Osteopathic Physicians Licensing Board

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Minutes

November 10, 2016

MINUTES

UTAH

OSTEOPATHIC PHYSICIANS

LICENSING BOARD MEETING

November 10, 2016

Room 475 – 4th Floor – 9:00 A.M.

Heber Wells Building

Salt Lake City, UT 84111

CONVENED: 9:06 A.M. / ADJOURNED: 11:09 A.M.
Bureau Manager: / Larry Marx
Board Secretary: / Lisa Martin
Compliance Assistant: / Debbie Harry
Board Members Present: / Layne A. Hermansen, DO, Chairperson
Jacob Jessop, DO
Lynsey J. Drew, DO
Noel C. Nye, DO
Board Members Absent: / Eric Pierce, Public Member
DOPL Staff: / Ron Larsen, Investigation
Kevin Nitzel, Investigation
Guests:

TOPICS FOR DISCUSSION

DECISIONS AND RECOMMENDATIONS

ADMINISTRATIVE BUSINESS:
MINUTES: / The minutes from the August 11, 2016 Board meeting were read.
Dr. Drew made a motion to approve the minutes as read. Dr. Nye seconded the motion. The Board vote was unanimous.
APPOINTMENTS:
9:15 A.M.
Investigation Update / Mr. Larsen states as of the August board meeting the investigation team has closed thirteen cases involving osteopathic providers. Mr. Larsen states seven of the cases were closed and did not warrant further investigation. Mr. Larsen states three cases were closed with citations; one provider was issued two citations due to FDA violations, while the third citation was issued for over prescribing practices. Mr. Larsen states administrative action was taken on one case and the last case was closed due to lack of evidence.
Mr. Larsen states the majority of complaints received are concerning prescribing practices. Mr. Larsen states seven new cases have been opened.
Mr. Nitzel states there has been a recent questions concerning supervision or physician presence concerning a particular procedure with new equipment. Mr. Nitzel asks for the board’s opinion.
Dr. Nye suggests the device and procedure be researched a bit more to understand the process and risks involved.
9:25 A.M.
Debbie Harry, Compliance Update / · Ms. Harry states Dr. Ronald Baird has submitted all required reports. Ms. Harry states new requested chaperones have contacted the division.
· Ms. Harry states Dr. Dennis Concoby will update the board on his status.
· Ms. Harry states Dr. Randy Relyea has submitted all reports and attending all meetings.
· Ms. Harry states this is Dr. Leventhal is compliant in Nevada, attending meetings, working part time and testing several times a month.
9:35 A.M.
Dr. Ronald Baird, Probationary Interview / Dr. Drew conducted the interview asking how Dr. Baird is doing.
Dr. Baird states he is working 10 hours a week at True North, at Fresh Start he is also working 10 hours a week. Dr. Baird states Paradigm Recovery closed about six weeks ago however they will re-open with a new name and new location. Dr. Baird states he will rewrite the practice plan once they re-open.
Dr. Baird states he has new employment opportunity location in Midway at The Chateau; Dr. Baird states he has submitted a practice plan. Dr. Baird states his responsibilities are similar to the other practice locations.
Dr. Drew asks how Dr. Baird is doing will all the changes in practice sites.
Dr. Baird states each location is very similar to the others and the transitions are simple. Dr. Baird requested the meeting be closed.
· Meeting closed in accordance with the Open and Public Meetings Act, 52-4-250(1)(a) to discuss the character, professional competence or physical or mental health of an individual. / · Dr. Nye made a motion to close the meeting in accordance with the Open and Public Meetings Act, 52-4-250(1)(a) to discuss the character, professional competence or physical or mental health of an individual. Dr. Jessop seconded the motion. All board members voted in favor of closing the meeting. Meeting was closed at 9:45 a.m. The meeting was opened at 9:55 a.m.
Dr. Hermansen states during the closed portion of the meeting Dr. Baird requested early release of probation. Dr. Hermansen states Dr. Baird has completed three years of the five year probation.
Dr. Jessop states Dr. Baird has completed all the requirements and has been sincere. Dr. Jessop states at each meeting Dr. Baird has no substantial changes in his status.
Dr. Drew addresses the concern of establishing a precedence for future request of early release.
Dr. Hermansen states early release requests are considered on a case by case basis. Dr. Hermansen states Dr. Baird has presented reasonable information with his request.
Dr. Nye states his agreement that Dr. Baird has made changes in his personal life and practice standards. Dr. Nye states to end probation two years early would not be the best option to balance the public safety and the quality to the provider.
Dr. Hermansen states the board agrees that it is not an appropriate time to grant Dr. Baird early release from probation.
Dr. Jessop states the board does recognize the changes Dr. Baird has made and the efforts to remain compliant. Dr. Jessop states the board decision is based on the need to continue to maintain public safety.
Dr. Nye made a motion allowing Dr. Baird to meet with the board every six months, so long as he is in compliance. Dr. Jessop seconded the motion. The board vote was unanimous.
The board states Dr. Baird is in compliance with his stipulation and order.
An appointment was made for Dr. Baird to meet with the board on May 11, 2017.
9:45 A.M.
Dr. Dennis Concoby, Telephonic Probationary Interview / Dr. Jessop conducted the interview asking how Dr. Concoby is doing.
Dr. Concoby states a telemedicine company that he has been in communication with. Dr. Concoby states if he were to be employed with this company there would not be a way to complete the required chart reviews. Dr. Concoby asks if he would be able to waive the chart review requirement for this position as there is a limited scope that he will be completing.
Dr. Jessop clarifies that there are reviews of the charts.
Dr. Concoby states there are several indiviuals that review charts however there is no way to have the same person review his charts to send a report to the division.
Dr. Jessop asks if the telemedicine will be by phone or by video.
Dr. Concoby states it is his understanding that all appointments are by phone and not by video.
Dr. Drew asks about the genetic testing component listed in the practice plan.
Dr. Concoby states he will be responsible to order genetic testing based on the medications the patient is currently taking.
Dr. Drew asks what Dr. Concoby’s role will be with this company.
Dr. Concoby states he will review the patient’s current medications and recommend and order testing based on the medications. Dr. Concoby states he will not be making changes to patient medications or managing the medical problems. Dr. Concoby states this company has recently contracted with a second company; the process is the same however they prescribe non-narcotic pain creams.
Dr. Jessop clarifies the genetic testing responsibilities Dr. Concoby would interpret results and give recommendations to follow up with providers.
Dr. Concoby states he will review the genetic testing results and recommends the patient follow up with providers with the provided results.
Dr. Hermansen confirms that Dr. Concoby will not be providing direct patient.
Dr. Jessop states Dr. Concoby is here due to boundary issues, this opportunity reduces the risk of boundary issues as there is not direct patient care.
Dr. Hermansen asks how many hours a week Dr. Concoby will be working.
Dr. Concoby states he was instructed to provide his available schedule. Dr. Concoby states he would want to start working five hours a day.
Dr. Hermansen states a practice plan will need to be submitted
Dr. Nye made a motion to amend the stipulation to remove chart reviews for this practice site. Dr. Jessop seconded the motion. The board vote was unanimous.
The board states Dr. Concoby is in compliance with his stipulation and order.
An appointment was made for Dr. Concoby to meet with the board on February 9, 2017.
9:55
Break
10:05 A.M.
Dr. Randy Relyea, Probationary Interview / Dr. Hermansen conducted the interview asking how Dr. Relyea is doing.
Dr. Relyea states his Medicare application is still pending and is expected to be completed in January. Dr. Relyea states at least once a week he is shadowing his supervisor on surgery days.
Dr. Hermansen asks about Dr. Relyea’s meetings attendance.
Dr. Relyea states he is attending twelve step meetings and a Professionals In Recovery (PIR). Dr. Relyea states he attends the PIR meeting once a month. Dr. Relyea states he has looked into different meetings that may be less informal.
Dr. Hermansen asks what Dr. Relyea gains from the meetings.
Dr. Relyea states the meetings help him recognize where he has been and how he has changed.
Dr. Hermansen asks what safety factors are built into the daily practice to avoid returning to negative behaviors.
Dr. Relyea states the entire staff is aware of his history. Dr. Relyea states the clinic has an electronic medical records system that holds accountability for all prescriptions.
Dr. Hermansen suggests that when Dr. Relyea obtains his DEA license his supervisor review Dr. Relyea’s prescribing history to ensure best prescribing practices.
The board states Dr. Relyea is in compliance with his stipulation and order.
An Appointment was scheduled for Dr. Relyea to meet with the board on February 9, 2017.
10:15 A.M.
Dr. Jaqueline Leventhal, Telephonic Probationary Interview / Dr. Nye conducted the interview asking how Dr. Leventhal is doing.
Dr. Leventhal states the clinic has opened a new office and things are going well. Dr. Leventhal states the clinic is a non-medicated pain management clinic.
Dr. Nye states the division has received a compliance letter from Nevada.
The board states Dr. Leventhal is in compliance with her stipulation and order.
An appointment was made for Dr. Leventhal to meet with the board telephonically on February 9, 2017.
DISCUSSION ITEMS:
Interstate Compact Update / Mr. Marx states the goal of the commission it to begin issuing compact licenses in January. Mr. Marx states the compact is very States’ rights focused as many have concerns of making this a national license.
Proposed Rule Changes / Mr. Marx states there are several rule changes presented.
Mr. Marx refers to the continuing education changes for volunteer time which was discussed at the previous meeting. Mr. Marx states there are a few changes to clean the rule. Mr. Marx states R156-37-402 makes changes to the database requirements. Mr. Marx states if the provider is using the database on a regular basis the database quiz with the renewal cycle would be waived.
Mr. Marx states there were changes to the controlled substance act that is being worked on with the programmers to make the database a dashboard.
CORRESPONDENCE:
ACCME Letter
Board Training:
Open Meeting Act / Mr. Marx states the open meeting act must be reviewed annually. Mr. Marx states under the open meeting act the board meeting should remain open and what information is required to inform the public. Mr. Marx states the act outlines when a meeting can be closed and that a motion must be made to close a meeting.
58-68-806 Representation of Medical Specialization / Mr. Marx states this section of the practice act was mentioned at the August meeting with the investigation report. Mr. Marx states this section of the practice act outlines how providers can advertise as a specialist.
NEXT MEETING SCHEDULED FOR: / February 9, 2017
Note: These minutes are not intended to be a verbatim transcript but are intended to record the significant features of the business conducted in this meeting. Discussed items are not necessarily shown in the chronological order they occurred.
______/ ______
Date Approved / Chairperson, Utah Osteopathic Physicians Licensing Board
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Date Approved / Bureau Manager, Division of Occupational & Professional Licensing