Sunset review of the regulatory board of physician assistants

              ARIZONA STATE SENATE ,
RESEARCH STAFF
TO: JOINT LEGISLATIVE AUDIT COMMITTEE HEATHER OWENS
Senator Robert Blendu, Chairman LEGISLATIVE RESEARCH ANALYST
IHEALTI- I COMMITTEE
Representative John Nelson, Cochair Telephone. ( 602) 926- 31 71
DATE: December 3,2007
SUBJECT: Sunset Review of the Regulatory Board of Physician Assistants
Attached is the final report of the sunset review ofthe Regulatory Board of Physician Assistants,
which was conducted by the Senate Health and House of Representatives Health Committee of
Reference.
This report has been distributed to the following individuals and agencies:
Governor of the State of Arizona
The Honorable Janet Napolitano
President of the Senate
Senator Tim Bee
Senate Members
Senator Tom O'Halleran, Cochairman
Senator Barbara Leff
Senator Paula Aboud
Senator Thayer Verschoor
Senator Amanda Aguirre
Regulatory Board of Physician Assistants
Arizona State Library, Archives & Public Records
Office of the Auditor General
Senate Majority Staff
Senate Research Staff
Senate Minority Staff
Senate Resource Center
Speaker of the House of Representatives
Representative James Weiers
House Members
Representative Bob Stump, Cochairman
Representative Nancy Barto
Representative Rick Murphy
Representative David Bradley
Representative Linda Lopez
House Majority Staff
House Research Staff
House Minority Staff
Chief Clerk
HOIjas
Attachment
Senate Health and House of Representatives Health
Committee of Reference Report
REGULATORY BOARD OF PHYSICIAN ASSZSTANTS
Background
Pursuant to Arizona Revised Statutes ( A. R. S.) 5 41 - 2953, the Joint Legislative Audit Committee
( JLAC) assigned the sunset review of the Regulatory Board of Physician Assistants ( Board) to the
Senate Health and House of Representatives Health Committee of Reference.
The Board was established in 1984 to regulate the physician assistant ( PA) profession. The
mission of the Board is to protect public safety through the licensing, regulation and education of
physician assistants. The Board's duties include: licensing and regulating PAS; reviewing the
credentials of applicants for licensure; establishing fees; developing standards to govern the profession;
initiating investigations, disciplining and rehabilitating PAS as necessary; and approving notifications of
supervision from physicians who intend to supervise a PA.
Pursuant to A. R. S. 5 32- 2506, the State Treasurer collects all monies received by the Board and
deposits ten percent of the monies and all civil penalties imposed on licensees into the state General
Fund. The remaining 90 percent of monies received are deposited in the Arizona Medical Board Fund
and are used by the Board for all necessary Board expenses.
Conzmittee of R& rence Sunset Review Procedures
The Committee of Reference held one public meeting on November 6, 2007, to review the
Board's responses to the sunset factors as required by A. R. S. 5 41- 2954, subsections D and F, and to
hear public testimony. The Board's responses to the 12 sunset factors and four additional questions
are attached.
Committee of Reference Recommenhtions
The Committee of Reference recommends continuing the Board for ten years.
Attaclzmerzts
1. Staff memo.
2. Sunset report requirements pursuant to A. R. S. tj 41- 2954, subsections D and F.
3. Meeting notice.
4. An excerpt of the minutes of the Committee of Reference meeting relating to the Board.
ARIZONA STATE SENATE
RESEARCH STAFF
TO: MEMBERS OF THE HOUSE AND SENATE
HEALTH COMMITTEE OF REFEREhrCE
DATE: October 25, 2007
HEATHER OWENS
ASSISTANT ANALYST
HEALTH COMMITTEE
Telephone: ( 602) 926- 3 171
Facsimile: ( 602) 926- 3833
SUBJECT: Sunset Review of the Regulatory Board of Phvsician Assistants
The Arizona Regulatory Board of Physician Assistants ( Board) is scheduled to sunset on July 1,
2008. The following is a brief description of the history and duties of the Board, as well as the Board's
response to the sunset questionnaire. A public meeting is scheduled for November 6,2007, to review,
discuss and make a final recommendation on the Board's continuation. If you have any questions or
need further assistance, please feel free to contact me.
BOARD HISTORY AND MlSSlON
The Board was established in 1984 to regulate the physician assistant profession. A physician
assistant ( PA) is a person who is licensed to practice medicine under the supervision of a physician.
PAS may perform services such as taking medical histories, conducting physical examinations, ordering
and interpreting lab tests, assisting in surgery, diagnosing illnesses. developing treatment plans, n~ aking
referrals as appropriate, performing minor surgery, counseling patients and prescribing medications. A
physician must submit a notification of supervision to the Board. notifying the Board that the physician
intends to supervise a PA, before the PA may begin working.
The mission of the Board is to protect public safety through the licensing, regulation and
education of physician assistants.
ORGANIZATION AND DUTIES
The Board consists of the following ten members appointed by the Governor: four licensed
PAS; two public members; two licensed and actively practicing osteopathic physicians, one of whom
supervises a physician assistant at the time of appointment: and two licensed and active allopathic
physicians. one of whom supervises a physician assistant at the time of appointment. Board members
serve four- year terms ending on July 1 . The executive director of the Arizona Medical Board ( AMB)
serves as the executive director of the Board and the staff of the AMB carries out the administrative
duties of the Board.
The Board's duties include: licensing and regulating PAS: reviewing the credentials of
applicants for licensure; establishing fees; developing standards to govern the profession; initiating
investigations, disciplining and rehabilitating PAS as necessary; and approving notifications of
supervision from physicians who intend to supervise a PA. The Board licenses over 1,500 PAS in
Arizona and, in FY 2006- 2007, approved license applications in an average of 17 days. In the same
fiscal year, the Board resolved 69 complaints against PAS. 10 of which resulted in disciplinary action.
MEMORANDUM
October 25: 2007
Page 2
FISCAL ISSUES
Since the administrative staff of the Board is also the staff of the AMB, the Board's budget is
included in the AMB's budget. The AMB's total operating budget in FY 2007- 2008 is $ 5,567,700.
The AMB currently has 58.5 full- time equivalent ( FTE) positions. Pursuant to A. R. S. $ 32- 2506, the
State Treasurer collects all monies received by the Board and deposits ten percent of the monies and all
civil penalties imposed on licensees into the state General Fund. The remaining 90 percent of monies
received are deposited in the Arizona Medical Board Fund and are used by the Board for all necessary
Board expenses.
LEGISLATIVE lSSUES
The Board identifies one issue for which it anticipates requesting a statutory change. The Board
would like to better define the relationship between physicians and PAS and set parameters for the
frequency of contact between the physician and the PA. The Board has a subcon~ mitteteh at is studying
this issue and is in the process of formulating recommendations with the AMB.
Janet Napolitano
Govemor
Timothy C. Miller, J. D.
Executive Director
Amanda J. Diehl, M. P. A.. C. P. M.
Deputy Execut~ veD ~ rector
Arizona Regulatory Board of
Physician Assistants
9545 East Doubletree Ranch Road . Scotlsdale, Ar~ zona 85258- 5514
Telephone: 480- 551 - 2700 . Toll Free: 877- 255- 221 2 Fax: 480- 551 - 2704
Website: www. azpa. qov Email: questions@ azpa QOV
Joan M. Reynolds, M. M. S., P. A.- C.
Chair
Peter C. Wagner, 0.0.
Vice- Cha~ r
August 22,2007
Ms. Rcth Kohler Lazare
Arizona State Senate
1700 West Washington
Phocmx, AZ 85007
Dear Ms. Lazare:
' Thank you Tor provid~ ngth e Ar~ zonaR egulatory Roard of Physician Assistants the opportunity to address
the Jolnt Legislat~ vcA ~ i dC~ otm mittee's sunset rcvlew. ' l'he agency's responses are as follows:
I Tl~ eob lectzve uricl purpose in estublishing tile agerzcy.
The Roard protects Arlzona cit~ zenst hrough Ilccnsing and rcg~~ lat~ pnhygs ic~ ana sslstants. The
agcncy p~ ocesscs applicat~ ons for licenses, handles complaints aga~ nst physlcian asslstants and
d~ sscmlnatcs inlorinatlon pcrtalning to physlcian assstants and the regulatory process. There arc
tun- cntly 1, 572 phys~ c~ aanss lstants hcensed In Ai- lmna
2 ' fhe effectiveness with wh~ chth e agency has met ~ tosb jective and purpose and the efliclency wlth
which ~ t has operated
' fhc agency has concentrated on refinlng its pollcies and proced~~ retos promote an effic~ entw ork
eiivlronment. l'hc agcncy staffs both the Arizona Medical Roard and Arizona llegulatory Board of
I'hys~ cian Ass~ stantsa nd the agency's proccsses for both boards are the same.
In the last fiscal ycar, tlic agency received 21 G phys~ ciana ssistant hcense applications, a 6.3 percent
inclease 11- 011th1c prevfous fiscal ycar, and approved llcense appllcatlons in an average of 17 days.
Stafi' also completed a total of 1,480 lnvest~ gations( MD and PA) on an average of 123 cases a
month. The agcncy currently has an open cascload of 15 PA cases and all but one case were
initiated in 2007
3 The extent to whiclz tlie ~ lgencyh as operalet1 ill the pzrhl~ c~ nteresl
' fhc agcncy operates In the publlc Interest by protecting citizens against the unsale practice 01'
health care tasks by physlclan assistants. ' l'he agency has processes in place to streamline the
investigative process and promptly address complaints against physician assistants. A portlon of
this p r o ~ s s ~ n c l ~ p~ edrseonsa lly contact~ nge ach complainant to ensure all pertinent information is
rccclved. F~ irtl7c1- moret1,1 1s p~ ocessid ent~ iiesp hyslcian assistants who may pose an ~ nim~ netnhtr eat
to public hcalth and safety and pro~ npts staJf to investigate those cases on a fast track bans to
determine if a summary action is wananted. In the last Jiscal year, the Hoard took two such
summary actlons
Arwona Kcgulatory Board of Phys~ clanA ss~ stants
Jolnt Legislative Audit Conlln~ ttecS unset Rcvlew
Page 2 of4
Additionally, the agency operates in the public interest by: tlmely licensing quahfied apphcants;
postlng all meetlng agendas, mlnutes and Board act~ onso n its website for publlc vlewlng; and
ldentlfylng and addressing pol~ cyIs sues affect~ ngp ubllc health and safety.
4. The exten1 to wlzich rules adopted by the agency are consistent with the legislative matzdate
With the exceptions as identified In questlon # 8, the agency's rules are consistent with the
legislat~ vem andate.
5. The extent to wlzich the agency has erzcouraged input from the public bejbre adopting its rules and
rlze extent to wlziclz it has injbrmed the public as it to its uctiolis und their expected impact on the
public.
-. I he agency encourages stakeholder involvement in its policy decision mak~ ng. The agency
malntalns email dlstrlbutlon llsts of stakeholders Involved In part~ cularI ssues and notifies them of
upcomlng meet~ ngsT. he Board's Phys~ cianA ssistant Supcrv~ s~ oSnu bcomm~ tteea ttracts a number
of stakeholders at each niectlng and ~ nvltes their comments before and durlng Subcomm~ ttee
meetings.
6 The exlent to which the agency has been able to znvestigate r~ ndr esolve co~ nplaznt~ tlsz at ure withzn
zts jurisclictiori
The agency recelves, on avelage, five complaints against phys~ clana ss~ stantse very month. Every
complaint is evaluated and if they fall wlthin the Board's jur~ sdlct~ onth, e y are opened, pr~ or~ t~ zed,
and brought before the Roard In a t~ melym anner. In Iiscal year 2007, the agency resolved 69 cases
against physician assistants. Ten of those cases resulted In dlsclplinary actlon, ~ ncludmgli ve loss of
Ilcenses, one practlce restr~ ct~ otnh, r ee 1, etters of Kepr~ manda, nd one order for Probation
7 The extent to wlriclz rhe Attorticy General or any other ~ ll~ plicclbnleg ency of stute governmenr lzus
the crzrtl~ o~- rttoy p rosecute actlotis under the enabling legi. sl( at~ ou
The agency's Execut~ veD lrector has the authority to prov~ dea ssistance to the Attorney General In
preparing, slgnlng and executing dlsclpllnary orders and notices of hearlngs as d~ rected by the
Board and to dlrectly refer cases to formal liear~ ng.( A. R. S. 532- 2505). Add~ t~ onallyth, e agency's
statutes classify physlc~ an asslstant conduct that 1s cons~ dercd to bc a Class 6 felony, pro~ npt~ ng
reScrral to the Attorney General's Ofiice for plosccutlon ( A. R S. $ 32- 2554) and author1i. e~ the
Super~ oCr ourt to issue an ~ njtlnct~ oang ainst physiclan assistants who perform health care tasks that
the Court detcrm~ iiesw ~ loli may cause ~ neparahled amage to the publlc health and safety ( A. R. S
$ 32- 2555)
8 711~ c'x letit to which the ageirqj // us trddre.~. cecld ejic. iei~ c.~ e11\ 1 11.5 eiirihl~ ngc. ~ utute. s th~ ztp i- cverzl 11
Jroni f~ iljillzng 1t. s . ctcztutot- y inatidate
' The agency recogn~ zed a defic~ encyI n ~ t sru les and stat~~ tersc gardlng physlc~ an assistant
supervlslon and has developed a Subcomm~ tteet o make recommcndatlons for statutory and Rule
7 7 changes. i hls Subconimlttee IS now In the plocess of harnionlzlng ~ trse commendations w~ thth e
Arizona Medical Roard. 1 ogethcr, these boards intend to bettcl define the dependent relatlonshlp
between physlclans and physlclan assistants; establ~ sha cceptable parameters fbr the li- equency and
naturc ot requlred weekly mcetlngs between thc physlc~ an and phys~ clan asslstant, and ensure
patlent safety through proper supervlslon
Ar~ zonaR egulatory Boa~ do f Phys~ clanA sslstants
Jolnt Leg~ slatlveA ud~ tC omm~ tteeS unset Kev~ ew
The recommendations from this committee will go to the Board's Rules Subcommittee ( currently
on hold) to create a comprehensive rule package for approval.
9. The extent to which changes are nece. ssury in the luws of the agency to udeyuately conzply with
these factors.
The agency anticipates that the issue identified in questlon # X will require statutory and rule
changes.
10. The extent ro which the ter~ ninutiono f the agency would signijicuntly harm thepublic health, safety
or weljure.
It IS the agency's miss~ ont o protect public safety through the judlclous I~ censingr, egulation, and
educatlon of physlclan assistants. I'hys~ c~ ana ss~ stantsa re used widely throughout the Slate, In
every form of practice ~ ncludlngu rban emergency department settings, physicIan offices and rural
underserved areas. Physician Asslstants are crit~ calt o helplng resolve the shortage of health care
provlders. Termination of the agency would si~ mificantlyd ecrease the ava~ labil~ toyf safe health
care provlders lo Arizona's cltlzens and the appropriate ovcrslght of a subset of health care
pract~ tioners who can practice qulte advanced mediclne such as mlnor surgical procedures and
prescribing narcot~ cs.
11. The exlent to which the level oj regulatzon exercised by the agency 1. s uppropriuie uncl wlzether- less
or more stringent 1evel. s oj regul~ itionw ould be upproprzute
The agency strlves to find regulatory balance that IS appropnate and that does not ~ nli- lngc on a
physician assistant's ablllty to make the right judgment when periorinlng health care tasks. Current
statutes and rules adequately address the vast majority of phys~ cian assistant practice and on gang
pol~ cyd ~ scusslonsc enter around thls Issues. The agency IS confident that physic~ aiia ssistants arc
regulated In a manner cons~ stenwt lth public and profess~ onale xpectations.
12 The extent to which the ugency h~ isu sed private contl- actors in the perjornzunce oj zts ~ 1ut~ ea. sn d
how efictzve the use ofprivute contractors could be acco~ izplished
?' he agency uses a pnvate contractor for the mon~ torlng and rchabil~ tation of physician ass~ stants
wlth substance abuse Issues. The agency oversees the contractor, obtains quarterly reports regard~ ng
each participant, and has processes In place to ensure physician ass~ stantsw ho relapse are promptly
reported lo the agency lor action.
Add~ t~ onalltyh, e agency has cteveloped a strateglc plan to address the following lssues
I'romotlon of p~ 1b11c safety through the examination of colnpell~ ng healthcare ~ ssucs, 111
collaborat~ onw ith Ilcensees, acadelnlc ~ nstltutions, h calthcare assoc~ atlonss, tate agency boards,
state medical boards, and other stakeholders;
I'romotc best practices through the educatlon of l~ censees, s takeholders and thc general p~~ blic,
Enhancement of Ilcenslng, regulatory and informat~ on dlssemlnatlon proccs'es, as well as
increased capacity for performance measurement, through lmproved ~ nforination technology and
other process ~ mprovements;
Pi- otection of thc publlc through the ldentlfication and rehab~ l~ tatioonf h in pan- ed physlclans and
physician assistants; and
Enco~ aagcc oiit~ nuousq uality improvement through stail niembcr development and perfomlance
evaluat~ on
The agency's strateglc plan ( attached) outllnes associated goals, objectives and performance nlcasures to
ensure tlic above listed issucs arc appl- opr~ atelya nd tlmely addiessed l'he Ar17ona Regulatory Board ol
Arizona Regrllatory Uoard of I'ltys~ c~ anA sslstants
Jolnt Legislative Audlt Commlttec Sunset Rev~ ew
Page 4 of4
. .
Phys~ clanA sslstants 1s the only Board In this State that l~ censesa nd regulates physicIan assistant pract~ ce
and thercforc, ~ t osb jectives do not duplicate or confllct wlth other agencles In this respect. There are
policy areas, such as physlc~ an assistant supervision, that may come in conflict with the Arizona Med~ cal
Board; however, both boards work together to ensure each entity concentrates on the area of pract~ ce
relat~ veto the licensees they regulate. Ehminat~ ngth e Ar~ zonaR egulatory Board of Physiclan Ass~ stants
would do a disserv~ ceto Arizona's c~ tizensb y removtng the regulatory authority of over 1,500 Ilcensees.
Add~ tlonallyp, hysician ass~ stantp ractlce is unlque and deserving of a regulatory board that understands
and 1s actlvely Involved In the policy and rule decls~ ons that affect physician assistant pract~ ce.
Comb~ n~ nthgls Board with another board, such as the Arlzona Medical Board, would shlft the reg~~ latory
focus of these healthcare providers to a board w~ tha different perspective.
Thank you again for allowmg the Arlzona liegulatory Board of Physiclan Ass~ stantsto provide the Jolnt
Legislative Aud~ tC ommittee the opportun~ tyt o share ~ trse sponses durlng the sunset review process. If
you have further questions, please do not hestate to contact me.
Sincerely,
' I'imothy C. Miller, J. D.
Executive Dlrcctor
MlI1,' I'I- YEAR AGENCY S'I'IIA'I'EGIC I' 1, AN ( FY 2008- 2010)
ARIZONA MEDICAL BOARD
And
AIilZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
Contact: Tllnothy Miller, J. D., Executive Dlrector
Phone ( 480) 551 - 2791
A. R. S. 532- 1401 c-. t.. seg. a nd A. R. S. 532- 2501 et.. seg
Mission:
The mission of thc agency is to protect public safety tliro~~ gthhe judicious licensing, regulation, and education of
phys~ ciansa nd physicIan ass~ stants.
Vision:
Protect~ ono f the Public through Regulatory Excellencc
Agency Description:
l'lie Agency staff s~ lpports two Boards - the Arizona Medlcal Board, whlch l~ censes and regulates allopatl~ ic
phys~ c~ ansan, d the Arli. ona lieg~~ latorByo ard of Pliys~ c~ aAns s~ stants, w hlch l~ ccnsesa nd regulates physlclan
ass~ stants. Tlic Agency processes apphcat~ ons for hcenses, handles publlc compla~ nts against I~ censees, and
cl~ ssen~~ na~ tensf orn~ at~ poenr ta~ n~ ntgo l~ censeesa nd the reg~ llatory process. The two Boards detern~ lnea nd
adm~ n~ stedr~ sclpllnarya ctlo11 In the event of proven v~ olat~ onosf then respective practlce acts. Together, the
Boards regulate over 20,000 l~ ccnsees.
Principles:
Protect~ ono f tlie publ~ cc omes first
Arizona c~ tlzensd eserve competciit, q~ lal~ ficpdh ys~ ciansa nd phys~ clana ssstants
Optln~ arle source ut~ llzat~ oisn best reallzed through a streamlined process of I~ ccnsccre gulat~ on
Excellent rcg~ llat~ orneq ~~ lrexsc ellent staff
l'rogress 1s accelerated through collaborat~ onw ith others and tlie use of advanced technology
1, icensees w~ thh calth problen~ sw hich affect thelr pract~ ces hould be provlcled w~ thth e opportun~ tyf or
rehab~ htat~ ownh cncver posslblc
I\ soe # 1: l'romotion of public s;~ fi'ty through the examini~ tion of' compelling hcalthci~ re issnes, in
collaboration with liccnsecs, acaclcmic institutions, hcalthcarc associ;~ tions, state agency boards,
5tate nietlic;~ l boal- ds, :~ ntl other stakcholclers
' The Ar~ zona Med~ cal Board and the Arizona Regulatory Board of Physlclan Ass~ stants cont~ nually
str~ veto p~ oactivelye xplo~ ea reas influenc~ ngh ealthcare dellvery and publ~ cs afety. By c o n t ~ n ~ ~ ~ n g
eflbrts to partner with the I~ ccnsees, a cadem~ c~ nstltut~ onhse, alth care assoc~ at~ onrse, g ulatory boards
and othe~ g overnmental agencies, the Board w~ lpll ay an Integral part In address~ i~ isgs ues of ~ mportancc
to the general publ~ ci, n cluding partlclpat~ onI n statewide d~ sasterp lanning efforts, and mvolvcment In
other compclllng Issues wh~ chs ~ gnlficantlyim pact healthcare provlslon and regulation
lssr~ e# 2: Promote best practices through the education of'licensees, stakeholders, and the general public
By vlrtue of tlielr roles, the Arizona Med~ cal Board and tlie Arlzona Regulatory Board of Physlclan
Assistants are In a prllue posltlon to ldentlfy and address the regulatory and healthcare Issues that are
most often tlie subject of conf~~ slaon~ di debate anlong healthcare professionals, stakeholders, and the
general publlc. These Issues are becomlng more complex as the role of technology In healthcare
expands, and tlie use of allled health care providers In healthcare dellvery Increases. A var~ etyo f venues
will be utlllzed to educate heensees, stakeholders, and the general pubhc regarding substantive pollcy
statements developed, rules promulgated, and educat~ onaln iatenals prepared to address these issues.
issue # 3: Enhancement of licensing, regulatory, and information dissemination processes, as well as
increased capacity for performance measurement, through improved information technology and
other process improvements.
Through colii~ nentsp rovlded on Board custoliier satlsfactlon surveys, ~ t 1s clear that e- llcenslng and e-renewal
1s a scrv~ cen iuch dcslred by 11cense applicants and Ilcensees. A new ~ nlorniat~ osny stem,
scheduled for ~ mplementat~ oenar ly In fiscal year 2008, IS expected to iliake e- llcens~ nga nd e- renewal a
reallty. The new lnforlnatlon system IS also expected to strealmllne llcenslng arid regulatory processes by
lntegratlng filnctions that now luust be done manually by staff. Perfonnance measurement capaclty 1s
also expected to Improve, with new opportunrtres for automated reporting of key perfonnancc
~ ndlcators. As wrth any tra~ is~ t~ toon a new lnfoniiat~ on system, unantlclpated lmplementat~ on
cliallcnges are llkely to arlse during the first several months after the new system 1s In place. Dunng thrs
transition period, tlie agency's focus will be to rnaintaln current levels of perfomlance while effectively
address~ ngt hese ~ n~ plcmentatloinss ues Once any ~ mplcmentatlonI ssues are overcome, rt 1s expected
that the new lnfonnatton system wlll lead to ~ ncreascde fiiclency In Ilccnslng and regulatory processes
Another area that wlll be tlie focus of process Improvement cflorts 1s the cunent backlog of cases
awaltlng fonnal hearing. Although great progress has been made in reduclng the amount of tlme taken to
lnvcstlgate a complaint, 11 a case goes to fonnal heanng, may take a year or more belore the case IS
adjudicated Stratcgles for reduclng the back log of' cases currently awaltlng fonnal Iicarlng wlll be
aggresslvel y p~ rrsued
Iwue # 4: 1' 1- otectian of the public through the iclentification ant1 rehabilitation of impaired physicians and
physician assistants
The An~ onaM ed~ cal1 3oard's Mon~ toicdA ttercare P~ ogramis a coni~~ dentiparlo gram for the treatment
and rehabilltatron of tloctors of med~ c~ nancd pliysiclan assl\ tants who arc rmpalred by alcohol or drugs
7 . I he Board also hay the statutory authority to create a confiticntlal IShysiclan Ilcalth Program, slnillar to
111c I3oard'\ exlstlng Monitored Aftcicare I'rogram, for allopathlc physlclans and pliyslclan assistants
who Ilavc a medrcal, psycli~ atrlc, psychological, or behavioral health d~ sorder that lnay Impalr the
liccnsce's ablllty to practlcc safely. l'he Board ~ ntcntls to explore dlllerent methods of creatlng a
l'hyslclan Ilcalth I'rogram, lncludlng the posslb~ lrt~ cosfi ntcgratlng the PhysicIan Ilcaltli and Mon~ tored
Altercarc I'rogranis Into one proglam and collaborating w~ th other healthcare professtonal Iicenslng
boards to create a common prograln that could be used by all boards that monltor llcellsees with health
and/ or substallce abusc problems In conlLulctlon wlth thrs effort, the Board plans to filrther reline ~ t s
ablllty to collect and analyx statlst~ csp ertinent to thrs Ilccnsee population
lssrie # 5: Encourage continuous quality improvement through staff member clevelopment and performance
evaluation
In early 2007, Board staff members responded to an Ar~ zonaS tate Government Employee Survey wli~ ch
explored e~ nployeea tt~ tudesr cgard~ ngv arlous aspects of employment. The results of th~ su rvey were,
overall, very favorable for the Arizona Med~ cal Board as compared to statewide survey results,
lnd~ catlngb oard staff n~ embersw ere morc satisfied w~ thm ore aspects of then employment than state
employees In general. I- lowevcr, survey quest~ onsp erta~ nlngt o job tra~ n~ ng/ profess~ ondeavl elopment
opportunltles and perfomlance evaluatlon were rated lower by Board staff members, as conipared to the
responses of state e~ nployees In general. In an effort to address these Issues, the agency ~ ntends to
revlew ~ t s current pract~ ces pertalnlng to performance evaluatlon and staff tralnmg/ profess~ onaI
developlnent opportun~ tles, a nd ~ mplements trateg~ esto Improve agency perforn~ anceI n these areas.
Agency Goals:
Goal I: To Increase act~ v~ tledesv oted to address~ ngp ubl~ cs afety, healthcare and regulatory Issues of Importance
to llccnsees, stakeholders, and the general publ~ cth rough eollaborat~ onw ~ tho thers, pol~ cym ak~ ng, a nd
~ nlorniat~ odn~ ssen~ lnat~ on
Objective 1. I ( 2008- 2010): Increase t~ mesp ent addressing pubhc safety, healthcare or regulatory issues
through subcomm~ tteed ~ scuss~ oand adopt~ ono f relevant substant~ vep ol~ cys tatements and rules
I'erfbrmance Measures:
1.1.1 Number of' new Board subco~ n~ nitteeIhsr nied
1.1.2 Number of act~ veB oard subcomm~ ttees
I .1.3 Nuniber of substant~ vep ol~ cys tatements, guidelines, r~~ leosr , r ille revlslons adopted
Objective 1.2 ( 2008- 2010): Increase Board part~ cipat~ o11n1 interagency comni~ tteesp, rojects, task forces,
conferences and at other venues where publlc safety, healthcare or regulatory Issues are d~ scussed
Performance Measures:
1.2.1 Number of interagency comni~ tteesp, rojects, or task forces in which agency staff or
Board members partlc~ pate
o FY 06 actual: 4
o FY 07 estrmate: 4
o FY 07 actual: I0
o FY 08 extlrnclte: 1 I
o FY 09 estimate: 12
o FY I0 estlrnate: 13
1.2.2 Number of conferences attended by agency staff or Board members
o FY 06 trctmal: 5
o FY 07 e. stinzate: 3
o FY 07 actual. 5
o FY 08 estrrnnte: 6
o FY 09 esfinicrte 7
o FY I0 e.\ trrntite: 8
Objective 1.3 ( 2008- 2010): Increase the ava~ lab~ l~ 01t. y educat~ onal and regulatory ~ nfoni~ at~ toon
I~ ccnseess, takeholders, and the gencral publ~ c
Performance Measures:
1.3.1 Number of newsletters published
1.3.2 Number of ptlbl~ cs peak~ nge ngagements
1.3.3 Number of press releases, health aclv~ sor~ easn, d othe~ n ot~ ficat~ onpsu bl~ slmedo n the
Board webs~ teo r trailsm~ ttedt o licensees vla c- mail blasts
o FY 06 actual: new tnea.\ ure - rlo prlor year couizt
o FY 07 estlnzate: new nzeasure - no FY07 estlnlate
o FY 07 actual: 31
o FY 08 estzmate: 34
o FY 09 estimate: 3 7
o FY I0 e. stlmate: 40
Goal 2: 1' o llnprove e- rficlency of liccnsmg, regulatory, and ~ nfonnationd ~ ssernlnat~ opnro cesses
Objective 2.1 ( 2008): 1' 0 inalntaln prlor year pcrfommancc levels In liccnsc processlng durmg trans~ t~ oton
a I~ CW~ nfonnat~ osyns tem
Ohjective 2.1 ( 2009- 201 0): 7.0 improve upon prlor year perfomlance levels In l~ censep rocesslng
Performance Measures:
2.1 . I Average tlnme to approve an MD 11ccnse from rccc~ pot f appl~ cat~ on
o FY 06 actual: 36
o FY 07 estimate: new ~ nc~ su- r etl o ]-' YO7 e\ tlrlzrrlc
o F Y 07 rrclurd: 24
o F Y 08 cstrnlrrtc: 24
o I+' Y 09 e.\ tlmnte. 2.1
o FY I0 esllil~ rrte2. 2
2.1.2 Average tl~ neto approve a PA J~ censcfr om ~ ccclpot l appl~ cat~ on
o F Y 06 actual: 29
o FY 07 eslrmate: rlew rnea. sure - tlo FY07 ettz7notc1
o F Y 07 crcttlnl: 17
o F Y0 8 estl~ nate: 1 7
o FY 09 estzrntrte: 16
o F Y I U estltllrrte: 1.5
2.1.3 Average n~ umbcro f days to process an ~ nitlalm edlcal doctor appl~ cat~ ounp on rcce~ pt
of completed appllcat~ on( locket/ hutlgct ~ n(~[~\~ ri- c)
2.1.4 Average number of days to process a rnedlcal doctor renewal upon recelpt of
completed appllcatlon ( locked hucIget tne~ zsure)
o FY 06 actual: 1.2
o FY 07 estimate: 2
o FY 07 actual: 1.1
o FY 08 estimate: 2
o FY 09 estimate: 2
o FY 10 estinzate: 2
2.1.5 Average score of agency- wide customer service satisfaction surveys ( scale of
1 - 8) ( locked huclget nzeasure)
o FY 06 actual: 7.9
o FY 07 cstlmute: 7.8
o FY 07 actual: 7.9
o FY 08 estinlale: 7.5'
o FY 09 estlnlate: 7.5
o FY 10 estltilate: 7.5
Objective 2.2 ( 2008): To ma~ ntaln prlor year performance levels In compla~ nt invcstlgatlon and casc
resolut~ ond uring transition to a new ~ nfonnat~ oslyis tem
Objective 2.2 ( 2009- 2010): 1' 0 llnprove upon prlor year perfbmiance levels 111 coniplaint lnvestlgatlon and
case resolution
2.2.1 Average number of days to co~ iipletea niedlcal doctor ~ nvest~ gatlo( nlo ckecl buclget
n~ eczs~ ire)
o FY 06 actual: 201
o FY 07 estlnltrte: 180
o FY 07 actual: 119
o FY 08 estltt~ ate: 120
o FY 09 estunnte: 120
o FY 10 e. s/ rtirnte: 120
2.2.2 Average number of clays to complete a phys~ clana ss~ stan~ t nvestlgatlon( locked hzltiget
trlecls ure)
I Muthodology lor calc~~ latlnsga tlsl:~ ct~ osn~ rrvuyr es~ lltsw ill change bcg~ nn~ n1g- Y OS
0
2.2.3 Average number of days to resolve a ~ nedicald octor case ( locked hrrdget measure)
o FY 06 actual: 276
o FY 07 estimate : 220
o FY 07 actual: 179
o FY 08 estzmate: 180
o FY 09 e. szirnute: 180
o FY 10 estz17zate: I 80
2.2.3 Average number of days to resolve a physician assistant case ( locked budget measure)
o FY 06 rrcfual: 282
o FY 07 estzmnte: 240
o FY 07 f~ cturil: 150
o FY 08 estzmnte: 180
o FY 09 eslun~ lte: 180
o FY 10 estunnte: 180
2.2.4 Percent of open Invest~ gatlonsg reater than 6 months old ( M. D.)
o FY 05 nclual: 36%
o FY 07 esflmtlte: 35%
o FY 07 actual: 4%
o 17Y ( IS esfzincrfe: 5%
o FY 09 estzrnatc: 5%
o FY I 0 esizmnte: 5'%
2.2.5 I'ercent of' open ~ nvestlgat~ ongrse ater than 6 months old ( P. A.)
o FY 06 r~ ctual: 4 4%
o FY 07 estz~ nnte: 40%
o FY 07 actual: 7'%
o FY 08 e.~ ti1n( zfe: 5%
o FY 09 estztnote: 5'%
o FY 10 eytonate: 5%
2.2.6 Number of Med~ calD octor cases referred to fornx~ lh car~ ng( l ocked hurlget ~ nerrsure)
o FY 06 nct~ lnl: 5 7
o FY 07 e.~ tunnfe3: 5
o FY 07 actual: 3 7
o FY 08 estunate: 3 7
o 17Y 09 estzmnte: 3 7
o FY 10 e. sfzlrznle: 37
0l) jective 2.3 ( 2008): To malntaln prlor year perforniance levels In responding to publ~ cr ecords and other . -
publ~ c~ ~ ifonnat~ reoqnu ests dur~ ngtr ansltlon to a new ~ nfonnatlons ystem
Objective 2.3 ( 2009- 2010): To Improve upon prlor year perfon~~ anclev els In respondlng to pubhc
records and other publlc lnformatlon requests
Performance Measures:
2.3.1 Average number of days to respond to public records requests
o FY 06 actual: 5
o FY 07 estrmate: 7
o FY 07 actu~ zl: 4
o FY 08 eststrrnnte: 7
o FY 09 estlmate: 7
o FY 10 est~ nzate: 7
2.3.2 Average number of days to respond to e- malls rece~ vedth rough Quest~ ons@ azmd. gov
or Questlons@ azl> a. gov
o FY 06 actual: llew measure - no prior year count
o FY 07 estlmate: new measure - no FY 07 estlrntlte
o FY 07 actunl: 0.6
o FY 08 c. stlnlate: I
o FY 09 eslltnafe: I
o FY I0 estlmclte: l
Goal 3: 1o Increase profectlon of the publ~ cb y promoting rchab~ l~ tat~ oof'nl~ censcesw ho are ~ mpa~ rebdy alcohol
or dri~ gs, o r who have a medical, psych~ atr~ pcs, ycholog~ cal, o r behavioral health dlsorder that may Impair the
I~ censee'sa b~ l~ ttoy p ract~ ces afely
Objective 3.1 ( 2008- 2010): 3' 0 identify and monitor the rehabilitation of licensees w ~ t hal cohol or
othcl- substance abuse or dcpendency, or with a med~ cal, p sych~ atr~ cp, s ycliolog~ cal, o r behav~ oral
health d~ sordctrh at may llnpalr the I~ censee'sa b~ l~ ttoy p lactlce safely
I'erforrn; lncc Measures:
3.1.1 Number of MAP part~ clpantsw ho completed the program successfully
o FY ( I6 actual. irew iiren. czrl- c - 110 prior y e ~ c~ orzlt lt
o FY 07 e.\ trt?~ clte tlew rnetl. cure - 1 1 0 FY 07 c\ f~ rnnle
o FY 07 nctunl. 15
o FY ( IS estlinnte 16
o FY 09 cctltnnte 17
o I< Y 10 e.$ t~ lilnte IS
3.1.2 Number of part~ c~ panItns the MAP as of June 30
o FY 09 estlmate: 118
o FY 10 estlnrnte: 123
3.1.3 Number of Ilcensees being monmtored for medical, psychiatric, psychological, or
behav~ oral health Issues as of June 30, excluding MAP partic~ pants.
o FY 06 actual: 27
o FY 07 estlmate: new rneasure - no FY 07 estrlnate
o FY 07 nctual: 29
o FY 08 eslltnrlte: 31
o FY 09 estimate: 33
o FY l U estlmate: 35
Goal 4: To Incrcase train~ ngp, rofess~ onald evelopment, and pcrfonnance evaluation opportun~ t~ feosr Agency staff
Objective 4.1 ( 2008- 2010): Incrcasc the ava~ labil~ toyf profess~ onalg rowth, tra~ nlngo pportun~ t~ casn, d
updated job reference materials available to Board staff members
l'erlormance Measures:
4.1.1 Number of staff members who attended one or more Board- funded train~ ngss, e mmnars,
or conferences
o FY 06 octual: tzew tnecl.\ ure - 110 prlor year courzt
o FY 07 estlmnte: new mensure - no FY 07 estzlnate
o FY 07 nctutzl- 20
o FY 08 c.~ li~? i~ 2i2I ~'
o FY 09 e. stl~ nr~ te2: 4
o FY 10 estztncrtc: 26
4.1.2 lJcrcent of employees who agree that they recelve the tralnlng they need to do thelr job
well
o FY 06 actual: new tnensure - no prlor year count
o FY 07 e. ttltnnfe: new r n e ~ ~ ~- u nroe FY 07 estlrnnte
o FY 07 nctual: 54.5' 96
o FY US estuntlte: 58%
o FY 09 estrinnte: 60%
o FY 10 e. ct~ rnnte: 63'%
4.1.3 Pelcent of employees who belleve the Agency supports their part~ c~ patloIn tra~ nlng
opportun~ t~ teos mnlprovc lob skills
o FY 06 rrctunl new ~ ncasure- no prior year coz111t
o FY 07 esllmrrte: new ~ nerr~ u- re n o FY 07 estltnnte
o FY 07 aczunl: 37.1f%
o FY US estzniaie. 46%
o FY 09 estzinntc. 55'%
o FY 10 estjlnnte: 64%
4.1.4 I'ercent of employees who belleve the Agency supports the~ pr artlclpat~ onI n educat~ on , .
and profess~ onal development opportun~ t~ es
o FY 06 actual: new tnerrJure - no prrol, year count
o FY 07 estimate: new measure - no FY 07 estz~ nLzte
o FY 07 actual: 42.4%
o FY 08 estlnxate: 47%
o FY 09 esllmale: 53%
o FY 10 estimate: 59%
Objective 4.2 ( 2008- 201 0): Increase formal perfornlance evaluation activities
I'erformance Measures:
4.2.1 Number of staff members w~ tha wr~ ttenp erfomlance evaluation completed w i t h the
past year
o FY 06 actual: new nleasurc - nopt- lor year count
o FY 07 estzmate: new inea.\ urc - no FY 07 estiniate
o FY 07 actual: 0
o FY 08 estzmclte: 80%
o FY 09 eslllnate: 90' X
o FY IO e. stirnate: lOO'%
4.2.2 TJcrcent of c~ nployeesw ho agree that they prov~ de~ nputIn to perfornlance plann~ nga nd
evaluation
o FY 06 actual: new nrctlsul- e - / lo prior yeal- cout~ t
o FY 07 eslilnn/ e. tlew ~ nerr. szlre- 110 FY 07 c.\/ r~ nolc
o FY 07 acturrl: 55.2%
o FY OS c. stztrrcz/ e. 57' X
o FY 09 e. stzmate: 59%
o FY 10 cstiniote 61 %
Interim agendas can be obtained via the Internet at http: llwww. azleg. state. az. usllnterimCommittees. asp
ARIZONA STATE SENATE
INTERIM MEETING NOTICE
OPEN TO THE PUBLIC
SENATE HEALTH AND HOUSE HEALTH COMMITTEE OF REFERENCE
Date: Tuesday, November 6,2007
Time: 9: 30 A. M.
Place: SHR I
AGENDA
1. Call to Order
2. Opening Remarks
3. Sunset Review of the Board of Homeopathic Medical Examiners
Presentation by Auditor General
Response by Board of Homeopathic Medical Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
4. Sunset Review of the Regulatory Board of Physician Assistants
Presentation by Regulatory Board of Physician Assistants
Public Testimony
Discussion
Recommendations by the Committee of Reference
5. Sunset Review of the Board of Behavioral Health Examiners
Presentation by Board of Behavioral Health Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
6. Sunset Review of the Acupuncture Board of Examiners
Presentation by Acupuncture Board of Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
7. Sunset Review of the Board of Occupational Therapy Examiners
Presentation by Board of Occupational Therapy Examiners
Public Testimony
Discussion
Recommendations by the Committee of Reference
Page I of 2
8. Sunrise application of the Arizona Alliance of Non- Physician Surgical Assistants
Presentation by Arizona Alliance of Non- Physician Surgical Assistants
Public Testimony
Discussion
Recommendations by the Committee of Reference
9. Sunrise application of the Southern Arizona Behavioral Health Coalition
Presentation by Southern Arizona Behavioral Health Coalition
Public Testimony
Discussion
Recommendations by the Committee of Reference
10. Sunrise application of the Arizona Dental Association
Presentation by Arizona Dental Association
Public Testimony
Discussion
Recommendations by the Committee of Reference
1 1. Sunrise application of Radiology Practitioner Assistants
Presentation by Radiology Practitioner Assistants
Public Testimony
Discussion
Recommendations by the Committee of Reference
12. Adjourn
Members:
Senator Tom O'Halleran, Co- Chair
Senator Paula Aboud
Senator Amanda Aguirre
Senator Barbara Leff
Senator Thayer Verschoor
Representative Bob Stump, Co- Chair
Representative Nancy Barto
Representative David Bradley
Representative Linda Lopez
Representative Rick Murphy
Persons with a disability may request a reasonable accommodation such as a sign language interpreter, by contacting the
Senate Secretary's Office: ( 602) 926- 4231 ( voice). Requests should be made as early as possible to allow time to arrange the accommodation.
Page 2 of 2
ARIZONA STATE LEGISLATURE
Forty- eighth Legislature - First Regular Session
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
Minutes of Interim Meeting
Tuesday, November 6,2007
Senate Hearing Room 1 - 9: 30 a. m.
Chairman O'Halleran called the meeting to order at 9: 32 a. m. and attendance was noted by the
secretary.
Members Present
Senator Tom O'Halleran, Co- Chair Representative Bob Stump, Co- Chair
Senator Amanda Aguirre Representative Nancy Barto
Senator Barbara Leff Representative David Bradley
Senator Thayer Verschoor Representative Linda Lopez
Representative Rick Murphy
Members Absent
Senator Paula Aboud
Speakers Present
Kim Hildebrand, Performance Audit Manager, Office of the Auditor General
Todd Rowe, Board of Homeopathic Medical Examiners
Christine Springer, Board of Homeopathic Medical Examiners
Jerry Weinsheink, representing himself
Marianne Cherney, representing herself
Neil Garfield, Association for Public Access to Medicine
Barney Nugent, representing himself
Linda Heming, CHOICE
Iris Bell, Doctor, Arizona Homeopathic and Integrative Medical Association
Cliff Heinrich, Doctor, representing himself
Kathleen Fry, Doctor, representing herself
Denise Nugent, representing herself
Lee Balcunin, Attorney, representing herself
Bruce Shelton, Doctor, Arizona Homeopathic and Integrative Medical Association
Amanya Jacobs, Director of Evolution of Self School of Homeopathy
Cindy Zukern~ anr, e presenting herself
Shelly Malone, representing herself
Stan Klusky, representing himself
Gladys Conroy, representing herself
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
November 6,2007
Joan Reynolds, Regulatory Board of Physician Assistants
Debra Rinaudo, Board of Behavioral Health Examiners
Stuart Goodman, Board of Behavioral Health Examiners
Bev Hermon, BH Consulting
Richard Poppy, Therapeutic Practitioners Alliance of Arizona ( The Alliance)
Rachael Hopkins, representing herself
Ronald Anton, representing himself
Josephine Sbrocca, representing herself
Cedric Davis, Board of Behavioral Health Examiners
Della Estrada, Arizona Acupuncture Board of Examiners
Kathryn Babits, Arizona State Board of Occupational Therapy Examiners
Eugene Smith, Arizona Alliance of Non- Physician Surgical Assistants
Susie Cannata, Arizona Alliance of Non- Physician Surgical Assistants
Rory Hays, Arizona Nurses' Association
Scott Leckie, Radiology Practitioner Assistants
Jane Van Valkenburg, Certification Board for Radiology Practitioner Assistants ( CBRPA)
Mary Connell, M. D., representing herself
Christine Lung, American Society of Radiologic Technologists ( ASRT)
John Gray, Grand Canyon University
Joyce Geyser, Arizona Radiological Society
James Abraham, National Society of Radiology Practitioner Assistants
Heather Owens, Senate Health Analyst
Aubrey Godwin, Medical Radiologic Technology Board of Examiners ( MRTBE)
Teresa Rodgers, Behavioral Health Coalition of Southern Arizona
David Giles, Behavioral Health Coalition of Southern Arizona
Holly Baumann, Southwest Autism Research and Resource Center
John MacDonald, Arizona Dental Association ( ADA)
Rick Murray, Arizona Dental Association
Anita Elliott, Arizona Dental Association
Nicole Laslavic, Arizona State Dental Hygienists' Association
Janet Midkiff, Arizona State Dental Hygienists' Association
Nicole Albo, Arizona Dental Assistants' Association
Alisa Feugate, Arizona Dental Hygienists' Association
OPENING REMARKS
Chairman O'Halleran welcomed everyone and requested that the speakers keep their comments
as brief as possible, as the committee members are well- versed in the issues to be discussed
today.
Presentation by Auditor General
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
2 November 6,2007
Chairman O'Halleran reconvened the committee at 12: 07 p. m.; all members were present except
Senator Aboud.
SUNSET REVIEW OF THE REGULATORY BOARD OF PHYSICIAN ASSISTANTS
Presentation by Regulatory Board of Phvsieian Assistants
Joan Reynolds, Regulatory Board of Physician Assistants, addressed the committee to describe
the Board composition, the number of Physician Assistants in Arizona, and the two training
programs in Arizona. She stated that the Board exists to protect Arizonans' health and to
monitor, license, and regulate physician assistants.
liecommendations by the Committee of Reference
Cochairman Stump moved that the Senate and House Health Committee of
Reference recommend the continuation of the Regulatory Board of Physician
Assistants for ten years. The motion carried by a voice vote.
/
Presentation by Board of Behavioral Health Examiners
Debra Rinaudo, Board of Behavioral Health Examine
the Board was originally established to offer a
disciplines:
1. marriage and family therapy,
2. professional counseling,
3. social work, and
4. substance abuse counseling.
She stated that the Board is responsible ing the public by ensuring that certified
professionals met minimum nd training, and investigating and taking
action on complaints. In licensure of psychotherapy was added to its
responsibilities. She stated t with certification into licensed status was
allowed.
Since 2004, due to has been a dramatic increase in complaints and the Board has
a complaints the complaints in order to address the most serious quickly.
what happens to the less serious complaints; Ms. Rinaudo replied that all are
those not dealing with client harm are deemed less serious. Ms. Rinaudo
investigators will be hired in FY 2008 which will allow the Board to
/ MS. Rinaudo discussed the two- year provisional license granted those who are licensed in other
states and who must work under direct supervision before they can obtain a full license. She
described the confidential impaired professionals program designed to encourage early self-
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
November 6,2007
Janet Midkiff, Arizona State Dental Hygienists' Association, stated that they support the concept
of training commuility people to be dental health representatives, and that the definition of the
COMR does make sense to them. She stated concerns about the education, licensing, or
certification of the people who fill the COHR positions. She said that her organization would
like to work with the ADA and to be a part of the access to care issue.
Nicole Albo, Arizona Dental Assistants' Association, stated her support for the COHR program
provided that the positions will be filled by certified dental assistants with additional training
components. She stated that she has been working with the ADA to develop a curriculum for
expanded COHR training.
Representative Murphy asked if the committee could approve the concept but not specify the
details, letting the Legislative process do that. Mr. Murray stated that the supervision issue is the
biggest concern.
Alisa Feugate, Arizona Dental Hygienists' Association, stated that she supports the concept of
the COHR but is neutral on the application at this time due to concerns about supervision and
scope of practice.
Recommendations bv the Committee of Reference
Cochairman Stump moved that the Senate and House Health Committee of
lieference recommend that the Legislature amend the statutes of the Arizona Board
of Dental Examiners to create a new certified professional, the Community Oral
Health Representative, to coordinate community- based oral health promotion and
provide specified dental care under the general supervision of a licensed dentist.
The motion carried by a voice vote.
Without objection, the meeting adjourned at 4: 15 p. m.
Jane Dooley, Committee Secretary
November 6,2007
( Original minutes, attachments and audio on file in the Office of the Chief Clerk; video archives
available at http:// www. azleg.~ ov/)
SENATE HEALTH AND HOUSE HEALTH
COMMITTEE OF REFERENCE
November 6,2007