MINUTES OF THE MEETING OF THE BOARD OF MEDICINE AND SURGERY. January 25, 2013

Transcription

1 MINUTES OF THE MEETING OF THE BOARD OF MEDICINE AND SURGERY January 25, 2013 ROLL CALL The meeting of the Board of Medicine and Surgery was called to order by Chairman Judith A. Scott, DO, at 9:00 am on January 25, 2013, in the Lighthouse Room, Country Inn and Suites, 5353 N 27 th Street, Lincoln, Nebraska. The following members answered the roll call: Judith A. Scott, DO, Chair Karen M. Higgins, MD, Vice-Chair Michael J. Bittles, MD, Secretary Roger A. Brumback, MD Merle J. Henkenius Vonn E. Roberts, MD Carl V. Smith, MD Absent: Jeffrey L. Howorth A quorum was present and the meeting convened. Also present to participate in the meeting: Julie Agena, Assistant Attorney General; Robert Semerena, Administrator, Investigations Unit; Patricia Lemke, Investigator; Dennis Scott, Investigator; Kathleen Krueger, Investigator; Suzanne Rydberg, Investigator; Janeen Berg, Investigator; Jeff Newman, Investigator; Becky Wisell, Administrator, Office of Medical and Specialized Health; and Vonda Apking, Health Licensing Coordinator, Licensure Unit. ADOPTION OF AGENDA Roberts moved, seconded by Higgins, to adopt the agenda. Voting aye: Scott, Higgins, Bittles, APPROVAL OF MINUTES OF THE MEETING Roberts moved, seconded by Henkenius, to approve the minutes of the December 14, 2012 meeting. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried. INVESTIGATIONAL REPORTS, DISCIPLINARY REPORTS, REVIEW OF DISCIPLINARY CASES PENDING, APPLICATION REVIEW Higgins moved, seconded by Brumback, to go into closed session to hear the investigational reports and all other closed session items as identified on the agenda. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried and the meeting went into closed session at 9:01 am. Roberts recused himself from the meeting at 9:04 am. Roberts returned to the meeting at 9:06 am. Smith and Roberts recused themselves from the meeting at 9:30 am.

2 Page 2 Smith and Roberts returned to the meeting at 9:46 am. Suzanna Glover-Ettrich, Department Legal Counsel, entered the meeting at 10:03 am. Smith moved, seconded by Henkenius to return the meeting to open session. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried and the meeting returned to open session at 10:33 am. PHYSICIAN APPLICATION REVIEW AND DISPOSITION Initial Licensure Abbott, William application for a license to practice medicine and surgery. Smith moved, seconded by Bittles, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Brumback, Chin, Steven application for a license to practice medicine and surgery. Brumback moved, seconded by Higgins, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Dulaney, Eugene application for a license to practice medicine and surgery. Smith moved, seconded by Higgins, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Schaiberger, Christopher application for a license to practice medicine and surgery. Brumback moved, seconded by Smith, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Stevanovic, Christopher application for a license to practice medicine and surgery. Smith moved, seconded by Bittles, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Toombs-Withers, Shayla application for a license to practice medicine and surgery. Higgins moved, seconded by Smith, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Daly, Christopher application for a license to practice medicine and surgery. Bittles moved, seconded by Smith, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Huffman, Contrina application for a license to practice medicine and surgery. Smith moved, seconded by Bittles, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Gordon, Robert application for a license to practice medicine and surgery. Smith moved, seconded by Higgins, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Brumback, McIntosh application for a license to practice medicine and surgery. Bittles moved, seconded by Smith, to recommend issuance of a license. Voting aye: Scott, Higgins, Bittles, Brumback,

3 Page 3 Russo, Louis application for a locum tenens to practice medicine and surgery. Smith moved, seconded by Bittles, to recommend issuance of a locum tenens. Voting aye: Scott, Higgins, Bittles, Stellmacher, Edward application for a license to practice medicine and surgery. Smith moved, seconded by Brumback, to recommend denial of a license because Stellmacher completed only two years of postgraduate medical education. As a foreign medical graduate, three years of postgraduate medical education are required for licensure. Voting aye: Scott, Higgins, Bittles, Brumback, Reinstatement After Discipline Bottlinger, Bruce application for reinstatement after disciplinary revocation. Bottlinger s disciplinary history in Nebraska dates back to 2001, with the most recent being the revocation of license on March 31, Smith moved, seconded by Bittles, to recommend reinstatement of the license on probation for a period of five years, with conditions to include two support group meeting each week; random body fluid screens; abstain from alcohol and controlled substances, unless prescribed; continued care with mental health providers and to follow their recommendations; all other standard conditions associated with alcohol dependence. Basis for the action is Bottlinger s history of disciplinary action and diagnosis of alcohol dependence. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried. Christine Johnson application for reinstatement after discipline. Johnson was seeking early termination of her probation. Johnson s license was reinstated on probation October 27, 2011 for a period of one year with the condition that she have a practice monitor conduct a retrospective review of the quality of care she provided by reviewing the medical records. The reason for the probation was the period of time Johnson had not been practicing medicine. Because Johnson had some periods of non-practice after the license was reinstated, she had completed eight months and eight days of her probation. Smith moved, seconded by Higgins, to approve reinstatement of the license without restrictions, based on the positive reports from the practice monitor and her recent passage of her Family Practice Board Examination. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried. Mail Ballots Smith, Jennifer reinstatement of license to practice osteopathic medicine and surgery. This application was reviewed by the Board via ballot with the recommendation to issue the license. The license was issued December 31, PHYSICIAN ASSISTANT APPLICATION REVIEW AND DISPOSITION Initial Licensure Berry, Christine application for a temporary and subsequent permanent license to practice as a physician assistant. Bittles moved, seconded by Higgins, to make the same recommendation as that made by the Physician Assistant Committee. The Physician Assistant Committee recommended issuance of a license. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried.

4 Page 4 Request for Waiver of Secondary Site Supervision Requirement Mowry, Alysia, PA the Tri Valley Health System was requesting a waiver of the requirement for 100% supervision of this physician assistant at a secondary site by the supervising physician, Lennie Deaver, MD. Time without direct physician supervision would be for one and one-half days per week. Higgins moved, seconded by Bittles, to follow the recommendation of the Physician Assistant Committee, which was to approve the waiver as requested. Voting aye: Scott, Higgins, Bittles, 2013 LEGISLATION The Board reviewed the following legislative bills: LB 54 a bill providing for changes to display of credential and advertisement provisions under the Uniform Credentialing Act. LB 132 a bill to adopt the Skin Cancer Prevention Act regulates tanning facilities. LB 338 a bill to ensure access to quality health care goods and services for persons enrolled in the medical assistance program, and to provide for disciplinary action against licensed health care facilities and professionals. Brumback moved, seconded by Smith, to send a letter to the legislative committee opposing the section of the bill stating that a health care facility or health care professional may be subject to disciplinary action for discriminating against a person with respect to their eligibility for the medical assistance program by denying access to health care goods and services. Board members mentioned that there could be acceptable reasons that a professional would not be able to treat a person under the medical assistance program. Voting aye: Scott, Higgins, Bittles, Brumback, LB 421 a bill to provide powers and duties for professional boards regarding credentialing veterans; and LB 422 a bill to provide duties for credentialing boards and temporary practice permits for military spouses. Smith moved, seconded by Roberts, to send a letter to the legislative committee opposing these bills, specifically regarding the provisions for issuance of a temporary license while an application for permanent licensure is being processed. An applicant s history must be considered prior to authorizing any practice. Issuing a temporary credential to spouses of military personnel and to veterans prior to such consideration appears to treat those applicants differently than other applicants, and does not adequately protect the public. The Board is supportive of persons who serve in the military and their families and supports the provisions of LB 421 and LB 422 that recognize training and experience acquired by persons while serving in the military. Voting aye: Scott, Higgins, Bittles, LB 526 a bill relating to the Optometry Practice Act; to change provisions relating to licensure and certification to perform minor surgery and use certain pharmaceutical agents; and LB 527 a bill relating to the Optometry Practice Act to change provisions relating to licensure and certification to use certain pharmaceutical agents. Smith moved, seconded by Roberts, to send a letter to the legislative committee in opposition to these bills. Board members stated that the training as required by this legislation is inadequate to allow for treatment of ocular disease with steroids. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried. LB 535 a bill relating to prescription drugs; to adopt the Prescription Monitoring Program Act; and to eliminate provisions relating to prescription drug monitoring. Smith moved, seconded by Roberts, to send a letter to the legislative committee in support of creating a prescription drug monitoring program

5 Page 5 with appropriate funding. The Board members felt that this legislation was a good starting point, but needed further revision to define the best program for Nebraska. Voting aye: Scott, Higgins, Bittles, LB 564 Adopts the Health Care Freedom of Conscience Act. Smith moved, seconded by Bittles, to send a letter of opposition to this bill to the legislative committee. This bill provides no exceptions, no emergency clause, no requirement to discuss or refer a patient to another provider or to inform either the employer or patient of the professional s moral position and is not in the best interests for the citizens of Nebraska. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried. LB 428 a bill relating to the Certified Nurse Midwifery Practice Act to change provisions relating to permitted practice. Higgins moved, seconded by Smith, to send a letter of opposition to this bill to the legislative committee. Board members are not in favor of eliminating the prohibition that certified nurse midwives cannot participate in home births as this is not regulated sufficiently and would not be in the interest of patient safety. Voting aye: Scott, Higgins, Bittles, Brumback, Henkenius, Roberts, Smith. Voting nay: none. Absent: Howorth. Motion carried. RESULTS OF PHYSICIAN SURVEY REGARDING MAINTENANCE OF LICENSURE Wisell presented the results of the survey which the Board conducted in conjunction with their recent license renewal. The response to the survey was excellent. The purpose of the survey was to aid the Board in their consideration of whether to make changes to the current continuing competency requirements for renewal by moving to a more comprehensive requirement as advocated by the Federation of State Medical Boards with the Maintenance of Licensure initiative. This initiative aligns Maintenance of Licensure with current American Board of Medical Specialties or American Osteopathic Association Board Maintenance of Competency requirements. Board members were not in favor of making changes to the continuing competency requirements for renewal at the present time. Board members discussed the postgraduate medical education requirement for initial licensure. Graduates of accredited schools in the United States or Canada need to complete one year of approved postgraduate medical education, and foreign medical graduates need to complete three years of approved postgraduate medical education. Roberts stated that he feels one year of postgraduate education is inadequate in order to obtain a full license to practice medicine in Nebraska. Brumback moved, seconded by Roberts, to propose a legislative concept for the Department to introduce legislation raising the requirement for initial licensure in medicine and surgery and osteopathic medicine and surgery to completion of a three-year continuum of postgraduate medical education for both US and Canadian accredited medical graduates and foreign medical graduates. Voting aye: Brumback, Henkenius, Roberts, Smith. Voting nay: Scott, Higgins, Bittles. Absent: Howorth. Motion carried. Wisell stated that legislative concepts for the 2014 session will be due to the Department in June. Board members wanted to work further on this concept, to include gathering data on license applications regarding the postgraduate medical education completed, and obtaining information on requirements in other states. REPORT ON FEDERATION OF STATE MEDICAL BOARDS SPECIAL MEETING TO EXPLORE MEDICAL LICENSURE MODELS Scott and Wisell recently attended a special meeting of representatives of state medical boards conducted by the FSMB. The group explored a variety of new models that would streamline current

6 Page 6 licensing processes for physicians and better accommodate the use of telemedicine. Results from the FSMB special meeting will be sent to all states for their review. The intent was to introduce a resolution at the 2013 FSMB Annual Meeting to be voted on by all delegates. FEDERATION OF STATE MEDICAL BOARDS ISSUES Annual Meeting and Appointment of Voting Delegate Board members discussed who would be able to attend the FSMB Annual Meeting April 18-20, 2013 in Boston, Massachusetts. Bittles moved, seconded by Roberts, to recommend that all members and staff who can attend the meeting be authorized by the Department to do so, and that Scott be the Voting Delegate, with Brumback as the alternate. Voting aye: Brumback, Henkenius, Roberts, Smith. Voting nay: Scott, Higgins, Bittles. Absent: Howorth. Motion carried. Report of Bylaws Committee Proposed Amendments The Board reviewed the report of the FSMB Bylaws Committee. ELECTION OF OFFICERS Roberts moved, seconded by Smith, to elect Higgins as Chair, Bittles as Vice-Chair, and Brumback as Secretary. Voting aye: Brumback, Henkenius, Roberts, Smith. Voting nay: Scott, Higgins, Bittles. Absent: Howorth. Motion carried. ADJOURNMENT There being no further business, the meeting adjourned at 12:19 pm. Respectfully submitted, *signature on file upon request* Roger A. Brumback, Secretary Board of Medicine and Surgery