BME Minutes December 01 & 02, 2000

OPEN SESSION BOARD MEETING

FLAMINGO MEETING ROOM EMBASSY SUITES LAS VEGAS

4315 Swenson Street Las Vegas, Nevada 89119

FRIDAY, DECEMBER 1, 2000 and SATURDAY, DECEMBER 2, 2000

MEMBERS PRESENT: Arne D. Rosencrantz, President; Susan S. Buchwald, M.D., Vice President; Paul A. Stewart, M.D., Secretary-Treasurer; Dipak K. Desai, M.D.; Jaculine C. Jones, Ed.D.; Joel N. Lubritz, M.D.; Donald H. Baepler, Ph.D., D. Sc.; Robin L. Titus, M.D.

MEMBER ABSENT: Cheryl A. Hug-English, M.D.

STAFF PRESENT: Larry D. Lessly, J.D., Executive Director; Maureen E. Lyons, Deputy Executive Director; Richard J. Legarza, J.D., General Counsel; Robert A. Frantz, Financial Manager

Jan J. Cohen, J.D., Assistant Chief Deputy Attorney General

AGENDA ITEM 1

Call to Order and Announcements - Arne D. Rosencrantz, President

- Reappointment of Members of Board, Jaculine C. Jones, Ed.D. and Cheryl A. HugEnglish, M.D.

- Appointment of Arne D. Rosencrantz, President, to Nominating Committee of the Federation of State Medical Boards of the United States, Inc.

- Appointment of Richard J. Legarza, J.D., General Counsel, to Planning Committee for Board Attorneys Round Table for Federation of State Medical Boards of the United States, Inc.'s 2001 Annual Meeting

The meeting was called to order by the Board President, Arne D. Rosencrantz, at 5:05 p.m.

Mr. Rosencrantz announced:

1) ...the Governor's reappointment of Jaculine C. Jones, Ed.D. and Cheryl A. Hug-English, M.D. to the board to serve second four-year terms;

2) ...his appointment by the Federation of State Medical Boards of the United States, Inc. to serve as a member of the Federation's Nominating Committee; and

3) ... Mr. Legarza's appointment by the Federation of State Medical Boards of the United States, Inc. to serve as a member of the Federation's Planning Committee for the Federation's 2001 Annual Meeting Board Attorneys Round Table.

Mr. Lessly announced that at the request of the Federation of State Medical Boards of the United States, Inc., Mr. Rosencrantz has been placed on the Federation's 2001 Annual Meeting general session agenda to give a presentation on Nevada's Controlled Substance Abuse Prevention Task Force.

AGENDA ITEM 2 Approval of Minutes

- August 25 & 26, 2000 Board Meeting - Open/Executive Sessions

- Request by Donna Dominguez, M.S.N., A.P.N. for Consideration of Amendment to Board Approved Minutes of June 30, 2000 Board Meeting

- August 25 & 26, 2000 Board Meeting - Open/Executive Sessions

Dr. Desai moved to accept the minutes of the August 25 & 26, 2000 Board Meeting - Open/Executive Sessions. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

- Request by Donna Dominguez, M.S.N., A.P.N. for Consideration of Amendment to Board Approved Minutes of June 30, 2000 Board Meeting

There was no discussion under this agenda item.

AGENDA ITEM 4 Consideration of Acceptance of Stipulation for Settlement in the Matter of the Nevada State Board of Medical Examiners vs. Michael Rosenman M.D. Case No. 00-11476-1 Adjudicating Board Members: Arne D. Rosencrantz, President; Susan S. Buchwald, M.D., Vice President; Dipak K. Desai, M.D.; Jaculine C. Jones, Ed.D.; Cheryl A. Hug-English, M.D. and Joel N. Lubritz, M.D.

Mr. Legarza reviewed the Complaint filed by the Investigative Committee and the proposed Stipulation for Settlement in the matter of the board vs. Michael Rosenman, M.D., and stated that he and the Investigative Committee recommend board acceptance of the Stipulation for Settlement.

Dr. Buchwald moved to accept the Stipulation for Settlement in the matter of the board vs. Michael Rosenman, M.D., Case No. 00-11476-1, as presented by Mr. Legarza. Dr. Desai seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

AGENDA ITEM 7 Reports

- Diversion Program: Annual Report - Carol R. Bowers, R.N., C.D., Executive Director, Nevada Health Professionals Assistance Foundation

Consideration of Renewal of Contract with Nevada Health Professionals Assistance Foundation

- Physician Assistant Advisory Committee - Committee Representative

- Committee to Study Post-Licensure Continuing Competency Evaluations - Committee Members: Arne D. Rosencrantz; Susan S. Buchwald, M.D.; and Donald H. Baepler, Ph.D., D.Sc.

- Investigative Committee - Paul A. Stewart, M.D., Chairperson

- Secretary-Treasurer - Paul A. Stewart, M.D., Secretary-Treasurer

- Public Service Announcement Committee: Results of Phone Survey Status of Public Service Announcement Program Committee Members: Arne D. Rosencrantz, Chairperson; Joel N. Lubritz, M.D.; and Larry D. Lessly, J. D.

- Educational Meetings: Fourth International Conference on Medical Regulation - Arne D. Rosencrantz

2000 CLEAR Annual Conference - Robert A. Frantz, Financial Manager

Federation of State Medical Boards of the United States, Inc. Sponsored Symposium on Medical Licensure in the 21⁵ Century - Donald H. Baepler, Ph.D., D.Sc. Federation of State Medical Boards of the United States, Inc.'s Medical Boards and Deceptive Health Care Practices Workshop - Jaculine C. Jones, Ed.D.

Tim Coughlin, M.D., President of the Nevada Health Professionals Assistance Foundation (NHPAF), thanked the board for its support to date. Ms. Bowers reviewed the distributed annual report of the activities of the NHPAF for members. Frederick E. Kirschner, Ed.D., NHPAF board director and the board's representative to the NHPAF, advised that he is the NHPAF's fund raiser and spoke on fund raising activities of the NHPAF. Jerry L. Cad e, M.D., NHPAF board director, spoke on the progress of the NHPAF in running the board's Diversion Program and stated that he expects the number ofparticipants in the program to increase dramatically during the next year. Discussion ensued concerning renewal of the board's contract with NHPAF.

Federation of State Medical Boards of the United States, Inc.'s Board Investigator Workshop - Vicki L. Knopf, Chief Investigator

Federation of State Medical Boards of the United States, Inc.'s Executive Management Seminar - Larry D. Lessly, J.D., Executive Director

Federation of State Medical Boards of the United States, Inc.'s Executive Director Advisory Council Meeting - Larry D. Lessly, J.D., Executive Director

- Diversion Program: Annual Report - Carol R. Bowers, R.N., C.D., Executive Director, Nevada Health Professionals Assistance Foundation Consideration of Renewal of Contract with Nevada Health Professionals Assistance Foundation

Dr. Stewart moved to renew the board's contract with NHPAF for a period of two years at $75,000.00 per year. Dr. Lubritz seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

RECESS

Mr. Rosencrantz recessed the meeting at 6:00 p.m.

SATURDAY. DECEMBER 2. 2000

MEMBER ABSENT: Cheryl A. Hug-English, M.D.

STAFF PRESENT: Larry D. Lessly, J.D., Executive Director; Maureen E. Lyons, Deputy Executive Director; Richard J. Legarza, J.D., General Counsel; Robert A. Frantz, Financial Manager

Jan J. Cohen, J.D., Assistant Chief Deputy Attorney General

The meeting was reconvened by Arne D. Rosencrantz, President, at 9:00 a.m. on Saturday, December 2, 2000.

AGENDA ITEM 7 (CONTINUED) Reports

- Diversion Program: Annual Report - Carol R. Bowers, R.N., C. D., Executive Director, Nevada Health Professionals Assistance Foundation

Consideration of Renewal of Contract with Nevada Health Professionals Assistance Foundation

- Physician Assistant Advisory Committee - Committee Representative

- Committee to Study Post-Licensure Continuing Competency Evaluations - Committee Members: Arne D. Rosencrantz; Susan S. Buchwald, M.D.; and Donald H. Baepler, Ph.D., D.Sc.

- Investigative Committee - Paul A. Stewart, M.D., Chairperson

- Secretary-Treasurer - Paul A. Stewart, M.D., Secretary-Treasurer

- Educational Meetings: Fourth International Conference on Medical Regulation - Arne D. Rosencrantz

2000 CLEAR Annual Conference - Robert A. Frantz, Financial Manager

Federation of State Medical Boards of the United States, Inc. Sponsored Symposium on Medical Licensure in the 21st Century - Donald H. Baepler, Ph.D., D.Sc. Federation of State Medical Boards of the United States, Inc.'s Medical Boards and Deceptive Health Care Practices Workshop - Jaculine C. Jones, Ed.D. Federation of State Medical Boards of the United States, Inc.'s Board Investigator Workshop - Vicki L. Knopf, Chief Investigator

Federation of State Medical Boards of the United States, Inc.'s Executive Management Seminar - Larry D. Lessly, J.D., Executive Director

Federation of State Medical Boards of the United States, Inc.'s Executive Director Advisory Council Meeting - Larry D. Lessly, J.D., Executive Director

- Public Service Announcement Committee: Results of Phone Survey

Status of Public Service Announcement Program

Committee Members: Arne D. Rosencrantz, Chairperson; Joel N. Lubritz, M.D.; and Larry D. Lessly, J.D.

Tim Quillin of Quillin & Company, the advertising and public relations company which developed the board's new public service announcement titled "Who's Examining Who?," was present at the meeting. Mr. Rosencrantz asked Mr. Quillin to present his sample video spot and sample film spot for the board's consideration as to whether the board's new public service announcement should be produced in a film or video version. Mr. Rosencrantz explained that the film version is $20,000.00 and the video version is $15,000.00 to produce.

After viewing the samples, Dr. Lubritz moved that the board's public service announcement be produced in a film version. Dr. Desai seconded the motion, and it passed unanimously.

Mr. Rosencrantz stated that he and the committee are satisfied with the service and air time the board has received from Nevada Broadcasters Association for its non-profit organization status public service announcements in the past, and recommends that the board renew its contract with the association for a $5,000.00 per month expenditure for statewide television and radio airing.

Dr. Lubritz moved that the board renew its contract with Nevada Broadcasters Association for a $5,000.00 per month expenditure to be reviewed quarterly. Dr. Titus seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

- Physician Assistant Advisory Committee - Committee Representative

a report.

There was no committee representative present at the meeting to give

- Committee to Study Post-Licensure Continuing Competency Evaluations - Committee Members: Arne D. Rosencrantz; Susan S. Buchwald, M.D.; and Donald H. Baepler, Ph.D., D.Sc.

Mr. Rosencrantz advised that the members ofthe Committee to Study Post-Licensure Continuing Competency Evaluations traveled to the offices ofthe Federation of State Medical Boards of the United States, Inc. in November for a workshop on the Special Purpose Examination (SPEX). Dr. Baepler reported that the workshop helped the committee to formulate a time schedule and set goals for its study, and that the SPEX could be one of the tools used for evaluating post-licensure continuing competency. Dr. Buchwald added that the committee is still in the infancy stage of its study. Mr. Lessly advised that the Nevada State Board of Medical Examiners is the only state medical board studying this issue. Mr. Rosencrantz added that both Canada and Great Britain have such an evaluation in place.

- Investigative Committee - Paul A. Stewart, M.D., Chairperson

Dr. Stewart advised that at the Investigative Committee meeting yesterday, the committee filed formal complaints against three licensees. He added that all cases are current. He distributed the listing of cases recommended for closure by the committee for the board's review and consideration.

- Educational Meetings: Fourth International Conference on Medical Regulation - Arne D. Rosencrantz

Mr. Rosencrantz and Dr. Buchwald reported that the meeting held in Oxford, England was well organized and very informative, and they enjoyed the small group forum. Dr. Jones stated that the discussion at the meeting left her with the feeling that medicine has become too specialized and needs to be re-considered on a worldwide basis from the perspective of wellness and societal impact. Dr. Titus stated that recertification and competency issues discussed during the meeting made her realize the importance of the issue of post-licensure continuing competency evaluation, and she was surprised that other countries already had post-licensure competency evaluation processes in place.

- Educational Meetings: 2000 CLEAR Annual Conference - Robert A. Frantz, Financial Manager

Mr. Frantz stated that the conference held in Miami, Florida was beneficial to his position as Financial Manager for the board. He added that an interesting tool that was discussed was CLEAR's on-line pharmacy tracking program.

- Educational Meetings: Federation of State Medical Boards of the United States, Inc. Sponsored Symposium on Medical Licensure in the 21s^t Century - Donald H. Baepler, Ph.D., D.Sc.

Dr. Baepler reported that the conference was well worth the trip to Washington, D.C. He stated that the most popular topic of the conference was post-licensure competency testing and added that the public is demanding it. He stated that the current continuing medical education (CME) programs used throughout the United States need to be improved to be at all useful. He added that the lecture on the Human Genomic Project was fascinating.

- Educational Meetings: Federation of State Medical Boards of the United States, Inc.'s Medical Boards and Deceptive Health Care Practices Workshop - Jaculine C. Jones, Ed.D.

Dr. Jones reported that the meeting held in Phoenix, Arizona was very informative and that the Nevada State Board of Medical Examiners seems to be, once more, one of the most progressive boards in the country. She stated that she appreciated the lecture on complementary medicine, which is medicine that combines alternative and conventional medical methods.

- Educational Meetings: Federation of State Medical Boards of the United States, Inc. 's Board Investigator Workshop - Vicki L. Knopf, Chief Investigator

Mrs. Knopf was not present to give a report.

- Educational Meetings: Federation of State Medical Boards of the United States, Inc.'s Executive Management Seminar - Larry D. Lessly, J.D., Executive Director

Mr. Lessly reported that the seminar held in Austin, Texas focused on various points of board management, including evaluation instruments for board staff performance. He stated that the board's Internal Affairs Committee will be reconsidering the performance evaluation tools currently in use for board staff.

- Educational Meetings: Federation of State Medical Boards of the United States, Inc.'s Executive Director Advisory Council Meeting - Larry D. Lessly, J.D., Executive Director

Mr. Lessly reported that among the topics discussed at the meeting held in Dallas, Texas were the Federation's verification service, which will be on-line by January 1, 2001, and military physicians will be required to have three years of postgraduate training to treat

federal government patients in any state, which three-year requirement has been enforced in Nevada for Nevada licensed physicians since 1985.

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

Mr. Frantz distributed copies of the boards balance sheet as of December 1, 2000 and expenses for July 1, through December 1, 2000 and reviewed the same for the board.

- Investigative Committee - Paul A. Stewart, M.D., Chairperson (CONTINUED)

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 3

Consideration of Request by Rudy R. Manthei. D.O., on Behalf of the Nevada State Board of Osteopathic Medicine, for Discussion of and Possible Action on Expansion of Scope of Practice Legislative Issues Regarding Other Medical Professions

Rudy R. Manthei, D.O. was not present to make his request.

AGENDA ITEM 5

Consideration of Request by Michael J Garcia R.R.T. President.

Nevada

Society for Respiratory Care for Licensure of Respiratory Therapists by Nevada State Board of Medical Examiners

Michael J. Garcia, R.R.T. appeared before the board, stating that the Nevada Society for Respiratory Care requests licensure of respiratory therapists by the Nevada State Board of Medical Examiners. He referred members to the documentation in the agenda book containing the language requested by the Nevada Society for Respiratory Care to be included in the proposed law for licensure of respiratory therapists by the board.

Mr. Lessly advised that the board must decide whether it wishes to take the respiratory therapists under its jurisdiction. He added that should the board decide to amend its current bill draft request to include the licensure of respiratory therapists, regulations would be required to be implemented similar to the board's existing regulations pertaining to the licensure of physician assistants. Dr. Baepler stated that the bill draft request for licensure of respiratory therapists by the board would be an enabling bill.

Discussion ensued with Dr. Baepler moving to amend the board's bill draft request to include the licensure of respiratory therapists by the Nevada State Board of Medical Examiners, and in order to accommodate the request of the Nevada Society for Respiratory Care, the language to be included by the Legislative Council Bureau is subject to approval by the Nevada Society for Respiratory Care. Dr. Stewart seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.

AGENDA ITEM 6

Consideration of Approval and Utilization of Program Director Reporting Form for Physicians Licensed to Participate in Postgraduate Training Programs in Nevada

Mr. Lessly stated that even though the board currently licenses resident physicians participating in programs in Nevada, there is no review process in place to monitor the resident physicians' progress in the programs. He advised that he and board staff recommend the board's approval of the utilization of the Program Director Reporting Form so that the board will be made aware of the progress of resident physicians in Nevada.

Discussion ensued, with Dr. Desai moving that the board utilize the Program Director Reporting Form on an annual basis prior to the renewal of a resident physician's limited license to participate in a residency program in Nevada. Dr. Buchwald seconded the motion, and it passed unanimously, with the Chair voting in favor of the motion.