supplemental public agenda alabama …...recommendation 1. (99) mason chasteen, pa patrick louis,...

ABME Public Agenda November 15, 2018 1

SUPPLEMENTAL PUBLIC AGENDA ALABAMA BOARD OF MEDICAL EXAMINERS

NOVEMBER 15, 2018

I MINUTES PUBLIC MINUTES OF OCTOBER 17, 2018 II ENDORSEMENT Name Medical School Endorsement

1. Oyinkansola Mary Adeogun University of Miami School of Medicine USMLE/CA

2. John Winfield Allred II University of Alabama School of Medicine Birmingham USMLE/MN

3. Lauren Ashley Braden University of Tennessee Memphis College of Medicine USMLE

4. Bradley Matthew Brooks Nova Southeastern University College of Medicine COMLEX

5. Brenda Garcia Burnett Edward Via Virginia College of Osteopathic Medicine COMLEX

6. Timothy Paul Chamberlain Texas A&M University Health Science Center COM USMLE/TX

7. Rong Chen Tianjin Medical University USMLE/MO

8. Gabriella Darlena Cozzi Vanderbilt University School of Medicine USMLE

9. Gina Adel Elhammady Mansoura University Faculty of Medicine USMLE/FL

10. Nicholas John Erickson George Washington University SOM and Health Sciences USMLE

11. Alice Marie Fagin University of Southern California Keck School of Medicine USMLE/CA

12. James Norman Foster University of Virginia School of Medicine USMLE/VA

13. * Jim Patrick Gray Ross University Northeastern Ohio Universities COM USMLE/MS

14. Meredith Mills Gray University of Alabama School of Medicine Birmingham USMLE

15. Travis Wesley Harris San Juan Bautista Escuela de Medicina USMLE

16. Patrick Stephen Harris University of Mississippi School of Medicine USMLE

17. Heeeun Kang Dartmouth Medical School USMLE/GA

18. Jordan Atanasov Kazakov Medical University of Sofia USMLE/OH

19. * Michael Kwakye SUNY Upstate Medical University College of Medicine USMLE/NY

20. Brittany Rochelle Love University of Kansas School of Medicine USMLE

21. Clea JerriLee Moore University of Connecticut School of Medicine USMLE

22. * Timothy Joseph Murphy Rocky Vista University College of Osteopathic Medicine COMLEX/TX

23. * Michael Ng New York Medical College USMLE/NY

24. Wendy Yvonne Pitt University of Oklahoma Health Science Center USMLE/OK

25. Audra McCay Prince University of Arkansas College of Medicine USMLE/AR

26. Kenny To Quang University of Oklahoma College of Medicine Tulsa USMLE

27. Wasiq Faraz Rawasia Aga Khan Medical College, Aga Khan University USMLE/KY

28. Ryan Edward Rebowe Louisiana State University School of Medicine New Orleans USMLE

29. Jacob Carl Rumley Kansas City University of Medicine & Biosciences NBOME/NE

30. * Kamaldeen Rizvie Saldin University of Szeged, Medical & Medical Sciences Centre USMLE/FL

31. Erin Frances Shufflebarger University of Alabama School of Medicine Birmingham USMLE

32. Rupert Stanborough University of Tennessee Memphis College of Medicine USMLE/TN

33. Suparna Thind Vinnitsa National Pirogov Memorial Medical University USMLE/AZ

34. Raj Vinu Vachhani University of Alabama School of Medicine Birmingham USMLE


35. Zachary Wendell Walker Indiana University School of Medicine Indianapolis USMLE

36. Kai Wang Henan Medical University / Zhengzhou University USMLE

37. Fady S. Wanna University of California, Irvine College of Medicine NBME/CA

38. Brent Robert Weed University of Nevada School of Medicine USMLE/MN

39. Ahmed M. Kamel Abdel Aal University of Cairo USMLE/NH

40. Jeffrey Scott Ahlstedt Augusta University USMLE

41. Brian Ahuja University of Toledo College of Medicine USMLE/CA

42. Cyriacus Uzoma Anaele University of Lagos USMLE/MD

43. Elizabeth Lauren Barton University of South Carolina School of Medicine USMLE

44. Lucas Scott Boone University of South Alabama College of Medicine USMLE

45. William Janika Brackett Ross University USMLE/FL

46. Eric Robert Bready University of Texas Medical School at San Antonio USMLE

47. Justin Allen Calvert University of Mississippi School of Medicine USMLE/TN

48. Lauren Fraser Clemmons Lincoln Memorial U Debusk College of Osteo Medicine COMLEX/FL

49. Kevin Charles Cormier American University of The Caribbean USMLE/GA

50. Marcus Harrell Crawford Baylor College of Medicine USMLE/GA

51. Bernard Dib American University of Beirut USMLE

52. Timothy Nathan Dunn Baylor College of Medicine USMLE

53. Shanthi Gatla Prathima Institute of Medical Sciences USMLE

54. Justin Mathew Glasgow University of Iowa College of Medicine USMLE/DE

55. Andrew Judson Hill IV Medical College of Georgia School of Medicine USMLE/MA

56. Eric Matthew Keasler Florida State University College of Medicine USMLE

57. Michael Donnell Kelso Jr. Jr. University of North Carolina School at Chapel Hill SOM USMLE/NC

58. Tessa Maria Kleyn University of South Alabama College of Medicine USMLE/LA

59. Matthew Chase Lustig Augusta University USMLE

60. Zeba Madni Jawaharlal Nehru Medical College, Aligarh USMLE/IN

61. Laura Joan McGuinn University of Texas Medical School at Galveston FLEX/TX

62. Tiffanie La`Toya Mann McGuire Alabama College of Osteopathic Medicine COMLEX

63. Adeel Ali Memon Dow Medical College, University of Karachi USMLE

64. Lattimore Madison Michael University of Tennessee Memphis College of Medicine USMLE/TN

65. Bethann Mohamed Florida State University College of Medicine USMLE/CT

66. James Henry Mooney Temple University School of Medicine USMLE

67. Parker Richard Mullen University of South Alabama College of Medicine USMLE

68. David Marc Northern Uniformed Services University USMLE/MS

69. Benjamin Adam Nunley University of South Alabama College of Medicine USMLE

70. Allen Si Won Oak University of Alabama School of Medicine Birmingham USMLE

71. Alyssa Kurtz Ovaitt University of Missouri School of Medicine Columbia USMLE

72. Luis Palomino University of Texas - Houston Medical School USMLE

73. Emma Caroline Panico University of Texas Medical School at Galveston USMLE

74. Misty Nicole Rea University of Mississippi School of Medicine USMLE/LA

75. Robin Pendleton Renfroe U of MN Med Sch Minneapolis/ USACOM NBME/FL

76. William Andrew Ricks University of South Alabama College of Medicine USMLE

77. Richard Ross Rieske College of Medicine, University of Arkansas USMLE

78. Antonio Lazaro Rodriguez Universidad Central Del Este (UCE) FLEX/FL

79. Joya Sahu Jefferson Medical College of Thomas Jefferson University USMLE/PA

80. Waleed Waseem Siddiqi King Edward Medical School USMLE/VA

81. Jordan Webster Steele William Carey University College of Osteopathic Medicine COMLEX/MS

82. Deanna Faye Taylor-Gantte University of Tennessee Memphis College of Medicine USMLE/TN

83. Todd Robert Washko Tulane University School of Medicine USMLE/LA

84. Lindsay Dianne Williams University of Kentucky College of Medicine USMLE


PROVISIONAL ENDORSEMENT Name Medical School Endorsement No Provisional Endorsement Applicants RETIRED SENIOR VOLUNTEER PROGRAM LICENSE (RSVP) RENEWAL APPLICANTS Name Facility Location

1. Curtis B. Edewaard, M.D. Community Free Clinic Huntsville 2. David Grandison, M.D. Community Free Clinic Huntsville 3. James W. Mathews, M.D. Mercy Medical Clinic Auburn

SPECIAL PURPOSE LICENSE Name Location Type of Practice

1. Paul Nicholas Groof, M.D. Independence, OH Teleradiology

II LIMITED LICENSE Name Medical School Endorsement

1. Christine Carolyn Arnesen Saint Georges University LL/AL 2. Leah Brianne Burch University of Mississippi School of Medicine LL/AL 3. Rana Abdulatif Aldrees King Abdulaziz University LL/AL 4. Razan Abed A Baloush King Abdulaziz University LL/AL 5. Mandeep Kaur Bath Vitebsk State Medical University LL/AL 6. Syeda Sabeeka Batool Services Institute of Medical Sciences LL/AL 7. Erin Dulaney Britt Alabama College of Osteopathic Medicine LL/AL 8. Jose Antonio Cavo UASOM Birmingham LL/AL 9. Fei Fei Southeast University Medical College LL/AL 10. Katherine Elizabeth Glosemeyer University of South Alabama College of Medicine LL/AL 11. Bryan Benjamin Grissett Philadelphia Col of Osteo Medicine – GA Campus LL/AL 12. Mariyam Humayun Aga Khan Medical College, Aga Khan University LL/AL 13. Mauricio Jacobo Kahn Chau Universidad Peruana Cayetano Heredia LL/AL 14. Sabrina Anna Matosz Poznan U of Medical Sciences , Faculty of Medicine LL/AL 15. Mariam Mansour Youssef Ain Shams University Faculty of Medicine LL/AL

Limited License Renewal Applicants Limited License Renewal Applicants


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

1. Mona Barlow, PA UAB 1150462 2. Jasmine Henderson, PA Our Lady of the Lake College 1127446 3. Amy Nowlin, PA Georgia Regents University 1121273 4. *Juliet Graham-Thornhill, PA Long Island University Brooklyn 1027702

5. Ivey Holt, PA UAB 1108959

6. Justin Juelich, PA Nova Southeastern University 1155206

7. Lori Tippets, PA Nova Southeastern University 1068788

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


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

PA / Physician Registration / Remote Site / Formulary Recommendation

1. Lauren Gibson, PA Michael Bobo, M.D.

Registration Birth Control Drugs and Devices

2. Gary Gould, PA William Roy, M.D.

Registration Remote site

3. Jasmine Henderson, PA Julie Gladsjo, M.D.


4. Sydney Jameson, PA Adam Kessler, D.O.

Registration

5. Mallory Nottenkamper, PA Nicole Kersh, M.D.


6. Lauren Sheffield, PA John Boyett, D.O.

Registration

7. Kelsey Wright, PA Juan Roneros, M.D.


8. SA

Douglas Baker, PA Thabet Alsheikh, M.D.

Registration

9. SA

Mona Barlow, PA Christopher B. Thomas, M.D.


10. SA

Lindsay Kolasa, PA Brian Larson, M.D.


11. SA

Julie Lucas, PA James Walker, M.D.


12. SA

Paul McGlynn, Jr., PA Jonas Salna, M.D.


13. SA

Lauren Palmer, PA Ryan Palmer, M.D.


14. SA

James Tumlin, PA Christopher Kelley, M.D.

Registration


With additional duties; Remote site; Misc. Formulary requests

PA / Physician Registration / Remote Site / Formulary / Skills Recommendation

1. (47)

Katie Morrison, PA Richard Marks, M.D.

Registration Request to train: Arthrocentesis, Injections of the Shoulder, Elbow (Olecranon Bursa), Knee, and Greater Trochanteric Bursa Standard Language is available

2. (71)

Jamie Sievers, PA Nicholas Patellis, M.D.

Registration Formulary Request: Antidepressants- SSRI, TCA, and SNRI

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

PA / Physician Skills and Formulary Requests / Miscellaneous Recommendation

1. (86)

Aliza Bircheat, PA Christopher Roney, M.D.

Request to Train: CVL Placement: Internal Jugular and Femoral Arterial line insertion: Radial and Femoral Standard Language is available

2. (93)

Mason Chasteen, PA Patrick Louis, M.D.

Request to Add Additional Practice Site Locations: Callahan Eye Foundation-1720 University Blvd, Birmingham, AL 35233 Children’s of Alabama-1601 5th Ave. S., Birmingham, AL 35233

3. (95)

Kathryn Mahaffey, PA Keith Wille, M.D.

Request to Train: CVL Placement: Internal Jugular and Femoral Arterial line insertion: Radial and Femoral Standard Language is available

4. SA

Amy Christensen, PA Ricardo Colbert, M.D.

Supervised Practice Transfer: Joint injections: Greater Trochanteric Bursa

5. SA

Lauren Palmer, PA Ryan Palmer, M.D.

Supervised Practice Transfer: Joint injections: Shoulder, Elbow (Olecranon Bursa), Knee Request to train: Joint injections: Arthrocentesis and Greater Trochanteric Bursa


Outside Protocol

PA / Physician Skills and Formulary Requests / Miscellaneous

Recommendation

1. (99)

Mason Chasteen, PA Patrick Louis, M.D.

Letter of Clarification Review: Oral Lesion Biopsies and Donor Site Wound Repair, including Deep Closure

2. (103)

Christina Cyriac, PA Anthony Morlandt, M.D.

Letter of Clarification Review: Oral Mucosa Biopsy

3. (108)

Christeen David, PA Kitturah Schomberg-Klaiss, D.O.

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

4. (124)

Elizabeth Giles, PA William Haller, III, M.D.

Remote Site Location Request: The location is less than one hour from the supervising physician’s principal site location.

5. (136)

Bennett Smith, PA Joseph Pettus, M.D.

Request to Train and Standard Language Review: Percutaneous Tibial Nerve Stimulation (PTNS)

P.A. QACSC Registration PA Physician

1. Sylvia Eldridge, PA Charles Hunt, M.D. 2. Thomas Mullican, PA David Dueland, M.D. 3. Tonya Weidman, PA Curtis Turner, M.D.

P.A. Limited Purpose Special Permit

PA / Physician LPSP Formulary Recommendation Approve Deny

1. (155)

April Crunk, PA Jeffrey Nix, M.D. Specialty: Urology

Request to Add to Existing LPSP Application: Hydrocodone Combinations Tapentadol

2. (167)

Chasity Gibson , PA Jamie Bishop, D.O. Specialty: Family Medicine

ADHD Medications Hydrocodone Combinations Hydrocodone Cough Preparations Oxycodone IR Tapentadol

3. (169)

Nikki Quinley, PA Paul Fineburg, M.D. Specialty: General Medicine

Hydrocodone Combinations Hydrocodone Cough Preparations


APN Miscellaneous Requests / Reports (171) Cover Sheet Within Protocol

Physician /NP Request Recommendation

1. (174)

Gino Castaneda, M.D. Tressa Bolton,, CRNP

Approval of supervised practice: Central Venous Line tunneled cath

2. (178)

Charles G. Cloutier, M.D. Christopher Pritchett, CRNP

Approval to train: trigger point injections below T-12 To transfer approval: Orthopedic Specialty Protocol and previously approved supervised practice

3. (189)

Christopher B. Gore, M.D. Joseph D. Williams, CRNP

Approval to train: trigger point injections below T-12

4. (192)

William Kuczerpa, M.D. Angela Michelle Bryant, CRNP

Approval of supervised practice: trigger point injections below T-12

5. (197)

Timothy Pflugner, M.D. Heather Bogart, CRNP

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

6. (206)

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

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

7. (219)

Nancy Tofil, M.D. Cassidy Black, CRNP

Approval to train :Critical Care Specialty Protocol: CVL, Internal jugular and femoral and subclavian; CVL remove and replace over guide wire; CVL removal percutaneous

8. (230)

Lowell Dean Mason, M.D. Brittany C. Wickware, CRNP

Transfer approval to train: Orthopedic Specialty Protocol

9. (236)

Jeffrey Scott Robertson, M.D. Elizabeth Milazzo, CRNP

Approval to train : Otolaryngology Specialty Protocol: Diagnostic Nasal Endoscopy (flexible and rigid)

10. (256)

David J. Thomason, M.D. Stefanie R. Miller, CRNP

Approval of supervised practice: trigger point injections below T-12

Outside Protocol / Miscellaneous

Physician/ NP Request Status

1. (260)

Andrew M. Brown, M.D. Wendy Miller, CRNP

Direction from the Board

2. (266)

David Clay Campbell, M.D. Tray B. Nesmith, CRNP

Approval to transfer Orthopedic Specialty Protocol; Approval of supervised practice previously completed not submitted for approval


Physician/ NP Request Status

3. (274)

T. Kevin Lackey, M.D. Beverly Richardson, CRNP

Approval of supervised practice joint injections of knee and shoulder – 4 procedures outside 1 year Approval to continue training for trigger point injections below T-12

4. (281)

Grace H. Thomas, M.D. Lacey Mixon, CRNP

Subdermal Contraceptive Implants, Insertion and Removal – outside standard protocol for NP Certification

5. (286)

FTE limitations for physicians

6. (292)

Proposed Protocol for State-Wide Criteria for Mid-Level Practitioners: Injection of Onabotulinuntoxin A (Botox) for Chronic Migraine

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 APN Limited Purpose Special Permit (308) Cover Sheet

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

LPSP formulary request:

Recommendation Approve Deny

1. (312)

Elizabeth Bataglia, M.D. Family Medicine MD Current Practice: Family Medicine Billy Golden, CRNP Family Nurse Practitioner (FNP)

ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations Morphine Sulfate, Immediate-release Oxycodone, Immediate-release





2. (319)

Thakorbhai Darji, M.D. Internal Medicine MD Current Practice: Internal Medicine Lisa Sims, CRNP FNP

ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Fentanyl, Long-acting Hydrocodone, Long-acting Hydromorphone Morphine, Long-acting Oxycodone, Long-acting Oxymorphone Tapentadol, Extended-release

3. (321)

Gregory Funk, D.O. General Practice Current MD Practice: General Practice/ Primary Care Heather Steigerwald, CRNP FNP

ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Tapentadol, Short-acting Fentanyl, Long-acting Hydrocodone, Long-acting Hydromorphone Morphine, Long-acting Oxycodone, Long-acting Oxymorphone Tapentadol, Extended-release

4. (323)

Joseph Jowers, M.D. Family Medicine Current MD Practice: Family Medicine Jenny Doss, CRNP FNP

ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations Oxycodone, Immediate-release





5. (324)

Ryan Kraemer, M.D. Internal Medicine Current MD Practice: Internal Medicine Catherine Adams, CRNP FNP

ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations Oxycodone, Immediate-release

6. (325)

Thomas Keith Lackey, M.D. Anesthesiology/ Pain Management Current MD Practice: Coosa Pain and Wellness Libby Turnipseed, CRNP FNP

Hydrocodone, Short-acting Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Tapentadol, Short-acting

7. (326)

Rony Lee, M.D. Family Medicine/ Sports Medicine/ Pain Management Current MD Practice: Gulf Coast Occupational Sports and Pain Management Shanna Harville, CRNP FNP

Hydrocodone, Short-acting Hydrocodone Cough Preparations Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Tapentadol, Short-acting

8. (327)

Bardya Naeini, M.D. Family Medicine Current MD Practice: Family Medicine Susan Miller, CRNP FNP

ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations

9. (328)

Naresh Purohit, M.D. Pediatrics Current MD Practice: Pediatrics Elizabeth Tucker, CRNP Pediatric NP

ADHD Medications

10. (329)

William Terry, Jr., M.D. Urology Current MD Practice: Urology Elizabeth Stuckey Lewis, CRNP FNP

Hydrocodone, Short-acting Hydrocodone Cough Preparations Oxycodone, Immediate-release





11. (330)

Felicia Wilson, M.D. Pediatric Hematology/ Oncology Current MD Practice: University of South Alabama Comprehensive Sickle Cell Center/ Division of Pediatric Hematology/ Oncology Ardie Pack-Mabien, CRNP FNP

Hydrocodone, Short-acting Hydrocodone Cough Preparations Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Hydromorphone Morphine, Long-acting Oxycodone, Long-acting

12. (335)

Richard Maughon, M.D. Pain Management Current MD Practice: Pain Management James David Miller, CRNP FNP

See attached formulary request for specific dosages for the following: ADHD Medications Hydrocodone, Short-acting Hydrocodone Cough Preparations Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Tapentadol, Short-acting Fentanyl, Long-acting Hydrocodone, Long-acting Hydromorphone Morphine, Long-acting Oxycodone, Long-acting Oxymorphone Tapentadol, Extended-release





13. (340)

Chrystal Rutledge, M.D. Pediatric Critical Care Current MD Practice: UAB Children’s Hospital Kristen Waddell, CRNP Acute Care Pediatric Nurse Practitioner

Consider as part of her LPSP formulary for inpatient orders: Hydrocodone, Short-acting Morphine Sulfate, Immediate-release Oxycodone, Immediate-release Fentanyl, Long-acting Hydromorphone Morphine, Long-acting Oxycodone, Long-acting

Joint Committee for Advanced Practice Nursing Joint Committee for Advanced Practice Nursing Meeting November 14, 2018, 6:00 p.m. CURRENT BUSINESS (2) 1. ABME Nationwide Deferred Compensation Plan and Frozen Non-Standardized Money Purchase Plan Trustee and Fiduciary Designee (3) 2. Administrative Rule 540-X-7-.04, Requirements for the Issuance of a License to Practice as a PA (8) 3. Administrative Rules 540-X-7-.07 and 540-X-7-41 License Renewal for PA and AA (17) 4. Administrative Rules 540-X-8-.05.1 and 540-X-8-.19.1 Reinstatement of Lapsed Approval for Practice as a CRNP and CNM (24) 5. Administrative Rule Chapter 540-X-20 Risk and Abuse Mitigation Strategies by Prescribing Practitioners (27) 6. FSMB Call for Award Nominations (39) 7. FSMB Call for Staff Fellow Nominations (44) 8. Oral and Maxillofacial Surgery – MD Scope of Practice (SA) 9. SureMed Compliance – Event Proposal PERSONNEL No Personnel Items


VI HEARINGS (2) ABME Hearing Schedule No Hearings Scheduled for November EXECUTIVE SESSION

supplemental public agenda alabama …...recommendation 1. (99) mason chasteen, pa patrick louis,...

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