Minutes. Charles Womack, MD, Chairman Don Flinn, PA Lindsey Gillispie, PA Don Coody, R.Ph Gerald Wootan, DO Daniel McNeill, PhD, PA Thomas Pickard, DO

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1 Minutes The Physician Assistant Advisory Committee of the Board of Medical Licensure and Supervision met on October 28, 2010, in accordance with the Open Meeting Act. The meeting was held at the office of the Board, 101 NE 51 st Street, Oklahoma City, Oklahoma. Members present were: Charles Womack,, Chairman Don Flinn, PA Lindsey Gillispie, PA Don Coody, R.Ph Gerald Wootan, DO Daniel McNeill, PhD, PA Thomas Pickard, DO Member absent was: Curtis Harris, Others present included: Robyn Hall, Director of Licensing Kathy Plant, Executive Secretary Bill O'Brien, Assistant Attorney General The meeting was called to order at 3:00 p.m. The minutes from July 15, 2010, Committee meeting were reviewed. Dr. McNeill moved to approve the minutes as presented. Ms. Gillispie seconded the motion and the vote was unanimous in the affirmative. STEPHEN VANCE PAUL appeared in support of his application for reinstatement of Physician Assistant license after revocation. Ms. Scott briefed the Committee on Mr. Paul's past history of disciplinary action, treatment for substance abuse and an arrest for assault and battery in 2008 that Mr. Paul did not report to the Board. Mr. Paul said he thought it was on the background check. He explained the arrest to the Committee and said he was not trying to hide the arrest, although no affidavit was provided with the application. He said he had obtained over 200 hours of continuing medical education in the past two years. The Committee expressed concern regarding his failure to disclose the arrest. When asked, he said he had not reported it to the Health Professionals Program either. The Committee directed him to disclose the arrest to the Director of the HPP and have the Director provide a response to the Committee with his recommendation about the domestic violence issue. Dr. Pickard moved to table the application until Mr. Paul provides a report from the HPP. Mr. Coody seconded the motion and the vote was unanimous in the affirmative. Ms. Scott reported on three pending disciplinary cases on the Board's agenda. KIMBERLY MIXON, PA had submitted a motion for modification of probation to allow her to prescribe controlled dangerous substances. Ms. Scott reported that staff did not necessarily

2 oppose the request. Her drug of choice had been alcohol; although there can be some crossover. It will be her burden to prove to the Board that she is ready for that responsibility. The case of SCOTT BEARDEN, PA alleges that he had sex with two patients. Dr. Womack said it would appear to be a pattern of conduct. Dr. McNeill said there is not an amount of time that can elapse between dismissing a patient and beginning a relationship that would make this acceptable. If they have ever been a patient of the PA, there is ample literature to state that that is the end of any relationship potential. The case of JUSTIN GENSON, PA involved several recent arrests for DUIs. Mr. Genson had recently been licensed under terms of an Agreement and never really practiced in the State. Ms. Scott reported that he had signed a Voluntary Surrender in Lieu of Prosecution. The case of BETTY WYMER, PA alleged that she practiced without supervision, employed her supervising physician, and allowed unlicensed persons to practice. Ms. Scott reported that the case would be continued to the January 2011 meeting due to the recent death of Ms. Wymer's husband. Representatives from the Kansas Nephrology Physicians, P.A. had submitted a request for a clarification of the requirements of OAC 435: Supervision; physician responsibility; independent care prohibited. The group oversees care of dialysis patients in a Ponca City dialysis unit. They have one of their physicians travel from Wichita to Ponca City twice a month to care for the patients. They wanted to have the physician come once per month and send a PA one to three times per month. Dr. McNeill said the requirement that the physician be present at least four hours/week has traditionally meant 10% of the time as long as the patient has access to the physician. If the clinic is open 40 hours/week, then four hours/week would be required. The Committee had questions about where the PAs were from and how often the clinic was open. Staff was directed to work with the attorney to contact the clinic to have those questions answered. Applications for licensure, reinstatement of licensure, transfer applications, applications for additional positions and additional alternate supervisors were considered. Dr. McNeill moved to recommend approval of the following applications for licensure: BOYLE, SHELLY DEANN SMITH, SANDRA SUE KINNEY-BUNDY, JENNIFER LORRAINE WHITE, JESSICA He further moved to recommend approval of the following applications for licensure pending satisfactory completion of the files: JOHNSON, DEIDRA DYAN NULL, SARAH KATHLEEN PLUMLEE, AMBER DEE SACHSEL, NANCY LOUISE LOVE, JENNIFER MICHELE PEARSON, MAROLYN JEAN REUSSER, ELIZABETH ERSKINE He further moved to recommend approval of the following applications for reinstatement of Physician Assistant licensure: HENSLEY, CRYSTAL LEE RAUCH, LEONARDO

3 VICK, LATASHA MARIE He further moved to recommend approval of the following applications for transfer of supervision: HUME, MICHAEL EDWARD TRANSFER TO CECIL A MOORE, DO3777 GROVER, NILA DEVONNA TRANSFER TO STEPHEN KOVACS, DO3860 PERKINS JR, ERNEST BURL TRANSFER TO FABIO MOTA-ABREU, SCHMIDT, CAROL S TRANSFER TO LISA ORTIZ, NIELSEN, JUDY WILBURN TRANSFER TO SUSAN A BEESON, DO3105 FIXLEY, VICKIE MCBEE TRANSFER TO ANDREW HOELSCHER, WILLIAMS, MATILDA KATHERINE TRANSFER TO FRANK WILSON, 8233 HALE, JAMES TRANSFER TO YVONNE FINE, 9930 HABBEN, LEE ANN TRANSFER TO DOUGLAS BRANT, DO3443 ABERLE, TERESA JULIANN TRANSFER TO LISA CONNERY, NIEHUES, CHRISTY ANN TRANSFER TO JUDITH FRAZIER, CARLTON, BRUCE SCOT TRANSFER TO JASPER WHEELER 6436 HAYS, CARYN SUE TRANSFER TO JASPER WHEELER 6436 PELTON, TODD BRADFORD TRANSFER TO MICHAEL HOUSTON, ADAMS, TAMMIE DAWN TRANSFER TO GREGORY SALOMON, GREEN, INA KIM TRANSFER TO JAMES DYER, SAFFA, TAMME MARIE TRANSFER TO DENNIS TROST, BATTOE, MARY KAY TRANSFER TO PAUL PISARIK, MEREDITH, MARGARET E TRANSFER TO FRANCIS BLAND 9084 WELLS, MARK LEE TRANSFER TO JOHN SEGUIN THOMS, MATTHEW WAYNE TRANSFER TO JOHN SCHRADER DAILEY, GREGORY CLINTON TRANSFER TO W. MARK BOOMER WHEELER, REBECCA RUTH TRANSFER TO GAIL GIROUARD, SCALF, MICHAEL SHAWN TRANSFER TO ROBERT GOODWIN, DO4905 DAGENAIS, MARY J TRANSFER TO J.R. PRIEST 8255 SIGL, JULIE ANN TRANSFER TO ROBERT SPENCER, WEBB, KIZZY JOY TRANSFER TO MATTHEW STEVENS, PAXSON, LAURIE SUE TRANSFER TO JOHN FULLER, PURVINE, AMBER DAWN TRANSFER OT AMY DARTER, YOZZO, MELODY JEAN TRANSFER TO JANELLE WHITT DO3610 PARKER, CRYSTAL L TRANSFER TO STEPHEN KOVACS, DO3860 BRADSHAW, JERRI LYNN TRANSFER TO PETER CHAMBERS DO3712 CAMPBELL, MINDIE JOYCE TRANSFER TO APRIL BOWLING CLAUNCH, JERE D TRANSFER TO SAMULE HAGUE, NORTON, AMANDA CATHLEEN TRANSFER TO KEVIN CONATSER, DO3562 PHILLIPS, KENDALL LEIGH TRANSFER TO GREGORY J DENNIS, DO4513 WATSON, PHILIP DEAN TRANSFER TO ARLES RAY, BRUSCHI, AMANDA LYNN TRANSFER TO JASON EMERSON, DO3947 TIEDE, JASON ALAN TRANSFER TO RICHARD MORGAN, HIERSCHE, CHRISTINA MARIE TRANSFER TO DAVID HOPKINS, DO4649 GRIGGS, JANIS KAY TRANSFER TO MICHELE BUCHOLTZ, DO4383

4 OWEN, MAX EDWARD TRANSFER TO WANDA DIAZ, GUERRERO, DAWN SETALA TRANSFER TO JEANNIE OWENS DO3872 MARTIN, REX EDWARD TRANSFER TO WILLIAM BOWEN, SPREITER, JILL NICOLE TRANSFER TO DARCI HAZELWOOD, DO4193 KALKBRENNER, EDITH ANN TRANSFER TO JEANNETTE POWER, ABBOTT, MONICA FAYE TRANSFER TO ANDREAS REVELIS, AHLBORN, LESLIE ANNE TRANSFER TO PAUL BECK, NGUYEN, NHANHIEN DUC TRANSFER TO TRACEY CHILDERS DO3296 VALGORA, CHARLES RAYMOND TRANSFER TO ANDREA ANDREWS, ESTES, TOD IRWIN TRANSFER TO DAWN HENSLEY, DO4522 WADE-LEWIS, TARA MIRANDA TRANSFER TO FRANK WILSON 8233 LAFAVE, SALLEE FERN TRANSFER TO ROBERT HAY, RANDALL, CARRIE LINDA TRANSFER TO TRACY BAKER, PITTMAN, BRADLEY DALE TRANSFER TO JOHN HESTER, DO2208 NOEL, STEPHANIE MARIE TRANSFER TO BRIAN SNELL, PENTZ, CYNTHIA JANE TRANSFER TO WILLIAM YARBOROUGH LAUDERDALE, JON MARK TRANSFER TO SUSAN A BEESON, DO3105 SALAMY-SULLINS, VICTORIA J TRANSFER TO MARTY LOFGREN, HOGAN, JAMES CAMERON TRANSFER TO ROBERT SPENCER WOODSON, TAMARA ANASTASIA TRANSFER TO SEYED SHOBEIRI, KECK-SMITH, TANYA MARIE TRANSFER TO DON CAUTHEN, HUNDLEY, JOHN PATRICK TRANSFER TO TERRI LEWELLING, PACKER, JOHNNA NADINE PA 1854 TRANSFER TO ROBERT NEBERGALL, DO2207 KELLEY, MARGARET PORTER TRANSFER TO BRYAN MARSH, JOHNSON, DENISE WAYNETTE TRANSFER TO CARLOS TRONCOSO, CUTTER, ELENA GENNADYEVNA TRANSFER TO MARTHA TARPAY, NICHOLS, SAMARA JA'NEL TRANSFER TO MACHELE BUCHOLTZ, DO4383 PARSONS, NANI DANIELLE TRANSFER TO DORIS HOFFMAN ROSADO, MARISA EMILY TRANSFER TO DONALD STOWELL, He further moved to recommend approval of the following applications for additional positions: HUME, MICHAEL EDWARD ADDITIONAL POSITION WITH WILLIAM VALUCK, DO4598 FREDERICK, ROBERT RAY ADDITIONAL POSITION WITH CYNTHIA REDDING, PARNELL, JACKIE J ADDITIONAL POSITION WITH ARLES RAY, FIXLEY, VICKIE MCBEE ADDITIONAL POSITION WITH LORRAINE WILSON, HOLLIMAN, BRENT KEITH ADDITIONAL POSITION WITH WILLIAM HALE,

5 19051 HOLDER, DEBORAH DEE ADDITIONAL POSITION WITH PAUL PISARIK, HARRIS, ELIZABETH ANNE ADDITIONAL POSITION WITH JAMIE DAUGHERTY, MCLAUGHLIN, JERRY TODD ADDITIONAL POSITION WITH TERRELL PHILLIPS, DO2427 SMITH, LESLEY JEANINE ADDITIONAL POSITION WITH DAVID D'ALESSANDRO, NIEHUES, CHRISTY ANN ADDITIONAL POSITION WITH MARIE CARTER, DO3450 VONGCHANYAKUL, VANCHAI ADDITIONAL POSITION WITH ANDREW HOELSCHER, D18631 BECERRA, MANUEL TED ADDITIONAL POSITION WITH JAY GREGSTON, ELERICK, KELLY JAMES ADDITIONAL POSITION WITH CHRISTOPHER MITCHELL, GREEN, INA KIM ADDITIONAL POSITION WITH ALBERTO DE ARMENDI, LEBLANC, DEBORAH SUSANN ADDITIONAL POSITION WITH ROBERT STONE DO3833 SALLEE, CASSANDRA LEIGH ADDITIONAL POSITION WITH KINION WHITTINGTON, DO3723 CORTEZ, DANA SHAREE ADDITIONAL POSITION WITH BILLY BUFFINGTON PAYNE, KATHERINE J ADDITIONAL POSITION WITH JOHN HACKNEY 7802 PRICE, HELGA RENEE ADDITIONAL POSITION WITH JERROLD BENEDICT JOHNSON, KYLE ERICK ADDITIONAL POSITION WITH JON HAMILTON, DO3896 CARTER, BRIAN THOMAS ADDITIONAL POSITION WITH JEFF BLACK, GARCIA, ARNULFO ALEXANDER ADDITIONAL POSITION WITH MONTE VEAL, DO3795 COLLINS, EDYTH MICHELLE ADDITIONAL POSITION WITH STEPHEN KHOURY, DO3769 PHILLIPS JR, JOE EDWARD ADDITIONAL POSITION WITH SCOTT HOUGH, WENNER, TREKA BROOKE ADDITIONAL POSITION WITH BRUCE CORNETT, DO3453 HANSON, TERRIE JO ADDITIONAL POSITION WITH GAYNELL ANDERSON, NOE, LISA DIANE ADDITIONAL POSITION WITH MICHAEL BABB, PEEBLES, MARK KEVIN ADDITIONAL POSITION WITH BUDDY LECRONE, 9728 NGUYEN, NHANHIEN DUC ADDITIONAL POSITION WITH RICHARD CARTER,

6 22887 FISHER, DENA MARIE ADDITIONAL POSITION WITH DONALD RILEY, DO3693 BOLING, KIMBERLY ANNE ADDITIONAL POSITION WITH CHAD CRAWLEY, DO4449 FAGAN, STACY LOUISE ADDITIONAL POSITION WITH GERALD AMUNDSEN, SALAMY-SULLINS, VICTORIA J ADDITIONAL POSITION WITH RICK CRENSHAW DO2159 SLACHTA, ANN ARLENE ADDITIONL POSITION WITH WELLIE ADLAON, BRAND, JEFFREY ALLEN ADDITIONAL POSITION WITH CYNTHIA NORMAN SHARP, ANTHONY DAVID ADDITIONAL POSITION WITH STEVEN ORWIG, MEDGAARDEN, ALEX EDWIN ADDITIONAL POSITION WITH KENNETH WILLIAMS MORROW, TAMRA ANN ADDITIONAL POSITION WITH DAVID TILLES, DO3292 WILCOX, DAVE MICHAEL ADDITIONAL POSITION WITH RON BARBER, He further moved to recommend approval of the following applications to add alternate supervisors to previously approved positions: ANTHONY BARBETTINI adding RUSSELL WORKMAN SHAY BEATTY adding SHERYL SMITH BRETT BENNETT adding ASHFAQ ULLAH, KOMI FOLLY, JILL LAGASO, JEANNETTE POWER, JORDAN BROWN DO and RICARDO QUEZADA VERA BOONE adding MICHAEL PAYNE and ONEITA TAYLOR BOBBY BOSSE adding MARK THOMPSON, JEANNETTE POWER, ASHFAQ ULLAH, KOMI FOLLY, SOON KIM, JILL LAGASO and RICARDO QUEZADA MICHELLE BOURNE adding JOHN CONLEY DO SABINE BROWN adding SYBIL CHENG DO, RENAE BERNARD, DOUGLAS RICHMOND and RANDY ENGELMAN DO BRIAN CARTER adding BRANDON BLOXHAM DO and JOE HUDDLESTON DO JAMES CLICK adding FRANCES MADDEN KARI COCHRAN adding KIMBER WARD DAVID COLLIER adding CARLOS TRONCOSO and RAJESH MALHOTRA JENNIFER COMPTON adding JEANNETTE POWER, ASHFAQ ULLAH, DAVID SCHRAM, JILL LAGASO, MUNISH TANEJA, JORDAN BROWN DO, KOMI FOLLY and RICARDO QUEZADA GLEN COTTRILL adding WANDA DIAZ JOSIE DEAN adding VYTAUTAS RINGUS CLAUDE DENIZE adding DAVID HAGGARD

7 GREG DINWIDDIE adding CLIFFORD HOWELL DOUGLAS DUFFY adding FRANCES MADDEN NANCY DUNCAN-LARRY adding JUDY TRENT DO MARY EASLEY adding WALTER BIERBAUM THOMAS ENGLE adding ROBERT CUNNINGHAM, JOE HUDDLESTON DO, JESS ROY DO, BRANDON BLOXHAM DO, STEVEN HOEL DO, KRISTY WINGERTER DO, GARRETT ZELKIND DO, AMANDA CAIN DO and LEROY WHITE TOD ESTES adding KRISTY WINGERTER DO, JESS ROY DO, and AMANDA CAIN DO GREGORY FAVORITE adding MARK NEWEY DO ERICA FINCH adding JEANNIE OWENS DO PAMELA FOSTER adding ASHLEY BAKER and HANUMANTHA POKALA DAN FOX adding CARLOS TRONCOSO JEFFREY FREDERICK adding CHRISTOPHER PASKOWSKI, JEFFREY BUYTEN, and JOSEPH LEONARD ROBYN FREELAND adding DAVID TILLES DO and GARY HILLMAN DO ARNULFO GARCIA adding TEODORO DARVIN, KENNETH DARVIN and GEORGE MARKERT JASON GATES adding GARRETT ZELKIND DO, AMANDA CAIN DO, JESS ROY DO, and KRISTY WINGERTER DO THERESA GAVULA adding TROY MAJOR DO MINI GEORGE adding RENAE BERNARD, SYBIL CHENG DO amd DOUGLAS RICHMOND MELISSA GIBSON adding KAREN SWISHER. MILES LANGMACHER, TAMARA HOLLOWAY DO MARY HAGEMANN adding ASHLEY BAKER and HANUMANTHA POKALA DAVID HARPER adding ROBERT GOODWIN DO SARAH HAWK adding HANUMANTHA POKALA and ASHLEY BAKER BRADLEY HELTON adding HUGO SALGUERO SHERRI HENDERSON adding VYTAUTAS RINGUS DANIEL HENSHAW adding ASHLEY ESTEP DO AMY HUGHES adding TIFFANY BRAZEAL SUZANNE ILIFF adding SYBIL CHENG DO, RANDY ENGELMAN DO, RENAE BERNARD. and DOUGLAS RICHMOND VICKI JARRELL adding SHERYL SMITH KRISTI KREBS adding JAMES CASH, RONALD LABUTTI DO, DAVID HICKS, JEFFREY MORRIS DO, THOMAS CRAVEN, ROBERT ROBERTSON, MICHAEL TANNER, PERRY INHOFE, JEFF FOX, DAVID WONG, DONNIE HAWKINS, BRIAN HOWARD, BRYAN HAWKINS and RANDALL HENDRICKS AMANDA LAUGHLIN adding JON HAMILTON DO ERIC LEACH adding JESS ROY DO, GARRETT ZELKIND DO, KRISTY WINGERTER DO and AMANDA CAIN DO

8 LINDEE LEDBETTER adding TAMARA HOLLOWAY DO, KAREN SWISHER, GARY RIGGS, MARK FOGLE and MILES LANGMACHER AMY LOVELACE adding KINION WHITTINGTON DO AUSTIN LYLE adding LAM NGUYEN DO ROBERT LYNCH adding DAVID TILLES DO and GARY HILLMAN DO ADAM MAKIN adding JON HAMILTON DO JOHNNY MCCABE adding DONALD RILEY DO JEAN MCGINNIS adding SYBIL CHENG DO and RENAE BERNARD HEATHER MCPHERSON adding CARLOS TRONCOSO JEFFREY MEEKS adding RANDY ENGELMAN DO, SYBIL CHENG DO, DOUGLAS RICHMOND, STEPHEN MELDON, and RENAE BERNARD HAROLD MILLER adding POOYA POURALIFAZEL and RANDALL HENTHORN ROGER MOORE adding KRISTY WINGERTER DO and JESS ROY DO MARK NEER adding RICHARD CARTER DEBRA ODOM adding ALEXIA MEHRLE, AMANDA CAIN DO, KRISTY WINGERTER DO, GARRETT ZELKIND DO, and JESS ROY DO ERIN O'DONNELL adding HANUMANTHA POKALA and ASHLEY BAKER AMANDA OXFORD adding OWEN GILMORE and TIMOTHY HSIEH JOHN PARMELEE adding WADDAH NASSAR MARK PERDUE adding KRISTY WINGERTER DO, AMANDA CAIN DO and JESS ROY DO CARROL PERRY adding CARLOS TRONCOSO and RAJESH MALHOTRA JENNIFER RAU adding JOE HUDDLESTON DO and BRANDON BLOXHAM DO ANNE RHODY adding DOUGLAS RICHMOND, SYBIL CHENG DO and RENAE BERNARD SHAWNA ROGERS adding JORDAN BROWN DO, JEANNETTE POWER, SOON KIM, ASHFAQ ULLAH, JILL LAGASO, DAWN HENSLEY DO, KOMI FOLLY and MUNISH TANEJA JOHN ROWE adding WANDA DIAZ CASSANDRA SALLEE adding ASHRAF HABIB and KIMBER WARD SARAH SCHMIDT adding MUNISH TANEJA STACY SCROGGINS adding NORMAN MCALESTER REBECCA SHEPARD adding ASHLEY ESTEP DO, CHARLES GEBETSBERGER, KRISTY WINGERTER DO, ROGER KINNEY, GARRETT ZELKIND DO, TERROLL RAMSEY, SHARON NOEL DO, ROGER WILSON, JESS ROY DO and AMANDA CAIN DO HOLLY SHINNEN adding DAVID HAGGARD ASHLEY SHOPE adding JON HAMILTON DO JEANINE SMITH adding JOE HUDDLESTON DO and BRANDON BLOXHAM DO KENNETH STEIN adding TROY MAJOR DO JENNIFER STEPHENS adding WADDAH NASSAR

9 GARY TAGGART adding BRANDON BLOXHAM DO and JOE HUDDLESTON DO ANITA TANNER adding JAMES SILMAN MARILYN TAYLOR adding JOE HUDDLESTON DO FRANK THOMAS adding DOUGLAS RICHMOND, RENAE BERNARD, RANDY ENGELMAN DO, and SYBIL CHENG DO NANCY THOMPSON adding MICHAEL STEELE DO ERIN TILLOTSON adding ASHLEY BAKER and HANUMANTHA POKALA ROSE TRIGG adding KALPNA KAUL KRISTEN WALTERS adding VYTAUTAS RINGUS KAREN WEBSTER adding ROBERT BOYCE FRANK WILLIAMS adding JOHN HARRISON DO, JEANNIE OWENS DO and LANCE WILLIAMS The Committee discussed the list of exceptions to the dispensing rule. The Department of Corrections had asked if their PAs could dispense medications. The rules at 435: (h) states "Physician Assistants may not dispense drugs, but may request, receive and sign for professional samples and may distribute professional samples directly to patients in accordance with written policies established by the supervising physician." The law at (D)(2) says a PA may not dispense drugs except for samples. Mr. Coody suggested that the Department of Corrections could set up a system like those found in nursing homes. Dr. McNeill stated the DOC seems to interpret the rules to mean that they cannot dispense. Every effort to help them has run into obstruction from their policies. He will direct them to the Pharmacy Board for additional guidance. Dr. Pickard stated it is more likely that they are distributing rather than dispensing pre-packaged or pre-prescribed drugs to the prisoners. The issue of whether an application to practice should be filed for non-patient activities, e.g., dictating discharge notes, was discussed. Dr. McNeill said this is an issue the Committee needs to address. Some facilities want the physician tied by licensure to the PA. He said, in his opinion, those PAs are just doing office work, not providing patient care. Dr. Pickard moved to state that the PA Committee has considered this and it is not necessary for the PA to be linked to the supervising physician through an application to practice when doing this type work. Ms. Gillispie seconded the motion and the vote was unanimous in the affirmative. The Committee discussed the exemption in Oklahoma Administrative Code 435: that allows a medical director or supervising physician of a state institution to be the primary supervisor for more than two PAs. The Committee discussed expanding the exemption to federal institutions such as the VA system, the Federal Bureau of Prisons, the Indian Health Service, military facilities, etc. The physicians in federal facilities are not required to have Oklahoma licensure to work in the federal system as long as they have a valid license in some state. This limits the number of Oklahoma licensed physicians available to supervise Oklahoma licensed PAs. Dr. Wootan moved to amend OAC 435: to add medical directors or supervising physicians of federal institutions to those who are exempt from the limit on number of PAs one physician may supervise. Ms. Gillispie seconded the motion. Dr. Wootan commented that the primary purpose of the rule was to prohibit one physician from setting up multiple clinics to be run by PAs and the exemption would not apply in those situations. Dr. McNeill said that it would

10 apply only to PAs working the federal system where they have many rules to which the physician and PAs would have to adhere, including the federal system's limit on physician to PA ratio. The proposed change would not apply to federally-designated rural health clinics. Board staff had received a question asking whether PA supervision of hyperbaric oxygen therapy was within the PA scope of practice. The Committee directed staff to respond that the same requirements for the physician/pa relationship apply in hyperbaric oxygen therapy. As long as it is within the supervising physician s scope of practice and within the PAs skills, the physician can delegate that care. The Committee discussed amending the continuing education rules to clarify that continuing education hours must be completed by December 31 st of the prior year in order to renew. Dr. Pickard moved to proceed with rule making process. Ms. Gillispie seconded the motion and the vote was unanimous in the affirmative. (See attachment # The following were set as meeting dates for 2011: January 6 th April 28 th July 7 th October 13 th There being no further business, the meeting was adjourned. The time was 4:20 p.m.

MONDAY, 08/28/2017 DOMESTIC DOCKET 9:00 AM GRAYS HARBOR SUPERIOR COURT DEPT 2 JUDGE DAVID L. EDWARDS

MONDAY, 08/28/2017 DOMESTIC DOCKET 9:00 AM GRAYS HARBOR SUPERIOR COURT DEPT 2 JUDGE DAVID L. EDWARDS 1. 08-3-00488-1 PETA A CRITES AND CURTIS A CRITES CRITES, PETA ANITA CRITES, CURTIS ALLEN SAMUEL, VINI