Wyo. Code R. 054-0002-8
General
Chapter 8: Procedure for Application, Licensure & Disciplinary Matters
Effective Date: 06/21/2023 to Current
Rule Type: Current Rules & Regulations
Reference Number: 054.0002.8.06212023
Section 1. Statement of Authority. The Board promulgates these rules according to its authority under Wyo. Stat. Ann. § 33-21-122(b), -122(c)(viii), (x), and (xxiv).
Section 2. Definitions.
(a) 'Abandon' means to terminate a client relationship, with or without the client's knowledge, without making arrangements for appropriate continuation of care.
(b) 'Abuse' means any behavior designed to control or subjugate another human being through the use of fear, humiliation, or assault, either verbal or physical.
(c) 'ARC' means Application Review Committee. The Application Review Committee may be comprised of:
(i) At least one (1) Board member; or
(ii) Executive Director in application review matrix process matters.
(d) 'Application Review Matrix' means guidelines that delegate limited authority to Board staff to recommend issuance of a license, issuance of a license with a Notice of Warning, or forward an application matter to an ARC for additional review and recommendation.
(e) 'Complainant' means the person(s), organization, or agency who files a complaint.
(f) 'IC' means Investigative Committee. The Investigative Committee may be comprised of:
(i) At least one (1) Board member; or
(ii) Executive Director in discipline matrix process matters.
(g) 'Discipline Decision Matrix' means guidelines that delegate limited authority to Board staff to pursue Summary Suspension, recommend Dismissal of a complaint, recommend issuance of a Notice of Warning, or forward a licensure or disciplinary matter to an IC for additional review and recommendation.
(h) 'License' means a license, certificate, recognition, permit, or prescriptive authority issued by the Board or a privilege to practice from a multistate license issued by another compact state.
(j) “Licensee” means an APRN, RN, LPN, or CNA who holds a valid license, certificate, recognition, permit, or prescriptive authority issued by the Board or a privilege to practice from a multistate license issued by another compact state.
(k) “Misappropriation of client property” means negligently or deliberately taking, misusing, exploiting, using, or selling money or property belonging to another, without consent, whether temporarily or permanently.
(l) “Neglect” means the failure to provide necessary goods, services, care, or attention and may include:
(i) Insufficient observation;
(ii) Failure to provide adequate assessment and intervention directly or indirectly through inadequate supervision;
(iii) Failure to intervene when a client condition warrants intervention;
(iv) Inappropriate delegation or assignment of care to an unqualified care giver; or
(v) Accepting assignments beyond level of competency or scope of practice.
(a) Disciplinary Action. The Board may take disciplinary action or refuse to issue, renew, relicense, or reinstate a license for one (1) or more of the following acts or conduct, upon proof the licensee or applicant:
(i) Was impaired with the intent of practicing nursing or nurse assisting due
to:
(A) Physical or mental disability;
(B) Lack of nursing competence;
(C) Substance abuse; or
(D) Substance dependency.
(ii) Was under the influence of alcohol, drugs, substances, or chemicals with the intent of practicing nursing or nurse assisting;
(iii) Has abused a client or member of a vulnerable population, including, but not limited to: physical, verbal, mental, emotional, financial, or sexual abuse;
(iv) Has engaged in sexual misconduct as defined in Wyoming Statute 33-1-118(b)(ii);
(v) Has neglected a client or member of a vulnerable population;
(vi) Has abandoned a client;
(vii) Has distributed, sold, or used without authorization, illegally possessed, or manufactured controlled or illicit drugs;
(viii) Has diverted drugs or medications for self or others;
(ix) Has interfered with a client’s plan of care;
(x) Has performed unsafe client care;
(xi) Has violated client boundaries including, but not limited to: sexual boundaries or entering into financial transactions with clients;
(xii) Has misappropriated client property;
(xiii) Has misappropriated property belonging to a hospital, medical clinic, or facility providing care to a client;
(xiv) Has violated the privacy or confidentiality of a client in any form including, but not limited to: written, verbal, or technological;
(xv) Has failed to appropriately supervise;
(xvi) Has improperly delegated a nursing task;
(xvii) With respect to APRNs, has failed to supervise or monitor the performance of acts by an individual working under the direction of the APRN;
(xviii) Has aided another licensee in practicing beyond the scope of the nurse’s license or experience;
(xix) Prescribing, dispensing, administering, or distributing drugs or medications in an unsafe manner or without adequate instructions to patients according to the acceptable and prevailing standards;
(xx) Prescribing, dispensing, administering, or distributing drugs or medications for other than therapeutic or prophylactic purposes;
(xxi) Prescribing or dispensing drugs or medications to individuals who are not patients of the APRN or who are not within the nurse’s role and population focus.
(b) Volunteer Nurse Discipline. In addition to those acts identified in subsection (a), the Board may take disciplinary action against a volunteer nurse, upon proof the volunteer nurse:
(i) Has accepted monetary compensation for providing nursing services while holding a volunteer nurse license;
(ii) Has practiced outside the premises of a nonprofit health care facility in the State;
(iii) Has provided care to persons other than low income uninsured; or
(iv) Has engaged in practice outside the scope of the volunteer nurse license in the State.
(a) Application Review and Investigation. In application matters:
(i) Every applicant bears the burden of satisfying licensure requirements; and
(ii) After an applicant has demonstrated that he or she meets the requirements for licensure, the burden shifts to the ARC to prove there are justifiable grounds for denying the license or certificate.
(b) Application Review Committee Action. The ARC may recommend:
(i) A license be issued, renewed, reactivated, relicensed, or reinstated;
(ii) A license be issued, renewed, reactivated, relicensed, or reinstated subject to a reprimand, conditions, restrictions, or other disciplinary action;
(iii) Approval of a settlement agreement; or (iv) Denial of the application.
(c) Notice of Intent to Recommend Approval Subject to Conditions, Restrictions, Other Disciplinary Action or Denial of License.
(i) The ARC shall notify the applicant of its intent to recommend:
(A) Approval of the license subject to a reprimand, conditions, restrictions, or other disciplinary action; or
(B) Denial of the application.
(ii) The Notice of Intent shall contain:
(A) A brief description of the facts or conduct that warrant denial or issuance of a license subject to a reprimand, conditions, restrictions, or other disciplinary action;
(B) A citation to the applicable provisions in the NPA and/or Board Rules; and
(C) Notice of the right to a hearing if a written request is received by the Board office within thirty (30) days of the date of mailing the Notice of Intent.
(d) Applicant’s Response. The applicant shall respond to the Notice of Intent within thirty (30) days of the date of the Notice of Intent. The applicant may:
(i) Request the Board hold a hearing on the ARC’s recommendation;
(ii) Request the Board table consideration of the application; or
(iii) Withdraw the application.
(e) If the applicant fails to timely respond to the Notice of Intent, the Board shall dismiss the application.
(a) Petition for Modification of Conditions or Restrictions.
(i) A licensee may petition the Board for modification of the conditions or restrictions imposed upon their license.
(ii) A licensee shall submit a petition for modification to the Board office in writing, which shall include documentation demonstrating compliance with the Board order, the modification is consistent with their treatment plan, and the modification is sufficient to ensure the public is adequately protected.
(iii) A petition for modification shall be reviewed by the IC.
(b) Investigative Committee Action.
(i) If the IC agrees with the requested modification, the parties may file a stipulated motion with the Board.
(ii) If the IC does not agree with the requested modification, the IC shall notify the licensee of its intent to recommend denial of the petition.
(c) Board Consideration.
(i) The Board shall consider the petition at its earliest convenience. The Board may accept or reject the petition for modification and shall consider the petition and the IC’s recommendation or stipulated motion.
(a) Complaint Review and Investigation.
(i) Complaints shall be submitted to the Board upon the form provided by the Board and contain the name, address, and signature of the person making the complaint. Board staff may initiate complaints.
(ii) Complaints shall be investigated by Board staff on behalf of the IC.
(iii) IC may meet informally with the licensee.
(b) Voluntary Surrender. A licensee may petition the Board, in writing, to voluntarily surrender their license. The Board shall consider the petition at its earliest convenience. The Board may accept or reject the petition for voluntary surrender and may consider whether the licensee is under investigation.
(c) Investigative Committee Action. The IC may recommend:
(i) Dismissal of the administrative complaint;
(ii) Issuance of a Notice of Warning;
(iii) Approval of a settlement agreement;
(iv) Disciplinary action, which may include a reprimand, conditions, restrictions, suspension, revocation, other discipline, or a combination thereof; or
(v) Summary suspension.
(a) Recommendation. If the IC recommends summary suspension, the Board shall conduct an expedited proceeding to determine whether the licensee's continued practice presents a clear and imminent danger to public health, safety or welfare.
(b) Notice of Intent to Recommend Summary Suspension.
(i) The IC shall notify the licensee of its intent to recommend summary suspension;
(ii) The Notice of Intent shall contain:
(A) Copy of the administrative complaint;
(B) A citation to the applicable provisions in the NPA and/or Board Rules; and
(C) Notice that an expedited summary suspension proceeding shall be set at the earliest opportunity a quorum of Board members may be assembled.
(c) Notice of Expedited Proceeding. Upon confirmation of the date and time of the expedited proceeding, Board staff shall notify the licensee in writing of the date and time of the proceeding.
(d) Scope of Expedited Proceeding.
(i) Summary Suspension proceedings shall not be governed by Section 26 Office of Administrative Hearings rules concerning contested case proceedings incorporated by reference in Chapter 1.
(ii) The expedited proceeding shall be limited to a presentation of the evidence the IC believes warrants summary suspension.
(iii) The Board shall order summary suspension if it concludes probable cause exists that the licensee's continued practice presents a clear and imminent danger to public health, safety or welfare. The Board shall incorporate a finding to that effect in an order granting summary suspension.
(a) Evaluations. In cases where the physical or mental condition or competence of an applicant or licensee is at issue, the ARC or IC may request the applicant or licensee submit to an evaluation. Such evaluations may include, but are not limited to: psychological, psychiatric, substance abuse, fitness for duty or competency. Such evaluations shall be conducted by a qualified provider selected or approved by the ARC or IC and at the sole expense of the applicant or licensee. In selecting a qualified provider, the ARC or IC shall consider the provider's credentials.
(b) Request. The request for an evaluation shall provide the following:
(c) Report. The ARC or IC shall receive the provider's written report, which shall include:
(a) Notice of Intent to Recommend Disciplinary Action.
(i) The IC shall notify the licensee of its intent to recommend disciplinary action.
(ii) The Notice of Intent shall:
intended action;
(B) A citation to the applicable provisions in the NPA and/or Board’s Rules; and
(C) Provide the licensee an opportunity to show compliance or respond to allegations for disciplinary action within fifteen (15) days of the date of the mailing.
(b) Informal Conference. The licensee may request an informal conference with the IC to provide any additional information or to resolve an administrative complaint without a hearing.
(a) The IC shall initiate formal proceedings for disciplinary action by serving a Petition to the last known address of the licensee by certified mail, by regular mail, by electronic mail to the e-mail address indicated to be the preferred method of communication, or by personal service.
(b) Within twenty (20) days of the date of the mailing of the Petition, the licensee may respond by filing an Answer admitting or denying the allegations in the Petition.
(a) Hearing. Upon receipt of a written request for hearing from an applicant or filing of a Petition in a disciplinary matter, the Board shall conduct a hearing. Board staff shall serve a Notice of Hearing on the applicant or licensee.
(b) Notice of Hearing. The Notice of Hearing shall contain:
(i) A brief statement of the matters asserted:
(A) In application matters, the recommendation to deny the application, the facts upon which the recommendation to deny is based, and citations to the applicable provisions of the NPA and/or Board Rules the applicant is alleged to have violated; or
(B) In discipline matters, the nature of the Petition, the facts upon which the Petition is based, and citations to the applicable provisions of the NPA and/or Board Rules the licensee is alleged to have violated;
(ii) The time, place, and nature of the hearing;
(iii) The legal authority and jurisdiction;
(iv) Notice of the burden and standard of proof; and
(v) A statement indicating:
(A) The applicant’s failure to appear at a noticed hearing or pursue proceedings may result in a dismissal; or
(B) The licensee’s failure to answer the allegations contained in the Petition within twenty (20) days of the date of mailing and failure to appear at a noticed hearing may result in a default judgment.
Section 12. Lawful Service. There shall be a presumption of lawful service of a Notice of Intent, Petition, and Notice of Hearing or any other communication required by these Board Rules if sent to the last known address of the applicant or licensee by certified mail, by regular mail, by electronic mail to the e-mail address indicated to be the preferred method of communication or by personal service.
(a) Dismissal. The Board may dismiss an application where the applicant or the applicant’s representative has not appeared at a noticed hearing or pursued proceedings.
(b) Default. The Board may enter an order of default judgment based on the allegations contained in the Petition in any case where the licensee or the licensee’s representative has not answered the allegations contained in the Petition and has not appeared at a noticed hearing.
Section 14. Contested Case Hearing. The hearing officer shall preside over the contested case hearing, which shall be conducted pursuant to the WAPA and the Office of Administrative Hearings rules concerning contested case proceedings incorporated by reference in Chapter 1.
(a) Application Matters. The applicant shall bear the burden, to prove by a preponderance of evidence, they meet the qualifications for licensure. The burden shall shift to the ARC, to prove by clear and convincing evidence, applicant should be denied a license. The burden shall shift to the applicant to persuade the Board the ARC’s grounds for denial are insufficient.
(b) Petition for Modification Matters. The licensee shall bear the burden to prove by a preponderance of evidence that the petition for modification of conditions should be granted.
(c) Discipline Matters. The IC shall bear the burden to prove by clear and convincing evidence a licensee violated the Act, Board Rules, or both.
(a) Board Action. The Board may resolve an application matter, administrative complaint, Petition for Modification, or Petition by:
(i) Approving the recommendations of the ARC or IC; or
(ii) Conducting a contested case hearing. Following the hearing and deliberation of all evidence admitted at a contested case hearing, the Board may:
(A) Issue, renew, reactivate, relicense, or reinstate a license;
(B) Issue, renew, reactivate, relicense, or reinstate a license subject to reprimand, conditions, restrictions, or other disciplinary action;
(C) Deny a license, renewal, reactivation, relicensure, or reinstatement;
(D) Approve or deny a petition for modification;
(E) Dismiss the Petition for lack of clear and convincing evidence;
(F) Issue a Notice of Warning; or
(G) Impose a reprimand, conditions, restrictions, suspension, revocation, other discipline, or a combination thereof.
(b) Board Order. The Board shall issue a written decision, which:
(i) Shall be sent to the applicant, licensee, or their representative by certified mail or regular mail;
(ii) Shall be deemed a public record and be available for inspection and dissemination in accordance with all federal and state laws.
(a) Appeals from decisions of the Board are governed by the WAPA and Wyoming Rules of Appellate Procedure.
(b) Costs of transcripts and any reasonable cost assessed by the Board regarding the record on appeal shall be borne by the party making the appeal.