supplemental public agenda alabama board of …

ABME Public Agenda October 17, 2018

1

SUPPLEMENTAL PUBLIC AGENDA ALABAMA BOARD OF MEDICAL EXAMINERS

October 17, 2018 848 Washington Avenue, Montgomery, AL 36104

I MINUTES PUBLIC MINUTES OF SEPTEMBER 19, 2018 II ENDORSEMENT Name Medical School Endorsement

1. Jaren Aksut University of Arkansas COM Drexel University COM USMLE/OH

2. Jeffrey Stephen Alvis University of Virginia School of Medicine USMLE/VA

3. * Ajay Behari American University of The Caribbean USMLE/OH

4. * Lee Walker Beville III Universidad Central Del Este (UCE) FLEX/OK

5. Robert Alden Lloyd Blake University of Tennessee Memphis College of Medicine NBME/TN

6. Meghan Patricia Bonds University of Vermont College of Medicine USMLE

7. * Aaron Brent Carter University of Missouri School of Medicine Columbia NBME/IA

8. Alexander Charles Cohen University of South Alabama College of Medicine USMLE

9. Joy Marie DeShazo University of Alabama School of Medicine Birmingham USMLE

10. Ryan Scott Dill Indiana University School of Medicine Indianapolis USMLE

11. Michael Justin Dinkels Jefferson Medical College of Thomas Jefferson University USMLE/NY

12. David Edward Kline Feldman Ross University USMLE

13. William Casey Frew Tulane University School of Medicine USMLE/LA

14. * Anteneh Mengie Gizaw Gondar Col of Medical Sciences, Addis Ababa University USMLE/GA

15. Wayne Floyd Ho University of Pennsylvania School of Medicine USMLE/DE

16. John Alexander Holt University of Tennessee Memphis College of Medicine USMLE/MO

17. * Michael Richard Kinney Case Western Reserve University School of Medicine USMLE/IL

18. Mrinalini N. Kulkarni-Date University of Texas Medical School at San Antonio USMLE/TX

19. Angela Kay Marshall Southern Illinois University School Of Medicine USMLE/FL

20. * Thomas Charles Militano Case Western Reserve University School of Medicine NBME/NC

21. Jennifer Rose Mullinax Medical College of Georgia School of Medicine USMLE/KY

22. Carl Michael Orquia Loma Linda University School Of Medicine USMLE/IL

23. Stuart Alan Ostby Mayo Medical School USMLE

24. Swati Patel Medical University of the Americas (Nevis) USMLE

25. Dhaval Pau American University of Antigua USMLE/MO

26. Carmen A. Peralta Johns Hopkins University School of Medicine USMLE/MA


2

27. Christy Lynn Pettes University of Tennessee Memphis College of Medicine USMLE/TN

28. Jenna Morgan Pfleeger University of South Alabama College of Medicine USMLE

29. Michael Dewayne Roach Kansas City University of Medicine & Biosciences COMLEX/MO

30. * Kelly Lynn Rose Medical University of South Carolina College of Medicine USMLE/GA

31. Ceylon Maurice Rowland Morehouse School Of Medicine NBME/NC

32. * Adam Lee Sewell University of Texas Medical School at Galveston USMLE/TX

33. Eric Bruce Sklar Temple University School of Medicine USMLE/VA

34. Allan Miles Stephenson University of Tennessee Memphis College of Medicine USMLE/TN

35. * Moyosore Mustafa Suleiman University of Ilorin USMLE/IL

36. Kunal Bhikhalal Tank B J Medical College, Gujarat University USMLE/OH

37. * Benjamin Hill Thurman University of Texas Southwestern Medical Center at Dallas FLEX/TX

38. Gary Neville Trewick American University of The Caribbean USMLE/GA

39. Ashley Nicole Walker UASOM Birmingham USACOM USMLE

40. Matthew David Walvick Touro University College Of Osteopathic Medicine COMLEX/CA

41. * Duke Jerrod Wood Oklahoma State University College of Osteo Medicine COMLEX/MS

42. * Michael Neall Wood Loma Linda University School Of Medicine NBME/CA

43. Tatiana Milenka Zeballos Escuela Autonoma De Ciencias Med De Centro America USMLE/PA

44. Mona Meliha Ahmad New York Medical College USMLE

45. John Clark McDermott Alves II University of Alabama School of Medicine Birmingham USMLE

46. Kristina Culotta Campbell Alabama College of Osteopathic Medicine COMLEX

47. Jean Emilcar Pennsylvania State University College of Medicine USMLE/PA

48. Adeel Ilyas University of Virginia School of Medicine USMLE

49. Louis Herman Isaacson Des Moines University of Osteopathic Medical Center USMLE/FL

50. Danielle Rachel Isen Midwestern University, Arizona Campus COMLEX

51. Bhavini Jitesh Kar Lady Hardinge Medical College, Delhi University USMLE

52. Beth Renee Keegstra Rosalind Franklin University of Medicine and Science NBME/CA

53. Jason Thomas King University of Mississippi School of Medicine USMLE

54. James David Lawrence III Medical University of the Americas USMLE/GA

55. William Benton Lee University of Alabama School of Medicine Birmingham USMLE

56. Alexandra Nicole Martirossian University of Texas Medical School at Galveston USMLE

57. Lisa Marie McDivitt Louisiana State University Medical Center In Shreveport USMLE

58. Rashmi Vijay Patil University of Michigan Medical School USMLE

59. Animesh Petkar Lewis Katz School of Medicine at Temple University USMLE/TN

60. Ndah Akwesi Poteh Augusta University School of Medicine USMLE

61. David Wyatt Saunders Mercer University School of Medicine USMLE/GA

62. Andrew Bradley Shaffer Eastern Virginia Medical School USMLE

63. Nancy Jean Shannon Michigan State University College of Human Medicine NBME/USMLE/MI

64. Ashlesha Sharma Des Moines University of Osteopathic Medical Center COMLEX/IA

65. Jason Yue Shen Texas A&M University Health Science Center COM USMLE/UT

66. John Patrick Simmons Medical College of Georgia School of Medicine USMLE

67. Kelley Marie Struble University of North Texas Health Science Center NBOME/OK


3

68. Robinson Dulk Taylor University of Central Florida College of Medicine USMLE

69. Panayotis Vardas Universita Di Rome La Sapienza USMLE/IL

70. * Nayyer Ul Islam Sindh Medical College, Univ of Karachi USMLE/GA

PROVISIONAL ENDORSEMENT Name Medical School Endorsement No Provisional Endorsement Applicants RETIRED SENIOR VOLUNTEER PROGRAM LICENSE (RSVP) Name Facility Location No RSVP License Applicants SPECIAL PURPOSE LICENSE Name Location Type of Practice

1. Angela Lynell Byrd-Gloster Brentwood, TN Telepathology

2. Hanan Fahmy Irving, TX Telehospitalist

3. Jasmin Manalo-Baleva Houston, TX Telehospitalist

INTERSTATE MEDICAL LICENSURE COMPACT REPORTS (Scanned with Endorsement) (1) 1. Interstate Medical Licensure Compact Licensees (3) 2. Interstate Medical Licensure Compact Letters of Qualification II LIMITED LICENSE Name Medical School Endorsement No Limited License Applicants


4

IV PHYSICIAN ASSISTANTS / ADVANCED PRACTICE NURSES (10) Cover Sheet P.A. License Name School NCCPA

1. Ann Elliott, PA Trevecca Nazarene University 1151324

2. Paul McGlynn, Jr., PA Alderson Broaddus College 1010584

3. Rachel Ragland, PA Trevecca Nazarene University 1151341

4. Marilyn Roberts, PA University of South Alabama 1150089

5. Angela Tortomase, PA University of South Alabama 1150098

6. Kayla Travis, PA University of South Alabama 1131263

7. Colleen Valdez, PA University of Tennessee 1149751

8. Lashea Young, PA Towson University 1156656

9. Pagett Bossi, PA Emory University 1035405

10. Vanessa Lazaro, PA Touro College 1070615

11. Rachel Rigsby, PA Trevecca Nazarene University 1151344

12. Jonathan Thompson, PA University of South Alabama 1150097

A.A. License Name School NCCAA No AA License Applicants Temporary P.A. License Name School NCCPA No Temporary License Applicants Temporary P.A. License to Full License Name School NCCPA No Temporary PA License to Full License Applicants


5

P.A. Registration Without additional duties; With Qualified Remote Sites; Formulary: #2, #21, #23

PA / Physician Registration / Remote site / Formulary Requests

Recommendation

1. Edith Agee, PA Gerald Crawford, Jr., M.D.

Registration Birth Control Drugs and Devices

2. Cameron Bass, PA Weifeng Song, M.D.

Registration

3. Paul Brown, PA Steven Johnson, M.D.

Registration

4. Karen Cox, PA Ralph Irvin, M.D.


5. Ashley Guy, PA Randall Knutson, M.D.


6. Karen Harness, PA Jarrod Roberts, M.D.


7. Lindsay Kolasa, PA Erin Delaney, M.D.


8. Priya Patel, PA Jennifer Palmer, M.D.


9. Lori Stockdale, PA Steven Johnson, M.D.

Registration

10. Angela Tortomase, PA Weifeng Song, M.D.

Registration

11. Joseph Watters, II, PA Sudhan Nagarajan, M.D.


(SA) Aliza Bircheat, PA Christopher Roney, M.D.

Registration

(SA) Rachael Kain, PA David Cleveland, M.D.

Registration

(SA) Vanessa Lazaro, PA Julie Gladsjo, M.D.

Registration

(SA) Harley Oliver, PA Theodore Kopp, M.D.

Registration

(SA) Michael Pugh, PA David Cleveland, M.D.

Registration

(SA) Rachel Rigsby, PA Joseph Boyett, D.O.

Registration

(SA) Nicolaus Ruehl, PA Frank Francone, M.D.



6

With additional duties; Remote site; Misc. Formulary requests

PA / Physician Registration / Remote site / Skills and Formulary Requests

Recommendation

1. (14)

Steven Laye, PA Jonathan Jennings, M.D.

Registration Approval to train: Arthrocentesis, Shoulder, Elbow-Olecranon, Knee, and Greater Trochanteric Bursa

2. (38)

Amanda Mitchell, PA Stephen Ikard, Jr., M.D.

Registration Approval to train: Arthrocentesis, Shoulder, Elbow-Olecranon, Knee, and Greater Trochanteric Bursa

A.A. Registration No AA Registration Applicants P.A. / A.A. Miscellaneous Requests / Reports Skills Requests Within Protocol

PA / Physician Skills Requests / Miscellaneous Recommendation

1. (58)

Donald Andrews, PA Gregory Thomas, M.D.

Skills Transfer : CVL Placement: IJ and Femoral CVL Placement: Subclavian CVL: Remove and replace over guidewire Arterial line insertion: Radial and Femoral Radial artery harvest Intra-aortic balloon insertion Intra-aortic balloon pump removal Sternal closure Thoracostomy tube insertion Primary sternotomy Primary thoracotomy

2. (63)

Karen Cox, PA Lee Irvin, M.D.

Skills and Supervised Practice Transfer: Joint injections: Shoulder, Knee, Greater Trochanteric Bursa Trigger point injection below T-12


7


3. (67)

Christina Cyriac, PA Anthony Morlandt, M.D.

Additional Practice Site

4. (72)

Nikki Quinley, PA Paul Fineburg, M.D.

Request to train: Joint injections: Arthrocentesis, Shoulder, Knee, and Greater Trochanteric Bursa

(SA) Jessie Coffey, PA Michael Blum, M.D.

Supervised Practice: Joint Injections: Knee, Shoulder, Greater Trochanteric Bursa

Skills Requests Outside Protocol


1. (77)

Tamara Austin, PA Stephanie Gafford, M.D.

Remote Site Location Request: All locations are less than one hour from the supervising physician’s principal site location.

2. (96)

Ashley Greer, PA David Thomason, M.D.

Request to train: Ultrasound guided joint injections (Shoulder, Elbow-Olecranon Bursa, Knee, and Greater Trochanteric Bursa) Lateral Epicondyle Injection

3. (101)

Lily Nizam, PA Sami Nizam, II, M.D.

Request to train: PDO thread lift; Peripheral Trigeminal Nerve Block; Shave and punch biopsies of suspicious lesions of the face and neck; Incisional intraoral biopsies; and Micro-needling (Skin Pen-FDA cleared device)

4. (108)

Bennett Smith, PA Joseph Pettus, M.D.

Request to train: Percutaneous Tibial Neuromodulation and Cystoscopy

P.A. QACSC Registration PA Physician

1. Karen Cox, PA Ralph Irvin, M.D.

2. Karen Harness, PA Jarrod Roberts, M.D.

3. Lori Stockdale, PA Steven Johnson, M.D.


8

P.A. Limited Purpose Special Permit

PA / Physician / Specialty LPSP Formulary Recommendation Approve Deny

1. (114)

Brent Blackwell, PA James Worthen, M.D. Specialty: Ortho Surgery

Hydrocodone Combinations Oxycodone IR Tapentadol

APN Miscellaneous Requests / Reports (122) Cover Sheet Skills Requests Within Protocol

Physician /NP Request Recommendation

1. (125)

Ryan Christopher Aaron, M.D. Amber G. Mitchell, CRNP

Approval of Supervised Practice: joint injections of shoulder (5), greater trochanteric bursa (14), knee (6).

2. (129)

Constantine Athanasuleas, M.D. Christopher Ford, CRNP

Approval of Supervised Practice: removal of pacing wires

3. (134)

Kenneth Bramlett, M.D. Christopher Berry, CRNP

Approval to train: Orthopedic Specialty Protocol-arthrocentesis; joint injections of shoulder, elbow (olecranon bursa only), greater trochanteric bursa and knee

4. (145)

Gino Castaneda, M.D. Brian Sellers DO William (Billy) Saliski, CRNP

Approval of Supervised Practice: removal of tunneled central venous lines (10).

5. (151)

Daryl Dykes, M.D. Holly Scott, CRNP

Transfer of approval for Orthopedic Specialty Protocol and previously approved supervised practice

6. (157)

Jason Robert Determann, M.D. Joshua Wing, CRNP

Approval of Supervised Practice: arthrocentesis (3), joint injections of shoulder(6), greater trochanteric bursa (4)and knee (14)- continue training for olecranon bursa (1)

7. (161)

Antonio Di Stassi, M.D. Natalie McRae, CRNP

Transfer approval for Critical Care Specialty Protocol: removal of central venous lines, percutaneous and tunneled

8. (173)

Racquel Innis-Shelton, M.D. Jessica McCreight, CRNP

Transfer approval for Critical Care Specialty Protocol: removal of central venous lines, percutaneous and tunneled


9

Physician /NP Request Recommendation

9. (179)

Keith A. Kowal, M.D. Tamberlynn Baker, CRNP

Approval to train: Otolaryngology Specialty Protocol-flexible nasopharyngoscopy/laryngoscopy; diagnostic nasal endoscopy (flexible and rigid)

10. (197)

Robert Allan Maples, M.D. Craig A. Reeves

Approval to train: Orthopedic Specialty Protocol- shoulder, elbow (olecranon bursa only), greater trochanteric bursa and knee

11. (212) (218)

Richard Oyler, M.D. Jonathan Parker, CRNP Stanley Alan Clayton, CRNP

Approval to train: Orthopedic Specialty Protocol-arthrocentesis; joint injections of the shoulder, greater trochanteric bursa and knee

12. (224)

Donna Salzman, M.D. Melinda Rogers, CRNP

Approval to train: Critical Care Specialty Protocol- removal of central venous lines, percutaneous and tunneled

13. (232)

Emily Smithermann, M.D. Victoria Helsper, CRNP

Approval to train: Orthopedic Specialty Protocol- arthrocentesis; joint injections of shoulder, elbow (olecranon bursa only), greater trochanteric bursa and knee

14. (269)

Bradford Woodworth, M.D. Shannon Locke Guthrie, CRNP

Approval of Supervised Practice: rigid diagnostic nasal endoscopy

Skills Requests Outside Protocol

Physician/ NP Request Recommendation

1. (274)

Ross Wayne Barnett, M.D. Christopher P. Pritchett, CRNP

Approval of Supervised Practice: joint injections of the knee and shoulder outside one year( see history on memo)

2. (280)

J Jeremy Thomas, M.D. April Garrigan, CRNP

Continuation of approval to train for Critical Care Specialty Protocol-central venous line insertion, internal jugular and femoral;

3. (308)

Erika Cristina Mendoza Plaut, M.D. Sara D. Ewert, CRNP

Approval to train: Critical Care Specialty Protocol- central venous line insertion, femoral; arterial line insertion femoral; removal of pacing wires and mediastinal chest tubes. Removal of peritoneal drain/dialysis catheter Chest tube insertion (pigtail)


10

Physician/ NP Request Recommendation

4. (331)

Hayden Zaccagni, M.D. Jonathan Hudson, CRNP

Approval to train: Critical Care Specialty Protocol- central venous line insertion, femoral; arterial line insertion femoral; removal of pacing wires and mediastinal chest tubes. Removal of peritoneal drain/dialysis catheter Chest tube insertion (pigtail)

5. (350) (355) (362) (367) (374) (379) (386) (396)

Children’s Hospital Russell Campus Santiago Borasino, M.D. Nicole P. Smith, CRNP Laura K. Brasseale, CRNP Robert Joseph Dabal, M.D. Staci Abernathy, CRNP Sarah T. Blair, CRNP William McMahon, M.D. Tonya Lisenba, CRNP Leslie Rhodes, M.D. Arley Melissa Potts, CRNP Robb Romp, M.D. Lauren Hunter, CRNP Phillip Weaver, CRNP

Approval to train: Care Specialty Protocol- central venous line insertion, femoral; arterial line insertion femoral; removal of pacing wires and mediastinal chest tubes. Removal of peritoneal drain/dialysis catheter Chest tube insertion (pigtail)

5. (403)

New Collaborative Practice Skill Protocol

Consideration for a Statewide Protocol for Advance Practices Nurses and Physician Assistants : Injection of Botox (see memo)

Collaborative Practice / APN QACSC Registration (SA) Collaborative Practice Registrations (SA) Collaborative Practice Modifications (SA) Collaborative Practice Covering Physician Applicants (SA) CRNP / CNM QACSC Registration Applicants


11

APN Limited Purpose Special Permit (419) Cover Sheet

Physician/ Specialty/ Current Clinical Practice, CRNP/ Specialty/ Current Practice:

LPSP formulary request:

Recommendation Approve:

Recommendation Deny:

1. (422)

David Call, D.O. Internal Medicine MD Current Practice: Internal Medicine Dana Norris, CRNP Family Nurse Practitioner (FNP)

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps

2. (423)

James Colvard, D.O. Family Medicine MD Current Practice: Family Medicine Haley Jost, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps Oxycodone IR

3. (424)

Steven Coppock, M.D. Emergency Medicine/ Family Medicine Current, M.D. Practice: Family Medicine/ Primary Care/ Emergency Medicine Holly Freeman, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps Morphine Sulfate IR Oxycodone IR Tapentadol SA

4. (425)

Jeb Hornsby, M.D. Family Medicine Current, M.D. Practice: Family Medicine Lori Henry, CRNP FNP


5. (427)

Wayne Jones, M.D. Family Medicine Current, M.D. Practice: Family Medicine Jessica Smith, CRNP FNP


6. (428)

Jason Junkins, M.D. Internal Medicine/ Pediatrics Current, M.D. Practice: Brandi Malsy, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preparation


12

7. (429)

Sudhakar Madanagopal, M.D. Orthopedic Surgery Current, M.D. Practice: Orthopedic Surgery Daniel Root, CRNP FNP

Hydrocodone SA Morphine Sulfate IR Oxycodone IR

8. (430)

Stephen Samelson, M.D. Orthopedic Surgery Current, M.D. Practice: Orthopedic Surgery Manuel Escobar, CRNP FNP

Hydrocodone SA Morphine Sulfate IR Oxycodone IR Tapentadol SA Hydromorphone

9. (432)

John Sheppard, M.D. Emergency Medicine Current, M.D. Practice: Family Medicine/ Primary Care/ Emergency Medicine Holly Freeman, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps Morphine Sulfate IR Oxycodone IR Tapentadol SA

10. (433)

Lacy Smith, M.D. Family Medicine Current, M.D. Practice: Family Medicine Joshua Elledge, CRNP FNP

ADHD Medications Hydrocodone SA Hydrocodone Cough Preps Oxycodone IR Tapentadol SA

11. (434)

Neil Yeager, M.D. Family Medicine Current, M.D. Practice: Family Medicine/ Urgent Care Charles Thornton, CRNP FNP and Adult-Gerontological Acute Care NP


12. (435)

Edgar Overton, M.D. Infectious Disease/ Internal Medicine Current, M.D. Practice: UAB HIV Clinic Gina C. Dobbs, CRNP FNP

Request to add, Dolophine; Methadone HCL Intensol; Methadose; and Methodose Sugar-Free to existing LPSP formulary for chronic pain only (See attached letter)


13

13. (446)

Eric Robinson, M.D. Anesthesiologist/ Pain Medicine Current, M.D. Practice: Auburn Pain Specialists Andrew Eden, CRNP FNP

Request to reconsider adding the following for maintenance, Dosing only (not initial) to existing LPSP: Fentanyl Hydrocodone LA Hydromorphone Methadone Morphine LA Oxycodone LA Tapentadol ER

Physician Assistant Advisory Committee Physician Assistant Advisory Committee Meeting – October 16, 2018, 5:30 p.m. CURRENT BUSINESS 1. ALBME Annual Budget (3) 2. Administrative Rules 540-X-8-.06 and 540-X-8-.20, Authorization for Practice as a CRNP or CNM (15) 3. Atlanta Psychiatric Consultation Center, LLC (25) 4. FSMB Bylaws – Call for Amendments (45) 5. Physician Assistant Advisory Committee (46) 6. Private Brain Autopsy Licensing Requirement (48) 7. CE Broker – Web-Cam Presentation, Wednesday, October 17, 2018, 10:00 a.m. (SA) 8. ALBME Employee Policies and Procedures Handbook (SA) 9. CTel Executive Telehealth Fall Summit (SA) 10. Request for Opinion: Supervision of Student CRNAs and AAs PERSONNEL (Scanned with Current Business)

(76) 1. Tiffany Seamons, ABME Licensing Assistant


14

VI HEARINGS (2) ABME Hearing Schedule (3) 1. Mohammad Sabry, M.D., Scottsboro Show Cause Hearing, Wednesday, October 17, 2018, 12:30 p.m. EXECUTIVE SESSION

supplemental public agenda alabama board of …

Documents