Georgia Composite Medical Board annual report fiscal year 2015 [2015]

ANNUAL REPORT
Fiscal Year 2015

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Table of Contents
Message from the Executive Director ............. 4 About the Board ................................................. 5 Licensing .............................................................. 7 Enforcement ........................................................ 9 Financial ............................................................... 11
The mission of the Georgia Composite Medical Board is to protect the health of Georgians through the proper licensing of physicians and certain members of the healing arts and through the objective enforcement of the Medical Practice Act.
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Message from the Executive Director
The Board members and staff are pleased to present the Fiscal Year 2015 Annual Report of the Georgia Composite Medial Board. Among other significant achievements, I am especially proud that the Board, in close consultation with the Department of Public Health, played a key role in the creation of the Low THC Oil Registry, which was authorized by Haleigh's Hope Act (House Bill 1).
Under HB 1, patients and caregivers of patients who believe they may be eligible can consult with their physician about the possibility of obtaining a card allowing them to possess 20 fluid ounces of low THC oil within the state of Georgia. If approved by the physician, the patient or patient's caregivers' information will be entered into DPH's secure Low THC Oil Registry, and a card will be issued.
I am also pleased to note our successful implementation of House Bill 504, which requires pharmacists and nurses who are parties to a vaccine protocol to hold current certification in Basic Cardiac Life Support, complete certain training, and to maintain individual liability insurance of at least $250,000. Each pharmacist and nurse who is a party to a protocol must also submit a notarized affidavit to the delegating physician attesting to compliance with the law's liability insurance, certification, and training requirements, and identifying the location or locations in which the pharmacist or nurse will administer vaccinations pursuant to the vaccine protocol agreement.
In each annual report, it is my great pleasure to recognize the hard work of the Board members, as well as the members of the Board's seven advisory committees. These men and women work tirelessly and without compensation to protect the citizens of our great state. Their contribution of time represents no small sacrifice in itself; Board meetings each month alone can cost the typical physician Board member hundreds of dollars in lost revenue each month. Our state is fortunate to have these public servants. I must also thank the small but dedicated staff of the Board, who faced obstacles posed by budget cuts and increasing workloads, yet remained committed and determined to give excellent service to their fellow citizens. I am honored and humbled to serve with this group of committed individuals.
Do you want to know more about the Board? Please visit us online at www.medicalboard.georgia.gov. Once you have done so, please help us get the word out about this valuable website, with resources for professionals and consumers.

LaSharn Hughes, MBA Executive Director
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Hughes and Gov. Nathan Deal

The Board

The Georgia Composite Medical Board is the agency that licenses physicians, physician assistants, respiratory care professionals, perfusionists, acupuncturists, orthotists, prosthetists, auricular (ear) detoxification specialists, residency training permits, cosmetic laser practitioners and pain management clinics. The Medical Board investigates complaints and disciplines those who violate The Medical Practice Act or other laws governing the professional behavior of its licensees.
The Board meets monthly to license and regulate the professions listed above. Although meetings times and location may vary, the majority of meetings are held at the Board's office in Atlanta. Agendas, minutes and additional information can be found on the Board's website.
Committees of the Board
Each of the 16 members of the Board is assigned to various committees to participate in the decision-making functions of the Board. The following list briefly describes committees of the Georgia Composite Medical Board.
The Investigative Committee is comprised of four members of the Board, and examines initial complaints made against professional licensees, the results of all investigations, and medical malpractice reports, in order to determine if a violation of the Medical Practice Act may have occurred.
The Physician Licensing Committee is comprised of four members of the Board. It evaluates each applicant's fitness to practice his or her profession in Georgia. It does this by establishing standards for licensure and practice, reviewing non-routine applications, and interviewing applicants as needed in order to grant licenses.
The Wellness Committee is comprised of five members of the Board. It is charged with reviewing cases in which an impairment issue could impact the licensee's practice or return to practice.
The Rules Committee is comprised of all members of the Board. It was created to develop rules to govern the performance of health care practitioners regulated by the Board. Its goal is to assist the Board in defining, assessing, and assuring the continued competency of all licensees throughout their professional careers.
Seven Advisory Committees, comprised of volunteer professionals from the community and at least two members of the Board, help regulate the following professions in much the same manner as the Physician Licensing Committee does for physicians:
Clinical Perfusionist Committee Acupuncture Committee APRN Protocol Committee Respiratory Care Committee Physician Assistant Committee Orthotist and Prosthetist Committee Cosmetic Laser Practitioner Committee
All matters reviewed and discussed before the Board Committees are sent to the full board for final review and approval.
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Board Members and Leadership Staff
The Georgia Composite Medical Board is comprised of 15 members appointed by the governor to fill four-year terms and one PA ex-officio member appointed by the Board. These men and women are unpaid volunteers who selflessly give more than 15 days per year in the service of their fellow Georgians. Each board member is an actively-practicing, highly-respected professional in medicine or, in the case of the Board's Consumer Members, in their own career fields.
Board Members

The Board

Alice A. House, MD Warner Robins Chairperson
John S. Antalis, MD Dalton Vice-Chairperson
Keisha Callins, MD Albany
E. Daniel DeLoach, MD Savannah
John Downey, DO Augusta
Charmaine Faucher, PA-C Kennesaw Ex-Officio
Alexander S. Gross, MD Dunwoody Past Chairperson
John Jeffrey Marshall, MD Gainesville

Jane Camille "Cami" McGarity Gainesville Consumer
B.K. Mohan, MD Riverdale
George E. "Trey" Powell III, MD Hahira
David W. Retterbush, MD Valdosta Immediate Past Chairperson
Joe Sam Robinson, MD Macon
Ronald "Ronnie" Wallace, MBA Rome Consumer
Richard L. Weil, MD Atlanta Past Chairperson
Charles L. White, DO Cleveland Past Chairperson

Board Leadership Staff
Edwin Slappey, MD Medical Director
Karl Reimers Director of Investigations
Carol Dorsey Licensure Unit Manager
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LaSharn Hughes, MBA Executive Director
Robert Jeffery, MBA Director of Operations
Jennifer Bass, MS Director of Special Projects
Pat Sherman Enforcement Unit Supervisor

Licensing and Nurse Protocol Review
The regulation of the practice of medicine and other professions by the state of Georgia is undertaken for one purpose to protect Georgians by ensuring that those who practice a particular profession have the education, training and skill to practice safely. The Board also reviews physicians' protocols with advanced practice registered nurses (APRN). Licenses must be renewed periodically in Georgia, typically every two years to help ensure continued competency.
In Fiscal Year 2015, the Board issued 4,652 new licenses, an increase of over 20 percent from the previous fiscal year. Also in FY 2015, the Board processed 1,150 applications to add or change supervising physicians for PAs and reviewed 1,984 APRN prescribing protocols, and during FY 2015, the Board processed 23,078 renewal applications.

New Licenses Issued, July 2014 Through June 2015 Total, All Types:

Assistant laser practitioner
10%

Senior laser practitioner 2%

Other 1%

Physician assistant 10%

Pain manangement clinic 2%

Orthotist & prosthetist 0%
Temp. residency training permit 16%

Licensing

Perfusionist 0%

Acupuncturist 1%
Respiratory care professional 8%

Physician 50%

Profession

Licenses Issued

Physician

2,321

Physician assistant

448

Respiratory care professional

396

Acupuncturist

25

Perfusionist

17

Temp. residency training permit

724

Orthotist & prosthetist

1

Pain management clinic

109

Assistant laser practitioner

469

Senior laser practitioner

113

Other

29

Total Licenses Issued in FY 2015 4,652

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Licensing Trends Over Previous Fiscal Years

Licensing

New physician licenses issued, fiscal years 2008 - 2015

2400

2300

2200

2100
2050
2000

1900

1781

1800

1751

1700 1592
1600
1500
2008

1597

2009

2010

2011

1648

2012

2013

2321 2056

2014

2015

PA/supervising physician applications and APRN protocols reviewed, fiscal years 2012 - 2015

Year 2012 2013 2014 2015

PA add/change Percent change APRN reviews Percent change

884

-

979

-

1014

14.71

1166

19.1

1059

4.44

1711

46.74

1150

8.59

1984

15.96

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Complaints Received by Fiscal Year

2500 2000 1500

1539

1923

2145

2195

2061

1729

1771

1550

1000

500

0 2008 2009 2010 2011 2012 2013 2014 2015

Enforcement

Enforcement
The Georgia Composite Medical Board is responsible for regulating and enforcing the Medical Practice Act and the rules adopted by the Board. The Board's staff devotes much of its time to this serious responsibility to ensure the public's safety.
Complaints come to the Board from a variety of sources including patients, family members, fellow practitioners, hospitals, other law enforcement agencies, other state medical boards, malpractice actions, the National Practitioner Data Bank (NPDB), etc.
Each complaint is evaluated by the Board's medical director and management staff to determine if the complaint is within the jurisdiction of the GCMB. A complaint within the jurisdiction of the Medical Board may then follow one of two paths: (1) a Matter Under Inquiry (MUI) or (2) a formal investigation. In an MUI, the licensee is asked to give a narrative response concerning their medical care rendered. The patient's records are subpoenaed for evaluation by a panel of Board members assigned to review the complaint. The panel presents its findings to the Board, which then determines if the licensee may have violated the Georgia Medical Practice Act or otherwise deviated from the generally accepted standards of care. An MUI may turn into a formal investigation by the Board.
Serious complaints, criminal violations, public safety threats, and similar situations are referred directly for formal investigations by the Board's agents. These agents are certified law enforcement personnel who are trained in traditional investigations. The results of investigations by agents are also evaluated by Board members to determine if there are violations and any discipline and/or prosecutions are warranted.
During Fiscal Year 2015, the Board received and opened 1,550 new complaints. Of the new complaints received, 1,202 (or 77.5 percent of the complaints) were found to be within the jurisdiction of the Board either inquired on (MUI) or investigated.
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Enforcement

Discipline
During FY 2015, the Board issued 50 public sanctions against 48 licensees through various dispositions (public reprimand, probation, revocation, etc.).

Public Sanctions Issued in FY 2015

F in e Cease and desist
CM E Term in atio n Mo dification Miscellaneo us
Pro bation R ep rimand Revocation Voluntary surrender Suspension
0

1 2
1
1
1
2

4 4

8

8 11

7

6

6

8

10

12

Cease and desi st 4%
CME 2%
Termi nati on 16%

Fi ne 2%

Suspensi on 12%
Vol untary s urrender
14%

Modi fi cati on 8%
Mi scel l aneous 2%
Probati on 16%
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Revocati on 2%
Repri mand 22%

Financial

The Georgia Composite Medical Board: Delivering Value to Georgia
The Georgia Composite Medical Board operates with a budget appropriated by the General Assembly and certain administrative fees. The services that the Board provides to the people of Georgia are delivered in an efficient, cost-effective way.
In FY 2015, the Board's total budget was $2,402,124, appropriated by the General Assembly, with which the Board enhanced the health and safety of Georgia's patients through its licensing and regulatory activities. During the year, the Board collected nearly three times that amount in fees, which were turned over to the state's treasury a return on investment of 190.8 percent.
While application and other license fees appear less than FY 2014, it is likely due to the influx of applications for licensure in FY 2014 during the implementation of the Georgia Pain Management Clinic Act.

Revenue Collected, Fiscal Year 2015

Fee category Renewal fees Application and other license fees Fines and enforcement cost recovery Other administrative fees Total

FY 2015 $4,340,040.00 $2,144,345.00 $202,500.00 $300,082.49 $6,986,967.49

Pct. change over FY 2014 8.16
(2.81) 55.17 11.04 5.55

Other administrative
fees 4%
Fines and enforcement cost recovery
3%

Renewal fees 62%

Application and other
license fees 31%

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