W. Va. Code R. § 11-1B-3 - Qualification and Application for Licensure to Practice as a Physician Assistant
3.1. Minimum
qualifications for licensure as a physician assistant are set forth in W. Va.
Code §
30-3E-4.
3.2. An application for a license to practice
as a physician assistant shall be completed on a form provided by the Board,
which is available on the Board's website. The Board shall not consider an
application or decide upon the issuance of a license to an applicant until the
complete application, including all third-party documentation or verification,
is on file with the Board and the Board has had at least 15 days to review the
application. An application for licensure must be accompanied by payment of a
nonrefundable application fee in an amount established by 11 CSR 4 unless the
applicant has applied for and been granted an initial licensing fee waiver as
set forth in 11 CSR 13.
3.3.
Applicants must provide the following information:
3.3.1. The applicant's name, email address,
home address, preferred mailing address and primary practice location
address(es) and telephone numbers;
3.3.2. Demographic information of the
applicant, such as date of birth, sex, etc.;
3.3.3. A photograph taken within the previous
12 months which substantially resembles the applicant;
3.3.4. A copy of the individual's birth
certificate, certificate of naturalization, or passport to be used in
identifying the applicant, and verifying his or her date of birth and the
appropriate spelling of his or her name;
3.3.5. Documentation establishing that the
applicant:
3.3.5.a. Obtained a baccalaureate
or master's degree from an accredited program of instruction for physician
assistants; or
3.3.5.b. Graduated
from an approved program of instruction in primary health care or surgery prior
to July 1, 1994; or
3.3.5.c. Was
certified by the Board as a "Type B" physician assistant prior to July 1,
1983;
3.3.6.
Documentation that the applicant has passed the Physician Assistant National
Certifying Examination administered by the NCCPA and documentation establishing
that the applicant:
3.3.6.a. Has a current
certification from the NCCPA; or
3.3.6.b. Has a current license in good
standing from a state that does not require a physician assistant to maintain
national certification;
3.3.7. A report from the National
Practitioner Data Bank and documentation and/or certification which establishes
that the applicant does not hold a physician assistant license, certification
or registration in any jurisdiction which is currently suspended or
revoked;
3.3.8. Information with
respect to the applicant's professional practice, character and fitness to
practice as a physician assistant;
3.3.9. Other information as determined by the
Board which relates to whether the applicant is mentally and physically able to
engage safely in practice as a physician assistant; and
3.3.10. Additional information identified by
the Board for licensure.
3.4. In addition to the requirements for
licensure set forth elsewhere in this legislative rule, all applicants for an
initial license to practice as a physician assistant in West Virginia shall
request and submit to the Board the results of a state and a national criminal
history record check.
3.5. The
purpose of the criminal history record check is to assist the Board in
obtaining information that may relate to the applicant's fitness for
licensure.
3.6. In addition to the
State Police, the Board may contract with and designate a company specializing
in the services required by this section instead of requiring the applicant to
apply directly to the West Virginia State Police or similar out-of-state agency
for the criminal history records checks. Provided, that any such company must
utilize protocols consistent with standards established by the Federal Bureau
of Investigation and the National Crime Prevention and Privacy
Compact.
3.7. The applicant shall
furnish to the State Police, or other organization duly designated by the
Board, a full set of fingerprints and any additional information required to
complete the criminal history record check.
3.8. The applicant is responsible for any
fees required by the State Police, or other organization duly designated by the
Board, for the actual costs of the fingerprinting and the actual costs of
conducting a complete criminal history record check.
3.9. The Board may require the applicant to
obtain a criminal history records check from a similar Board approved agency or
organization in the state of the applicant's residence, if outside of West
Virginia.
3.10. The applicant shall
authorize the release of all records obtained by the criminal history record
check to the Board.
3.11. A
criminal history record check submitted in support of an application for
licensure must have been requested by the applicant no earlier than 12 months
immediately prior to the Board's receipt of the applicant's electronic
application for licensure.
3.12. An
initial licensure application is not complete until the Board receives the
results of a state and a national criminal history record check conducted by
the State Police or another entity duly authorized by the Board. The Board
shall not grant an application for licensure submitted by any applicant who
fails or refuses to submit the criminal history record check required by this
section.
3.13. Should criminal
offenses be reported on an applicant's criminal history record check, the Board
shall consider the nature, severity, and recency of offenses, as well as
rehabilitation and other factors on a case by case basis for
licensure.
3.14. The results of the
state and national criminal history record check may not be released to or by a
private entity except:
3.14.1. To the
individual who is the subject of the criminal history record check;
3.14.2. With the written authorization of the
individual who is the subject of the criminal history record check;
or
3.14.3. Pursuant to a court
order.
3.15. Criminal
history record checks and related records are not public records for the
purposes of W. Va. Code §
29B-1-1 et. seq.
3.16. The Board may require an applicant to
provide original documents and/or certified documents in support of an
application for licensure. The application, together with all documents
submitted, becomes the property of the Board and shall not be
returned.
3.17. An applicant may be
required to appear before Board members at the meeting at which his or her
application is to be considered.
3.18. The burden of satisfying the Board of
the applicant's qualifications for licensure is upon the applicant. The Board
may deny an application for a physician assistant license to any applicant
determined to be unqualified for licensure by the Board.
Notes
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