Notice of Proposed Rule

DEPARTMENT OF HEALTH
Board of Medicine
RULE NO: RULE TITLE
64B8-31.0101: Standard Terms Applicable to Orders
64B8-31.0102: Probation Variables
PURPOSE AND EFFECT: The proposed new Rules 64B8-31.0101 and 64B8-31.0102, F.A.C., are intended to set forth standard terms which are applicable to Board orders and to set forth the various probation terms imposed by Orders of the Board in disciplinary proceedings with regard to anesthesia assistants.
SUMMARY: The proposed Rule 64B8-31.0101, F.A.C., sets forth standard terms which the Board applies to disciplinary orders. The proposed Rule 64B8-31.0102, F.A.C., sets forth various probationary terms typically imposed by Board order.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 456.072(2), 458.309(1), 458.331(5), 458.3475 FS.
LAW IMPLEMENTED: 456.072(2) 458.3475, 458.331(5) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Larry McPherson, Jr., Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253

THE FULL TEXT OF THE PROPOSED RULE IS:

64B8-31.0101 Standard Terms Applicable to Orders.

Unless otherwise approved by the Board or its designee, or addressed by the Final Order, the following are the terms applicable to all Final Orders rendered by the Board in disciplinary proceedings.

(1) PAYMENT OF FINES AND COSTS. All fines and costs shall be paid by check or money order made payable to the Board and sent to DOH/Client Services, P. O. Box 6320, Tallahassee, Florida 32314-6320, within 30 days of the filing of the Order.

(2) ADDRESSES. Respondent must keep current residence and practice addresses on file with the Board. Respondent shall notify the Compliance Office, in writing, within 10 days of any changes of those addresses. Furthermore, if the Respondent’s license is on probation, the Respondent shall notify the Compliance Office within 10 days in the event that Respondent leaves the active practice as an anesthesiologist assistant in Florida.

(3) COMPLIANCE ADDRESS. All reports, correspondence and inquiries shall be sent to: DOH, Client Services Unit, 4052 Bald Cypress Way, Bin #C01, Tallahassee, Florida 32399-3251, Attn: Medical Compliance Officer.

(4) CONTINUITY OF PRACTICE.

(a) TOLLING PROVISIONS. In the event the Respondent leaves the State of Florida for a period of 30 days or more or otherwise does not or may not engage in practice as an anesthesiologist assistant in the State of Florida, then certain provisions of the requirements in the Board’s Order shall be tolled and shall remain in a tolled status until Respondent returns to the active practice in the State of Florida. Respondent shall notify the Compliance Officer 10 days prior to his/her return to practice in the State of Florida. The following requirements shall be tolled until the Respondent returns to active practice:

1. The time period of probation shall be tolled.

2. The provisions regarding supervision by the probation supervisor, and required reports from the probation supervisor shall be tolled.

3. Any provisions regarding community service shall be tolled.

4. Any requirements regarding lectures.

(b) ACTIVE PRACTICE. In the event that Respondent leaves the active practice as an anesthesiologist assistant for a period of one year or more, the Respondent may be required to appear before the Board and demonstrate the ability to practice with reasonable skill and safety to patients prior to resuming practice in the State of Florida.

(5) COMMUNITY SERVICE AND CONTINUING EDUCATION UNITS. All community service requirements, continuing education units/courses must be completed, and documentation of such completion submitted to DOH/Client Services, at the address set forth in subsection (3) above.

(a) DEFINITION OF COMMUNITY SERVICE. “Community service” shall be defined as the delivery of volunteer services to an entity which is exempt from federal taxation under 26 U.S.C. s. 501(c)(3), without fee or cost to the patient or the entity, for the good of the people of the State of Florida. Community service shall be performed outside the anesthesiologist assistant’s regular practice setting. Community service plans must be pre-approved by the Board’s Probationer’s Committee.

(b) CONTINUING EDUCATION. Continuing education imposed by Board Order shall be in addition to those hours required for biennial renewal of licensure. Said continuing education courses must be pre-approved by the Board’s Probationer’s Committee and shall consist of a formal live lecture format.

(6) PROBATION TERMS. If probation was imposed by Board Order, the following provisions are applicable:

(a) DEFINITIONS:

1. PROBATION SUPERVISOR – is a board-certified anesthesiologist who has agreed to monitor the anesthesiologist assistant for purposes of the Board-imposed probation.

2. PROBATION COMMITTEE – or “Committee” are members of the Board of Medicine designated by the Chair of the Board to serve as the Probation Committee.

(b) REQUIRED SUPERVISION:

1. If the terms of the Order include probation, the Respondent shall not practice without an approved probation supervisor, as specified by the Final Order.

2. The probation supervisor must be a board-certified anesthesiologist licensed under Chapter 458, F.S., in good standing, in active status, without restriction or limitation on his/her license, must be qualified by training and experience, and must not have any conflicts of interest that would prohibit him or her from impartially performing his or her duties as a supervisor. Specific grounds for rejecting a proposed supervisor by the Board or its designee shall include but are not limited to the following:

a. The proposed supervisor has previously been subject to disciplinary action against his/her medical license in this or any other jurisdiction;

b. The proposed supervisor is currently under investigation, or is the subject of a pending disciplinary action;

c. The proposed supervisor is a relative or employee of the Respondent.

(c) TEMPORARY APPROVAL. The Board confers authority on the Chair of the Probation Committee to temporarily approve Respondent’s probation supervisor. To obtain this temporary approval, Respondent shall submit to the Compliance Officer the name and curriculum vitae of the proposed supervisor. This information shall be furnished to the Chair of the Probation Committee by way of the Compliance Officer. This information may be faxed to the Compliance Officer at (850)414-0864, or may be sent by overnight mail to the Compliance address as set forth in subsection (3) above. Should Respondent’s probation supervisor be temporarily approved, said approval shall only remain in effect until the next meeting of the Probationer’s Committee. Absent said approval, Respondent shall not practice until a probation supervisor is approved. Temporary approval shall only remain in effect until the next meeting of the Probation Committee.

(d) FORMAL APPROVAL. Respondent shall have the probation supervisor with him/her at the first probation appearance before the Probation Committee. Prior to consideration of the probation supervisor by the Committee, the Respondent shall provide the probation supervisor a copy of the Administrative Complaint and the Board’s Order in this case. Respondent shall submit a current curriculum vitae, a description of current practice, and a letter agreeing to serve from the proposed probation supervisor to the Compliance Officer no later than 21 days before the Respondent’s first scheduled probation appearance. Respondent’s probation supervisor shall also appear before the Probation Committee at such times as directed by the Committee. It shall be the Respondent’s responsibility to ensure the appearance of his/her probation supervisor as directed. Failure of the probation supervisor to appear as directed shall constitute a violation of the terms of the Board’s Order and shall render the Respondent subject to additional disciplinary action.

(e) CHANGE IN PROBATION SUPERVISOR. In the event that Respondent’s probation supervisor is unable or unwilling to fulfill his/her responsibilities as a probation supervisor as described above, the Respondent shall advise the Compliance Office of this fact within 24 hours of becoming aware of the situation. Respondent shall submit to the Compliance Office the name of a temporary probation supervisor for consideration. Respondent shall not practice pending approval of this temporary probation supervisor by the Chair of the Probation Committee. Furthermore, Respondent shall make arrangements with his/her temporary probation supervisor to appear before the Probation Committee at its next regularly scheduled meeting for consideration of the probation supervisor by the Committee. Respondent shall only practice under the supervision of the temporary probation supervisor (approved by the Chair) until the next regularly scheduled meeting of the Probation Committee whereat the issue of the Committee’s approval of the Respondent’s new probation supervisor shall be addressed.

(f) REPORTS. If directed by Board Order, probation reports, in affidavit form, shall be submitted by the Respondent and shall contain the following:

1. Brief statement of why anesthesiologist assistant is on probation.

2. Practice location.

3. Describe current practice (type and composition).

4. Brief statement of compliance with probationary terms.

5. Describe relationship with probation supervisor.

6. Advise Compliance Officer of any problems including office incident reports filed; loss or restriction of hospital staff privileges; or any Medicare/Medicaid program exclusions, restrictions or limitations.

(g) PROBATION SUPERVISOR REPORTS. If directed by Board Order, probation supervisor reports, in affidavit form shall include the following:

1. Brief statement of why anesthesiologist assistant is on probation.

2. Description of probationer’s practice.

3. Brief statement of probationer’s compliance with terms of probation.

4. Brief description of probationer’s relationship with probation supervisor.

5. Detail any problems which may have arisen with probationer.

(h) INVESTIGATIVE REPORTS. Respondent understands that during the period of probation, at a minimum, semi-annual investigative reports will be compiled with the Department of Health concerning compliance with the terms and conditions of probation and the rules and statutes regulating the practice of medicine.

(7) COSTS OF COMPLIANCE. Respondent shall pay all costs necessary to comply with the terms of the Board’s Order. Such costs include, but are not limited to, the costs of preparation of the investigative reports detailing compliance with the terms of the Order, the cost of analysis of any blood or urine specimens submitted pursuant to the Order, and administrative costs directly associated with Respondent’s probation. See Section 458.331(2), F.S.

(8) SUSPENSION. In the event that a Respondent’s license expires during the period that the license is suspended, this action shall not relieve the Respondent of the responsibility to renew the license at the end of each licensure period. If the Respondent fails to renew the license at the end of any licensure period, all normal conditions and consequences imposed by statute or rule of the Board for failure to timely and properly renew a license shall apply. Renewal of a suspended license during the period of suspension shall not affect the suspension of the license and the suspension shall continue until all requirements for reinstatement have been met.

(10) RETURN OF LICENSE. Any Order which suspends a license, revokes a license, or accepts a Respondent’s offer to voluntarily relinquish his/her license shall require the Respondent to return the license to the Department within 30 days from the date the Final Order is filed. This shall not apply to instances where the Board or a court has granted the Respondent a stay of the suspension.

Specific Authority 458.309(1), 458.331(5) FS. Law Implemented 458.3475, 458.331(5) FS. History–New_______.

 

64B8-31.0102 Probation Variables.

In instances where a Respondent is placed on probation by the Board, the Board shall determine the terms and conditions of Respondent’s probation. The following terms of probation are utilized by the Board to ensure that Respondents are safely practicing as anesthesiologist assistants. Possible terms of probation and restrictions on practice include, but are not limited to:

(1) APPEARANCES REQUIRED. Respondent shall appear before the Probationer’s Committee at the first meeting after said probation commences, at the last meeting of the Probationer’s Committee preceding termination of probation and either quarterly, semiannually, or annually as set forth in the final order. Respondent shall also be responsible for ensuring that the proposed probation supervisor is present at the first meeting before the Probationer’s Committee following commencement of probation. Respondent shall be noticed by Board staff of the date, time and place of the Board’s Probationer’s Committee whereat Respondent’s appearance is required. Failure of the Respondent to appear as requested or directed shall be considered a violation of the terms of probation, and shall subject the Respondent to disciplinary action.

(2)(a) The responsibilities of a probation supervisor shall include:

(b) Submit quarterly reports, in affidavit form, which shall include:

1. Brief statement of why the anesthesiologist assistant is on probation.

2. Description of probationer’s practice.

3. Brief statement of probationer’s compliance with terms of probation.

4. Brief description of probationer’s relationship with probation supervisor.

5. Detail any problems which may have arisen with probationer.

(3) Prior to the approval of the probation supervisor by the committee, Respondent shall submit to the committee a current curriculum vitae and description of the current practice of the proposed probation supervisor. Said materials shall be received in the Board office no later than 21 days before the Respondent’s first scheduled probation appearance.

(4) ALTERNATE MONITOR/SUPERVISOR. In view of the need for ongoing and continuous supervision, Respondent shall also be required to submit the curriculum vitae and name of an alternate probation supervisor who shall be approved by Probationer’s Committee. Such physician shall be a board-certified anesthesiologist licensed pursuant to Chapter 458, F.S., and shall have the same duties and responsibilities as specified for Respondent’s probation supervisor during those periods of time which Respondent’s probation supervisor is temporarily unable to provide supervision. Respondent shall not practice unless Respondent is under the supervision of either the approved probation supervisor or the approved alternate.

(5) CONTINUING MEDICAL EDUCATION. Should the Board determine that continuing medical education (CME) is appropriate during the probationary period, the Board shall determine the number of hours and subject area of the required CME. The CME shall be Category I Continuing Medical Education. Respondent shall submit a written plan to the Chairperson of the Probationer’s Committee for approval prior to the completion of said courses. The Board confers authority on the Chairperson of the Probationer’s Committee to approve or disapprove said continuing education courses. In addition, Respondent shall submit documentation of completion of these continuing medical education courses in each report. These hours shall be in addition to those hours required for biennial renewal of licensure. Said continuing education courses shall consist of a formal live lecture format.

(6) PRN REQUIRED. Should the Board determine that a contract by the Professionals Resource Network (PRN) is appropriate, Respondent shall participate and comply with the PRN contract.

(a) Respondent shall enter into an after care contract with PRN, shall comply with all its terms, and shall be responsible for assuring that the medical director of PRN send the Board a copy of said contract.

(b) Respondent shall execute a release that authorizes PRN to release information and medical records (including psychiatric records and records relating to treatment for drug dependence and alcoholism) to the Board of Medicine as needed to monitor the progress of Respondent in the PRN program.

(c) Respondent shall authorize the director of PRN to report to the Board of Medicine any problems that may occur with Respondent and any violations of Chapter 456 or 458, F.S. Such a report shall be made within 30 days of the occurrence of any problems, or violations of Chapter 456 or 458, F.S.

(7) RESTRICTION ON TREATING PATIENTS OF THE OPPOSITE GENDER. Should the Board determine there should be a restriction on treating patients of the opposite gender, Respondent shall not examine or treat any patients of the opposite gender without an employee who is of the same patient gender and who is a health care practitioner licensed by the Department of Health present in the room.

Specific Authority 456.072(2) FS. Law Implemented 456.072(2) FS. History–New________.


NAME OF PERSON ORIGINATING PROPOSED RULE: Anesthesiologist Assistant Committee
NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Board of Medicine
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 11, 2007
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: November 17, 2006