Compliance & Regulation: Disciplinary/Investigations

Department Functions:

The Disciplinary division of the Compliance and Regulation Department is comprised of and responsible for implementing the duties of three different sections within the agency: Complaints, Investigation and Monitoring.

Complaints:

The Complaint Coordinator receives complaints from patients, family members, interested parties, medical staff, co-workers, medical facilities, licensees, or insurance companies, and logs them into a database.  Disciplinary Counsel reviews the complaint and makes an initial determination: the complaint must pertain to the practice of the healing arts, and must allege facts constituting a violation of the laws administered by the Board.  These two requirements are necessary to open a case for investigation. Sometimes the complaint contains insufficient information and more information may be requested of the complainant.  Although many facets are considered, a highly utilized ‘guide’ is, “If the allegation is substantiated, would it constitute a violation of the applicable Practice Act?”   If “yes”, an investigation is opened. If “no”, the complaint is closed. (However, the complaint does remain in the licensee’s database record.)

Overview of Complaint Process

  1. Receive Complaint
  2. If Authorized, Open Investigation
  3. Review by the Appropriate Profession’s Review Committee (SOC)
  4. Review by Disciplinary Panel
  5. Close Investigation or Receive Authorization for Further Action
  6. Board Decision

Investigations:

Investigations are assigned to one of KSBHA’s investigators. Investigations usually involve getting medical records from the licensee/registrant and any health care facility that is involved. It may also involve interviewing witnesses, visiting facilities, obtaining drug profiles and getting information from law enforcement or other regulatory agencies, in this state or elsewhere.  Investigations are conducted through the authority set forth by K.S.A. 65-2839a: “Investigations and proceedings conducted by board; access to evidence; subpoenas; access to criminal history; confidentiality of information.”  Board investigations are time consuming and may take several months, depending on the seriousness and complexity of the allegations. Board investigations are required by law to be confidential, pursuant to K.S.A. 65-2898a. Therefore, there are limits to what information may be released, even to the person making the complaint. The Board has broad authority to obtain information even though the information may otherwise be confidential as a privileged communication. However, other information may be available only with the patient's specific consent.  Once a complaint is investigated and Disciplinary Counsel reviews the investigative information, the case is either closed due to lack of credible evidence to support the allegations or statutory authority; or forwarded to a Review Committee, a Professional Council, or a Disciplinary Panel depending upon the licensee’s profession and the nature of the complaint.  If the issue involves competency, the case may be reviewed by a panel of peers, Review Committee or Professional Council, to determine whether the standard of care has been met.  If the issue involves unprofessional conduct (sexual misconduct, false advertising, etc.), the case is reviewed by a staff attorney to determine whether there is sufficient evidence of a violation of the statutes and regulations. If there is evidence of a violation, the case is reviewed by a Disciplinary Panel of the Board to determine what action, if any, to take.

Overview of Investigation Process

  1. Letter Sent to Complainant, Case File Opened, Case Given to Investigator
  2. Letter to Licensee Informing of Complaint, Requesting Response, or other Initial Contact, as appropriate
  3. Subpoena Patient Records, Billing Records, Other Reports and Documents, as appropriate
  4. Conduct Witness Interviews, Inspection of Facilities, Analyze Information, Write Interim Reports, and Complete All Necessary Tasks Related to the Investigation
  5. File Final Report to Disciplinary Counsel

Complaint/Investigative Flow Chart (Select)

Review Committees & Councils:

A Review Committee or Council reviews the allegations, evidence, and findings of the investigation.  As a whole, the Committee or Council then makes a determination as to whether or not the standard-of-care was met. Once complete, the Review Committee or Council recommends whether there was a breach to the SOC or if the SOC was met.  If the SOC was met, the recommendation to close the investigation is made.  If the SOC was not met, then the recommendation and evidence are forwarded to Litigation Counsel to present the case to a Disciplinary Panel for review.

Disciplinary Panel:

DP’s are comprised of at least four current Board members ~ 1 MD, 1 DO, 1 DC, and 1 Public Member.  New DPs are formed and responsibilities are rotated amongst Board members every May. Therefore, a number of DPs may be referred to during a Board meeting since each case may have been reviewed by a different DP.  A DP reviews all investigations and makes a recommendation to close the investigation (if evidence does NOT support allegations or merit action), pursue informal action, or proceed with formal actions.  If a DP makes a recommendation to pursue further action, the case is forwarded to one of KSBHA’s litigation attorneys.

Monitoring:

When applicable, agency staff will make all necessary arrangements and issue orders for monitoring, payment of fines, and various other actions.  During such event, agency staff provides the Compliance Coordinator with a copy of this order for complete and continued monitoring of Licensee’s compliance with such provisions of the order.  Once Licensee has successfully completed or violated the monitoring requirements within the order, the Compliance Coordinator informs Board counsel of the same, whereupon the appropriate course of act is taken.

Department Staff

Disciplinary Forms

Complaints