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Date: October 23, 1996
Senate Health Committee ofReference &
House Health Committee ofReference
HEALTH COMMITTEE OFREFERENCE
REPORT ON THE BOARD OF
RESPIRATORY CARE EXAMINERS
The Board ofRespiratory Care Examiners be
continuedfor ten years.
To: JOINT LEGISLATIVE AUDITCOMMIITEE
Patricia Noland, Co-Chair
Sue Grace, Co-Chair
Janice,Brewer
/
James Henderson
Pursuant to Title 41, Chapter 27, Arizona Revised Statutes, the Committee ofReference, after
perfonning a sunset review and conducting a public hearing, recommends the following:
Don Aldridge ' .
~~r~·=------'::::::~~:::J...:::01:..L...o)~_
_______~ LS~~~~
s~n~ e~~z;;t'z~
David Petersen Lou-Ann Preble
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COMMITTEE OF REFERENCE REPORT
ON THE
BOARD OF RESPIRATORY CARE EXAMINERS
I. BACKGROUND
Pursuant to section 41-2953, Arizona Revised Statutes, the Joint Legislative
Audit Committee (JLAC) assigned the sunset review of the Board of Respiratory Care
Examiners to the Committee of Reference comprised of members of the Senate Health
Committee and the House of Representatives Health Committee. A performance audit
of the Board was conducted by the Health Committee of Reference and is included
(Attachment ).
II. COMMITTEE SUNSET REVIEW PROCEDURE
The Committee of Reference held one public hearing on Wednesday October
23, 1996, to consider the sunset report and receive public testimony regarding the
Board of Respiratory Care Examiners. The Committee heard testimony form Ms. Mary
Hauf Martin, Executive Director of the Board of Respiratory Care Examiners, David
Feuerherd, Program Director, American Lung Association, and John Coleman, RCP
and Member of the Board.
Ms. Hauf Martin testified:
• that the Board compares favorably to similar boards as indicated by an
independent study performed by the Auditor General;
• that the Board is adapting to a changing health care delivery system
environment;
• that a majority of the Board is not made up of practitioners and takes its
responsibility to protect the public health very seriously;
• that there is a gradual increase in the number of complaints against practitioners
and the biggest problem is substance abuse by practitioners. She noted that
facilities routinely perform preemployment and "for cause" drug screens.
Mr. Feuerherd expressed his support for continuing the Board.
Mr. Coleman indicated that the issue of benefits being cut back in the managed
health care environment requires that home care companies adapt their contracts with
managed care health plans.
Minutes of the public hearing held on October 23, 1996, are attached.
III. COMMITTEE RECOMMENDATIONS
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The Health Committee of Reference recommends that the Board of Respiratory
Care Examiners be continued for ten years.
IV. STATUTORY REPORT PURSUANT TO SECTION 41-2954 (F), ARS
1. Identification of the Problem or the Needs that the Board is Intended to
Address.
The Board of Respiratory Care Examiners was established in 1990 to
regulate the practice of respiratory care. The Board's primary purpose is to
protect the public from unauthorized and unqualified practice of respiratory care
and from unprofessional conduct by persons licensed to practice respiratory
care. The Board consists of 3 practitioners, 1 medical doctor, 1 hospital
administrator, and 2 public members all of which are appointed by the governor.
2. A Statement, to the Extent Practicable, in Quantitative and Qualitative
Terms, of the Objectives of Such Board and Its Anticipated
Accomplishments.
The objectives of the Board of Respiratory Care Examiners are to process
respiratory care license applications and review and adjudicate complaints
against licensees. In addition, Board subcommittees are established to work on
subjects such as practice issues and rule drafting. The Board also is to mandate
continuing education requirements and maintain minimum standards of
competence for those who practice respiratory care.
3. Identification of Any Other Boards Having Similar, Conflicting or
Duplicating Objectives.
The Board of Respiratory Care Examiners has no other boards, agencies,
or councils with conflicting or duplicating objectives.
4. Assessment of the Consequences of Eliminating the Board or of
Consolidating it with Another Board.
Regulation of respiratory care practitioners is necessary for the protection
of the public health, safety and welfare. The need for control, guidance,
intervention, monitoring and supervision of practitioners is well established.
Regulatory oversight ensures that practitioners are continuing their educations. In
addition, the Board must ensure that a practitioner who enters the homes of
patients, and care for and evaluate those patients, can effectively respond to their
needs.
V. ATTACHMENTS
A. Cover Letter
B. Meeting Notice
C. Performance Audit
D. Minutes of Committee of Reference Meeting
E. Attendance List
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COVER LETTER
(Section A)
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J\rt:;oltu ~tnt£ IfcBtslnturc
1700 IDrst Wnsryington
lff~ocnix, J\rizona 85007
June 13, 1996
Ms. Meryl Salit
Board ofRespiratory Care Examiners
1400 West Washington
Suite 200
Phoenix, AZ 85007
Dear Ms. Salit:
The sunset review process prescribed in Title 41, Chapter 27, Arizona Revised Statutes,
provides a system for the Legislature to evaluate the need to continue the existence of state agencies.
Under the sunset review process, an agency is reviewed by a legislative committee of reference.
Upon completion ofthe sunset review, the committee of reference recommends to continue, revise,
consolidate or terminate the agency.
The Joint Legislative Audit Committee (JLAC) has assigned the sunset review ofthe Board
ofRespiratory Care Examiners to the Committee ofReference comprised of members ofthe Senate
Health Committee and the House ofRepresentatives Health Committee.
ARS section 41-2954 requires the Committee of Reference to consider certain factors in
deciding whether to recommend continuance or termination of an agency. Please provide your
response to those factors as provided below:
1. The objective and purpose in establishing the Board.
2. The effectiveness with which the Board has met its objective and purpose and the
efficiency with which it has operated.
3. The extent to which the Board has operated within the public interest.
4. The extent to which rules adopted by the Board are consistent with the legislative mandate.
5. The extent to which the Board has encouraged input from the public before adopting its
rules and the extent to which it has informed the public as to its actions and their expected impact on
the public.
Thank you for your cooperation. Please contact me if you have any questions.
9. The extent to which changes are necessary in the laws ofthe Board to adequately comply
with the factors listed in this subsection.
10. The extent to which the termination of the Board would significantly harm the public
health, safety or welfare.
11. The extent to which the level of regulation exercised by the Board is appropriate and
whether less or more stringent levels of regulation would be appropriate.
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Sue Gerard
Co-Chair
Health Committee ofReference
Sincerely,
12. The extent to which the Board has used private contractors in the performances of its
duties and how effective use of private contractors could be accomplished.
8. The extent to which the Board has addressed deficiencies in its enabling statutes which
prevent it from fulfilling their statutory mandate.
Board ofRespiratory Care Examiners
June 13, 1996
Page 2
6. The extent to which the Board has been able to investigate and resolve complaints that are
within its jurisdiction.
7. The extent to which the Attorney General or any other applicable agency of state
government has the authority to prosecute actions under the enabling legislation.
In addition to responding to the factors in ARS section 41-2954, please provide the committee
of reference with copies of minutes from your meetings during fiscal years 1994 through 1996, and
an annual report, and respond to the attached questionnaire by July 30, 1996 so that we may proceed
with the sunset review and schedule the required public hearing.
AD/SG/cmh
Attachment
cc: Mary Hauf-Martin
Senator Ann Day
Co-Chair
Health Committee of Reference
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BOARD OF RESPIRATORY CARE EXAMINERS
Please respond to the following questionnaire:
1. Describe the role and function of the board including major activities/projects,
accomplishments and obstacles to success.
2. Provide financial data such as number offull time employees, expenditures and
revenues and fee structure.
3. Provide infonnation regarding board composition including number ofmembers,
number of public members and method of appointment.
4. Discuss the need for licensure including potential harm to the public and
examples of complaints.
5. Provide licensing data including number oflicenses by category, number of out
of state licenses, number of limited or restricted licenses and reciprocity
agreements.
6. Provide examination data such as use of a national exam, use of oral and
practical exams and weighing of exams.
7. Provide disciplinary data, including the number of complaints (by type), number
dismissed (by reason), number of hearings held and number of actions
(probations, suspensions and revocations).
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MEETING NOTICE
(Section B)
SUNSET REVIEWS OF THE
II. AZ Council on Arthritis & Musculoskeletal Diseases
MEETING NOTICE
BOARD OF RESPIRATORY CARE EXAMINERS
Representative Gerard, Co-chair
Representative Aldridge
Representative Preble
Representative Foster
Representative Horton
AGENDA
Wednesday, October 23, 1996
9:00 a.m. - Noon
Senate Hearing Room 2
JOINT LEGISLATIVE COMMITTEE FOR THE ARIZONA HEALTH
CARE COST CONTAINMENT SYSTEM (AHCCCS)
ARIZONA STATE LEGISLATURE
OPEN TO THE PUBLIC
SENATE AND HOUSE HEALTH COMMITTEES OF REFERENCE
ARIZONA COUNCIL ON ARTHRITIS & MUSCULOSKELETAL DISEASES
KB/ak
-TItle II of the Americans With Disabilities Act prohibits the Arizona Senate from discriminating on the basis of disability in the
provision of its services and public meetings. Individuals with disabilities may request reasonable acconwnodations, such as
interpreters or ahernative formats, by contacting the Senate Secretary's Office at (602) 642-4231 (voice) as soon as possible.
Please be specific about the agenda item in which you are interested and for which you are requesting an accommodation. The
Senate may not be able to provide certain accommodations prior to the meeting unless they are requested a reasonable time in
advance of the meeting. This agenda will be made available in an ahernative format on request.
MEMBERS:
Senator DayI Co-chair
Senator Brewer
Senator Petersen
Senator Henderson
Senator Kennedy
TIME:
DATE:
PLACE:
III. Joint Legislative Committee for AHCCCS
I. Board of Respiratory Care Examiners
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PERFORMANCE AUDIT
(Section C)
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Board was created:
Dear Co-Chairs and Members of the Committee of Reference:
Mary HaulManin
Executive Director
Dee Doyle
Administrative Assistant
Telephone No. (602) 542-5995
Fax No. (602) 542-5900
State ofArizona
Board ofRespiratory Care Examiners
1400 W Washington, Suite 200
Phoenix, Arizona 85007
Honorable Ann Day
Honorable Sue Gerard
Co-Chairs
Health committee of Reference
Arizona State Legislature
1700 West Washington
Phoenix, Arizona 85007
and welfare and should be SUbject to regUlation and control by
protect the pUblic from unauthorized and unqualified practice of
respiratory care and from unprofessional conduct by persons
the board of respiratory care examiners in the pUblic interest to
respiratory care in this state affects the pUblic health, safety
"The legislature finds and declares that the practice of
have this opportunity to provide information in response to your
is evident in the Legislative intent clause provided at the time the
letter and que~tionnaire dated June 13, 1996, regarding the Board's
The Arizona Board of Respiratory Care Examiners is pleased to
sunset review.
In response to the questions posed by A.R.B. 541-2954:
I. The objective and purpose in establishing the Board.
The Board was created by the Thirty-ninth Legislature, Second
Regular session, 1990 (A.R.S. §32-3501 et seg.). The Board's purpose
July 30, 1996
Meryl S. SaUl, R.C.P., Chair
Kit Mehnens, Vice-Chair
Sheilah N. Bowen, R.C.P.
John E. Coleman, R. C.P.
Mary Lynn Kelly
Gerald Schwanzberg, M.D.
Karen L Staudenmier
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licensed to practice respiratory care."
2. Tbe effectiveness witil wbicb tile Board bas met: it:s object:ive
and purpose and tile efficiency witil whicb it: bas operat:ed.
The Board has been meeting its overall objective to protect the
pUblic health, while processing license applications and complaints
against licensees in a fair and expedient manner. A review of the
recent independent audit of all health regulatory boards, released by
the Auditor General in December 1995, reveals a very favorable
comparison between the Board and other, similar entities. While the
initial estimate (in 1990, during the legislative enactment) was that
the Board would have regulatory oversight of approximately 1,400
Respiratory Care Practitioners (RCP), the number is closer to 4,000.
This number does not include the many, and widely fluctuating number,
of Temporary Licensees under the Board's jurisdiction. The Board
issues Temporary Licenses, to qualified persons, 24 hours after the
receipt of a complete license application. Currently, from the time a
complaint against an RCP is received, it takes 60 days, on average,
for final Board action to occur. 26% (73 out of 280) of complaints
have resulted in disciplinary action, while 34% (96 out of 280)
complaints resulted in a warning being given to a licensee (this
warning is called a Letter of Concern.)
The Board makes a resolute effort to receive pUblic input on its
activities by providing an opportunity for the pUblic to speak at
every monthly Board meeting. The Board has established working
subcommittees, with a large percentage of licensees participating, on
sUbjects such as scope of practice issues and rule drafting. The
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Board staff makes a concerted effort to provide easy access to all
pUblic information to Arizona citizens.
3. The extent: t:o which 'the Board has operat:ed wit:bin 'the public
int:erest:.
The Board of Respiratory Care Examiners has an ongoing commitment
to operating in the pUblic interest. The Legislature established the
Board with an excellent blend of membership: 3 practitioners, 1
medical doctor, 1 hospital administrator, and 2 pUblic members.
Because a majority of the Board is not made up of practitioners, the
pUblic is consistently well served. The 3 practitioner members serve
a very important, and valuable, role in providing expertise on the
complicated issues involved in the practice of respiratory care.
Board meetings are well attended by the pUblic, health care facilities
and interested licensees. The licensed pUblic is treated fairly and
expediently by the Board's administrative process. Allegations against
licensees that prove to be without merit are dismissed; and when the
Board finds that a licensee has engaged in unprofessional conduct, it
results in discipline fitting the particular level of seriousness of
the offense. The Board periodically reviews its disciplinary history
in an effort to be consistent and fair in its deliberations and
decisions.
4. The extent to which rules and regulations promulgat:ed by 'the
Board are consistent: wit:h the legislative mandat:e.
The only rules and regulations promulgated by the agency have
been the administrative rules necessary to administer the enacting
legislation.
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s. The erten1: 1:0 which t:he Board has encouraged inpu1: from t:he
public before promulga1:ing i 1:s rules and regula1:ions and t:he
erten1: 1:0 which i 1: has informed t:he public as 1:0 i 1:s ac1:ions
and t:heir expec1:ed impact: on t:he public.
During the development of the Board's administrative rules, a
Rules Committee was established. The Rules Committee met for many
months. Representatives from every segment of the licensed
population, were on the Committee, along with a representative of the
state Society for Respiratory Care and pUblic members. Every
reasonable and practicable recommendation by members of the Committee
was incorporated into the rules package. The proposed rules were so
well accepted that during the required comment period, and oral
hearing, there was no additional input to the Board.
6. The extent to which t:he Board has been able to investiga1:e
and resolve complaints wit:hin its jurisdiction.
The Board is committed to fair and expedient resolution of
complaints. Due to the very large number of licensees, and the small
staff, the Board has had to place special emphasis on the aggressive
pursuit of serious complaints. The Legislature responded to the
Board's needs and established an FTE, in fiscal year 1997, to
accommodate the Board's need for fair and expedient determination of
jurisdiction, investigation and resolution of complaints. until now,
the Board had been managing, but had been using contract employees on
a part-time basis. Being able to utilize in-house staff will provide
stability and allow the Board to have better, consistent, and more
frequent, state-wide inspections; and more constant oversight of the
Board's probationary licensees.
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(* Individuals who held Temporary licenses, but failed to or
never met criteria for licensure)
Total number of license denials 18
Total number of complaints
1992 30
1993 74
1994 52
1995 84
1996 (six months only) -i.Q
Total 280
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Board Statistics
Total number of licensees:
Total RCP licenses issued
Current active RCP licenses
Inactive RCP Licenses (Expired)
CUrrent Temporary Licenses
Total Temporary Licenses expired
Letters of Concern
5
4,056
3,805
251
124
662
96
*
[Note: please see attached Exhibit A for a full summary of
Board activity.]
Disciplinary Actions:
Decrees of Censure
Probation
Board Ordered
Stipulated
Disciplinary
Non-Disciplinary
Suspensions
Surrendered license
Revocations
Total Disciplinary Actions
Cases dismissed
Cases referred to another agency
6
17
2
27
5
2
1
ll.
73
35
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7. Phe ertent to which the Attorney General., or any other
applicable agency of state government has the authority to
prosecute actions under enabling legislation.
The Attorney General and the county attorneys all have authority
under the Board's enabling statutes to prosecute unlawful actions.
Depending on the type of unlawful act that is committed, the Board
contacts the appropriate agency.
8. Phe extent to which the Board has addressed deficiencies in
its enabling statutes which prevent it from fulfilling its
statutory mandates.
In 1995, the Board attempted to have a bill passed that would
have "cleaned up" the enabling statutes. All the changes recommended
by the Board were simple things; i.e. technical, language and clarity
changes. Unfortunately, the bill was amended in such a way as to be
detrimental to the pUblic health. The amendment language was so
harmful to the pUblic that the state Society for Respiratory Care
urged the Board to allow the bill to fail, rather than accept the
amendment language. In the end, that is exactly what happened. The
legislative sponsor asked the Board for input. The Board asked the
bill's sponsor to allow the bill to die; and it did.
9. Phe ertent to which changes are necessary in the laws of the
Board to adequately comply with the factors in the Sunset
Law.
The Board can continue to operate as it has since its inception.
The technical, language and clarity changes proposed by the Board in
1995 would be helpful, but are not necessary at this time.
The Board would also propose that the Legislature allow the Board
to study the situation regarding Temporary Licensees. While the
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original intent was to allow students to receive Temporary Licenses
while they waited to take the credentialling exam (Note: by law,
Temporary Licensees must only practice under the direct supervision of
a licensed RCP or licensed physician), the current statutory language
provides for a Temporary License to be issued to all qualified persons
who apply. The Board could report back to the Legislature in the 1998
Legislative Session with proposed statutory changes.
~O. The ertent to which the termination of the Board would
significantly harm the public health, safety and welfare.
Regulation of RCPs is necessary for the protection of the public
health, safety and welfare. The need for the control, guidance,
intervention, monitoring and supervision of RCPs is well established.
Forty-two states (and the District of Columbia and Puerto Rico) have
laws regulating the practice of RCPs. RCP's are trained to use hightechnology
medical equipment and perform procedures which may strongly
affect the health, welfare and safety of their patients. Respiratory
care often calls for the use of complex medical equipment such as
mechanical ventilators, which requires special training and on-going
education regarding the new technologies upon which the medical
industry will increasingly depend. Regulatory oversight ensures that
RCPs are continuing their educations. RCPs currently provide services
in settings covering the full continuum of health care -- from
hospitals to skilled nursing facilities to home health care. As RCPs
are following their patients into the community, a strong licensure
and enforcement act is especially critical. The Board must ensure
that RCP who enters the homes of patients, and care for and evaluate
those patients, can effectively respond to their needs.
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~~ • The exten't 'to which 'the level of regula'tion eJCercised by 'the
Board is appropria'te and whe'ther less or more s'tringen't
levels of regula'tion would be appropria'te.
In the Board's enabling statutes, the legislative intent clause
makes it clear that:
liThe legislature also recognizes that the practice of respiratory
care is a dynamic and changing art and science which is
continually evolving to include new developments and more
sophisticated techniques in patient care, thus creating a need
for continuing education and maintenance of minimum standards of
competence for those who practice this area."
liThe intent of the legislature in this act is to provide clear
legal authority for functions and procedures which have common
acceptance and usage. In this act, the legislature also intends
to recognize the existence of overlapping functions between
physicians, registered nurses, physical and occupational
therapists, respiratory care practitioners and other licensed
health care personnel and to continue to allow appropriate
sharing of functions among the various health care professions."
Therefore, the Board has endeavored to be strong, yet flexible,
in exercising its regulatory responsibilities. Reps are, by training,
adaptable to the evolving health care environments and have
historically worked collaboratively with interdisciplinary health care
teams. The Board has made every effort to find the appropriate
balance between oversight and interference.
~2 • The extent to which 'the Board has used private contractors
in the performance of its duties and how effective use of
the private contractors could be accomplished.
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Due to the small size of the Board's staff, the only current use
of private companies is in the area of court reporting for
disciplinary hearings. This is a necessary utilization of a private
company, because when a licensee appeals a Board decision (as all
licensees are entitled to do), a transcript must be available for the
appeal process.
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In response to the survey entitled "BOARD OF RESPIRATORY CARE
EXAMINERS·:
~ • Describe tile role and function of tile board including major
activities/projects, accomplishments and obstacles to success.
As stated above, the Board's function is to protect the public
health while fairly and expediently processing license applications
and complaints against licensees. In the process of carrying out
these functions, the Board has participated in various activities.
Some of these activities have included the obligation of the Board to
define the scope of practice of the Respiratory Care Practitioner.
One special project which has been undertaken is the organization
of a subcommittee to address the fast-growing medical specialty for
the diagnosis and treatment of sleep disorders. The role of the RCP
is essential to the field, and it has been necessary to determine the
relationship of other non-licensed providers who are employed in this
field. A multi-disciplinary committee was set up which included two
practitioner members of the Board, one pUblic member, a Board
Certified sleep physician, and two certified polysomnographic
technicians who supervise the sleep disorder centers at major
community hospitals. A recommendation for the definition of practice
by the disciplines in the diagnosis and treatment of sleep disorders
was made by the subcommittee, and is now being reviewed by the
Attorney General's office.
The Executive Director and Chair of the Board frequently speak at
programs for the continuing education of the RCPs. These
presentations serve to inform the licensed pUblic about the law and
about their responsibilities in servicing and protecting the public
health. The Board also uses these opportunities to give the licensees
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instructions on how to fulfill their obligations as licensees, while
explaining the functions of the Board and familiarizing the licensees
on its operations.
The Board has also been involved in contracting with the National
Board of Respiratory Care (NBRC) national disciplinary data base.
Participation in this database will allow the Board access to
disciplinary information about RCPs throughout the nation. This
information will be valuable in the issuance of licenses to new
residents, and in conducting investigations. Annually, a
representative of the Board meets with the NBRC and representatives
from respiratory boards from allover the country. This has allowed
the Board to give input in the development of the database, and make
recommendations to the NBRC.
Obstacles to the success of the Board may include only the
constraint of limited staff to explore the numerous opportunities
available to the Board to further its mission.
2. Provide financial data such as number of full time employees,
expenditures and revenues and fee structure.
FISCAL YEAR 1995-1996 FISCAL YEAR 1996-1997
(Projected)
FTE's
Expenditure's
BUdget
3
$164,000
$166,000
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4
$165,700
$165,700
PEES
Fiscal Year
1994 & 1995 Combined
Fiscal Years
1996 & 1997 Combined
Projected
Application
Foreign Application
Initial license
Renewal
Extension to Temporary
License Verification
Duplicate License
Purchase RCP List
Insufficient funds
1994 & 1995
$95,600 $110,000
$600 $900
$48,555 $68,000
$121,000 $178,500
N/A $8,750
N/A $3,400
$80 $100
$300 $625
$360 $725
---------- ---------
$266,595 $371,000
90% $330,900
yearly avg. $166,950
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3. Provide informa'tion regarding board composi'tion inc~uding number
of members, number of pub~ic members and met:bod of appoin'tmen't.
As stated above, the Legislature established the Board with an
excellent blend of membership: 3 practitioners, 1 medical doctor, 1
hospital administrator, and 2 pUblic members. Board members are
appointed by the Governor to staggered 3 year terms. No individual
may serve more than 2 consecutive terms.
4. Discuss t:be need for ~icensure including po'ten'tial barm 'to t:be
public and examples of comp~ain'ts.
A well-known example of the importance of RCPs can be found in
the actor Christopher Reeve who suffered a tragic accident that left
him paralyzed. * (Note: Mr. Reeves lives in Virginia, which licenses
RCPs. See footnote for source.) Reeves required around the clock
care by an RCP while he was hospitalized (for nearly five weeks)
following the accident because he could not breathe for himself at
all, and then again for several months in a rehabilitation center.
Now that he has been able to go home, he uses a portable ventilator
when away from home, which is housed in the back of his wheelchair.
According to Reeves, "Really, (with this) what you have is mobile life
support," adding that ventilator technology in the past few years have
been "a remarkable achievement" because it allows paralyzed persons to
do all kinds of things that otherwise wouldn't be possible. "I'm
trying to do everything I can to remind myself I'm a person, not a
patient" says Reeves. Reeve's RCP started out with home care visits
twice a week, but now only it's only twice a month. Reeve says he
only agreed to work with his RCP for "as long as his services were
necessary." At home, Reeves has two ventilators and his RCP makes
sure that all of his equipment is functioning properly. He calls his
14
RCP his ·terrific therapist, who comes to my house and pushes me and
challenges me. H Reeve says of his RCP: ·We'll go at the pace that we
can go, and the partnership is the most important aspect of it. It
all has to fit together in a plan, where the patient and the therapist
work together, first to overcome the fearful aspects of being on a
vent, and then to push the patient -- but not too hard -- to find a
comfortable quality of life level. H
RCPs are on duty in hospitals seven days a week, 24 hours a day.
They work in skilled nursing facilities and, more and more, in the
home. In order to protect the pUblic health, the Board must ensure
that only individuals with the education and skills necessary to
provide respiratory treatments and evaluations of patients are
permitted to practice in Arizona. We have an ever-increasing elderly
population who are particularly at risk of respiratory disease. The
Board must ensure that RCPs have the necessary abilities to operate
technically advanced equipment and work with health care teams to
ensure quality patient care and cost containment. In addition,
because more and more RCPs are going out into the community, into
people's homes, that the Board ensure that individuals with histories
of criminal activity or illegal drug use are carefully screened to
protect the pUblic.
with the advent of managed care, many patients are being released
from the hospital in a condition that in the past would have required
them to stay in the hospital for treatment. It is important that we
have qualified personnel to care for these people after their
discharge from the hospital. Licensing can only assure that this
qualified care will continue.
[* Source: AARC (American Association for Respiratory Care) Times,
June 1996, pages 34,35,36,37,38,71]
15
Here are some examples of cases over the last few years:
EXAMPLE 1: License denial for cause (felony conviction on record)
Mark S. Goldstone
Mr. Goldstone applied for a license on October 3, 1995. He
received a Temporary license, and an Extension, valid from October 4,
1995 through October 5, 1996. He passed the CRTT exam in March 1996.
On his application, Mr. Goldstone answered yes to Question 19 by
attaching copies of court documents. He wrote a letter stating that
on January 1, 1993 and March 10, 1993 he was found driving without a
license, or driving while his license was suspended in Massachusetts.
He stated (and documents confirm) that all fines were paid, time took
its course and his license was reinstated. He stated that on January
8, 1993 he was found "uttering a forged instrument." His explanation
was that "it was a joke that a friend of mine and I got carried away
with, and the other party did not take it lightly. We all make stupid
mistakes. I got a $50 fine that was paid and I did 2 years of
probation (unsupervised) that ended on April 28, 1995."
In the course of the normal staff review of this license
application, staff determined that Mr. Goldstone's offense of
"uttering a forged instrument" is a felony. Staff wrote to Mr.
Goldstone informing him that he was, and would be, ineligible to
receive a permanent license while he has a felony on his record.
Staff informed Mr. Goldstone that he needed to petition the court in
Massachusetts to see if he can have the offense expunged from his
record or designate a misdemeanor. In April, the Board voted to hold
Mr. Goldstone's application until more information could be gathered.
In response, Mr. Goldstone wrote to the Executive Director in a letter
16
received on April 29 and again in a letter received on May 23, 1996 to
which he attached a copy of the Massachusetts court documents which
state that he is ineligible to have his conviction reduced to a
misdemeanor for 15 years. The Board met to consider Mr. Goldstone's
Application on June 27, 1996. The Board's Executive Director duly
caused the matter to be noticed in accordance with the Arizona Open
Meeting Law. Pursuant to A.R.S. §32-3552(B) in conjunction with
A.R.S.§32-3523(4), the Board denied Mr. Goldstone's license
application.
EXAMPLE 2: Revocation for failure to comply with probationary order
Sheila Marshall
Sheila L. Marshall applied for a license on April 21, 1995. Ms.
Marshall's application for licensure contained information the Board
had deemed necessary to determine the qualifications of the applicant.
Ms. Marshall acknowledged in her application form that she has a
previous addiction to crack cocaine and has sought mental health and
substance abuse counseling.
Based upon the foregoing, on April 27, 1995, the Board held a
meeting to determine whether or not Ms. Marshall had violated any of
the provisions of A.R.S. § 32-3552(A). Ms. Marshall was present at
the February 16, 1995 Board Meeting and admitted to having violated
the Arizona Respiratory Care Practice Act and consented to the
imposition of an Order in which the Board approved her application for
licensure based upon her license being placed on probation for a two
year period.
On May 5, 1995, the Board's office sent, by certified mail, the
Board approved Stipulation and Consent Order for Approval of License,
17
Probation and Rehabilitation. Ms. Marshall signed and returned the
Board Order on July 5, 1995. At that time, Ms. Marshall also paid the
requisite licensure fee. The Board's Executive Director signed the
Order on July 28, 1995 placing the Order into effect.
On september 21, 1995, the Board's office sent Ms. Marshall a
letter reminding her that her first quarterly report, as part of her
stipUlation, was to have been filed on September 15, 1995. No report
was received. On October 23, 1995, the Board's office sent Ms.
Marshall a letter informing her that her failure to comply with the
stipUlation and Consent Order necessitated her attendance at the next
scheduled meeting of the Board. On or about November 16, 1995, the
Board held its monthly meeting to consider this matter. Ms. Marshall
was informed of the date, time and location of the meeting; she was
informed that she was required to attend; but she did not attend. Ms.
Marshall failed to comply with the requirements of the Order,
including: her failure to file a report to the Board regarding her
employment as a respiratory care practitioner, (the report was due on
September 15, 1995); and her failure to appear in person for
interviews before the Board upon request. After discussion, the Board
voted to hold a formal hearing for possible disciplinary action with
Sheila L. Marshall, pursuant to A.R.S. §32-3553(G), and the explicit
provision in the Board Order which states that any violation of the
Consent Order constitutes unprofessional conduct within A.R.S. §323501(
10) (I) and (k), and may result in disciplinary action pursuant to
A.R.S. §32-3553(H).
On December 21, 1995, the Board held the formal hearing in this
matter. The Board's Executive Director duly caused the matter to be
noticed in accordance with the Arizona Open Meeting Law. Ms. Marshall
18
was subpoenaed to attend, and did attend. The Board took testimony
from Ms. Marshall. The Board found substantial evidence was provided
to establish the facts set forth above. The Board issued an order
revoking Sheila Lorraine Marshall's, license (number 03579) pursuant
to A.R.S. § 41-1062(B).
EXAMPLE 3: Decree of Censure (for unprofessional conduct) and
Probationary Order for Rehabilitation (drug diversion and use
while on duty)
Keyin J. Marquis
Kevin J. Marquis, RCP, is the holder of license number 02343
initially issued on June 15, 1994 and currently valid through June 15,
1998. On December 27, 1995, the Board received a notice from Boswell
Hospital that Mr. Marquis was terminated from his job for cause. Mr.
Marquis was terminated for unacceptable job performance, sleeping on
the job, and for the admitted use of Halothane on the job. Halothane
is an anesthetic agent. The Board's investigator determined that Mr.
Marquis had received several written reprimands. These reprimands
were placed in his employee file. The documentation establishes poor
job performance for the following reasons: not following departmental
procedures; not answering pages; sleeping on the job; and admitted use
of Halothane while on duty. The Board's investigator further
determined that during the latter period of his emplOYment, Mr.
Marquis was tested for drugs, but no positive reports were found. The
Board's investigator was told, by a representative of Sun Health, that
Halothane does not appear on a standard drug screen. When Mr. Marquis
was terminated, Sun Health advised him to contact a Dr. Mike Cofield
at employee counseling because of his admitted drug use. The Board's
19
office wrote to Mr. Marquis on January 23, 1996 asking him to confirm
or deny the following questions related to the allegations: 1)
whether he was terminated from Walter o. Boswell on December 27, 1995;
2) requesting him to describe the circumstances surrounding the
termination; 3) if he has now, or has ever had, a substance abuse
problem; 4) asking him if he is currently, or has recently,
participated in a substance abuse program; and 5) whether he is
currently employed, and, if so, by whom. The Board received a written
response from Mr. Marquis on February 2, 1996. He answered the above
questions the following way: 1) yes, he was terminated from Walter o.
Boswell Hospital; 2) he was terminated due to the use of an inhaled
anesthetic; 3) "I do not have nor have I ever had a substance abuse
problem; 4) "I have received counseling for this particular incident
and will seek further counseling in the future if needed; 5) yes,
Immediate Respiratory Staffers (IRS). Mr. Marquis also expressed his
willingness to be of assistance in the Board's investigation, and to
appear in person or accommodate the Board. On March 5, 1996, Mr.
Marquis called the Board's office and reported that he would be
bringing his counselor, Judy Creecy, to the Board meeting.
In response to the Board's subpoena, Sun Health Corporation
provided substantial documentation on Mr. Marquis. The materials
contain the following:
A) Notes containing the following:
(1) From an evaluation done on June 1, 1995. It is hospital
policy "to assure pages are responded to promptly, and if they
can't be handled personally at the time, ask personnel present to
return calls and take a message and relay when you can expect to
20
assure those paging that the page was received." From an
anecdotal record on June 14, 1995 "co-workers not able to
obtain a response when paging in the morning to receive a page
and on several of these occasions they found you in the OPS ECG
procedures room with door locked - respond to all pages promptly
"if sleeping on the job is occurring this is a serious offense
and will be dealt with as such and must stop immediately"
(2) Second warning. October 4, 1995. October 1, 1995 found him
sleeping in the physician's lounge. October 2, 1995 nursing
unable to get response from him with paging. September 28, 1995
not checking the oximeter.
(3) November 28, 1995 report. November 25, 1995 found sleeping
in department, also not responding to pages (he requested
transfer to another shift).
(4) December 8, 1995 report. December 7, 1995 suspicious
behavior, not responding to pages, emerged from IABP (Inter
Aortic Balloon Pump) room observed - looked like drugs. Drug
tested. December 23, 1995, at 07:15 a.m. found sleeping in OPS
ECG room, rag over face, had difficulty waking up, disoriented,
stumbling, off duty. Mike stated that night before he was not
responding to pages from nursing:
December 23, 1995. Last check IABP at 02:30 a.m., found by day
shift at 07:00 a.m.
December 24, 1995. Not responding to pages for ABG's and Alines,
overhead paging too.
B) The Boswell Nursing Department's Anecdotal Record for Employee
Evaluation dated June 14, 1995. This document includes the policy
21
regarding response to pages noted above along with an occurrence "on
numerous occasions your co-workers have not been able to obtain a
response when paging in the morning to receive the page and on several
of these occasions they have found you in the OPS ECG procedures room
with the door locked. It also mentions an occurrence on June 8, 1995
when a request was sent down for ABG's at 22:30 at 21:40 and ABG was
not drawn until after 11:30 by Mr. Marquis after a nurse pointed out
that ABG had not been drawn. Also in incident on June 11, 1995 when a
code was called on 5C and Mr. Marquis responded and intubated a
patient without being checked off on intubation or providing
documentation to his supervisor that he had been checked off at Del
Webb. Suggested resolutions included: as discussed previously, all
pages need to be responded to promptly; requisitions left by the
previous shift must be verified that they are completed or not, and
assumptions must not be made that RCP will get ABG's on their
patients; Mr. Marquis should get checked off at Boswell for intubation
or obtain approval from Doctor Dunbrow for check-off from Del Webb if
it exists; if sleeping on the job is occurring, this is a serious
offense and will be dealt with as such and must stop immediately.
C) The Second Warning: A Sun Health Employee Reprimand, dated October
4, 1995, personnel present for interview included Craig Walter, Penny
Schmiege and Mr. Marquis. The reprimand was written by Craig Walter
and states that on October 1, 1995 at 6:20 a.m. the O.R. personnel
found Mr. Marquis sleeping in the physician's lounge in the O.R. On
June 14, 1995, Mr. Marquis had been counseled and this offense was
discussed and cannot be tolerated and represents a serious offense.
Also, the O.R. lounge is off-limits to non-O.R. staff. Also, on
22
October 2, 1995, a complaint was received from the nursing unit that
they attempted to contact Mr. Marquis for over an hour for an ECG and
no response was received until the A.M. ECG tech arrived and performed
the ECG. This had also been addressed before about the importance of
answering pages promptly. Additionally, on September 28, 1995, a
sleep study oximetry was ordered. Mr. Marquis was told that it needed
to be checked Q1 hour. It was not checked all night and the patient
study had been repeated because the patient did not have the study on
room air as ordered. This would have been noticed if the patient had
been checked. The results ordered at that time included: answer
pages promptly; be available when on the clock; perform procedures
when ordered, and check when indicated. Sleeping on the job will not
be tolerated.
D) A message from Diane Seago, written on November 27, 1995 at 5:29
a.m., to Bernie Swietnicki and Rita Borden at Boswell Administration,
and Penny Schmiege, regarding "napping on the job." It relates an
incident which occurred on November 25, 1995. At 2200 hours she
received a call that a STAT ECG had been ordered but the ordering
personnel had been unable to reach cardiology. No one was responding
to the beeper. Ms. Seago tried different numbers and several
locations in the hospital, but could not locate Mr. Marquis. Ms.
Seago then had Cardiology paged on the overhead system. still, no
response. She then went to the department and searched. She reports
finding Mr. Marquis sleeping in 112, the pulmonary function testing
room. He was stretched out on the floor behind the screen with the
door locked. He was sleeping so soundly that he did not hear Ms.
Seago unlock the door and enter. At that point, Ms. Seago decided to
23
call Barb the day shift supervisor to be a second witness. Mr.
Marquis slept through that phone call. However, when she closed the
door to leave and meet Barb in the hall, he must have woken up. A few
seconds later, he exited the room and Ms. Seago informed him that they
had been attempting to reach him for a STAT ECG. She states that she
stressed that he has a responsible job and is not to be sleeping on
the job. Mr. Marquis then went to 2A to do the ECG and Barb arrived.
Barb asked Ms. Seago where she had found him so that if she should
have a similar problem, she would know where to find Mr. Marquis. Ms.
Seago showed Barb the room and they found the pillow still on the
floor with a head shaped indent. Ms. Seago also states she would be
forwarding a report about not being able to reach Mr. Marquis from the
personnel that requested the ECG.
E) The Final Warning: A Sun Health Employee Reprimand, dated November
27, 28, 1995, personnel present included Penny Schmiege, Craig Walter
and Mr. Marquis. This document states that on November 25, 1995, at
approximately 22:30 Mr. Marquis was found sleeping in room 0-112 of
the department by a nursing supervisor after repeated attempts to
reach Mr. Marquis by page for a STAT ECG, attempts by the operator to
reach Mr. Marquis with no response, it was reported that this was "yet
another incident of sleeping on the job as counseled on 10/4/1995."
The recommended solutions were "Do not sleep on the job and answer
pages promptly." Mr. Marquis wrote "1 would like to request to be
transferred to another shift to accommodate this problem."
F) An Employee Corrective Action Form, dated December 8, 1995,
witnessed by Penny Schmiege, Craig Walter, Bev Robertson, and Mr.
24
Marquis. The problems outlined include: "On 12/7/95 you did not
respond to several pages from your co-workers; you emerged from the
IABP room, observed by several co-workers, having great difficulty
walking and speaking; they reported that your eyes were red, your
speech unintelligible, and your posture was bent over at the waist.
You have been counseled about sleeping on the job and not answering
pages promptly on reprimands dated 11/28/95, and previously on
10/4/95, and on an anecdotal record 6/14/95, and on job performance
evaluation dated 6/1/95 (due 5/95 answering pages promptly only
mentioned). The Recommended Corrective Action: "Employee submit to
drug testing. Employee to be suspended until drug tests come back.
Further disciplinary and/or remedial action will be taken at that
time."
G) A note from -Hike- dated 12/25/95 to Brenda Conant relating that on
Sunday night he had paged Mr. Marquis and paged him twice on the
overhead and Mr. Marquis still not did respond.
H) An Employee Corrective Action Form, dated December 27, 1995 which
is the termination notice. witnesses were Penny Schmiege, Craig
Walter and Mr. Marquis. The problems were identified as a repeat of
the information on the Corrective Action Form dated December 8, 1995
with the following addition: "Complaints from nursing of you not
responding to pages and for unacceptable job performance continued
12/23/95 and 12/24/95. On 12/25/95 he was found sleeping both while
on duty and off duty in the Recovery Room. You confirmed to your
supervisor, who was present, that the reason you were using a drug
(anesthetic - Halothane) was to help you sleep. You were relieved of
25
duty at that time 7:30 p.m." The Recommended Corrective Action was:
"Termination for sleeping on the job, unacceptable job performance,
and/or admitted use of the anesthetic Halothane. Employee encouraged
to contact Employee Counseling, Dr. Mike Cofield." Mr. Marquis wrote
"I would like to thank my co-workers and management for their support
and understanding. I apologize for the embarrassment(?).-
I) A letter from Hr. Marquis to Sun Health dated December 25, 1995 in
which he states "At this time I am at a point where I need help in
controlling my urges. I have a problem with my mental capacity and
seek help. This evening I reached a point in which I could not
control myself. Thank you for your help." Kevin, Marquis, RCP.
J) Many other documents from Sun Health inclUding documents, such as a
memo dated 3/9/95 recommending Mr. Marquis for Employee of the Month
because of his being punctual in returning pages and providing
equipment and services as soon as he was able. Also because he
performed his duties with a smile and a sense of humor and because his
co-workers enjoyed working with him. It is signed by 8 co-workers.
Also there is a letter of thanks to Mr. Marquis, dated August 10,
1994, for his assistance in a tough situation from Harry Reafling,
RCP, Administrative Director.
In light of the above, the Board met on March 21, 1996, to
consider the allegation of unprofessional conduct against Mr. Marquis.
At that time, after discussion, the Board voted to invite Mr. Marquis
to an Informal Interview Hearing pursuant to A.R.S. §32-3553(G), and
requested that Mr. Marquis submit himself for physical and
psychological evaluations and to have the results of those
26
examinations made available to the Board. On May 9, 1996, the Board
received an evaluation from Celia A. Drake, Ph.D. of the Arizona
Community psychiatric Group. She states that she evaluated Mr.
Marquis on April 15, 1996 and May 1, 1996. Her report is in the Board
books. She states that he referred himself to her as a result of
notification made to the Board from Boswell Hospital. She states that
"findings of the evaluation reveal that Mr. Marquis has a diagnosis of
alcohol abuse and possible alcohol dependence. In addition, he
acknowledges using Halothane, an anesthetic agent, for several months
while employed at Boswell Hospital. He denies history of other drug
abuse. He, however, continues to abuse alcohol. He reports no prior
history of mental health intervention other than that received at
Contact Managed Care, having attended for three sessions. At that
time it was recommended by his treating therapist, Judy Creecy, CISW,
that he attend Alcoholics Anonymous. He has yet to participate in
that program and has not returned to Contact Managed Care, stating
that he has not done so because of a change in his insurance. Mr.
Marquis' personality style is such that he tends to minimize, deny,
and rationalize his use of alcohol, although he does acknowledge that
he has a problem. Because of his abuse of alcohol as well as his use
of Halothane, it is recommended that he have some form of ongoing
structured chemical dependency treatment on an outpatient basis." Dr.
Drake also recommends individual psychological counseling.
On May 30, 1996, the Board met for the purpose of conducting an
informal interview with Mr. Marquis. The Board's Executive Director
duly caused the matter to be noticed in accordance with the Arizona
Open Meeting Law. Mr. Marquis provided the Board with a letter from
John V. deGuzman, M.D., which contained a medical evaluation of Mr.
Marquis. According to Dr. deGuzman, "The patient's physical
27
examination was entirely within normal limits." After discussion, the
Board voted to issue a disciplinary order and offer Mr. Marquis a
stipulated Order for Rehabilitation. After discussion, the Board
voted to issue a disciplinary order to Mr. Marquis for repeatedly
falling asleep while on duty, i.e., repeated negligence; and to offer
Mr. Marquis a stipulated Order for Rehabilitation. Mr. Marquis is
currently on probation.
(Example 3 continued: sample probationary order)
This case provides an example of what a typical probationary
order entails.
Excerpts from Kevin Marquis' Order:
Kevin J. Marquis, RCP, is hereby placed on probation; and, as a
condition of probation shall remain enrolled in an out-patient
rehabilitation program, approved by the Board, for five (5) years.
Kevin J. Marquis, RCP, shall find an out-patient rehabilitation
program and a sponsor and submit them for approval of the program.
Kevin J. Marquis, RCP, shall instruct his therapist or counselor
from the Program to release to the Board of Respiratory Care
Examiners, upon its request, any and all records relating to his
treatment and to submit quarterly reports to the Board of Respiratory
Care Examiners regarding his diagnosis, prognosis and recommendation
for the continuing care, treatment and supervision of Kevin J.
Marquis, RCP; and, said reports to be submitted on or before the 15th
day of March, June, September and December of each year. ~
aforementioned therapist or counselor shall be provided with a copy of
this Order by Respondent.
28
Kevin J. Marquis, RCP, shall inform his current employer of the
Board's Order of Probation and restriction of the professional
practice as a respiratory care practitioner.
Respondent shall instruct his therapist or physician from the
rehabilitation program to release to the Board all documents and
information relating to his treatment that are requested by the Board.
In the event Respondent fails to satisfactorily complete the
rehabilitation program, he shall be considered to have violated the
terms of this Probation Order and Respondent shall be sUbject to
disciplinary action and possible revocation of license by the Board.
Kevin J. Marquis, RCP, shall participate in a 12-step recovery
program appropriate for substance abuse as determined by his treating
therapist or counsel, and attend a minimum Qf Qne meeting per week
while on prQbation. keeping a written record of times, locatiQns and
attendance.
Kevin J. Marquis, RCP, shall obtain a sole treating physician who
shall be SUbject to approval by the Board and he shall inform the
Board by letter of the name, address and telephone number of the
physician. Kevin J. Marquis. Rep. shall advise his treating physician
of his rehabilitation effQrts and prQvide a CQPY of this BQard Order
to the apprQved treating physician. Kevin J. Marquis, RCP, shall
further advise any health care practitioner providing medical care and
treatment of his chemical misuse problems.
Kevin J. Marquis, RCP, shall abstain completely from the
consumption of alcohQlic beverages.
Kevin J. Marquis, RCP, shall take nQ drugs or medications
whatever (except for plain aspirin and/or plain acetaminophen),
whether controlled substances, prescription-only drugs or over-the29
counter preparations, unless such drugs or medication was prescribed
for him by his treating physician.
Kevin J. Marquis, RCP, shall comply immediately (i.e., within
sixty (60) minutes) with requests from the Board or the Program
Director, or their agents or designees, including but not limited to
his therapist or counselor, to submit to witnessed random biological
fluid collection; and, he shall authorize any person or organization
conducting tests on these collected samples to provide testing results
to the Board and the Program Director.
Kevin J. Marquis, RCP, shall maintain a log of any and all
medications whatever (except plain aspirin and/or plain
acetaminophen), whether controlled substances, prescription-only drugs
or over-the-counter preparations prescribed for him by his treating
physician and shall make such logs available to the Board, its agents
or designees upon request. Such logs, at a minimum, shall include the
following:
(A) The medication taken;
(B) The date and time the medication taken;
(C) The name of the prescribing physician;
(D) The reason for the medication.
Kevin J. Marquis, RCP, agrees to pay all charges from the Board
of Respiratory Care Examiners, or its designee (including, but not
limited to, the Program) for conducting biological fluid testing, as
well as charges for therapy sessions conducted by the Program.
Kevin J. Marquis, RCP, shall submit to mental, physical or
medical competency examinations, or any combination thereof, at such
times and under such conditions as directed by the Board to assist the
Board in monitoring his ability to safely engage in the practice of
30
respiratory care, or his compliance with the terms of this Order.
Kevin J. Marquis, RCP, shall submit to any additional therapy
ordered by the Board or recommended by his therapist or counselor from
the Program.
Kevin J. Marquis, RCP, shall obey all federal state and local
laws, and all rules governing the practice of respiratory care in the
state of Arizona.
Kevin J. Marquis, RCP, shall appear in person before the Board
for interviews upon request, at various intervals and with reasonable
notice (i.e., a minimum of five days). He shall immediately advise
the Board of any change in his place of emploYment or home address and
of any plans he makes to be away from his place of emploYment or home
for more than five (5) continuous days. Respondent shall notify the
Board by letter delivered by certified mail\return receipt requested
within three (3) days of the date of the change.
This Order shall remain effective for a minimum of five (5) years
from the effective date; and, after one (1) year, Respondent may apply
to the Board by letter seeking modification of the Order of Probation
upon showing satisfactory compliance with the Order during the period
of probation. Unless violation of the Board's Order is established in
a hearing before the Board, pursuant to A.R.S. 32-3553(G) or (I), the
Order shall be automatically terminated in five (5) years.
Example 4: Revocation for cause (unprofessional conduct,
misrepresentation of criminal history)
Malcolm Val Phoenix
On August 10, 1995, Mr. Phoenix applied for his biennial license
renewal. His application included an affirmative answer to Question
31
Number One: Have you since your initial application or last renewal
been arrested, pled guilty to or no contest to or been convicted of a
felony, misdemeanor or undesignated offense? Mr. Phoenix provided a
note that listed the case numbers of the charges, but no dates. He
stated that the Board could find the cases in Tucson City Court, that
the matters were civil and set aside after a fine. On or about
October 19, 1995, the Board received information from the Office of
the City Attorney in Tucson, criminal Division, regarding this matter.
It stated that Mr. Phoenix (under the name Charles Hamill) was in the
process of appealing a criminal matter, that a decision had been
reached in December of 1992, said decision placed Mr. Phoenix on 12
months of unsupervised probation, and ordered a $200 fine to be
payable in monthly installments of $25. On December 20, 1995, the
Board received a written response from Respondent admitting that it
was not a civil matter and a document establishing that Mr. Phoenix
had filed an application to set aside the jUdgment against him in the
City Court of the City of Tucson, County of Pima, state of Arizona.
On September 11, 1995, the Board received a letter from the
staff at Central Arizona Medical Center (the Center) alleging
unprofessional conduct against Mr. Phoenix because he had been
terminated from employment effective September 6, 1995 due to certain
acts of misconduct. The Board's office subpoenaed documentation of
the termination from both the Center and Mr. Phoenix via certified
mail. On September 15, 1995, the Board received an answer from the
Center documenting four notices of concern which had been issued to
Mr. Phoenix.
The first was issued in May 1995 and had the following concerns:
Absenteeism. No batch number for 5/18/95 charges (pulmonary
32
section). This causes revenue loss and late charges.
The second was issued in June 1995 and had the following
concerns: 6/22/95 MOl missing for Room 1407. 6/12/95 EKG
malfunctions due to technician error 6-2-95 (Malcolm). ABG
calibration is now printing out copious amounts of calibrations.
Does not respond to communications from fellow workers but
becomes defensive. Accuses fellow workers from department of
being saboteurs. Does not read communications book 5-5-95.
The third was issued on August 18, 1995 and had the following
concerns: Malcolm doesn't feel obligated to attend department
meetings. Work performance sub standard -- this is not the
first, rather a pattern has developed that causes concern, no ABG
report given to nursing - nurses didn't sign off. Discovery of
errant billing - due to slipshod work habits causing client
dissatisfaction. Date of occurrence 03-10-95 patient charged for
services not rendered, interpersonal relationships with fellow
workers (i.e., vulgar gestures) unacceptable.
The fourth was issued in September 1995 and had the following
concerns: Transcription of doctors orders from "physicians order
sheet" to "respiratory therapy inpatient master log" incorrect.
Administration of SVN prescription without proper drugs as
ordered by Physician 8-31-95. Confirmation report and summary
was not run on 9-1-95, for ABG machine. 9-1-95 EKG - no data,
i.e., name, numbers, etc. Due to overall misconduct of RCP
duties Malcolm is hereby released from emploYment with Central
Arizona Medical Center. Mr. Phoenix's comments were that he felt
he was being forced out due to "nursing staff games and pressure
from different people." He also felt that the R.C.P. on day
33
shift would leave without charting, and would mix up names and
numbers, and that Mr. Phoenix was being blamed for it. He
further stated that nursing changed things and that paper work
was being stamped in wrong. He stated that he thought he'd had
at least a year of problems.
On October 5, 1995, the Board held its monthly meeting to
consider the allegation against Mr. Phoenix as part of its
investigation in this matter pursuant to A.R.S. §32-3553. Mr. Phoenix
was notified of the time, place and location of the meeting, but did
not attend. After discussion, the Board voted to hold an informal
interview hearing with Malcolm Val Phoenix pursuant to A.R.S. §323553
(G) .
Board staff investigated this matter by personally interviewing
staff members of Central Arizona Medical Center. During the
interview, for clarification, Center staff stated that Mr. Phoenix had
been suspended from work for three (3) days without pay, on August 18,
1995, for concerns that included: non-calibration of the ABG machine
on at least four (4) instances, giving the wrong medication to a
patient while not following physician orders, charging for therapy
that was not done, and reporting EKG results to the ER without a
patient name, number or any patient identification available on the
abnormal, and potentially dangerous EKG. Following that suspension,
Mr. Phoenix returned to work and continued to provide poor quality and
dangerous patient care, according to Center staff, which resulted in
the termination in September.
On November 16, 1995, the Board met for the purpose of
conducting the informal interview hearing with Mr. Phoenix. Mr.
Phoenix was notified of the time, place and location of the meeting;
34
was sent a written invitation to the meeting; attended the meeting for
a time, but left before the Board heard this matter. Mr. Phoenix
wrote a note to the Board during the Meeting stating that he had to
leave; the meeting lasted longer than he had thought it would; and
that he understood the concern with the statements before the Board.
since Mr. Phoenix was not in attendance of the informal interview, the
Board voted to hold a formal hearing for possible disciplinary action
with Malcolm Val Phoenix pursuant to A.R.S. §32-3553(G).
On December 20, 1995, the Board received a written response from
Mr. Phoenix. In his written response, Mr. Phoenix generally denies
the allegations of professional competence because his two previous
years of job evaluations were satisfactory.
On December 21, 1995, the Board held the formal hearing in this
matter. The Board's Executive Director duly caused the matter to be
noticed in accordance with the Arizona Open Meeting Law. Mr. Phoenix
was SUbpoenaed to attend, and did attend. The Board took testimony
from Mr. Phoenix and Phil Putnam, Ph.D., RRT, of Central Arizona
Medical Center and Mr. Phoenix's former supervisor at Central Arizona
Medical Center.
Based upon the documents received and the testimony of Phil
Putnam, Ph.D., RRT, and Mr. Phoenix, the Board found that substantial
evidence was provided to establish the facts set forth above.
Pursuant to A.R.S. § 32-3553, the Board issued an Order revoking the
license to practice respiratory care of Malcolm Val Phoenix.
35
Example 5: Decree of Censure (Fraud on Application for Licensa
Renewal) and probationary Order for Rehabilitation (Alcohol
and Drug Abuse)
Mark Largesse
Mark Largesse is the holder of license no. 01066, renewed on
March 20, 1996, currently valid through March 20, 1998. On Mr.
Largesse's biennial renewal application he wrote that he had acquired
the necessary CEUs for his license renewal. On April 1, 1996, in a
telephone call from staff at John C. Lincoln Hospital, followed by a
facsimile transmission (received on April 4, 1996), the Board was
informed that Mr. Largesse did not have the necessary CEUs and had
therefore falsified his biennial renewal application to the Board.
Staff at John C. Lincoln state that Mr. Largesse was requested on
March 22, 1996 to provide proof of his CEUs, that a second request for
his CEUs was made on March 29, 1996 (via telephone) and that on March
29, 1996, Mr. Largesse admitted that he had no CEUs. Staff at John C.
Lincoln states that at that time, Mr. Largesse was taken off the
schedule. On April 1, 1996, Board staff wrote to Mr. Largesse, via
certified mail, asking him to submit documentation supporting his
compliance with the Board's CEU requirement. On April 10, 1996, Mr.
Largesse provided a written answer to the Board's letter. (He also
stated that he has been having difficulty receiving his mail -- all
correspondence to him had been returned to the Board as undeliverable
and Mr. Largesse picked it up on April 10). Mr. Largesse states that
as of March 20, 1996 he "did not have sufficient CEUs to meet the
criteria required by the State to renew my license and filled out the
renewal form anyway. There are reasons behind this stupid action but
honesty must prevail. I will obtain the CEUs and face the
36
consequences handed down from the Board."
Based upon the foregoing, the Board met on April 25, 1996 to
consider the allegation of unprofessional conduct against Mr.
Largesse. At that Board meeting, Mr. Largesse discussed this
allegation with the Board. In addition, he told the Board that he had
been admitted to a substance abuse program during his last license
renewal period and had failed to disclose that on his license renewal
application. He offered to provide documentary evidence of his
successful completion of a substance abuse program. Following the
April Board meeting, Board Staff was informed by personnel at John C.
Lincoln Hospital that Mr. Largesse may have worked the following dates
without a valid license: March 24, 25, 26, 27 and 28. After
discussion, the Board voted to invite Mr. Largesse to an informal
interview hearing pursuant to A.R.S. §32-3553(G).
On May 30, 1996, the Board conducted informal interview hearings
with the Respondent. The Board's Executive Director duly caused the
matter to be noticed in accordance with the Arizona Open Meeting Law.
Mr. Largesse provided documentary evidence of his completion of 20
approved continuing education units and of his completion of an
alcohol and drug rehabilitation program at the Salvation Army Adult
Rehabilitation Center. After discussion, during which Mr. Largesse
denied practicing respiratory care during the period of March 24
through March 28, 1996, the Board voted to issue a Decree of Censure
to Mr. Largesse for fraud in the procurement of his license and to
offer Mr. Largesse a Stipulation and Consent Order for Rehabilitation.
Mr. Largesse is currently on probation.
37
Example 6: Case dismissed
sally Pelton Beicht
Ms. Sally Pelton Beicht was the holder of a Temporary License
during the investigation of the allegation against her. Her Temporary
license was issued on December 27, 1995, and its expiration date would
have been August 27, 1996. On February 12, 1996, the Board received
an allegation of unprofessional conduct against Ms. Pelton Beicht.
The allegation was that she was a no show, no call, on several
occasions. The allegation was made by the President of one of the
temporary staffing agencies which provides Reps to health care
facilities (including homes), who stated that "the last two puts us
and a hospital in a very difficult situation. I am faxing you my
nightshift/weekend staffing coordinator's account of what happened."
There is a memo attached:
Dated 2/8/96. Assignment at Thunderbird Samaritan. Scheduled
for 2/3/96 at 10:00 p.m. and again on 2/4/96 at 6:00 p.m. "I
called her on Saturday at approximately 3:00 p.m. to ask her to
be there at 6:00 p.m. instead of 10:00 p.m. She said that she
could not but would be at the hospital at 10:00 p.m. as planned.
She also stated that she was scheduled for 6:00 p.m. the
following night. She didn't show up at 10:00 p.m. on saturday
night. I called her home and her husband stated that she was out
with friends and was not going to work. On Sunday 2/4, again she
did not show up for work. When I called her home, her husband
stated that she was sleeping and that she was not scheduled to
work that night. He would not put her on the phone. Both of
these incidents created problems for the hospital since she could
not be replaced."
38
On February 20, 1996, Board staff wrote to Ms. Pelton-Beicht
asking her to confirm or deny the allegation that she accepted two
assignments at Thunderbird Samaritan Hospital, confirmed them in a
telephone call with Anita Fink, yet failed to report for both assigned
shifts. Ms. Pelton-Beicht responded in a letter received on March 1,
1996. She denies accepting either assignment "due to the fact that on
Thursday Feb. 1st Debbie Richards Supervisor of Resp. Care at Phoenix
Baptist Hospital called and asked me to work overtime on Saturday Feb.
3rd and to work Sunday Feb. 4th. I had started an on call position at
Phoenix Baptist Hospital Jan. 29, 1996 which I told IRS and wrote them
a letter telling them I will be unavailable to work for them at this
time. On Feb. 3rd I was called. IRS asked me if I could work on that
night from 6-6:30. I told her I was working 10-6 at Phoenix Baptist."
She also states that IRS had her pager number and could have paged
her.
On March 13, 1996, the Board received a letter from Ms. PeltonBeicht
stating "enclosed is a copy of the letter I sent to IRS on 126-
96. I'm sorry it took so long sending it to you." Enclosed is a
copy of a letter addressed "To IRS" and stating "This is to inform you
that as of 1-29-96 I will be unavailable to work for your agency. I
just acquired a pool position at Phoenix Baptist Hospital and will be
starting on that date. Sincerely, Sally F Beicht."
On May 30, 1996, the Board met to consider the allegation of
unprofessional conduct against Ms. Pelton Beicht. The Board's
Executive Director duly caused the matter to be noticed in accordance
with the Arizona Open Meeting Law. Ms. Pelton Beicht was present.
After discussion, the Board voted to table this matter and directed
staff to investigate this matter. On June 10, 1996, Board staff wrote
39
to IRS requesting that someone from IRS attend the June meeting. On
June 11, 1996, the Executive Director sent a subpoena to Phoenix
Baptist Hospital for the staff schedule on the days in question.
On June 27, 1996, the Board met to continue the consideration of
the allegation. Ms. Pelton Beicht was present. The Board reviewed
materials submitted by Phoenix Baptist Hospital received in response
to its subpoena. The Board determined that no evidence was produced
to substantiate the allegation of unprofessional conduct. After
discussion, the Board voted to dismiss the allegation of
unprofessional conduct against Ms. Pelton Beicht pursuant to A.R.S.
§32-3553.
At the same Board meeting, held on June 27, 1996, Ms. Pelton
Beicht's application for a license to practice respiratory care was
approved by the Board.
5. Provide licensing data including the number of licenses by
category, number of out of state licenses, number of restricted
licenses and reciprocity agreements.
Total number of licenses issued
Number of current temporary licenses
4,056
124
(Note: temporary licenses are restricted -- individuals who hold
temporary licenses may only practice under the direct supervision
of a licensed Rep or a licensed physician)
Number of expired temporary licenses 662
Average time to issue a Temporary License 24 hours
40
A.R.S. 532-3554(3) (a) provides for licensure without examination for
Applicants who hold licenses in good standing in another state and who
have already passed the CRTT exam (Note: the CRTT is the Entry Level
Respiratory Care Examination).
The Board does not issue out of state licenses.
6. Provide exaJlJination data such as use of a national exam, use of
oral and practical exams and weighing of exams.
The Board requires that initial Applicants for licensure take and
pass a national exam, the CRTT exam administered by the National Board
of Respiratory Care Examiners (NBRC). A passing score is considered
to be the same as required by the NBRC; which is 75 scaled-score units
or 95 correct answers. There is no limit on how many times an
Applicant can take the exam. It is offered three times a year.
7. Provide disciplinary data, including the number of complaints (by
tyPe), number dismissed (by reason), number of hearings held and
number of actions (probations, susPensions and revocations).
41
Number of complaints
Number dismissed
Number of hearings held
informal interviews
formal hearings
Actions
Letters of concern
Decrees of censure
Probation
Board Ordered
stipulated
Disciplinary
Non-disciplinary
Total Probation
suspensions
Surrendered licenses
Revocations
2
27
34
2
1
19
280
35
28
45
96
17
[Note: please see attached Exhibit A for a full summary of
Board activity.]
If you need any further information, please do not hesitate to contact
me.
"Sin erel~ I
/ ! / . h;U<1 I2d-x~
cutrv D~rector . "
~ I
,_J
42
BOARD OF RESPIRATORY CARE EXAMINERS
BOARD MEETING
,
Thursday, January 25, 1996 at 12:00 p.m.
2nd Floor Conference Room
1400 W. Washington, Phoenix AZ
Board Members Present: Chair Meryl Salit, Vice-Chair Kit Mehrtens, Sheilah Bowen, John
Coleman, Gerald Schwartzberg, M.D., and Karen Staudenmier
Board Members Absent: Mary Lynn Kelly
Staff Present Mary Hauf Martin, Executive Director
Dolores Doyle, Administrative Assistant
Board's Legal Counsel: Mike Harrison, Assistant Attorney General
I. CALL TO ORDER
The Meeting was called to order at 12:04 p.m. by the Board's Chair, Meryl Salil.
D. ELECTION OF OFFICERS FOR 1996
John Coleman nominated Meryl Salit for another term as Board Chair. Sheila Bowen
seconded. The Motion passed unanimously.
Meryl Salit nominated Kit Mehrtens for another term as Board Vice Chair. Karen
Staudenmier seconded. The Motion passed unanimously.
ID. APPROVAL OF MINUTES
John Coleman moved approval of the Minutes as presented. Karen Staudenmier
seconded. The Motion passed unanimously.
lYllDUU:S 01 ..auWlC)' M;), ~:r.nJ
Board Meeting
Page 2
IV. DISCUSSION!ACTION ON APPLICATIONS FOR UCENSURE
A. Recommended for approval by the Executive Director
Judith A. Alderman
Beverly N. Caldwell
Vicki L. Dickson
William D. Hall
Randy J. Hillyer
Elaine D. Martin
Donna E. Ochoa
James Sallis
Cathy L. Spencer
Joseph A. Bettini
Alexandra C. Cheek
Erica A. Faigle
Mark S. Hanson
Ashely C. Hubbell
Kenneth E. Newton
Clay Patterson
Greg R. Sanvik
Katherine L. Tanner
Carmelita Burdick
Wendell A. Chow
Andrea J.. Glasscock
'vasant J Honest
Joan L. Loewen
Robert Rapp
Teresa A. Salazar
Patrick Smith
Maria Velez
Kit Mehrtens moved approval of all the individuals listed on the Agenda and
recommended by the Executive Director. Sheila Bowen seconded the Motion. The
Motion passed unanimously.
B. Application for Licensure
1. Eric Cahill
The Executive Director summarized Mr. Cahill's situation. Mr. Cahill was not present.
After discussion, John Coleman moved that Mr. Cahill be granted a license. Kit
Mehrtens seconded. The Motion passed unanimously.
2. Mark D. Olson
Mr. Olson was present. The Executive Director summarized Mr. Olson's situation.
After discussion, John Coleman moved that Mr. Olson be granted a license. Karen
Staudenmier seconded. The Motion passed unanimously.
3. Rose Troia
The Executive Director reviewed Ms. Troia's application for licensure. Ms. Troia was
not present. Kit Mehrtens moved to table discussion of Ms. Troia's application until
further information can be presented to the Board. Sheila Bowen seconded. The Motion
passed unanimously.
lYllDUU:S 01 .January ~, .I.:r.l'U
Board Meeting
Page 3
4. Stephen Spencer
Mr. Spencer was not present. The Executive Director reviewed Mr. Spencer's
application. Karen Staudenmier moved to table discussion of Mr. Spencer's application
until further information can be presented to the Board. Sheila Bowen seconded. The
Motion passed unanimously.
5. Nancy Jean Wilcox
Ms. Wilcox was not present. The Executive Director reviewed Ms. Wilcox's
application. Sheila Bowen moved to table discussion of Ms. Wilcox's application until
further information can be presented to the Board. Karen Staudenmier seconded. The
Motion passed unanimously.
6. Sheryl R. Radowick
Ms. Radowick was not present. The Executive Director reviewed Ms. Radowick's
application. Kit Mehrtens moved that Ms. Radowick's license be granted. Sheila Bowen
seconded. The Motion passed unanimously.
C. Request for an Extension to a Temporary License
1. Susan Klement
Ms. Klement was present. The Executive Director stated that Ms. Klement's request did
not meet with the Board's requirements for receiving an extension to a temporary license.
She had not signed up to take the CRTI. Karen Staudenmier moved that the Board deny
Ms. Klement's request for an extension to her temporary license. Kit Mehrtens
seconded. The Motion passed unanimously.
V DISCUSSIONIACTION ON ADMINISTRATIVE CLOSING OF
APPLICATION FILES
Mitchell D. Barnes
Corey L. Bell
Leonard Bell
Marlitza L. Belmontes
Juanita J. Craig
Katrina N. Dumbauld
Kelly A. Fitzgerald
David L. Yardley
Susan Klement
Terry Kloppenberg
Kelly A. Kriesel
Tami J. Olson
Richard Russell
Jose L. Silva
Brian E. Trufley
Donna Trumbo
Thomas R. Wyatt
Joseph F. Brancotto
Grace E. Colden
Don R. Dela Cruz
Christopher S. Grattenhaler
Ameer R. Muhammad
Minutes of January 25, 1996
Board Meeting
Page 4
After discussion between the Board members and the Executive Director regarding
individuals who had completed their license applications after the Agenda was written,
Karen Staudenmier moved that the Board administratively close the application files of
all the items on the agenda except for Susan Klement, Grace E. Colden and Christopher
S. Grattenhaler. Sheila Bowen seconded. The Motion passed unanimously.
VI DISCUSSION\ACTION ON NOTICES OF UCENSE EXPIRATIONS
\
The Executive Director stated that these were routine license expirations.
Michelle Angus
Lynn C. Birgman
Kimberlee K. Birrell
Cathryn Clayton
Tracy Duepner
Patricia Johnson
Euginia Berry
Chantel R. Davis
1anet K. Eichenberger
Mark Meins
Sheila Palermo
10hn-Mark Stuebing
Hal Wagner
James Kentner
David M. Krepp
Don D. Maples
Gabriel M. Martinez
Adrienne Meyer
Heidi Lynn Nichols
Bonnie L. Bouchez
Victoria A. Devaney
Alice Hinton
Lisa S. Nasca
Chris Stein
Michelle Thompson
John Porter
Tammy M. Smith
Tamara L. Snyder
Christy B. Steffen
Tine Tenenti
Andrew M. Torrez
Sheri L. Clarke
Mary E. Edelman
Linda L. Medansky
Walter R. Palass
Blair W. Steinberg
Shirley A. Trebelhom
Karen Staudenmier moved to issue these notices of license expirations. Kit Mehrtens
seconded. The Motion passed unanimously.
vn DISCUSSION ACTION ON REINSTATEMENT OF EXPIRED UCENSES
The Executive Director reported that these were routine license reinstatements.
Julie Evans-Barba
Dan Dillon
Dolores M. Blake Merry Gayle Pineda
John Coleman moved to ratify these reinstated licenses. Sheila Bowen seconded.
The Motion passed unanimously.
VITI CONSIDERATION/ACTION ON INVESTIGATIONS OF
UNPROFESSIONAL CONDUCT
l".lJIIUI.IC03 u. "iUIIUU-, MJ, ~77V
Board Meeting
Page 5
1. Kerry Adair
Mr. Adair was present. The Executive Director reviewed an allegation of unprofessional
conduct against Mr. Adair. The Board received Mr. Adair's biennial renewal application
on October 13, 1995. He admitted that he pled guilty to a misdemeanor DUI and expired
car registration. He said he paid a DUI fine of $459 and a fine for his expired car
registration of over $500. He stated that he completed: an 80 hour.intensive outpatient
care program through Tri-City Behavioral Health; and a 12 week program with Arizona
Addiction Council. He says that he has been attending an AA program (ADAM)
sponsored by the LDS church once a week. He also states that he was terniinated from
Desert Samaritan for personal differences with the supervisor. Mr. Adair had accepted
2 certified letters from the Board's office requesting documentation of the above - he
has failed to respond. The Board's investigator has spoken with Joni Shultz at Desert
Sam. Ms. Shultz stated that he was a -Type A-employee - which is similar to an oncall
position. Mr. Adair worked the night shift and made what she felt was a "bad
judgment call." Ms. Shultz stated that in light of this incident, she took him off the
schedule because she felt he needed more supervision than she could offer a "Type A"
employee. After discussion, Mr. Adair provided documentation ofhis misdemeanor DUI
and a misdemeanor for driving without a valid drivers license. He also provided a
Certificate of Completion of a 12 week outpatient program from the Arizona Addiction
Council. Upon questioning as to why he hadn't responded to the Board's information
requests, Mr. Adair said he had been negligent.
For purposes of receiving legal advice, John Coleman moved that the Board go into Bmme
Session at 12:50 p.m. Sheila Bowen seconded. The Motion passed unanimously. John
Coleman moved that the Board return to public session at 12:55 p.m. Karen Staudenmier
seconded. The Motion passed unanimously.
After discussion, John Coleman moved that the Board table discussion of this matter until
its next Board meeting, and for staff to draft a standard stipulated order for the Board
and Mr. Adair to review prior to that meeting. Sheila Bowen seconded. The Motion
passed unanimously.
2. Mary Condel
Ms. Condel was not present. The Executive Director explained that the Board received
Ms. Condel's biennial renewal application on October 24, 1995. On her application she
states that she received a Dill and that is was resolved. She offered to provide
documentation. In November of 1995 she accepted a certified letter from the Board's
office requesting information regarding her biennial renewal application: copies of the
court records of her Dill; documentation of any fines or penalties; certificates of
completion for the alcohol awareness program she said she attended. No response has
been received. In December of 1995 she was sent a letter asking her to document her
...................'-'U' " .. "-"'-"J -, ...".,,-
Board Meeting
Page 6
completion of CEUs. No response has been received. Howard Jones of Phoenix
Memorial Hospital, Ms. Condel's direct supervisor, was present. The Board discussed
Ms. Condel's lack of documentation of acquiring the required CEU's with Mr. Jones.
Karen Staudenmier moved that the Board invite Ms. Condel to an informal interview
hearing and that she be asked to provide the required documentation to the Board. Sheila
Bowen seconded. The Motion passed unanimously.
3. Rodney M. Flickinger
Mr. Flickinger was present. The Executive Director explained that on November 9,
1995, the Board received a Lab Report from Corning Labs which showed a positive
result for Cannabinoids, from a specimen collected from Mr. Flickinger on November
2, 1995. The Board's investigator determined that the drug screen was taken as a preemployment
drug screen with Immediate Respiratory Staffers. The Board's office wrote
to Mr. Flickinger on November 9, 1995 asking him to confirm or deny the allegation.
On November 27, 1995, the Board received the results of second drug screen, also from
Corning Labs, taken November 22, which also showed a positive result for Cannabinoids.
On November 29, 1995, the Board received a letter from Mr. Flickinger admitting that
the test done on specimen collected on November 2 came back positive for Cannabinoids.
On December 7, 1995, the Board received a letter from Mr. Flickinger questioning the
validity of the Corning Lab tests because the positive result was not confirmed by a
different chemical process (he refers to the Labor Laws). He went to the Treatment
Assessment Screening Center (TASC) and had another drug urine screen - from a
specimen collected on November 28 which came out negative. On December 8, 1995,
the Board sent a letter to Mr. Flickinger regarding the positive test results from the
specimen taken on November 22 at Corning Clinical Labs. On December 14, 1995, the
Board received a test result from Corning Labs showing that the positive result from the
specimen taken on November 22 was verified by GCMS. On December 20, 1995, the
Board received a letter from Mr. Flickinger admitting that the second drug screen at
Coming Labs had come back positive for Cannabinoids. On January 5, 1996, the Board
received a letter from Mr. Flickinger with the results of a second drug screen taken at
TASC, from a specimen taken on December 22 which came back negative.
For purposes of receiving legal advice, Sheila Bowen moved that the Board go into BImi\e
Session at 3:44 p.m. Karen Staudenmier seconded. The Motion passed urminnJsly. Kit
Mehrtens moved that the Board return to public session at 3:50 p.m. Karen Staudenmier
seconded. The Motion passed unanimously.
After discussion, during which Mr. Flickinger agreed to entering into a Stipulation and
Consent Order, Kit Mehrtens moved that the Board table discussion of this matter until
the next Board Meeting and that staff draft a modified probationary order for the Board
and Mr. Flickinger to review prior to the next meeting. Dr. Schwartzberg seconded.
The Motion passed unanimously.
------ -- _-__., --7 ----
Board Meeting
Page 7
4. Michael Hartman
Mr. Hartman was not present. The Executive Director reviewed for the Board Mr.
Hartman's history. In September, Mr. Hartman was issued a Decree of Censure and
Probationary Order pursuant to a Board decision made in March of 1995 - for exceeding
the scope of practice of an RCP. The terms of his probation, which were spelled out in
the Order, called for reports to the Board in October and Decembc;r of 1995, with the
last one due in March when his Order is due to expire. 'Mr. Hartman has never filed
either of the two required reports. The Board's investigator has also determined that Mr.
Hartman has failed to notify his employer of his Board ordered probation. Kit Mehrtens
moved that the Board issued a Complaint and Notice of Formal Hearing to Mr. Hartman.
John Coleman seconded. The Motion passed unanimously.
5. Frank Mamone
Mr. Mamone was present. Karen Staudenmier recused herself from all proceedings
involving this matter. The Executive Director reviewed for the Board an allegation of
unprofessional conduct against Mr. Mamone. On November 2, 1995, the Board received
a letter from Vencor Hospital stating that Mr. Mamone had been terminated, effective
September 13, 1995. Discrepancies and potentially fraudulent charting were noted upon
review of the charts of patients under Mr. Mamone's care. On November 17, 1995, the
Board's office sent Mr. Mamone, at his address of record, a letter asking him to confirm
or deny the allegation. The letter was returned. On November 21, 1995, the Board's
office subpoenaed documents relative to this matter from the Custodian of Records of
Vencor Hospital. In response, on November 30, 1995, staff at Vencor Hospital
responded to the subpoena by sending his job description and disciplinary reports. The
Vencor records show repeated over-eharging for therapist time and, in violation of
Medicare regulations, therapy given to more than one patient at a time. When asked for
an explanation by his manager, Mr. Mamone stated that the treatment times were
adjusted to reflect when they were due, rather than when they were actually done. After
discussion, John Coleman moved that the Board invite Mr. Mamone to an informal
interview hearing. Kit Mehrtens seconded. The Motion passed unanimously.
6. Steven Statts
Mr. Statts was not present. The Executive Director reviewed the allegation of
unprofessional conduct against Mr. Statts. The Board voted to open an investigation into
this matter in October - it involves an allegation which was brought before the Board
some time ago (December 1994) because the allegation was that Mr. Statts was a
potential danger to the public. The allegation is that he was pacing back and forth in
front of patients at Thunderbird Samaritan Medical Center, asked to leave 4 times, but
refused, the police were eventually called and a Behavioral Health RN was also called.
The allegation also stated that Mr. Statts was paranoid, agitated, and seemed to be having
.1T.uJlU..C3 U.l .,......... .1 ~, A77V
Board Meeting
Page 8
a hard time processing on a cognitive level why his behaviors/actions were causing a
great deal of concern. He was offered a crisis assessment at the behavioral health unit,
but refused. At one point he agreed to go talk, but started running down the hospital
hallway and was chased out by the Glendale police. Also, that he cornered an RN,
Laura, before telling her to walk out of the hospital with him - this frightened and upset
the RN. Finally, there was an allegation that he was also escorted by the Phoenix police
in December, 1994. When the Board opened the investi~ation, we/wrote to Mr. Statts
(letter dated November 2). He responded in a letter received by the Board on December
8, 1995. He apologizes for not responding sooner, stating that he has been working in
several different states. He says that he had not corresponded with his Arizona address
of record for several months. He denies the allegation. He states that he is not, and was
not, involved with drugs or having behavioral and/or emotional problems. He states that
he was asked to leave the hospital via another exit, other than the front door. He says
that hospital security did not want him to exit via the front door. He states that he
requested that the police be summoned and that the police escorted him to the front door
without incident. He adds that the Glendale police never apprehended him, detained him,
or charged him with any crime. He apologizes for any misunderstanding for what
occurred that day. Regarding the other allegation, concerning the Phoenix police, Mr.
Statts states that he summoned the Phoenix police when "certain individuals would not
leave the premises of a residence. The police escorted me elsewhere, no arrest was
made, no charges were filed against him." In response to the Boards questions on these
issues, he denies that he has a substance abuse problem with drugs or alcohol. He says
he has not recently received any treatment for substance abuse or behavioral problems.
Board staff has spoken to Paul Berg, RN, who wrote the original letter to the Board
informing the Board of the allegations. He has stated his willingness to help the Board
in its investigation. Mr. Berg is trained in behavioral health. John Coleman moved that
the Board invite Mr. Statts to an informal interview hearing. Kit Mehrtens seconded.
The Motion passed unanimously.
IX CONSIDERATION AND ACTION ON INFORMAL INTERVIEWS PURSUANT
TO A.R.S. 32-3553(G)
1. Charles Oehler
Mr. Oehler was present. The Executive Director reviewed an allegation of
unprofessional conduct against Mr. Oehler - that he had reported to work under the
influence of alcohol and had been abusive to a patient. Mr. Oehler denied the allegation.
The Board received testimony from Mr. Oehler, Mr. Chuck Cox, and Mr. Sam Uesele.
For the purpose of receiving legal advice, Sheila Bowen moved that the Board go into Executive
Session at 3:05 p.m. Kit Mehrtens seconded. The Motion passed unanimously. Sheila Bowen
moved that the Board return to public session at 3:09 p.m. Kit Mehrtens seconded. The Motion
passed unanimously.
Board Meeting
Page 9
After discussion, Karen Staudenmier moved that the Board invite Mr. Oehler to continue
this informal interview hearing and that staff prepare a draft Findings of Fact and
Conclusions ofLaw for the Board to review at its next meeting. Sheila Bowen seconded.
After further discussion, Karen Staudenmier moved that staff prepare a draft probationary
order for the Board to consider at its next meeting. Dr. Schwartzberg seconded. John
Coleman asked if the Motion could be amended to say the probationary order will contain
a requirement for a 12 step outpatient program and random testing. ,Karen Staudenmier
accepted the friendly amendment. Dr. Schwartzberg seConded. The Motion passed
unanimously. John Coleman moved that the Board issue a Decree of Censure. Kit
Mehrtens seconded. After discussion, in order to preserve the issue for the next Board
meeting, the Motion failed.
X. CONSIDERATIONANDACTIONONFORMALCOMPLAINTHEARINGS
PURSUANT TO A.R.S. §32-3SS3(H)
1. Marvin Jerew
Mr. Jerew was not present. The Executive Director requested that the Board table
consideration of this matter until the next Board meeting. Kit Mehrtens moved that the
issue be tabled until the February Board meeting. Karen Staudenmier seconded. The
Motion passed unanimously.
XI. CALL TO THE PUBLIC
There was no public presentation to the Board.
XII. DISCUSSIONIACTION ON EXECUTIVE DIRECTOR'S REPORT
A. Discussion and Action on Proposed Administrative Rules
The Executive Director advised the Board of a proposed amendment to the Board's
Proposed Rules clarifying the requirements for biennial renewal applications. After
discussion, Kit Mehrtens moved that the Board adopt the Proposed Rule with the
amendment outlined by the Executive Director:
Page 10, line 1, after the word of, insert "information on the biennial renewal
application or of," and after the word compliance, insert "in acquiring CEU's".
Karen Staudenmier seconded. The Motion passed unanimously.
B. Discussion and Action regarding legislative matters.
Board MeetiD&
Page 10
The Executive Director gave the Board an update on legislative matters.
C. Report on the Agency Budget.
The Executive Director updated the Board on the status of the Board's budget.
D. Report on Formal Attorney General Opinion regarding the ~d's Administrative
Hearings.
The Executive Director reported on the formal A.G. opinion which clarifies that Board
members can, indeed, conduct their own administrative hearings.
E. Discussion and Action on sharing expenses to send legal counsel to training:
FARB meeting, Salt Lake City, February 8 - 11.
Kit Mehrtens moved that the Board authorize expending monies to cover half of the
expenses to send its legal counsel to this training. Karen Staudenmier seconded. The
Motion passed unanimously.
1
i
F. Report on Cannabinoid Testing.
The Executive Director reviewed staff's report on Cannabinoid testing.
For the purpose of receiving legal advice, Karen Staudenmier moved that the Board go
into Executive Session at 4:45 p.m. Kit Mehrtens seconded. The Motion passed
unanimously. Sheila Bowen moved that the Board return to public session at 4:55 p.m.
Kit Mehrtens seconded. The Motion passed unanimously.
Xill. FSTABLISH DATE AND TIME OF NEXT BOARD MEETING
Thursday, February 22, 1996 at 12:00 p.m.
XIV. ADJOURNMENT
John Coleman moved to adjourn the meeting at 5:05 p.m. Karen Staudenmier seconded.
The Motion Passed unanimously.
DATED this ~'th day of FebruaI)', 1996. l
';- ,. ,:- - C--./---j --J
BOARD OF RESPIRATORY CARE EXAMINERS
BOARD MEETING MINUTES
Thursday, February 22, 1996 at 12:00 p.m.
2nd Floor Conference Room
1400 W. Washington, Phoenix AZ
Board Members Present: Chair Meryl Salit, Vice-Chair Kit Mehrtens, Sheilah Bowen, Mary
Lynn Kelly, John Coleman, Gerald Schwartzberg, M.D., and
Karen Staudenmier
Staff Present: Mary Hauf Martin, Executive Director
Dolores Doyle, Administrative Assistant
Board's Legal Counsel: Mike Harrison, Assistant Attorney General
I CALL TO ORDER
The Meeting was called to order at 12: 10 p.m. by the Board's Vice Chair, Kit Mehrtens.
IT APPROVAL OF MINUTES
John Coleman moved approval of the Minutes as presented. Mary Lynn Kelly seconded.
The Motion passed unanimously.
....._-- _.. -----.1 -7 ----
Board Meetine
Page 2
m DISCUSSIONIACTION ON APPLICATIONS FOR LICENSURE
A. Recommended for approval by the Executive Director
John H. Brohard
Beth Anne Cisco
Stephanie Graeter
Steve Johnson
Anthony McDonald
Richard Schoer
Barbara Smith
Erwin Toro
Yvonne V. Burroughs
Elizabeth Cloutier
Kathryn Hood
John T. McCarville
Terri Morfesy
Doris Sharp
Johnny L. Smith
Kristie Butterfield
Emosito Del Rosario
Jodene :S;ume Rowland
'Debora J. Maxwell
Walter D. Ruth, Sr.
Clyde D. Sigmon
Tim D. Steinmetz
Sheila Bowen moved approval of all the individuals listed on the Agenda and
recommended by the Executive Director. Mary Lynn Kelly seconded the Motion. The Motion
passed unanimously.
B. Application for Licensure
1. John Rauch
The Executive Director summarized Mr. Rauch' situation, stating that he had provided
the necessary documents establishing that he is eligible for permanent licensure. Mr. Rauch was
not present. After discussion, Mary Lynn Kelly moved that Mr. Rauch be granted a license.
Sheila Bowen seconded. The Motion passed unanimously.
2. Rose Troia
The Executive Director summarized Ms. Troia's situation, stating that she had provided
the necessary documents establishing that she is eligible for permanent licensure. Ms. Troia was
not present. After discussion, John Coleman moved that Ms. Troia be granted a license. Sheila
Bowen seconded. The Motion passed unanimously.
3. Nancy Wilcox
The Executive Director summarized Ms. Wilcox's situation, stating that she had provided
the necessary documents establishing that she is eligible for permanent licensure. Ms. Wilcox
was present and made a presentation to the Board. After discussion, John Coleman moved that
Ms. Wilcox be granted a license. Sheila Bowen seconded. The Motion passed unanimously.
C. Request for an Extension to a Temporary License
1. John Rauch (if necessary) NO ACTION WAS NECESSARY
Board MN"tjng
Page 3
IV DISCUSSION/ACTION ON ADMINISTRATIVE CLOSING OF
APPLICATION FILFS
Kimberly A. Brodeur
Candice L. Lockheart
John R. Jones
Susan Klement
Jane Senderhauf
Julianna Phillips
Apryl D. Freeman-Rice
Derrick Groves
Sheila Bowen moved that the Board administratively close the appliCation files of all the
items on the agenda. Mary Lynn Kelly seconded. The Motion passed unanimously.
V DISCUSSION/ACTION ON ADMINSTRATIVE CLOSING OF TWO YEAR
INACTIVE FILES
The Executive Director stated that these were routine two year inactive license files.
Debbie Allyn
Jim F. Durham
Thomas Fields, Jr.
Laura Hames-Wengert
Michelle Johnsen
Gary Nichols
Andrew Perez
Deanna Tsosie
John Anaya
Michael J. Evans
John R. Fleming
David Hanrahan
Marlene Jones
Rena O'Donnal
Ann Reed
Renee Tucker
Risa Bell
Robert Faubion
Roberto Guzman
Sharon D. Henry
Wendy A. Lucas
Lawrence Pavlica
Laura Taylor-Fishbeck
Asima Wagner
Mary Lynn Kelly moved that the Board administratively close the two year inactive files
of all the items on the agenda. Mary Lynn Kelly seconded. The Motion passed unanimously.
VI DISCUSSION/ACTION ON NOTICES OF LICENSE EXPIRATIONS
The Executive Director stated that these were routine license expirations.
James Abril
Al Alabado, Jr.
Eva Berstein
Larry Davis
Reynold Gilsdorf
Megan Heemsoth
Frank Keller
Donald Libby
Kirk Metzger
Nancy Pomeroy
Duke Terwillegar
Deborah Adams
John Allison
Frank Berry
Jon Farley
Maryann Gaghagen
Howard Holz ill
Karen Koenig
Karl B. Lynham
Joseph Nichols
Sue Stratton
Stephanie Watkins
Dale Alexander
Lynne Bell
Jeffrey Bills
Marian Graves
Gerry Greenfield
Dale Hostetler
Tammy Lambrecht
Cheryl L. Magallanes
Pete Pochiro
Deborah Sumner
James Valiquette
....-.....- -- ------J -7 ----
Board Meeting
Page 4
Mary Lynn Kelly moved to appove these license expirations. Karen Staudenmier
seconded. The Motion passed unanimously.
vn DISCUSSION!ACTION ON REINSTATEMENT OF EXPIRED LICENSFS
The Executive Director reported that these were routine license reinstatements.
Michelle Angus
Gerald Greenfield
Susan Delich
Howard Holz ill
4
Mary E. Edelman
Mary Lynn Kelly moved to ratify these reinstated licenses. Sheila Bowen seconded. The
Motion passed nnanimously.
VllI CONSIDERATION AND ACTION ON INVESTIGATIONS OF
UNPROFESSIONAL CONDUCT
1. Kerry Adair (continued)
Mr. Adair was present. After discussion, :Mary Lynn Kelly moved to accept the draft
standard stipulated order. Sheila Bowen seconded. Mr. Adair presented his signed copy of the
order and stated that he had read and agreed to sign the order. The Motion passed
unanimously with John Coleman recusing himself from voting.
2. Rodney M. Flickinger (continued)
Mr. Flickinger was present.
At 12:50 p.m., for purposes of receiving legal advice, Sheila Bowen moved that the Board go
into Executive Session. Karen Stmdenmier seconded. The Motion passed unanimously. At
12:58 p.m., Mary Lynn Kelly moved that the Board return to public session. John Coleman
seconded. The Motion passed unanimously.
After discussion, Mary Lynn Kelly moved to revise the draft modified stipulated order and offer
it to Mr. Flickinger. Karen Staudenmier seconded. Mr. Flickinger informed the Board that he
was willing to agree to the modified order. The Motion passed unanimously.
3. Bruce Ashworth
Mr. Ashworth was not present. The Executive Director explained that the allegation
against Mr. Ashworth is that he worked without a valid license during a time period when his
license lapsed (September 11, 1995 when his temporary license expired, through November 9,
1995 when the Board received his license fee.) The Board's office wrote to him on four (4)
occasions asking him to confirm or deny the allegation. Finally, on February 13, 1996, Mr.
Board Meeting
PageS
Ashworth called the office to say that he will not answer the questions in the letters. He stated
that he is living and working in Salt Lake City; he left Phoenix last Spring and he will not be
back. He stated in his phone message that he did not practice without a license. After
discussion, Mary Lynn Kelly moved that the Board close its investigative file on Mr. Ashworth
and that the Executive Director write him a letter to confirm what he said on the phone about
not working without a valid license. Karen Staudenmier seconded. The Motion passed
unanimously.
4. Pamela Daniels
Ms. Daniels was not present. The Executive Director explained that on November 15,
1995, the Board received a copy of the paperwork on Pamela Daniels for a positive drug screen
submitted to the University Medical Center on November 1, 1995. The test was positive for
Cannabinoids and was taken as a pre-employment drug screen with Immediate Respiratory
Staffers. The Board's office wrote to Ms. Daniels on November 20, 1995 asking her to confirm
or deny the allegation. She responded in a letter received by the Board on December 7, 1995.
Ms. Daniels states that he she submitted to a pre-employment urine drug screen on November
1, 1995 but that she had not received anything in writing as to the outcome of that screen. She
states that she tested negative on a previous screen with IRS. After discussion, Mary Lynn
Kelly moved that the Board invite Ms. Daniels to an informal interview hearing to consider the
allegation of uprofessional conduct against her. Karen Staudenmier seconded. The Motion
passed unanimously with John Coleman recusing himself from participation.
5. David Denyes
Mr. Denyes was present. The Executive Director explained that on his renewal
application, received on May 11, 1995, Mr. Denyes informed the Board of a Dill conviction
in early 1995. Since that time, Mr. Denyes has provided the Board with all the documentation
the Board requested regarding his completion of an outpatient alcohol abuse program at Verde
Valley Guidance Center in Cottonwood. In a letter received by the Board on January 24, 1996,
Mr. Denyes admits that during the time period when his license lapsed (from his previous
license expiration date of November 8, 1994 through when he applied again on May 10, 1995)
to working for All-Med Equipment and Services and performing duties including "setting up
oxygen and other home respiratory care equipment.· After discussing the matter with Mr.
Denyes, during which Mr. Denyes admitted that he had been practicing respiratory care without
a valid license for 6 months, John Coleman moved that the Board offer Mr. Denyes a Stipulated
Order which will require 6 additional approved CEU's for his biennial license renewal. Karen
Staudenmier seconded. The Motion passed unanimously.
Board Meeting
Page 6
IX CONSIDERATION AND ACTION ON INFORMAL INTERVIEWS PURSUANT
TO A.R.S. 32-3SS3(G)
1. Charles W. Oehler, case No. 01199-95-070, 2:30 p.m. (continued)
Mr. Oehler was not present.
,
At 2:40 p.m., for purposes of receiving legal advice, Sheila Bowen moved that the Board go into
Executive Session. Karen Staudenmier seconded. The Motion passed unanimously. At 2:47
p.m., Mary Lynn Kelly moved that the Board return to public session. Kit Mehrtens seconded.
The Motion passed unanimously.
After discussion, Kit Mehrtens moved that the Board issue a Formal Complaint and
Notice of Hearing to Mr. Oehler. Sheila Bowen seconded. The Motion passed unanimously.
X CONSIDERATIONANDACTIONONFORMALCOMPLAINTHEARINGS
PURSUANT TO A.R.S. §32-3SS3(G)
1. Marvin Jerew, Case No. 03720-95-067, 1:30 p.m.
Mr. Jerew was not present. Legal counsel presented the case. The Board, at its
October, 1995 meeting granted Mr. Jerew his permanent license. He was in attendance at the
meeting. The Board discussed his background, including two arrests -- one for marijuana
possession and one for domestic violence (when he got into a struggle with his teenage son while
driving and had an accident). The Board determined that the convictions were misdemeanors.
Mr. Jerew told the Board that his life was straightened out now. On October 11, 1995, we
received a Laboratory Report (from Corning Clinical Labs) from Immediate Respiratory Services
alleging that Mr. Jerew had tested positive for Cannabinoids (marijuana) on September 15, 1995.
On October 12, 1995, we wrote a letter to Mr. Jerew asking him to respond to the allegation
that he had tested positive for Cannabinoids. We asked him to respond within 10 days, but he
did not. He never responded. Mr. Jerew did not attend the Board meetings for the original
allegation of unprofessional conduct or his informal interview hearing, either. After discussion,
Kit Mehrtens moved that the Board adopt the findings of facts and conculsions of law as outlined
by legal counsel and set forth in the Formal Complaint and Notice of Hearing. Sheila Bowen
seconded. The Motion passed unanimously. Karen Staudenmier moved that the Board revoke
Mr. Jerew's license to practice respiratory care based on said findings of fact and conclusions
of law. Kit Mehrtens seconded. The Motion passed unanimously.
2. Michael Hartman, case No. 02877-95-005, 2:00 p.m.
Mr. Hartman was present. Legal Counsel presented the case. In September, Mr.
Hartman was issued a Decree of Censure and Probationary Order pursuant to a Board decision
made in March of 1995 -- for exceeding the scope of practice of an RCP. The terms of his
_._-- -- -----." ~-7 ----
Board Meeting
Page 7
probation, which were spelled out in the Order, called for reports to the Board in October and
December of 1995, with the last one due in March when his Order is due to expire. Mr.
Hartman has never filed either of the two required reports. The Board's investigator has also
determined that Mr. Hartman has failed to notify one of his employer of his Board ordered
probation. In a telephone call to the Board's office, Mr. Hartman had stated that one of his
employers has been writing reports. The Board's investigator determined that Mr. Hartman had
failed to tum the reports in to the Board. After discussion, during which Mr. Hartman • established that he believed his employer was submitting the required reports, and establishing
that reports had been generated, Mary Lynn Kelly moved that the allegation against Mr.
Hartman be dismissed. Kit Mehrtens seconded. The Motion passed unanimously. After
further discussion, during which Mr. Hartman demonstrated that reports had been prepared at
his request by his new employer, Thunderbird Samaritan Hospital, John Coleman moved that
the Board accept the reports from Thunderbird Samaritan Hospital as Mr. Hartman's final report
to the Board, completing his probation. Mary Lynn Kelly seconded. The Motion passed
unanimously.
XI CONSIDERATION AND ACTION ON REQUFST FOR REHEARING
1. Malcolm Val Phoenix, Case No. 01509-95-059, 4:00 p.m.
Mr. Phoenix was not present. Legal counsel presented the case. The Board received a
letter from Malcolm Val Phoenix requesting reconsideration and rehearing of the Board's Order
of Revocation. The Board's Order was issued on December 22, 1995, and mailed by certified
mail with return receipt requested on the aforementioned date. The U.S. Mail return receipt
received by the Board's Executive Director reflects that Mr. Phoenix signed for receipt of the
Board's Order on January 2, 1996. Mr. Phoenix submitted his request for rehearing by letter
which was received by the Board on January 10, 1996. Said letter fails to set forth any grounds,
such as mistakes of law or fact, upon which to support his argument for rehearing. After
discussion, John Coleman moved to deny Mr. Phoenix's request for a rehearing based on the
findings of fact and conclusions of law presented by legal counsel. Kit Mehrtens seconded. The
Motion passed unanimously.
xu CONSIDERATION AND ACTION ON REQUFST FOR WAIVER OF CEU'S
1. Bema McDonald
Ms. McDonald was not preset. The Executive Director -reviewed Ms. McDonald's
request and informed the Board that Ms. McDonald meets the criteria for requesting a waiver
from completion of CEU's set forth in Board Rule 212(C)(I). After discussion, John Coleman
moved to grant Ms. McDonald's request for a waiver of the CEU requirement for her current
license renewal. Kit Mehtens seconded. The Motion passed unanimously.
Board MeetiDI
Page 8
xm CONSIDERATION AND ACTION ON REQUEST FOR MODIFICATION OF
PROBATION
1. Paul Bianco
Mr. Bianco was not present. The Executive Director reviewed Mr. Bianco's request.
In January, 1995, Mr. Bianco stipulated to an Order for Probation and ~ehabilitation. Mr.
Bianco appeared before the Board in November. He is living mGeorgia and has applied for
licensure in that state. He states in his letter of request, received by the Board on January 24,
1996, that he is scheduled to go before the Georgia licensing Board but that he does not know
whether his license will be granted "free and clear" or whether it will include probation. He
also states that his Georgia application file is not complete because his last Arizona employer
has not yet written the necessary letter for him. After discussion, Karen Staudenmier moved
the Board offer an amended stipulation agreement to Mr. Bianco which will place a stay on the
Arizona requirements while he is living in Georgia, and that since this is a stipulation, should
Mr. Bianco refuse to agree to the modifications, the original stipulated order will remain in
effect. Sheila Bowen seconded. The Motion passed 6-1 with Mary Lynn Kelly voting no.
XIV CALL TO THE PUBLIC
There was no public presentation to the Board.
XV DISCUSSIONIACTION ON EXECUTIVE DIRECTOR'S REPORT
A. Discussion and Action regarding legislative matters.
The Executive Director gave the Board an update on legislative matters.
XVII ESTABLISH DATE AND TIME OF NEXT BOARD MEETING
Thursday, March 21, 1996 at 10:00 a.m.
XVIII ADJOURNMENT
John Coleman moved to adjourn the meeting at 4:02 p.m. Karen Staudenmier seconded.
The Motion Passed unanimously.
DATED this 1th day of March, 1996.
- i
/
BOARD OF RESPIRATORY CARE EXAMINERS
BOARD MEETING MINUTES
,
Thursday, March 21, 1996 at 10:00 a.m.
2nd Floor Conference Room
1400 W. Washington, Phoenix AZ
Board Members Present: Chair Meryl Salit, Vice-Chair Kit Mehrtens, Sheilah Bowen,
John Coleman, Gerald Schwartzberg, M.D., and
Karen Staudenmier
Board Members Absent: Mary Lynn Kelly
Staff Present: Mary Hauf Martin, Executive Director
Dolores Doyle, Administrative Assistant
Board's Legal Counsel: Mike Harrison, Assistant Attorney General
I. CALL TO ORDER
The Meeting was called to order at 10: 12 a.m. by Chair Meryl Salil.
ll. APPROVAL OF MINUTES
Kit Mehrtens moved approval of the Minutes as presented. Karen Staudenmier seconded.
The Motion passed unanimously.
MlDUles 01 lV.aan::II ~.1, .1.7:71)
Board Meeting
Page 2
ID. DISCUSSION/ACTION ON APPUCATIONS FOR UCENSURE
A. Recommended for approval by the Executive Director
Shelly David Biletsky
Janet L. Carter
Denise M. Castricone
James D. Cristaniello
Michael P. Drabek
Sherry L. Bartley
Cristian E. Chera
Douglas A. Elliott
James W. Ervin, Jr.
Ernest C. Esteban
Patricia A. Ferraro
David W. King
Kimberly A. Brodeur
Debra A. Zwier
Tracy Jo Paulley
Joseph Schermick, Jr.
Rebecca A. Valenzuela
Donn Webb
Kimberly D. Caldwell
Karen Staudenmier moved approval of all the individuals listed on the Agenda and
recommended by the Executive Director. Kit Mehrtens seconded the Motion. The
Motion passed unanimously.
B. Application for Licensure
C. Request for an Extension to a Temporary License
IV. DISCUSSION/ACTION ON ADMINISTRATIVE CWSING OF
APPLICAnON FILES
The Executive Director recommended the following files to be closed:
Loren "Harlan" Green
Jon R. Farley
Karen L. Peebles
Richard Topey
Leighton Bartell
Teresa M. Holt
Raid M. Rabadi
Leo P. Wangen
Kit Mehrtens moved that the Board administratively close the application files of all the
items on the agenda. Sheila Bowen seconded. The Motion passed unanimously.
V. DISCUSSION/ACTION ON ADMINISTRATIVE ,CLOSING OF TWO YEAR
INACTIVE FILES
The Executive Director stated that these were routine two year inactive license files.
Dorothy J. Blevins
Lee Douglas
Thomas R. Kolich
Amy R. Boyd
Robert W. Dunn
Joy A. Lynn Schroeder
Susan L. DeFabis
Victor A. Ince
Paula A. O'Connor
MlDUles 01 MaI'CD ~J., J.~
Board Meeting
Page 3
Mitchell A. Pederson Gwendolyne E. Rouse Ruth Williams
John Coleman moved that the Board administratively close the two year inactive files of
all the items on the agenda. Sheila Bowen seconded. The Motion passed unanimously.
VI. DISCUSSION/ACTION ON NOTICES OF UCENSE EXPIRATIONS
,
The Executive Director stated that these were routine license expirations.
Brenda Blum
Linda Doherty
Deanna Jeffries
Kim Hoffmeyer
Rickie Ishmael
Deborah Nutt
Lorraine Vanover
Nancy Butterick
Steven Bide
Joseph Haskins
Joanne Holliday
Richard Mitchell
Marilyn Pena
Kieran Cox
James Gamboa
George Hay
Shirley Hughes
Tracy Mulvaney
Carol Record
Karen Staudenmier moved to approve these license expirations. John Coleman seconded.
The Motion passed unanimously. John Coleman moved that the Board open an
investigation into case of Nancy Butterick. Karen Staudenmier seconded. The Motion
passed unanimously.
Vll. DISCUSSION/ACTION ON REINSTATEMENT OF EXPIRED LICENSFS
The Executive Director reported that these were routine license reinstatements.
Megan L. Heemsoth John W. Hampton
John Coleman moved to ratify these reinstated licenses. Sheila Bowen seconded. The
Motion passed unanimously.
VllI. CONSIDERATION AND ACTION ON INVESTIGATIONS OF
UNPROFESSIONAL CONDUCT
1. Richard Luscher
Mr. Luscher was not present. The Executive Director explained that Mr. Luscher
applied for licensure on June 8, 1994. He received a Temporary License on June 9,
1994 valid through February 9, 1995. The Board approved his permanent license on
June 30, 1994. His permanent license became valid on July 5, 1994 when he remitted
his licensure fee. He is currently the holder of License No. 03211 which is valid through
October 1, 1996. On his license application to the Board, on question number 19 which
asks ·omitting minor traffic violations, have you ever been arrested or charged or
Minutes or March 21, 1996
Board Meeting
Page 4
convicted of or pled no contest (nolo contendre) to any violation of any law of any state,
the United States or a foreign country? THIS INCLUDES ALL MISDEMEANORS
AND FELONIES, Mr. Luscher answered -no. - On December 28, 1995, the Board
received an allegation from Sun Health Corporation that Mr. Luscher pled guilty to a
class 4 felony and was convicted in 1981 for criminal simulation. The allegation further
stated that Mr. Luscher's rights had been restored in 1985. When Sun Health
Corporation contacted Mr. Luscher regarding this info~tion, he denied (to Sun Health)
that this infonnation was about him. When the Board staff investigated this allegation
we subpoenaed infonnation from the agency that did the background check for Sun
Health, Arizona Investigations. In a letter to the Executive Director, Arizona
Investigations stated that Mr. Luscher also has an outstanding felony warrant charging
aggravated theft out of Medford, Oregon. After discussion, John Coleman moved that
the Board issue a Fonnal Complaint and Notice of Hearing to Mr. Luscher. Kit
Mehrtens seconded. The Motion passed unanimously.
2. Kevin J. Marquis
Mr. Marquis was present. The Executive Director explained that Mr. Marquis is the
holder of license number 02343 issued on June 15, 1994 and valid through June 15,
1996. On December 27, 1995, the Board received a notice from Boswell Hospital that
Mr. Marquis was terminated from his job for cause. Mr. Marquis was terminated for
unacceptable job perfonnance, sleeping on the job, and for the admitted use of Halothane
on the job. Halothane is an anesthetic agent. The Board's investigator determined that
Mr. Marquis had received several written reprimands. These reprimands were placed
in his employee file. The documentation establishes poor job perfonnance for the
following reasons: not following departmental procedures; not answering pages; sleeping
on the job; and admitted use of Halothane while on duty. The Board's investigator
further detennined that during the latter period of his employment, Mr. Marquis was
tested for drugs, but no positive reports were found. The Board's investigator was told,
by a representative of Sun Health, that Halothane does not appear on a standard drug
screen. When Mr. Marquis was terminated, Sun Health advised him to contact a Dr.
Mike Cofield at employee counseling because of his admitted drug use. After discussing
the matter with Mr. Marquis, and detennining that more infonnation is needed, Mr.
Marquis stated his willingness to work with the Board. Kit Mehrtens moved that the
Board issue a Fonnal Complaint and Notice of Hearing to Mr. Marquis. Karen
Staudenmier seconded. After discussion, Kit Mehrtens withdrew her motion and Karen
Staudenmier withdrew her second. Karen Staudenmier moved that the Board invite Mr.
Marquis to an Informal Interview Hearing. Kit Mehrtens seconded. The Motion passed
unanimously. Sheila Bowen moved that the Board subpoena the policy or rule of
Boswell hospital which would be pertinent to this case. Karen Staudenmier seconded.
The Motion passed unanimously. After discussion, during which Mr. Marquis agreed
to have a complete medical evaluation done and submit the results to the Board, Karen
Staudenmier moved to place the lnfonnal Interview Hearing with Mr. MarqUis on the
MInutes 01 .M.81"CD. :.u., l~
Board Meeting
Page 5
agenda for the May 1996 Board meeting. Kit Mehrtens seconded. The Motion passed
unanimously.
3. Franklin Miller
Mr. Miller was present. The Executive Director explained that Mr. Miller is the holder
of license number 00706, valid through August 6, 1996. Qn January 8, 1996, the Board
received a request to investigate this matter from the Arizona Department of Health
Services, Emergency Medical Services. The allegation was instructed to be sent to the
Board by Toni Brophy, M.D., Medical Director for Emergency Medical Services along
with the results of E.M.S. 's preliminary investigation which found that their Office had
no jurisdiction over any of the individuals involved. E.M.S. identified the respiratory
technician on board as Frank Miller, CRTT. The allegation was also forwarded to the
Arizona Board of Medical Examin~rs and the Board of Nursing. After discussion, Karen
Staudenmier moved to open an investigation in this case to determine whether there was
basis for an allegation against Mr. Miller. Kit Mehrtens seconded. The Motion passed
unanimously. Dr. Schwartzberg moved to reopen this agenda item. Karen Staudenmier
seconded. The Motion passed unanimously. After discussion, Dr. Schwartzberg moved
to rescind the Board's prior vote to open an investigation. Kit Mehrtens seconded. The
Motion passed unanimously. Dr. Schwartzberg moved to dismiss the allegation against
Mr. Miller. Kit Mehrtens seconded. The Motion passed unanimously.
4. Robert E. Schrader
Mr. Schrader was present. The Executive Director explained that Mr. Schrader is the
holder of license number 02449, valid through April 23, 1997. On December 7, 1995,
the Board received a letter containing an allegation of unprofessional conduct against Mr.
Schrader from Lynn Hill, the Human Resources Manager at Paradise Valley Hospital.
The allegation involves an incident regarding Mr. Schrader which occurred on November
23, 1995. The incident was "inappropriate behavior in conjunction with the odor of
alcohol." The letter states that Mr. Schrader was counseled on November 24, 1995 and
given final warning against any reoccurrence. Mr. Schrader told the Board that due to
illness, he had recently been hospitalized and unable to work. He presented the Board
with a release from his doctor to return to work. He stated his willingness to work with
the Board and enter into a Stipulation and Consent Order for Rehabilitation. After
discussion, Kit Mehrtens moved that the Board offer Mr. Schrader a standard Stipulation
and Consent Order for Rehabilitation. Sheila Bowen seconded. The Motion passed
unanimously.
Minutes of March 21, 1996
Board Meeting
Page 6
IX. CONSIDERATION AND ACTION ON INFORMAL INTERVIEWS PURSUANT
TO A.R.S. 32-3SS3(G)
1. Pamela Daniels, Case No. 01685-95-075
Ms. Daniels was present. The Executive Director explained that on November 15, 1995,
the Board received a copy of the paperwork on Pamela DaJ,1iels for a positive drug screen
submitted to the University Medical Center on November 1, 1995. The test was positive
for Cannabinoids and was taken as a pre-emp1oyment drug screen with Immediate
Respiratory Staffers, and was subsequently verified by GeMS. The Board's office wrote
to Ms. Daniels on November 20, 1995 asking her to confirm or deny the allegation. She
responded in a letter received by the Board on December 7, 1995. Ms. Daniels states
that he she submitted to a pre-employment urine drug screen on November 1, 1995 but
that she had not received anything in writing as to the outcome of that screen. She states
that she tested negative on a previous screen with IRS. After discussion, during which
the Executive Director informed the Board that it is IRS' policy to inform people
regarding positive test results via the telephone, Kit Mehrtens moved that the Board offer
Ms. Daniels a .modified Stipulation and Consent Order for Rehabilitation. Karen
Staudenmier seconded. The Motion passed unanimously with John Coleman recusing
himself from participation.
2. Frank Mamone, Case No. 01460-95-074
Mr. Mamone was not present. Karen Staudenmier recused herself from the proceeding.
The Executive Director explained that on November 2, 1995, the Board received a letter
from Vencor Hospital stating that Mr. Mamone had been terminated, effective September
13, 1995. Discrepancies and potentially fraudulent charting were noted upon review of
the charts of patients under Mr. Mamone's care. The Executive Director explained that
at the January Board Meeting, Mr. Mamone appeared and discussed this matter with the
Board. The Board voted to invite Mr. Mamone to this Informal Interview Hearing and
to subpo
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| Rating | |
| TITLE | Final sunset report: Board of Respiratory Care Examiners |
| CREATOR | Senate Health Committee of Reference & House Health Committee of Reference. |
| SUBJECT | Sunset reviews of government programs--Arizona; Respiratory therapists--Arizona; |
| Browse Topic |
Government and politics |
| DESCRIPTION | 156 pages (PDF version). File size: 6224271 Bytes. |
| Language | English |
| Publisher | Senate Health Committee of Reference & House Health Committee of Reference. |
| TYPE | Text |
| Material Collection |
State Documents House Received Reports |
| Acquisition Note | Publication or link to publication sent to reports@lib.az.us |
| RIGHTS MANAGEMENT | Copyright to this resource is held by the creating agency and is provided here for educational purposes only. It may not be downloaded, reproduced or distributed in any format without written permission of the creating agency. Any attempt to circumvent the access controls placed on this file is a violation of United States and international copyright laws, and is subject to criminal prosecution. |
| DATE ORIGINAL | 1996-10-23 |
| Time Period |
1990s (1990-1999) |
| ORIGINAL FORMAT | Paper |
| DIGITAL IDENTIFIER | BOARD OF RESPIRATORY SUNSET 1996.pdf |
| DIGITAL FORMAT |
PDF (Portable Document Format) |
| DIGITIZATION SPECIFICATIONS | Digitized into PDF form through scanning at the Records Management Division, Arizona State Library. |
| REPOSITORY | Arizona State Library, Archives and Public Records--Law and Research Library. |
| Full Text | Date: October 23, 1996 Senate Health Committee ofReference & House Health Committee ofReference HEALTH COMMITTEE OFREFERENCE REPORT ON THE BOARD OF RESPIRATORY CARE EXAMINERS The Board ofRespiratory Care Examiners be continuedfor ten years. To: JOINT LEGISLATIVE AUDITCOMMIITEE Patricia Noland, Co-Chair Sue Grace, Co-Chair Janice,Brewer / James Henderson Pursuant to Title 41, Chapter 27, Arizona Revised Statutes, the Committee ofReference, after perfonning a sunset review and conducting a public hearing, recommends the following: Don Aldridge ' . ~~r~·=------'::::::~~:::J...:::01:..L...o)~_ _______~ LS~~~~ s~n~ e~~z;;t'z~ David Petersen Lou-Ann Preble I I I I I I I I I I I I I I I I I I COMMITTEE OF REFERENCE REPORT ON THE BOARD OF RESPIRATORY CARE EXAMINERS I. BACKGROUND Pursuant to section 41-2953, Arizona Revised Statutes, the Joint Legislative Audit Committee (JLAC) assigned the sunset review of the Board of Respiratory Care Examiners to the Committee of Reference comprised of members of the Senate Health Committee and the House of Representatives Health Committee. A performance audit of the Board was conducted by the Health Committee of Reference and is included (Attachment ). II. COMMITTEE SUNSET REVIEW PROCEDURE The Committee of Reference held one public hearing on Wednesday October 23, 1996, to consider the sunset report and receive public testimony regarding the Board of Respiratory Care Examiners. The Committee heard testimony form Ms. Mary Hauf Martin, Executive Director of the Board of Respiratory Care Examiners, David Feuerherd, Program Director, American Lung Association, and John Coleman, RCP and Member of the Board. Ms. Hauf Martin testified: • that the Board compares favorably to similar boards as indicated by an independent study performed by the Auditor General; • that the Board is adapting to a changing health care delivery system environment; • that a majority of the Board is not made up of practitioners and takes its responsibility to protect the public health very seriously; • that there is a gradual increase in the number of complaints against practitioners and the biggest problem is substance abuse by practitioners. She noted that facilities routinely perform preemployment and "for cause" drug screens. Mr. Feuerherd expressed his support for continuing the Board. Mr. Coleman indicated that the issue of benefits being cut back in the managed health care environment requires that home care companies adapt their contracts with managed care health plans. Minutes of the public hearing held on October 23, 1996, are attached. III. COMMITTEE RECOMMENDATIONS I I I-I I I ,I I I I I I I I I I I I I I I I I I' I Ii I I I, I' I I "I I I I The Health Committee of Reference recommends that the Board of Respiratory Care Examiners be continued for ten years. IV. STATUTORY REPORT PURSUANT TO SECTION 41-2954 (F), ARS 1. Identification of the Problem or the Needs that the Board is Intended to Address. The Board of Respiratory Care Examiners was established in 1990 to regulate the practice of respiratory care. The Board's primary purpose is to protect the public from unauthorized and unqualified practice of respiratory care and from unprofessional conduct by persons licensed to practice respiratory care. The Board consists of 3 practitioners, 1 medical doctor, 1 hospital administrator, and 2 public members all of which are appointed by the governor. 2. A Statement, to the Extent Practicable, in Quantitative and Qualitative Terms, of the Objectives of Such Board and Its Anticipated Accomplishments. The objectives of the Board of Respiratory Care Examiners are to process respiratory care license applications and review and adjudicate complaints against licensees. In addition, Board subcommittees are established to work on subjects such as practice issues and rule drafting. The Board also is to mandate continuing education requirements and maintain minimum standards of competence for those who practice respiratory care. 3. Identification of Any Other Boards Having Similar, Conflicting or Duplicating Objectives. The Board of Respiratory Care Examiners has no other boards, agencies, or councils with conflicting or duplicating objectives. 4. Assessment of the Consequences of Eliminating the Board or of Consolidating it with Another Board. Regulation of respiratory care practitioners is necessary for the protection of the public health, safety and welfare. The need for control, guidance, intervention, monitoring and supervision of practitioners is well established. Regulatory oversight ensures that practitioners are continuing their educations. In addition, the Board must ensure that a practitioner who enters the homes of patients, and care for and evaluate those patients, can effectively respond to their needs. V. ATTACHMENTS A. Cover Letter B. Meeting Notice C. Performance Audit D. Minutes of Committee of Reference Meeting E. Attendance List I I I-I I 'I I \1 I I I I 'I I I I' I I I I ,I I I I I I I, 1/ '. I I 'l I I I I I I COVER LETTER (Section A) I I, I I I If I t ,~ lI I I I I I I Ii J\rt:;oltu ~tnt£ IfcBtslnturc 1700 IDrst Wnsryington lff~ocnix, J\rizona 85007 June 13, 1996 Ms. Meryl Salit Board ofRespiratory Care Examiners 1400 West Washington Suite 200 Phoenix, AZ 85007 Dear Ms. Salit: The sunset review process prescribed in Title 41, Chapter 27, Arizona Revised Statutes, provides a system for the Legislature to evaluate the need to continue the existence of state agencies. Under the sunset review process, an agency is reviewed by a legislative committee of reference. Upon completion ofthe sunset review, the committee of reference recommends to continue, revise, consolidate or terminate the agency. The Joint Legislative Audit Committee (JLAC) has assigned the sunset review ofthe Board ofRespiratory Care Examiners to the Committee ofReference comprised of members ofthe Senate Health Committee and the House ofRepresentatives Health Committee. ARS section 41-2954 requires the Committee of Reference to consider certain factors in deciding whether to recommend continuance or termination of an agency. Please provide your response to those factors as provided below: 1. The objective and purpose in establishing the Board. 2. The effectiveness with which the Board has met its objective and purpose and the efficiency with which it has operated. 3. The extent to which the Board has operated within the public interest. 4. The extent to which rules adopted by the Board are consistent with the legislative mandate. 5. The extent to which the Board has encouraged input from the public before adopting its rules and the extent to which it has informed the public as to its actions and their expected impact on the public. Thank you for your cooperation. Please contact me if you have any questions. 9. The extent to which changes are necessary in the laws ofthe Board to adequately comply with the factors listed in this subsection. 10. The extent to which the termination of the Board would significantly harm the public health, safety or welfare. 11. The extent to which the level of regulation exercised by the Board is appropriate and whether less or more stringent levels of regulation would be appropriate. I I I-Ij '1 t I it ~, I I I I I I I I I Sue Gerard Co-Chair Health Committee ofReference Sincerely, 12. The extent to which the Board has used private contractors in the performances of its duties and how effective use of private contractors could be accomplished. 8. The extent to which the Board has addressed deficiencies in its enabling statutes which prevent it from fulfilling their statutory mandate. Board ofRespiratory Care Examiners June 13, 1996 Page 2 6. The extent to which the Board has been able to investigate and resolve complaints that are within its jurisdiction. 7. The extent to which the Attorney General or any other applicable agency of state government has the authority to prosecute actions under the enabling legislation. In addition to responding to the factors in ARS section 41-2954, please provide the committee of reference with copies of minutes from your meetings during fiscal years 1994 through 1996, and an annual report, and respond to the attached questionnaire by July 30, 1996 so that we may proceed with the sunset review and schedule the required public hearing. AD/SG/cmh Attachment cc: Mary Hauf-Martin Senator Ann Day Co-Chair Health Committee of Reference I I I I: I I f IIII I I j II I I BOARD OF RESPIRATORY CARE EXAMINERS Please respond to the following questionnaire: 1. Describe the role and function of the board including major activities/projects, accomplishments and obstacles to success. 2. Provide financial data such as number offull time employees, expenditures and revenues and fee structure. 3. Provide infonnation regarding board composition including number ofmembers, number of public members and method of appointment. 4. Discuss the need for licensure including potential harm to the public and examples of complaints. 5. Provide licensing data including number oflicenses by category, number of out of state licenses, number of limited or restricted licenses and reciprocity agreements. 6. Provide examination data such as use of a national exam, use of oral and practical exams and weighing of exams. 7. Provide disciplinary data, including the number of complaints (by type), number dismissed (by reason), number of hearings held and number of actions (probations, suspensions and revocations). I I I 1\ I II I, I I) I J I, I J I I I I, MEETING NOTICE (Section B) SUNSET REVIEWS OF THE II. AZ Council on Arthritis & Musculoskeletal Diseases MEETING NOTICE BOARD OF RESPIRATORY CARE EXAMINERS Representative Gerard, Co-chair Representative Aldridge Representative Preble Representative Foster Representative Horton AGENDA Wednesday, October 23, 1996 9:00 a.m. - Noon Senate Hearing Room 2 JOINT LEGISLATIVE COMMITTEE FOR THE ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM (AHCCCS) ARIZONA STATE LEGISLATURE OPEN TO THE PUBLIC SENATE AND HOUSE HEALTH COMMITTEES OF REFERENCE ARIZONA COUNCIL ON ARTHRITIS & MUSCULOSKELETAL DISEASES KB/ak -TItle II of the Americans With Disabilities Act prohibits the Arizona Senate from discriminating on the basis of disability in the provision of its services and public meetings. Individuals with disabilities may request reasonable acconwnodations, such as interpreters or ahernative formats, by contacting the Senate Secretary's Office at (602) 642-4231 (voice) as soon as possible. Please be specific about the agenda item in which you are interested and for which you are requesting an accommodation. The Senate may not be able to provide certain accommodations prior to the meeting unless they are requested a reasonable time in advance of the meeting. This agenda will be made available in an ahernative format on request. MEMBERS: Senator DayI Co-chair Senator Brewer Senator Petersen Senator Henderson Senator Kennedy TIME: DATE: PLACE: III. Joint Legislative Committee for AHCCCS I. Board of Respiratory Care Examiners I I I I I I »1(; I I I I I I I I I I I I I t I I I f Ii I I ,I I"·, , I I IaI PERFORMANCE AUDIT (Section C) 1 Board was created: Dear Co-Chairs and Members of the Committee of Reference: Mary HaulManin Executive Director Dee Doyle Administrative Assistant Telephone No. (602) 542-5995 Fax No. (602) 542-5900 State ofArizona Board ofRespiratory Care Examiners 1400 W Washington, Suite 200 Phoenix, Arizona 85007 Honorable Ann Day Honorable Sue Gerard Co-Chairs Health committee of Reference Arizona State Legislature 1700 West Washington Phoenix, Arizona 85007 and welfare and should be SUbject to regUlation and control by protect the pUblic from unauthorized and unqualified practice of respiratory care and from unprofessional conduct by persons the board of respiratory care examiners in the pUblic interest to respiratory care in this state affects the pUblic health, safety "The legislature finds and declares that the practice of have this opportunity to provide information in response to your is evident in the Legislative intent clause provided at the time the letter and que~tionnaire dated June 13, 1996, regarding the Board's The Arizona Board of Respiratory Care Examiners is pleased to sunset review. In response to the questions posed by A.R.B. 541-2954: I. The objective and purpose in establishing the Board. The Board was created by the Thirty-ninth Legislature, Second Regular session, 1990 (A.R.S. §32-3501 et seg.). The Board's purpose July 30, 1996 Meryl S. SaUl, R.C.P., Chair Kit Mehnens, Vice-Chair Sheilah N. Bowen, R.C.P. John E. Coleman, R. C.P. Mary Lynn Kelly Gerald Schwanzberg, M.D. Karen L Staudenmier I I I I I I ,I I I I I J, I I I1 I I licensed to practice respiratory care." 2. Tbe effectiveness witil wbicb tile Board bas met: it:s object:ive and purpose and tile efficiency witil whicb it: bas operat:ed. The Board has been meeting its overall objective to protect the pUblic health, while processing license applications and complaints against licensees in a fair and expedient manner. A review of the recent independent audit of all health regulatory boards, released by the Auditor General in December 1995, reveals a very favorable comparison between the Board and other, similar entities. While the initial estimate (in 1990, during the legislative enactment) was that the Board would have regulatory oversight of approximately 1,400 Respiratory Care Practitioners (RCP), the number is closer to 4,000. This number does not include the many, and widely fluctuating number, of Temporary Licensees under the Board's jurisdiction. The Board issues Temporary Licenses, to qualified persons, 24 hours after the receipt of a complete license application. Currently, from the time a complaint against an RCP is received, it takes 60 days, on average, for final Board action to occur. 26% (73 out of 280) of complaints have resulted in disciplinary action, while 34% (96 out of 280) complaints resulted in a warning being given to a licensee (this warning is called a Letter of Concern.) The Board makes a resolute effort to receive pUblic input on its activities by providing an opportunity for the pUblic to speak at every monthly Board meeting. The Board has established working subcommittees, with a large percentage of licensees participating, on sUbjects such as scope of practice issues and rule drafting. The 2 I I I-I j I ,t, I I I I I, I I I I I I I I I I I I II I 1 I J, I I fi I I Board staff makes a concerted effort to provide easy access to all pUblic information to Arizona citizens. 3. The extent: t:o which 'the Board has operat:ed wit:bin 'the public int:erest:. The Board of Respiratory Care Examiners has an ongoing commitment to operating in the pUblic interest. The Legislature established the Board with an excellent blend of membership: 3 practitioners, 1 medical doctor, 1 hospital administrator, and 2 pUblic members. Because a majority of the Board is not made up of practitioners, the pUblic is consistently well served. The 3 practitioner members serve a very important, and valuable, role in providing expertise on the complicated issues involved in the practice of respiratory care. Board meetings are well attended by the pUblic, health care facilities and interested licensees. The licensed pUblic is treated fairly and expediently by the Board's administrative process. Allegations against licensees that prove to be without merit are dismissed; and when the Board finds that a licensee has engaged in unprofessional conduct, it results in discipline fitting the particular level of seriousness of the offense. The Board periodically reviews its disciplinary history in an effort to be consistent and fair in its deliberations and decisions. 4. The extent to which rules and regulations promulgat:ed by 'the Board are consistent: wit:h the legislative mandat:e. The only rules and regulations promulgated by the agency have been the administrative rules necessary to administer the enacting legislation. 3 s. The erten1: 1:0 which t:he Board has encouraged inpu1: from t:he public before promulga1:ing i 1:s rules and regula1:ions and t:he erten1: 1:0 which i 1: has informed t:he public as 1:0 i 1:s ac1:ions and t:heir expec1:ed impact: on t:he public. During the development of the Board's administrative rules, a Rules Committee was established. The Rules Committee met for many months. Representatives from every segment of the licensed population, were on the Committee, along with a representative of the state Society for Respiratory Care and pUblic members. Every reasonable and practicable recommendation by members of the Committee was incorporated into the rules package. The proposed rules were so well accepted that during the required comment period, and oral hearing, there was no additional input to the Board. 6. The extent to which t:he Board has been able to investiga1:e and resolve complaints wit:hin its jurisdiction. The Board is committed to fair and expedient resolution of complaints. Due to the very large number of licensees, and the small staff, the Board has had to place special emphasis on the aggressive pursuit of serious complaints. The Legislature responded to the Board's needs and established an FTE, in fiscal year 1997, to accommodate the Board's need for fair and expedient determination of jurisdiction, investigation and resolution of complaints. until now, the Board had been managing, but had been using contract employees on a part-time basis. Being able to utilize in-house staff will provide stability and allow the Board to have better, consistent, and more frequent, state-wide inspections; and more constant oversight of the Board's probationary licensees. 4 I I I I I I, I I J I I I I I I ,I I I (* Individuals who held Temporary licenses, but failed to or never met criteria for licensure) Total number of license denials 18 Total number of complaints 1992 30 1993 74 1994 52 1995 84 1996 (six months only) -i.Q Total 280 I I t I I I II I I IJ I I I I I I I Board Statistics Total number of licensees: Total RCP licenses issued Current active RCP licenses Inactive RCP Licenses (Expired) CUrrent Temporary Licenses Total Temporary Licenses expired Letters of Concern 5 4,056 3,805 251 124 662 96 * [Note: please see attached Exhibit A for a full summary of Board activity.] Disciplinary Actions: Decrees of Censure Probation Board Ordered Stipulated Disciplinary Non-Disciplinary Suspensions Surrendered license Revocations Total Disciplinary Actions Cases dismissed Cases referred to another agency 6 17 2 27 5 2 1 ll. 73 35 8 I I I-I I I I I I I I I I II I I I I I I I I I I t I II I I f II I I I I I 7. Phe ertent to which the Attorney General., or any other applicable agency of state government has the authority to prosecute actions under enabling legislation. The Attorney General and the county attorneys all have authority under the Board's enabling statutes to prosecute unlawful actions. Depending on the type of unlawful act that is committed, the Board contacts the appropriate agency. 8. Phe extent to which the Board has addressed deficiencies in its enabling statutes which prevent it from fulfilling its statutory mandates. In 1995, the Board attempted to have a bill passed that would have "cleaned up" the enabling statutes. All the changes recommended by the Board were simple things; i.e. technical, language and clarity changes. Unfortunately, the bill was amended in such a way as to be detrimental to the pUblic health. The amendment language was so harmful to the pUblic that the state Society for Respiratory Care urged the Board to allow the bill to fail, rather than accept the amendment language. In the end, that is exactly what happened. The legislative sponsor asked the Board for input. The Board asked the bill's sponsor to allow the bill to die; and it did. 9. Phe ertent to which changes are necessary in the laws of the Board to adequately comply with the factors in the Sunset Law. The Board can continue to operate as it has since its inception. The technical, language and clarity changes proposed by the Board in 1995 would be helpful, but are not necessary at this time. The Board would also propose that the Legislature allow the Board to study the situation regarding Temporary Licensees. While the 7 original intent was to allow students to receive Temporary Licenses while they waited to take the credentialling exam (Note: by law, Temporary Licensees must only practice under the direct supervision of a licensed RCP or licensed physician), the current statutory language provides for a Temporary License to be issued to all qualified persons who apply. The Board could report back to the Legislature in the 1998 Legislative Session with proposed statutory changes. ~O. The ertent to which the termination of the Board would significantly harm the public health, safety and welfare. Regulation of RCPs is necessary for the protection of the public health, safety and welfare. The need for the control, guidance, intervention, monitoring and supervision of RCPs is well established. Forty-two states (and the District of Columbia and Puerto Rico) have laws regulating the practice of RCPs. RCP's are trained to use hightechnology medical equipment and perform procedures which may strongly affect the health, welfare and safety of their patients. Respiratory care often calls for the use of complex medical equipment such as mechanical ventilators, which requires special training and on-going education regarding the new technologies upon which the medical industry will increasingly depend. Regulatory oversight ensures that RCPs are continuing their educations. RCPs currently provide services in settings covering the full continuum of health care -- from hospitals to skilled nursing facilities to home health care. As RCPs are following their patients into the community, a strong licensure and enforcement act is especially critical. The Board must ensure that RCP who enters the homes of patients, and care for and evaluate those patients, can effectively respond to their needs. 8 I I I-I I I t I II I I I' ,I I I I I, I I I I I I I I I, I I I I I Ij I I ~~ • The exten't 'to which 'the level of regula'tion eJCercised by 'the Board is appropria'te and whe'ther less or more s'tringen't levels of regula'tion would be appropria'te. In the Board's enabling statutes, the legislative intent clause makes it clear that: liThe legislature also recognizes that the practice of respiratory care is a dynamic and changing art and science which is continually evolving to include new developments and more sophisticated techniques in patient care, thus creating a need for continuing education and maintenance of minimum standards of competence for those who practice this area." liThe intent of the legislature in this act is to provide clear legal authority for functions and procedures which have common acceptance and usage. In this act, the legislature also intends to recognize the existence of overlapping functions between physicians, registered nurses, physical and occupational therapists, respiratory care practitioners and other licensed health care personnel and to continue to allow appropriate sharing of functions among the various health care professions." Therefore, the Board has endeavored to be strong, yet flexible, in exercising its regulatory responsibilities. Reps are, by training, adaptable to the evolving health care environments and have historically worked collaboratively with interdisciplinary health care teams. The Board has made every effort to find the appropriate balance between oversight and interference. ~2 • The extent to which 'the Board has used private contractors in the performance of its duties and how effective use of the private contractors could be accomplished. 9 Due to the small size of the Board's staff, the only current use of private companies is in the area of court reporting for disciplinary hearings. This is a necessary utilization of a private company, because when a licensee appeals a Board decision (as all licensees are entitled to do), a transcript must be available for the appeal process. 10 I I II I I I I I1 I I t I I I i I I In response to the survey entitled "BOARD OF RESPIRATORY CARE EXAMINERS·: ~ • Describe tile role and function of tile board including major activities/projects, accomplishments and obstacles to success. As stated above, the Board's function is to protect the public health while fairly and expediently processing license applications and complaints against licensees. In the process of carrying out these functions, the Board has participated in various activities. Some of these activities have included the obligation of the Board to define the scope of practice of the Respiratory Care Practitioner. One special project which has been undertaken is the organization of a subcommittee to address the fast-growing medical specialty for the diagnosis and treatment of sleep disorders. The role of the RCP is essential to the field, and it has been necessary to determine the relationship of other non-licensed providers who are employed in this field. A multi-disciplinary committee was set up which included two practitioner members of the Board, one pUblic member, a Board Certified sleep physician, and two certified polysomnographic technicians who supervise the sleep disorder centers at major community hospitals. A recommendation for the definition of practice by the disciplines in the diagnosis and treatment of sleep disorders was made by the subcommittee, and is now being reviewed by the Attorney General's office. The Executive Director and Chair of the Board frequently speak at programs for the continuing education of the RCPs. These presentations serve to inform the licensed pUblic about the law and about their responsibilities in servicing and protecting the public health. The Board also uses these opportunities to give the licensees 11 instructions on how to fulfill their obligations as licensees, while explaining the functions of the Board and familiarizing the licensees on its operations. The Board has also been involved in contracting with the National Board of Respiratory Care (NBRC) national disciplinary data base. Participation in this database will allow the Board access to disciplinary information about RCPs throughout the nation. This information will be valuable in the issuance of licenses to new residents, and in conducting investigations. Annually, a representative of the Board meets with the NBRC and representatives from respiratory boards from allover the country. This has allowed the Board to give input in the development of the database, and make recommendations to the NBRC. Obstacles to the success of the Board may include only the constraint of limited staff to explore the numerous opportunities available to the Board to further its mission. 2. Provide financial data such as number of full time employees, expenditures and revenues and fee structure. FISCAL YEAR 1995-1996 FISCAL YEAR 1996-1997 (Projected) FTE's Expenditure's BUdget 3 $164,000 $166,000 12 4 $165,700 $165,700 PEES Fiscal Year 1994 & 1995 Combined Fiscal Years 1996 & 1997 Combined Projected Application Foreign Application Initial license Renewal Extension to Temporary License Verification Duplicate License Purchase RCP List Insufficient funds 1994 & 1995 $95,600 $110,000 $600 $900 $48,555 $68,000 $121,000 $178,500 N/A $8,750 N/A $3,400 $80 $100 $300 $625 $360 $725 ---------- --------- $266,595 $371,000 90% $330,900 yearly avg. $166,950 13 3. Provide informa'tion regarding board composi'tion inc~uding number of members, number of pub~ic members and met:bod of appoin'tmen't. As stated above, the Legislature established the Board with an excellent blend of membership: 3 practitioners, 1 medical doctor, 1 hospital administrator, and 2 pUblic members. Board members are appointed by the Governor to staggered 3 year terms. No individual may serve more than 2 consecutive terms. 4. Discuss t:be need for ~icensure including po'ten'tial barm 'to t:be public and examples of comp~ain'ts. A well-known example of the importance of RCPs can be found in the actor Christopher Reeve who suffered a tragic accident that left him paralyzed. * (Note: Mr. Reeves lives in Virginia, which licenses RCPs. See footnote for source.) Reeves required around the clock care by an RCP while he was hospitalized (for nearly five weeks) following the accident because he could not breathe for himself at all, and then again for several months in a rehabilitation center. Now that he has been able to go home, he uses a portable ventilator when away from home, which is housed in the back of his wheelchair. According to Reeves, "Really, (with this) what you have is mobile life support," adding that ventilator technology in the past few years have been "a remarkable achievement" because it allows paralyzed persons to do all kinds of things that otherwise wouldn't be possible. "I'm trying to do everything I can to remind myself I'm a person, not a patient" says Reeves. Reeve's RCP started out with home care visits twice a week, but now only it's only twice a month. Reeve says he only agreed to work with his RCP for "as long as his services were necessary." At home, Reeves has two ventilators and his RCP makes sure that all of his equipment is functioning properly. He calls his 14 RCP his ·terrific therapist, who comes to my house and pushes me and challenges me. H Reeve says of his RCP: ·We'll go at the pace that we can go, and the partnership is the most important aspect of it. It all has to fit together in a plan, where the patient and the therapist work together, first to overcome the fearful aspects of being on a vent, and then to push the patient -- but not too hard -- to find a comfortable quality of life level. H RCPs are on duty in hospitals seven days a week, 24 hours a day. They work in skilled nursing facilities and, more and more, in the home. In order to protect the pUblic health, the Board must ensure that only individuals with the education and skills necessary to provide respiratory treatments and evaluations of patients are permitted to practice in Arizona. We have an ever-increasing elderly population who are particularly at risk of respiratory disease. The Board must ensure that RCPs have the necessary abilities to operate technically advanced equipment and work with health care teams to ensure quality patient care and cost containment. In addition, because more and more RCPs are going out into the community, into people's homes, that the Board ensure that individuals with histories of criminal activity or illegal drug use are carefully screened to protect the pUblic. with the advent of managed care, many patients are being released from the hospital in a condition that in the past would have required them to stay in the hospital for treatment. It is important that we have qualified personnel to care for these people after their discharge from the hospital. Licensing can only assure that this qualified care will continue. [* Source: AARC (American Association for Respiratory Care) Times, June 1996, pages 34,35,36,37,38,71] 15 Here are some examples of cases over the last few years: EXAMPLE 1: License denial for cause (felony conviction on record) Mark S. Goldstone Mr. Goldstone applied for a license on October 3, 1995. He received a Temporary license, and an Extension, valid from October 4, 1995 through October 5, 1996. He passed the CRTT exam in March 1996. On his application, Mr. Goldstone answered yes to Question 19 by attaching copies of court documents. He wrote a letter stating that on January 1, 1993 and March 10, 1993 he was found driving without a license, or driving while his license was suspended in Massachusetts. He stated (and documents confirm) that all fines were paid, time took its course and his license was reinstated. He stated that on January 8, 1993 he was found "uttering a forged instrument." His explanation was that "it was a joke that a friend of mine and I got carried away with, and the other party did not take it lightly. We all make stupid mistakes. I got a $50 fine that was paid and I did 2 years of probation (unsupervised) that ended on April 28, 1995." In the course of the normal staff review of this license application, staff determined that Mr. Goldstone's offense of "uttering a forged instrument" is a felony. Staff wrote to Mr. Goldstone informing him that he was, and would be, ineligible to receive a permanent license while he has a felony on his record. Staff informed Mr. Goldstone that he needed to petition the court in Massachusetts to see if he can have the offense expunged from his record or designate a misdemeanor. In April, the Board voted to hold Mr. Goldstone's application until more information could be gathered. In response, Mr. Goldstone wrote to the Executive Director in a letter 16 received on April 29 and again in a letter received on May 23, 1996 to which he attached a copy of the Massachusetts court documents which state that he is ineligible to have his conviction reduced to a misdemeanor for 15 years. The Board met to consider Mr. Goldstone's Application on June 27, 1996. The Board's Executive Director duly caused the matter to be noticed in accordance with the Arizona Open Meeting Law. Pursuant to A.R.S. §32-3552(B) in conjunction with A.R.S.§32-3523(4), the Board denied Mr. Goldstone's license application. EXAMPLE 2: Revocation for failure to comply with probationary order Sheila Marshall Sheila L. Marshall applied for a license on April 21, 1995. Ms. Marshall's application for licensure contained information the Board had deemed necessary to determine the qualifications of the applicant. Ms. Marshall acknowledged in her application form that she has a previous addiction to crack cocaine and has sought mental health and substance abuse counseling. Based upon the foregoing, on April 27, 1995, the Board held a meeting to determine whether or not Ms. Marshall had violated any of the provisions of A.R.S. § 32-3552(A). Ms. Marshall was present at the February 16, 1995 Board Meeting and admitted to having violated the Arizona Respiratory Care Practice Act and consented to the imposition of an Order in which the Board approved her application for licensure based upon her license being placed on probation for a two year period. On May 5, 1995, the Board's office sent, by certified mail, the Board approved Stipulation and Consent Order for Approval of License, 17 Probation and Rehabilitation. Ms. Marshall signed and returned the Board Order on July 5, 1995. At that time, Ms. Marshall also paid the requisite licensure fee. The Board's Executive Director signed the Order on July 28, 1995 placing the Order into effect. On september 21, 1995, the Board's office sent Ms. Marshall a letter reminding her that her first quarterly report, as part of her stipUlation, was to have been filed on September 15, 1995. No report was received. On October 23, 1995, the Board's office sent Ms. Marshall a letter informing her that her failure to comply with the stipUlation and Consent Order necessitated her attendance at the next scheduled meeting of the Board. On or about November 16, 1995, the Board held its monthly meeting to consider this matter. Ms. Marshall was informed of the date, time and location of the meeting; she was informed that she was required to attend; but she did not attend. Ms. Marshall failed to comply with the requirements of the Order, including: her failure to file a report to the Board regarding her employment as a respiratory care practitioner, (the report was due on September 15, 1995); and her failure to appear in person for interviews before the Board upon request. After discussion, the Board voted to hold a formal hearing for possible disciplinary action with Sheila L. Marshall, pursuant to A.R.S. §32-3553(G), and the explicit provision in the Board Order which states that any violation of the Consent Order constitutes unprofessional conduct within A.R.S. §323501( 10) (I) and (k), and may result in disciplinary action pursuant to A.R.S. §32-3553(H). On December 21, 1995, the Board held the formal hearing in this matter. The Board's Executive Director duly caused the matter to be noticed in accordance with the Arizona Open Meeting Law. Ms. Marshall 18 was subpoenaed to attend, and did attend. The Board took testimony from Ms. Marshall. The Board found substantial evidence was provided to establish the facts set forth above. The Board issued an order revoking Sheila Lorraine Marshall's, license (number 03579) pursuant to A.R.S. § 41-1062(B). EXAMPLE 3: Decree of Censure (for unprofessional conduct) and Probationary Order for Rehabilitation (drug diversion and use while on duty) Keyin J. Marquis Kevin J. Marquis, RCP, is the holder of license number 02343 initially issued on June 15, 1994 and currently valid through June 15, 1998. On December 27, 1995, the Board received a notice from Boswell Hospital that Mr. Marquis was terminated from his job for cause. Mr. Marquis was terminated for unacceptable job performance, sleeping on the job, and for the admitted use of Halothane on the job. Halothane is an anesthetic agent. The Board's investigator determined that Mr. Marquis had received several written reprimands. These reprimands were placed in his employee file. The documentation establishes poor job performance for the following reasons: not following departmental procedures; not answering pages; sleeping on the job; and admitted use of Halothane while on duty. The Board's investigator further determined that during the latter period of his emplOYment, Mr. Marquis was tested for drugs, but no positive reports were found. The Board's investigator was told, by a representative of Sun Health, that Halothane does not appear on a standard drug screen. When Mr. Marquis was terminated, Sun Health advised him to contact a Dr. Mike Cofield at employee counseling because of his admitted drug use. The Board's 19 office wrote to Mr. Marquis on January 23, 1996 asking him to confirm or deny the following questions related to the allegations: 1) whether he was terminated from Walter o. Boswell on December 27, 1995; 2) requesting him to describe the circumstances surrounding the termination; 3) if he has now, or has ever had, a substance abuse problem; 4) asking him if he is currently, or has recently, participated in a substance abuse program; and 5) whether he is currently employed, and, if so, by whom. The Board received a written response from Mr. Marquis on February 2, 1996. He answered the above questions the following way: 1) yes, he was terminated from Walter o. Boswell Hospital; 2) he was terminated due to the use of an inhaled anesthetic; 3) "I do not have nor have I ever had a substance abuse problem; 4) "I have received counseling for this particular incident and will seek further counseling in the future if needed; 5) yes, Immediate Respiratory Staffers (IRS). Mr. Marquis also expressed his willingness to be of assistance in the Board's investigation, and to appear in person or accommodate the Board. On March 5, 1996, Mr. Marquis called the Board's office and reported that he would be bringing his counselor, Judy Creecy, to the Board meeting. In response to the Board's subpoena, Sun Health Corporation provided substantial documentation on Mr. Marquis. The materials contain the following: A) Notes containing the following: (1) From an evaluation done on June 1, 1995. It is hospital policy "to assure pages are responded to promptly, and if they can't be handled personally at the time, ask personnel present to return calls and take a message and relay when you can expect to 20 assure those paging that the page was received." From an anecdotal record on June 14, 1995 "co-workers not able to obtain a response when paging in the morning to receive a page and on several of these occasions they found you in the OPS ECG procedures room with door locked - respond to all pages promptly "if sleeping on the job is occurring this is a serious offense and will be dealt with as such and must stop immediately" (2) Second warning. October 4, 1995. October 1, 1995 found him sleeping in the physician's lounge. October 2, 1995 nursing unable to get response from him with paging. September 28, 1995 not checking the oximeter. (3) November 28, 1995 report. November 25, 1995 found sleeping in department, also not responding to pages (he requested transfer to another shift). (4) December 8, 1995 report. December 7, 1995 suspicious behavior, not responding to pages, emerged from IABP (Inter Aortic Balloon Pump) room observed - looked like drugs. Drug tested. December 23, 1995, at 07:15 a.m. found sleeping in OPS ECG room, rag over face, had difficulty waking up, disoriented, stumbling, off duty. Mike stated that night before he was not responding to pages from nursing: December 23, 1995. Last check IABP at 02:30 a.m., found by day shift at 07:00 a.m. December 24, 1995. Not responding to pages for ABG's and Alines, overhead paging too. B) The Boswell Nursing Department's Anecdotal Record for Employee Evaluation dated June 14, 1995. This document includes the policy 21 regarding response to pages noted above along with an occurrence "on numerous occasions your co-workers have not been able to obtain a response when paging in the morning to receive the page and on several of these occasions they have found you in the OPS ECG procedures room with the door locked. It also mentions an occurrence on June 8, 1995 when a request was sent down for ABG's at 22:30 at 21:40 and ABG was not drawn until after 11:30 by Mr. Marquis after a nurse pointed out that ABG had not been drawn. Also in incident on June 11, 1995 when a code was called on 5C and Mr. Marquis responded and intubated a patient without being checked off on intubation or providing documentation to his supervisor that he had been checked off at Del Webb. Suggested resolutions included: as discussed previously, all pages need to be responded to promptly; requisitions left by the previous shift must be verified that they are completed or not, and assumptions must not be made that RCP will get ABG's on their patients; Mr. Marquis should get checked off at Boswell for intubation or obtain approval from Doctor Dunbrow for check-off from Del Webb if it exists; if sleeping on the job is occurring, this is a serious offense and will be dealt with as such and must stop immediately. C) The Second Warning: A Sun Health Employee Reprimand, dated October 4, 1995, personnel present for interview included Craig Walter, Penny Schmiege and Mr. Marquis. The reprimand was written by Craig Walter and states that on October 1, 1995 at 6:20 a.m. the O.R. personnel found Mr. Marquis sleeping in the physician's lounge in the O.R. On June 14, 1995, Mr. Marquis had been counseled and this offense was discussed and cannot be tolerated and represents a serious offense. Also, the O.R. lounge is off-limits to non-O.R. staff. Also, on 22 October 2, 1995, a complaint was received from the nursing unit that they attempted to contact Mr. Marquis for over an hour for an ECG and no response was received until the A.M. ECG tech arrived and performed the ECG. This had also been addressed before about the importance of answering pages promptly. Additionally, on September 28, 1995, a sleep study oximetry was ordered. Mr. Marquis was told that it needed to be checked Q1 hour. It was not checked all night and the patient study had been repeated because the patient did not have the study on room air as ordered. This would have been noticed if the patient had been checked. The results ordered at that time included: answer pages promptly; be available when on the clock; perform procedures when ordered, and check when indicated. Sleeping on the job will not be tolerated. D) A message from Diane Seago, written on November 27, 1995 at 5:29 a.m., to Bernie Swietnicki and Rita Borden at Boswell Administration, and Penny Schmiege, regarding "napping on the job." It relates an incident which occurred on November 25, 1995. At 2200 hours she received a call that a STAT ECG had been ordered but the ordering personnel had been unable to reach cardiology. No one was responding to the beeper. Ms. Seago tried different numbers and several locations in the hospital, but could not locate Mr. Marquis. Ms. Seago then had Cardiology paged on the overhead system. still, no response. She then went to the department and searched. She reports finding Mr. Marquis sleeping in 112, the pulmonary function testing room. He was stretched out on the floor behind the screen with the door locked. He was sleeping so soundly that he did not hear Ms. Seago unlock the door and enter. At that point, Ms. Seago decided to 23 call Barb the day shift supervisor to be a second witness. Mr. Marquis slept through that phone call. However, when she closed the door to leave and meet Barb in the hall, he must have woken up. A few seconds later, he exited the room and Ms. Seago informed him that they had been attempting to reach him for a STAT ECG. She states that she stressed that he has a responsible job and is not to be sleeping on the job. Mr. Marquis then went to 2A to do the ECG and Barb arrived. Barb asked Ms. Seago where she had found him so that if she should have a similar problem, she would know where to find Mr. Marquis. Ms. Seago showed Barb the room and they found the pillow still on the floor with a head shaped indent. Ms. Seago also states she would be forwarding a report about not being able to reach Mr. Marquis from the personnel that requested the ECG. E) The Final Warning: A Sun Health Employee Reprimand, dated November 27, 28, 1995, personnel present included Penny Schmiege, Craig Walter and Mr. Marquis. This document states that on November 25, 1995, at approximately 22:30 Mr. Marquis was found sleeping in room 0-112 of the department by a nursing supervisor after repeated attempts to reach Mr. Marquis by page for a STAT ECG, attempts by the operator to reach Mr. Marquis with no response, it was reported that this was "yet another incident of sleeping on the job as counseled on 10/4/1995." The recommended solutions were "Do not sleep on the job and answer pages promptly." Mr. Marquis wrote "1 would like to request to be transferred to another shift to accommodate this problem." F) An Employee Corrective Action Form, dated December 8, 1995, witnessed by Penny Schmiege, Craig Walter, Bev Robertson, and Mr. 24 Marquis. The problems outlined include: "On 12/7/95 you did not respond to several pages from your co-workers; you emerged from the IABP room, observed by several co-workers, having great difficulty walking and speaking; they reported that your eyes were red, your speech unintelligible, and your posture was bent over at the waist. You have been counseled about sleeping on the job and not answering pages promptly on reprimands dated 11/28/95, and previously on 10/4/95, and on an anecdotal record 6/14/95, and on job performance evaluation dated 6/1/95 (due 5/95 answering pages promptly only mentioned). The Recommended Corrective Action: "Employee submit to drug testing. Employee to be suspended until drug tests come back. Further disciplinary and/or remedial action will be taken at that time." G) A note from -Hike- dated 12/25/95 to Brenda Conant relating that on Sunday night he had paged Mr. Marquis and paged him twice on the overhead and Mr. Marquis still not did respond. H) An Employee Corrective Action Form, dated December 27, 1995 which is the termination notice. witnesses were Penny Schmiege, Craig Walter and Mr. Marquis. The problems were identified as a repeat of the information on the Corrective Action Form dated December 8, 1995 with the following addition: "Complaints from nursing of you not responding to pages and for unacceptable job performance continued 12/23/95 and 12/24/95. On 12/25/95 he was found sleeping both while on duty and off duty in the Recovery Room. You confirmed to your supervisor, who was present, that the reason you were using a drug (anesthetic - Halothane) was to help you sleep. You were relieved of 25 duty at that time 7:30 p.m." The Recommended Corrective Action was: "Termination for sleeping on the job, unacceptable job performance, and/or admitted use of the anesthetic Halothane. Employee encouraged to contact Employee Counseling, Dr. Mike Cofield." Mr. Marquis wrote "I would like to thank my co-workers and management for their support and understanding. I apologize for the embarrassment(?).- I) A letter from Hr. Marquis to Sun Health dated December 25, 1995 in which he states "At this time I am at a point where I need help in controlling my urges. I have a problem with my mental capacity and seek help. This evening I reached a point in which I could not control myself. Thank you for your help." Kevin, Marquis, RCP. J) Many other documents from Sun Health inclUding documents, such as a memo dated 3/9/95 recommending Mr. Marquis for Employee of the Month because of his being punctual in returning pages and providing equipment and services as soon as he was able. Also because he performed his duties with a smile and a sense of humor and because his co-workers enjoyed working with him. It is signed by 8 co-workers. Also there is a letter of thanks to Mr. Marquis, dated August 10, 1994, for his assistance in a tough situation from Harry Reafling, RCP, Administrative Director. In light of the above, the Board met on March 21, 1996, to consider the allegation of unprofessional conduct against Mr. Marquis. At that time, after discussion, the Board voted to invite Mr. Marquis to an Informal Interview Hearing pursuant to A.R.S. §32-3553(G), and requested that Mr. Marquis submit himself for physical and psychological evaluations and to have the results of those 26 examinations made available to the Board. On May 9, 1996, the Board received an evaluation from Celia A. Drake, Ph.D. of the Arizona Community psychiatric Group. She states that she evaluated Mr. Marquis on April 15, 1996 and May 1, 1996. Her report is in the Board books. She states that he referred himself to her as a result of notification made to the Board from Boswell Hospital. She states that "findings of the evaluation reveal that Mr. Marquis has a diagnosis of alcohol abuse and possible alcohol dependence. In addition, he acknowledges using Halothane, an anesthetic agent, for several months while employed at Boswell Hospital. He denies history of other drug abuse. He, however, continues to abuse alcohol. He reports no prior history of mental health intervention other than that received at Contact Managed Care, having attended for three sessions. At that time it was recommended by his treating therapist, Judy Creecy, CISW, that he attend Alcoholics Anonymous. He has yet to participate in that program and has not returned to Contact Managed Care, stating that he has not done so because of a change in his insurance. Mr. Marquis' personality style is such that he tends to minimize, deny, and rationalize his use of alcohol, although he does acknowledge that he has a problem. Because of his abuse of alcohol as well as his use of Halothane, it is recommended that he have some form of ongoing structured chemical dependency treatment on an outpatient basis." Dr. Drake also recommends individual psychological counseling. On May 30, 1996, the Board met for the purpose of conducting an informal interview with Mr. Marquis. The Board's Executive Director duly caused the matter to be noticed in accordance with the Arizona Open Meeting Law. Mr. Marquis provided the Board with a letter from John V. deGuzman, M.D., which contained a medical evaluation of Mr. Marquis. According to Dr. deGuzman, "The patient's physical 27 examination was entirely within normal limits." After discussion, the Board voted to issue a disciplinary order and offer Mr. Marquis a stipulated Order for Rehabilitation. After discussion, the Board voted to issue a disciplinary order to Mr. Marquis for repeatedly falling asleep while on duty, i.e., repeated negligence; and to offer Mr. Marquis a stipulated Order for Rehabilitation. Mr. Marquis is currently on probation. (Example 3 continued: sample probationary order) This case provides an example of what a typical probationary order entails. Excerpts from Kevin Marquis' Order: Kevin J. Marquis, RCP, is hereby placed on probation; and, as a condition of probation shall remain enrolled in an out-patient rehabilitation program, approved by the Board, for five (5) years. Kevin J. Marquis, RCP, shall find an out-patient rehabilitation program and a sponsor and submit them for approval of the program. Kevin J. Marquis, RCP, shall instruct his therapist or counselor from the Program to release to the Board of Respiratory Care Examiners, upon its request, any and all records relating to his treatment and to submit quarterly reports to the Board of Respiratory Care Examiners regarding his diagnosis, prognosis and recommendation for the continuing care, treatment and supervision of Kevin J. Marquis, RCP; and, said reports to be submitted on or before the 15th day of March, June, September and December of each year. ~ aforementioned therapist or counselor shall be provided with a copy of this Order by Respondent. 28 Kevin J. Marquis, RCP, shall inform his current employer of the Board's Order of Probation and restriction of the professional practice as a respiratory care practitioner. Respondent shall instruct his therapist or physician from the rehabilitation program to release to the Board all documents and information relating to his treatment that are requested by the Board. In the event Respondent fails to satisfactorily complete the rehabilitation program, he shall be considered to have violated the terms of this Probation Order and Respondent shall be sUbject to disciplinary action and possible revocation of license by the Board. Kevin J. Marquis, RCP, shall participate in a 12-step recovery program appropriate for substance abuse as determined by his treating therapist or counsel, and attend a minimum Qf Qne meeting per week while on prQbation. keeping a written record of times, locatiQns and attendance. Kevin J. Marquis, RCP, shall obtain a sole treating physician who shall be SUbject to approval by the Board and he shall inform the Board by letter of the name, address and telephone number of the physician. Kevin J. Marquis. Rep. shall advise his treating physician of his rehabilitation effQrts and prQvide a CQPY of this BQard Order to the apprQved treating physician. Kevin J. Marquis, RCP, shall further advise any health care practitioner providing medical care and treatment of his chemical misuse problems. Kevin J. Marquis, RCP, shall abstain completely from the consumption of alcohQlic beverages. Kevin J. Marquis, RCP, shall take nQ drugs or medications whatever (except for plain aspirin and/or plain acetaminophen), whether controlled substances, prescription-only drugs or over-the29 counter preparations, unless such drugs or medication was prescribed for him by his treating physician. Kevin J. Marquis, RCP, shall comply immediately (i.e., within sixty (60) minutes) with requests from the Board or the Program Director, or their agents or designees, including but not limited to his therapist or counselor, to submit to witnessed random biological fluid collection; and, he shall authorize any person or organization conducting tests on these collected samples to provide testing results to the Board and the Program Director. Kevin J. Marquis, RCP, shall maintain a log of any and all medications whatever (except plain aspirin and/or plain acetaminophen), whether controlled substances, prescription-only drugs or over-the-counter preparations prescribed for him by his treating physician and shall make such logs available to the Board, its agents or designees upon request. Such logs, at a minimum, shall include the following: (A) The medication taken; (B) The date and time the medication taken; (C) The name of the prescribing physician; (D) The reason for the medication. Kevin J. Marquis, RCP, agrees to pay all charges from the Board of Respiratory Care Examiners, or its designee (including, but not limited to, the Program) for conducting biological fluid testing, as well as charges for therapy sessions conducted by the Program. Kevin J. Marquis, RCP, shall submit to mental, physical or medical competency examinations, or any combination thereof, at such times and under such conditions as directed by the Board to assist the Board in monitoring his ability to safely engage in the practice of 30 respiratory care, or his compliance with the terms of this Order. Kevin J. Marquis, RCP, shall submit to any additional therapy ordered by the Board or recommended by his therapist or counselor from the Program. Kevin J. Marquis, RCP, shall obey all federal state and local laws, and all rules governing the practice of respiratory care in the state of Arizona. Kevin J. Marquis, RCP, shall appear in person before the Board for interviews upon request, at various intervals and with reasonable notice (i.e., a minimum of five days). He shall immediately advise the Board of any change in his place of emploYment or home address and of any plans he makes to be away from his place of emploYment or home for more than five (5) continuous days. Respondent shall notify the Board by letter delivered by certified mail\return receipt requested within three (3) days of the date of the change. This Order shall remain effective for a minimum of five (5) years from the effective date; and, after one (1) year, Respondent may apply to the Board by letter seeking modification of the Order of Probation upon showing satisfactory compliance with the Order during the period of probation. Unless violation of the Board's Order is established in a hearing before the Board, pursuant to A.R.S. 32-3553(G) or (I), the Order shall be automatically terminated in five (5) years. Example 4: Revocation for cause (unprofessional conduct, misrepresentation of criminal history) Malcolm Val Phoenix On August 10, 1995, Mr. Phoenix applied for his biennial license renewal. His application included an affirmative answer to Question 31 Number One: Have you since your initial application or last renewal been arrested, pled guilty to or no contest to or been convicted of a felony, misdemeanor or undesignated offense? Mr. Phoenix provided a note that listed the case numbers of the charges, but no dates. He stated that the Board could find the cases in Tucson City Court, that the matters were civil and set aside after a fine. On or about October 19, 1995, the Board received information from the Office of the City Attorney in Tucson, criminal Division, regarding this matter. It stated that Mr. Phoenix (under the name Charles Hamill) was in the process of appealing a criminal matter, that a decision had been reached in December of 1992, said decision placed Mr. Phoenix on 12 months of unsupervised probation, and ordered a $200 fine to be payable in monthly installments of $25. On December 20, 1995, the Board received a written response from Respondent admitting that it was not a civil matter and a document establishing that Mr. Phoenix had filed an application to set aside the jUdgment against him in the City Court of the City of Tucson, County of Pima, state of Arizona. On September 11, 1995, the Board received a letter from the staff at Central Arizona Medical Center (the Center) alleging unprofessional conduct against Mr. Phoenix because he had been terminated from employment effective September 6, 1995 due to certain acts of misconduct. The Board's office subpoenaed documentation of the termination from both the Center and Mr. Phoenix via certified mail. On September 15, 1995, the Board received an answer from the Center documenting four notices of concern which had been issued to Mr. Phoenix. The first was issued in May 1995 and had the following concerns: Absenteeism. No batch number for 5/18/95 charges (pulmonary 32 section). This causes revenue loss and late charges. The second was issued in June 1995 and had the following concerns: 6/22/95 MOl missing for Room 1407. 6/12/95 EKG malfunctions due to technician error 6-2-95 (Malcolm). ABG calibration is now printing out copious amounts of calibrations. Does not respond to communications from fellow workers but becomes defensive. Accuses fellow workers from department of being saboteurs. Does not read communications book 5-5-95. The third was issued on August 18, 1995 and had the following concerns: Malcolm doesn't feel obligated to attend department meetings. Work performance sub standard -- this is not the first, rather a pattern has developed that causes concern, no ABG report given to nursing - nurses didn't sign off. Discovery of errant billing - due to slipshod work habits causing client dissatisfaction. Date of occurrence 03-10-95 patient charged for services not rendered, interpersonal relationships with fellow workers (i.e., vulgar gestures) unacceptable. The fourth was issued in September 1995 and had the following concerns: Transcription of doctors orders from "physicians order sheet" to "respiratory therapy inpatient master log" incorrect. Administration of SVN prescription without proper drugs as ordered by Physician 8-31-95. Confirmation report and summary was not run on 9-1-95, for ABG machine. 9-1-95 EKG - no data, i.e., name, numbers, etc. Due to overall misconduct of RCP duties Malcolm is hereby released from emploYment with Central Arizona Medical Center. Mr. Phoenix's comments were that he felt he was being forced out due to "nursing staff games and pressure from different people." He also felt that the R.C.P. on day 33 shift would leave without charting, and would mix up names and numbers, and that Mr. Phoenix was being blamed for it. He further stated that nursing changed things and that paper work was being stamped in wrong. He stated that he thought he'd had at least a year of problems. On October 5, 1995, the Board held its monthly meeting to consider the allegation against Mr. Phoenix as part of its investigation in this matter pursuant to A.R.S. §32-3553. Mr. Phoenix was notified of the time, place and location of the meeting, but did not attend. After discussion, the Board voted to hold an informal interview hearing with Malcolm Val Phoenix pursuant to A.R.S. §323553 (G) . Board staff investigated this matter by personally interviewing staff members of Central Arizona Medical Center. During the interview, for clarification, Center staff stated that Mr. Phoenix had been suspended from work for three (3) days without pay, on August 18, 1995, for concerns that included: non-calibration of the ABG machine on at least four (4) instances, giving the wrong medication to a patient while not following physician orders, charging for therapy that was not done, and reporting EKG results to the ER without a patient name, number or any patient identification available on the abnormal, and potentially dangerous EKG. Following that suspension, Mr. Phoenix returned to work and continued to provide poor quality and dangerous patient care, according to Center staff, which resulted in the termination in September. On November 16, 1995, the Board met for the purpose of conducting the informal interview hearing with Mr. Phoenix. Mr. Phoenix was notified of the time, place and location of the meeting; 34 was sent a written invitation to the meeting; attended the meeting for a time, but left before the Board heard this matter. Mr. Phoenix wrote a note to the Board during the Meeting stating that he had to leave; the meeting lasted longer than he had thought it would; and that he understood the concern with the statements before the Board. since Mr. Phoenix was not in attendance of the informal interview, the Board voted to hold a formal hearing for possible disciplinary action with Malcolm Val Phoenix pursuant to A.R.S. §32-3553(G). On December 20, 1995, the Board received a written response from Mr. Phoenix. In his written response, Mr. Phoenix generally denies the allegations of professional competence because his two previous years of job evaluations were satisfactory. On December 21, 1995, the Board held the formal hearing in this matter. The Board's Executive Director duly caused the matter to be noticed in accordance with the Arizona Open Meeting Law. Mr. Phoenix was SUbpoenaed to attend, and did attend. The Board took testimony from Mr. Phoenix and Phil Putnam, Ph.D., RRT, of Central Arizona Medical Center and Mr. Phoenix's former supervisor at Central Arizona Medical Center. Based upon the documents received and the testimony of Phil Putnam, Ph.D., RRT, and Mr. Phoenix, the Board found that substantial evidence was provided to establish the facts set forth above. Pursuant to A.R.S. § 32-3553, the Board issued an Order revoking the license to practice respiratory care of Malcolm Val Phoenix. 35 Example 5: Decree of Censure (Fraud on Application for Licensa Renewal) and probationary Order for Rehabilitation (Alcohol and Drug Abuse) Mark Largesse Mark Largesse is the holder of license no. 01066, renewed on March 20, 1996, currently valid through March 20, 1998. On Mr. Largesse's biennial renewal application he wrote that he had acquired the necessary CEUs for his license renewal. On April 1, 1996, in a telephone call from staff at John C. Lincoln Hospital, followed by a facsimile transmission (received on April 4, 1996), the Board was informed that Mr. Largesse did not have the necessary CEUs and had therefore falsified his biennial renewal application to the Board. Staff at John C. Lincoln state that Mr. Largesse was requested on March 22, 1996 to provide proof of his CEUs, that a second request for his CEUs was made on March 29, 1996 (via telephone) and that on March 29, 1996, Mr. Largesse admitted that he had no CEUs. Staff at John C. Lincoln states that at that time, Mr. Largesse was taken off the schedule. On April 1, 1996, Board staff wrote to Mr. Largesse, via certified mail, asking him to submit documentation supporting his compliance with the Board's CEU requirement. On April 10, 1996, Mr. Largesse provided a written answer to the Board's letter. (He also stated that he has been having difficulty receiving his mail -- all correspondence to him had been returned to the Board as undeliverable and Mr. Largesse picked it up on April 10). Mr. Largesse states that as of March 20, 1996 he "did not have sufficient CEUs to meet the criteria required by the State to renew my license and filled out the renewal form anyway. There are reasons behind this stupid action but honesty must prevail. I will obtain the CEUs and face the 36 consequences handed down from the Board." Based upon the foregoing, the Board met on April 25, 1996 to consider the allegation of unprofessional conduct against Mr. Largesse. At that Board meeting, Mr. Largesse discussed this allegation with the Board. In addition, he told the Board that he had been admitted to a substance abuse program during his last license renewal period and had failed to disclose that on his license renewal application. He offered to provide documentary evidence of his successful completion of a substance abuse program. Following the April Board meeting, Board Staff was informed by personnel at John C. Lincoln Hospital that Mr. Largesse may have worked the following dates without a valid license: March 24, 25, 26, 27 and 28. After discussion, the Board voted to invite Mr. Largesse to an informal interview hearing pursuant to A.R.S. §32-3553(G). On May 30, 1996, the Board conducted informal interview hearings with the Respondent. The Board's Executive Director duly caused the matter to be noticed in accordance with the Arizona Open Meeting Law. Mr. Largesse provided documentary evidence of his completion of 20 approved continuing education units and of his completion of an alcohol and drug rehabilitation program at the Salvation Army Adult Rehabilitation Center. After discussion, during which Mr. Largesse denied practicing respiratory care during the period of March 24 through March 28, 1996, the Board voted to issue a Decree of Censure to Mr. Largesse for fraud in the procurement of his license and to offer Mr. Largesse a Stipulation and Consent Order for Rehabilitation. Mr. Largesse is currently on probation. 37 Example 6: Case dismissed sally Pelton Beicht Ms. Sally Pelton Beicht was the holder of a Temporary License during the investigation of the allegation against her. Her Temporary license was issued on December 27, 1995, and its expiration date would have been August 27, 1996. On February 12, 1996, the Board received an allegation of unprofessional conduct against Ms. Pelton Beicht. The allegation was that she was a no show, no call, on several occasions. The allegation was made by the President of one of the temporary staffing agencies which provides Reps to health care facilities (including homes), who stated that "the last two puts us and a hospital in a very difficult situation. I am faxing you my nightshift/weekend staffing coordinator's account of what happened." There is a memo attached: Dated 2/8/96. Assignment at Thunderbird Samaritan. Scheduled for 2/3/96 at 10:00 p.m. and again on 2/4/96 at 6:00 p.m. "I called her on Saturday at approximately 3:00 p.m. to ask her to be there at 6:00 p.m. instead of 10:00 p.m. She said that she could not but would be at the hospital at 10:00 p.m. as planned. She also stated that she was scheduled for 6:00 p.m. the following night. She didn't show up at 10:00 p.m. on saturday night. I called her home and her husband stated that she was out with friends and was not going to work. On Sunday 2/4, again she did not show up for work. When I called her home, her husband stated that she was sleeping and that she was not scheduled to work that night. He would not put her on the phone. Both of these incidents created problems for the hospital since she could not be replaced." 38 On February 20, 1996, Board staff wrote to Ms. Pelton-Beicht asking her to confirm or deny the allegation that she accepted two assignments at Thunderbird Samaritan Hospital, confirmed them in a telephone call with Anita Fink, yet failed to report for both assigned shifts. Ms. Pelton-Beicht responded in a letter received on March 1, 1996. She denies accepting either assignment "due to the fact that on Thursday Feb. 1st Debbie Richards Supervisor of Resp. Care at Phoenix Baptist Hospital called and asked me to work overtime on Saturday Feb. 3rd and to work Sunday Feb. 4th. I had started an on call position at Phoenix Baptist Hospital Jan. 29, 1996 which I told IRS and wrote them a letter telling them I will be unavailable to work for them at this time. On Feb. 3rd I was called. IRS asked me if I could work on that night from 6-6:30. I told her I was working 10-6 at Phoenix Baptist." She also states that IRS had her pager number and could have paged her. On March 13, 1996, the Board received a letter from Ms. PeltonBeicht stating "enclosed is a copy of the letter I sent to IRS on 126- 96. I'm sorry it took so long sending it to you." Enclosed is a copy of a letter addressed "To IRS" and stating "This is to inform you that as of 1-29-96 I will be unavailable to work for your agency. I just acquired a pool position at Phoenix Baptist Hospital and will be starting on that date. Sincerely, Sally F Beicht." On May 30, 1996, the Board met to consider the allegation of unprofessional conduct against Ms. Pelton Beicht. The Board's Executive Director duly caused the matter to be noticed in accordance with the Arizona Open Meeting Law. Ms. Pelton Beicht was present. After discussion, the Board voted to table this matter and directed staff to investigate this matter. On June 10, 1996, Board staff wrote 39 to IRS requesting that someone from IRS attend the June meeting. On June 11, 1996, the Executive Director sent a subpoena to Phoenix Baptist Hospital for the staff schedule on the days in question. On June 27, 1996, the Board met to continue the consideration of the allegation. Ms. Pelton Beicht was present. The Board reviewed materials submitted by Phoenix Baptist Hospital received in response to its subpoena. The Board determined that no evidence was produced to substantiate the allegation of unprofessional conduct. After discussion, the Board voted to dismiss the allegation of unprofessional conduct against Ms. Pelton Beicht pursuant to A.R.S. §32-3553. At the same Board meeting, held on June 27, 1996, Ms. Pelton Beicht's application for a license to practice respiratory care was approved by the Board. 5. Provide licensing data including the number of licenses by category, number of out of state licenses, number of restricted licenses and reciprocity agreements. Total number of licenses issued Number of current temporary licenses 4,056 124 (Note: temporary licenses are restricted -- individuals who hold temporary licenses may only practice under the direct supervision of a licensed Rep or a licensed physician) Number of expired temporary licenses 662 Average time to issue a Temporary License 24 hours 40 A.R.S. 532-3554(3) (a) provides for licensure without examination for Applicants who hold licenses in good standing in another state and who have already passed the CRTT exam (Note: the CRTT is the Entry Level Respiratory Care Examination). The Board does not issue out of state licenses. 6. Provide exaJlJination data such as use of a national exam, use of oral and practical exams and weighing of exams. The Board requires that initial Applicants for licensure take and pass a national exam, the CRTT exam administered by the National Board of Respiratory Care Examiners (NBRC). A passing score is considered to be the same as required by the NBRC; which is 75 scaled-score units or 95 correct answers. There is no limit on how many times an Applicant can take the exam. It is offered three times a year. 7. Provide disciplinary data, including the number of complaints (by tyPe), number dismissed (by reason), number of hearings held and number of actions (probations, susPensions and revocations). 41 Number of complaints Number dismissed Number of hearings held informal interviews formal hearings Actions Letters of concern Decrees of censure Probation Board Ordered stipulated Disciplinary Non-disciplinary Total Probation suspensions Surrendered licenses Revocations 2 27 34 2 1 19 280 35 28 45 96 17 [Note: please see attached Exhibit A for a full summary of Board activity.] If you need any further information, please do not hesitate to contact me. "Sin erel~ I / ! / . h;U<1 I2d-x~ cutrv D~rector . " ~ I ,_J 42 BOARD OF RESPIRATORY CARE EXAMINERS BOARD MEETING , Thursday, January 25, 1996 at 12:00 p.m. 2nd Floor Conference Room 1400 W. Washington, Phoenix AZ Board Members Present: Chair Meryl Salit, Vice-Chair Kit Mehrtens, Sheilah Bowen, John Coleman, Gerald Schwartzberg, M.D., and Karen Staudenmier Board Members Absent: Mary Lynn Kelly Staff Present Mary Hauf Martin, Executive Director Dolores Doyle, Administrative Assistant Board's Legal Counsel: Mike Harrison, Assistant Attorney General I. CALL TO ORDER The Meeting was called to order at 12:04 p.m. by the Board's Chair, Meryl Salil. D. ELECTION OF OFFICERS FOR 1996 John Coleman nominated Meryl Salit for another term as Board Chair. Sheila Bowen seconded. The Motion passed unanimously. Meryl Salit nominated Kit Mehrtens for another term as Board Vice Chair. Karen Staudenmier seconded. The Motion passed unanimously. ID. APPROVAL OF MINUTES John Coleman moved approval of the Minutes as presented. Karen Staudenmier seconded. The Motion passed unanimously. lYllDUU:S 01 ..auWlC)' M;), ~:r.nJ Board Meeting Page 2 IV. DISCUSSION!ACTION ON APPLICATIONS FOR UCENSURE A. Recommended for approval by the Executive Director Judith A. Alderman Beverly N. Caldwell Vicki L. Dickson William D. Hall Randy J. Hillyer Elaine D. Martin Donna E. Ochoa James Sallis Cathy L. Spencer Joseph A. Bettini Alexandra C. Cheek Erica A. Faigle Mark S. Hanson Ashely C. Hubbell Kenneth E. Newton Clay Patterson Greg R. Sanvik Katherine L. Tanner Carmelita Burdick Wendell A. Chow Andrea J.. Glasscock 'vasant J Honest Joan L. Loewen Robert Rapp Teresa A. Salazar Patrick Smith Maria Velez Kit Mehrtens moved approval of all the individuals listed on the Agenda and recommended by the Executive Director. Sheila Bowen seconded the Motion. The Motion passed unanimously. B. Application for Licensure 1. Eric Cahill The Executive Director summarized Mr. Cahill's situation. Mr. Cahill was not present. After discussion, John Coleman moved that Mr. Cahill be granted a license. Kit Mehrtens seconded. The Motion passed unanimously. 2. Mark D. Olson Mr. Olson was present. The Executive Director summarized Mr. Olson's situation. After discussion, John Coleman moved that Mr. Olson be granted a license. Karen Staudenmier seconded. The Motion passed unanimously. 3. Rose Troia The Executive Director reviewed Ms. Troia's application for licensure. Ms. Troia was not present. Kit Mehrtens moved to table discussion of Ms. Troia's application until further information can be presented to the Board. Sheila Bowen seconded. The Motion passed unanimously. lYllDUU:S 01 .January ~, .I.:r.l'U Board Meeting Page 3 4. Stephen Spencer Mr. Spencer was not present. The Executive Director reviewed Mr. Spencer's application. Karen Staudenmier moved to table discussion of Mr. Spencer's application until further information can be presented to the Board. Sheila Bowen seconded. The Motion passed unanimously. 5. Nancy Jean Wilcox Ms. Wilcox was not present. The Executive Director reviewed Ms. Wilcox's application. Sheila Bowen moved to table discussion of Ms. Wilcox's application until further information can be presented to the Board. Karen Staudenmier seconded. The Motion passed unanimously. 6. Sheryl R. Radowick Ms. Radowick was not present. The Executive Director reviewed Ms. Radowick's application. Kit Mehrtens moved that Ms. Radowick's license be granted. Sheila Bowen seconded. The Motion passed unanimously. C. Request for an Extension to a Temporary License 1. Susan Klement Ms. Klement was present. The Executive Director stated that Ms. Klement's request did not meet with the Board's requirements for receiving an extension to a temporary license. She had not signed up to take the CRTI. Karen Staudenmier moved that the Board deny Ms. Klement's request for an extension to her temporary license. Kit Mehrtens seconded. The Motion passed unanimously. V DISCUSSIONIACTION ON ADMINISTRATIVE CLOSING OF APPLICATION FILES Mitchell D. Barnes Corey L. Bell Leonard Bell Marlitza L. Belmontes Juanita J. Craig Katrina N. Dumbauld Kelly A. Fitzgerald David L. Yardley Susan Klement Terry Kloppenberg Kelly A. Kriesel Tami J. Olson Richard Russell Jose L. Silva Brian E. Trufley Donna Trumbo Thomas R. Wyatt Joseph F. Brancotto Grace E. Colden Don R. Dela Cruz Christopher S. Grattenhaler Ameer R. Muhammad Minutes of January 25, 1996 Board Meeting Page 4 After discussion between the Board members and the Executive Director regarding individuals who had completed their license applications after the Agenda was written, Karen Staudenmier moved that the Board administratively close the application files of all the items on the agenda except for Susan Klement, Grace E. Colden and Christopher S. Grattenhaler. Sheila Bowen seconded. The Motion passed unanimously. VI DISCUSSION\ACTION ON NOTICES OF UCENSE EXPIRATIONS \ The Executive Director stated that these were routine license expirations. Michelle Angus Lynn C. Birgman Kimberlee K. Birrell Cathryn Clayton Tracy Duepner Patricia Johnson Euginia Berry Chantel R. Davis 1anet K. Eichenberger Mark Meins Sheila Palermo 10hn-Mark Stuebing Hal Wagner James Kentner David M. Krepp Don D. Maples Gabriel M. Martinez Adrienne Meyer Heidi Lynn Nichols Bonnie L. Bouchez Victoria A. Devaney Alice Hinton Lisa S. Nasca Chris Stein Michelle Thompson John Porter Tammy M. Smith Tamara L. Snyder Christy B. Steffen Tine Tenenti Andrew M. Torrez Sheri L. Clarke Mary E. Edelman Linda L. Medansky Walter R. Palass Blair W. Steinberg Shirley A. Trebelhom Karen Staudenmier moved to issue these notices of license expirations. Kit Mehrtens seconded. The Motion passed unanimously. vn DISCUSSION ACTION ON REINSTATEMENT OF EXPIRED UCENSES The Executive Director reported that these were routine license reinstatements. Julie Evans-Barba Dan Dillon Dolores M. Blake Merry Gayle Pineda John Coleman moved to ratify these reinstated licenses. Sheila Bowen seconded. The Motion passed unanimously. VITI CONSIDERATION/ACTION ON INVESTIGATIONS OF UNPROFESSIONAL CONDUCT l".lJIIUI.IC03 u. "iUIIUU-, MJ, ~77V Board Meeting Page 5 1. Kerry Adair Mr. Adair was present. The Executive Director reviewed an allegation of unprofessional conduct against Mr. Adair. The Board received Mr. Adair's biennial renewal application on October 13, 1995. He admitted that he pled guilty to a misdemeanor DUI and expired car registration. He said he paid a DUI fine of $459 and a fine for his expired car registration of over $500. He stated that he completed: an 80 hour.intensive outpatient care program through Tri-City Behavioral Health; and a 12 week program with Arizona Addiction Council. He says that he has been attending an AA program (ADAM) sponsored by the LDS church once a week. He also states that he was terniinated from Desert Samaritan for personal differences with the supervisor. Mr. Adair had accepted 2 certified letters from the Board's office requesting documentation of the above - he has failed to respond. The Board's investigator has spoken with Joni Shultz at Desert Sam. Ms. Shultz stated that he was a -Type A-employee - which is similar to an oncall position. Mr. Adair worked the night shift and made what she felt was a "bad judgment call." Ms. Shultz stated that in light of this incident, she took him off the schedule because she felt he needed more supervision than she could offer a "Type A" employee. After discussion, Mr. Adair provided documentation ofhis misdemeanor DUI and a misdemeanor for driving without a valid drivers license. He also provided a Certificate of Completion of a 12 week outpatient program from the Arizona Addiction Council. Upon questioning as to why he hadn't responded to the Board's information requests, Mr. Adair said he had been negligent. For purposes of receiving legal advice, John Coleman moved that the Board go into Bmme Session at 12:50 p.m. Sheila Bowen seconded. The Motion passed unanimously. John Coleman moved that the Board return to public session at 12:55 p.m. Karen Staudenmier seconded. The Motion passed unanimously. After discussion, John Coleman moved that the Board table discussion of this matter until its next Board meeting, and for staff to draft a standard stipulated order for the Board and Mr. Adair to review prior to that meeting. Sheila Bowen seconded. The Motion passed unanimously. 2. Mary Condel Ms. Condel was not present. The Executive Director explained that the Board received Ms. Condel's biennial renewal application on October 24, 1995. On her application she states that she received a Dill and that is was resolved. She offered to provide documentation. In November of 1995 she accepted a certified letter from the Board's office requesting information regarding her biennial renewal application: copies of the court records of her Dill; documentation of any fines or penalties; certificates of completion for the alcohol awareness program she said she attended. No response has been received. In December of 1995 she was sent a letter asking her to document her ...................'-'U' " .. "-"'-"J -, ...".,,- Board Meeting Page 6 completion of CEUs. No response has been received. Howard Jones of Phoenix Memorial Hospital, Ms. Condel's direct supervisor, was present. The Board discussed Ms. Condel's lack of documentation of acquiring the required CEU's with Mr. Jones. Karen Staudenmier moved that the Board invite Ms. Condel to an informal interview hearing and that she be asked to provide the required documentation to the Board. Sheila Bowen seconded. The Motion passed unanimously. 3. Rodney M. Flickinger Mr. Flickinger was present. The Executive Director explained that on November 9, 1995, the Board received a Lab Report from Corning Labs which showed a positive result for Cannabinoids, from a specimen collected from Mr. Flickinger on November 2, 1995. The Board's investigator determined that the drug screen was taken as a preemployment drug screen with Immediate Respiratory Staffers. The Board's office wrote to Mr. Flickinger on November 9, 1995 asking him to confirm or deny the allegation. On November 27, 1995, the Board received the results of second drug screen, also from Corning Labs, taken November 22, which also showed a positive result for Cannabinoids. On November 29, 1995, the Board received a letter from Mr. Flickinger admitting that the test done on specimen collected on November 2 came back positive for Cannabinoids. On December 7, 1995, the Board received a letter from Mr. Flickinger questioning the validity of the Corning Lab tests because the positive result was not confirmed by a different chemical process (he refers to the Labor Laws). He went to the Treatment Assessment Screening Center (TASC) and had another drug urine screen - from a specimen collected on November 28 which came out negative. On December 8, 1995, the Board sent a letter to Mr. Flickinger regarding the positive test results from the specimen taken on November 22 at Corning Clinical Labs. On December 14, 1995, the Board received a test result from Corning Labs showing that the positive result from the specimen taken on November 22 was verified by GCMS. On December 20, 1995, the Board received a letter from Mr. Flickinger admitting that the second drug screen at Coming Labs had come back positive for Cannabinoids. On January 5, 1996, the Board received a letter from Mr. Flickinger with the results of a second drug screen taken at TASC, from a specimen taken on December 22 which came back negative. For purposes of receiving legal advice, Sheila Bowen moved that the Board go into BImi\e Session at 3:44 p.m. Karen Staudenmier seconded. The Motion passed urminnJsly. Kit Mehrtens moved that the Board return to public session at 3:50 p.m. Karen Staudenmier seconded. The Motion passed unanimously. After discussion, during which Mr. Flickinger agreed to entering into a Stipulation and Consent Order, Kit Mehrtens moved that the Board table discussion of this matter until the next Board Meeting and that staff draft a modified probationary order for the Board and Mr. Flickinger to review prior to the next meeting. Dr. Schwartzberg seconded. The Motion passed unanimously. ------ -- _-__., --7 ---- Board Meeting Page 7 4. Michael Hartman Mr. Hartman was not present. The Executive Director reviewed for the Board Mr. Hartman's history. In September, Mr. Hartman was issued a Decree of Censure and Probationary Order pursuant to a Board decision made in March of 1995 - for exceeding the scope of practice of an RCP. The terms of his probation, which were spelled out in the Order, called for reports to the Board in October and Decembc;r of 1995, with the last one due in March when his Order is due to expire. 'Mr. Hartman has never filed either of the two required reports. The Board's investigator has also determined that Mr. Hartman has failed to notify his employer of his Board ordered probation. Kit Mehrtens moved that the Board issued a Complaint and Notice of Formal Hearing to Mr. Hartman. John Coleman seconded. The Motion passed unanimously. 5. Frank Mamone Mr. Mamone was present. Karen Staudenmier recused herself from all proceedings involving this matter. The Executive Director reviewed for the Board an allegation of unprofessional conduct against Mr. Mamone. On November 2, 1995, the Board received a letter from Vencor Hospital stating that Mr. Mamone had been terminated, effective September 13, 1995. Discrepancies and potentially fraudulent charting were noted upon review of the charts of patients under Mr. Mamone's care. On November 17, 1995, the Board's office sent Mr. Mamone, at his address of record, a letter asking him to confirm or deny the allegation. The letter was returned. On November 21, 1995, the Board's office subpoenaed documents relative to this matter from the Custodian of Records of Vencor Hospital. In response, on November 30, 1995, staff at Vencor Hospital responded to the subpoena by sending his job description and disciplinary reports. The Vencor records show repeated over-eharging for therapist time and, in violation of Medicare regulations, therapy given to more than one patient at a time. When asked for an explanation by his manager, Mr. Mamone stated that the treatment times were adjusted to reflect when they were due, rather than when they were actually done. After discussion, John Coleman moved that the Board invite Mr. Mamone to an informal interview hearing. Kit Mehrtens seconded. The Motion passed unanimously. 6. Steven Statts Mr. Statts was not present. The Executive Director reviewed the allegation of unprofessional conduct against Mr. Statts. The Board voted to open an investigation into this matter in October - it involves an allegation which was brought before the Board some time ago (December 1994) because the allegation was that Mr. Statts was a potential danger to the public. The allegation is that he was pacing back and forth in front of patients at Thunderbird Samaritan Medical Center, asked to leave 4 times, but refused, the police were eventually called and a Behavioral Health RN was also called. The allegation also stated that Mr. Statts was paranoid, agitated, and seemed to be having .1T.uJlU..C3 U.l .,......... .1 ~, A77V Board Meeting Page 8 a hard time processing on a cognitive level why his behaviors/actions were causing a great deal of concern. He was offered a crisis assessment at the behavioral health unit, but refused. At one point he agreed to go talk, but started running down the hospital hallway and was chased out by the Glendale police. Also, that he cornered an RN, Laura, before telling her to walk out of the hospital with him - this frightened and upset the RN. Finally, there was an allegation that he was also escorted by the Phoenix police in December, 1994. When the Board opened the investi~ation, we/wrote to Mr. Statts (letter dated November 2). He responded in a letter received by the Board on December 8, 1995. He apologizes for not responding sooner, stating that he has been working in several different states. He says that he had not corresponded with his Arizona address of record for several months. He denies the allegation. He states that he is not, and was not, involved with drugs or having behavioral and/or emotional problems. He states that he was asked to leave the hospital via another exit, other than the front door. He says that hospital security did not want him to exit via the front door. He states that he requested that the police be summoned and that the police escorted him to the front door without incident. He adds that the Glendale police never apprehended him, detained him, or charged him with any crime. He apologizes for any misunderstanding for what occurred that day. Regarding the other allegation, concerning the Phoenix police, Mr. Statts states that he summoned the Phoenix police when "certain individuals would not leave the premises of a residence. The police escorted me elsewhere, no arrest was made, no charges were filed against him." In response to the Boards questions on these issues, he denies that he has a substance abuse problem with drugs or alcohol. He says he has not recently received any treatment for substance abuse or behavioral problems. Board staff has spoken to Paul Berg, RN, who wrote the original letter to the Board informing the Board of the allegations. He has stated his willingness to help the Board in its investigation. Mr. Berg is trained in behavioral health. John Coleman moved that the Board invite Mr. Statts to an informal interview hearing. Kit Mehrtens seconded. The Motion passed unanimously. IX CONSIDERATION AND ACTION ON INFORMAL INTERVIEWS PURSUANT TO A.R.S. 32-3553(G) 1. Charles Oehler Mr. Oehler was present. The Executive Director reviewed an allegation of unprofessional conduct against Mr. Oehler - that he had reported to work under the influence of alcohol and had been abusive to a patient. Mr. Oehler denied the allegation. The Board received testimony from Mr. Oehler, Mr. Chuck Cox, and Mr. Sam Uesele. For the purpose of receiving legal advice, Sheila Bowen moved that the Board go into Executive Session at 3:05 p.m. Kit Mehrtens seconded. The Motion passed unanimously. Sheila Bowen moved that the Board return to public session at 3:09 p.m. Kit Mehrtens seconded. The Motion passed unanimously. Board Meeting Page 9 After discussion, Karen Staudenmier moved that the Board invite Mr. Oehler to continue this informal interview hearing and that staff prepare a draft Findings of Fact and Conclusions ofLaw for the Board to review at its next meeting. Sheila Bowen seconded. After further discussion, Karen Staudenmier moved that staff prepare a draft probationary order for the Board to consider at its next meeting. Dr. Schwartzberg seconded. John Coleman asked if the Motion could be amended to say the probationary order will contain a requirement for a 12 step outpatient program and random testing. ,Karen Staudenmier accepted the friendly amendment. Dr. Schwartzberg seConded. The Motion passed unanimously. John Coleman moved that the Board issue a Decree of Censure. Kit Mehrtens seconded. After discussion, in order to preserve the issue for the next Board meeting, the Motion failed. X. CONSIDERATIONANDACTIONONFORMALCOMPLAINTHEARINGS PURSUANT TO A.R.S. §32-3SS3(H) 1. Marvin Jerew Mr. Jerew was not present. The Executive Director requested that the Board table consideration of this matter until the next Board meeting. Kit Mehrtens moved that the issue be tabled until the February Board meeting. Karen Staudenmier seconded. The Motion passed unanimously. XI. CALL TO THE PUBLIC There was no public presentation to the Board. XII. DISCUSSIONIACTION ON EXECUTIVE DIRECTOR'S REPORT A. Discussion and Action on Proposed Administrative Rules The Executive Director advised the Board of a proposed amendment to the Board's Proposed Rules clarifying the requirements for biennial renewal applications. After discussion, Kit Mehrtens moved that the Board adopt the Proposed Rule with the amendment outlined by the Executive Director: Page 10, line 1, after the word of, insert "information on the biennial renewal application or of," and after the word compliance, insert "in acquiring CEU's". Karen Staudenmier seconded. The Motion passed unanimously. B. Discussion and Action regarding legislative matters. Board MeetiD& Page 10 The Executive Director gave the Board an update on legislative matters. C. Report on the Agency Budget. The Executive Director updated the Board on the status of the Board's budget. D. Report on Formal Attorney General Opinion regarding the ~d's Administrative Hearings. The Executive Director reported on the formal A.G. opinion which clarifies that Board members can, indeed, conduct their own administrative hearings. E. Discussion and Action on sharing expenses to send legal counsel to training: FARB meeting, Salt Lake City, February 8 - 11. Kit Mehrtens moved that the Board authorize expending monies to cover half of the expenses to send its legal counsel to this training. Karen Staudenmier seconded. The Motion passed unanimously. 1 i F. Report on Cannabinoid Testing. The Executive Director reviewed staff's report on Cannabinoid testing. For the purpose of receiving legal advice, Karen Staudenmier moved that the Board go into Executive Session at 4:45 p.m. Kit Mehrtens seconded. The Motion passed unanimously. Sheila Bowen moved that the Board return to public session at 4:55 p.m. Kit Mehrtens seconded. The Motion passed unanimously. Xill. FSTABLISH DATE AND TIME OF NEXT BOARD MEETING Thursday, February 22, 1996 at 12:00 p.m. XIV. ADJOURNMENT John Coleman moved to adjourn the meeting at 5:05 p.m. Karen Staudenmier seconded. The Motion Passed unanimously. DATED this ~'th day of FebruaI)', 1996. l ';- ,. ,:- - C--./---j --J BOARD OF RESPIRATORY CARE EXAMINERS BOARD MEETING MINUTES Thursday, February 22, 1996 at 12:00 p.m. 2nd Floor Conference Room 1400 W. Washington, Phoenix AZ Board Members Present: Chair Meryl Salit, Vice-Chair Kit Mehrtens, Sheilah Bowen, Mary Lynn Kelly, John Coleman, Gerald Schwartzberg, M.D., and Karen Staudenmier Staff Present: Mary Hauf Martin, Executive Director Dolores Doyle, Administrative Assistant Board's Legal Counsel: Mike Harrison, Assistant Attorney General I CALL TO ORDER The Meeting was called to order at 12: 10 p.m. by the Board's Vice Chair, Kit Mehrtens. IT APPROVAL OF MINUTES John Coleman moved approval of the Minutes as presented. Mary Lynn Kelly seconded. The Motion passed unanimously. ....._-- _.. -----.1 -7 ---- Board Meetine Page 2 m DISCUSSIONIACTION ON APPLICATIONS FOR LICENSURE A. Recommended for approval by the Executive Director John H. Brohard Beth Anne Cisco Stephanie Graeter Steve Johnson Anthony McDonald Richard Schoer Barbara Smith Erwin Toro Yvonne V. Burroughs Elizabeth Cloutier Kathryn Hood John T. McCarville Terri Morfesy Doris Sharp Johnny L. Smith Kristie Butterfield Emosito Del Rosario Jodene :S;ume Rowland 'Debora J. Maxwell Walter D. Ruth, Sr. Clyde D. Sigmon Tim D. Steinmetz Sheila Bowen moved approval of all the individuals listed on the Agenda and recommended by the Executive Director. Mary Lynn Kelly seconded the Motion. The Motion passed unanimously. B. Application for Licensure 1. John Rauch The Executive Director summarized Mr. Rauch' situation, stating that he had provided the necessary documents establishing that he is eligible for permanent licensure. Mr. Rauch was not present. After discussion, Mary Lynn Kelly moved that Mr. Rauch be granted a license. Sheila Bowen seconded. The Motion passed unanimously. 2. Rose Troia The Executive Director summarized Ms. Troia's situation, stating that she had provided the necessary documents establishing that she is eligible for permanent licensure. Ms. Troia was not present. After discussion, John Coleman moved that Ms. Troia be granted a license. Sheila Bowen seconded. The Motion passed unanimously. 3. Nancy Wilcox The Executive Director summarized Ms. Wilcox's situation, stating that she had provided the necessary documents establishing that she is eligible for permanent licensure. Ms. Wilcox was present and made a presentation to the Board. After discussion, John Coleman moved that Ms. Wilcox be granted a license. Sheila Bowen seconded. The Motion passed unanimously. C. Request for an Extension to a Temporary License 1. John Rauch (if necessary) NO ACTION WAS NECESSARY Board MN"tjng Page 3 IV DISCUSSION/ACTION ON ADMINISTRATIVE CLOSING OF APPLICATION FILFS Kimberly A. Brodeur Candice L. Lockheart John R. Jones Susan Klement Jane Senderhauf Julianna Phillips Apryl D. Freeman-Rice Derrick Groves Sheila Bowen moved that the Board administratively close the appliCation files of all the items on the agenda. Mary Lynn Kelly seconded. The Motion passed unanimously. V DISCUSSION/ACTION ON ADMINSTRATIVE CLOSING OF TWO YEAR INACTIVE FILES The Executive Director stated that these were routine two year inactive license files. Debbie Allyn Jim F. Durham Thomas Fields, Jr. Laura Hames-Wengert Michelle Johnsen Gary Nichols Andrew Perez Deanna Tsosie John Anaya Michael J. Evans John R. Fleming David Hanrahan Marlene Jones Rena O'Donnal Ann Reed Renee Tucker Risa Bell Robert Faubion Roberto Guzman Sharon D. Henry Wendy A. Lucas Lawrence Pavlica Laura Taylor-Fishbeck Asima Wagner Mary Lynn Kelly moved that the Board administratively close the two year inactive files of all the items on the agenda. Mary Lynn Kelly seconded. The Motion passed unanimously. VI DISCUSSION/ACTION ON NOTICES OF LICENSE EXPIRATIONS The Executive Director stated that these were routine license expirations. James Abril Al Alabado, Jr. Eva Berstein Larry Davis Reynold Gilsdorf Megan Heemsoth Frank Keller Donald Libby Kirk Metzger Nancy Pomeroy Duke Terwillegar Deborah Adams John Allison Frank Berry Jon Farley Maryann Gaghagen Howard Holz ill Karen Koenig Karl B. Lynham Joseph Nichols Sue Stratton Stephanie Watkins Dale Alexander Lynne Bell Jeffrey Bills Marian Graves Gerry Greenfield Dale Hostetler Tammy Lambrecht Cheryl L. Magallanes Pete Pochiro Deborah Sumner James Valiquette ....-.....- -- ------J -7 ---- Board Meeting Page 4 Mary Lynn Kelly moved to appove these license expirations. Karen Staudenmier seconded. The Motion passed unanimously. vn DISCUSSION!ACTION ON REINSTATEMENT OF EXPIRED LICENSFS The Executive Director reported that these were routine license reinstatements. Michelle Angus Gerald Greenfield Susan Delich Howard Holz ill 4 Mary E. Edelman Mary Lynn Kelly moved to ratify these reinstated licenses. Sheila Bowen seconded. The Motion passed nnanimously. VllI CONSIDERATION AND ACTION ON INVESTIGATIONS OF UNPROFESSIONAL CONDUCT 1. Kerry Adair (continued) Mr. Adair was present. After discussion, :Mary Lynn Kelly moved to accept the draft standard stipulated order. Sheila Bowen seconded. Mr. Adair presented his signed copy of the order and stated that he had read and agreed to sign the order. The Motion passed unanimously with John Coleman recusing himself from voting. 2. Rodney M. Flickinger (continued) Mr. Flickinger was present. At 12:50 p.m., for purposes of receiving legal advice, Sheila Bowen moved that the Board go into Executive Session. Karen Stmdenmier seconded. The Motion passed unanimously. At 12:58 p.m., Mary Lynn Kelly moved that the Board return to public session. John Coleman seconded. The Motion passed unanimously. After discussion, Mary Lynn Kelly moved to revise the draft modified stipulated order and offer it to Mr. Flickinger. Karen Staudenmier seconded. Mr. Flickinger informed the Board that he was willing to agree to the modified order. The Motion passed unanimously. 3. Bruce Ashworth Mr. Ashworth was not present. The Executive Director explained that the allegation against Mr. Ashworth is that he worked without a valid license during a time period when his license lapsed (September 11, 1995 when his temporary license expired, through November 9, 1995 when the Board received his license fee.) The Board's office wrote to him on four (4) occasions asking him to confirm or deny the allegation. Finally, on February 13, 1996, Mr. Board Meeting PageS Ashworth called the office to say that he will not answer the questions in the letters. He stated that he is living and working in Salt Lake City; he left Phoenix last Spring and he will not be back. He stated in his phone message that he did not practice without a license. After discussion, Mary Lynn Kelly moved that the Board close its investigative file on Mr. Ashworth and that the Executive Director write him a letter to confirm what he said on the phone about not working without a valid license. Karen Staudenmier seconded. The Motion passed unanimously. 4. Pamela Daniels Ms. Daniels was not present. The Executive Director explained that on November 15, 1995, the Board received a copy of the paperwork on Pamela Daniels for a positive drug screen submitted to the University Medical Center on November 1, 1995. The test was positive for Cannabinoids and was taken as a pre-employment drug screen with Immediate Respiratory Staffers. The Board's office wrote to Ms. Daniels on November 20, 1995 asking her to confirm or deny the allegation. She responded in a letter received by the Board on December 7, 1995. Ms. Daniels states that he she submitted to a pre-employment urine drug screen on November 1, 1995 but that she had not received anything in writing as to the outcome of that screen. She states that she tested negative on a previous screen with IRS. After discussion, Mary Lynn Kelly moved that the Board invite Ms. Daniels to an informal interview hearing to consider the allegation of uprofessional conduct against her. Karen Staudenmier seconded. The Motion passed unanimously with John Coleman recusing himself from participation. 5. David Denyes Mr. Denyes was present. The Executive Director explained that on his renewal application, received on May 11, 1995, Mr. Denyes informed the Board of a Dill conviction in early 1995. Since that time, Mr. Denyes has provided the Board with all the documentation the Board requested regarding his completion of an outpatient alcohol abuse program at Verde Valley Guidance Center in Cottonwood. In a letter received by the Board on January 24, 1996, Mr. Denyes admits that during the time period when his license lapsed (from his previous license expiration date of November 8, 1994 through when he applied again on May 10, 1995) to working for All-Med Equipment and Services and performing duties including "setting up oxygen and other home respiratory care equipment.· After discussing the matter with Mr. Denyes, during which Mr. Denyes admitted that he had been practicing respiratory care without a valid license for 6 months, John Coleman moved that the Board offer Mr. Denyes a Stipulated Order which will require 6 additional approved CEU's for his biennial license renewal. Karen Staudenmier seconded. The Motion passed unanimously. Board Meeting Page 6 IX CONSIDERATION AND ACTION ON INFORMAL INTERVIEWS PURSUANT TO A.R.S. 32-3SS3(G) 1. Charles W. Oehler, case No. 01199-95-070, 2:30 p.m. (continued) Mr. Oehler was not present. , At 2:40 p.m., for purposes of receiving legal advice, Sheila Bowen moved that the Board go into Executive Session. Karen Staudenmier seconded. The Motion passed unanimously. At 2:47 p.m., Mary Lynn Kelly moved that the Board return to public session. Kit Mehrtens seconded. The Motion passed unanimously. After discussion, Kit Mehrtens moved that the Board issue a Formal Complaint and Notice of Hearing to Mr. Oehler. Sheila Bowen seconded. The Motion passed unanimously. X CONSIDERATIONANDACTIONONFORMALCOMPLAINTHEARINGS PURSUANT TO A.R.S. §32-3SS3(G) 1. Marvin Jerew, Case No. 03720-95-067, 1:30 p.m. Mr. Jerew was not present. Legal counsel presented the case. The Board, at its October, 1995 meeting granted Mr. Jerew his permanent license. He was in attendance at the meeting. The Board discussed his background, including two arrests -- one for marijuana possession and one for domestic violence (when he got into a struggle with his teenage son while driving and had an accident). The Board determined that the convictions were misdemeanors. Mr. Jerew told the Board that his life was straightened out now. On October 11, 1995, we received a Laboratory Report (from Corning Clinical Labs) from Immediate Respiratory Services alleging that Mr. Jerew had tested positive for Cannabinoids (marijuana) on September 15, 1995. On October 12, 1995, we wrote a letter to Mr. Jerew asking him to respond to the allegation that he had tested positive for Cannabinoids. We asked him to respond within 10 days, but he did not. He never responded. Mr. Jerew did not attend the Board meetings for the original allegation of unprofessional conduct or his informal interview hearing, either. After discussion, Kit Mehrtens moved that the Board adopt the findings of facts and conculsions of law as outlined by legal counsel and set forth in the Formal Complaint and Notice of Hearing. Sheila Bowen seconded. The Motion passed unanimously. Karen Staudenmier moved that the Board revoke Mr. Jerew's license to practice respiratory care based on said findings of fact and conclusions of law. Kit Mehrtens seconded. The Motion passed unanimously. 2. Michael Hartman, case No. 02877-95-005, 2:00 p.m. Mr. Hartman was present. Legal Counsel presented the case. In September, Mr. Hartman was issued a Decree of Censure and Probationary Order pursuant to a Board decision made in March of 1995 -- for exceeding the scope of practice of an RCP. The terms of his _._-- -- -----." ~-7 ---- Board Meeting Page 7 probation, which were spelled out in the Order, called for reports to the Board in October and December of 1995, with the last one due in March when his Order is due to expire. Mr. Hartman has never filed either of the two required reports. The Board's investigator has also determined that Mr. Hartman has failed to notify one of his employer of his Board ordered probation. In a telephone call to the Board's office, Mr. Hartman had stated that one of his employers has been writing reports. The Board's investigator determined that Mr. Hartman had failed to tum the reports in to the Board. After discussion, during which Mr. Hartman • established that he believed his employer was submitting the required reports, and establishing that reports had been generated, Mary Lynn Kelly moved that the allegation against Mr. Hartman be dismissed. Kit Mehrtens seconded. The Motion passed unanimously. After further discussion, during which Mr. Hartman demonstrated that reports had been prepared at his request by his new employer, Thunderbird Samaritan Hospital, John Coleman moved that the Board accept the reports from Thunderbird Samaritan Hospital as Mr. Hartman's final report to the Board, completing his probation. Mary Lynn Kelly seconded. The Motion passed unanimously. XI CONSIDERATION AND ACTION ON REQUFST FOR REHEARING 1. Malcolm Val Phoenix, Case No. 01509-95-059, 4:00 p.m. Mr. Phoenix was not present. Legal counsel presented the case. The Board received a letter from Malcolm Val Phoenix requesting reconsideration and rehearing of the Board's Order of Revocation. The Board's Order was issued on December 22, 1995, and mailed by certified mail with return receipt requested on the aforementioned date. The U.S. Mail return receipt received by the Board's Executive Director reflects that Mr. Phoenix signed for receipt of the Board's Order on January 2, 1996. Mr. Phoenix submitted his request for rehearing by letter which was received by the Board on January 10, 1996. Said letter fails to set forth any grounds, such as mistakes of law or fact, upon which to support his argument for rehearing. After discussion, John Coleman moved to deny Mr. Phoenix's request for a rehearing based on the findings of fact and conclusions of law presented by legal counsel. Kit Mehrtens seconded. The Motion passed unanimously. xu CONSIDERATION AND ACTION ON REQUFST FOR WAIVER OF CEU'S 1. Bema McDonald Ms. McDonald was not preset. The Executive Director -reviewed Ms. McDonald's request and informed the Board that Ms. McDonald meets the criteria for requesting a waiver from completion of CEU's set forth in Board Rule 212(C)(I). After discussion, John Coleman moved to grant Ms. McDonald's request for a waiver of the CEU requirement for her current license renewal. Kit Mehtens seconded. The Motion passed unanimously. Board MeetiDI Page 8 xm CONSIDERATION AND ACTION ON REQUEST FOR MODIFICATION OF PROBATION 1. Paul Bianco Mr. Bianco was not present. The Executive Director reviewed Mr. Bianco's request. In January, 1995, Mr. Bianco stipulated to an Order for Probation and ~ehabilitation. Mr. Bianco appeared before the Board in November. He is living mGeorgia and has applied for licensure in that state. He states in his letter of request, received by the Board on January 24, 1996, that he is scheduled to go before the Georgia licensing Board but that he does not know whether his license will be granted "free and clear" or whether it will include probation. He also states that his Georgia application file is not complete because his last Arizona employer has not yet written the necessary letter for him. After discussion, Karen Staudenmier moved the Board offer an amended stipulation agreement to Mr. Bianco which will place a stay on the Arizona requirements while he is living in Georgia, and that since this is a stipulation, should Mr. Bianco refuse to agree to the modifications, the original stipulated order will remain in effect. Sheila Bowen seconded. The Motion passed 6-1 with Mary Lynn Kelly voting no. XIV CALL TO THE PUBLIC There was no public presentation to the Board. XV DISCUSSIONIACTION ON EXECUTIVE DIRECTOR'S REPORT A. Discussion and Action regarding legislative matters. The Executive Director gave the Board an update on legislative matters. XVII ESTABLISH DATE AND TIME OF NEXT BOARD MEETING Thursday, March 21, 1996 at 10:00 a.m. XVIII ADJOURNMENT John Coleman moved to adjourn the meeting at 4:02 p.m. Karen Staudenmier seconded. The Motion Passed unanimously. DATED this 1th day of March, 1996. - i / BOARD OF RESPIRATORY CARE EXAMINERS BOARD MEETING MINUTES , Thursday, March 21, 1996 at 10:00 a.m. 2nd Floor Conference Room 1400 W. Washington, Phoenix AZ Board Members Present: Chair Meryl Salit, Vice-Chair Kit Mehrtens, Sheilah Bowen, John Coleman, Gerald Schwartzberg, M.D., and Karen Staudenmier Board Members Absent: Mary Lynn Kelly Staff Present: Mary Hauf Martin, Executive Director Dolores Doyle, Administrative Assistant Board's Legal Counsel: Mike Harrison, Assistant Attorney General I. CALL TO ORDER The Meeting was called to order at 10: 12 a.m. by Chair Meryl Salil. ll. APPROVAL OF MINUTES Kit Mehrtens moved approval of the Minutes as presented. Karen Staudenmier seconded. The Motion passed unanimously. MlDUles 01 lV.aan::II ~.1, .1.7:71) Board Meeting Page 2 ID. DISCUSSION/ACTION ON APPUCATIONS FOR UCENSURE A. Recommended for approval by the Executive Director Shelly David Biletsky Janet L. Carter Denise M. Castricone James D. Cristaniello Michael P. Drabek Sherry L. Bartley Cristian E. Chera Douglas A. Elliott James W. Ervin, Jr. Ernest C. Esteban Patricia A. Ferraro David W. King Kimberly A. Brodeur Debra A. Zwier Tracy Jo Paulley Joseph Schermick, Jr. Rebecca A. Valenzuela Donn Webb Kimberly D. Caldwell Karen Staudenmier moved approval of all the individuals listed on the Agenda and recommended by the Executive Director. Kit Mehrtens seconded the Motion. The Motion passed unanimously. B. Application for Licensure C. Request for an Extension to a Temporary License IV. DISCUSSION/ACTION ON ADMINISTRATIVE CWSING OF APPLICAnON FILES The Executive Director recommended the following files to be closed: Loren "Harlan" Green Jon R. Farley Karen L. Peebles Richard Topey Leighton Bartell Teresa M. Holt Raid M. Rabadi Leo P. Wangen Kit Mehrtens moved that the Board administratively close the application files of all the items on the agenda. Sheila Bowen seconded. The Motion passed unanimously. V. DISCUSSION/ACTION ON ADMINISTRATIVE ,CLOSING OF TWO YEAR INACTIVE FILES The Executive Director stated that these were routine two year inactive license files. Dorothy J. Blevins Lee Douglas Thomas R. Kolich Amy R. Boyd Robert W. Dunn Joy A. Lynn Schroeder Susan L. DeFabis Victor A. Ince Paula A. O'Connor MlDUles 01 MaI'CD ~J., J.~ Board Meeting Page 3 Mitchell A. Pederson Gwendolyne E. Rouse Ruth Williams John Coleman moved that the Board administratively close the two year inactive files of all the items on the agenda. Sheila Bowen seconded. The Motion passed unanimously. VI. DISCUSSION/ACTION ON NOTICES OF UCENSE EXPIRATIONS , The Executive Director stated that these were routine license expirations. Brenda Blum Linda Doherty Deanna Jeffries Kim Hoffmeyer Rickie Ishmael Deborah Nutt Lorraine Vanover Nancy Butterick Steven Bide Joseph Haskins Joanne Holliday Richard Mitchell Marilyn Pena Kieran Cox James Gamboa George Hay Shirley Hughes Tracy Mulvaney Carol Record Karen Staudenmier moved to approve these license expirations. John Coleman seconded. The Motion passed unanimously. John Coleman moved that the Board open an investigation into case of Nancy Butterick. Karen Staudenmier seconded. The Motion passed unanimously. Vll. DISCUSSION/ACTION ON REINSTATEMENT OF EXPIRED LICENSFS The Executive Director reported that these were routine license reinstatements. Megan L. Heemsoth John W. Hampton John Coleman moved to ratify these reinstated licenses. Sheila Bowen seconded. The Motion passed unanimously. VllI. CONSIDERATION AND ACTION ON INVESTIGATIONS OF UNPROFESSIONAL CONDUCT 1. Richard Luscher Mr. Luscher was not present. The Executive Director explained that Mr. Luscher applied for licensure on June 8, 1994. He received a Temporary License on June 9, 1994 valid through February 9, 1995. The Board approved his permanent license on June 30, 1994. His permanent license became valid on July 5, 1994 when he remitted his licensure fee. He is currently the holder of License No. 03211 which is valid through October 1, 1996. On his license application to the Board, on question number 19 which asks ·omitting minor traffic violations, have you ever been arrested or charged or Minutes or March 21, 1996 Board Meeting Page 4 convicted of or pled no contest (nolo contendre) to any violation of any law of any state, the United States or a foreign country? THIS INCLUDES ALL MISDEMEANORS AND FELONIES, Mr. Luscher answered -no. - On December 28, 1995, the Board received an allegation from Sun Health Corporation that Mr. Luscher pled guilty to a class 4 felony and was convicted in 1981 for criminal simulation. The allegation further stated that Mr. Luscher's rights had been restored in 1985. When Sun Health Corporation contacted Mr. Luscher regarding this info~tion, he denied (to Sun Health) that this infonnation was about him. When the Board staff investigated this allegation we subpoenaed infonnation from the agency that did the background check for Sun Health, Arizona Investigations. In a letter to the Executive Director, Arizona Investigations stated that Mr. Luscher also has an outstanding felony warrant charging aggravated theft out of Medford, Oregon. After discussion, John Coleman moved that the Board issue a Fonnal Complaint and Notice of Hearing to Mr. Luscher. Kit Mehrtens seconded. The Motion passed unanimously. 2. Kevin J. Marquis Mr. Marquis was present. The Executive Director explained that Mr. Marquis is the holder of license number 02343 issued on June 15, 1994 and valid through June 15, 1996. On December 27, 1995, the Board received a notice from Boswell Hospital that Mr. Marquis was terminated from his job for cause. Mr. Marquis was terminated for unacceptable job perfonnance, sleeping on the job, and for the admitted use of Halothane on the job. Halothane is an anesthetic agent. The Board's investigator determined that Mr. Marquis had received several written reprimands. These reprimands were placed in his employee file. The documentation establishes poor job perfonnance for the following reasons: not following departmental procedures; not answering pages; sleeping on the job; and admitted use of Halothane while on duty. The Board's investigator further detennined that during the latter period of his employment, Mr. Marquis was tested for drugs, but no positive reports were found. The Board's investigator was told, by a representative of Sun Health, that Halothane does not appear on a standard drug screen. When Mr. Marquis was terminated, Sun Health advised him to contact a Dr. Mike Cofield at employee counseling because of his admitted drug use. After discussing the matter with Mr. Marquis, and detennining that more infonnation is needed, Mr. Marquis stated his willingness to work with the Board. Kit Mehrtens moved that the Board issue a Fonnal Complaint and Notice of Hearing to Mr. Marquis. Karen Staudenmier seconded. After discussion, Kit Mehrtens withdrew her motion and Karen Staudenmier withdrew her second. Karen Staudenmier moved that the Board invite Mr. Marquis to an Informal Interview Hearing. Kit Mehrtens seconded. The Motion passed unanimously. Sheila Bowen moved that the Board subpoena the policy or rule of Boswell hospital which would be pertinent to this case. Karen Staudenmier seconded. The Motion passed unanimously. After discussion, during which Mr. Marquis agreed to have a complete medical evaluation done and submit the results to the Board, Karen Staudenmier moved to place the lnfonnal Interview Hearing with Mr. MarqUis on the MInutes 01 .M.81"CD. :.u., l~ Board Meeting Page 5 agenda for the May 1996 Board meeting. Kit Mehrtens seconded. The Motion passed unanimously. 3. Franklin Miller Mr. Miller was present. The Executive Director explained that Mr. Miller is the holder of license number 00706, valid through August 6, 1996. Qn January 8, 1996, the Board received a request to investigate this matter from the Arizona Department of Health Services, Emergency Medical Services. The allegation was instructed to be sent to the Board by Toni Brophy, M.D., Medical Director for Emergency Medical Services along with the results of E.M.S. 's preliminary investigation which found that their Office had no jurisdiction over any of the individuals involved. E.M.S. identified the respiratory technician on board as Frank Miller, CRTT. The allegation was also forwarded to the Arizona Board of Medical Examin~rs and the Board of Nursing. After discussion, Karen Staudenmier moved to open an investigation in this case to determine whether there was basis for an allegation against Mr. Miller. Kit Mehrtens seconded. The Motion passed unanimously. Dr. Schwartzberg moved to reopen this agenda item. Karen Staudenmier seconded. The Motion passed unanimously. After discussion, Dr. Schwartzberg moved to rescind the Board's prior vote to open an investigation. Kit Mehrtens seconded. The Motion passed unanimously. Dr. Schwartzberg moved to dismiss the allegation against Mr. Miller. Kit Mehrtens seconded. The Motion passed unanimously. 4. Robert E. Schrader Mr. Schrader was present. The Executive Director explained that Mr. Schrader is the holder of license number 02449, valid through April 23, 1997. On December 7, 1995, the Board received a letter containing an allegation of unprofessional conduct against Mr. Schrader from Lynn Hill, the Human Resources Manager at Paradise Valley Hospital. The allegation involves an incident regarding Mr. Schrader which occurred on November 23, 1995. The incident was "inappropriate behavior in conjunction with the odor of alcohol." The letter states that Mr. Schrader was counseled on November 24, 1995 and given final warning against any reoccurrence. Mr. Schrader told the Board that due to illness, he had recently been hospitalized and unable to work. He presented the Board with a release from his doctor to return to work. He stated his willingness to work with the Board and enter into a Stipulation and Consent Order for Rehabilitation. After discussion, Kit Mehrtens moved that the Board offer Mr. Schrader a standard Stipulation and Consent Order for Rehabilitation. Sheila Bowen seconded. The Motion passed unanimously. Minutes of March 21, 1996 Board Meeting Page 6 IX. CONSIDERATION AND ACTION ON INFORMAL INTERVIEWS PURSUANT TO A.R.S. 32-3SS3(G) 1. Pamela Daniels, Case No. 01685-95-075 Ms. Daniels was present. The Executive Director explained that on November 15, 1995, the Board received a copy of the paperwork on Pamela DaJ,1iels for a positive drug screen submitted to the University Medical Center on November 1, 1995. The test was positive for Cannabinoids and was taken as a pre-emp1oyment drug screen with Immediate Respiratory Staffers, and was subsequently verified by GeMS. The Board's office wrote to Ms. Daniels on November 20, 1995 asking her to confirm or deny the allegation. She responded in a letter received by the Board on December 7, 1995. Ms. Daniels states that he she submitted to a pre-employment urine drug screen on November 1, 1995 but that she had not received anything in writing as to the outcome of that screen. She states that she tested negative on a previous screen with IRS. After discussion, during which the Executive Director informed the Board that it is IRS' policy to inform people regarding positive test results via the telephone, Kit Mehrtens moved that the Board offer Ms. Daniels a .modified Stipulation and Consent Order for Rehabilitation. Karen Staudenmier seconded. The Motion passed unanimously with John Coleman recusing himself from participation. 2. Frank Mamone, Case No. 01460-95-074 Mr. Mamone was not present. Karen Staudenmier recused herself from the proceeding. The Executive Director explained that on November 2, 1995, the Board received a letter from Vencor Hospital stating that Mr. Mamone had been terminated, effective September 13, 1995. Discrepancies and potentially fraudulent charting were noted upon review of the charts of patients under Mr. Mamone's care. The Executive Director explained that at the January Board Meeting, Mr. Mamone appeared and discussed this matter with the Board. The Board voted to invite Mr. Mamone to this Informal Interview Hearing and to subpo |
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