OPEN SESSION BOARD MEETING
Conference Room at the Offices of the
MEMBERS PRESENT: Arne D. Rosencrantz,
President; Susan S. Buchwald, M.D., Vice President (arrived at 10:00 am); Paul A.
Stewart, M.D., Secretary-Treasurer; Dipak K. Desai, M.D.; Jaculine C. Jones,
Ed.D.; Cheryl A. Hug-English, M.D.; Joel N. Lubritz, M.D. (present
telephonically); Donald H. Baepler, Ph.D., D.Sc.; Robin L. Titus, M.D.
STAFF PRESENT: Larry D. Lessly, J.D., Executive
Director; Maureen E. Lyons, Deputy Executive Director; Richard J. Legarza,
J.D., General Counsel; Vicki L. Knopf, Chief Investigator; Rebecca A.
Gaul-Richard, Senior License Specialist; Kasey M. Miller, Administrative
Assistant to General Counsel
ALSO PRESENT: Brian T. Kunzi, J.D.,
Assistant Chief Deputy Attorney General; John B. Lanzillotta, P.A.-C,
Representative, Physician Assistant Advisory Committee to the Board; Robert R.
Barengo, J.D., Legislative Counsel
AGENDA ITEM 1
Call to Order - Arne D. Rosencrantz, President
The meeting was called to order by Arne D.
Rosencrantz, President, at
Mr. Rosencrantz congratulated Dr. Jones on
her recent re-appointment by Governor Guinn to serve a second term as a member
of the board.
AGENDA ITEM 2
Consideration of Advanced Practitioners of
Nursing's Request for Board's Position on Proposed Legislation to Allow
Advanced Practitioners of Nursing to Prescribe Controlled Substances
Dr. Buchwald asked Kathy Apple, Executive
Director of the Nevada State Board of Nursing, to speak on this agenda item.
Ms. Apple gave a brief legislative history of the prescribing privileges of
nurses in
Discussion ensued, with Dr. Buchwald
expressing her feeling that should advanced practitioners of nursing wish to
practice independently, they need to be under the jurisdiction of the board or
the joint jurisdiction of the board and the Nevada State Board of Nursing. Dr.
Titus expressed her feeling that advanced practitioners of nursing should be
allowed controlled substance prescribing privileges, as they are currently able
to prescribe other drugs which may have even more harmful effects than
controlled substances if prescribed inappropriately. Dr. Lubritz stated his
feeling that advanced practitioners of nursing are too loosely
"collaborated" with and should be more strictly
"supervised" as are physician assistants by their supervising
physicians.
Mr. Lessly offered several options for the
board to consider in acting on the matter:
1) ...take no action until such time that an
actual bill draft is presented to the board for consideration;
2) ...should the bill pass in the
Legislature, work with the Nevada State Board of Nursing to draft regulations
addressing the prescribing of controlled substances by advanced practitioners
of nursing;
3) ...amend the bill draft to include the
board, along with the Nevada State Board of Nursing, as an agency with
jurisdiction over advanced practitioners of nursing; or
4) ... should the bill pass in the
Legislature, the board can draft regulations clearly defining the
responsibilities of collaborating physicians over the controlled substance
prescribing practices of their advanced practitioners of nursing.
Dr. Baepler moved to approve the concept of
the request of the advanced practitioners of nursing and that the language of
the proposed bill draft is to be reviewed by the board as soon as it is
available. Dr. Desai seconded the motion, and it passed unanimously.
AGENDA ITEM 4
Consideration of Proposed New Regulations
- Practice of Integrative and Complementary
Medicine - Licensing of Physician Assistants
- Requirement for Hearing Officer Synopsis
Mr. Legarza reviewed for members the
proposed regulations as they appear in the agenda book.
Discussion ensued, with Dr. Buchwald moving
to approve the proposed regulations for hearing at public workshops and at the
board's August meeting. Dr. Stewart seconded the motion, and it passed
unanimously, with the Chair voting in favor of the motion.
AGENDA ITEM 5
Consideration of Proposed Board Bill Request
for 2001 Legislative Session
Mr. Lessly stated that Mr. Barengo was
present to advise members regarding the proposed amendments to NRS Chapter 630 contained
in the proposed bill draft as it appears in the agenda book. Mr. Lessly
reviewed each item of the proposed bill draft for members and discussion
ensued.
During discussion ofthe proposed amendment
to NRS 630.288, which would add language as follows: 4. Effective July 1. 2003.
the board may not grant biennial registration to any physician who has not
within the ten (10) years prior to that biennial registration passed the
Special Purpose Examination or the examination required by NRS 630.160(2)(c), Dr.
Desai stated that he did not believe that the board would have a consensus to
approve this proposed amendment for inclusion in the bill draft at this time.
He expressed his feeling that post-licensure testing is in the future of all
state medical boards, but that he believes the board should be fully
comfortable with the actual examinations to be considered. He questioned
whether the SPEX is the appropriate examination and whether the board should
accept American Board of Medical Specialties Specialty Board re-certification.
He added that all the issues surrounding this proposed change need to be
examined further. Dr. Desai moved that the President appoint a special study
committee of members of the board, to include a public member, to study the
matter during the next year. This study would include seeking and evaluating
input from the public, the profession, the health care industry, the Federation
of State Medical Boards of the United States (which developed and administer
the SPEX examination), and other state's medical licensure boards. The
committee would report back to the board with a recommendation in one year from
now. Dr. Baepler seconded the motion, and it passed unanimously, with the Chair
voting in favor of the motion.
AGENDA ITEM 3
Consideration of Request by Joel F.
Bower. M.D. for the Creation of a Special Volunteer in Medicine
License to Allow Limited Practice by Retired Physicians
Mr. Lessly described the practice parameters
that would be allowed for physicians under the proposed Special Volunteer in
Medicine license. He explained the licensure requirements for applicants and
the time that would be involved for staff to issue this proposed special
license. Mr. Barengo advised that an added burden would be placed on the board
to validate, on a case-by-case basis, the volunteer organization advocating for
the issuance of each proposed special license. Mr. Lessly added that there
would be no fees collected for the issuance of the special license.
Discussion ensued, with the consensus of the
board being that the Special Volunteer in Medicine license would be of great
public service to the citizens of
AGENDA ITEM 5 (CONTINUED)
Consideration of Proposed Board Bill Request
for 2001 Legislative Session
Mr. Lessly proposed that the board consider
another amendment to its statutes, not appearing in the proposed bill in the
agenda book, to add language that would require a licensed homeopathic
physician in
Discussion ensued, with Dr. Baepler moving
to direct Mr. Barengo to seek amendment of the bill draft of the Nevada State
Board of Homeopathic Examiners at the 2001 Legislative Session to require a
licensed homeopathic physician in
Dr. Baepler moved to direct Mr. Barengo to
submit the board's proposed bill as amended at today's meeting to the 2001
Legislature for consideration and approval. Dr. Buchwald seconded the motion,
and it passed unanimously, with the Chair voting in favor of the motion.
AGENDA ITEM 6
Reports
- Federation of State Medical Boards of the
United States, Inc.'s 2000 Annual Meeting - Ame D. Rosencrantz, President and
Delegate
- Medical Marijuana Task Force - Joel N.
Lubritz, M.D., Board Representative on Task Force
- Federation of State Medical Boards of the
United States, Inc.'s 2000 Annual Meeting - Arne D. Rosencrantz, President and
Delegate
Mr. Rosencrantz reported that the Federation
of State Medical Boards of the United States, Inc.'s 2000 Annual Meeting held
in
- Medical Marijuana Task Force - Joel N.
Lubritz, M.D., Board Representative on Task Force
Dr. Lubritz reported that he attended the second
meeting of the Medical Marijuana Task Force, but that he missed the first
meeting due to a lack oftimely notification of the meeting date and time. He
advised that at the second meeting, the task force decided to have the
University of Nevada School of Medicine conduct a research project on the issue
of the true efficacy for cannabinoid drugs. He added that he was provided with
a sixteen-page executive summary of marijuana medicine which described the
efficacy of marijuana drugs as being moderately well-suited for limited
conditions, with the potential therapeutic benefits being modest and more
effective medications being available.
AGENDA ITEM 7
Matters for Future Agenda
There was no discussion under this agenda
item.
AGENDA ITEM 8
Public Comment
Meg Yuram, P.A.-C, President of the Nevada
Academy of Physician Assistants, appeared and requested the board's support of
the Academy's proposed bill to be drafted for submission to the 2001
Legislature, sponsored by Assemblyman Joseph E. Dini, Speaker of the Assembly,
to add physician assistants to the list in the Nurse Practice Act of those
health care practitioners from whom nurses are authorized to take orders.
Mr. Rosencrantz requested that the Nevada
Academy of Physician Assistants provide board staff with a copy of the proposed
bill once it is drafted.
AGENDA ITEM 7
Matters for Future Agenda (CONTINUED)
Mr. Rosencrantz directed that the Nevada
Academy of Physician Assistants' request for the board's support of the
Academy's proposed bill to add physician assistants to the list in the Nurse
Practice Act of those health care practitioners from whom nurses are authorized
to take orders be placed on the board's August meeting agenda for consideration
and action.
ADJOURNMENT
Mr. Rosencrantz adjourned the meeting at