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What Happens if an IEP Is Out of Compliance?

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What happens when an IEP is not in compliance? And to clarify, it’s what happens when the school is not complying with the IEP. What can a parent, guardian, or student do? So, there are several things. And this is the biggest misconception around IEPs: parents and guardians are not informed that they have legal remedies codified in federal and state statutes and regulations on how they can make the school comply. A couple of things that I would do in a specific order.

So first, if the school is blatantly not complying with the IEP. Maybe the student needs to get the required minutes for specific therapy, and they need to be pulled out for instruction for special education. They’re not getting accommodations and more time on tests if they’re allowed to leave the room.  A big issue we’re seeing now with clients is that students are granted aid to be with them. But there are many staffing issues in multiple states where it’s hard to retain staff members at schools. So, the students are not receiving those accommodations.

They need the aid to follow them during specific times of the day that are designated in the IEP. There are a couple of examples of what’s written for the IEP. So, what can you do about this? First, I always prefer and suggest it in writing, not a phone call. That’s just my opinion. It’s better in the future if there are issues. So, in writing, either a letter to the school, or email or both to whoever the special education coordinator is, and then likely administrative staff as well, notifying them that you are aware that your child is not receiving the accommodations or the modifications outlined in their IEP. And you are putting them on notice that you are aware of this and would request that they comply.

Most of the time here, you ask for a meeting with the IEP team to determine why the school is not complying. Again, it might be a staffing issue. Let’s get creative here. If we can have an aid, how can we accommodate that student so they can still meet the goals? Now, if at this meeting or after you’ve given notice, the school is just saying there’s nothing we can do; this happens a lot, then that is not a reasonable response. But it’s good that you try to sort this out yourself first.

If the school is not complying, the parent or guardian can file a complaint with the State Board of Education. They are the ones who are going to enforce the IEP. The IEP and its requirements are federal law. But usually, the State Board of Education is the one who enforces them. So, you can ask for a hearing whenever you file the complaint. Your complaint must state all the identifying information of the school, your student, the IEP, and what they’re not complying with.

If the state finds that the school is not in compliance, there’s likely to be a hearing where they’ll hear both sides and decide. Here in Arizona, it’s through the State Board of Arizona, and we meet with the Office of Administrative Hearings. And we have an administrative law judge who would preside over those hearings. Most states are very similar to that. At that hearing, the judge would find out if they were out of compliance and could order them to comply. You can also ask for reasonable attorney’s fees if you have an attorney represent you to enforce those.

So again, parents do have legal rights. This remedy will not give you money for damages, emotional distress, or anything like that. It’s not litigation; it’s simply the State Board of Education looking at the IEP. They’re talking to the school, and there’s a hearing, and they’ll decide whether they comply. They can then order the school to comply with the IEP, and they find that the IEP meets the standard of free and appropriate education.

Again, the most significant thing parents and guardians don’t realize is that there are remedies. An IEP is a contract with the school stating what services they will provide for your student. It’s based on federal law.  Sometimes states can expand on this, but federal law is the baseline of what needs to be provided and the framework of the IEP once the IEP is in place unless the team meets and decides to change the IEP. And even then, if that happens, you could still file a complaint that you disagree with the modification of the IEP. Parents do have legal rights and remedies.

I would start by trying to communicate with the school that you’re aware they’re not in compliance and that you would like them to comply. And if they don’t, you will file a complaint with the State Board of Education. You could skip this step and go straight to filing a complaint. But sometimes, if you send a letter, you can stop the process, and it’s less stressful. And you meet with their IEP team and come up with a solution.

November 30, 2022/by admin
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How Long Is An IEP Good For?

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How long is an IEP good for? The timeframes for the IEP are based on federal law. There are specific timelines on how you get up to the creation of the IEP, but once the IEP is created and signed, it is suitable for three years. However, annually, so every school year, there needs to be an IEP meeting where the IEP team meets. This might include healthcare providers, therapists, special education coordinators or teachers, general education teachers, and parents. And then school administration. They’ll come together every year to assess the student regarding the IEP.

What Happens in an IEP Meeting?

In an IEP, goals will be set, and benchmarks for progress monitoring and how they will reach those goals. So, every year, the IEP will be looked over. Everybody will meet as a team and discuss if that student is progressing towards their goals. If they are, they will keep it on track and keep it the same way it is; it’s working. If the student is not meeting those benchmarks through progress monitoring, then the IEP may be adjusted. Additional therapy or accommodation time needs to be added to the IEP. However, the student remains qualified for the IEP for up to three years. So, every year there will be an IEP meeting to check the student’s progress.

Are they meeting their benchmarks through progress monitoring and reaching those goals? And if they’re not, what needs to be adjusted for that to happen? The student will be reassessed at the three-year mark to see if they still need an IEP. So, when you are initially getting an IEP, meaning the first time you see if the student is qualified, there may be evaluations or assessments. That is needed to collect data on that student to see if they qualify for an IEP. If this is a renewal at the three-year mark, usually, most of the time, they already have all the data that they need to evaluate that student. Also, did they meet their goals? If they have completed their goals and are up to grade level on everything, then there are no roadblocks.

And the least restrictive environment would be for them to be in a regular general education classroom with no accommodations. Then the IEP would stop. There’s no reason for it because there’s no need for accommodations. However, if the student has yet to reach the goals, or if they feel like other sorts of obstacles substantially affect their ability to learn, then potentially new plans will be made at the three-year mark. And new assessments, evaluations, and collecting data could recur at the three-year mark. Now, an IEP can take a student through secondary education. At the college level, that’s when it’s likely that the school or university would switch to a 504 plan.

Duration of an IEP

But again, to reiterate, an IEP is good for three years. You’ll have an annual meeting every year, and every three years, the IEP will be recreated, which can follow the student through 12th grade. And if they are potentially in a life skills classroom, they could be in that secondary education setting for up to age 21. And then, at that point, the IEP would stop. So, those are just the guidelines for how long an IEP is good. And when I say three years, it will keep everything. They’re just going to reassess the student and ensure they’re still qualifying for an IEP.

Who Qualifies for an IEP?

Who qualifies for an IEP? This is outlined in the Individuals with Disabilities Education Act in federal statute, which says a child must have a qualifying disability that falls within 13 categories that are outlined in federal statutes. The child has to have a disability that falls within those categories. Still, not only that, but it also has to be shown that the disability has adversely affected the child’s ability to learn. Because they have a disability doesn’t mean they automatically qualify for an IEP. Because the disability first must affect them lately, they need this IEP.

13 IEP Categories

Let’s go through the 13 categories listed in the Individuals with Disabilities Education Act. The first one is a specific learning disability. I would say that the best example of this would be dyslexia. If you have a disability with reading or interpreting words or anything specific to learning, dyslexia is the most common one. So, that’s what I’m using as an example. And if it adversely affects your education, then you would likely qualify for an IEP. The next one is other health impairments. So again, I’ll keep saying this, anything that’s a health impairment that would adversely affect your ability to learn.

One good example here would be AHD. It is a health impairment and affects the child’s ability to focus and process information in the classroom. So, therefore, it would likely be that that student would qualify for an IEP. The next one would be autism spectrum disorder. As you know, autism spectrum disorder is a spectrum. So, if your child has a diagnosis, we use the term on the spectrum or, as I said, autism spectrum disorder. And it adversely affects them in the classroom, so they’re likely to qualify for an IEP. That one is straightforward. Next, emotional disturbance. Suppose they have emotional disorders or trouble regulating their emotions, such as depression and anxiety; these things will fall within that category. And again, then they would likely qualify.

The fifth category would be speech or language impairment. This is the one where the adverse effect has to come into play. Just because this child has a speech impediment, it may not adversely affect their learning. So, they might not be qualifying for an IEP. A 504 plan is required if therapy is brought into the school. But if they do have a disability that is considered a speech or language impairment, then they could qualify for an IEP. The sixth category is visual impairment, including blindness. And that one is straightforward. If you have a diagnosis of extreme visual impairment or blindness, then you would likely qualify as well.

And then deafness. Again, if the student cannot hear, it would interrupt their learning, and there would need to be other ways that the information is brought to the student. Next is hearing impairment. Not just deafness, but maybe there are hearing impairment issues that don’t rise to the level of deafness. That would be the eighth category as well. Then there’s also deaf-blindness. When a child is blind and deaf, that will fall into that ninth category. Next is orthopedic impairment. Again, I’ll touch on this as well because just because a child has an orthopedic impairment, if it’s not adversely affecting their education, they wouldn’t qualify.

However, if it is, then they would qualify for an IEP. And they fit within that 10th category. The 11th one is an intellectual disability. The best example of this is if the child is just not at the academic level of their peers, and maybe they need different types of instruction. Then they would likely qualify for an IEP. Traumatic brain injury. So, an accident, damage, or something like that would adversely affect their learning ability because they’re working with a brain injury. They would likely qualify as well.

And then multiple disabilities. If there are multiple disabilities working together to affect that student, again adversely, they would be likely to qualify for an IEP. So, to summarize that list again, it would be a specific learning disability, and I gave dyslexia as an example. Other health impairments include autism spectrum disorder, emotional disturbance, speech impairment, visual impairment, deafness, hearing impairment, deaf-blindness, orthopedic impairment, intellectual disability, traumatic brain injury, and multiple disabilities. Those are the 13 categories that your child must fit in. And again, I’ve probably said it a million times in this blog; it needs to affect their learning ability.

Is AZ IEP Free?

You might have a perception that education is expensive. However, the good news is that IEP is a free program in Arizona. The federal and state government have put in place adequate measures to ensure that all children with disabilities can access this form of education at no cost. However, this does not mean that the program is entirely free. Families must pay for some costs associated with IEP, such as travel expenses, books, and other materials.

How Do I Get an IEP For My Child in Arizona?

As a parent or guardian, you can request an IEP evaluation for your child if you think they might need special education services. You can make this request to the school district in which your child attends school. The school district must evaluate whether your child is eligible for special education services.

If the school district determines that your child is eligible for special education services, they will develop an IEP for your child. The IEP is a document that outlines the special education services that your child will receive.

November 30, 2022/by admin
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Dental Malpractice Insurance (What is TAIL Coverage?)

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What is tail insurance for dental malpractice insurance? This is one thing they usually don’t teach you in dental school. But if you are a dentist, you will need malpractice insurance. You need to be aware of different types of malpractice insurance. And potentially, you may have to pay for. First, the employer should pay for your annual premium. The annual premium is the amount needed to insure you each year. And that’s how it works. You pay a premium every year, and then you’re insured for that year. There are two common types of malpractice insurance coverage for a dentist.

Two Common Types of Dental Malpractice Insurance for Dentists

There are two common types of malpractice insurance for a dentist. One is occurrence-based coverage, and the other is claims-made. In an occurrence-based policy, tail insurance is not necessary. It just means a policy must be in effect when the malpractice occurs. The other coverage is called claims-made. Here, ail insurance is necessary because it states that a policy must be in effect when the claim is made. It’s possible if you leave an employer, someone could sue you one or two years later. And if you didn’t have a tail insurance policy, you wouldn’t be covered even though it happened two and a half years ago. 

Adding Tail to Claims-Made Insurance Policy

Let’s kind of dive into the cost of these types of things. If you have a claims-made policy, which the vast majority of dental associates will have. After the contract ends, for whatever reason, it’s terminated, or it just ends. It’s not renewed, or maybe someone is in breach of contract. But for whatever reason, once the contract terminates, you’ll have to get a policy that covers the gap in between your last patient you saw and the last date that they can sue you. 

For most states, it’s two years. There are some exceptions for people who are no longer minors. And it’s usually from the date you either knew or should have known of the malpractice event. It’s certainly possible that someone may not even know that malpractice occurred for a year or two. And in that scenario, that’s how they can sue the dentist after the fact. So, you’d have to purchase a tail coverage, it’s also called gap insurance or extended reporting, but it’s mostly known as tail insurance in the industry. You’d have to purchase that before the end of your current contract, which would be for a set amount of time.

So, you can get a one-year tail, two-year, five-year, or unlimited. Obviously, the longer the tail, the more expensive it is. But most policies will cover somewhere between three to five years because people figure that’s far off enough to cover any claim that people could make.

Other Blogs of Interest

  • How Much Paid Time Off Should a Dentist Get?
  • What is Occurrence-Based Insurance for a Dentist?

How Much is Tail Insurance Coverage?

Regarding cost, tail insurance is generally about twice your annual premium. If your annual premium is 3000 a year, then your tail cost would be around 6,000. The shorter you’re with the employer may be down to 1.5 times your annual premium. Whereas if you’ve been there a very long time and want an unlimited tail. It could go up to 3 times your annual premium. A good rule of thumb is it’s about twice.

If it were $6,000, you’d have to pay it upfront before the contract terminates so that a policy is in place. It’s a one-time charge. You don’t have to pay it annually. You pay the six grand; that’ll cover you for as long as the tail coverage lasts. Now, who pays for that? It depends on what it says in the employment contract. Many employers will make the dental professional pay for their own tail. It’s just a matter of negotiation between you and the employer. One strategy if the employer isn’t willing to pay for it. You could ask them to make a forgiveness per year. For instance, if you had a three-year initial term. Maybe you would say that the employer would chip in 33% of the tail costs every year that you’re there.

If you leave between year two and three, they’ll pay for two-thirds of the tail. And then you’d pay for thirds long. They will pay for everything if you’re there for three years. It’s not prohibitively expensive for a dentist. Indeed, when you get into more specialized surgical specialties and that type of thing. It will be slightly more than if you’re just doing general dentistry. But it’s still something you need to think about, which most dentists have no idea about.

dental malpractice paper

Which Malpractice Coverage Should a Dentist Choose?

Should a dentist choose occurrence-based or claims-made coverage? First, the two most common types of malpractice insurance for dentists are occurrence and claims-made. And if you are an employed dentist with the practice, the practice will likely use claims-made. Let’s go through the differences between the two and which one would benefit you. If you are thinking of signing an employment contract, there’s going to be a section there discussing malpractice insurance. The employer absolutely should pay for your underlying premium if you’re an employee. An underlying premium is just how much it costs to insure you yearly.

They should pay for that. Now, if it’s a claims-made policy, it means a policy has to be in effect when someone makes a claim. Say you leave an employer. There’s going to be a statute of limitation. It’s a period that someone can sue you. In most states, it’s two years, but there are exceptions. A few states have a little longer than that. But let’s use two years as an example. If you had a claims-made policy, you would need tail insurance, which covers the gap between when you leave, and the last day somebody can sue you. A claims-made policy versus an occurrence policy is kind of the differentiator’s price. With an occurrence-based policy, you don’t need tail insurance. But it’s about a third more expensive than a claims-made policy.

Add Tail Coverage in Your Insurance 

A claims-made policy would be a third cheaper than an occurrence-based policy. However, you would be responsible for paying for tail insurance. And a good rule of thumb is tail insurance costs about twice your annual premium. Let’s say an annual premium of $4,000. Then if you’re responsible for paying for tail insurance, it would be around $8,000. Now, that’s a one-time cost, it’s not yearly. And you would pay that prior to the contract’s expiration, or if it’s terminated on your last day of work. And you’d have to pay the entire amount upfront, but then you would be covered for however long.

The tail costs can vary a little bit based upon two things. One, how long you’ve been with an employer, and then two, the length of the tail. So, it can be anywhere from 1.5 times your annual premium, all the way up to three times. Based upon those factors. 

You would rarely have an employer say to you, we can offer you both policies, we can do occurrence-based or claims-made. Well, if it’s up to you, you should get an occurrence-based policy so as not to worry about tail insurance. It’s a no-brainer. If they say to you, we’ll pay for whatever underlying annual premium it is, and it’s up to you. Then get an occurrence-based policy. Maybe you’re an independent contractor and whoever your employer will be stated, you’re responsible to pay for the annual premium. And if you get claims-made tail, that would be a scenario where you would have to decide.

When To Use Occurrence-Based Policy

Think of it this way. If you’re working for someone as an independent contractor, and let’s just say you’re only going to work for one year. And you can choose between either coverage. In that scenario, it would make sense to get an occurrence-based policy. Let’s just say you have a, as I said before, $4,000 annual premium. At the claims-made level, it’s a third more, so you’d be paying roughly $5,300 yearly with an occurrence-based policy. Wherein if you had a $4,000 claims-made policy. The contract ends, and it’s twice as much, then you have to pay 4,000 for the annual premium. Plus 8,000 for the tail, maybe a little bit less than that. So, you have a $12,000 total cost if you went with claims-made and if you’re only staying with an employer for one year. And then if you had an occurrence-based policy, you’re only paying 5,300.

Occurrence-Based Insurance Policy for a New Dentist

So, you’re saving roughly $6,700 just by utilizing an occurrence-based policy. That scenario, once again, makes complete sense. Now, if you’re staying with an employer for a long period, or as an independent contractor. Let’s say it’s 10 years. You’d have to do the math. If I’m paying a third more per year over 10 years, is that going to be more expensive than having a policy that’s a third cheaper and then tacking on $8,000 at the end?

The longer the time you’re with an employer, the more it makes sense to go with a claims-made coverage. If you had the choice. In my opinion, expecting to work an extended period like 5 or 10 years with one practice is foolhardy. With the proliferation of all these corporate dental practices swooping in and buying up all these dentist-owned practices. Places that were great to work with before are now maybe not so great to work at. So I would not go into any relationship expecting it to last more than 5 to 10 years. It’s just improbable in this environment that that would happen. So, that’s a breakdown of occurrence versus claims-made. And then maybe which one you should choose if you’re looking for a new position.

dental insurance policy

How Much Does Tail Coverage Cost for a Dentist?

How much does tail insurance cost for a dentist? First, let’s talk about when you would need tail insurance, and then we’ll talk about how much it costs. There are two common medical malpractice policies for dentists, and that’s either occurrence-based or claims-made. An occurrence-based policy requires a policy in place when the incident occurs. Tail insurance is not necessary. Under a claims-made policy, a policy has to be in effect when someone makes a claim. You may terminate a contract and leave an employer, but there will still be a statute of limitation. The period that somebody could sue you for malpractice in most states, it’s two years.

There are exceptions, but I’ll say for these purposes, it’s two years. Tail insurance coverage covers the gap between when you leave an employer and the last day somebody can sue you. Most places require tail  coverage to be at least two years at most. In the employment contract, it’s going to state who is responsible for tail insurance if you have a claims-made policy. If it doesn’t say that, you must figure it out and ensure that language is there before signing the agreement. In the agreement, it will have a section that states that the employer will provide the underlying annual premium. It’s how much it costs to insure you yearly. And then usually, it will state what type of policy they utilize. And if it is a claims-made policy, who’s responsible for paying for tail insurance.

Why Employers Prefer Claims-Made

Often, the dental practices will put the burden to pay the tail insurance on the dentist leaving the practice. They would use one policy over another because an occurrence-based policy is generally about a third more expensive than claims-made. Suppose the employer uses a claims-made policy. Which is a third cheaper and puts the onus on the dentist to pay the tail insurance costs. In that case, they’re saving a decent amount throughout an employment relationship between them and a dentist. 

So, how much does it cost if you are responsible for paying for tail insurance? Well, a good rule of thumb is it’s about twice what your annual premium is. As I said before, the annual premium is how much it costs to insure you yearly. And you multiply that times two, which will be how much you must pay for tail.

Tail Coverage Cost

It’s a one-time charge, so you don’t have to pay tail insurance yearly. It’ll be covering you for however long a policy you choose. I would suggest if they had, and will have, an unlimited tail coverage, which will cover you indefinitely. That’s the way to go. As I said before, there are some exceptions and then some longer statute limitations based upon your state. And so, it would be a bad idea to get a policy that didn’t cover the entire amount. If you get sued, and there is no insurance to cover you. You may be personally reliable for those damages if it gets to that point. Then you’ll have to pay for your attorney and go through that. And then the settlement will come out of your funds. 

So, it just makes sense to pay by the indefinite tail. That way, you’re covered. How much it costs kind of varies based upon specialty. If you’re doing general dentistry, it’s going to be a little bit less. And if you’re maybe an endodontist or doing some more surgical procedures, it would be more expensive. But I’d consider a reasonable amount for insurance is somewhere between 2,000 to 4,000 for an annual premium. Which would not be uncommon for a general dentist. And so, your tail costs would be somewhere between 48,000 in that scenario. Not a prohibitive amount of money, but still an amount you’re most likely going to pay for. Essentially a budget that you’re going to pay for that amount.

Lastly, it has to be paid before the termination of the contract. So, before the contract terminates, you must purchase that policy. The employer would then require you to prove that you had purchased that policy. That’s how much tail insurance costs.

What is Dental Malpractice Insurance and How Does Coverage Work?

Dentists encounter unique risks and challenges in their careers. The increased exposure to dental malpractice affects many dentists, with about 242 dental malpractice cases recorded yearly. This leaves many dental professionals financially and emotionally drained since they must pay for the damages incurred by patients during dental care. This usually amounts to huge fines, penalties, and even a bad reputation that may affect the dental practice and dentist’s careers in the long run. 

As a dentist, it is imperative to protect yourself against liabilities that may arise from dental negligence by acquiring dental malpractice insurance. This coverage plays a crucial role in meeting your financial needs and protecting your practice, assets, reputation, and employees when a patient files a dental malpractice case against you. Below is essential information about dental malpractice insurance. 

What Is Dental Malpractice Insurance Coverage?    

Dental malpractice insurance is professional insurance coverage that protects healthcare providers from incurring financial losses on injury claims filed against them due to medical negligence from the practice. It helps dental professionals avoid covering the liabilities from their pockets. This coverage is usually necessary because injury claims can be huge and can affect the practice operations due to financial losses in the long run. 

What are the Common Dental Malpractice Claims?

There are different dental malpractice claims that a patient can sue you for negligence when you deviate from the required ethical standards in the healthcare sector. 

Knowing the dental malpractice claims is imperative to help you make informed decisions when a patient sues you for negligence. Below are the most common dental malpractice claims. 

  • A dentist using too much force on a young patient 
  • Removing teeth that don’t need to be removed 
  • A broken dentist instrument inside a patient’s tooth
  • Misdiagnosis, infections, delayed treatment
  • Not using the suitable anesthetic
  • Dental issues resulting from a broken jaw, broken tooth, and extractions
  • Improperly sterilized or non-sterilized dental tools 

It is worth noting that some malpractice claims occur more frequently than others. This can lead to negligence claims when you least expect it. Having malpractice insurance can save you a lot of headaches and financial losses. It may also be suitable to hire an experienced Dental Contract Lawyer to provide you with a dental contract review for your practice. 

Who Needs Dental Malpractice Insurance?

Dental malpractice coverage is essential for dentists, dental hygienists, dental or dental hygiene students, and dental entities. So it is basically for anyone directly interacting with patients to provide dental care because they are susceptible to dental malpractice claims. Whether full-time, part-time, a volunteer, or a beginner in dental practice, you may need dental malpractice coverage. 

What Does Dental Malpractice Insurance Cover?

Dental malpractice policy covers different claims based on various factors such as the type of insurance company, damages incurred by the patient, and the severity of the matter. If a patient sues you for malpractice, you may need to pay them for the damages incurred whether the claim bears any truth or not. Below are the types of damages you may need to pay the patient. 

  • Compensatory and punitive damages
  • Arbitration costs 
  • Attorney and court fees
  • Settlement costs
  • HIPAA violation fines 

It is best to do due diligence when looking for an insurance provider for your dental practice and choosing the right policy that suits your needs. Some providers impose high claims, so you should inquire and research before selecting an insurer. You should also check the policy limits and what it covers and doesn’t cover (like non-compete violations).

If you are experiencing any doubts about dental malpractice, it is best to consult an experienced dental attorney such as Chelle Law for dental associate employment contract review services. 

How Much Is Dental Malpractice Coverage? 

The cost of dental malpractice insurance depends on various factors listed below.

  • Whether the patient suffered physical pain
  • Whether the dentist can work on the injury and correct it
  • The dentist’s professional background
  • The seriousness of the damage caused

Whether the injury affects the patient’s future activities such as speaking and chewing. 

It also depends on the policy type, how old your practice is, your location, and the purchase policy amount. For instance, a newly established dentist may pay lower rates within the first five years of operations. 

It is best to analyze your practice needs and choose the right dental malpractice coverage. You can also work closely with an insurance agent to take you through their policies, thus, making informed decisions before signing up for the policy. 

The insurance company will use various parameters such as your personal claims history and state requirements to determine your yearly premiums and tailor the right coverage for your practice while also spreading risks for the entire coverage period.

What Should You Look for in a Carrier for Your Dental Malpractice Coverage?

You need to factor in so many things when looking for an insurance provider for your dental practice. With multiple dental malpractice carriers around you, it is imperative to take your time and search for an insurance company that can meet all your needs and expectations. 

Look for the best provider that offers quality services and good customer care. The provider should have in-depth experience in the field and should be willing to show you how dental malpractice coverage works. Check the company’s claim procedures, premiums, and risk management programs for supporting dental practices. 

You can check the carrier’s website and social media pages to know about them before committing to their services. It is also best to ask other professional dentists for referrals from other dental professionals for reputable insurance carriers who can give discounts and offer emotional support to defendants. 

If you’d like to know more about dental malpractice insurance, we can help. Chelle Law has experienced attorneys who can take you through the process and offer you legal advice.

Get a Professional Dental Contract Review from an Experienced Arizona Lawyer 

If you are looking for dental contract review services for your practice, it is imperative to hire an experienced dental lawyer to guide you through. Chelle Law has experienced lawyers who can help you with contract review for your dental practice. Contact us for effective contract review services for your dental practice. 


Claims Made Insurance for a Dental Associate Explained

What is claims-made insurance for a dentist? Every dental professional needs a malpractice policy while they’re practicing. And there are two common types of malpractice insurance: claims-made and occurrence-based. Claims-made insurance policy means a policy must be in effect when someone makes a claim. Say you’re an employee and leave an employer. There’ll be a gap between the last patient you see for that employer and the last day they can sue you. That’s the statute of limitations. And generally, it’s two years in most states. It varies from state to state. And there are also exceptions for minors becoming adults and that type of thing.

But let’s use two years as an example. Someone has two years to sue you. If you had a claims-made policy, you need an additional insurance policy that covers that gap, called tail insurance. If you have a claims-made policy, you need tail insurance. An occurrence-based policy means a policy must be in effect when the incident occurs. No tail insurance is necessary for an occurrence-based policy. 

Now, the main difference between the two is cost. An occurrence-based insurance policy is about a third more expensive per year than a claims-made policy. And then, after a claims-made policy ends, you must purchase tail insurance. Tail insurance is about twice your annual premium. So, if you had a $3,000 annual premium and had to pay for tail insurance under a claims-made policy. It would be a $6,000 payment, depending upon who’s responsible for it, that they should pay. That’s a one-time charge and doesn’t go on year to year. You just pay it all upfront.

How to Get Tail Malpractice Coverage 

Normally, the employer would require a secured tail coverage before the end of the employment relationship between the two parties. If the employer says, it’s your choice what insurance policy you want to use, it will depend on who’s paying. If the employer says, I don’t care if it’s an occurrence or claims-made, we will pay the premiums. Then obviously, you want an occurrence-based policy because you won’t have to pay for tail. Most of the time, you don’t get a choice. Often, it is claims-made. And mostly, the employer will require the dental professional to pay for tail insurance.

A couple of ways to handle that. One, you can negotiate in advance to get the employer to cover the cost of tail insurance. If they’re unwilling to cover all the costs, one thing we’ve been successful with is forgiving an amount of it. Depending on how long you’ve been there. Suppose you have a three-year initial term. Then we’d say, alright, for every year that the dentist stays employed, one-third of that tail cost is then forgiven.

That way, if you’ve been there for three years, you wouldn’t have to pay for the tail after you left. That’s been an effective way of getting them to cover some tail insurance costs. Another one would be if you were in a state, used an insurance company, and switched jobs. Then the new job uses the same insurance company as the old job. Most of the time, they’ll just roll over your old policy into your new one.

Claims Made Coverage Needs Tail

In that way, you wouldn’t have to pay for a tail. And then the third way of getting out of having to pay for tail is if your new employer pays for your old tail. And that’s called nose coverage. It’s not prohibitively expensive for most general dentists. If you get into some subspecialties into surgical specialties, that type of thing can be more expensive. But it’s not a break-the-bank type cost. If you have claims-made coverage, you do not want to go on without tail coverage. I have had a few people who said, you know what, I don’t want to pay the tail costs. I’m willing to accept the risk.

And it just seems like a foolish risk to take $6,000 to cover your tail. Whereas a dental malpractice insurance claim could be many multiples of that potentially. Plus, I would hate to have that hanging over anyone’s head. Anyway, that’s a little primer for claims to make coverage for a dentist.

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November 29, 2022/by admin
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RVU Compensation (WRVU v RVU Compensation for Physicians)

Blog, Physician Contract Review

When a physician is either switching a job or many times when someone is coming out of training. They may receive an employment agreement containing RVU (Relative Value Unit). An obvious question to most people not used to being compensated in that way is: what is an RVU? How do I get paid for it? I’m going to break this down in the simplest way possible. Make it digestible for people looking at a job where they may be paid based on RVUs. 

From Income Guarantee to Productivity Model

Just an initial matter, most of the time, if you’re entering a job. Is that, there will be a guarantee period before a productivity-based agreement kicks in. For instance, let’s say a gastroenterologist works as an employee at the hospital. They’ll usually have an income guarantee for the first year or two. A base salary that’s not tied to productivity in any way. Then maybe after year two and entering year three, it’ll transition into a productivity model. In most cases, at least as far as being employed at the hospital, it would be RVU based. 

What are RVUs?

Let’s talk about what an RVU is and how you get paid for it. An RVU stands for relative value unit. The CMS (Center for Medicare) and Medicaid services came up with the system. I believe it was in the early 90s when essentially, they gave every CPT code a value or a number based on how long it takes, how acute it is, and how much time and skill are involved. All the specialties with all the encounters and CPT codes have an RVU number attached to them. 

3 Types of RVU

There are three types of RVUs. You have the work RVU for the physician, the practice expense RVUs, and the malpractice RVUs. The only RVUs that matter to the physician is the work RVUs. That just considers what the physician does. One of the benefits of RVUs versus net-collections is that RVUs take out any collection problems.  Net-collections is another common way of being compensated for production.

Even though a physician may do a service, provide a service to a patient if they’re being compensated via net-collections. If the management doesn’t receive the money or the hospital or whoever the employer is, the physician won’t see it.

How RVUs Work

Let’s say write-offs, reductions by insurance companies, or just straight defaults by the patient in paying. All those will go towards the physician doing the work but not getting paid for it. RVU kind of takes that away. It’s only based upon what the physician does. In this case, as I’ve mentioned, each encounter is given a number. That number is then multiplied by what we’d call a conversion factor. That’s how much the physician will get paid. 

Let’s do primary care, for instance. Let’s say the median RVUs generated in a year for primary care is roughly 5,000 to 6,000. If they were receiving compensation annually based on RVUs, you’d take 6,000 RVUs, and multiply those times the conversion factor. That’s what they would make for the year.

There are multiple ways of paying them. No one’s going to wait till the end of the year. Generally, they would have a draw. So, there’d be a number that they’d agree to where the physician would be paid that amount. Then either monthly or quarterly, there’d be reconciliation. Suppose there’s a leftover amount, meaning they’ve generated more RVUs than they were actually paid via the draw. They would receive that as a bonus at the end of the month, the quarter, or whatever the reconciliation period. 

There is no negotiation as far as what an encounter is worth, as far as RVUs go. CMS sets that, and that’s what it is. There can be a negotiation in the conversion factor that changes based upon specialty. One specialty may have a conversion factor of 35, which is like the average. Whereas possibly, like a neurosurgeon, it might be 75 or $80. It just depends.

Negotiating Your Compensation Factor in RVUs

If you’re with a health network or a hospital, they usually have their internal benchmarks for what each specialty will receive for their compensation factor. Maybe if you were with a small physician-owned group using RVUs, you’d have more leverage in negotiating your compensation factor. How to use this information practically? I would search right out on the internet for what an annual RVU amount would be in your medical specialty. Also, look for the compensation factor. 

Another way of compensating physicians is they’ll have tiers. For instance, if their expectation is 5,000 RVUs in a year, then maybe between 5,000 and 6,000. They’ll be paid this comp factor 6 to 7. It would raise to maybe $5 more and then 7 to 8, another $5. That’s not uncommon either. Anyway, that is what an RVU is for a physician. Once again, you only care about the work RVU. There are multiple ways of compensating for it. Still, hopefully, that’s a bare-bones analysis to at least give you knowledge about it.

Chelle Law will provide a physician contract review to identify areas we could improve and to assist you in negotiating the best contract possible. 

Other Blogs of Interest

  • What Should be in a J-1 Physician Contract?
  • Is a Physician an Independent Contractor?

What is a Physician Base Compensation Plus Productivity Model? 

How does a base salary plus productivity model work in a contract? It can work in several different ways. We’ll go through that in this article. In a physician contract, if someone is just coming out of training or is switching jobs, there will likely be an income guarantee period. It doesn’t make much sense for physicians to join a medical practice or a hospital. Then go straight production from the beginning. Now, it could be specialty-dependent. Maybe that may make sense if you’re doing staffing or shift work with an ED or hospitalist.

Productivity Based Model

However, if you are building a practice in primary care, cardiology, or any outpatient-based clinic practice. It takes time to build up a patient base. 12 to 18 months is an average time for practice to reach maturity. If you come in, there likely will be an income base guarantee. And maybe some stretch goal production models where you’ll get a bonus if you hit certain thresholds. But in that case, after the income guarantee period, after the first year or two, it can then switch. And today I’ll talk specifically about how a base salary plus productivity model would work. It’s basically a hybrid compensation model. I’ll take two scenarios and kind of walk through them briefly.

Physicians Base Salary Plus RVUs

Let’s say, physicians have a guaranteed base, plus RVU-based productivity bonuses involved. And let’s talk about how that would work. Let’s say you made 240,000 in year one. And then 240,000 in year two is the income guarantee. And after that, your compensation then shifts to the productivity model. An employer could, instead of just paying you 240, they could cut your base guarantee in half. So, you’d be making 120. Then once you hit certain productivity thresholds, they would calculate, and you would get the surplus. Let’s take RVUs as an example. Let’s say you’re in primary care and the annual RVU goal is 6,000. Most places would do maybe a quarterly reconciliation. It’s 1,500 RVUs that you’re expected to generate.

You have the 120 annual base, right? Divide that by 12. And so, you have 10,000 a month, and after the quarter, they’ve paid you 30,000. In addition, at the end of that, they would say, alright, did you generate 1500 RVUs? Then anything above that, you would get multiplication where they’ll take the surplus RVUs times compensation factor. You would get that as a bonus at the end of the quarter. In that scenario, that’s not how most places would do it. Because most physicians won’t be okay with getting a small base each month and a big windfall at the end. 

Base Salary Plus Net-Collections

Additionally, if you were getting half base, you wouldn’t be expected to have a normal median RVU productivity to get additional comp. They would lower it. Another way to do a base plus productivity would be through net-collections. The scenario would be the same: care physicians would have a base salary. And then they would have a net collection threshold. One way would be that the physician is getting paid 20,000 a month. The management would say, okay, once you cover your base pay, once you’d get 20,000 in collections that month. Anything above that amount, you would get a percentage of usually somewhere between 30% to 40%. And then they would get that at the end of the month.

Usually within 15 to 30 days of the end of the month. That would be a normal way of doing it as well. From contract to contract, the way physicians earn probably varies the most from any other term.

In Practice, is One Better Than the Others?

There are so many ways of doing compensation. Is there one that’s better than the others? No, I don’t think so. It depends on the specialty and how efficient the billing practices of your business are. The volume and how established the practice is. All those variables, I guess, combine to determine what type of compensation model would be best for you.

Until we can take a total look at it, there’s no way of knowing what’s the best in your situation. Then also, some employers say, this is the compensation model we’re using. And it would help if you dealt with that as well. In that case, say you know what the compensation model is and that they’re not changing the model. The one variable they can change is the numbers used. The RVU threshold, the net collection percentage, and the base straw. These are all things that can change and determine whether it’s a great opportunity for physicians in their careers. That’s a brief example of a base compensation plus productivity model for physicians.

How is Physician Productivity Calculated? 

What are the different ways of calculating physician productivity? As someone who reviews contracts daily, I find that the two most likely methods of calculating productivity are either net-collections or RVUs. And so, let’s break both of those down. Suppose someone is an employee of a hospital network. In that case, their productivity will likely be calculated through RVUs.

What are RVUs (Relative Value Unit) and How is it Computed?

RVUs are relative value units. CMS, Center for Medicare Services, issues a list every year and has different RVU values associated with the different types of encounters that the physician has. In most scenarios, whatever RVUs generate is multiplied by a conversion factor, and that number can also vary. It’s usually somewhere between $35 to $80, based on the physician’s medical specialty. 

A Scenario for RUVs Measuring Physician Productivity 

Let’s take a scenario where a physician has been employed in the hospital network for a couple of years on an income guarantee. Then their contract will switch to just pure RVU production. Usually, the base salary level will be chosen below what they would’ve made the year prior. So, if somebody made $240,000 and their RVU production matched that in year two and then switched to production, maybe they’ll back down whatever the draw is, like what they’re paid per payroll. So, if they’re receiving 20,000 per month, perhaps they would back that down to 15,000. And then if the physician, when they did the RVU calculation, exceeded that, they would get paid that amount at the end of the month, or quarterly as well as a usual way of doing it.

How RVUs are Calculated

If they’re doing RVU production, it’d rarely be less than quarterly or monthly. That’s how a physician gets paid for RVUs. You take the RVUs generated, multiplied by a conversion factor, and that’s what they get. And then, at some point, there’s always a reconciliation to ensure they are getting what they burn. And there are scenarios where a physician may make less than what they had been earning. Then, in that case, most contracts will carry forward the deficit. So, a care physician could have a negative balance in a month. And if so, the contract will likely state that the negative balance will be carried forward into the next month until a physician exceeds the negative balance. 

Net-Collection

The other way is through net-collections. Net collections are literally what the management collects for the physician services. Now, net-collections are utilized for the most part in private physician-owned practices. The difference between why someone would use RVUs versus net-collections is a hospital network operates RVUs because there are many times when a physician must provide healthcare. They know the person they provide healthcare to can’t pay the bill. 

Hospitals and physicians also don’t think it’s fair that they are part of the job of giving that charity care. However, they still provide that healthcare and want to get paid. And RVUs only consider the work that the physicians do. It doesn’t consider what’s collected. Whereas, with net-collections, most physician-owned practices utilize net-collections because almost everyone they’re providing health care to in practice has insurance or private pay.

Most smaller physician practices aren’t going to provide that charity care. They want to know, will the care physician be paid for what we receive? Now, why can it be different? Well, there could be write-downs from the insurance companies. There could be write-offs from patient care issues where they give a refund, something like that. So, even though the physician may provide healthcare, what the practice receives could be less. And in a net-collections productivity model, usually, it would be monthly productivity. 

Guaranteed Minimum Base Pay for RUV Model

The physician would likely much like the RVU scenario where they’d have a small, guaranteed base, or maybe it’s not even guaranteed, but just like a draw. Let’s take the same amount of money. Let’s say 20,000 a month for a physician. Most practices will say, okay, once your collections exceed your salary for the month. You will get a percentage of whatever is collected after that, usually somewhere between 20% to 35%. And once they reached the threshold, as far as they go up, let’s say they collected 40,000 in a month and had a 25% net collection with a 20,000 threshold. Then they would get 25% of 20,000.

Are Medical Physicians Paid Purely on Net Collections?

Now, I’d say rarely is a physician paid purely on net-collections, meaning there’s no minimum guarantee or draw. It’s just whatever they do in the month, that’s what they receive. Those scenarios are challenging, especially when the physician is starting. Because there’s no guaranteed payment for the first couple of months. And so, they could be working for 30 days without receiving any money. I mean, the average accounts receivable cycle is somewhere between 30 to 90 days.

 In that scenario, the physician wants to ensure a minimum draw, so they make at least a little bit of money in the first couple of months. Then it will ramp up over time. The last consideration is, and this goes for both RVUs and net-collections: if there is a bonus structure involved, there will be language in the contract that states, if the contract is terminated, how is the physician paid? There are times when it will state that the bonuses will only be paid out if the physician is an employee at the time of the payment. 

So, even though they may have earned the bonus if they terminate the contract. Or leave the employee who made it and it’s paid out. They won’t get any of it. Strategically, sometimes the physician must wait until the management pays whatever bonus is coming. Then they can give notice and leave. I mean, that makes the most sense to remember in their careers. So, that’s how they measure physician productivity, or at least the two main ones are RVUs and net-collections.

What Is the Best Physician Compensation Model?

What is the best physician compensation model? I wish I had a black and white answer, but it depends. Let’s work through the different types of physician compensation models and who can benefit from each. There are three main types of physician compensation models. 

3 Main Types of Physician Compensation Models

First, just a straight-based salary. You work for the management. They pay you 300,000 a year. You do the work, that’s it. You get the straight base, no productivity incentives, compensation, nothing. Second, you could earn on net-collections. Whatever revenue your services bring into the practice, you would get a percentage of that. Typically somewhere between 35% to 45%. And then lastly, RVUs. The physician produces work RVUs for every encounter and generates a certain revenue based on the schedule released by CMS. Then there is the compensation factor. An actual monetary value multiplied by the RVUs generated times that compensation factor. That’s how much physicians will make in their careers. 

There are certainly hybrid models that combine one or all of these. It would be rare to have a compensation model with both net-collections and RVUs. That seldom happens. Maybe there would be a half-based salary minimum. And then the rest of your compensation would be tied to either net-collections or RVUs. I find that most physician-owned practices will have some productivity compensation and use net-collections. And then most hospital-based health network employment would utilize RVUs.

Why do they separate them? Not sure. But that’s just how it works in this industry. Which one is best? I think having a straight base salary with absolutely no performance incentives or productivity incentives doesn’t make sense to me. Now, if you’re a new physician coming into a new job. I’ll say, with the hospital, you’re establishing a practice in the area. There will almost always be an income guarantee for the first few years.

RVU Not For Newly Practicing Medical Physicians

It usually takes 12 to 18 months for a practice to reach maturity. So, it only makes sense that physicians wouldn’t be placed on productivity compensation immediately. Especially primary care, cardiology, and any medical specialty where you must build up a patient base like ED or hospitalists. Those types of things where you’re just doing the work before you. You’re not building up a practice. You can hit the ground running. In those scenarios, it’s okay if it was in the RVU-based productivity model. But it makes no sense initially if you’re building up a practice. Many organizations will have an income guarantee for the first year or two. And adjustment into a hybrid of base salary plus RVUs. 

Let’s first take net-collections. The main point of negotiation in the net collections-based agreement is the percentage. When I speak to physicians, they’re taken aback upon seeing they’ll only make 35% of revenue collected by the management. However, overhead is expensive. 60% is not an unusual amount in physician practices. If the management is going to have revenue, they need a percentage within that area. As I said, usually somewhere between 35% and 45% is normal. You will not see a net collections-based agreement over 50%. And if they’re a good businessperson, honestly, anything over 40 to 45 wouldn’t make financial sense unless they’re efficient. 

Negotiate the Percentage of Collection

One thing to negotiate would be the percentage of collection the management gives. It can either be calculated monthly, quarterly or yearly in some instances. And then it’s tier up, or there’s reconciliation at the end of those periods. So, the percentage will be the negotiating point if it’s a net collections-based agreement.

It can be just pure net-collections, meaning everything you bring in that’s your revenue. Or maybe you have a base salary. And let’s say that any quarterly collected over $200,000. You get a percentage of whatever it is, in addition to your base salary. As far as RVUs are concerned, once again, you could be paid monthly, quarterly, or yearly if it’s reconciled. You’re not getting paid yearly, but they could reconcile it at that period. Usually, in an RVU-based contract, they would come up with a draw.

Let’s say you’re taking home 10,000 a month, no matter what. And then, at the end of the month or quarter, there’ll be a target. And then any RVUs generated above that target would be multiplied by that compensation factor. Then that’s what you would take home. So, what is the best? Well, as I said at the beginning, it depends upon the setting for the physicians. Net-collections based do not work in a hospital environment. So, if you are in a healthcare network hospital, it simply doesn’t work. RVU is the only thing that works in that environment. 

It All Depends on the Setting and Practice

I think RVUs are fair, but you also must consider this. If you’re in a medical specialty like ED or hospitalists, and you’re only getting on RVUs. You could be completely screwed if the volume of the hospital is very low. If the sense is slow, if the ED is slow, there’s nothing you can do. In that scenario, you would not want to be paid purely on production. And honestly, it doesn’t happen very often, but I’ve seen it before. And it’s just a bad idea. 

Now, if you’re in primary care, you’re at the mercy of, is the office manager good? Is the office set up well, and are they efficient? Is the medical billing and collection department on top of it? If you’re on a net collection base agreement and the billing and collections department is terrible. Well, you’re the one going to suffer from that. So, I always try to work in a hybrid where you’ll get a guaranteed base. But if you perform over a certain amount, you’ll also reap the benefits of the production. I mean, it’s just human nature. If you can get a bonus, then most people are incentivized to work harder to get that bonus. 

That’s why most of these employers provide something like that. When you’re on a base salary, with no opportunity for production, you’re just doing work that’s in front of you. It’s just human nature that you likely won’t focus or work as hard if there’s no opportunity to make more revenue. So, which one is better? It depends upon the setting. But all three can work perfectly for physicians if it fits the practice that they’re in.

What is the Most Common Physician Compensation Model?

What are the most common types of physician compensation models? Spoiler alert! There is no common model. From contract to contract, the way people get compensated varies the most. It’s the most variable part of any physician contract across contracts. I review hundreds of physician contracts a year. It just blows my mind how many ways different organizations compensate physicians. But there are probably three main types, and I’ll go through those right now. 

Straight-Based Compensation 

The easiest and simplest way of paying physicians is just a straight-based salary. There is no productivity attached to it, no volume expectations. You do the work; you get paid a base salary, and that’s it. For people just coming out of training and starting their careers. It’s not uncommon for them to receive a guaranteed base without productivity for the first year or two. And there are many jobs where they pay the base, and that’s it. 

Pay Through Production 

However, there are also different ways to compensate physicians that introduce some productivity in practice. I’d say the first one is RVUs. When someone enters an organization, whether they’ve been out for a long time or just coming out of training. Just starting out their careers. If you’re joining an organization. This goes mostly for hospitals and big healthcare networks. It’s rare to have a physician-owned practice use RVUs. So they’ll have an income guarantee, usually for a year or two. And then, their physician compensation model will switch completely to RVU performance compensation. How much they make each year depends on how many RVUs they generate in their careers. 

I will not get into what an RVU is or how they calculate it. I do have a couple of videos. If you’re interested, you can look at it. I go through what an RVU is and how a physician gets compensated for it. 

But on the basic level, they multiply the number of RVUs you generate times the compensation factor. Like a monetary amount that varies by medical specialty. Usually, it’s somewhere between 40 to $80. And then they multiply that times your RVUs, and that’s how much you make for the year. Now, there must be some details that go into that. Usually, there’ll be a base draw. So the physician will continue to get a regular monthly salary, but then it’s reconciled quarterly.

Example Scenario on the Job

For instance, let’s say they’re taking home 20,000 a month. At the end of the quarter, they’ve been given 60,000 from the management. And then they’ll look back on how many RVUs they generated times the compensation factor if there is a surplus. It means they generated more RVUs than they made and are usually given a bonus. Most employers in that scenario will not give a full percentage with a base draw. Let’s say in the previous year, someone just via RVUs generated like $240,000, right? So, it’s 20,000 a month. The management will not give them a base of 20,000 a month because there will be variables involved. If someone takes a two-week vacation but keeps getting paid 20,000 per month. 

There will be a deficit they will either have to pay back or carry forward. Most employers will give maybe around 80% of what they made in the previous year as their base draw. And then that way, there aren’t a lot of negative balances to carry forward. Most physicians do not like that at all. One way to do it is just after the income guarantees a straight RVU compensation model. Others will do a hybrid of a guaranteed base in addition to RVUs. They’ll give monthly, quarterly, and yearly targets for RVUs. Once the physician hits that total amount, they can receive a production bonus. 

As I said, it would be just the RVUs generated above several times the compensation factor. Hospital management and healthcare organizations primarily use them. 

How Net Collections-Based Model Works

I would say that a different compensation model is net collections-based, primarily from physician-owned groups from smaller practices. How it works is that they’d calculate the amount collected by the practice that directly results from the physician’s services. And then the physician would get a certain percentage of that.

Usually, the percentage would be between 30% to 40%, somewhere in there. Now, you think that’s completely unfair if you’re a physician. I only get 30% to 40%. Still, when you consider overhead staffing, supplies, payroll taxes, and all that stuff. It does work out mathematically to be equitable for both parties. You are not going to get net collections-based compensation. It is like 50% or anything. It’s just not going to happen. Net collections-based compensation models are like RVU-based models, and there’ll usually be monthly reconciliation. And if you were to generate a hundred thousand dollars monthly, then they would just do the calculation.

If you’re on 40%, you will get $40,000, usually paid within 15 to 30 days of the end of the month. And that’s what you make. Some more variables go into it, which is tricky if you go into a job. It’s just pure collections from the very beginning. You aren’t making a lot in the first couple of months. Because the average accounts receivable revenue cycle can be anywhere from 30 to 90 days. It’s from when you do a service to when you get paid through the insurance companies. You could work for the first month or two and make a tiny amount of money. And then it grows over time. Usually, in those scenarios, we try to bake in a draw. So that the physician isn’t just making a tiny amount in the first few months. 

Summary

My opinion on what’s fair and what’s not? It just depends upon the job and the medical specialty of the physician.

All the different models are fair if the compensation is proper. I think on a kind of motivational level. It makes sense to incorporate some production into the contract. Someone who only has a physician base salary and has no bonus or upside in producing more or working more? It’s just human nature though, that they’re just. I don’t know if being ‘stagnant’ is the right word. But people are motivated by money. That’s just a reality. And if an management can incorporate some way of compensating an ultra-productive physician, there’s no downside to that. It’s probably a matter of whether the employer’s creative. But, I mean, there are a million ways of doing compensation. 

So those are the three most common physician compensation models: straight-based salary, RVU-based production, and net-collections. And then there are so many permutations that would be a hybrid model of all three of those.

How Much are Resident Physician Salaries? 

One question med students have is the average salary for a resident physician. After a physician graduates from medical school, they move on to an internship or residency within their specialty. Then earn. But for most of them, it’s simply not even remotely enough for the work that they’re doing. So, it’s not uncommon for residents to work 70- or 80-hour weeks. The average salary for residents in the United States is around $63,000. Maybe you’re a resident right now, thinking, I don’t even make close to that, or maybe I make more. This is average across all specialties. Some specialties will make a little bit more in their careers than others.

Leverage in Salary Negotiation

Some could be as high as the 60s. Whereas maybe in family medicine, you could be about 50s. Can residents negotiate their salary during training? No, they have no leverage. Anytime you’re negotiating a contract, you base it upon leverage. Even those residents coming out of training and moving on to their first employed job don’t have much leverage either. The only leverage they have in those situations is if they’re in a needed medical specialty. Or two, if they’re willing to go to an under-served geographic area and need physicians.

So, around 63,000 is the medical residency salary. If you think of it this way, if they work 70 to 80 hours a week, they’re making about $15 hourly. And providing healthcare as a doctor for $15 an hour. Now, once they move out of training, the salary increases substantially. And for some specialties could be an eight-fold increase, at least just coming out. But that’s what it is. One consideration we make when reviewing and negotiating the resident’s or fellow’s first contract. Most of them don’t have much money coming out of training. 

Importance of Relocation Assistance 

So, suppose the new employer is offering a signing bonus or relocation assistance. In that case, we want to ensure they’re getting a chunk of that before moving and starting the new job. Wherever, if they are moving from where they’re currently training. Simply most residents, especially if they have family, maybe the only breadwinner. At that point, they don’t have $10,000 to $15,000 if they’re making a cross-country move. So, we need to ensure that either the employers pay their moving costs directly to the moving company. Or they’re going to front the money before the physician needs to spend it on the move.

In that way, they don’t have to outlay a ton of cash. Because it certainly is expensive moving from one place to an entirely different one. Medical residents certainly are underpaid. Unfortunately, it’s part of the process they must go through to be fairly compensated for the services they provide. But it’s just tough when you’re making that little. And I think the average physician has about. I think 47% of physicians have student loans over $200,000. It could be a big burden.

When Should a Physician Resident Start Looking for a Job?

When should resident physicians start looking for jobs? This is a complicated question. First, I do contract reviews daily for physicians. Many are individuals getting their first jobs who’ve never had an employment contract before. They’re either in their last year of residency or fellowship and have an offer they want me to review. There are occasions where there’s a multiple-year fellowship, maybe a PGY-2 or something like that. Wherein residents already have an offer that won’t begin for two years and want me to look at, as well.

Search for a Residency Job

Let me give some words of wisdom, just from doing this for a couple of decades now. One, if you are a resident or a fellow. You know where you need to be geographically. Maybe you have to move home, or you have a significant other completing trading themselves elsewhere. Want to move close to your family, whatever it is. If you have a pinpoint location in mind, getting started sooner than later is probably a good idea. Start looking for work when you still have two years left in training. Think of it from an employer’s perspective. Some employers don’t have immediate needs for physicians, right? So, if they are well run, they’ll have financial forecasts.

Forecasts as far as the patient load will be, perhaps the management is expanding and opening a new office. But they’re not going to open it for a year. I guess I’m saying that employers know that they’d have a need for a physician. But sometimes, it’s not for a couple of years. That’s why management will start looking immediately for a position that’s not immediately available. Once they get out there and see some candidates, even if that candidate has two years left in training. It’s not uncommon for them to offer them a position and make them sign an employment contract. One benefit of looking early in their careers is simply getting in before someone else takes the part. So the earlier you look at the job, the more likely you’d have a chance to get it. If that makes sense. 

If You Take a Practice Early 

Next, the downsides of going early. What’s the negative part of finding a position far out from when medical residents have completed training? Suppose you sign an employment agreement that doesn’t commence for two years. And then you have some change in the family. Maybe the significant other that was supposed to move to one city is now moving to another. Or there’s a sickness in the family. There are a million reasons why a location is perfect at one point, and two years later, it’s not. The downside of signing early is that things may change in your life, but you have signed the employment agreement. Then it gets into: how can I terminate this agreement even before I’ve started? Are there any penalties associated with it? Some contracts have built in that if the physician doesn’t start, they will owe some penalty.

Which Year to Start the Job Search?

I would suggest. Before signing an agreement with that kind of language, probably get it reviewed by someone to go over the ramifications. What happens if I sign the agreement, I either can’t start or don’t want to start. And then need to get out of the contract? Another possibility is you sign early and get a better offer. So maybe it’s just a better opportunity for you. The compensation is more. The benefits are better. The concern is that if you sign a contractor early, you’re foregoing any potential opportunities down the road. Now, some employers are okay with letting someone out with enough notice. 

The contract will have a notice requirement, but if you haven’t even started, most employers are understanding. If there is some actual change in family circumstances. They’re not as forgiving if it’s simply that this person is paying me more than you. I don’t want to complete the terms of this agreement. Once the contract is signed, the employer relies upon you to start, so they will stop recruiting anyone else. They’re going to make plans to either bring in more patient volume. Or maybe the office they’re opening up is contingent upon you being there.

Where Residents Should be Looking

So, I guess there are problems for both sides if the physician doesn’t want to start. The employer could have some damages associated with the physician not completing the terms of the agreement. Overall, I’d say the sooner, the better to start looking. However, taking the first offer and signing an employment agreement without comparing different bids is a bad idea. There are almost always multiple opportunities for somebody. Just to accept the first one just because they are the first doesn’t make a lot of sense to me. So I’d suggest you look at multiple offers, gauge the compensation structure amongst them, and then go from there.

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Can You Get Your Nursing License Back After Being Revoked?

Nursing, Blog
banner: Your Nursing License was Revoked. Now What? | RN License Revocation

What should a nurse do after a nursing license is revoked? Well, the first question is, why was it revoked? Normally, a nurse’s license would be revoked because they violated the consent agreement terms if a nurse were to get in trouble or have a substance abuse issue. Usually, a board would put them on probation, which would be through a document called a consent agreement. And then in that agreement, it would have terms of, let’s say, a nurse has an opiate addiction or something like that. And then, they were caught diverting, and the board found out and put them on probation. Usually, those would include random drug testing, supervision at work, AA or NA attendance, a nurse recovery group, or something like that.

Nursing Board License Suspension Consequences

Maybe they can’t work nights or home health. In this scenario, a nurse failed a drug test. The agreement states that it automatically revokes their license if they fail a drug test. Normally, in each agreement, it’s going to say if it’s revoked. This is how long the license is revoked until you can reapply. I want to discuss some strategies and tips on what a nurse should do during that revocation period. These tips would put them in a better position to get their license back once that period ends. In most states, it’s usually somewhere between three to five years. If a nurse has a license revoked, after that period ends, you can then reapply. Well, why the license was revoked depends on what you need to do in the interim.

When Your Nursing Board License Is Revoked

So, it would help if you thought about it like, okay, you violated an agreement for a reason; this would put you on a contract for a reason. What was the reason? Substance abuse is an easy thing to handle. If they are concerned that you have a substance abuse problem, they put you on that agreement and show you what they want you to do to be safe to practice. Let’s say you had your license revoked because you violated the terms of an agreement and you were an alcoholic. Well, during that period, you need to work on the addiction. Meaning you need to go to AA, and you need to get a sponsor. It would be best if you documented all the times you went there. I don’t usually suggest doing random drug screens. Other blogs of interest 

They can get expensive. And I don’t think it’s necessary. Getting a random drug screen through that entire period would be helpful if you want to do everything possible. I mean, if you’re going to do that, then I’d probably only do that in about six months leading up to one year or two. Talk about continuing to go to a nurse recovery group or changing lifestyles, eating better, getting into shape, and dealing with stress. Most of the time, they’re concerned that a stressor leads the nurse to drink for whatever reason. Another great thing to do would be counseling, so meeting with a licensed professional counselor, substance abuse counselor, or psychologist and dealing with those issues.

Nurse’s Revoked License Probable Reinstatement

Generally, the psychologist would then state that you don’t need to come to me anymore after a period. Then you want a letter from that person saying the nurse completed this many sessions. I don’t believe that they need to continue counseling. And then, when you reapply, you would send that letter to the board. Suppose the board wanted you to go into rehabilitation or an intensive outpatient treatment program. In that case, If you didn’t do it before the suspension of your license, you should do it right away. 

What are some strategies if substance abuse is involved? If it’s a clinical issue, recovering from it is more challenging. If you had your license revoked purely due to a clinical problem, it’s tough to rehab that, right? You could do continuing education, but after a period, you’ll always have to do a refresher course if they allow you to get your license back. But, only continuing education is the only thing you can do if it is an ongoing clinical issue. Or going back to school and showing success is another thing you can do. 

Action That Prevents a Nurse From Regaining Their Licensure

There are some things that a nurse cannot recover. Usually, physical abuse towards a patient, sexual misconduct, and some major criminal issues result in a felony. There are just certain things that if a nurse does, regardless of the time, they will never get their license back. If it’s a high-profile case, I find the boards like I’m in Arizona. For instance, there have been a few high-profile cases. And I think from the board’s perspective, they kind of feel like it would be bad publicity if they took someone’s license away for whatever the issue was. 

And then, after five years or ten years, they gave it back to that nurse simply because what they did initially was. I guess so bad that they wouldn’t want to seem like they were lenient in, I think, facilitating that behavior and giving them their life license back. That doesn’t happen very often. A nurse rarely does something so wrong that no board would give them a second chance. Still, some things happen. Unfortunately, suppose you did one of those I listed. In that case, regardless of its state, you may never get your license again.

Summary From An Attorney

So, in summary, think of it like, alright, what led to the revocation? And then what can I do in that period to show the board that I’m taking the initiative, I’m dealing with my issues. Document everything you’ve done because they will want to see that when you reapply and try to fix whatever the problems were. If you were on a consent agreement and violated the contract, reapply in whatever period. It is almost 100% certain that you will be placed back on a consent agreement, regardless of how much you had rehabilitated over that period. They’re just not going to take the nurse’s word for it, and they’ll want to see at least some level of supervision or probation for a period. And then, after that, the nurse would be kind of free from any of those probationary requirements.

Your Nursing License was Revoked. Now What? | RN License Revocation

Ask an Attorney

Arizona Nursing License Suspension: Nurses contact our office and frequently ask our attorneys, does state law allow the Arizona State Board of Nursing to suspend a nurse’s license? The short answer is yes. The board can issue a license suspension based upon ARS 41-1092.11. That statute states nurses can be suspended (and ultimately have their license revoked):

“B. Revocation, suspension, annulment, or withdrawal of any license is not lawful unless, before the action, the agency provides the licensee with notice and an opportunity for a hearing following this article. Suppose the agency finds that the public health, safety, or welfare imperatively requires emergency action and incorporates a finding to that effect in its order. In that case, the agency may order a summary suspension of a license pending proceedings for revocation or other action. These proceedings shall be instituted and determined.”

Nursing Board Discipline

So, in short, yes. The Arizona Board of Nursing has the power to suspend your license if it determines you are an immediate threat to the public’s health, safety, and welfare. Some usual reasons for a nursing license suspension include:

  • Diverting narcotics.
  • Healthcare problems.
  • Criminal issues (felony, misdemeanor).
  • Past disciplinary issues.
  • Substance abuse (alcohol, prescription medications, illegal drugs).
  • Sexual misconduct.
  • Mental health disorders necessitate immediate action.

AZ Nurse Complaint for an RN, LPN, or LNA

Many ask Can a Nurse Continue to Work if Suspended by the Arizona Nursing Board? No, a nurse cannot work as a nurse if the board suspends their license. The Arizona State Board of Nursing (“Board”) protects the medical welfare of the people of Arizona. They do this by ensuring each Medical professional with a nursing license in Arizona can practice safely. If the board believes a nurse cannot practice safely, they can initiate a summary suspension.

A summary suspension can occur when the board believes that the public health, safety, or welfare imperatively requires emergency action necessitating the immediate suspension of a nurse’s license. Examples of actions that can lead to a summary suspension:

  • Substance Abuse
  • Sexual Misconduct
  • Mental Health Concerns
  • Refusal to Follow Board Order

Board grants the summary suspension of a nurse’s license; the nurse must immediately cease providing care as a nurse. A hearing will then be scheduled (within 60 days) in front of an Administrative Law Judge at the Arizona Office of Administrative Hearings.

Criminal Report

A misdemeanor criminal charge would likely not reach the threshold needed for the Bd to initiate a summary suspension (such as a misdemeanor DUI or Disorderly Conduct charge).

Other Blogs of Interest

  • Nursing Law: Pros and Cons of Alternative to Discipline Programs for Nurses
  • Easiest Way For a Nurse to be Suspected of Diverting Narcotics
  • What Does it Mean When a Nurse is Suspended?

Does a DUI Affect your Nursing License?

Can a DUI affect your nursing license? As in all my other blogs, this is a general discussion. This is not state specific. Every state has its own rules and regulations as far as when and how to report. So, this is just going to be a general discussion of the things you need to think about that may affect your nursing license if you get a DUI. 

Charge vs. Conviction

First, you need to identify whether your board in nursing has a reporting requirement. For instance, here in Arizona, our nurses have to report it when they’re charged, not even when they’re convicted. A charge is when you get a DUI and a ticket with an arraignment date; that’s considered a charge. Sometimes, they’ll wait to charge you if they’re waiting for a blood test. But when you are charged, it just means when they decided to move forward with whatever the violations were. 

A conviction is when you’re guilty, or you sign a plea agreement, or a pretrial diversion program, or at least most boards consider a pretrial diversion program a conviction. Like an end to whatever the criminal conduct was, that isn’t a complete dismissal. For the most part, those need to be reported. Now, when they need to be reported varies from state to state. Some require it upon renewal, and some require it upon conviction; then, as I said before, it’s when they are charged, regardless of whether they’re ultimately convicted. That’s the first thing you need to identify.

Your Nursing License was Revoked. Now What? | RN License Revocation

When Do Nurses Need to Report DUIs?

Alright, when do I need to report it? If I need to report it, then how do I need to report it? For the most part, it needs to be in writing. And I would not submit a long story about all the details, like I went out to dinner with Sally and had this many drinks. That is not going to help you.

It would help if you stuck to the facts. I was charged with this on this date, and my arraignment date is this; I’ll supplement in the future with more information. Or I was convicted of this on this date, which is what I’ve done. And leave it at that. You don’t want to give them any more information than you must. And the essential requirement is that you let them put them on notice of what happened criminally. Still, it doesn’t mean you must give every detail about what happened. 

Is It Substance Abuse or a Deeper Issue?

Some broad thoughts on substance abuse and DUI: the biggest concern of any board of nursing is that if you do get a DUI, you have a substance abuse issue. The stated purpose of nearly every board of nursing is not to protect the nurses. It’s to protect the public. And so, they don’t want a nurse with substance abuse issues providing patient care. Now, just because you have one DUI doesn’t mean that you have substance abuse issues, but it could be that you do. Let me say this delicately. I always speak to people with what I would consider chronic drinking problems. And they think it’s wonderful. For example, if you have a six-pack or a bottle of wine every night, the board of nursing will consider that a substance abuse problem.

Suppose you just went out, went to dinner, had a few drinks with friends, you occasionally drink socially a couple of times a month. In that case, you don’t drink too much intoxication; that’s just regular alcohol consumption. That’s not a substance abuse problem, but the board will think that no matter what, they will start at this person as an alcoholic and then work their way down. So, suppose it’s just your first-time regular DUI. In that case, you have a relatively low BAC, and most boards of nursing aren’t going to formally discipline a nurse for something like that. If it’s a third DUI and you had a super extreme BAC level here in Arizona, that’s above 0.2. 

What Will Happen if a Nurse  Commits Third DUI?

The board is going to be concerned. And what they would do here is have the nurse undergo a substance abuse evaluation with the psychologist. Then that psychologist would write recommendations to the board. And then, the board would incorporate those recommendations into probation if they thought they had substance abuse issues. It’s implausible that a nurse with a low-level DUI will lose their nursing license. I mean, it’s infrequent. 

There must be more underlying things to end up with that result. But, if you have chronic problems, a criminal problem with alcohol or drugs, that could lead to a board decision. We don’t want this person to provide care anymore. Now, they’re almost always going to give the nurse at least the option of going on probation or entering a confidential monitoring program. Most states call it an alternative to discipline or something like that. In a worst-case scenario, at least at the beginning, you’d have the option of doing that.

Confidential Monitoring Program

Where most nurses get in trouble with persistent problems with alcohol, they’re in the confidential monitoring program, have a positive drug screen for alcohol, and get kicked out of that program. They get put on formal disciplinary probation. The same thing happens, then they get their nursing license suspended. And then, if you continue to violate the terms of the probation, it could end up in revocation. If you’ve had one DUI as a nurse, it will not end your career. It’s most likely not going to prohibit you from getting jobs in the future. 

You must be aware of this. You cannot let it happen again, but if you screwed up, I find the best defense for people who have screwed up, and it’s a lower-level thing, is to admit, you know what? I just made the wrong decision. I don’t have a drinking problem if it’s just one night, and I’ve learned from it. These are the things I’ve learned from it. These are the things I’ll do now to prevent it. And then, this is what I will do in the future. And that’s what most boards of nursing want to hear. Is that if there is an identifiable problem, you have learned from it and then incorporated that into your practice and move forward in the future.

On Complaints: Common Board of Nursing Disciplinary Actions

What are the options for a board to discipline a nurse? Now, before I get started, this topic is very state-specific. Every state has its own spectrum of disciplinary actions. So, my talk today will be general, meaning the state you’re in might make a difference. But this is the standard structure of what kind of disciplinary action is for the board. There are usually three options for non-disciplinary activities, and I think I should go through those first. There are several reasons a case can be dismissed and could be dismissed in filing a complaint.

Two Most Common Forms of Dismissal

Usually, the two most common reasons for dismissal are, one, the board doesn’t have jurisdiction over the complaint. Two, the conduct alleged in the complaint is not a violation of the nurse practice act. And then the other way of dismissing the case is obviously after an investigation. It can be dismissed if they believe there are no grounds to discipline the nurse. Most boards will then have a non-disciplinary option. I know here in Arizona, it’s called a letter of concern. It could be a reprimand or an advisory letter. It goes by different names. Still, I’ll call it a “letter of reference.” It’s simply a letter in your board file stating concern about the incident. Still, it’s not considered formal disciplinary action and wouldn’t be reported to any databases, nurses, or national practitioner databases.

Non-Disciplinary Continuing Education

It would just be kind of on file with the board. And if the nurse were to get in trouble in the future, they would look back at the letter of concern and decide whether they needed to take additional action. Some boards also offer an administrative penalty, which would be considered non-disciplinary. Other boards will give a fine or admit a straight liability if a nurse files for the renewal late or doesn’t provide the necessary fee. Some boards will give a fine, typically, or admit a straight penalty. The last option would be a non-disciplinary agreement for continuing education. Most of the time, that’s not considered disciplinary action. Not every state requires continuing education for nurses. Still, many states offer non-disciplinary continuing education where they’d have to take a course in documentation, nursing ethics, assessments, etc. 

Common Disciplinary Action Options 

Decree of Center

Those are all the non-disciplinary options. We’re here for the standard disciplinary options, and I’ll go through those. Most states usually have a decree of center or letter of reprimand. It’s a formal document that states the nurse did violate the state law in some way, but it doesn’t rise to the level where the nurse is put on probation. It’s like a formal slap on the wrist. It is necessary to report it to the database, and nurses and the nurse would have to register it in the future. Suppose any employment application states, “Have you ever been formally disciplined by a board?” In that case, they’d have to answer “yes,” but it’s a decent outcome in many cases. I guess the two choices were probation or decree of center. The decree of center is the better route to go.

Disciplinary Order for Continuing Education

Another disciplinary option is disciplinary order for continuing education. There’s a non-disciplinary potential and then a disciplinary potential. It would just depend upon the facts of the situation. I mean, the order would be the same. They must do a certain amount of continuing education where they could get in trouble. But in this case, maybe the clinical problem rose to the level that the board felt they needed to put on the record.

And so, a disciplinary order for continuing education is another option. Usually, somewhere between $500 to $2,000 is used as a civil penalty in many states, just like a fine. The difference between what led up to a complaint that ended up in a decree center and a civil penalty is maybe the civil penalty route was a little more concerning to the board, but that’s another option as well. Anything after that, for the most part, would be probationary.

Probationary

Let’s take, for instance, a nurse with substance abuse problems and several DUIs. The board felt it was necessary to put her on probation. Normal probation would include testing for substance abuse, random drug testing, AA participation, and some level of monitoring at work. Maybe you can’t pass narcotics for a period. Maybe they’ll make the nurse do counseling. They could add continuing education to a consent agreement as well. Probation can last from a year to up to three years or more. And then, after the probationary period is over. The nurses fulfilled all of the obligations of probation. They’re no longer on probation, their licenses are unencumbered, and they can work freely without restrictions.

How Can a License Be Suspended?

The levels after that are wrong. One would be a suspension. Several ways to suspend a nurse. If they were on a consent agreement and they violated the terms of the agreement. Most boards have the option to suspend the nurse’s license. The board can take a summary suspension if there’s a nasty incident. The board will take emergency action to suspend a nurse’s license. Those are kind of two ways the board can suspend a license. And finally, revocation is the worst-case scenario for a nurse. That is discipline. Suppose they violate the terms of a current consent agreement once again. In that case, many boards have an automatic option where the nurse’s license is revoked. Once again, if there’s a heinous incident, it could lead to a quick revocation.

Voluntary Surrendering of License

It’s not common for a nurse’s license to be revoked. I mean, less than 1% of nurses have their license revoked. It must be challenging and concerning conduct to get to that level. But it is always an option. A nurse can voluntarily surrender their license. That is considered a disciplinary action. I have nurses sometimes, and maybe they’re toward the end of their careers. They’re not interested in going on probation or fulfilling the terms of whatever their offer of consent agreement is. And they can give up their license. It’s called surrender.

Therefore, they no longer have their license. Normally, there would be a period when they could reapply if they wanted to. But a voluntary surrender is considered a disciplinary action as well. Those are the common reasons for a board of nursing. I guess the common reasons for disciplinary actions from the board of nursing. There’s a wide spectrum of things they can do.

Summary

I get asked, what’s your win rate, or what are your outcomes? I mean, it’s impossible to answer as an attorney who represents nurses. Getting a nurse on probation and not getting their license revoked can be a huge win. Getting somebody dismissed versus a decree of center could also be a huge one. It just depends upon the conduct. And most boards will have a range. I mean, I can see a case and understand, alright, this is where it will fall. But suppose you’re looking for an attorney, and you ask that question. 

In that case, it’s difficult to answer because every situation is unique. And so, one outcome could be enormous for one person and a terrible outcome for another. It just depends upon the situation. Some states require a certain period after either the felony. I guess the nurse or potential nurse was either convicted of the felony or completed the probationary requirements. I know here in Arizona, someone must have at least three years from the date of termination of probation for a felony case to be eligible to reapply or apply for a nursing license.

The first things are heinous crimes, and two, high negative publicity events. I know it sounds strange, but boards of nursing are very concerned about the public image of nurses. And if there’s been a past incident with an applicant that sheds negatively upon the nursing profession, that board will be much less likely to issue the license. Most of those end up being criminal in nature. Still, you need to consider that these are political agencies and the politics of issuing licenses to people that are looked at as either dangerous or incompetent is not something most boards are willing to do. 

When the State Revokes Your RN License 

Lastly, if you’ve had another healthcare license and you’ve been placed on the OIG exclusionary list, so the office of the inspector general has this list where if you’ve had a license revoked, suspended, voluntary surrender, or a certain number of crimes, they can exclude you from billing under Medicare or Medicaid. The nursing boards, for the most part, don’t care about that at all. However, the employers, or at least some employers, will. If they can’t bill for you, they will not employ you. So, you need to think, alright, what happened to put me on that exclusionary list? And then you also need to consider there are ways of getting off it after a period and, I guess, jumping through certain hoops. You need to investigate doing that disqualify as well. 

Very few things can completely disqualify a nurse from getting a license. Most nursing boards just want to see if something bad happened, have you learned from it? Did you take steps to remediate the behavior in some way? If it was maybe drugs or alcohol like DUI, did you go to AA? Did you go to counseling? Did you go to an intensive outpatient treatment program or rehab? Have you made just healthy changes in your lifestyle so that you can deal with stress better? Do you exercise discipline over your life? These are the things the boards want to hear. Just because you’ve had one bad thing happen in your past, if you’ve learned from it and incorporated positive things into your life, that’s what the nursing boards want to see.

What Can Disqualify You From Being a Nurse?

What can disqualify you from becoming a nurse? I’m only going to talk about applicants, not people the state has already licensed. This is just going to be a general discussion. Maybe I’m thinking of going to nursing school, or perhaps I’m still a nursing student, or I’ve completed nursing school. Now I must apply to a board. What things in my past could disqualify me from being a nurse in the future? Lastly, this is not going to be state-specific. It’s just going to be a general discussion. 

The first, probably the most apparent, is some heinous criminal incidents in your past. Almost none of the boards in any state contain a list of things like, if you’ve done these things, you can’t get a license as a nurse. No matter what the case, they’ll have a general guideline. But, any violent crimes, if you were a possible heavy distributor of drugs in some way, sexual misconduct. These are things that are hard to rehabilitate, or at least in the eyes of the board. And so, having those in your past could be a barrier to ever getting a nursing license. 

Getting a License After A Crime

It may not feel like it when I talk to nurses. Who are always concerned about DUI, marijuana possession, theft, domestic violence, disorderly conduct, and assault charges. But these are relatively low-level crimes. And just because you’ve had some of those in your past generally will not disqualify you from getting a nursing license. Now, if you’ve had 20 assault charges, it’s probably not going to happen to you. Still, if it’s a handful of things from 20 years ago, it will not hinder you from getting your nursing license.

And even in this scenario, where the board was very concerned about past behavior, they almost always offered the nurse a probationary license, meaning they would grant the license. Still, they would simultaneously put them on probation for one to three years. And at the end of that probationary period, their license is unfettered. That’s usually what the case is. 

The Board Is Concerned About Public Image

People make mistakes. But if the same thing keeps happening and you’re not learning from it. I mean, at some point, you’ll likely have an interview with an investigator from a nursing board if you’ve applied to some criminal history. You state I was set up, making excuses. Those are not the things that they want to hear.

Arizona Nursing Board Questions?

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Can You Be a Nurse With a Felony? (the TRUTH From a Lawyer)

Blog, Nursing
Banner: Can a Felon Become a Nurse?

This is going to deal with people who may be thinking of going to nursing school. They might decide, alright, maybe I can get into nursing school. But will getting a license from a state be a problem down the road? I’m not going to focus on a currently licensed nurse who gets a felony. In short, if you do have a felony in your past, can it completely bar you from becoming a nurse? The short answer is no. But, it’s going to be state-specific. I’m not going to talk about one state over another. This will be a general analysis of how to determine if you can get a license or not.

First, every state is going to have different rules, unfortunately. So if you apply to one state, it might be no problem. With another, it might be a complete bar to getting licensed. Before you go into nursing school, you must think, what state do I want to end up in? Then you need to research the rules of that state to figure out what felony conviction issues there are.

Most states won’t completely bar you to license if you’ve had a past felony. But they will initiate an investigation and then investigate. What was the reason behind the conviction? That conviction is going to be a big determining factor in whether you can get licensed or not. 

Enrolling in Nursing School with a Felony Record 

The first thing you should probably do is call an attorney in the state you want to get licensed in who deals with nursing board issues. They’re not going to give you a “you will get licensed”, or “there’s no way” answer. But they can give you some general guidelines of what they’ve done before. The rules they’ve followed as far as felonies go. Also what you can do to put yourself in the best position to get licensed. That’s the most efficient use of your time. 

You could also go on the board’s website and find out what the rules are for felonies. Some states call it a “felony bar,” so Google that. But let’s say you do apply, they run a criminal background check, and it pops up. Almost every application is going to state that if you’ve had a felony, you must disclose it. Then you’ll need to provide police records, court documents, or any documentation saying you’ve completed your sentence. 

After you gather all of that, the board usually wants you to write a statement about what happened. At some point, you’ll have an interview with the board investigator. They will inquire about the reasons behind the incident. Now, some felony crimes will probably completely bar you from ever getting a license. Any kind of child abuse, sexual misconduct, and involving yourself in the distribution of prescription drug felonies are some examples. You’re going to have access to all the narcotics in the world when you’re a nurse. So if you have any convictions before with diverting or selling prescription meds, they’re going to be very concerned about that.

Criminal Records that Pose the Biggest Obstacle to Becoming a Nurse

Super violent crimes, adult abuse, or things that are difficult to rehabilitate from are the biggest problem for past felonies. If you have drugs, alcohol, or domestic violence problems, you can do anger management, Alcoholics Anonymous, Narcotics Anonymous, or counseling. Things that you can rehabilitate from are much easier to get a license after. Meanwhile, abuse, sexual misconduct, convictions involving honesty like fraud, and identity theft, are things some people won’t consider something you can rehab from. 

Just to recap. First, you need to figure out what state you would like to get licensed in. Second, call an attorney in that state knowledgeable about the nursing board. Ask them, what are the laws around past felony convictions there?

There may not be a bunch of specific rules about the past. I know most boards will have specific implementations if you’re currently licensed and then get a felony. But not all the boards are going to have laws that state what’s going to happen if you’ve had a past felony. But still, talk it over. Where does the board usually look? What did they do with this type of felony in the past? If there are some steps you can take during nursing school, like either going to AA, rehab, or counseling? Things that will then set you up and put you in a better position when you ultimately apply for your license. Those are important things that you need to think about.

So, take a deep breath. If you do have a felony, it’s not going to completely bar you from being a nurse most likely. Just kind of do your research and good luck with your nursing career.

Other Blogs Of Interest

  • What Would a Nurse be Subject to if Recently Convicted of a Felony?
  • Can you be a Nurse in Indiana with a Felony?
  • Nursing Law: Can you be a Nurse with a Misdemeanor Assault Charge?
a group of medical professionals.

Can You Be a Nurse With a Misdemeanor?

Can you become a nurse with a misdemeanor in your past?  Two things: one, this is not state specific. This is general information about what most boards will consider. And two, applicant nurses will be the target of this post. I’m not going to talk about what happens if you’re currently a licensed nurse and get a misdemeanor. This is about people with a past misdemeanor, who are going to apply for their first LPN, RN, or CNA. Let’s talk about the application process.

Entering Nursing School With Past Record

Normally, almost any nursing board application is going to ask for any past felonies. You’ll have to disclose those. And two, this is the important language: it may ask if you’ve ever been convicted of a misdemeanor. Some will just say, have you ever been convicted of a misdemeanor involving drugs or alcohol? Each state is a little bit different. You need to look at the specific language and then determine if it’s necessary for you to disclose the misdemeanor. Now, every board is going to run a criminal background check. I find from state to state, the sensitivity of that background check varies wildly. 

So, in one state, something can pop up whereas, in another, it doesn’t pop up at all. One consideration for many nurses is not having disclosed anything, say, from 25 years ago, which they should have done. Now it popped up on the background check. Then the board initiated an investigation and asked them to explain what happened and why they failed to disclose it.

One thing you could do is find an attorney in your state that handles nursing board cases. And if you’re unsure whether something qualifies for disclosure, talk to them and see if it meets the threshold. What you don’t want to do is fail to disclose something that should have been disclosed. And that could open you up to discipline. The board may decide to grant you a license. But they will still formally discipline you for failing to disclose a prior criminal incident you should’ve disclosed. That’s the first thing you need to think about. Alright, what does the application say? And then do I need to disclose it or not? Now, the next analysis is what’s the likelihood of you not getting licensed because of a past misdemeanor. 

a doctor probably checking a patient's record

Boards Will Most Likely Make Nurses Disclose Felonies

As I said, almost every board will make a nurse disclose felonies. And depending upon what it is, it could mean that a nurse will not get their license. Now, just because you’ve had a felony in your past, doesn’t mean that you won’t get your nursing license. That’s not a guarantee. It would depend upon the nature of the felony, how long ago it was, that type of thing. It’s highly unlikely that any misdemeanor in your past would prevent you entirely from obtaining a nursing license. What could prevent that would be if there are a bunch of misdemeanors. If you’ve committed various offenses in the past, it might affect whether you receive a license or not. If you’ve had one 20 years ago, when you were 19, it’s extremely unlikely that it will prevent you from obtaining a license. 

There are scenarios where you have had several misdemeanors in your past. Let’s just say someone had three DUIs. Maybe 10 years ago. In that time period, the board is going to ask you questions about your use of drugs and alcohol. How much do you drink? When was the last time you were intoxicated? Did you ever go into AA? Did you ever do any kind of rehab or IOP? 

They want to know if you’ve experienced brief periods of distress, which is common among people struggling with substance abuse. Or who may be experiencing other problems in their lives, such as an abusive partner or a mental health problem? Have you resolved the issues from the past, as the board will want to know? Do they believe that you pose a future risk to patient safety? It is worse for the nurse the shorter the period of time between the criminal act and the license application.

Determined to Become a Nurse?

If you’ve had three DUIs within the past year, the board will be very concerned that you have an alcohol-related problem. And they may flatly deny your application or, alternatively, offer probation while also granting you a license. And they’ll tell you, “You’ll have to do drug tests. There’ll be supervision at work. You may have to do AA or a nurse recovery group. You can’t pass narcs.” There may be restrictions on the license, but they’ll likely also grant it. 

It’s rare that someone’s criminal background would completely bar them from being licensed. If you are willing to go on probation in some situations, it shouldn’t matter. Additionally, the board will consider it favorably if you clearly took some proactive measures to resolve the problems. Will a misdemeanor hurt your chances? Yes, it’ll make it harder, but it certainly is unlikely to be a complete bar for getting it.

Since we’re in Arizona, this won’t help you if you live in another state. But I believe this is sound general advice for nurses regarding what to consider if you have a criminal record. Sometimes people wanting to go to nursing school will call. They’ll say, “I don’t want to enroll in nursing school if it’s even unlikely for me to get licensed.” In that scenario, reach out to an attorney that does nursing board work in your state and ask if they have experience dealing with this type of crime. If they think it’s worth it, if it’s okay, and the likelihood of you getting a license. That’s valuable information. It would be a terrible situation to enroll in nursing school, spend all that money and time, then apply with no chance of receiving a license due to past criminal incidents. I hate for that to happen to anybody.

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November 29, 2022/by admin
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Letter of Intent for a Job (Is it BINDING?)

Employment Contract, Blog
Is a Letter of Intent for Employment Binding?

Is a letter of intent for a job or employment binding? The short answer is probably not when a professional is looking for a new position. The employer may state that before we give you an employment contract, we’d like you to sign a letter of intent or offer letter. And then, that letter of intent will outline the main points of the employment relationship. Normally, in a letter of intent, you’d have the term of the contract. So, how long does it last? Maybe it terminates? What is the length of notice required if it is terminated without cause? Indeed, it will have compensation details like base salary, productivity bonuses, and commission percentage.

Letter of Intent for a Job Contents

Maybe a brief description of the benefits would be helpful. And then, if there’s a non-compete involved. If it’s a healthcare contract, maybe some details about the malpractice insurance. Quick bullet points: This is how we anticipate the employment relationship. And at that point, there may be some negotiation between the professional and the employer. For instance, if the professional wants a higher base salary or a higher percentage of collections, or whatever it is, that’s the time to negotiate. Once an agreement is reached, the professional signs the offer letter, and generally, the company will also. The company will typically draft a formal employment contract with legally binding terms. What are some reasons why someone would back out after signing an offer letter?

What May Affect the Details in a Contract?

Well, the details in a contract can significantly change when provided with more context. For instance, if the offer letter states, let’s discuss the non-compete. It may be two years and 10 miles from your primary practice location, in sales, from your sales territory, or something like that. And then, when you investigate the agreement. It may be much more prohibitive because you can’t only work in your specialty, but you also can’t work in sales in this area if you’re selling software or something like that. Then normally, non-competes would apply only to software. So, you could switch industries for a brief period and then come back if you wanted to.

However, suppose the language says you can’t work in sales during this period within a 10-mile radius or something. In that case, that could substantially change the job. Or perhaps, if there are some commission-based bonuses, it may state that if the contract terminates, A professional won’t receive any of those bonuses if they don’t get paid. And so, someone could work for an entire year, earn bonuses, and then maybe leave in month 10 of the year. They get nothing as far as bonuses go. These are a few reasons someone would be okay with an offer letter. Then maybe not with the employment agreement. Unless specifically stated in the offer letter, the professional is not bound by language that states a binding document in some way.

What Happens When Change of Mind After Signing an Offer Letter?

It is exceedingly rare to see an offer letter with that language. Generally, it’s just, here are the basic terms of employment. Then it moves forward to an employment agreement. Until the professional signs the employment agreement. It’s still mostly a handshake. Other times, if someone received an offer letter. Find a new and better position and pay more. They’ll say, I’m not going to entertain this job anymore. I’m going to move out. In that scenario, if someone wanted to back out after signing an offer letter. Then you need to say warmly, this isn’t going to work out for me. I will pursue a different opportunity, appreciate the consideration and move on. You don’t need to give any explanation if you don’t want to, as far as why you’re doing that.

Generally, offer letters or letters of intent is not binding. And the professional is free to continue looking. Now, the last consideration is some bad blood may pop up after someone pulls out after signing an offer letter. As I said before, try to be professional and cordial about letting them know that you’re not going to move forward with that employment agreement. However, this is business; most companies understand that people sometimes change. Their minds in a competitive job environment. I wouldn’t be that concerned about that. But it may happen, so you want to avoid burning bridges if possible.

Other Blogs of Interest

  • Should You Sign a Physician Letter of Intent?
  • Can a Physician Sign Multiple Letters of Intent?
  • What Benefits Should Go In a Physician Assistant Offer Letter? | PA Offer Letter Benefits

Employment Agreement for Physicians: Is a Physician Letter of Intent Binding?

In the employment arena, these letters of intent go far. We’d have an employment agreement if you signed the letter of intent. That would start with a new job. Briefly, in general, is a letter of intent binding? No. The only way a letter of intent would be binding is if there is a language that states this letter of intent is binding. I don’t recall seeing something like that before. The reason why it’s essential for the physician not to sign a letter of intent that states binding. Because in the employment agreement, the actual long contract that the physician gets sometimes can be substantially different. Maybe the context provided by the employment agreement can do a job. A job which, at the basic level, seemed great. Then once you read the fine print, it’s not so great.

Before You Sign an Offer Letter

So, it’s always important for the physician to know. It is Even if you come to terms on the letter of intent like compensation, benefits, bonuses, termination notice, or non-compete. Even if you agree to all those things, getting the employment agreement is different. Either the terms are substantially different, or perhaps the way they worded them made them substantially different. In that scenario, don’t sign the employment agreement. Due to those factors, you can always negotiate, even after you sign a letter of intent. Maybe the letter of intent states yes. A non-compete lasts one year, but it doesn’t list the geographic limitation. You get the contract, saying it’s a one-year non-compete. Okay, great. And then it says, but it’s 50 miles from every location the employer has in the state or something crazy like that.

Well, no physician will sign, or at least they shouldn’t, a non-compete like that. Although the letter of intent is okay at first glance, this is a one-year non-compete. That seems fair. But it’s not so fair when you get into the details of it. Or perhaps there’s language about productivity. In this case, maybe you get 25% of net-collections over a certain amount you collect in a month. Okay, well, that sounds great. 

And then you talked to the employer about the volume, meaning. What’s the average a physician makes in my specialty here? And they say no one’s ever got the productivity bonus. Okay, that looks great on 11 and 10, but in practice, not so great. Or maybe in the agreement, they say it’s an initial one-year term. But then, when you investigate the agreement’s language, it automatically renews. 

Is a Letter of Intent for Employment Binding?

Is a Letter of Intent Still a Binding Employment Contract?

There’s no ability to terminate the contract without cause. Then the physician theoretically could just be stuck in a loop without the ability to get out of the contract. That’s just something that physicians must work out in advance. So, is a letter of intent binding for a physician? Typically, no, it’s not.

If there is a language that states it is binding, run the other way and get a new job that isn’t trying to take advantage of you. Someone would rarely put language in there without in-depth understanding. Most business owners are at least savvy enough. To understand that forcing someone to sign a binding letter of intent without seeing the actual employment contract is terrible. So, anyway, keep that in mind before you sign anything.

Is a Letter of Intent for Employment Binding? 

The short answer is probably not. It is how the process would work when a professional is looking for a new position. The employer may state before they give you an employment contract. They’d like you to sign a letter of intent, also referred to as an offer letter. And then, that letter of intent will outline the main points of the employment relationship. Normally, in a letter of intent, you’d have the term of the contract. So, how long does it last? Maybe how can it be terminated? If it has without cause termination, what’s the length of notice needed. Certainly, it’s going to have compensation details. These include base salary, productivity bonuses, and commission percentage, which will also be listed.

What to Look on Sample Physician Letter of Intent

Maybe a brief description of the benefits. And then if there’s a non-compete involved if it’s a healthcare contract. Perhaps some details about malpractice insurance. Kind of quick bullet points of, alright, this is what we expect the employment relationship to be. And at that point, there may be some negotiation between the professional and the employer. For instance, if the professional wants a higher base salary or a higher percentage of collections, or whatever it is, that’s the time to negotiate. And then, once it reaches an agreement, the professional signs the offer letter. Generally, the company will as well. And then, at that point, the company will usually prepare an actual employment agreement with the binding terms. What are some reasons why someone would back out after signing an offer letter?

Well, providing more context, a contract’s details can significantly change. For instance, if the offer letter states, let’s discuss the non-compete. It may state, oh, it’s two years and 10 miles from your primary practice location. In sales, from your sales territory, something like that. And then, when you investigate the agreement. It may be much more prohibitive in that you can’t. Not only work in your specialty, but you can’t work in sales in this area if you’re selling software or something like that. Typically, non-competes would apply only to software. So, you could switch industries for a brief period and then come back if you wanted to.

Can you Negotiate After Signing a Letter of Intent?

Can a professional negotiate after signing a letter of intent? In short, yes, obviously, you can. Let’s talk about what a letter of intent is. The differences between that and an employment contract. Then the areas of negotiation after that. A letter of intent, also called an offer letter, is simply a brief letter outlining the employment relationship’s main terms. Normally, it would be the term of the agreement. So how long does it last if there’s without cause termination? What is the notice requirement? Any compensation detail like base salary. Those details will be in some productivity, commission-based, net collections.

Maybe a brief description of the benefits: health, vision, dental, life, disability, retirement, that type of thing. And then, if there are any restrictive covenants, a non-compete, a non-solicit, something like that. And if they’re a healthcare provider, if there’s what malpractice insurance offers. Suppose they must pay for tail insurance. There’s just a brief description of the main points of the contract. And so, the employer, if they do make the professional sign a letter of intent in advance. Once they get those locked in before offering an employment contract. Many employers will go straight to the employment contract. Maybe they’ll have a brief discussion with the potential employee. About, alright, here’s what we’re thinking about all those things. And then, if there is verbal agreement from the professional, yes, I’m okay with those.

Negotiating for an Employment Agreement

Let’s move forward with an employment agreement. The employer will then present the employment agreement, and negotiation can occur. Suppose you have agreed on the terms of offer letters or a letters of intent. In that case, you certainly can negotiate once you receive the employment contract for several reasons. Suppose the offer letter briefly describes the employment relationship terms when you have seen the actual language many times. In that case, it can completely change what you were expecting. For instance, there will be a non-compete in the agreement that doesn’t give the description. Then when you read the terms of the non-compete, instead of expecting maybe a one-year non-compete with a 10-mile radius, it’s a three-year non-compete with a 50-mile radius. 

So, that substantially changes whether an offer is worth it or not. And often, if there is foul language in the agreement, it can also shift the compensation. For instance, let’s say a professional is okay making 200,000 a year. But if they have these bad restrictive covenants after the contract ends, 200,000 may not be worth it. Maybe they’ll say if I’m going to accept these restrictive covenants. Then I need more compensation during the year to make it worthwhile. Although you’ve agreed on the terms of the offer letter. It doesn’t mean you can’t return to the employer unless explicitly stated in the offer letter. The letter of intent that it is binding, which rarely happens.

Reasonable Considerations in an Employment Contract

Normally, that would only happen in maybe an academic position. You’re free to negotiate up until signing the employment agreement. Now, it may tick off the employer that you agreed to essential terms. Then after the fact. You came back at them and said, I know we agreed to this, but we need to revisit this. However, no professional wants to enter an employment relationship where they’re unhappy with the terms. Better to risk off the employer with terms that favor the employee versus just accepting an agreement that you’re unhappy. And usually, that’s going to spiral. Let’s say, alright, well, I agreed to terms in the offer letter. It does change once I read the actual employment agreement. And then, at that point, I’m like, ah, I don’t want to go back to them.

I’m just stuck with it. Well, you will have, or at least you will likely have. Some negative attitude spills over once you begin with the employer. And maybe you’re always thinking, ah, I’m underpaid, or this non-compete is bad, or the benefits are below what I was expecting. So, even if you risk the employer being annoyed by continued negotiation. The professional is free to continue, and they should. The bonus structure is good if it’s a reasonable offer and the salary is good. Then you continuously come back to the employer asking for more and more. At some point, they’ll yank the offer and move elsewhere. That’s always a consideration when talking to a professional about negotiating a contract. Yes, we want to ask for more, but it needs to be reasonable.

Is a Letter of Intent for Employment Binding?

When Can an Employer Yank the Offers?

Suppose you’re asking for insane increases in certain things many times. In that case. I can tell the professional, look, if you come back at them with these things, they’re going to say no. They’re likely going to yank the offers just because you’re coming off as unreasonable. So, it’s good to know the industry standards in all those terms. That way, when you ask for the increases, you have some backing of. Well, these are the industry standards. And if you don’t want to meet the industry standard. I’m going to move on to a better opportunity. So, yes, you can negotiate after signing a letter of intent or an offer letter. And, in fact, you probably should. Once you read the language of the employment agreement, it changes the opportunity.

Can You Reject a Letter of Intent?

Can you reject a letter of intent? The quick answer is yes. You certainly can, and should, if you’re unhappy with the terms of it. A letter of intent, also known as an offer letter, can be provided once negotiations or discussions about a position move forward. Normally, it would work if a potential candidate would find out about a job. Either through a job listing or word of mouth, or maybe they were reached out through a recruiter. There’s a discussion of the main point of the position. Like the salary, benefits, that type of thing, and location. And once there’s interest on both sides, many employers will offer the letter of intent or the offer letter.

And that is a description of the main points of the employment relationship. In most offer letters, there will be the start date, location, and contract length. This is called the term, maybe a brief discussion on how both parties can terminate the contract, compensation, so is there a base salary? Are there bonus opportunities? Is it net collections, commission-based RVUs? It would be a brief description. It wouldn’t go into a long four paragraphs about comp. If malpractice insurance is necessary, who pays for that, and then who pays for the tail insurance if that’s necessary? Are there restrictive covenants? The restrictive covenants are normally a non-disparagement, a non-solicit, a non-compete, and it might go through briefly like this is how long go last.

What Is Inside an Offer Letter?

And maybe this is the geographic restriction associated with the non-compete and then a brief description of the benefits like health, vision, life, dental, disability, retirement, and maybe expenses. What expenses is the employer going to pay for? That’s what would normally be in an offer letter. The candidate, when viewing this letter, if the terms of it are unfavorable, or maybe not what the candidate was looking for, they can say, no, I’m not interested in this. I’m not going to sign this. I wouldn’t suggest just saying, no, I’m not taking this job. Take a hike. It would simply make sense to counter. You can say, I’m not going to sign this offer letter. However, these things would make this opportunity good for me. 

So, if you’re offering a 200-base salary, then maybe I want 250 or a signing bonus of 10,000, and I want a 20,000-signing bonus. And will you provide relocation assistance if I move into a new city? These are all things that employees should do at this stage. And even though a professional gives an offer letter. It doesn’t mean that’s the end of it. And then, even further, if you come to terms with the offer letter, what will then follow will be an employment agreement. Even if you sign another offer letter unless there’s the language that says this is a binding offer letter. You can change no terms, which you will never see. Once you get the employment agreement, you can still negotiate terms.

Why Is it Important to Understand the Industry Standards?

So, you need to think strategically, alright? I would suggest never signing an employment agreement that you’re unhappy with. Even if you reject the offer letter and decline the employment agreement, it doesn’t mean that the negotiation is over. Suppose the professional is reasonable in what they’re asking for. In that case, I find most employers expect at least some negotiation when they’re bringing in new candidates. I mean, it is the expectation. But once again, if they’re reasonable. Suppose someone is asking for a 200% increase in base salary. In that case, the employer is likely going to, look, you are delusional, and we will move on to a different candidate. So, it helps the professional understand the industry standards in their profession. That way, they can ask for reasonable changes to the contract. There are also many times when you’ll get brief details in the offer letter. 

Then when you see the actual written language in the agreement. It substantially changes what it looked like in the offer letter. Maybe if it just briefly mentions there will be a non-compete. Once you review the employment agreement, it’s a terrible non-compete. Maybe you are expecting a one-year non-compete, and they offer three, or you’re expecting a small geographic radius of 10 miles. They came back with a hundred, or something like that. That can change from “yes, this is a great offer” to “there’s no chance I would ever accept this job.” So, there can be negotiation throughout the process until the professional signs the employment agreement. At that point, those are the terms. It would be best if you made certain before you sign anything that you’re okay with what is in agreement. Then understand there will be obligations after the employment relationship ends.

Can a Physician Negotiate After Signing a Letter of Intent?

Can a physician negotiate after signing a letter of intent? The letter of intent is also known as an offer letter. The normal recruitment process would be close to the end of their residency or fellowship. And then, most people find a job through one of three ways: either word of mouth amongst colleagues or mentors, a physician recruiter can reach out to them. And say here’s a position that might fit your needs. Then initiate the process that way, or the physician can always find job opportunities through job listings on the internet. Once the process has been initiated and the physician is discussing it with the physician recruiter. Such as the terms of the relationship, salary, bonus opportunity, locations, that type of thing. Many employers will then ask the physician to sign the letter of intent.

Basics in an Offer Letter

The letters of intent is just the basic structure of the employment relationship: start date, location, and contract length. Which is known as the term, how both parties can terminate the contract, compensation. So what’s the base salary? Is it RVU production? What are the thresholds? Is it a collection? What’s the net collection percentage? And then, the restrictive covenants, non-solicit, what are the terms of the non-compete? And then usually, the basic benefits, so what do they offer in terms of health, vision, dental, life, disability, retirement? What does the employer pay for continuing medical education, licensing fees, DEA registration, association, and societies?

Just basic things. These are all the things we’re going to provide to you. Now, some letters of intent are more detailed than others. Still, if a physician is okay with the general terms of the offer letter. Then, the employer will say, we need you to sign the offer letter. And then, at that point, we will get the employment agreement drafted, and then they’ll offer the physician the employment agreement. Is the offer letter or letter of intent binding? The answer is no, unless there’s language there that says it is binding. You rarely find a letter of intent stating this is a binding document. For several reasons, it doesn’t make sense for a physician to sign that under any scenario.

When Should a Physician Decline an Employment Agreement?

Basic terms in an offer letter with no context or explanation can change substantially. Once we can see the actual language of the employment agreement. Maybe they will state it in the offer letter. There is a non-compete, but there’s no description of it. Well, perhaps you read the employment agreement, and you’re expecting a one-year non-compete. They say it’s three years, or you’re expecting a 10-mile restriction geographically, but it’s 50. The initial offer letter may look like, okay, a non-compete, well, that’s expected for a physician. But once you read the terms, it goes from being reasonable and okay to be completely unreasonable. In that scenario, although the physician signed the offer letter, they do not need to go through with signing the employment agreement. 

And then, I would also suggest that even though the physician has come to terms with the offer letter. It doesn’t stop them from renegotiating the terms before signing the employment agreement. As I said before, once one reviews the actual language of the contract. It can completely change someone’s perception of a job. I’m willing to make a smaller base salary if the non-compete is not as restrictive when I leave. Or let’s say you have a claims-made malpractice policy and the employer is saying. We will pay for your tail insurance once you go. They might be willing to accept a smaller base because the employer will pay tail insurance. Then when you look, and you get the employment agreement, the language states the employee must cover their tail.

Negotiating the Terms Before the Employment Agreement

Maybe depending upon specialty, that could be a significant amount of money. And then the physician may say, well, I had no idea I had to pay $50,000 tail insurance. Therefore, I want a more extensive base salary to offset that. So, even after the physician signs the letter of intent, they certainly can continue negotiating once they see the actual terms of the employment agreement. Now, a couple of considerations: it’s not bad form to go back and renegotiate terms. However, some employers may get ticked off when the physician agrees to the offer letter terms and then return to renegotiate those terms. It can be off-putting to some employers. However, if the physician frames it in, well, you said that I would have this, and I expected this to be kind of industry-standard, but once I saw the language, it wasn’t.

For instance, there are normally 60 to 90 days without cause termination. This means either party can terminate the agreement for any reason, with a certain amount of notice to the other. So, they’re expecting a 60-day without cause termination notice. And then the employer says, you have to give us a one-year notice. Well, that’s insane! No physician should agree to that. And they absolutely should renegotiate the terms once they see the actual language in the employment agreement. No physician should sign a contract that they’re either unwilling to meet the terms or are significantly unhappy with before starting the job. There will always be push and pull when it comes to a contract. There is no perfect contract. It doesn’t exist. There will be things that the physician has to relent on that maybe they’re unhappy with.

Fair Negotiation

And maybe the employer has to relent as far as compensation goes or have to pay tail insurance. Or any of the things I’ve already discussed. But, if both sides feel relatively bad about the agreement. It usually means it was a fair negotiation. If one side is super happy, it usually means the other side is not. So, don’t sign an offer letter if you’re not happy with the terms. But even if you sign an offer letter that you’re okay with doesn’t mean you can’t renegotiate the terms after the fact. Now,  lose out on an opportunity if you do that. An employer could theoretically pull a job offer. But in that scenario, I don’t think it’s worth moving forward because you don’t want to tick off an employer. It doesn’t make sense.

Physician Negotiating an Offer Letter in an Agreement

Can you reject a letter of intent? The quick answer is yes, you certainly can, and should, if you’re unhappy with the terms of it. Letters of intent, also known as an offer letter, can be provided once negotiations or discussions about a position move forward. Normally, it would work if a potential candidate would find out about a job. Either through a job listing or word of mouth. Or maybe they were reached out through a recruiter. There’s a discussion of the main point of the position. Like the salary, benefits, that type of thing, and location. And once there’s interest on both sides, many employers will offer the letter of intent or the offer letter.

And that is a description of the main points of the employment relationship. In a letter of intent for a job, the contract’s start date, location, and length will be included. This is referred to as the term; perhaps a brief discussion about how both parties can terminate the contract with compensation would be beneficial. So is there a base salary? Are there bonus opportunities? Is it net collections, or commission-based RVUs? It would be a brief description. It would not go into a lengthy four-paragraph discussion of comp. If malpractice insurance is necessary, who pays for that. And then who pays for the tail insurance if that’s necessary? Are there restrictive covenants? The restrictive covenants are typically non-disparagement, non-solicitation, and non-compete, and they may be reviewed briefly as if this is how long they will last.

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November 29, 2022/by admin
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Who Qualifies for an IEP?

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IEP Eligibility

Who qualifies for an IEP? This is outlined in the Individuals with Disabilities Education Act in federal statute, which says a child must have a qualifying disability that falls within 13 categories that are outlined in federal statutes. The child has to have a disability that falls within those categories. Still, not only that, but it also has to be shown that the disability has adversely affected the child’s ability to learn. Because they have a disability doesn’t mean they automatically qualify for an IEP. Because the disability first must affect them lately, they need this IEP.

13 IEP Categories

Let’s go through the 13 categories listed in the Individuals with Disabilities Education Act. The first one is a specific learning disability. I would say that the best example of this would be dyslexia. If you have a disability with reading or interpreting words or anything specific to learning, dyslexia is the most common one. So, that’s what I’m using as an example. And if it adversely affects your education, then you would likely qualify for an IEP. The next one is other health impairments. So again, I’ll keep saying this, anything that’s a health impairment that would adversely affect your ability to learn.

One good example here would be AHD. It is a health impairment and affects the child’s ability to focus and process information in the classroom. So, therefore, it would likely be that that student would qualify for an IEP. The next one would be autism spectrum disorder. As you know, autism spectrum disorder is a spectrum. So, if your child has a diagnosis, we use the term on the spectrum or, as I said, autism spectrum disorder. And it adversely affects them in the classroom, so they’re likely to qualify for an IEP. That one is straightforward. Next, emotional disturbance. Suppose they have emotional disorders or trouble regulating their emotions, such as depression and anxiety; these things will fall within that category. And again, then they would likely qualify.

The fifth category would be speech or language impairment. This is the one where the adverse effect has to come into play. Just because this child has a speech impediment, it may not adversely affect their learning. So, they might not be qualifying for an IEP. A 504 plan is required if therapy is brought into the school. But if they do have a disability that is considered a speech or language impairment, then they could qualify for an IEP. The sixth category is visual impairment, including blindness. And that one is straightforward. If you have a diagnosis of extreme visual impairment or blindness, then you would likely qualify as well.

And then deafness. Again, if the student cannot hear, it would interrupt their learning, and there would need to be other ways that the information is brought to the student. Next is hearing impairment. Not just deafness, but maybe there are hearing impairment issues that don’t rise to the level of deafness. That would be the eighth category as well. Then there’s also deaf-blindness. When a child is blind and deaf, that will fall into that ninth category. Next is orthopedic impairment. Again, I’ll touch on this as well because just because a child has an orthopedic impairment, if it’s not adversely affecting their education, they wouldn’t qualify.

However, if it is, then they would qualify for an IEP. And they fit within that 10th category. The 11th one is an intellectual disability. The best example of this is if the child is just not at the academic level of their peers, and maybe they need different types of instruction. Then they would likely qualify for an IEP. Traumatic brain injury. So, an accident, damage, or something like that would adversely affect their learning ability because they’re working with a brain injury. They would likely qualify as well.

And then multiple disabilities. If there are multiple disabilities working together to affect that student, again adversely, they would be likely to qualify for an IEP. So, to summarize that list again, it would be a specific learning disability, and I gave dyslexia as an example. Other health impairments include autism spectrum disorder, emotional disturbance, speech impairment, visual impairment, deafness, hearing impairment, deaf-blindness, orthopedic impairment, intellectual disability, traumatic brain injury, and multiple disabilities. Those are the 13 categories that your child must fit in. And again, I’ve probably said it a million times in this blog; it needs to affect their learning ability.

Arizona Individual Education Program: How Arizona IEP Attorney Can Help

Statistics in 2016 showed that more than 53,000 students in Arizona had specific learning disabilities. Such students must be subjected to the Individualized Education Program (IEP). This form of special education has been designed to assist Arizona students with various learning disabilities. It’s also essential to communicate that this program has been prevalent in the country for many years.

If you believe that your child needs special education, it’s essential to consider taking them for an Individualized Education Program. However, for this system to work for your child, they must meet a few fundamental requirements. Understanding some unique factors behind IEP will enable you to seek this program for your child seamlessly.

What are Team-Based Early Intervention Services in Arizona?

The Individuals with Disabilities Education Act (IDEA) is a federal law that helps to ensure that all children with disabilities have access to a free and appropriate education. The law also requires states to provide early intervention services to infants and toddlers with developmental delays. In Arizona, these services are known as Team-Based Early Intervention Services (TB EIS).

TB EIS is a statewide system of services and supports designed to meet the needs of infants and toddlers with developmental delays. The system is based on the belief that all children have the right to participate in meaningful activities in their homes, communities, and schools.

Is AZ IEP Free?

You might have a perception that education is expensive. However, the good news is that IEP is a free program in Arizona. The federal and state government have put in place adequate measures to ensure that all children with disabilities can access this form of education at no cost. However, this does not mean that the program is entirely free. Families must pay for some costs associated with IEP, such as travel expenses, books, and other materials.

How Do I Get an IEP For My Child in Arizona?

As a parent or guardian, you can request an IEP evaluation for your child if you think they might need special education services. You can make this request to the school district in which your child attends school. The school district must evaluate whether your child is eligible for special education services.

If the school district determines that your child is eligible for special education services, they will develop an IEP for your child. The IEP is a document that outlines the special education services that your child will receive.

What Are the Components of An IEP In Arizona?

The components of an IEP vary from state to state. However, in general, an IEP must include:

  • A statement of the child’s present level of educational performance
  • A description of the child’s special education and related services
  • Annual goals for the child’s educational progress
  • A description of how the child’s progress will be measured
  • The date by which the IEP will be reviewed and revised, if necessary

It’s essential to understand that an IEP is a living document that can be revised. As your child’s needs change, the IEP can be revised to address those changes.

What Is the Difference Between A 504 Plan and IEP In Arizona?

You might wonder whether your child needs an IEP or a 504 plan.

IEPs and 504 plans help children with disabilities succeed in school. However, there are some critical differences between the two. IEPs are individualized education programs created for students who need special education services. IEPs must be reviewed and updated at least once per year.

504 plans are for students who do not need special education services but still need accommodations to help them succeed in school. For example, a student with a 504 plan might need extra time to take tests or have a quiet place to work. 504 plans do not need to be reviewed as often as IEPs.

What Is the Arizona IEP Timeline?

As a parent with a child in the Arizona IEP process, it’s essential to understand the timeline for each process step. This timeline can vary depending on your child’s individual needs and the school district in which you live.

However, in general, the Arizona IEP timeline looks like this:

  • The parent requests an IEP evaluation from the school district
  • The School district evaluates the child to determine if they are eligible for special education services
  • If the child is eligible for special education services, the school district develops an IEP
  • The IEP is reviewed and revised as necessary at least once per year

When Must an IEP Meeting be Convened?

Understand that the team must convene an IEP meeting within 30 days of the child’s eligibility determination. The IEP team will meet to discuss the child’s needs and create an individualized education program. If the team did not meet the time frame for the IEP meeting, you, as the parent, have the right to request a due process hearing.

What Should You Not Say at An Arizona IEP Meeting?

It’s natural for parents to want to advocate for their child at an IEP meeting. However, there are some things that you should avoid saying during an IEP meeting. These things can jeopardize your child’s chances of getting the necessary services.

Some of the things you should avoid saying at an IEP meeting are:

  • Making demands
  • Threatening legal action
  • Saying that you don’t trust the IEP team
  • Speaking in a negative tone

It’s also important to remember that an IEP meeting is not a place for you to vent your frustrations. Instead, it’s a place for you to collaborate with the IEP team to create a plan to help your child succeed.

November 27, 2022/by admin
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What is an IEP Meeting?

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What is an IEP meeting? An IEP or the Individualized Education Plan mandated through federal statutes, specifically the Individuals with Disabilities Education Act, states that all children are allowed a free and appropriate education. And if they need special services or accommodations, then they can have an IEP, which says all sorts of accommodations, special education, goals, and progress monitoring. All of that is included in the IEP document. Now, when is an IEP meeting held? There are a couple of different types of IEP meetings. It can start with the initiation of the evaluations or the creation of the IEP team.

When is an IEP Meeting held?

All the members, parents, teachers, special education teachers, maybe therapists, and healthcare providers assemble to look at the data and decide if the child qualifies for an IEP. Their disability has to be allowed under the categories in the federal statutes unless the state law expands that. An IEP meeting again might mean that the team assembles for the first time to look at the data and see if the child qualifies for an IEP. There may be an additional IEP meeting to create the IEP itself. As I had previously just talked about, there are many different aspects of the IEP, such as the data, the child’s diagnosis, and their accommodations.

IEP Goals and Progress of a Child

But what’s unique about an IEP, though, is that there are goals for the student to accomplish, and there is progress monitoring like how are you going to reach those goals, and how often are they checked? Also, the status and the progress and if the plans have been met. In the creation of the IEP, there could be several meetings. And then, once a year, the IEP meeting is held for that student. Parents are also considered valuable members of the IEP team, and they can be there. And then, the goals will be checked. Has the student met the goal? Do the plans need to be adjusted? Has anything changed in the student’s diagnosis?

IEP Annual Meeting and Evaluation

To streamline it and ensure that everything is taken care of and that the school complies with the IEP. Then after three years, you’ll need to start the whole process again. So again, if there’s still data, it’s easy to transfer that over. Just in summary, what is an IEP meeting? It’s when the team assembles to construct, implement, progress, and monitor goals to see where the student falls within the IEPs and set goals. There has to be a meeting at the creation, and then there has to be a meeting every year. And then, in the third year, there must be an additional meeting to re-initiate the process.

Arizona IEP Evaluation Concerns

What are some evaluation concerns regarding an IEP in Arizona? An evaluation is the very beginning of the IEP process. It not only decides if your child or student is eligible for an IEP but what that may entail accommodations or specialized instruction, special education. So, evaluations are a critical part of the IEP process, but today we’re talking about concerns. Sometimes, well, let me backtrack. So, the purpose of an evaluation is to collect data, assess if the student is eligible for an IEP, and what type of accommodations or specialized instructions they will be granted. Again, evaluations sometimes actually aren’t even necessary to take place.

Whose Assessment is Reliable?

If the teacher has observed certain behavior and grades, medical health professionals, or maybe your primary care provider or specialized therapist have already assessed the student, you may not need an additional evaluation. That was probably one of the first concerns that parents have. If they just don’t need an additional evaluation from the information they have, they can decide if the student is eligible. Now, if they’re eligible for an IEP, that’s great. 

Arizona Individual Education Program: How Arizona IEP Attorney Can Help

Statistics in 2016 showed that more than 53,000 students in Arizona had specific learning disabilities. Such students must be subjected to the Individualized Education Program (IEP). This form of special education has been designed to assist Arizona students with various learning disabilities. It’s also essential to communicate that this program has been prevalent in the country for many years.

If you believe that your child needs special education, it’s essential to consider taking them for an Individualized Education Program. However, for this system to work for your child, they must meet a few fundamental requirements. Understanding some unique factors behind IEP will enable you to seek this program for your child seamlessly.

What are Team-Based Early Intervention Services in Arizona?

The Individuals with Disabilities Education Act (IDEA) is a federal law that helps to ensure that all children with disabilities have access to a free and appropriate education. The law also requires states to provide early intervention services to infants and toddlers with developmental delays. In Arizona, these services are known as Team-Based Early Intervention Services (TB EIS).

TB EIS is a statewide system of services and supports designed to meet the needs of infants and toddlers with developmental delays. The system is based on the belief that all children have the right to participate in meaningful activities in their homes, communities, and schools.

Is AZ IEP Free?

You might have a perception that education is expensive. However, the good news is that IEP is a free program in Arizona. The federal and state government have put in place adequate measures to ensure that all children with disabilities can access this form of education at no cost. However, this does not mean that the program is entirely free. Families must pay for some costs associated with IEP, such as travel expenses, books, and other materials.

How Do I Get an IEP For My Child in Arizona?

As a parent or guardian, you can request an IEP evaluation for your child if you think they might need special education services. You can make this request to the school district in which your child attends school. The school district must evaluate whether your child is eligible for special education services.

If the school district determines that your child is eligible for special education services, they will develop an IEP for your child. The IEP is a document that outlines the special education services that your child will receive.

What Are the Components of An IEP In Arizona?

The components of an IEP vary from state to state. However, in general, an IEP must include:

  • A statement of the child’s present level of educational performance
  • A description of the child’s special education and related services
  • Annual goals for the child’s educational progress
  • A description of how the child’s progress will be measured
  • The date by which the IEP will be reviewed and revised, if necessary

It’s essential to understand that an IEP is a living document that can be revised. As your child’s needs change, the IEP can be revised to address those changes.

What Is the Difference Between A 504 Plan and IEP In Arizona?

You might wonder whether your child needs an IEP or a 504 plan.

IEPs and 504 plans help children with disabilities succeed in school. However, there are some critical differences between the two. IEPs are individualized education programs created for students who need special education services. IEPs must be reviewed and updated at least once per year.

504 plans are for students who do not need special education services but still need accommodations to help them succeed in school. For example, a student with a 504 plan might need extra time to take tests or have a quiet place to work. 504 plans do not need to be reviewed as often as IEPs.

What Is the Arizona IEP Timeline?

As a parent with a child in the Arizona IEP process, it’s essential to understand the timeline for each process step. This timeline can vary depending on your child’s individual needs and the school district in which you live.

However, in general, the Arizona IEP timeline looks like this:

  • The parent requests an IEP evaluation from the school district
  • The School district evaluates the child to determine if they are eligible for special education services
  • If the child is eligible for special education services, the school district develops an IEP
  • The IEP is reviewed and revised as necessary at least once per year

When Must an IEP Meeting be Convened?

Understand that the team must convene an IEP meeting within 30 days of the child’s eligibility determination. The IEP team will meet to discuss the child’s needs and create an individualized education program. If the team did not meet the time frame for the IEP meeting, you, as the parent, have the right to request a due process hearing.

What Should You Not Say at An Arizona IEP Meeting?

It’s natural for parents to want to advocate for their child at an IEP meeting. However, there are some things that you should avoid saying during an IEP meeting. These things can jeopardize your child’s chances of getting the necessary services.

Some of the things you should avoid saying at an IEP meeting are:

  • Making demands
  • Threatening legal action
  • Saying that you don’t trust the IEP team
  • Speaking in a negative tone

It’s also important to remember that an IEP meeting is not a place for you to vent your frustrations. Instead, it’s a place for you to collaborate with the IEP team to create a plan to help your child succeed.

November 27, 2022/by admin
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How to Write an IEP

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How do you write an IEP? If you’re at this stage where you’re writing the IEP, your child has qualified for an IEP through evaluations and assessments. They have decided that the student’s disability qualifies under federally outlined statutes. And then, the team will come together to write the IEP. The IEP team sometimes goes by different names, but it’s essentially the group of people who come together for the meetings and are going to be writing the IEP. It’s usually the special education director or teacher, and the general education teacher is also involved.

First Step: Data Assessments and Creating Goals

Any therapist or healthcare provider giving therapy or services through the school, and sometimes other healthcare providers are also involved. And then sometimes, school administrators also assist in this process. The first step of writing the IEP is looking at the data and the assessments and creating goals. So, the team will make goals for that student that they feel are reasonable. And this could be behavioral goals, cognitive goals, and a plethora of things within the school environment that they think the student needs to work towards achieving. So, the plans will be set, and then progress monitoring.

Tracking Goals and Accommodations of the Student

So, how often will this team and who on the team will be tracking these goals? Is this a weekly track tracking? Or is monthly or quarterly monitoring the progress of the student? And then also, what accommodations does that student get? Again, this could be a plethora of things. It could be things within the general education classroom, like the student receiving more time for assessments. It could be that they get specific time outside of the school for special education instruction or therapy that could be provided for the student. It’s tailored to meet their needs and what the school will provide for them. So, we have goals, progress monitoring, and then accommodations. Also, when you’re writing the IEP, a summary or assessment will be attached.

So, where the student is starting from, and all the members will also be included in the IEP. They’ll be listed, their title, and how they assist that student. So, those are the basics of how to write an IEP.  When it comes down to typing the document, it’s usually the special education teacher or the special education coordinator. Sometimes it’s the school administrator. It doesn’t have to be an exact person, but generally, within your district, a designated person does the actual drafting of the IEP. And then, the team, as I said, will come together to review it. If the parent disagrees with anything, they can also write comments there.

IEP is a Legal Binding Contract

If they disagree, they can also ask for things to be adjusted, and the team can then make that determination. So, that’s how you write an IEP. It looks like a contract because that’s what it is. It’s a binding document that holds the school accountable for what services, interventions, and accommodations they will grant to your student. So, you can think about it just like a legally binding contract between the school, the parents, and the student. They’re ordinarily lengthy because they will include, as I said, a lot of observations and data. All the things clearly show where the students are at and where they need to be, their goals and progress monitoring, accommodations, and how they will get there.

Is an Arizona IEP Free?

How much does an IEP cost in the state of Arizona? First, we’ll start with the cost of the parent. This one is easy. It costs the parents $0. If your student is in public school or charter school here in Arizona, the cost of the IEP is at the expense of the school.

Meeting the Needs of the Child

However, if you are trying to get your child a diagnosis or an evaluation before the IEP even starts, it’s likely that that is a cost you would incur. So, this is your healthcare provider, maybe a behavioral health specialist. If you take them to a physician who specializes in meeting your child’s needs, that would be a cost you would incur.

School’s Role in IEP Evaluation

However, the school is responsible for getting any evaluators or assessments for your child to decide if they are eligible for an IEP. The school is responsible for the cost of the educators, the team who’ll construct the IEP, to meet with the parents, and if any additional services are needed, so if you need to bring anybody into the school to provide (for example, a specialized type of therapy)— that’s the school’s cost. That’s the school’s responsibility.

It is rooted in federal statutes, federal case law, and Supreme court cases. Also, here in Arizona, federal statutes and regulations are as well. So, any cost of the IEP—which can vary depending on the student’s needs—is the school’s responsibility to meet those needs and get the evaluations needed to decide if they are eligible for an IEP.

All those costs can range greatly, but it’s the school’s responsibility to do that, not the parent’s. So, as a short answer, parents, it should cost you zero for the actual IEP itself. However, if you get any pre-evaluation or assessments done, that would be a cost you would incur.

Provide Support Staff for an IEP Student

But then, once the process of the IEP starts, any of the services the IEP requires are all responsibility of the school, and that cost can vary greatly.

Suppose support staff needs to be brought in for that student if they need aid in the general education classroom. If they need therapy, the IEP team brings in a therapist, an occupational therapist, a speech therapy, or a behavioral health analyst. If they need to have any adaptations for their environment, this could make classrooms more accessible to them.

What are the Components of an IEP in Arizona

What are the components of an IEP in Arizona? First, an IEP stands for an Individualized Education Plan. 

What is an Individualized Education Plan (IEP)?

IEP is a legally binding document codified in state and federal statutes. If a student is eligible for special education or other education or modifications within the school, they are legally granted those and not discriminated against.

Let’s talk about this. Say a parent has requested an IEP, the student has been evaluated and assessed, and they are eligible for an IEP. You sit down for the IEP meeting, in which a parent or guardian is included.

Individualized Education Plan Components

So, let’s discuss the components of the IEP. 

Goal Setting

We’ll start first with the goals. There will be goals that the student is expected to hit. They might be academic, behavioral, or emotional. They may be short-term, and they may be long-term. It varies and depends on the student’s needs, but there are goals. So, what are we all expecting of the student?

Progress Level Monitoring of the Child’s Goals

Next, after the goals, there will be information on where the child is and where they are achieving their level at the moment. Again, this might be academic, emotional, or behavioral, and we need to know where the student is currently. So, we have the goal, where they are, and how they will get there. It is the progress monitoring of the goals.

Student’s Accommodation | Special Education Services Provision

So, how will they be assessed, how often, and is there an end or a start date? They’re going to get specific on that. Also, what actual accommodation is the student going to receive? It might be special education being pulled out. It could be in the classroom, additional services, or therapy coming to the school.

Again, there are just so many things, and it’s very fact sensitive, but overall, what sort of accommodation will this student receive? How often? For what duration? And what is it that’s going to be happening?

Frequency of the Student’s Re-evaluation and Assessment

Again, this is important because an IEP is a legally binding document, meaning the school and all of the staff have to abide by this. So, that’s important. What services or accommodation is the student going to receive? Also, how frequently are they going to be monitored, and how? We have spoken about that before.

Also, on an annual review, there’ll be a statement of how the student is doing. Have they reached those goals and feel they’re on the right track? Do the goals or services need to be reassessed? And then, every three years, the student will be reevaluated. Then the process starts over or is carried over depending on how the assessment goes. So, those are the main components of an IEP.

IEP Components in Arizona

To summarize, you have goals for the future and progress monitoring—so, how often will you be testing or assessing that student to see if they’re hitting their goals? How are they going to get there? What services or accommodations will the school handle in the regular classroom and outside of the classroom? 

Will they bring in other help, such as therapy or other accommodations? Also, where the student started, their initial assessment, and an annual report, where you’ll see how they’ve made progress, the plan, and if they need reassessment.

So, we can break it down into:

  • What are the needs of the student?
  • What are the goals, and how are we getting there?
  • Are we there, or do we need more evaluations?
  • Do we need more accommodations?

And those are monitored on an annual basis. And then again, at three years, the student is reassessed. And everyone must comply with an IEP. Furthermore, it is a legally binding document. That’s why it’s so important to have those components that give the student the best opportunity, environment, and accommodations to succeed within their environment.

November 27, 2022/by admin
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Gabriela Martinez
2023-01-29
Definitely recommend! I’m a nurse practitioner and was able to renegotiate my contract with the help of Chelle Law. The outcomes were above expectations.
Linda Price
Linda Price
2023-01-27
I placed my trust in Chelle Law to handle my issue with the State Board of Nursing and they did not disappoint. Service was professional and courteous. I could not have asked for a better outcome. I highly recommend this firm!
Anni R
Anni R
2023-01-25
I had a great experience with Chelle Law. I’m so glad I found them and hired their services. Their communication was on point 👌 they’re very professional, always kept me updated, always returned my calls and emails in a timely manner. They’re compassionate and understanding of every situation. I would 100% use them again and refer them to anyone.
Chin Kim
Chin Kim
2023-01-24
Great hep overall. Fast response and even it was an hour review, the attorney stayed on the phone longer to answer all my questions.
Amelia
Amelia
2023-01-20
Booking the consultation was easy and I got all my questions answered! Excellent customer service.
Steven Yang
Steven Yang
2023-01-18
I am a veterinarian about 3 years+ out from school changing jobs for the first time since graduating . The idea of needing to closely review a contract was foreign to me and I honestly had no idea what I would be signing . Luckily I found Chelle law and worked with Erin who put all my worries at ease . She took the time and even went over our scheduled time slot to review / translate every section of my contract and make valuable suggestions that I could bring up to my future employer. Throughout our discussion it was clear to me that Chelle law is very familiar with the intricacies of a veterinary contract and what it typically should entail. I was very pleased with my experience .
Tiffany Efantis
Tiffany Efantis
2023-01-11
I used Chelle law for a non-compete clause review. I was referred to them by a friend. They were helpful, quick, and affordable for what I needed. I will definitely use them again for any employment contract review in the future!
Nicholas Peracchio
Nicholas Peracchio
2022-12-13
Erin was so thorough with my contract I felt extremely confident in my negotiations and ended up getting everything I wanted and more! I can’t recommend her enough. She took her time and made sure I understood everything I was signing and did so with a kind and caring demeanor. Thanks so much Erin!!
Seth Bricel
Seth Bricel
2022-12-13
I needed a lawyer to review my partnership contract and Chelle Law provided a great experience at a fair price. My lawyer thoroughly explained the meaning of the contract in terms I could understand and provided valuable perspective as to which parts were normal and which parts were atypical or in need of modification. Thanks to their help, I've reached a contract that I and my partners are very happy with!

Call Us Today!

602.344.9865

Hours/Office

Monday-Friday: 8:00am-5:00pm (MST/MDT)

Chelle Law 5425 E. Bell Rd, Ste 107

Scottsdale, AZ 85254

Contact Us Today!

5425 E. Bell Rd, Ste 107, Scottsdale, AZ 85254

info@chellelaw.com

Practice Areas

  • Professional Licensing Board Defense
  • Medical Contract Lawyer
  • Administrative Appeals & Hearings
  • Medical Contract Drafting
  • Fingerprint Card Attorney

Office Locations

  • Arizona
  • Indiana

Company

  • Robert S. Chelle, Esq. Founder & CEO
  • Sara Stark, Esq. Attorney
  • Renee Osipov, Esq. Attorney
  • Erin Howlett, Esq. Attorney

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