State of Tennessee Board of Respiratory Care Minutes/August 10, 2011

Respiratory Care Minutes

 * August 10, 2011


 * Board of Respiratory Care Minutes
 * Date:   August 10, 2011
 * Time:  9:00 C.S.T.

Location:
 * Iris Conference Room, Ground Floor
 * 227 French Landing Drive
 * Heritage Place, Metro Center
 * Nashville, TN 37243

Members Present:
 * Candace Partee RRT, Chair
 * Teresa Hatcher, Consumer Member
 * Ray Davis, RRT
 * Gene Gantt, RRT
 * Delmar Mack, RRT, Ed.D.
 * Jeffrey McCartney, MD
 * Brian Cook, Hospital Administrator

Member (s) Absent:
 * Roger Major, RRT, Secretary

Staff Present:
 * Rosemarie Otto, Medical Board Director
 * Mary Webb, Board Administrator
 * Mona Jean-Baptiste, Assistant General Counsel

Guest(s) Present:      Elaine Eaton, Tennessee Professional Assistance Program

Office of General Counsel Rules Discussion
The board discussed amendments to Rule 1330-01-.24, Endorsement of Respiratory Therapists to provide Polysomnographic Services. The Notice of Rulemaking has been filed with the Secretary of State. The rule is authorized by Tenn.Code Ann. § 63-31-107(a)(5). The rulemaking hearing will be held at the November 10, 2011 board meeting.

Litigation
There are currently four (4) open disciplinary cases for the Board of Respiratory Care. These cases are being presented to the Board for review and disciplinary consideration.

1. CASE NO.: RBS-201100594
The pending matter is relative to a violation of a 2010 Board Order. Respondent has a lengthy disciplinary history before this Board. The current action alleges that Respondent has failed to comply with his 25 June 2010 Consent Order, requiring that Respondent be evaluated by and enter into a monitoring agreement with the Tennessee Professional Assistance Program. Respondent’s license was suspended until such time as the agreement was entered. The evaluation indicated that Respondent should not return to practice until cleared by a psychiatrist. Respondent is currently engaged in unlicensed practice in New Mexico and has not complied with any of TnPAP’s directives. As such Respondent is not a candidate for a monitoring agreement. TnPAP’s records will support a failure to comply. Prior discipline: Consent Order, 25 June 2010; Agreed Order 6 June 2008; OGC Recommendation: Revoke – A motion was made by Gene Gantt and seconded by Dr. Mack to accept the OGC recommendation to revoke the license. The motion carried.

2. Case No.: 201002355
The Department of Health’s investigation revealed that the Respondent discharged a patient from the Outpatient Cardiopulmonary Department at Northcrest Medical Center with knowledge that the patient had two (2) irregular EKGs. Patient returned to the Northcrest Medical Center Emergency Department in distress later that day. Respondent provided care to the patient upon his return to the emergency department; Respondent did not notify emergency department staff that the patient had been in the Outpatient Cardiopulmonary Department with similar distress. Prior discipline: none OGC Recommendation: Reprimand regarding placing patient in danger and violating hospital policy and require three units of continuing education relative to patient safety. A motion was made by Dr. Mack and seconded by Mr. Gantt to complete nine (9) units of continuing education relative to patient safety as opposed to the three (3) units as recommended. The motion carried.

3. Case No.: RBS-201002356
The Board received information from the Tennessee Peer Assistance Program indicating that Respondent, who had been referred by the Board in August 2009 as a result of a reckless driving conviction revealed on her application to upgrade from CRT to RRT, had failed to comply with the Board’s recommendation as of 10 September 2010. Respondent was granted a license as an RRT contingent upon a favorable result of that evaluation. As a result of this failure to be evaluated and adhere to the results of said evaluation the Tennessee Peer Assistance Program has closed Respondent’s file. Prior discipline: None OGC Recommendation: Revocation. License was granted based upon a condition Respondent failed to satisfy. A motion was made by Dr. Mack and seconded by Brian Cook to accept the recommendation to revoke the license. The motion carried.

4. Case No.: RBS-201000985
The Board received a complaint that Respondent practiced as a respiratory therapist without a license. Complainant, a medical doctor, alleges that Respondent misrepresented her credentials when she came to work for his practice. She was originally hired through a staffing agency but was ultimately hired by the doctor shortly after her arrival. She was hired by the staffing agency to provide support to the licensed tech the staffing agency also placed in the office. She worked from approximately 10 August 2009 to January 2010. Earlier in the year, Respondent failed the certification exam and her temporary licenses in Tennessee and Mississippi expired (in April and May of 2009). The placement agency was aware of her status when it placed her in the complainant’s office to do manual labor. Pursuant to TENN. CODE ANN. §63-27-102(4)(A)(i) and the Board of Medical Examiners’ interpretation of TENN. CODE ANN. §63-6-204(b), Respondent was legally able to provide those services under the supervision of a licensed medical doctor. The complainant is a licensed medical doctor and despite any later protestations. Respondent is an unapproved applicant for licensure in Tennessee; hence the Boards capacity to discipline is limited to civil penalty. Prior discipline: none Recommendation: This case should be closed with no action. The Respondent is an unapproved applicant, thus the Board can only impose a civil penalty. The cost of pursuing this matter will outweigh any discipline imposed. Further, there are several theories under which Respondent could have legally provided those services. A motion was made by Gene Gantt and seconded by Brian Cook to accept the recommendation. The motion carried.

Approval of Minutes
Mr. Gantt made a motion seconded by Ms. Hatcher to approve the minutes of the May 9, 2011 as amended. The motion carried.

Dr. Mack made a motion seconded by Mr. Gantt to approve the minutes of the July 29, 2011 from the EMS – Respiratory Ad Hoc committee meeting. The motion carried.

Investigation and Disciplinary Reports
Juanita Stone, Disciplinary Coordinator, presented the Investigative and Disciplinary reports. There is one (1) RRT complaint being investigated and two (2) CRT complaints currently being investigated. There are ten (10) RRT’s, sixteen (16)) CRT’s, and one (1) CRA currently being monitored following Board disciplinary action.

Order of Compliance
Silvia Cole – Requested to be removed from Probation. Ms. Cole performed ABG endorsement for nine (9) years without the ABG endorsement on her license. Ms. Cole was placed on probation for one (1) year and paid $2500.00 in civil penalties. Ms. Cole has served one (1) year probation and has paid all civil penalties and is in compliance with all of the terms and conditions of the Agreed Order. A motion was made by Dr. McCartney seconded by Dr. Mack to remove Ms. Cole from probation. The motion carried.

Tennessee Professional Assistance Program (TnPAP) Report
Elaine Eaton, Representative of Tennessee Professional Assistance Program (TnPAP), submitted the report for the period of July 1, 2010 through June 30, 2011. Eight (8) practitioners are being monitored. There were fifteen (15) referrals from the Board. These referrals were made for a history of arrest/illegal drug use/DUI and unprofessional conduct. During this period, one (1) practitioner was discharged from the program because the monitoring agreement was complete, eleven (11) because monitoring was deemed unnecessary, one (1) because of noncompliance (which was reported to the Department of Health), one (1) relocated outside of Tennessee, and two (2) evaluated refused services and were reported to TDOH. Applicant Interview/File Review

A. Thomas Donato—Mr. Donato was not present. The application was reviewed for a pending criminal charge. Gene Gantt made a motion seconded by Brian Cook to defer action on the application due to the pending charge and also request that Mr. Donato appear before the Board at the next meeting. The motion carried.

B. Janet Kluesner—Ms. Kluesner was not present. The application was reviewed due to DUI convictions in 2004 and 2007. After review and discussion a motion was made by Mr. Gantt and seconded by Dr. McCartney to approve Ms. Kluesner for licensure pending the results of a TnPAP evaluation. The motion carried.

C. Constance Polk—Ms Polk was not present. The application was reviewed due to a 2004 misdemeanor conviction. After review a motion was made by Brian Cook and seconded by Gene Gantt to grant Ms. Polk a license. The motion carried.

D. John Tyler Currin- Mr. Currin appeared before the Board to answer questions regarding a DUI conviction. Mr. Currin showed proof to the Board that he had gone through an evaluation with the Tennessee Professional Assistance Program (TnPAP), and he had received a favorable TnPAP evaluation that stated no monitoring was necessary. Dr. Mack made a motion seconded by Gene Gantt to grant Mr. Currin a license. The motion carried.

E. Jeremy Wentzel – Mr. Wentzel appeared before the Board to answer questions regarding a pending reckless driving charge. After review and discussion, Gene Gantt made a motion seconded by Dr. McCartney to grant Mr. Wentzel a license. Mr. Wentzel must report the outcome of his case to the Board. The motion carried.

F. Joshua Helton- Mr. Helton was not present. The application was reviewed due to a public intoxication conviction in 2010 and conviction of the charge of possession of a handgun in 2005. A motion was made by Mr. Gantt and seconded by Dr. Mack to grant Mr. Helton a license because he has gone through TnPAP and received a favorable evaluation. The motion carried.

Ad Hoc Meeting with EMS and Respiratory Board
Ms. Partee and Dr. Mack gave a report regarding the meeting on July 29, 2011. Both stated that the meeting was informative and would like for the discussion to be placed on the November 10, 2011 agenda to allow Mr. David Johnson, TSRC, Chair Government Affairs Committee, a chance to appear before the entire board.

Correspondence/Discussion
A. Charlie Brooks- The Board would like to invite Mr. Charlie Brooks to the November 10, 2011 Board meeting to discuss his previous request from the May 9, 2011 board meeting regarding the proposed requirement to maintain a current NBRC credential in order to renew a respiratory license. After much discussion a motion was made by Gene Gantt and seconded by Dr. McCartney, to interpret the rules that it is not necessary in the State of Tennessee to maintain a current NBRC credential to renew one’s respiratory license; however, it is required in order to practice the Arterial Blood Gas endorsement. The motion carried.

The Board reviewed and discussed the letter from Mr. Charlie Brooks requesting to consider changing the rule requiring traditional lecture and classroom continuing education hours from five (5) hours on line and five (5) hours in the classroom. No action was taken at this meeting. The Board has requested to defer this discussion to the November 10, 2011 board meeting.

B. Mr. Gantt suggested for the TDOH to develop a registry to keep track of how many ventilator dependent patients there are in the State of Tennessee. Dr. McCartney and Mr. Cook both contributed to the discussion and stated their concerns of how the data would be used to keep track of the cost involved. Mr. Gantt asked Dr. McCartney and Mr. Cook if the State of Tennessee could implement such a data bank, would they be supportive of it, and both responded yes. No action was taken at this time.

C. Ms. Partee reminded the Board that they discussed and approved for the rules to be amended at the May 9, 2011 Board meeting to state that a person seeking a new license must apply within a certain number of years after graduation whether that individual is a new applicant or coming in by reciprocity. Ms. Mona Jean-Baptiste responded that she is working to formulate a solution that would not be cost prohibitive to applicants to prevent them from returning to practice. Ms. Jean-Baptiste will bring her recommendation to the Board in November for review.

D. Fee decrease - Rosemarie Otto explained to the Board that since it is in good financial standing a $66,000.00 or 20% fee decrease in license renewals should be considered by the Board. A motion was made by Gene Gantt and seconded by Ray Davis to approve a 20% fee decrease. The motion carried.

E. Susan Deaton –Inquired as to whether registered respiratory therapists giving Theophlyine and Perstatine medications in IV’s are within the scope of practice. Request was initially brought before the Board at the May 9, 2011 and the Board stated it was not in the scope of practice for Respiratory Therapists. Ms. Partee brought the letter back before the Board for reconsideration. A motion was made by Gene Gantt and seconded by Dr. McCartney that the administration of these medications are not prohibited in the respiratory care practice but would need to be approved by individual hospitals or individual physician practices by the governing bodies, as the administration of these medications is necessary to diagnose and implement treatment to promote disease prevention and provide rehabilitation to the cardio respiratory patient. The motion carried.

Ratifications
A motion was made by Mr. Cook and seconded by Mr. Gantt to approve the following lists of initial and reinstatement applications for licensure and polysomnography endorsements. The motion carried.

REGISTERED RESPIRATORY THERAPISTS

 * NEW LICENSES


 * REINSTATEMENTS

POLYSOMNOGRAPHIC ENDORSEMENTS FOR REGISTERED REPIRATORY THERAPISTS
RAQUEL BROOKS – 3RD PATHWAY WILLIAM BOWMAN – 3RD PATHWAY M. EDELL BENNETT – BRPT EXAM CERTIFIED RESPIRATORY THERAPISTS NEW LICENSES KAYLA HOWARD LONG ASHLEY ELIZABETH ADAMS CHRISTOPHER TODD ASBERRY ASHLEY HITE BANKS ASHLEY LYNN BENEFIELD LYDIA ANN BLACKBURN TIMOTHY WADE BROWN KATHERINE LORRAINE CARRIER JOSHUA KEITH CHURCH TIFFANY NICOLE COLEMAN SCOTT ANTHONY COLLINS CRYSTAL MAE COMBS TESSA MIRANDA FRYE KRISTEN AMBER GOLEY MARTY DERRELL GREENE TIMOTHY PRESTON GREGORY DANIELLE RENEE GRIMM ROBERT W. GUYNN WILL GORDON HARGIS MIRANDA CASTEEL HARRIS ERICA NICOLE HAY GALINA ZHUAVLEVA HESTER BRENDA JESSEE JOHNSON SARAH MCAMIS JONES JOSEPHINE TUCKER KAWA CHRISTOPHER KERBY KENNON ARUN L. MALIKAYIL ROBIN COX MAY CAMERON CLINE MEADOWS JEFFREY BENJAMIN MIESSAU JOY LATRICE MOORE PATSY DISHNER NELSON CHAD HALDEN OLSON GREGORY KIRK PALMER STACY WADDELL PARTON AMANDA FAYE PHILLIPS JESSIE GARLAND PITRE MELONEY CARR RHODES DAVIS S. RICHARDSON ASHLEY KRISTEN SCHWEER LAWRENCE CALVIN SELF DARREN KEITH SUTTON CHRISTINE JUANITA TAYLOR PORTIA CERESE THARPE AMBER HOWSON TRENT CHRISTOPHER PAUL VANN MICHAEL DANIEL VAUGHN JANETT SMITH WAKAT LASHELIA DEYVONNE WALKER AMBER MARIE WALTERS MELISSA DEAN WEBB TIFFANY CAMPER WEST JEFFREY LYNN WESTBROOKS JESSEE MICHAEL WHITE NICOLE LATRICIA WILBOURN JOSHUA RYAN WILMETH MAGIN LEANN WILSON TONI MICHELLE WOODS REINSTATEMENTS VALENCIA MICHELE BRYANT MARK J. LONG RANDY EUGENE MCDANIEL, JR.

POLYSOMNOGRAPHIC ENDORSEMENTS FOR CERTIFIED THERAPISTS
JANICE ANN BILBREY – BRPT EXAM

LISA MARTIN – BRPT EXAM

As of July 31, 2011 the numbers of active licensees were:
 * Administrator’s Report
 * RRT—2778
 * CRT—1748
 * RCA—21

Board activity totals from May 6, through August 5, 2011
RRT CRT New licenses—86 New licenses—58 Reinstated—5 Reinstated—3 Retired—9 Retired—8 Failed to Renew—26 Failed to Renew—29 470 practitioners renewed during this period with 159 renewing online.

Board Members
All positions are currently filled.

Financial Report
As of June 30, 2011, direct expenditures and were $93,000.40 and revenue collections during this period were $370,624.29. Indirect expenditures have not been finalized. Adjournment

There being no further business, a motion was made by Dr. Mack seconded by Mr. Cook to adjourn the meeting at 11:31 a.m. The motion carried.

These minutes were ratified at the November 10, 2011 meeting.