulant effects.

Part 6 Continuing Education

Section 6.1 MINIMUMS

All persons certified to practice electrology must complete a minimum of 10 hours of continuing education during the two-year certification period and must report these hours at the time of certificate renewal. After January 1, 2005 the continuing education requirement will not apply for the first period in which a person obtains certification. It will apply to the period after the first renewal.

Section 6.2 APPROVED COURSES

A. The Director will approve a course, seminar, or speaker session for continuing education credit if it is:

(1) Relevant to the theoretical or clinical aspects of electrology; or is;

(2) Offered by one of the following entities:

(a) A college or university approved by the Vermont Department of Education;

(b) A state or national professional electrology association;

(d) A director-approved electrology institution.

B. If a course is not listed in section (a) of this rule, an electrologist may request that the Director approve the course by submitting in writing, at least 60 days in advance of the course registration date, the following information on an application form provided by the Director:

(1) Title, location, and date of the course;

(2) Sponsoring agency;

(3) Course objective and content;

(4) Hours of study;

(5) Name of each instructor; and

(6) Educational background and experience of each instructor.

C. The Director shall notify the electrologist by mail of the decision as to whether the course is approved.

D. A change in subject matter, length, or instructor of a course requires approval by the Director.

Section 6.3 FAILURE TO OBTAIN PRIOR APPROVAL

If an electrologist has not received prior approval for continuing education credits for a course under Rule 6.2(B) above by November 15 of the licensure renewal year, the director may deny recognition of the credits claimed.

Part 7 Duty to Report Changes

Section 7.1 An electrologist shall notify the Office in writing within 30 days of the following

An electrologist shall notify the Office in writing within 30 days of the following:

A. a change in the licensee's name;

B. a change to the licensee's business address;

C. a change to the licensee's business telephone number;

D. the conviction of any offense in a District or Superior Court in Vermont or court outside Vermont.

Part 8 Unprofessional Conduct

Section 8.1 An electrologist shall notify the Office in writing within 30 days of the following

Unprofessional conduct means misusing a title in professional activities and any of the conduct listed in section 129a of Title 3, whether committed by a certified electrologist or an applicant Unprofessional conduct includes:

(a) Failing to comply with provisions of federal or state statutes or rules governing the practice of the profession,

(b) Failure to practice competently by reason of any cause on a single occasion or on multiple occasions may constitute unprofessional conduct. Failure to practice competently includes:

(1) performance of unsafe or unacceptable patient or client care; or

(2) failure to conform to the essential standards of acceptable and prevailing practice.

Section 8.2 DISCIPLINARY PROCEDURE

Hearings on charges of unprofessional conduct are held before an administrative law officer appointed by the Secretary of State. Copies of rules and statutes governing disciplinary proceedings are available from the Director. A party aggrieved by a decision of an administrative law officer may, within 30 days of the decision, appeal by filing a written notice with the Director in the manner provided in Vermont Rules of Appellate Procedure 3 and 4. A check for the court filing fee, made payable to the Clerk of the Washington Superior Court, must accompany the filing fee. The appeal shall be decided by Washington Superior Court on the basis of the record before the administrative law officer. Any request for a stay pending appeal should be filed with the Washington Superior Court.

Section 8.3 SANCTIONS FOR UNPROFESSIONAL CONDUCT

After a hearing, and upon a finding of unprofessional conduct, sanctions may include, but are not limited to, fine of up to $ 1,000 for each violation, refusal to grant or renew certification, suspension or revocation or imposing limitations or conditions, obtaining injunctions, issuing warnings and other similar sanctions.

Appendix. Electrology Practice Considerations.

Some practice considerations taken from the American Electrology Association provide the rationale for the rules above.

Cleaning:

Cleaning is the basic first step for all decontamination. Cleaning physically removes debris and reduces the number of microorganisms present. Cleaning is the removal of organic material or soil from objects and is usually done by using detergent and water. Generally, cleaning is designed to remove rather than kill microorganisms. Technology has provided cleaning products and devices that are especially appropriate for the cleaning of instruments used in electrology.

Use of Gloves:

The consistent wearing of gloves will decrease the risk of potential exposure. Wearing gloves will also protect the patient/client from potential exposure to the microbial flora of the electrologist, including blood-borne organisms should there be cuts, scrapes, or micro-lesions on the electrologist's hands. When gloves are worn, hand washing is also recommended because gloves may become perforated during use and because bacteria can multiply rapidly on gloved hands. Torn or perforated gloves should be removed immediately and hands washed after gloves are removed.

If one chooses latex gloves, powder-free gloves with reduced protein content are suggested. Such gloves reduce exposure to latex protein and thus reduce the risk of latex allergy. When wearing latex gloves, do not use oil-based hand creams or lotions (which can cause glove deterioration) unless they have been shown to reduce latex-related problems and maintain glove barrier protection.

Washing gloves during the treatment of the same patient/client is not recommended. Washing with surfactants may cause "wicking"; i.e., the enhanced penetration of liquids through microscopic holes in the gloves that would not otherwise leak. Disinfecting agents or oils may cause deterioration of glove material. Wearing gloves will not guarantee absolute protection as gloves may have micro tears.

Use of Chlorine:

Chlorine solutions in concentrations of 0.05 to 0.5% free chlorine are generally considered to be intermediate-level disinfectants for specific site disinfection. Solutions of 0.5% (household bleach contains approximately 5% sodium hypochlorite) have broad-spectrum germicidal activity, and exhibit sporicidal activity, are tuberculocidal, inactivate vegetative bacteria, and are fungicidal and virucidal. Klein and Deforest (1965) reported that all of 25 viruses were inactivated in 10 minutes by as little as 0.02%) available chlorine.

Standard Precautions:

Standard Precautions as Recommended by the Centers for Disease Control and Prevention (CDC)

A. Standard Precautions appropriate to the practice of electrology are included above. These precautions as included in the Standards should be performed universally for all patient/clients.

B. Standard Precautions are designed to reduce the risk of transmission of blood-borne pathogens and reduce the risk of transmission of pathogens from moist body substances. Standard Precautions apply to all patient/clients receiving treatment, regardless of their diagnosis or presumed infection status. Standard Precautions apply to (1) blood; (2) all body fluids, secretions, and excretions, regardless of whether or not they contain visible blood; (3) non-intact skin; and (4) mucous membranes.

C. Standard Precautions are intended to prevent parenteral, mucous membrane, and non-intact skin exposures of health care workers to blood-borne pathogens. In addition, immunization with HBV vaccine is recommended as an important adjunct to Standard Precautions for health care workers who have accidental exposures to blood.

Hepatitis B:

The Centers for Disease Control and Prevention (CDC) report that HBV infection is a major infectious occupational hazard for health care workers. They risk hepatitis B virus (HBV) exposure if their tasks involve contact with blood or blood-contaminated body fluids. The risk of acquiring HBV infection from occupational exposures is dependent on the frequency of percutaneous and permucosal exposures to blood or blood products.

Risks among health care professionals vary during the training and working career, but are often highest during the professional training period. For this reason, when possible, vaccination should be completed during training in schools before workers have their first contact with blood.

Other Resources and Suggestions:

In addition to familiarity with Exposure Control Procedures, practitioners should refer to the Centers for Disease Control's "Exposure to Blood: What Every Health Care worker needs to know" found at http://www.cdc.gov/ncidod/hip/Blood/Exp_to_Blood.pdf for the most up to date information on exposure procedures. Note: If information differs from information contained in these rales, follow these guidelines. See also, http://www.cdc.gov/ncidod/hip/Blood/UNIVERSA.HTM for information on universal precautions for prevention of transmission of HIV and other blood borne infections.

Environmental Controls:

Hospital-grade disinfectants registered with the Environmental Protection Agency (EPA) should be used for environmental surface cleaning. Product labels give the EPA registration number and should give adequate safety and precautionary information. Manufacturer's instructions on the use of the product should be followed. Information on specific manufacturer label claims and the classification of disinfectants can be obtained by writing the Anti Microbial Division, EPA 751OC, Office of Pesticides Programs, 401 M Street SW, Washington, DC 20460. http://www.epa.gov/.

History

STATUTORY AUTHORITY: 26 V.S.A. § 4404
EFFECTIVE DATE: October 11, 2003 Secretary of State Rule Log #03-039
AMENDED: June 1, 2015 Secretary of State Rule Log #15-015

Chapter 380 ADMINISTRATIVE RULES FOR NATUROPATHIC PHYSICIANS

04-380 Code Vt. R. 04-030-380-X ADMINISTRATIVE RULES FOR NATUROPATHIC PHYSICIANS

Part 1 GENERAL INFORMATION ON LICENSURE OF NATUROPATHIC PHYSICIANS

Section 1.1 The Purpose of Licensure

To protect the public health, safety and welfare, the Vermont Secretary of State has the duty to license and regulate naturopathic physicians. Vermont Statutes Annotated Title 26, Chapter 81("Chapter 81").

Section 1.2 Laws That Govern Licensure

Chapter 81 governs the issuance of licenses and the regulation of professional practice for naturopathic physicians. Chapter 81 also authorizes rulemaking authority to carry out these regulatory duties. In enforcing Chapter 81, the Director of the Office of Professional Regulation (the "Director") follows the Administrative Procedure Act (Vermont Statutes Annotated, Title 3 §§ 801-849), Vermont Open Meeting Law (Vermont Statutes Annotated, Title 1 §§ 311-314), Access To Public Records (Vermont Statutes Annotated, Title 1 §§ 315-320), and Professional Regulation (Vermont Statutes Annotated, Title 3 §§ 121-131).

These laws set forth the rights of applicants, licensed naturopathic physicians, and the public. The complete text of these laws is available at most libraries and town clerks' offices. "Vermont Statutes Online" is available at http://www.leg.state.vt.us. The text of statutes and administrative rules governing naturopathic physician practice is available at http://www.vtprofessionals.org.

Part 2 INFORMATION FOR APPLICANTS

Section 2.1 Application

Applications and information about licensure requirements are available from the Office of Professional Regulation ("Office"). An applicant must submit a completed application form with all supporting documentation and the fee to the Office.

The Office reviews applications only after the supporting documentation is received, including evidence of a degree and examination results, as required in Rule 2. 2, or evidence of a license in another jurisdiction and its licensing standards, as required by 26 V.S.A. § 4129.

Initial licenses issued within 90 days of the renewal date will not be required to renew or pay the renewal fee. The license will be issued through the next full license period. Applicants issued an initial license more than 90 days prior to the renewal expiration date will be required to renew and pay the renewal fee.

Section 2.2 Qualifications for Licensure as a Naturopathic Physician

(a) Degree requirement: The degree required is a doctoral degree in naturopathic medicine from a program accredited by the Council on Naturopathic Medical Education (CNME), or a degree determined by the Director to be essentially equivalent and which meets educational standards essentially equivalent to those established by the CNME.

(b) Licensing Examination: The Director, or the Director's designee, administers a written examination on naturopathic medicine. The Director currently uses the Naturopathic Physicians Licensing Examinations (NPLEX). To be eligible for licensure as a naturopathic physician in Vermont, an applicant must have passed the NPLEX and the Minor Surgery Clinical Elective Examination. The passing score and the minimal competency requirements for the NPLEX are established by NPLEX. The Director, or the Director's designee, shall administer the licensing examination at least twice a year at a time and place set well in advance.

(c) Applicants under this section who have not actively practiced the profession or who have not been enrolled in an approved naturopathic program during the two years immediately preceding the submission of their application must complete the continuing education requirements required by Rule 3.2 prior to receipt of a Vermont license.

Part 3 INFORMATION FOR NATUROPATHIC PHYSICIANS

Section 3.1 Renewing Licensure Biennially

Licenses renew on a fixed biennial schedule: September 30 of the even-numbered years.

Before the expiration date, the Office will mail a renewal application and notice of the renewal fee to the latest address on file with the Office. A license will expire automatically within 14 days if the renewal application and fee are not returned to the Office by the expiration date.

Licensees possessing a special license endorsement to practice naturopathic childbirth must submit proof of current cardiopulmonary resuscitation certification for adults and newborns and for neonatal resuscitation biennially, with each license renewal. See Rule 3.7(b) below. Such licensees must also file with the Director a written plan for consultation with other health care providers for emergency transfer and transport of an infant or a maternity patient, or both, to an appropriate health care facility. The written plan must be submitted to the Director on an approved form with the initial application for the naturopathic childbirth special license endorsement and with subsequent renewals. See Rule 3.7(d) below.

Section 3.2 Continuing Education Requirements

(a) As a condition of license renewal, naturopathic physicians must complete a minimum of 30 hours of continuing education during the two-year renewal period and must so certify at the time of license renewal. The continuing education requirement does not apply for the renewal period during which a naturopathic physician initially obtained licensure. It will begin with the first full two-year renewal period. Licensees who complete more than the required 30 hours of continuing education may carry-over a total of 10 (ten) hours of continuing education from the preceding licensure renewal period. Licensees seeking the special license endorsement for prescription medications pursuant to 26 V.S.A. § 4125(d) may apply credits from the Medical Pharmacology course, or a substantially equivalent course approved by the Director, described in Rule 3.5(a) for two (2) renewal cycles.

(b) A continuing education program means classes, institutes, lectures, conferences, workshops, naturopathic journals, scientific journals, audio, video, or online presentations, and preceptorships. A program shall consist of study covering new, review, experimental, research and specialty subjects within the scope of practice of naturopathic medicine. Excluded are programs that promote a company, individual, or product and programs on practice economics. However, courses specifically dealing with medical workers compensation or medical recordkeeping in the context of practice economics are acceptable.

(c) A physician-level continuing medical education course is acceptable as a continuing education program. A course is considered physician-level if presented by a physician or other medical professional to a predominantly physician audience. Once a continuing education provider is approved by the Director, the continuing education activity sponsored by that provider is approved for credit and no application to the Director must be made for approval. The Office shall maintain a List of Approved Providers which may be obtained from the Office's web site at http://vtprofessionals.org/.

(d) Licensees possessing the special license endorsement for prescription medications must complete 10 hours biennially in the pharmacology of legend drugs.

(e) Licensees possessing a special license endorsement to practice naturopathic childbirth must complete 15 hours biennially in naturopathic childbirth. A course in neonatal resuscitation may count toward these 15 hours. Ten of the 15 hours may be applied to general requirements for continuing education.

(f) At the time of license renewal, each licensee must certify on the official renewal form that he or she has complied with the continuing education requirements. The Office may randomly audit licensees to ensure compliance. A licensee who is audited will be notified in writing by the Office and will be required to produce documentation verifying successful completion of the 30 hours of continuing education during the two-year period at issue. A licensee must maintain documentation for at least two years following the renewal period at issue. The Director may require a licensee who cannot produce satisfactory evidence of successful completion to develop and complete a specific corrective action plan within 90 days, prior to renewal.

Section 3.3 Change of Name or Address

A licensee is responsible for notifying the Office promptly of any changes in name, mailing address, business address or other relevant contact information. See 3 V.S.A. § 129a(a)(14).

Section 3.4 Professional Standards

Naturopathic physicians may be disciplined for unprofessional conduct pursuant to 26 V.S.A. § 4132(a) and 3 V.S.A. § 129a.

Section 3.5 Special License Endorsement for Prescription Medications

(a) The naturopathic pharmacology examination, defined at 26 V.S.A. § 4121(13), the passage of which is required for the special prescriptive license endorsement pursuant to 26 V.S.A. § 4125(d), shall be the National Board of Medical Examiners ("NBME") subject matter examination in pharmacology, or the examination(s) given in the Medical Pharmacology course taught within the Department of Pharmacology through Continuing Medical Education at the University of Vermont's College of Medicine, or a substantially equivalent examination approved by the Director after consultation with the Commissioner of Health. In order to obtain the special license endorsement which shall authorize a naturopathic physician to prescribe, dispense, and administer prescription medicines, an otherwise qualified naturopathic physician will be required to pass the NBME pharmacology examination, or the Medical Pharmacology course examination(s) at the University of Vermont, or a substantially equivalent examination approved by the Director, after consultation with the Commissioner of Health. Approval for a substantially equivalent examination may be obtained by applying to the Office at anytime but no later than 90 days before the alternate course begins.

(b) For no less than one year after receiving the special license endorsement, and until the first one hundred (100) drug prescriptions are issued, prescriptions shall be reviewed by an objective and independent supervising physician licensed under Chapter 23 or 33 of Title 26, or a naturopathic physician licensed under Chapter 81 of Title 26. The supervising physician shall possess an unencumbered license and have been prescribing and administering prescription drugs without limitation for five years or more in Vermont. The supervising physician shall evaluate the naturopathic physician's ability to:

(1) safely prescribe and administer prescription drugs within the naturopath's scope of practice;

(2) comply with federal and state statutes; and

(3) comply with the applicable administrative rules of the Vermont Board of Pharmacy.

(c) The naturopathic and supervising physicians shall have a formal written agreement. The agreement shall address the requirements of subsection (b) of this rule. The agreement shall be available for inspection upon request by the Office.

(d) A naturopathic physician who satisfies the supervision requirement in subsection (b) of this rule shall notify the Office that this requirement has been met and file a certificate of completion signed by the supervisor.

(e) The Director may waive the prescription review requirement in subsection (b) of this rule if the newly endorsed naturopathic physician can show that they have substantial experience in prescribing prescription medicines under the laws of another jurisdiction that has standards and qualifications for a naturopathic physician to prescribe prescription medications at least equal to those required under these rules.

(f) The use of prescription medications in a manner that has not been approved by the FDA is referred to as "off-label." In addition to the use of prescription medications in a manner approved by the FDA, a naturopathic physician who has appropriate competency, training and experience may prescribe medications in an "off-label" manner in conformance with generally accepted standards of practice, including safety and efficacy, for both allopathic and naturopathic physicians.

Section 3.6 Advertising

(a) 26 V.S.A. § 4122 lists five designations that a naturopathic physician licensed in Vermont may use. The five designations are: N.D., Doctor of Naturopathic Medicine, Naturopathic Doctor, Doctor of Naturopathy, and Naturopathic Physician. Licensees must prominently feature at least one of the five designations in any advertising.

(b) A licensee who complies with the law in this way may then use the designation "Dr." in the advertisement. The purpose of this rule is to prevent deceptive advertising and to inform the public that the licensee is a naturopathic physician licensed under Title 26, Chapter 81 and not another health care licensee.

(c) The terms "board certified" and "diplomate" imply that the licensee has completed an advanced level of training. A licensee advertising either term or similar terms must state the area of specialty, and the private credentialing organization that issued the specialty certification. The purpose of this rule is to provide the public with complete and accurate information about the licensee's credentials and level of training.

Section 3.7 Naturopathic Childbirth

No licensee may practice naturopathic childbirth without first obtaining a special endorsement on his or her license. To obtain this endorsement, a licensee must:

(a) Show evidence of completion of a naturopathic childbirth or midwifery program from an approved naturopathic college or hospital and furnish a signed log showing evidence that sections (1), (2) and (3) of this subsection have been completed under the direct supervision of a licensed practitioner with specialty training in obstetrics or natural childbirth.

(1) The licensee must have taken part in the care of 50 cases each in prenatal and postnatal care. One case may qualify for both areas of care.

(2) The licensee must have observed and assisted in the intrapartum care and delivery of 50 natural childbirths in a hospital or alternative birth setting 3 of which must have occurred within the last two years. A minimum of 26 of these births must be under the supervision of a naturopathic physician. No more than 10 of the 50 births may be under the supervision of a medical doctor (allopathic or osteopathic physician). No more than 10 of the births may be observation only. A labor and delivery that starts under the care of a naturopathic physician and includes hospitalization shall count as a birth.

(3) The course work must consist of at least 200 hours in naturopathic childbirth.

(b) Hold a current cardiopulmonary resuscitation certification for adults and newborns and for neonatal resuscitation. The Director will accept courses in external cardiopulmonary resuscitation which are approved by the Vermont Heart Association or the American Red Cross and for courses in neonatal resuscitation approved by the American Academy of Pediatrics (AAP).

(c) Pass a specialty examination in naturopathic childbirth approved by the Director. The Director, or designee, will administer the specialty examination in naturopathic childbirth at least once each year if applications are pending. A licensee may sit for this examination in another state and have the results of the examination transferred to this state.

(d) File with the Director a written plan for consultation with other health care providers for emergency transfer and transport of an infant or a maternity patient, or both, to an appropriate health care facility. Licensees must submit the plan to the Director on an approved form with the initial application for a naturopathic childbirth endorsement and with every subsequent renewal of the endorsement.

(e) Applicants under this section requesting a naturopathic childbirth endorsement who have not passed the naturopathic childbirth exam within the two years preceding the application shall show evidence of completion of the continuing education requirements required by this section.

(f) Licensees possessing a naturopathic childbirth endorsement must, as a condition of renewal:

(1) obtain 15 hours in naturopathic childbirth continuing education during each two-year renewal period. A course in neonatal resuscitation may count toward these 15 hours. Ten of the 15 hours may be applied to general requirements for continuing education. See Rule 3.2 above (continuing education requirements).

(2) submit proof of current cardiopulmonary resuscitation certification for adults and newborns and for neonatal resuscitation biennially, with each license renewal. See subsection (b) above.

(3) have performed 3 natural childbirths in the preceding two year renewal period.

(g) Licensing or disciplinary action by an Administrative Law Officer or judicial authority shall be deemed to have an equal effect upon a special endorsement to practice naturopathic childbirth issued to a licensee, unless specifically provided otherwise in the licensing or disciplinary action. When the subject of a licensing or disciplinary proceeding relates specifically to the practice of naturopathic childbirth by a licensee who possesses a special endorsement, the licensing or disciplinary action may, instead of affecting the entire scope of the licensee's practice, suspend, revoke, condition, or restrict only the licensee's authority under the special endorsement.

Section 3.8 Informed Consent for Naturopathic Childbirth

(a) Before accepting a client for prenatal and natural childbirth, the naturopathic physician must first obtain a written informed consent. Informed consent must be shown in a written statement and signed by the ND and the client to whom care is to be given, in which the ND certifies that full disclosure has been made and acknowledged by the client of the following:

(1) The naturopathic physician's credentials.

(2) A copy of the written plan for consultation, emergency transfer, and transport.

(3) A description of the procedures, benefits, and risks of home birth.

(b) The informed consent form must be filed in the client's chart, and a copy must be provided to the client.

Section 3.9 Scope and Practice Standards for Naturopathic Childbirth

(a) Prenatal Care:

(1) Information: The client will be presented accurate information conforming to the requirements of informed consent and also including but not limited to:

(A) Financial charges for services.

(B) Services the ND provides, and the advantages and disadvantages of home birth.

(D) Values and ethics of practice.

(E) Information on emergency consultation, transfer, and transport.

(F) Choices regarding prenatal lab testing, including but not limited to sexually transmitted diseases, blood type and antibody screen, CBC, rubella, HIV, Hepatitis B, and urinalysis.

(2) History and Physical Assessment: At the initial prenatal visit, a personal and health history will be obtained, including medical history, family history, current pregnancy history, nutritional history, and physical assessment, including review of systems and prenatal care.

(3) On-going Prenatal care: Will be conducted in such a way as to promote the health of the client and baby, screen for problems, develop a relationship with the client and family, exchange information, and do a physical assessment of the prenatal health.

(4) Prenatal visits should occur every four weeks through the 32 [nd ]week, every two weeks until the 36 [th ]week, and weekly thereafter. The prenatal visit includes:

(A) Physical evaluation including weight, blood pressure, urine screen, fetal heart tones, fundal heights, fetal growth, fetal position and presentation.

(B) Discussion during these visits includes: recent illnesses, social or emotional problems, diet, supplements, exercise for pregnancy, birth preparation, partner's role, transport arrangements, newborn care, postpartum care, and parenting.

(5) Parents' Responsibilities:

(A) Obtain all supplies on birth list.

(B) Have an accessible telephone.

(D) Post all emergency phone numbers.

(E) Make child care arrangements.

(F) Arrange for help after the birth.

(6) Naturopathic Physician's Responsibilities:

(A) Alert parents to signs of labor and when to call.

(B) Alert parents to signs of complications that necessitate immediate contact with the naturopathic physician.

(D) Arrange for a birth assistant.

(E) Make a home visit before the 37 [th ]week.

(F) Maintain appropriate equipment for assessing maternal, fetal, and newborn well being, carry anti-hemorrhagic agents, supplies to maintain asepsis, and emergency resuscitation equipment.

(G) Maintain a record of the care provided and data gathered for each client, subject to the federal medical records laws and those of the State of Vermont regarding accessibility and confidentiality.

(7) Discontinuation of Services: During prenatal care, a naturopathic physician shall evaluate a client and baby and determine continuing appropriateness for the home birth. All concerns shall be shared with the client. If an impasse is reached between what is deemed appropriate by the naturopathic physician and the client or family, it is the right of the ND to refuse or discontinue service and to make appropriate referrals when indicated for the protection of the client, baby, and naturopathic physician.

(b) Labor, Birth, and Immediate Postpartum:

(1) Labor: During labor and birth, the naturopathic physician shall use all of the resources available to assure and enhance the well being of the mother and baby.

(2) The naturopathic physician's labor responsibilities include:

(A) Assessing the well being of the laboring woman and baby, fetal heart tones, blood pressure, maternal temperature, position and presentation of the baby, and client's attitude, ability, and energy to cope with labor. A vaginal examination will be performed as necessary to assess progress of labor. Aseptic technique shall be observed with use of OSHA and VOSHA regulations relevant to home birth.

(B) Provide adequate fluid and nutrition throughout the labor, provide support and encouragement during the birth process, assist with delivery of the placenta, manage interpartum hemorrhage, and perineal repair as needed.

(3) Immediate Care of Newborn: Following the birth the naturopathic physician shall:

(A) Maintain a warm environment for the baby.

(B) Assess newborn using APGAR scoring and provide appropriate care; continue assessment of newborn vital signs.

(D) Conduct a newborn exam, offering vitamin K and eye prophylaxis.

(4) Immediate Postpartum Care: Following the birth, the naturopathic physician shall remain with the client and baby until both are stable and secure and at least two hours have passed since the birth. During this time, the naturopathic physician shall assess maternal well being, bleeding, blood pressure, and uterine size and consistency, examine the perineum, and repair if necessary. Assess the client's ability to urinate and be ambulatory. Postpartum instructions shall be given including information on normal postpartum bleeding, appropriate size and consistency of uterus, perineal care and hygiene, rest and nutritional requirements, breast feeding, newborn care, and indications which warrant contacting the naturopathic physician.

(c) Postpartum Follow-up Care: Postpartum visits are recommended at 24 hours, day 3, one week, three weeks and six weeks, with phone consultation as necessary. During these visits, the mother is assessed for normal postpartum recovery and health, breast feeding status, uterine status, lochia status, normal bowel and urinary output, nutritional status and emotional status. The baby is assessed for over all well being, normal nursing or feeding habits, jaundice of the newborn, activity level, growth, vital signs, bowel and urinary patterns, umbilical assessment, and neurological evaluation. A blood sample for newborn metabolic screening shall be obtained after 24 hours and submitted as required by the Vermont Department of Health newborn screening program.

(d) Final Postpartum Visit: A six to eight week final visit for mother and baby. At this time, the naturopathic physician shall make inquiries concerning breast feeding, feeding habits, bleeding, activity level, family adjustments, and sexual activity, perform a gynecological exam with a pap smear, and discuss family planning or birth control. Provisions shall be made for ongoing well child care.

Section 3.10 Written Plan for Consultation, Emergency Transfer, and Transport

(a) The naturopathic physician recognizes that there are certain conditions when medical consultation or transfers, or both, are advisable. Each naturopathic physician practicing naturopathic childbirth must develop a written plan for consultation with other health appropriate care providers, including at least one M.D. or D.O., for emergency transfer and transport of an infant or mother to the appropriate health care facility. The written plan must be submitted to the Director on an approved form with the initial license application and with every subsequent license renewal.

(b) Prenatal Medical Conditions: If the following medical conditions present during prenatal care, the naturopathic physician shall consult with the appropriate health care provider:

(1) Possible ectopic pregnancy.

(2) Multiple gestation.

(3) Persistent breech presentation at 36 weeks.

(4) Signs and symptoms of preeclampsia.

(5) Suspected post-maturity.

(6) Polyhydramnios and oligohydramnios.

(7) Indications that the fetus has died in utero.

(8) Development of any medical condition potentially detrimental to the pregnancy or the well being of the fetus.

(9) Hyperthyroidism currently treated by medication.

(10) Acute Toxoplasmosis, Rubella, Cytomegalovirus, or Parvovirus infection, where the client is currently symptomatic.

(11) Second or third trimester bleeding.

(12) History of intrauterine death after 20 weeks gestation, or stillbirth due to a situation which might recur.

(13) Previous myomectomy.

(14) Tuberculosis.

(c) Transfer: If the following conditions become apparent during prenatal care, the naturopathic physician shall transfer the client to hospital care for the birth. The naturopathic physician may continue to give co-care and accompany the mother at the birth.

(1) Placenta previa or placental abruption.

(2) Preeclampsia.

(3) Transverse fetal position.

(4) Testing positive for HIV.

(5) Suspected premature labor, less than 36 weeks of pregnancy.

(6) Premature labor (gestation less than 36 weeks).

(7) Thrombosis.

(8) Primary or active Herpes simplex cervical or vaginal lesion at the time of delivery.

(9) Premature rupture of membranes at 37 weeks or less with a positive GBS.

(d) Labor and Birth Transfer: If the following conditions become apparent during labor, birth, or immediate postpartum, the naturopathic physician shall facilitate transfer to a hospital setting if time allows or consult with an OB/GYN to determine whether and when transfer is advisable:

(1) Malpresentation.

(2) Multiple gestation.

(3) Fetal distress as indicated by fetal heartbeat monitoring or gross meconium staining.

(4) Client distress.

(5) Prolapsed cord.

(6) Uncontrolled maternal hemorrhage or retained placenta.

(7) Signs of maternal or fetal infection.

(8) All stage 4 and any maternal perineal lacerations beyond the naturopathic physician's ability to repair.

(9) APGAR score of less than seven at ten minutes or fetal distress not responding to CPR.

(10) Any newborn whose vital signs are absent or exhibiting signs of respiratory distress.

(11) Obvious congenital anomalies.

(12) Active A hepatitis.

(13) Thrombosis.

(e) Decision-making Conflicts: If the client chooses to remain at home against the medical advice of the naturopathic physician during the interpartum period, the naturopathic physician may refer them to an alternative birth provider. If the birth is imminent, the naturopathic physician will leave only if the naturopathic physician has made reasonable attempts to assure that the client is not unattended (i.e., calling an ambulance).

Section 3.11 Uncomplicated Childbirth

(a) Uncomplicated naturopathic childbirth is the provision of care, support and education to healthy women during the childbearing cycle, including normal pregnancy, labor, childbirth and the postpartum period. There are certain pre-existing medical conditions which may prevent the ability to have a natural home birth assisted by a naturopathic physician.

(b) If a history of any of the following disorders or situations is found to be present at the initial interview or if any of the following disorders or situations becomes apparent through history, examination, or laboratory report as prenatal care proceeds, the naturopathic physician must not assume or continue to take responsibility for the client's pregnancy and birth care. For clients already under care, it is the responsibility of the naturopathic physician to arrange for orderly transfer of care to a licensed M.D. or D.O.

(1) Uncontrolled insulin dependent diabetes mellitus.

(2) Uncontrolled epilepsy.

(3) Active non-A hepatitis.

(4) HIV positive.

(5) Current alcohol or drug addiction.

(6) Rh sensitivity with positive antibody titer.

(7) Previous cesarean delivery, except as provided for in Rule 3. 14, below.

Section 3.12 Previous Cesarean Delivery

The following requirements must be met for vaginal birth after cesarean (VBAC). In addition, prenatal consultation is advised when available.

(a) The naturopathic physician must obtain records to ascertain that the client had only one documented previous lower uterine segment cesarean section with uterine closure of more than one layer.

(b) There must be at least 18 months from the client's cesarean to the due date of the current pregnancy.

(c) The client must obtain ultrasound documentation to determine that the location of the placenta is not previa or is not low and anterior.

(d) Signed informed consent must be present in the client's chart. See Appendix A.

(e) The naturopathic physician must perform fetal auscultation at least every 15 minutes during active labor and more frequently if necessary and at least every five minutes during the second stage of labor and more frequently if necessary.

(f) The birth site must be located within 30 minutes' transport time from a hospital emergency room.

(g) A naturopathic physician must be accompanied by another licensed physician or midwife.

(h) No labor induction or augmentation of any kind must be done. Specific examples of labor induction or augmentation prohibited by this section include administration of pitocin or its cogeners, or stimulation of the release of pitocin by nipple stimulation, or the use of prostaglandin preparations. This section does not prohibit the use of calmative, sedative or analgesic preparations that are not primarily intended to induce or augment labor, and that are included in the naturopathic physician formulary when, in the judgment of the naturopathic physician, their use for their calmative, sedative or analgesic effects is indicated.

(i) Pre-admission forms must be completed for the client before labor, for the hospital to which the client may possibly be transferred.

(j) Prenatal records for the client must be sent before labor to the back-up system for the birth (hospital, labor and delivery unit, or physician practice).

Effective date: November 1, 2013

History

STATUTORY AUTHORITY: 26 V.S.A. § 4125
EFFECTIVE DATE: September 1, 2003 Secretary of State Rule Log #03-27
AMENDED: November 1, 2013 Secretary of State Rule Log #13-033

Chapter 381 NATUROPATHIC PHYSICIAN FORMULARY RULES

04-381 Code Vt. R. 04-030-381-X NATUROPATHIC PHYSICIAN FORMULARY RULES

I PURPOSE, AUTHORITY, AND PROHIBITION

Purpose

This is a formulary of prescription drugs that may be used by natuaropathic physicians in a manner that is consistent with their scope of practice.

Authority

In accordance with 26 VSA A § 4125(c), this formulary has been established by the Commissioner of Health with the advice of the advisor appointees described at 26 VSA A § 4126.

A Prohibition

A person licensed under 26 VSA Chapter 81 (Naturopathic Physicians) shall not prescribe, dispense, or administer any controlled substances except those natural medicines authorized by these rules. "Natural medicines" are substances present in or produced by nature, not artificial or man-made.

Licensed naturopathic physicians may only order, prescribe, dispense and administer certain medications of mineral, animal and botanical origin which are:

A "Natural" according to the following definition: -present in or produced by nature, not artificial or man made. (Source - American Heritage Dictionary)
A Not substances prohibited by other Vermont or federal law.
A Appropriate within a general naturopathic practice, that is primary care in focus, recognizing that naturopathic physicians are also specialists in natural medicines and often serve in an adjunctory capacity for other chronic illness.
A Prescribed in doses that are non-poisonous accepted therapeutic dosages. This is defined as a dose which by its actions does not impair function or destroy human life, and is consistent with the naturopathic principle - "First Do No Harm."
The substance being prescribed is clinically effective for the condition that the patient is seeking health care for. This will require the naturopathic physician to assess if the natural substance, or substances being used in a particular treatment protocol are working for that patient within a safe and reasonable amount of time for that condition. This assessment needs to be made within the context of naturopathic medical philosophy, the conventional standard of care as defined by such groups as the Vermont Program for Quality, and the patient's choice as long as adequate information and education is provided.

II PRESCRIPTION DRUGS THAT MAY BE USED BY NATUROPATHIC PHYSICIANS

Drugs That May be Prescribed

The following products may be prescribed by naturopathic Physicians: Routes of administration are usual routes.

PO = By Mouth

IM = Intra Muscular

IV = Intra Venous

SQ = Subcutaneous

Topical = Applied To Skin

Amino Acids and Amino Acid Combinations: (Usually PO)

Alanine, Arginine, Aspartic Acid, Cystine, Glutamic Acid, Glycine, Histidine, Hydroxyproline, Isoleucine, Leucine, Levocarnitine, Lysine, Methionine, N-acetyl cysteine, Phenylalanine, Proline, Serine, Threonine, Tryptophan, Valine

Antimicrobials - naturally derived - (PO,IM, Topical)

a. Erythomycin

b. Penicillins - Amoxycillin, Ampicillin, Penicillin G, Penicillin VK

c. Tetracycline

d. Anti-fungal agents

Nystatin

Barrier Contraceptives
Botanical Extracts and their derivatives -

Botanical Medicines as exemplified in traditional botanical and herbal pharmocopea may be utilized by naturopathic physicians, following the above guidelines. The botanicals listed below represent substances that are currently available by prescription only, or they are botanicals that have both prescriptive and non-prescriptive dosage forms available.

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Electrolytes - (IV)

Saline, Sodium Bicarbonate, Dextrose injection, Dextrose and Saline, Lactated Ringer's Solution, Ringer's Solution

Expectorants and Mucolytics - (PO)

Guaiacol, Iodinated Glycerol

Enzyme preparations - (PO, Topical)

Amylase, Chymotrypsin, Lipase, Pancreatin, including Pancrelipase, Papain, Protease, Typsin

Homeopathic preparations - all prescription and non-prescription remedies that are manufactured according to the pharmaceutical guidelines set forth in the H.P.U.S. (PO, SQ)
Hormones - (PO, IM, Topical)

a. Adrenal - e.g., adrenal extract, cortisol, DHEA, pregnenolone

b. Gonadal - for hormone replacement purposes, does not include oral contraceptive pills or anabolic steriods

Estrogens - conjugated estrogens, estradiol, ethinyl estradiol, etriol, estrogens, esterified, estrone, estropipate, quinestrol

Progesterone

Testosterone

c. Thymus

d. Thyroid - preparation as defined in the USP

e. Melatonin

Liver Preparations - (PO, IM)

Minerals - (PO/Topical/IM/IV) for example: calcium compounds, calcium folinate, fluoride compounds, iodine (including potassium iodine, niacinmide hydroiodide), iron compounds, magnesium compound, potassium compounds, silver nitrate, trace mineral compounds (chromium, selenium, molybdenum, banadium, boron)

Miscellaneous - (PO, SQ, IM, IV, Topical)

a. Digestive aids - betaine and glutamic hydrochloric acid (non RX)

b. Biological agents - urea

c. Bile salts and Acids - Chenodiol, Cholic Acid, Chenodeoxycholic acid, Dehycrocholic acid, Ox Bile, Ursodeoxycholic acid, Ursodiol

d. DMSO, Hyaluronidase, Grain Alcohol

e. Epinephrine - (SQ)

f. Glutathione, Reduced Glutathione - (IV or PO)

g. Oxygen

Vaccines/Toxoids - to be used consistent with Vermont Health Department Recommendations - (IM, PO)

Vitamins - All prescriptions and non-prescription vitamin preparations and their deratives -(PO/IM/IV, Topical)

Vitamin A, Betacarotene and Derivatives

Thiamin (Vitamine B1)

Riboflavin (Vitamine B2)

Niacin (Vitamine B3)

Pantothenic Acid including dexpanthenol (Vitamine B5)

Pyridoxine (Vitamine B6)

Cyanocobalamin or hydroxycobalamin (Vitamine B12), including intrinsic factor

Folic Acid

Biotin

Ascorbic Acid (Vitamin C)

Vitamin D (including calcitrol, calcifediol, ergocalciferol)

Vitamin E

Vitamin K (including menadiol)

Topical Medicines

a. Debridement/escharotic agents - Urea Cream 40%

b. Miscellaneous topical agents

Cantharidin, Capsaicin, DMSO, Selenium Sulfide 2.5%, Retin A, Hydrocortisone 1%, mineral salts such as copper sulfate to be used for iontophoresis

c. Topical antibiotics - Silver sulfadiazine cream, colloidal silver preparations

d. Scabicides and Pediculosides - Lindane, Permethrin or whichever agent is the current recommended treatment for these infections

Drugs That May be Used but Not Prescribed

The following products may be purchased or otherwise obtained by naturopathic physicians in any dosage form for appropriate use, but may not be prescribed:

A. Diagnostic Agents

Cobalt (57Co)

Corticotropin

Glucola

Lactulose/Mannitol Solution

Pentagastrin

Zylose

B. In Vivo Diagnostic Biologicals

Tuberculin Tests

Diptheria Toxin

Coccidioidin

Histoplasmin

Candida and Trichophyton Extracts

Mumps skin test antigen

Skin test antigens, multiple

C. Topical Medicines

Podophyllum Resin 25%

Podofilox 0.5% Solution

Topical anethetics and local anasthetics as described in the USP.

III TERM OF RULES

This formulary will be reviewed and revised on an annual basis.

History

EFFECTIVE DATE:
July 7, 1998 (Secretary of State Rule Log #98-41)
AMENDED:
March 24, 2000 (Secretary of State Rule Log #00-15); June 14, 2017 [transferred from Agency of Human Services, Department of Health by operation of law]

Vermont Code of Rules, Agency 04 — Secretary of State

Subagency 000 GENERAL

Chapter 001 RULE ON RULEMAKING

04-001 Code Vt. R. 04-000-001-X RULE ON RULEMAKING

Chapter 002 UNIFORM SCHEDULE OF PUBLIC RECORD CHARGES FOR STATE AGENCIES

04-002 Code Vt. R. 04-000-002-X UNIFORM SCHEDULE OF PUBLIC RECORD CHARGES FOR STATE AGENCIES

Chapter 003 SAFE AT HOME ADDRESS CONFIDENTIALITY PROGRAM

04-003 Code Vt. R. 04-000-003-X SAFE AT HOME ADDRESS CONFIDENTIALITY PROGRAM

Subagency 010 ELECTIONS DIVISION

Chapter 004 VERMONT ELECTIONS - ADMINISTRATIVE COMPLAINT PROCEDURE

04-004 Code Vt. R. 04-010-004-X VERMONT ELECTIONS - ADMINISTRATIVE COMPLAINT PROCEDURE

Chapter 005 ADMINISTRATIVE RULE 2000-1: VERMONT CAMPAIGN FINANCE LAW; REGULATION OF RELATED EXPENSES

04-005 Code Vt. R. 04-010-005-X ADMINISTRATIVE RULE 2000-1: VERMONT CAMPAIGN FINANCE LAW; REGULATION OF RELATED EXPENSES

Subagency 030 OFFICE OF PROFESSIONAL REGULATION

Chapter 006 ADMINISTRATIVE RULES FOR RESPIRATORY CARE PRACTITIONERS

04-006 Code Vt. R. 04-030-006-X ADMINISTRATIVE RULES FOR RESPIRATORY CARE PRACTITIONERS

Chapter 007 ADMINISTRATIVE RULES FOR PROPERTY INSPECTORS

04-007 Code Vt. R. 04-030-007-X ADMINISTRATIVE RULES FOR PROPERTY INSPECTORS

Chapter 008 ADMINISTRATIVE RULES FOR CERTIFIED APPRENTICE ADDICTION PROFESSIONALS, CERTIFIED ALCOHOL AND DRUG ABUSE COUNSELORS, AND LICENSED ALCOHOL AND DRUG ABUSE COUNSELORS

04-008 Code Vt. R. 04-030-008-X ADMINISTRATIVE RULES FOR CERTIFIED APPRENTICE ADDICTION PROFESSIONALS, CERTIFIED ALCOHOL AND DRUG ABUSE COUNSELORS, AND LICENSED ALCOHOL AND DRUG ABUSE COUNSELORS

Chapter 009 ADMINISTRATIVE RULES FOR FORESTERS

04-009 Code Vt. R. 04-030-009-X ADMINISTRATIVE RULES FOR FORESTERS

Chapter 010 ADMINISTRATIVE RULES FOR THE BOARD OF PUBLIC ACCOUNTANCY

04-010 Code Vt. R. 04-030-010-X ADMINISTRATIVE RULES FOR THE BOARD OF PUBLIC ACCOUNTANCY

Chapter 011 ADMINISTRATIVE RULES FOR WASTEWATER SYSTEM AND POTABLE WATER SUPPLY DESIGNERS

04-011 Code Vt. R. 04-030-011-X ADMINISTRATIVE RULES FOR WASTEWATER SYSTEM AND POTABLE WATER SUPPLY DESIGNERS

Chapter 012 ADMINISTRATIVE RULES FOR POLLUTION ABATEMENT FACILITY OPERATORS

04-012 Code Vt. R. 04-030-012-X ADMINISTRATIVE RULES FOR POLLUTION ABATEMENT FACILITY OPERATORS

Chapter 013 ADMINISTRATIVE RULES FOR POLLUTION ABATEMENT FACILITY OPERATORS

04-013 Code Vt. R. 04-030-013-X ADMINISTRATIVE RULES FOR THE ASSESSING OF PROFESSIONAL CREDENTIALS OBTAINED OUTSIDE THE UNITED STATES

Chapter 014 ADMINISTRATIVE RULES FOR NOTARY PUBLIC CONTINUING EDUCATION

04-014 Code Vt. R. 04-030-014-X ADMINISTRATIVE RULES FOR NOTARY PUBLIC CONTINUING EDUCATION

Chapter 015 ADMINISTRATIVE RULES FOR NOTARIES PUBLIC

04-015 Code Vt. R. 04-030-015-X ADMINISTRATIVE RULES FOR NOTARIES PUBLIC

Chapter 020 RULES OF THE BOARD OF ARCHITECTS

04-020 Code Vt. R. 04-030-020-X RULES OF THE BOARD OF ARCHITECTS

Chapter 030 ADMINISTRATIVE RULES FOR BARBERS, COSMETOLOGISTS, ESTHETICIANS AND NAIL TECHNICIANS

04-030 Code Vt. R. 04-030-030-X ADMINISTRATIVE RULES FOR BARBERS, COSMETOLOGISTS, ESTHETICIANS AND NAIL TECHNICIANS

Chapter 040 BOXING CONTROL BOARD RULES

04-040 Code Vt. R. 04-030-040-X BOXING CONTROL BOARD RULES

Chapter 050 BOARD OF CHIROPRACTIC ADMINISTRATIVE RULES

04-050 Code Vt. R. 04-030-050-X BOARD OF CHIROPRACTIC ADMINISTRATIVE RULES

Chapter 070 ADMINISTRATIVE RULES FOR LICENSED CLINICAL SOCIAL WORKERS

04-070 Code Vt. R. 04-030-070-X ADMINISTRATIVE RULES FOR LICENSED CLINICAL SOCIAL WORKERS

Chapter 080 RULES OF THE BOARD OF DENTAL EXAMINERS

04-080 Code Vt. R. 04-030-080-X RULES OF THE BOARD OF DENTAL EXAMINERS

Chapter 090 ADMINISTRATIVE RULES RELATING TO THE DIETITIAN ADVISORY COMMITTEE

04-090 Code Vt. R. 04-030-090-X ADMINISTRATIVE RULES RELATING TO THE DIETITIAN ADVISORY COMMITTEE

Chapter 100 ADMINISTRATIVE RULES OF THE BOARD OF PROFESSIONAL ENGINEERING

04-100 Code Vt. R. 04-030-100-X ADMINISTRATIVE RULES OF THE BOARD OF PROFESSIONAL ENGINEERING

Chapter 110 RULES OF THE BOARD OF FUNERAL SERVICE

04-110 Code Vt. R. 04-030-110-X RULES OF THE BOARD OF FUNERAL SERVICE

Chapter 111 ADMINISTRATIVE RULES FOR THE OPERATIONS OF CREMATORY ESTABLISHMENTS

04-111 Code Vt. R. 04-030-111-X ADMINISTRATIVE RULES FOR THE OPERATIONS OF CREMATORY ESTABLISHMENTS

Chapter 112 ALTERNATIVE PREPARATORY PATH FOR FUNERAL DIRECTORS

04-112 Code Vt. R. 04-030-112-X RULE ON ALTERNATIVE PREPARATORY PATHS FOR FUNERAL DIRECTORS AND EMBALMERS

Chapter 120 RULES FOR HEARING AID DISPENSERS

04-120 Code Vt. R. 04-030-120-X RULES FOR HEARING AID DISPENSERS

Chapter 130 ADMINISTRATIVE RULES OF THE BOARD OF LAND SURVEYORS

04-130 Code Vt. R. 04-030-130-X ADMINISTRATIVE RULES OF THE BOARD OF LAND SURVEYORS

Chapter 131 CODE OF ETHICS - BOARD OF LAND SURVEYORS

04-131 Code Vt. R. 04-030-131-X CODE OF ETHICS - BOARD OF LAND SURVEYORS

Chapter 160 RULES RELATING TO MOTOR VEHICLE RACING COMMISSION

04-160 Code Vt. R. 04-030-160-X RULES RELATING TO MOTOR VEHICLE RACING COMMISSION

Chapter 170 ADMINISTRATIVE RULES OF THE BOARD OF NURSING

04-170 Code Vt. R. 04-030-170-X ADMINISTRATIVE RULES OF THE BOARD OF NURSING

Chapter 180 BOARD OF EXAMINERS FOR NURSING HOME ADMINISTRATORS; ADMINISTRATIVE RULES

04-180 Code Vt. R. 04-030-180-X BOARD OF EXAMINERS FOR NURSING HOME ADMINISTRATORS; ADMINISTRATIVE RULES

Chapter 190 ADMINISTRATIVE RULES FOR OCCUPATIONAL THERAPISTS AND OCCUPATIONAL THERAPY ASSISTANTS

04-190 Code Vt. R. 04-030-190-X ADMINISTRATIVE RULES FOR OCCUPATIONAL THERAPISTS AND OCCUPATIONAL THERAPY ASSISTANTS

Chapter 200 RULES OF THE BOARD OF OPTICIANS

04-200 Code Vt. R. 04-030-200-X RULES OF THE BOARD OF OPTICIANS

Chapter 210 RULES OF THE STATE BOARD OF OPTOMETRY

04-210 Code Vt. R. 04-030-210-X RULES OF THE STATE BOARD OF OPTOMETRY

Chapter 220 ADMINISTRATIVE RULES OF THE BOARD OF OSTEOPATHIC PHYSICIANS AND SURGEONS

04-220 Code Vt. R. 04-030-220-X ADMINISTRATIVE RULES OF THE BOARD OF OSTEOPATHIC PHYSICIANS AND SURGEONS

Chapter 230 BOARD OF PHARMACY ADMINISTRATIVE RULES

04-230 Code Vt. R. 04-030-230-X BOARD OF PHARMACY ADMINISTRATIVE RULES

Chapter 231 INSTITUTIONAL PHARMACIES

04-231 Code Vt. R. 04-030-231-X INSTITUTIONAL PHARMACIES