California
Medical Board of California Launches New Web Applicant Access System
Applicants for licensure in California now have the ability to go online to check the status of their application for a Physician and Surgeon License or Postgraduate Training Authorization Letter. The Medical Board of California launched its new Web Applicant Access System (WAAS) on February 10, 2010, providing significant features that help make the application process much more convenient.
The new system displays information regarding each required application document; specifically, when a document is received and whether that document is approved or deficient. Applicants must use an Applicant Tracking System (ATS) number, which is provided upon receipt by the Board of an application and application fee. For more information www.medbd.ca.gov/
Source: Medical Board of California website, April 2010
California Physicians to be Required to Notify Patients of Medical Board of California Licensing
Effective June 27, 2010, physicians practicing in California must inform their patients that they are licensed by the Medical Board of California, and include the Board's contact information. The information must read as follows.
NOTICE TO CONSUMERS
Medical doctors are licensed and regulated by the Medical Board of California (800) 633-2322 www.mbc.ca.gov
The purpose of the new regulation is to inform consumers where to go for information or with a complaint about California medical doctors.
“The Medical Board's mandate is public protection, and this new requirement will assist patients by directing them to our Web site and our call center, where they can access very basic yet important information about our public services,” said Medical Board President Barbara Yaroslavsky. “And it will take very little effort for physicians to comply.”
Physicians may provide this notice by one of three methods:
Prominently posting a sign in an area of their offices conspicuous to patients, in specified type.
Including the notice in a written statement, signed and dated by the patient or patient's representative, and kept in that patient's file.
Including the notice in a statement on letterhead, discharge instructions, or other document given to a patient or the patient's representative, where the notice is placed immediately above the signature line for the patient in specified type.
The three options are designed to serve a multitude of practice settings, including emergency departments, skilled nursing facilities, and surgical settings.
The Medical Board is an agency within the Department of Consumer Affairs (DCA). At least nine of DCA's other agencies have similar disclosure requirements, including the Pharmacy Board, the Contractors State License Board, the Bureau of Automotive Repair, and the Board of Optometry.
Source: Medical Board of California News Release, April 5, 2010
New York
Policy for Medication Reviews by PTs is Clarified
A recent agreement between the New York State Board for Physical Therapy and the state's Department of Health helps clarify the role of physical therapists regarding medication reviews by physical therapists. Specifically, the new agreement clarifies the role of physical therapists in completing comprehensive assessments, including drug regimen reviews for certified home health agency (CHHA) and long term home health care program (LTHHCP) patients who are receiving therapy services only.
Background
The Federal Home Health Agency Medicare/Medicaid Conditions of Participation require that providers conduct a comprehensive assessment including a drug regimen review (DRR) for all patients as outlined in regulations. This stipulation became effective in 1999 and has permitted the completion of the comprehensive assessment by the appropriate therapist for therapy-only cases.
After recent concerns were raised regarding the propriety of physical therapists (PTs) conducting medication regimen reviews, however, the Board for Physical Therapy determined that the conduct of a drug regimen review is outside the scope of permissible practice for physical therapists.
New Policies
After discussion, it was determined that the comprehensive assessment may be completed by a physical therapist only if the agency has implemented a policy and procedure that requires collaboration between the physical therapist and other agency staff. The physical therapist, in this situation, will:
Collect information on all the medications used by the patient, including any overt issues regarding the drug regimen, e.g. rash, obvious non-compliance with regimen, or continued presence of symptoms such as pain.
Document and report this information back to the designated drug regimen reviewer at the agency.
Document the receipt of the findings from the designated reviewer when the DRR is complete and what, if any, actions were taken to address issues identified by the review to the extent required to complete the assessment.
The physical therapist cannot make medication changes, but can document that such changes were made, by whom and what they were. The date of receipt of this information from the reviewer by the PT will be the completion date of the assessment as directed in the CMS OASIS-C Guidance Manual, Chapter 3 page L-1. The designated drug regimen reviewer must document the review, including date and signature in the clinical record. If areas of concern are identified during the DRR, the agency must notify the physician and obtain orders for any nursing intervention to further assess and resolve issues and educate the patient regarding medication changes and management. Documentation in the clinical record by the designated reviewer must include all actions reflected in the DRR.
Source: New York State Office of the Professions website, April 2010; State of New York Department of Health letter to administrators, January 26, 2010
Washington
Death with Dignity Update: Washington Issues First Annual Report
Washington's first annual report on use of the Death with Dignity Act shows lethal doses of medication were dispensed to 63 people in 2009. The law allows terminally ill adults to request these prescriptions from physicians.
The state Department of Health issued the report as required by the act, which went into effect March 5, 2009. The report covers March 5 to December 31, 2009. The 63 prescriptions were written by 53 different physicians and dispensed by 29 different pharmacists.
Of the 63 individuals who received lethal doses of prescription medication last year, 47 are known to have died. Thirty-six died after ingesting the medication. Those who died were between the ages of 48 and 95. More than 90 percent resided west of the Cascades. Most had terminal cancer and all were expected to die within six months.
According to prescribing physicians, all of the patients who received medication and died had expressed concern about loss of autonomy as a reason for requesting a prescription. Other common reasons included concerns about loss of dignity and loss of the ability to participate in activities that make life enjoyable.
Under Washington's Death with Dignity Act, the Department of Health must collect information from patients and providers who choose to participate, monitor compliance with reporting requirements, and produce an annual statistical report.
More information about the 2009 Death with Dignity report is available at www.doh.wa.gov/dwda/
Source: Washington State Department of Health News Release, March 4, 2010
Wisconsin
New Rules on Remote Pharmacy Dispensing Sites
The Wisconsin Pharmacy Examining Board has approved a change to the Wisconsin Administrative Code that governs pharmacy practice related to establishing and operating remote dispensing sites. The changes went into effect on April 1, 2010.
In general, the new rules allow for remote dispensing of medications in certain facilities and with certain safeguards in place. Examples:
For Pharmacy Customers
A pharmacy technician with appropriate training may staff a remote dispensing site, but a pharmacist is required to check the prescription and talk with customers each time they pick up prescriptions. If the pharmacist is not available or the technology to connect customers with a pharmacist is not working, the staff at the remote site cannot provide them with medication.
The remote dispensing site is required to display a sign informing customers that prescriptions may be filled at that location, and letting them know the name, address and telephone number of the store that is responsible for the supervision of the site.
For Pharmacists and Pharmacies
As with all other pharmacy operations, a remote dispensing site must follow state dispensing and labeling law and federal controlled-substances law.
Managing pharmacists must have written policies and procedures for system operations and safety, security, accuracy and access as well as implement an on-going quality assurance program.
Managing pharmacists are required to visit the remote dispensing site at least monthly to perform a prescribed list of responsibilities. Documentation of the visits must be kept for two years.
For Pharmacy Technicians
Basic requirements must be met to staff a remote dispensing site, including completing at least 1,500 hours of work as a technician within the three years prior to employment or completion of a training program approved by the board.
Source: State of Wisconsin Department of Regulation and Licensing website, April 2010
