OPEN SESSION BOARD MEETING

OPAL 1 & 2 MEETING ROOM EMERALD SPRINGS HOLIDAY INN

325 East Flamingo Road Las Vegas, Nevada 89109

 

SATURDAY, DECEMBER 4, 1999

 

MEMBERS PRESENT: Arne D. Rosencrantz, President; Susan S. Buchwald, M.D., Vice President; Paul A. Stewart, M.D., Secretary-Treasurer; Rex T. Baggett, M.D.; Dipak K. Desai, M.D.; Jaculine C. Jones, Ed.D.; Cheryl A. Hug-English, M.D.(arrived at meeting at 9:20 am); Joel N. Lubritz, M.D.; Donald H. Baepler, Ph.D.

STAFF PRESENT: Larry D. Lessly, J.D., Executive Director; Maureen E. Lyons, Deputy Executive Director (left meeting at 12:15 pm); Richard J. Legarza, J.D., General Counsel; Robert A. Frantz, Financial Manager; Vicki L. Knopf, Chief Investigator; Rebecca A. Gaul-Richard, Senior License Specialist

ALSO PRESENT: Leslie A. Nielsen, J.D., Assistant Chief Deputy Attorney General; Susan M. Morgan, P.A.-C, Representative, Physician Assistant Advisory Committee to the Board; John B. Lanzillotta, P.A.-C, Representative, Physician Assistant Advisory Committee to the Board; F. Victor Rueckl, M.D., Director, Nevada Health Professionals Assistance Foundation

 

AGENDA ITEM 1

Call to Order - Ame D. Rosencrantz, President

The meeting was called to order by the Board President, Arne D. Rosencrantz, at 8:00 a.m.

 

AGENDA ITEM 2

Approval of Minutes

- August 28, 1999 Board Meeting - Open/Executive Sessions

- October 6, 1999 Telephone Conference Call Board Meeting - Open Session

Dr. Desai moved to accept the minutes of the August 28, 1999 Board Meeting - Open/Executive Sessions and the October 6, 1999 Telephone Conference Call Board Meeting - Open Session. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 3

Approval of Revisions to Organizational and Operational Charts Personnel Policies and Officer, Committee and Job Descriptions Manual - Larry D. Lessly, J.D., Executive Director

Mr. Lessly reviewed the proposed changes to the manual and requested the board's approval to revise the manual for year 2000 as proposed, including the new job description for Senior License Specialist.

Dr. Desai moved to approve the changes to the manual for year 2000. Dr. Stewart seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 4

Personnel

Executive Session to Discuss Professional Competency of: - Rebecca A. Gaul-Richard, License Specialist

There was no motion made to go into Executive Session, and no discussion was held in Executive Session under this agenda item.

Open Session

- Setting of Salary for Rebecca A. Gaul-Richard, Senior License Specialist

Mr. Lessly requested that the board consider promoting Mrs. Gaul­Richard to Senior License Specialist, as she is senior in employment longevity to the other license specialists, and she performs numerous additional tasks over and above her licensing duties. He recommended raising her annual salary to $36,000.00.

Dr. Desai moved to promote Rebecca A. Gaul-Richard to Senior License Specialist and to raise her annual salary to $36,000.00 effective immediately.

- Consideration of Staff Salary Caps

Mr. Lessly requested that the board remove the caps from all salaries of board staff. He stated that the salary caps are restricting board staff's salaries from being equivalent to other state agency salaries for state employees in similar type jobs.

Dr. Baepler moved to remove the caps from board staff' s salaries. Dr. Baggett seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 5

Pubic Service Announcement Program - Ame D. Rosencrantz, President

- Report from Nevada State Medical Association Re: Participation in Joint Public Service Announcement with Nevada State Board of Medical Examiners

- Consideration of Continuing Contract with Nevada Broadcasters Association Beginning January 1, 2000

Mr. Rosencrantz referred members to the copy of the letter in the agenda book from Mitchell E. Miller, M.D., President of the Nevada State Medical Association, indicating the association's decision not to participate in a joint public service announcement program with the board.

He advised that at it's last meeting in August 1999, the board voted to approve an expenditure of $5,000.00 per month to be paid to Nevada Broadcasters Association to air the board's television public service announcement featuring Lorraine Hunt, Lieutenant Governor, along with several of the new radio announcements, from October 1, 1999 through December 31, 1999. He recommended that the board approve continuing the contract with Nevada Broadcasters Association for another three months beginning January 1, 2000, at $5,000.00 per month.

Dr. Desai moved to approve the continuation of the board's contract with Nevada Broadcasters Association for an additional three-month period at $5,000.00 per month, beginning January 1, 2000. Dr. Baggett seconded the motion, and it passed unanimously.

Mr. Lessly was directed to forward to all board members copies ofthe videotape of the television public service announcement featuring Lorraine Hunt, Lieutenant Governor, and transcripts of the radio announcements that are currently being aired.

 

AGENDA ITEM 12

Diversion Program - F. Victor Rueckl, M.D., Director, Nevada Health Professionals Assistance Foundation

Dr. Stewart briefly summarized the past six month history of the board's Diversion Program as contracted with the Nevada Health Professionals Assistance Foundation. He explained that he, Mr. Rosencrantz, Mr. Lessly, and Mrs. Lyons met several times with a task force ofthe Nevada Health Professionals Assistance Foundation, and that new guidelines to insure the successful future of the Diversion Program have been established.

Dr. Rueckl introduced Carol Bowers, R.N., the new Executive Director of the Nevada Health Professionals Assistance Foundation, effective January 15, 2000. He also introduced Melvin I. Pohl, M.D., an Addiction Medicine specialist practicing in Las Vegas, who will act as a consultant to the foundation. Dr. Rueckl stated that he and the foundation will comply with the guidelines that have been established by the working group, which include the appointment of up to two board appointees as members of the Board of Directors of the foundation.

Discussion ensued, with Dr. Baggett making a motion that the oversight of the Diversion Program be delegated to the Investigative Committee of the board. Dr. Desai seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

Dr. Lubritz moved to direct Mr. Rosencrantz to appoint up to two board appointees as members of the Board of Directors of the Nevada Health Professionals Assistance Foundation. Dr. Stewart seconded the motion, and it passed unanimously.

 

AGENDA ITEM 7

Licensure Application Process and Forms - Rebecca A. Gaul-Richard, Senior License Specialist

Mrs. Gaul-Richard referred members to the copies of the applications for physician and physician assistant licensure, and the proposed application for physician assistant registration in the agenda book. She gave a brief review of the forms and recommended that the:

1)         ... Affidavits of Moral and Professional Character forms be removed from and a change be made to question number 6 on the physician application for licensure;

2)         ... board consider amending NAC 630.281(c), so that physician assistant applicants for licensure will not be required to provide proof that they are of good moral and professional character; and

3)         ... board approve the proposed application for physician assistant registration.

Dr. Desai moved to remove the Affidavits of Moral and Professional Character forms from and make the proposed change to question number 6 on the physician application for licensure, and to approve the proposed application for physician assistant registration. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 8

Adjudication in the Matter of the Nevada State Board of Medical Examiners vs. Chad Reed Niles, M.D.. Case No. 99-12312-1

Adjudicating Board Members: Arne D. Rosencrantz, President; Susan S. Buchwald, M.D., Vice President; Paul A, Stewart, M.D., Secretary-Treasurer, Cheryl A. Hug-English, M.D.; Donald H. Baepler, Ph.D.; and Rex T, Baggett, M.D.

A court reporter was present to record this agenda item. Please refer to the court reporter's transcript.

Dr. Hug-English, M.D. recused herself from the adjudication. Chad Reed Niles, M.D. was in attendance during the adjudication.

Dr. Baggett moved to return the case to the hearing officer for further review relating to his findings regarding credibility of witnesses in the case, and that such review be returned to the board for consideration and adjudication at the board's February 26, 2000 meeting. Dr. Buchwald seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 10

Adjudication in the Matter of the Nevada State Board of Medical Examiners vs. Robin John Willcourt. M.D.. Case No. 99-7313-1

Adjudicating Board Members: Arne D. Rosencrantz, President; Susan S. Buchwald, M.D., Vice President; Paul A. Stewart, M.D., Secretary-Treasurer, Cheryl A. Hug-English, M.D.; Donald H. Baepler, Ph.D.; and Rex T. Baggett, M.D.

A court reporter was present to record this agenda item. Please refer to the court reporter's transcript.

Dr. Baggett moved to find Dr. Willcourt not guilty of the one count of the Complaint. Dr. Baepler seconded the motion, and the motion failed, with Dr. Hug-English, Dr. Buchwald, Dr. Stewart and Mr. Rosencrantz voting against the motion.

Dr. Hug-English moved to find Dr. Willcourt guilty of the one count of the Complaint. Dr. Buchwald seconded the motion, and the motion passed, with Dr. Baggett and Dr. Baepler voting against the motion, and the Chair, Dr. Buchwald, and Dr. Hug-English voting in favor of the motion.

Dr. Hug-English moved to require Dr. Willcourt to pay all costs incurred by the board relating to the disciplinary proceedings against him, and to perform twenty hours of uncompensated public service to be approved in advance by the Secretary-Treasurer. Dr. Stewart seconded the motion, and it passed, with the Chair, Dr. Buchwald, Dr. Stewart, Dr. Hug­English, and Dr. Baepler voting in favor of the motion and Dr. Baggett voting against the motion.

 

AGENDA ITEM 11

Chapter 630 of the Nevada Administrative Code - Richard J. Legarza, General Counsel

- Public Hearing on Approval of Revisions to NAC 630.080 -10.00 am. or as soon thereafter as it may be heard

Mr. Legarza reviewed the proposed revisions to NAC 630.080 for members.

Dr. Stewart moved to adopt the revisions to NAC 630.080 as proposed. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

- Discussion and Interpretation of Amendment to Regulations Re: Pain Management

Mr. Legarza stated that he has been contacted by several entities, including the Nevada State Medical Association, regarding their concerns about the board's newly adopted pain management regulations (NAC 630.193, 630.195 and 630.197). He stated that he feels that the language of the regulations does not in at least one regard reflect the intent of the board regarding pain management. He recommended that the board authorize him to draft amendments to the language, so that the regulations better represent the board's intent, and to hold public workshops and a hearing on the proposed amendments.

Mr. Rosencrantz recognized Daniel K. Kim, M.D., an Anesthesiologist and Pain Management specialist from Las Vegas, who appeared before the board to express his feeling that the regulations as written seem to imply that licensees should fear disciplinary action from the board regarding their pain management practices. Dr. Kim added that he does not believe that this was the board's intent when it adopted the regulations.

Mr. Rosencrantz directed Dr. Kim to put his concerns in writing to Mr.        Legarza, and advised him that the forum for expression of his concerns was not at this meeting, but was at the workshops and the hearing which were held when the regulations were initially being considered for adoption.

Mr. Rosencrantz recognized Weldon E. Havins, M.D., an Ophthalmologist from Las Vegas, who appeared before the board to express his concern with the regulations and recommended that the board consider adopting an "emergency" regulation that would, at minimum, immediately remove the consent form requirement from the regulations. He gave a written petition to Mr. Legarza regarding his recommendations for amendments to the regulations.

 

RECESS

The meeting recessed for lunch at 12:15 p.m. and reconvened at 1:05 p.m.

 

AGENDA ITEM 9

Adiudication in the Matter of the Nevada State Board of Medical Examiners vs. William O Murray, M. D.. Case No. 99-9170-1

Adjudicating Board Members: Arne D. Rosencrantz, President; Susan S. Buchwald, M.D., Vice President; Paul A. Stewart, M.D., Secretary-Treasurer, Cheryl A. Hug-English, M.D.; Donald H. Baepler, Ph.D.; and Rex T. Baggett, M.D.

A court reporter was present to record this agenda item. Please refer to the court reporter's transcript.

Dr. Buchwald moved to find Dr. Murray guilty of all 59 counts of the Complaint. Dr. Baggett seconded the motion, and the motion passed unanimously, with the Chair voting in favor of the motion.

Dr. Buchwald moved to revoke Dr. Murray's license to practice medicine in the state of Nevada, issue him a public written reprimand, assess him a fine in the amount of $5,000.00 and require him to pay all costs incurred in the disciplinary proceeding against him. Dr. Hug-English seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 12

Acceptance of Applications for Licensure - Appearances

12 (a) Henry Blum, M.D.

Mr. Rosencrantz advised that Henry Blum, M..D. withdrew his application for licensure prior to today's meeting.

Dr. Buchwald moved to go into Executive Session to discuss the character and professional competence of applicants for licensure. The motion was seconded by Dr. Stewart, and it passed unanimously.

Executive Session

12 (b) H. Douglas Cooper. M. D.

Upon returning to Open Session, Dr. Stewart moved to accept Douglas Cooper, M.D.'s application for licensure. Dr. Baepler seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

12 (c) Mark Ezekiel, M. D.

Mr. Rosencrantz advised that Mark Ezekiel, M..D. withdrew his application for licensure prior to today's meeting.

Dr. Buchwald moved to return to Executive Session for the same purposes stated before. Dr. Jones seconded the motion, and it passed unanimously.

12 (d) Ronald Foote, M.D.

Upon returning to Open Session, Dr. Buchwald moved to accept Ronald Foote, M.D.'s application for licensure. Dr. Desai seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

Dr. Hug-English moved to return to Executive Session for the same purposes stated before. Dr. Stewart seconded the motion, and it passed unanimously.

12 (e) William Jacks, M.D.

Upon returning to Open Session, Dr. Desai moved to accept William Jacks, M.D.'s application for licensure. Dr. Hug-English seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

Dr. Jones moved to return to Executive Session for the same purposes stated before. Dr. Buchwald seconded the motion, and it passed unanimously.

12 (f) Rafael Mirchou. M.D.

Upon returning to Open Session, Dr. Desai moved to accept Rafael Mirchou, M.D.'s application for licensure. Dr. Baggett seconded the motion, and it passed, with the Chair and Dr. Buchwald voting against the motion, and Dr. Lubritz abstaining from the vote. Voting for the motion were Dr. Desai, Dr. Baggett, Dr. Hug-English, Dr. Jones, and Dr. Stewart.

 

AGENDA ITEM 20

Legal Reports - Richard J. Legarza, J.D., General Counsel

- Leslie A. Nielsen, J.D., Assistant Chief Deputy Attorney General - Board Ordered Terms, Conditions and Probation Status Report

- Status Report on Supervising/Collaborating Physician Interviews - Vicki L. Knopf, Chief Investigator

Mr. Legarza stated that all licensees currently on disciplinary probation with the board are in compliance and that he had nothing further to report.

Ms. Nielsen reported that:

1)         ... oral argument in the case in which Alan J. Mishler, M.D. alleges civil rights violations against the board was held on June 15, 1999 in the Ninth Circuit Court of Appeals. She advised that the Court has since published a decision in favor ofthe board, resolving all ofthe federal civil rights violations claims against the board. She added that still unresolved are the state law claims, for which she anticipates her office will file on behalf of the board a motion for summary judgment;

2          ... the Nevada Supreme Court appeal of the board's disciplinary order against Harriston L. Bass, M.D. has been set for oral argument on December 16, 1999;

3)         . . . in the appeal of the petition for judicial review filed by David B. Cohen, M.D., the filing of an opening brief by Dr. Cohen in the matter is still pending;

4)         ... a patient and her husband, who were dissatisfied with the Investigative Committee's decision to close the investigation of a complaint they had filed with the board, filed a petition for judicial review in the matter. She explained that a patient has no right to appeal any decision made by the Investigative Committee. She advised that she filed a motion to dismiss and a request for sanctions against the attorneys representing the patient and her husband in the matter, and, subsequently, the matter was dropped by the plaintiffs in October 1999; and

5)         ... the case of Jerry K. Poulsen, who was indicted by the Clark County Grand Jury on eleven felony counts of practicing medicine without a license, has been negotiated. She advised that Dr. Poulsen pled guilty to one count of gross misdemeanor practicing medicine without a license and his sentencing is scheduled for January 20, 2000.

 

AGENDA ITEM 13

Acceptance of Applications for Licensure - Non-Appearances

13 (g) Ajai Khanna, M.D.

Dr. Desai moved to accept Ajai Khanna, M.D.'s application for licensure. Dr. Jones seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

13 (h) Robert Platt, M.D.

Dr. Hug-English moved to accept Robert Platt, M.D.'s application for licensure. Dr. Baepler seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 14

Approval of Changes of Licensure Status from Inactive to Active - Non-Appearances

14 (i) George Collins, M.D.

Dr. Desai moved to accept George Collins, M.D.'s application for change of licensure status from inactive to active. Dr. Baepler seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

14(j) S. Malvern Dorinson. M.D.

Dr. Baepler moved to accept S. Malvern Dorinson, M.D.'s application for change of licensure status from inactive to active. Dr. Desai seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

14 (k) Jeffrey Mast, M. D.

Dr. Buchwald moved to accept Jeffrey Mast, M.D.'s application for change of licensure status from inactive to active. Dr. Hug-English seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

14 (1) Robert Sanchez, M.D.

Dr. Desai moved to accept Robert Sanchez, M.D.'s application for change of licensure status from inactive to active. Dr. Stewart seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

14 (m) Hugh Sanders, M.D.

Dr. Hug-English moved to accept Hugh Sanders, M.D.'s application for change of licensure status from inactive to active. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

14 (n) Donald Wasserman, M. D.

Dr. Desai moved to accept Donald Wasserman, M.D.'s application for change of licensure status from inactive to active. Dr. Hug-English seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 15

Approval of Change of Licensure Status from Retired to Inactive - Non-Appearance

- Steven Brady, M. D.

Dr. Hug-English moved to accept Steven Brady, M.D.'s application for change of licensure status from retired to inactive. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 16

Approval of Change of Licensure Status from Retired to Active - Non-Appearance

- Joseph Calabrese, M.D.

Dr. Desai moved to table Joseph Calabrese, M.D.'s application for change of licensure status from retired to active until such time that he successfully passes the SPEX and that he be advised of the board's requirement that he pass the SPEX. Dr. Baggett seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 17

Ratification of Licenses Issued Since the August 1999 Board Meeting

Dr. Buchwald moved to ratify the licenses issued since the August 1999 board meeting. Dr. Desai seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 18

Informational Reports

- Physician Assistant Advisory Committee - Susan M. Morgan, P.A.-C, Committee Representative

- Secretary-Treasurer- Paul A. Stewart, M.D., Secretary-Treasurer Robert A. Frantz, Financial Manager

- Physician Assistant Advisory Committee - Susan M. Morgan, P.A.-C, Committee Representative

Mrs. Vanselow advised that the Nevada Academy of Physician Assistants has formed a legislative committee to research the issue of facilitating the employment of physician assistants by hospitals. She explained that hospitals are having difficulty keeping physician assistants on staff due to nurses refusing to take orders from physician assistants, as physician assistants are not specifically included in NRS Chapter 632 as practitioners from whom a nurse may take an order.

- Secretary-Treasurer - Paul A. Stewart, M.D., Secretary-Treasurer Robert A. Frantz, Financial Manager

Mr. Frantz distributed copies of the board's balance sheet as of December 3, 1999 and expenses for July 1, through December 3, 1999 and reviewed the same for the board.

 

AGENDA ITEM 19

Investigative Committee Report - Paul A. Stewart, M.D., Secretary-Treasurer, Chair - Request for Closure of Cases

Dr. Stewart advised that the Investigative Committee held a four-hour meeting yesterday and requested that the board consider closing the cases recommended for closure by the committee per the listing distributed. He added that the board's disciplinary action statistics as compiled by the Federation of State Medical Boards ofthe United States, Inc. for year 1999 should reflect favorably upon the board.

After a review by members of the cases recommended for closure, Dr. Desai moved to approve the cases recommended for closure by the Investigative Committee. Dr. Jones seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

 

AGENDA ITEM 21

Executive Director's Report - Larry D. Lessly, J.D., Executive Director

- Maureen E. Lyons, Deputy Executive Director

- Report - Staff and Board Member Presentation to American Medical Student Association - Larry D. Lessly, J.D., Executive Director and Ame D. Rosencrantz, President

- Reports and Requests - Member and Staff Attendance at Workshops, Meetings and Training Sessions

- Computer Licensing/Disciplinary Tracking Software Update

- Federation of State Medical Boards of the United States, Inc.'s Call for Nominations for Awards - Informational Matters

- Informational Matters

Mr. Lessly reported on the Executive Leadership Training seminar conducted by the University of Texas for the Federation of State Medical Boards of the United States, Inc. in Austin, Texas, which he, Mr. Legarza and Mrs. Knopf attended in October 1999.

Mr. Lessly reported that following the seminar in Austin, he went directly to Dallas, Texas to participate in his first meeting of the Federation of State Medical Boards of the United States, Inc.'s Executive Advisory Council since his appointment by the federation to that council. He spoke on some of the topics discussed during the meeting, including Internet prescribing, the Health Integrity and Protection Data Bank, and licensing of military physicians.

- Report - Staff and Board Member Presentation to American Medical Student Association - Larry D. Lessly, J.D., Executive Director and Ame D. Rosencrantz, President

Both Mr. Lessly and Mr. Rosencrantz participated in the presentation, which took place in Reno.

- Reports and Requests - Member and Staff Attendance at Workshops, Meetings and Training Sessions

Mr. Lessly requested attendance at a workshop entitled "Essentials of Managing the Front Desk" in Reno for Brandie L. Duncan, Receptionist, on January 14, 2000, at a cost of $139.00. Dr. Desai moved to authorize Ms. Duncan to attend the workshop as described. Dr. Jones seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

- Computer Licensing/Disciplinary Tracking Software Update

Mr. Lessly reported that the License 2000 licensing/disciplinary tracking computer software program has been successfully installed and is being used by staff. He advised that the total cost for the project should reach approximately $150,000.00 after upgrade of the hardware is completed. He added that Mrs. Lyons, who acts as the board's information technology coordinator, is pleased with the program.

 

AGENDA ITEM 22

Matters for Future Agenda

Mr. Lessly advised that Carol A. Clothier, Assistant Vice President, Examination and Board Action Services, Federation of State Medical Boards of the United States, Inc. will make a presentation at the board's February 26, 2000 meeting on the federation's Post­Licensure Assessment System.

 

AGENDA ITEM 23 Public Comment

There was no public comment.

 

ADJOURNMENT

Mr. Rosencrantz adjourned the meeting at 3:45 p.m.