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APPENDIX GNational Commission for Health Certifying Agencies Criteria for Approval of Certifying Agencies . , A certifying agency responsible for attesting to the competency of health care practitioners has a responsibility to the individuals desiring certifica- tion, to the employers of those individuals, to those agencies that reimburse for the services, and to the public. The National Commission for Health Certifying Agencies was formed to identify how those varying responsi- bilities can be met and to determine if a certifying agency meets those responsibilities. Membership of a certifying agency in the Commission in- dicates that the certifying agency has been evaluated by the Commission and deemed to meet all of the established criteria. In order to be "approved" for membership in the commission, a certifying agency shall meet the following criteria: Purpose of Certifying Agency a. shall have as a primary purpose the evaluation of those individuals who wish to enter, continue and/or advance in the health profes- sions, through the certification process, and the issuance of cre- dentials to those individuals who meet the required level of competence. 2. Structure a. shall be non-governmental; b. shall conduct certification activities which are national in scope; Amended December 1984. The term certifying agency as used in this document means an independent, not-for-profit certifying agency or a not-for-profit association with a certifying component. 324

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APPENDIX G 325 c. shall be administratively independent* in matters pertaining to certification, except appointment of members of the governing body of the certifying agency. A certifying agency which is not a legal entity in and of itself shall provide proof that the agency's governing body is administratively independent in certification matters from the organization of which it is a part; d. shall have a governing body which includes individuals from the discipline being certified. A certifying agency which certifies more than one discipline or more than one level within a discipline shall have representation of each on the governing body; e. shall require that members of the governing body who represent the certified profession shall be selected by the certified profession or by an association of the certified profession and such selection shall not be subject to approval by any other individual or orga- . . n~zat~on; f. shall have formal procedures for the selection of members of the governing body which shall prohibit the governing body from . . se ectlng its successors; g. shall provide evidence that the public consumer and the super- vising professional and/or employers of the health professionals have input into the policies and decisions of the agency, either through membership on the governing body or through formal- ized procedures as advisors to the governing body. This criterion is effective January 1, 1981; and h. the certifying body of a professional organization shall be separate from the accrediting body of the professional association. 3. Resources of Certifying Agencies a. shall provide evidence that the agency has the financial resources to properly conduct the certification activities; b. shall provide evidence that the staff possesses the knowledge and skill necessary to conduct the certification program or has available and makes use of non-staff consultants and professionals to suf- ficiently supplement staff knowledge and skill. 4. Evaluation Mechanism a. shall provide evidence that the mechanism used to evaluate in- dividual competence is objective, fair and based on the knowledge and skills needed to function in the health profession; *Administratively independent means that all policy decisions relating to certification matters are the sole decision of the certifying body and not subject to approval by any other body and that all financial matters related to the operation of the certifying component are seg- regated from those of the professional association.

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326 APPENDIX G b. shall have a formal policy of periodic review of evaluation mech- anisms and shall provide evidence that the policy is implemented to insure relevance of the mechanism to knowledge and skills needed in the profession; shall provide evidence that appropriate measures are taken to protect the security of all examinations; d. shall provide evidence that pass/fail levels are established in a man- ner that is generally accepted in the psychometric community as being fair and reasonable. This criteria is effective January 1, 1981, after standards are established; and e. shall provide evidence that the evaluation used evidence of at- tempts to establish both reliability and validity for each form of . . t be examination. 5. Public Information a. shall publish a document which clearly defines the certification responsibilities of the agency and outlines any other activities of the agency which are not related to certification; b. shall make available general descriptive materials on the proce- dures used in test construction and validation and the procedures of administration and reporting of results; c. shall publish a comprehensive summary or outline of the infor- mation, knowledge, or functions covered by the test; and d. shall publish at least annually, a summary of certification activities, including number tested, number passing, number failing, num- ber certified and number recertified (if agency conducts a recer- tification program). 6. Responsibility on Applicants for Certification or Recertification a. shall not discriminate among applicants as to age, sex, race, reli- gion, national origin, handicap or marital status and shall include a statement of non-discrimination in announcement of the certi- ~ . location program; b. shall provide all applicants with copies of formalized procedures for application for, and attainment of, certification and shall pro- vide evidence to the Commission that such procedures are uni- formly followed and enforced for applicants; c. shall have a formal policy for the periodic review of application and testing procedures to insure that they are fair and equitable and shall give evidence to the Commission of the implementation of the policy; d. shall publicize nationally appropriate data concerning certification program including eligibility requirements for certification, basis of examination, dates and places of examinations;

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APPENDIX G 327 e. shall provide evidence that competently proctored testing sites are readily accessible in all areas of the nation at least once annually; f. shall publicize nationally the specific education background or employment backgound required for certification; g. shall give evidence that a means exists for individuals who have obtained a skill or knowledge outside the formal educational set- ting to be evaluated and obtain certification or in the absence of such means, provide reasonable justification for exclusion. These means employed should be consistent with the evaluation stan- dards. The criterion is effective January 1, 1982; h. shall provide evidence of uniformly prompt reporting of test re- sults to applicants; . shall provide evidence that applicants failing the examination are given information on general areas of deficiency; l shall provide evidence that each applicant's test results are held confidential; k. shall have a formal policy on appeal procedures for applicants questioning examination results and shall publish this information In examination announcements; anct 1. shall have a formal policy, acceptable to the Commission, deline- ating grounds, based on applicants prior or current conduct, for refusing applicants eligibility to take the certification examination and shall provide applicants the opportunity to present their cases to an impartial decisionmaker in the event of denial of eligibility or denial of certification. (Effective January 1, 1987) 7. Responsibilities to the Public and to Employers of Certified Personnel a. shall drive to insure that the examination adequately measures the knowledge and skill required for entry, maintenance and/or ad- vancement into the profession; b. shall provide evidence that the agency awards certification only after the skill and knowledge of the individual has been evaluated and determined to be acceptable; shall periodically publish a list of those persons certified by the agency; d. shall have a formal policy and procedure for discipline of certi- ficants, including the sanction of revocation of the certificate, for conduct which clearly indicates incompetence, unethical behavior and physical or mental impairment affecting performance that is acceptable to the Commission. These procedures shall incorporate due process (effective January 1, 1987~; e. any title or credential awarded by the credentialing body shall appropriately reflect the practitioner's daily occupational duties

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328 APPENDIX G and shall not be confusing to employers, consumers, health profes- sionals and/or other interested parties (effective January 1, 19851; The membership committee may consider the following factors in determining whether practitioner's titles or credentials comply . . . . Wit n t nls criterion: (i) educational background; (ii) function of profession; (iii) occupational duties and breadth of these activities; (iv) level of supervision by other practitioners, or of any other practitioners and (v) various titles already in the field, other titles considered, and a justification of why these titles were not utilized or why they were changed. 8. Recertification a. shall have in existence or shall be in the process of developing a plan for periodic recertification: b. shall provide evidence that any recertification program is designed to measure continued competence or to enhance the continued competence of the individual. 9. Responsibilities to Commission . . a. shall provide the Commission on a regular basis with copies of all publications related to the certifying process; b. shall advise the Commission of any change in purpose, structure or activities of the certifying agency; c. shall advise the Commission of substantive change in test admin- . . . Stratton procedures; d. shall advise the Commission of any major changes in testing tech- niques or in the scope or objectives of the test; and e. shall undergo re-evaluation by the Commission at five year inter- vals. In this document the term recertification includes periodic renewal or revalidation of certification based on reexamination, continuing education, or other methods developed by the certifying agency. This criterion is effective January 1, 1982.