This webinar is a “must watch” for PMA licensees to review information about the new 2017 Agreement for Wellness Services (AWS) and revised Administrative Rules and PMA Scope of Practice. Note that the recording has been edited to include new content relating to PMA licensee professional responsibilities not covered in the original live presentation.
In addition to viewing the webinar, please download and review the special Question & Answer summary titled, “Value of the PMA License, Legal Issues & Concerns.”
PRESENTATION BY ATTORNEY DAVID GIBBS
[Below is an edited transcription of the presentation by attorney David Gibbs, included as part of the webinar. The full webinar provides much more detail and discussion of the points highlighted by David regarding the value of the PMA license and related legal issues.]
Hi, I’m attorney David Gibbs with the National Center for Life and Liberty. I want to share with you the goals we have for this session:
- We want to overview the new PMA agreement for wellness services, often referred to as the AWS.
- We’re going to discuss all of the diverse legal issues that are impacting your practice and what we want to do is let you accomplish your goals.
We want you to have maximum effectiveness but we’d like to see that done with minimal liability. We’re certainly honored to serve with the PMA and to help in these areas and we want to let you know if you have any questions the NCLL team is available to answer any concerns or thoughts that you may have.
The Agreement for Wellness Services defines your relationship with clients
First of all, as you look at the Agreement for Wellness Services, you can visit the PMA website and pull it up and you can navigate to it by looking online at the links that are being provided to you. As you make your way to it, you’ll notice that there are some specific provisions where the Agreement for Wellness Services is up on the screen now what the AWS does is define your relationship with your clients; these are the people that are coming in and you’re having the opportunity to minister, understanding the nature of that relationship begins with an understanding of pastoral science and medicine and the basis of your PMA license.
Pastoral science and medicine as we put in the slides is the term that’s used to describe the system of natural approaches. These are founded on spiritual principles to promote and improve physical, mental and spiritual health. That’s what your PMA license authorizes you to offer to your clients.
Now in promoting your services, we advise that clients of PMA practitioners achieve health improvements by making positive lifestyle changes and following other natural procedures that are scripturally sound, scientifically based and professionally administered, pursuant to acceptable standards of care.
The PMA scope of practice
The PS&M services you’re permitted to offer under your PMA license are and limited by what we call the PMA scope of practice. You’ll see there that all activities under your license need to be within eight categories:
- They need to be Scripture based.
- They must be within the documented education and training you possess.
- They need to only include safe natural substances and protocols.
- They must address one or more of the physical mental or spiritual aspects of health either directly or indirectly.
- They should not harm any individual or place anyone’s health or life at risk.
- They must have a basis in improving or restoring health and not be promoted, this is important or offered to diagnose cure or treat any illness or disease condition.
- They must not use or recommend the use of any machine, equipment, device, product, protocol, or otherwise that:
- violates any law or is considered unsafe;
- is contraindicated in view of the client’s health condition or prescription medications the client may be taking;
- has been negatively publicized by the press; or
- would bring governmental action against you as a licensee, or negative publicity to the Association.
- You must not recommend the discontinuance of any legal drugs or controlled substances that are prescribed by an appropriately licensed health care practitioner.
Obviously, you can refer people back to their medical doctor for that to be considered, but under your PMA license you should not be taking people off of their authorized prescriptions.
The basis of your PMA license and the protection it provides
In the United States, your PMA license is premised upon the First Amendment; and that’s in our Constitution as we know the Bill of Rights for the first ten amendments and it is under your religious freedom that the Congress cannot inhibit what we call the free exercise of religion.
Now there is some concern, some confusion. State medical boards will often say the PMA is not licensed in the state. This is a correct statement when the references to being recognized as a license to practice medicine. We are not authorizing doctors to provide medical care.
The PMA license does not authorize, or purport to authorize, the practice of medicine, chiropractic, or any health care profession that is a licensed or regulated by secular governmental authorities. However, states do not have the legal authority to recognize the PMA or to deny it.
Accordingly, the PMA is not bound or required to have any state acceptance authority or permission. It’s an ecclesiastical license which means under the First Amendment these can be issued by the organization but this constitutional freedom as you might imagine is not absolute. There are still legal tests as to whether you’ll be protected under the First Amendment.
It’s very fact specific what you’re doing and how you’re holding yourself out. For example, oftentimes the law will ask are you sincere? Is this really a religious belief or you just doing this to maybe do something that you would not otherwise be licensed to do? And some States can impose limits on spiritual practices if they deem it to be some type of risk to the public or to the consumers.
The PMA the licensing rules and regulations including the Agreement for Wellness Services are designed to help you solidify and protect your right to practice pastoral science and medicine free from government regulation or problem.
When offering your services, this is where certain things become very important and valuable:
- separating your PMA practice not co-mingling it with a state license practice,
- having a dedicated PMA website,
- having a written practice disclosure,
- providing all the required PMA explanations, disclosures and disclaimers in your advertising,
- and specifically using the Agreement for Wellness Services with every client; thus, creating a legally binding agreement or contract that can be enforced.
In other words, your actions can support or undermine your constitutional rights. Your PMA license only gives you the baseline; the opportunity to succeed in this area.
The role of the Agreement for Wellness Services
Now let’s talk for a moment about the role of the Agreement for Wellness Services. It operates to clarify your relationship with your clients, among other things.
The agreement declares the parties’ beliefs in the right to seek health care of their choice, it establishes a private association relationship, it confirms the client’s understanding of the pastoral nature so they can’t say they were confused or didn’t understand, and it specifies the manner means by which client grievances and disputes will be resolved.
In short, the agreement confirms the private nature of your relationship with your clients and gives you additional constitutionally protected contractual rights.
All provisions of the AWS are important and helpful but you should note specifically your responsibility stated in paragraph 2: to provide your clients a written practice disclosure describing your education training and experiences in the services to be provided.
If you’re not a medical doctor, you certainly wouldn’t want someone to be confused and to think that you are, and so that written disclosure is important. The provision intentionally mirrors requirements of health freedom laws enacted in several states that allow practitioners of complementary and alternative medicine to practice without a license as long as certain conditions are met and disclosures are given to clients.
This is simply another legal angle that AWS integrates for your protection. We are helping you meet these required disclosures to protect your right.
You can now use the AWS page on PMA’s website and it’s listed there in the PowerPoint to facilitate signing the AWS with your clients through an exchange of emails. You can submit your and your client’s contact information through the form and then it will proceed forward with various confirmations. This is a very practical and handy tool that we would encourage you to check out.
How the PMA can promote you
Now for a moment let’s talk about how PMA wants to promote you and what it is. It’s an established ecclesiastical organization and it’s helping people who value and prioritize their health, who believe in the freedom of choice when it comes to health care, and who are seeking natural means for restoring health and promoting vitality and well-being for themselves and others.
To these ends the PMA does four things:
- they license Minded health professionals
- they promote the PMA licensee safety effectiveness and growth including the right to practice
- they connect clients and PMA license practitioners
- they provide diverse health care resources plus health savings for PMA Health Network subscribers.
PMA’s newly expanded mission is to focus on lifelong health and well being to help end the epidemic of chronic illness that we see gripping our nation.
Strategies are coming forward to enhance the licensee’s legal protections, to improve client clinical outcomes, and to help PMA practitioners grow their practices and reach more clients.
PMA licensees do not “examine,” “diagnose,” or “treat”
It’s important to note, and I want to stress this loudly, PMA licensees do not, and again I say do not practice medicine. More specifically, practitioners of pastoral science and medicine do not examine, diagnose, or treat.They don’t recommend or prescribe any drugs or medications. Instead, what they are doing is a completely natural approach founded upon spiritual principles for promoting and improving physical mental and spiritual health.
Join the PMA Health Network
We certainly encourage health-conscious people to join PMA’s Health Network and enjoy the rewards. You can partner with healthcare providers, you can monitor your wellness index, you learn how to get healthy and stay that way, lose weight, feel great, have more energy, stop and reverse the progression of chronic illness, set a positive example for family and friends, and you can save money.
This is huge in today’s world. By managing health care costs more effectively, you’ll have more money to spend on what’s important to you. And you can receive PMA’s health network news and gain the resources PMA gathers for Health Network members. Visit PMA’s website and you can learn how you can join.
Things that can get a practitioner in trouble
Now let me go through what we’ll call the trouble areas; things that can get a practitioner into trouble.
Failing to separate your pastoral practice. If you commingle your state-licensed operations and your pastoral practices you have now opened up your entire pastoral practice to state review. You simply cannot be co-mingling records or providing state-licensed services and pastoral counseling to a client in the same appointment.
To help promote separation, the PMA now has leased could be a help to you. You have really four basic choices:
- you can lease a customizable website
- you can have a stand-alone AWS “micro-site”
- you can engage PMA’s web developer to help you create a website
- you can create your own website
However, don’t use your secular website to promote your pastoral practice other than linking your PMA credential or logo to PMA’s website.
The inappropriate promotion of your pastoral practice. Making claims advertising that you’re diagnosing, treating, reversing, or healing diseases through protocols or supplements will catch the attention of regulatory boards. So will Referring your services as therapy or treatments.
Failing to include the PMA disclaimer and use the AWS. Now if a client says, “well I thought,” or “it was my understanding that you were a medical doctor,” something that you’re not; or failing to provide clients with a written practice disclosure that appropriately describes your education, your training and your experience and the services that you’re going to be providing.
Misconceptions about the PMA license. Please understand some people get a misconception about the PMA license. It’s wrong to think that the PMA license covers everything that you do. It covers YOU, the individual. It’s your license. It’s not every activity your office may do.
Believing that the PMA allows you to use certain equipment it does not.
A mistaken belief about when the PMA will provide legal services. The PMA will defend your right to practice under the license but you are responsible for your own defense of violation of state laws or regulations and you are responsible for your own defense of any client malpractice action.
Now at the National Center for Life and Liberty, we have programs where practitioners will join with us, and we provide legal services as general counsel. If that’s something that would be a help to you we’d certainly be glad to talk with you.
Failing to read the policies rules and regulations. I know it seems basic, it’s all online. It’s there for you, but so many folks don’t take the time to understand. They pass along here saying they don’t understand the rules, they don’t understand the importance of carrying malpractice or liability insurance. They exercise poor judgment as to referring clients to a more experienced practitioner or back to their own doctors. And this is important: if you have someone that you’re not able to successfully serve, it’s very important that you refer them to appropriate trained professionals. Or they violate the escrow policy which is the number one area we get complaints about at the PMA’s handling other people’s money.
Describing your practice or services inappropriately. Please note carefully, describing your practice or services in ways that mirror state regulated health care activities will catch attention and often times a board review. Using your position as a pastoral health counselor to influence client actions to benefit you personally, be very careful, you’re a person of trust you’re a counselor.
Be careful of business deals. It’s very important, that you recognize that business deals or other things can create problems for you because the other party the person that the client coming to see you is now not an equal negotiator. And dating or having sexual relations with clients — while not commenting on the morality of this — this is a horrible business practice.
Please understand that type of activity can often create huge liability on a civil side or even sometimes a criminal side. So be very careful when you’re engaging in any type of personal activity with clients. A best practice: stay professional, stay pastoral, and you’ll stay safe.
Thank you for watching and listening to this the licensing and legal issues webinar and we hope that you found this to be helpful. If you have any questions visit our NCLL website, ncll.org, or all of the resources that are on the PMA website. We want to make sure that you succeed and do everything you’re called to do.
Maximum outreach, maximum service. We want you to keep all of your goals but to do that with minimal liability.
Thank you for watching and thank you for listening.