FROM: Ashley Engelbrecht, RN, BSN, JD, Staff Attorney
RE: Report of IBM Public Session Meeting on March 8, 2013
The Iowa Board of Medicine met in public session on Friday, March 8, 2013. Physician Board members in attendance included: Greg Hoversten, DO, Sioux City; Colleen Stockdale, MD, West Burlington, Chair; Hamed Tewfik, MD, Iowa City, Secretary; Michael Thompson, DO, Pella; and Joyce Vista-Wayne, MD, Ottumwa. Public Board members in attendance included: Frank Bognanno, Des Moines; and Ann Gales, Bode. Physician Board members Julie Perkins, MD, Carroll and Jeff Snyder, MD, Crescent, Vice Chair, were not in attendance. Public Board member Diane Clark, Lake Mills, was not in attendance.
The Governor has announced new appointments for the Board of Medicine, with terms to begin May 1, 2013. The new appointees are Dr. Robert Bender, Clive; Dr. Julie Carmody, Clive; and Dr. Allison Schoenfelder, Akron. Public Board member, Ann Gales, Bode, was re-appointed for another term.
Executive Director’s Report
Legislative Update: Friday, March 8, 2013, ended the first funnel week at the capitol. The Board of Medicine had two legislative proposals this session – SSB 1015 and SSB 1085. SSB 1015, regarding prescriber use of Iowa’s Prescription Drug Monitoring Program (PDMP), did not survive the first funnel and will not be pursued further this year by the board. SSB 1085 has survived the first funnel, and the board will continue to monitor its progression through the legislative session. SSB 1085 clarifies the use of alternate board members for scheduled hearings, clarifies and places a cap on the board’s civil penalty authority, and allows an administrative law judge to hear certain board-assigned cases without a hearing panel.
The board has followed several other bills this session including: SSB 1055 (regarding the practice of interventional pain procedures), SSB 1162 (regarding psychologist prescribing), and HF 345 (regarding vital statistics CME). None of these bills survived the first funnel. SF 353, regarding vaccine administration by licensed pharmacists, has progressed in the legislature and the board will continue to monitor its movement this session.
Administrative Rules – Licensure Fee Exemption
Recommendation: The board’s licensure committee is recommending amendments to subrules in Iowa Administrative Code 653 – Chapters 8, 9, and 11, to exempt the licensure renewal fee for a physician in active military duty. Administrative Code language would be modified as follows:
Chapter 8 – Fees
New Section 8.4(1)(c)(1) – There is no renewal fee for a physician who was assigned to active duty in a branch of the U.S. Armed Forces, Reserves or National Guard during their renewal period. Active Duty means full-time training or active service in the U.S. Armed Forces, Reserves, or National Guard. Physicians who fail to renew prior to the expiration of the license will be assessed the penalty fee.
Chapter 9 – Permanent License
New Section 9.13(3)(a)(1) – There is no renewal fee due for a physician who was assigned to active duty in a branch of the U.S. Armed Forces, Reserves or National Guard during their renewal period. Active Duty means full-time training or active service in the U.S. Armed Forces, Reserves or National Guard. Physicians who fail to renew prior to the expiration of the license will be assessed the penalty fee.
Chapter 11 – Continuing Education and Training Requirements
New Section 11.1 – Definitions – “Active Duty” means full-time training or active service in the U.S. Armed Forces, Reserves or National Guard.
New Section 11.4(a)(1) – Exemptions from renewal requirements – Periods that the licensee served honorably on active duty in the military.
The board voted to approve the amendment to the licensure renewal fees.
Administrative Rules – Physician Assistant Supervision
Recommendation: The board ad hoc committee chaired by Jeffrey Snyder, MD, has identified a proposed amendment to Iowa Administrative Code 653 – Chapter 21. The subrule needs to be amended to conform with a new state law that allows physicians to supervise no more than five physician assistants at the same time. Administrative Code language would be modified as follows:
Chapter 21.4 – Grounds for Discipline
21.4(2) A physician supervises more than two five physician assistants at the same time.
The board voted to approve this amendment.
Ad Hoc Committee – Physician Supervision of PAs
The ad hoc committee has issued a press release as a result of concluding that more education and guidance about existing laws and rules on physician assistant supervision would be helpful to Iowa physicians. Included in the press release are the responsibilities of a supervising physician. The press release can be accessed on the Iowa Board of Medicine’s website and viewed here.
Licensure Report – Director of Licensure
- The Federation of State Medical Boards (FSMB) held a special meeting to discuss advocacy and opportunities related to state medical licensure and discipline. This meeting was well attended with a lot of idea sharing.
- Maintenance of Licensure: nothing new to report – still gathering information at this point. There was a complaint received from a licensee urging the board to stop its participation in the pilot project.
- FSMB draft report on re-entry for the ill physician: emphasis on distinguishing the difference between the ill physician and the physician who is impaired. Not all ill physicians are impaired. FSMB encourages the use of programs to assess and monitor improvements.
- FSMB memorandum on USMLE policy on attempt limits: the FSMB recommends that a physician cannot take more than six attempts on any given step. Individual states could make exceptions, but FSMB advises against exceptions. The board feels that this is generous enough and will likely not make exceptions for anyone who cannot complete a step after six attempts. Additionally, for step three, state sponsorship will be discontinued (including associated fees). Iowa’s rules require physicians to pay a $50 fee – this will have to be eliminated by 2014 based on discontinued state sponsorship. The administrative rules will be amended accordingly in the future by the board.
- Licensure Committee Report: two permanent licenses and two temporary licenses have been issued. Also, a resolution to study multistate licensure has been considered. The board is supportive of an interstate compact for licensure, but not supportive of a national license. The board does have concerns with disciplinary procedures and how those would be handled in a multistate situation. Information sharing, confidentiality and jurisdiction would all be hurdles in developing a multistate licensing process. For now, this is simply a resolution to consider.
Iowa Physician Health Committee – Report by Coordinator
- There are new members in the program. The program and its members continue to do well. Right now there are 76 participants. The program has the same number of participants and physicians under contract at this time last year.
- Lester Yen, MD, is up for re-appointment on the committee. The board held a vote to re-appoint Dr. Yen and the acceptance was unanimous.
Legal Update – Assistant Attorney General
There are seven cases pending – the Collison case was just affirmed by the district court and the Assistant Attorney General will monitor for whether an appeal of that decision is made. Four of the remaining pending cases are at the Supreme Court or the Court of Appeals.
The annual meeting will be April 18 – April 20 in Boston, Massachusetts. Dr. Hoverston and Dr. Olds will attend with members of the administration. There are five resolutions that will be considered, with Dr. Hoverston acting as the Board of Medicine delegate for Iowa.
The board members were encouraged to review the annual report from the Board of Pharmacy regarding the Prescription Drug Monitoring Program. Also, an article by Janice Lloyd in USA Today may be of interest – titled “Hospice care used more, but often too late.”
Board moved into closed session.
Next Board Meeting
Thursday and Friday, April 25 – 26, 2013.