800, Sec. 678, Sec. An application for a license when there is a CHOW is an application for an initial license. Sept. 1, 1989. (a) A person who is otherwise eligible to renew a license may renew an unexpired license by submitting a completed application for renewal and paying the required renewal fee to the department not later than the 45th day before the expiration date of the license. The rules must provide for notice and an opportunity for a hearing. Sept. 1, 1999. The United States has experienced a peaceful and orderly transfer of power between presidential administrations for 224 years. April 2, 2015. WASHINGTONDemocratic congressional leaders called for President Trump to be removed from office while two cabinet officials resigned, a day after the Capitol was stormed by rioters encouraged by. (15) "Hospice services" means services, including services provided by unlicensed personnel under the delegation of a registered nurse or physical therapist, provided to a client or a client's family as part of a coordinated program consistent with the standards and rules adopted under this chapter. Sept. 1, 1993; Acts 1995, 74th Leg., ch. (d) The reports, records, and working papers used or developed in an investigation made under this section are confidential and may not be released or made public except: (2) to federal, state, or local law enforcement personnel; (3) with the consent of each person identified in the information released; (4) in civil or criminal litigation matters or licensing proceedings as otherwise allowed by law or judicial rule; (5) on a form developed by the department that identifies any deficiencies found without identifying a person, other than the home and community support services agency; (6) on a form required by a federal agency if: (A) the information does not reveal the identity of an individual, including a patient or a physician or other medical practitioner; (B) the service provider subject to the investigation had a reasonable opportunity to review the information and offer comments to be included with the information released or made public; and, (C) the release of the information complies with any other federal requirement; or. 459 (H.B. In determining appropriate categories, the department shall make distinctions based on factors useful to the public in assessing the quality of services provided by a home and community support services agency, including whether the complaint: (1) was determined to be valid or invalid; (2) involved significant physical harm or death to a patient; (3) involved financial exploitation of a patient; or. 1, eff. April 2, 2015. Acts 2015, 84th Leg., R.S., Ch. Ensure Item 4 indicates the name the agency that your agency will be DBA. (b) The executive commissioner by rule shall establish eligibility requirements for a branch office license. June 19, 2009. Completing Form 2021 Licensing Application, Home and Community Support Services Agencies, Section 12 Ownership and Control Interest Disclosure, Section 14 Affidavit of Financial Solvency, Document Checklist for Initial and CHOW Applications, Document Checklist for Medicare Applications, Document Checklist for Renewal Applications, city, county, state or federal government authority or hospital district/authority, administrator and alternate administrator, Completed entity documents for business organizations. 142.020. 142.0173. Requires an adult day-care facility director to show evidence of 12 contact hours of annual continuing education; requires a facility to provide a minimum of three hours of 40 T.A.C. Acts 1989, 71st Leg., ch. Feb. 1, 2004. 826 (H.B. In this section you must disclose information about the owner/applicant and affiliates. 800, Sec. 1.02, eff. (e) A permit is valid for one year and is not transferable. 800, Sec. Added by Acts 1999, 76th Leg., ch. INVESTIGATIONS OF HOME AND COMMUNITY SUPPORT SERVICES AGENCIES PROVIDING HOSPICE SERVICES. About 220,200 openings for nursing assistants and orderlies are projected each year, on average, over the decade. Sec. (11) "Counselor" means an individual qualified under Medicare standards to provide counseling services, including bereavement, dietary, spiritual, and other counseling services, to both the client and the family. 2.156(a)(1), eff. 980 (H.B. 14.779, eff. (l) The department and other state agencies that are under the commission and that contract with home and community support services agencies to deliver services for which a license is required under this chapter shall execute a memorandum of understanding that establishes procedures to eliminate or reduce duplication of standards or conflicts between standards and of functions in license, certification, or compliance surveys and complaint investigations. All agencies must have an administrator and an alternate administrator.The supervising nurse and alternate supervising nurse are required for agencies requesting Licensed Home Health, Licensed and Certified Home Health Services, and Hospice categories. From the Republican party to the Democratic party. April 2, 2015. Sept. 1, 1999; Acts 1999, 76th Leg., ch. Medicare will separately reimburse properly documented, medically necessary services. 1310 (S.B. (c) Within the 30-day period, a person who acts under Subsection (b)(3) may: (A) paying the penalty to the court for placement in an escrow account; or, (B) giving to the court a supersedeas bond that is approved by the court for the amount of the penalty and that is effective until all judicial review of the order is final; or. (3) any other individual who, because of a personal, familial, or other relationship with the owner, manager, or provider of a home and community support services agency, is in a position of actual control or authority with respect to the agency, without regard to whether the individual is formally named as an owner, manager, director, officer, provider, consultant, contractor, or employee of the agency. An agency is not required to pay a fee to report a change in alternate administrator, but the agency must pay a late fee, as described in 97.208, if the agency does not report the change within the time frame required. 11, eff. Overall employment of nursing assistants and orderlies is projected to grow 5 percent from 2021 to 2031, about as fast as the average for all occupations. September 1, 2015. Do not leave any blanks on the form. 142.012. (j) Except as provided by Subsections (h) and (l), an on-site survey must be conducted within 18 months after a survey for an initial license. 142.022. Sec. 800, Sec. 1317, Sec. (b) A home and community support services agency that purchases, stores, or transports a vaccine or tuberculin under this section shall ensure that any standing order for the vaccine or tuberculin: (1) is signed and dated by the physician; (2) identifies the vaccine or tuberculin covered by the order; (3) indicates that the recipient of the vaccine or tuberculin has been assessed as an appropriate candidate to receive the vaccine or tuberculin and has been assessed for the absence of any contraindication; (4) indicates that appropriate procedures are established for responding to any negative reaction to the vaccine or tuberculin; and. You know that." Sign it in a few clicks 980 (H.B. April 2, 2015. A legal entity could be a corporation, limited partnership, general partnership, sole proprietor, limited liability company, city, county, state or federal government authority or hospital district/authority or a trust, living trust, estate; Franchise tax account status from the State Comptroller's Office or exemption letter; Proof of National Provider Identification Number; Job descriptions for the agency administrator and alternate administrator; Job description for the supervising nurse and alternate supervising nurse; A written plan to provide annual continuing education for management personnel; Current resume or curriculum vitae for the agency administrator and the alternate administrator; Current resume or curriculum vitae for the supervising nurse and alternate supervising nurse; Form 2022, criminal history check, for each owner, administrator, alternate administrator and chief financial officer; Copies of the initial 8 hour administrator training certificates; and. ); and. Amended by Acts 1991, 72nd Leg., ch. The children then go through immigration proceedings where they are able to present a claim for relief under the law. Amended by Acts 1991, 72nd Leg., ch. 31, Sec. Remember PAS agencies must designate an administrator and an alternate administrator and all other types of agencies must designate an administrator, alternate administrator, supervising nurse and alternate supervising nurse. 1, eff. 1272 (S.B. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 22 That the Laws of Maryland read as follows: Added by Acts 1990, 71st Leg., 6th C.S., ch. 800, Sec. (k) If a person is renewing or applying for a license to provide more than one type of service under this chapter, the surveys required for each of the services the license holder or applicant seeks to provide shall be completed during the same surveyor visit. 609 (S.B. 800, Sec. The regulation states that in general, when patients are transferred from one facility to another on the same day, you can bill only one code. Ensure the legal business entity shown in Section 3 matches the name on the tax documents, articles of incorporation or articles of organization, Submit a copy of the documentation from the NPI office and documentation from the IRS of the tax ID number. On January 10, 2022, CMS provided HHSC conditional approval of the spending plan. Added by Acts 1993, 73rd Leg., ch. Acts 2011, 82nd Leg., R.S., Ch. Edit your form 2021 online Type text, add images, blackout confidential details, add comments, highlights and more. 223), Sec. 1720), Sec. (c) The department shall require a permit holder to satisfactorily complete a continuing education course approved by the department for renewal of the permit. (c) This section does not affect the duty or authority of any state agency to conduct an investigation of alleged abuse, exploitation, or neglect as provided by other law. 800, Sec. Get email updates. LICENSE APPLICATION. 9, eff. (2) the alleged perpetrator of the abuse, neglect, or exploitation is an employee, volunteer, contractor, or subcontractor of the home and community support services agency. If an agency does not receive the reminder from DADS at least 90 days before the expiration date of a license, the agency must notify DADS and submit a written request for a renewal application. (b) For purposes of this section, reasonable expenses and costs include expenses incurred by the department and the attorney general in the investigation, initiation, and prosecution of an action, including reasonable investigative costs, attorney's fees, witness fees, and deposition expenses. BRANCH OFFICE. Mental Health Discharge: live: Mental Health eDischarge 2.9.0-live: 30 July 2021: Transfer of Care information to support . April 2, 2015. CHANGE IN APPLICATION INFORMATION. (b) The penalty shall be not less than $100 or more than $1,000 for each violation. September 1, 2015. Sept. 1, 2001. At the end of the questions please click on the button to check your answers. Acts 2011, 82nd Leg., R.S., Ch. September 1, 2015. Sept. 1, 1993. In order to bill for a consult, the referring physician is requesting an opinion or advice on how to treat the patient. (a) The executive commissioner shall adopt rules necessary to implement this chapter. 11, eff. 8, eff. (1) The facility must permit each resident to remain in the facility, and not transfer or discharge the resident from the facility unless: (a) The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility; 1160 (H.B. Those agencies requesting only the category of Personal Assistance Services do not require a supervising nurse or alternate supervising nurse. 5.95(49), eff. (b) A home and community support services agency shall provide both verbal and written instructions to the agency's client regarding the proper procedure for disposing of sharps. Each provider must submit to the department documentation from the accrediting body indicating that the provider is accredited when the provider is applying for the initial license and annually when the license is renewed. 4001), Sec. Sept. 1, 1993; Acts 1995, 74th Leg., ch. 4, eff. 1, eff. (5) any other vaccine approved, authorized for emergency use, or otherwise permitted for use by the United States Food and Drug Administration to treat or mitigate the spread of a communicable disease, as defined by Section 81.003. Those persons providing Home Health, Hospice or Personal Assistance Services (PAS) for pay or other considerations in a client's residence, an independent living environment or another appropriate location should submit this application. (4) administers noninjectable medication under circumstances authorized by the memorandum of understanding executed by the department and the Texas Board of Nursing. This specification may be subject to controlled future changes. 878 (H.B. (b) A home and community support services agency that owns or operates an administrative support site is not required to obtain a separate license under this chapter for the administrative support site. The term includes: (B) health-related services performed under circumstances that are defined as not constituting the practice of professional nursing by the Texas Board of Nursing under the terms of a memorandum of understanding executed by the board and the department; and. . Acts 1989, 71st Leg., ch. Acts 2007, 80th Leg., R.S., Ch. 892, Sec. Sec. CANHR's mission is to educate and support long term health care advocates and consumers regarding the rights and remedies under the law, and to create a united voice for long term care reform and . On the application section 12b (vi), list the information requested if the owner/applicant is a subsidiary of another organization. (3) document in the patient's clinical record that the policies and procedures were provided and discussed under Subdivisions (1) and (2). Sept. 1, 1993; Acts 1995, 74th Leg., ch. Sec. (e) The hearing and an appeal from a disciplinary action related to the hearing are governed by the department's rules for a formal hearing and Chapter 2001, Government Code. The memorandum of understanding must be approved by the commission. (c) A suit for injunctive relief must be brought in Travis County. OEMS COMM 21-02 - 2021 Legislation Pertaining to EMS Education (Aug 2021) . 800, Sec. (viii) 20 (c) before initiating care in accordance with 8 -6c 04(a)(22) of 21 this subtitle, in addition to obtaining the informed consent agreement 22 required under subsection (a) of this section, a licensed . (a) The department may issue a branch office license to a person who holds a license to provide home health or personal assistance services. DADS requires certain updates be reported using Form 2021. (b) A penalty assessed under this section shall be $500. Please click on the button at the end to check your answers. Sept. 1, 1993; Acts 1997, 75th Leg., ch. SCOPE, PURPOSE, AND IMPLEMENTATION. 219), Sec. 142.0061. (i) Repealed by Acts 2003, 78th Leg., ch. Additional update information on the next slide. All agencies with the category of Licensed and Certified Home Health Services, Licensed and Certified Home Health Services with Dialysis, or Hospice Services must have a board of directors/governing body. 15 (2021 Replacement Volume and 2022 Supplement) 16 BY adding to 17 Article - Health Occupations 18 Section 8-6C-04(a)(22) and (e) 19 Annotated Code of Maryland 20 (2021 Replacement Volume and 2022 Supplement) 21 SECTION 1. Use professional pre-built templates to fill in and sign documents online faster. September 1, 2011. Acts 2015, 84th Leg., R.S., Ch. 889 (H.B. 219), Sec. 980 (H.B. If a complete and correct application packet and license fee to DADS is received by the date of sale, the applicant must prove to DADS' satisfaction that the health and safety of the agency's clients requires an emergency CHOW. (d) A person whose application is denied or whose license is suspended or revoked is entitled to a hearing if the person submits a written request to the commission. Critical care interfacility transport face-to-face ( 99466, 99467) or supervisory services ( 99485, 99486) and initial neonatal critical care services ( 99468) may be reported by the same individual or individuals in the same group practice and same specialty when provided to a patient on the same day. 219), Sec. The approval is conditional upon HHSC complying with federal requirements. Scroll over the image for more information. 1, eff. Acts 1989, 71st Leg., ch. Added by Acts 1999, 76th Leg., ch. (5) minimum standards for on-site supervision of a permit holder by a registered nurse. An individual having power of attorney from the license holder or other authority to act on behalf of the license holder may request renewal of the license. 809 (S.B. Acts 2015, 84th Leg., R.S., Ch. All Rights Reserved. (b) In developing and updating the training required by Subsection (a), the department shall consult with and include providers of home health, hospice, habilitation, and personal assistance services, recipients of those services and their family members, and representatives of appropriate advocacy organizations. 3.0408, eff. ET, January 7, 2021 The House just rejected an objection to Pennsylvania's electoral vote From CNN's Kristin Wilson The House voted to reject an objection to throw out Pennsylvania's. (c) A branch office license expires on the same date as the license to provide home health or personal assistance services held by the applicant for the branch office license. On the application section 12b (ii), complete a separate section for each legal business entity and disclose the name, address, Tax ID number (EIN) and contact person information for the management company. 6, eff. Sec. (a) The department shall issue a home and community support services agency license to provide home health, hospice, habilitation, or personal assistance services for each place of business to an applicant if: (A) qualifies for the license to provide the type of service that is to be offered by the applicant; (B) submits an application and license fee as required by this chapter; and, (C) complies with all applicable licensing standards required or adopted under this chapter; and. Do report additional information within a section by copying and completing that section for each additional entry. 2.194, eff. 15, eff. Sept. 1, 1989. Sec. January 7, 2021 / 7:16 AM / CBS/AP. Acts 2015, 84th Leg., R.S., Ch. At the end of the quiz please clck on the answer button to see your score. Fill out the application with each owner applicants information. 958 (S.B. (2) any controlling person with respect to the applicant complies with all applicable licensing standards required or adopted under this chapter. (a) Except as provided by Section 142.003, a person, including a health care facility licensed under this code, may not engage in the business of providing home health, hospice, habilitation, or personal assistance services, or represent to the public that the person is a provider of home health, hospice, habilitation, or personal assistance services for pay without a home and community support services agency license authorizing the person to perform those services issued by the department for each place of business from which home health, hospice, habilitation, or personal assistance services are directed. the designated administrator, alternate administrator, supervising nurse and alternate supervising nurse of all other types of agencies. Acts 2011, 82nd Leg., R.S., Ch. The Registered Nurse utilizes the nursing care process consistent with their license and/or certification including initiation of culturally competent continuum of care including inpatient, outpatient and community settings. (2) not later than 20 days after receipt of the order, send a copy of the order as signed by and received from the physician to the dispensing pharmacy. June 19, 1990. 800, Sec. When there is no transfer of care, services of a physician other than the surgeon may be reported with the appropriate level E/M code. 889 (H.B. 21-1 effective June 22, 2021; P.A. Document Checklist for Initial and CHOW Applications The following documents must be submitted with the application packet: Completed application Form 2021 ; Completed Affidavit of Capability; Completed Affidavit of Financial Solvency; Non-refundable licensing fee; Completed entity documents for business organizations. (b) The department shall make the information maintained under this section available to the public in a useful format that does not identify individuals implicated in the complaints. Added by Acts 1993, 73rd Leg., ch. (e) A license issued under this chapter may not be transferred to another person, but may be transferred from one location to another location. If needed you may refer back to the previous slide. 3, eff. April 2, 2015. In addition, contact the Medicare program's information line: 1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048 for the hearing impaired). Texas Administrative Code (TAC), Title 40, Part 1, Chapter 97 Subchapter B; and. Acts 2019, 86th Leg., R.S., Ch. An agency whose license expires must close and apply for an initial license. In section 12, check the type of organizational structure of your agency. An important source of information about services is the Elder Care Locator 1-800-677-1116. TEMPORARY LICENSE. (26) "Respite services" means support options that are provided temporarily for the purpose of relief for a primary caregiver in providing care to individuals of all ages with disabilities or at risk of abuse or neglect. Sept. 1, 1993. CONTROLLING PERSON. 142.005. (4) the agency maintains a written record of the dates and times the container is in the possession of a registered nurse or licensed vocational nurse. 31, Sec. includes information from Title 40, Part 1, Chapter 97 Subchapter B to ensure the participant has all the required information to complete Form 2021. the designated administrator and an alternate of a personal assistance agency; or. Following your discharge or transfer, we will send a discharge or transfer summary within the time frames specified by federal regulations to your primary care practitioner or other health care professional who will be providing care and services to you after discharge or transfer from our agency. 1 (S.B. 219), Sec. The training must include information relating to: (1) the conduct of appropriate surveys that do not focus exclusively on medical standards under an acute care model; (2) acceptable delegation of nursing tasks; and. A license holder is not authorized to operate the agency for which the license was obtained after the expiration of the license unless and until the license holder actually renews the license. In 2021, Wellstar invested more than $915 million in unreimbursed care for patients across the region and remains a top provider of charity care in the state and the nation. 5, eff. This is any organization that exercises operational or managerial control over the day-to-day operations of the HCSSA. 198, Sec. (4) an administrator's responsibility to be available to the agency at all times in person or by telephone. Sept. 1, 1999; Acts 2003, 78th Leg., ch. 12, eff. Remember that an application is not considered complete until the applicant pays the full licensing fee. September 1, 2007. A dignified transfer is conducted for every U.S. military member who dies in the theater of operation while in the service of their country. Sec. Sec. 609 (S.B. Renewal applications must be submitted before the expiration date. A home and community support services agency shall: (1) assist clients as necessary with registering for disaster evacuation assistance through 2-1-1 services provided by the Texas Information and Referral Network; and. 916), Sec. Acts 1989, 71st Leg., ch. (b) An emergency suspension is effective immediately without a hearing on notice to the permit holder. Section 1395nn and its subsequent amendments. Sept. 1, 1999. Sept. 1, 1989. In addition, one of the following must be submitted: (as filed with the Texas Secretary of State). Fill out all the required information. If an agency submits a renewal application that is postmarked later than the 45th day before the expiration date of a license, but no later than the expiration date of the license, DADS assesses the late fee set out in 97.3(b). 3.0403, eff. Each day of a continuing violation that occurs after the day on which the person receives written notice of the violation from the department constitutes a separate violation. Sept. 1, 1991; Acts 1993, 73rd Leg., ch. Sept. 1, 1999. (a) The application. 800, Sec. September 1, 2015. 10, eff. Physicians have the primary responsibility to ensure effective transfers of care. 800, Sec. April 2, 2015. SUBCHAPTER B. The term does not include an administrative support site. The applicant may have an approved accreditation organization conduct a certification survey. DADS will issue a license or deny the application within 45 days of receipt of a complete application, which includes all required documentation and fees. Acts 2007, 80th Leg., R.S., Ch. 3.1639(48), eff. Sec. 276, Sec. Acts 2015, 84th Leg., R.S., Ch. 2, eff. If CMS certifies an agency to participate in the Medicare program, DADS sends a notice to the agency that the category of Licensed and Certified (L&C) has been added to the license. (c) A fee charged under this section is nonrefundable. The notice shall include: (1) a brief summary of the alleged violation; (2) a statement of the amount of the proposed penalty based on the factors listed in Section 142.017(d); and. 4, eff. 219), Sec. April 2, 2015. Acts 2007, 80th Leg., R.S., Ch. The nonrefundable license fee must be submitted with the application. 142.003. Sept. 1, 1999. The agency must cease operation on the date the license expires if DADS does not receive a renewal application postmarked before the expiration date. April 2, 2015. 3193), Sec. Although transfer is to be avoided at all costs, there may be circumstances when it is necessary for the resident to be transferred. (11-c) "Habilitation" means habilitation services, as defined by Section 534.001, Government Code, delivered by a licensed home and community support services agency. 1 (S.B. 9, eff. 800, Sec. If an agency reports a change in physical location, the agency must pay a fee and may be subject to a late fee, as described in 97.208. 3079), Sec. 8, eff. (a) The department may assess an administrative penalty against a person who violates: (1) this chapter or a rule adopted under this chapter; or. 142.044. 1, eff. 142.0104. (d) The executive commissioner may adopt rules that specify the ownership interests and other relationships that qualify a person as a controlling person. (a) For the violation of this subchapter or a rule adopted under this subchapter, the department may: (1) deny, suspend, revoke, or refuse to renew a permit; (2) suspend a permit in an emergency; or. Note: if this section does not apply, check the box on the application and skip to Item 12. b. 3.0402, eff. 223), Sec. 1808), Sec. 276, Sec. 678, Sec. Added by Acts 1997, 75th Leg., ch. (c) Based on the findings of fact and conclusions of law and the recommendations of the administrative law judge, the department by order may find that a violation has occurred and may assess a penalty or may find that no violation has occurred. 7, eff. 3.0410, eff. (b) In addition to the requirements of Subsection (a), if the applicant is a certified agency when the application for a license to provide certified home health services is filed, the applicant must maintain its Medicare certification. Added by Acts 1999, 76th Leg., ch. September 1, 2015. President Donald J. Trump's initial refusal to start the formal presidential transition process and long refusal to concede the electiononly conceding after his supporters attacked Capitol Hillhas drawn heightened attention to the approximately 75 days between Election Day and the inauguration of a new President.. Acts 2015, 84th Leg., R.S., Ch. 26, eff. September 1, 2007. Acts 1989, 71st Leg., ch. 1318), Sec. Sec. June 10, 2019. 1020, Sec. Sec. The processing of the application with DADS mail room and DADS Account Receivable could take up to 10 days from the date mailed. Sec. June 10, 2019. For an initial or renewal of a registration of an employee who is not a key employee, the fee shall be fifty dollars. The attorney general shall bring suit on behalf of the state to collect the civil penalty. (2) engages in conduct that violates Section 102.001, Occupations Code. In order to continue providing services to clients, an agency must renew its license and have a successful survey or be satisfactorily accredited. September 1, 2015. Sec. 6, eff. must be signed and completed by the owner or a person having signing authority for initial and CHOW applications; Completed Affidavit of Financial Solvency; Completed entity documents for business organizations. Edit your form 2021 online Type text, add images, blackout confidential details, add,. Controlling person with respect to the permit holder by a registered nurse full fee... Military member who dies in the theater of operation while in the of... Administers noninjectable medication under circumstances authorized by the department and the Texas Board of nursing ;.. One of the questions please click on the application with DADS mail room and DADS Receivable... Application section 12b ( vi ), eff in a few clicks 980 (.. 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In this section does not include an Administrative support site Code ( TAC ), list the information if. Submitted before the expiration date your score the category of Personal Assistance services do not require a supervising or... Add images, blackout confidential details, add images, blackout confidential details, add images, blackout details! Rules must provide for notice and an opportunity for a hearing about services is Elder..., alternate administrator, alternate administrator, supervising nurse to fill in and Sign documents online.. ( b ) an emergency suspension is effective immediately without a hearing on notice to the previous.. Adopt rules necessary to implement this chapter circumstances when it is necessary for the resident be... Power between presidential administrations for 224 years submitted with the application with each applicants... Application postmarked before the expiration date, chapter 97 Subchapter b ; and, of... A few clicks 980 ( H.B $ 500 $ 2021 initial orderly transfer of care or more than $ 1,000 for each entry... Support services agencies PROVIDING HOSPICE services and have a successful survey or satisfactorily... Office license support site or adopted under this chapter year, on average, over the decade each! A fee charged under this chapter nurse and alternate supervising nurse and alternate supervising nurse establish. The button to see your score by telephone not a key employee, fee. Agency must cease operation on the answer button to see your score the permit holder by a nurse.
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