Annual Meeting Highlights
Election
Results
Annual Reports for Year 2000 Activity
Committee and Liaison Reports:
- Nominating, Chair Andrew B. Cole, MD, FACEP
- Membership, Chair Raul E. Armengol, MD, FACEP
- Government Affairs, Chair Mark D. Tripp, MD, FACEP
- Health Finance/Reimbursement, Chair Michael W.
Potter, MD, FACEP
- Doctors Insurance Reciprocal, Liaison Francis L.
Counselman, MD, FACEP
- Emergency Medical Services, Chair James R. Dudley, MD
- Emergency Medical Services for Children, Liaison
Kenneth Frumkin, MD, FACEP
- Governor’s EMS Advisory Board, Representative
Carl F. Wentzel, MD, FACEP
- BTLS Executive Committee, State Medical Director
Joanne E. Lapetina, MD, FAAP
- Education, Chair Timothy C. Evans, MD, FACEP
- Research Awards, Chair David H. Lander, MD, FACEP
- Bylaws, Chair Michael J. Bono, MD, FACEP
- Technology, Chair Pamela A. Ross, MD, FACEP
- Long Range Planning, Chair Peter J. Weimerskirch, MD,
FACEP
Nominating
Chair: Andrew B. Cole, MD, FACEP
Committee Members:
Mark D. Tripp, MD, FACEP
Peter J. Weimerskirch, MD, FACEP
Goals and Accomplishments:
The committee developed a slate of candidates for open positions on
the Board of Directors, as well as Councillors and Alternates, for vote by the members
present at the Annual Meeting. In addition, the committee will make recommendations for
Officer positions, for vote by the Board at it’s next meeting.
ABC/gmh
Membership
Chair: Raul E.
Armengol, MD, FACEP
Members: Board of Directors
Goals and Accomplishments:
Implemented a system of notifying Board members monthly of any
membership cancellations so aggressive follow-up could be taken. At the close of calendar
year 2000, national ACEP reports we have 462 members.
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Government Affairs
Chair: Mark
D. Tripp, MD, FACEP
Committee Members:
Andrew B. Cole, MD, FACEP
Pamela A. Ross, MD, FACEP
Raul E. Armengol, MD, FACEP
Peter J. Weimerskirch, MD, FACEP
Advisor:
Melanie R. Gerheart, Lobbyist
Goals and Accomplishments:
During the 2000 General Assembly our major goal
was to make sure that PA’s could be used in the emergency department in an effective
manner (as they had in the past). After being unsuccessful in resolving this issue with
the Board of Medicine via the regulatory process, we decided to go the legislative route
and successfully passed HB 979. Governor Gilmore signed this legislation and the matter
has been resolved.
Another issue raised in the 2000 General Assembly was HB 1171, a
proposed law that would force Emergency Physicians to report and obtain patient blood
alcohol levels to the police, without patient consent. The bill was carried over and after
several meetings and discussions with the proposing Commonwealth Attorneys’, a less
onerous bill that protected patient rights and protected ED personnel from liability was
drafted. However, the patron chose not to reintroduce this bill and the issue is
considered "dead" and resolved to our satisfaction. We will continue to monitor
this in the event it is brought up again.
Issues regarding emergency physician requests for Temporary
Detention Orders and how this process works with magistrates in Virginia have led to a
multidisciplinary task force. Many issues are being evaluated including how the present
system raises significant potential for EMTALA violations. V ACEP is an active participant in
these discussions, and potential exists for legislation in 2002 to resolve the conflict
between state and federal law.
The General Assembly for 2001 is currently in
session. VACEP
has not promoted any specific bills of our own. We are actively monitoring numerous bills,
including COPN, several EMS issues and in particular, two primary seatbelt bills, HB1672
and SB1041. Another bill, HB2689 would require a phase in for seatbelts on school buses. VACEP is actively opposing the
repeal of the motorcycle helmet law for persons over the age of 18, HB2508. Unfortunately
this has cleared the House committee vote. If this measure passes the House, we will
actively oppose it in the Senate.
An update on these bills will be provided at the Annual Meeting.
MDT/gmh
Health
Finance/ Reimbursement
Chairman: Michael W. Potter, MD, FACEP
Members:
Andrew Cole, MD, FACEP
Jason Garrison, MD, FACEP
Gaylord Ray, MD, FACEP
Advisory Members: Gay Barnes; Martin Gottlieb; Frank Hammond; Susan Harris; Rusty Hundley;
Garland "Moe" Mosby; Sandy Oliver; Kevin Pillow; Jean M. Pletl; Fran Rogers;
Kaye Wear; Patricia A. Criswell.
Goals and Accomplishments:
Since assuming the position of chair of
the Health Finance & Reimbursement committee in January 2000 some interesting events
have unfolded. The state agency responsible for the administration of Medicaid (the Dept.
of Medical Assistance Service (DMAS)) voiced an interest in changing its reimbursement
structure so as to be in compliance with the prudent layperson standard enacted in the
Balanced Budget Act of 1997. Currently DMAS uses a system, by which claims are
automatically divided, using the final diagnosis, into one of three categories: 1)
automatically paid, 2) pend for further review, and 3) automatically deny. The problem
with this is two fold. One, using the final diagnosis to automatically deny payment does
not allow for the claim to be reviewed to see if the prudent layperson standard was met.
Second, using the final diagnosis only may not accurately reflect that a person prudently
sought care (i.e. 45 yo male presents with chest pain with the final diagnosis being
GERD).
DMAS convened a meeting on Feb. 2nd in which they
proposed changing the system to one where claims would be divided, using the final
diagnosis and/or the presenting complaint, into one of two categories: 1) automatically
paid, or 2) pend for further review. In early April 2000 we convened several meetings to
discuss DMAS’ proposed pend list (given to us in late March) and then sent back to
them our proposals for changes to that list. It was DMAS’ initial stated intent to
review the changes we had suggested and convene a final meeting to discuss/compromise on
the ultimate content of the list. Unfortunately to date we have not heard anything from
DMAS in this regard and when we call to inquire as to the status of their review we only
get the run around. Our plan at this point after many discussions with Mrs. Gerheart and
national ACEP is to mail a final letter detailing our dealings with them to this point and
their continued non-compliance with federal law. Copies of this letter will be sent to
HCFA and Gov. Gilmore.
The second event is that United HealthCare
Insurance Co. had asked to be let out of its current contract with HCFA as the Medicare
carrier for Virginia. Trailblazers Health Enterprises was ultimately chosen to replace
them and a full transition has now taken place. I have not heard of any significant
problems as a result of this change.
As usual we conducted our March coding seminar in Richmond and our
Practice Management day at the Summer Symposium in July. We received positive reviews from
both of these.
MWP/gmh
Doctors Insurance
Reciprocal (DIR)
Liaison: Francis L. Counselman, MD, FACEP
Goals and Accomplishments:
DIR is working on obtaining CME for their
educational courses. The Accreditation Council on Continuing Medical Education (ACCME)
will make a decision on DIR’s accreditation status at their March meeting. They
should receive word by the end of March 2001.
DIR is acting responsibly in increasing their rates due to the
changes in the malpractice environment. One out of nine physicians in Virginia was sued in
1999. Malpractice awards in Virginia jumped nearly 50% in 1999. In the past five years,
the defense costs for DIR has increased 81%. Malpractice carriers that are not increasing
their rates should cause one to be suspicious. With the number of lawsuits, malpractice
awards, and legal fees increasing, the costs of medical malpractice insurance can only go
up. Some carriers may offer little or no increase to lure new business. One needs to be
sure those carriers are going to be viable when needed.
FLC/gmh
Emergency Medical Services
Chair: James
R. Dudley, MD
Members:
Sabina Braithwaite, MD, FACEP
George Lindbeck, MD, FACEP
Stewart W. Martin, MD, FACEP
John M. Sheridan, III, DO, FACEP
Lori A. Givonetti, MD, Rep to TEMS Board
Mark D. Tripp, MD, FACEP, Rep to WEMS Board
Liaison Members:
Kenneth Frumkin, MD, FACEP, EMSC
Carl F. Wentzel, III, MD, FACEP, GAB
Joanne Lapetina, MD, FAAP, State BTLS Medical Director
Advisory Member:
Carol Gilbert, MD, State EMS OMD
Goals and Accomplishments:
VACEP, through its EMS committee and various Board members,
as well as others, has been actively involved with EMS activities in the Commonwealth. We
are currently working on a new curriculum for all Operational Medical Directors (OMD's),
in close association with the Virginia Office of Emergency Medical Services (OEMS). A
national curriculum has been developed, with ACEP, NAEMSP, and NHTSA sponsorship, and with
the co-direction of Dr. Perina at UVA. The Virginia OEMS task force is using that
curriculum as the starting point from which to develop the Virginia curriculum. The OEMS
task force meets next at 10:30, on March 1st, 2001, at the Office of EMS in Richmond, and
we welcome any interested VACEP members. We anticipate a revised and exciting program at the EMS
Symposium in November. Dr. Gilbert has agreed to revise the OEMS OMD handbook, which
further delineates much of which an OMD in Virginia needs to know.
JRD/teb
EMS-C
Liaison: Kenneth Frumkin, MD, FACEP
Goals and Accomplishments:
VACEP Representative to the Emergency Medical Services for
Children.
(EMSC) Subcommittee, Virginia Emergency Medical Services Advisory
Board.
The EMS-C Committee continues to expand its focus on injury
prevention and violence. There is an associated expansion of VCU's role in this area with
grants in Youth Violence Prevention and Child Violence Intervention. They are offering a
Senate Joint Resolution to study Virginia emergency services for children. Grants and
training are offered
KF/gmh
Governor’s
Advisory Board for Emergency Medical Services
Representative: Carl F.
Wentzel, III, MD, FACEP
The dominant topic of discussion this year was funding. Last
year the board submitted to the Governor’s office a study of funding for EMS in
Virginia. In that report several areas of funding shortfalls were highlighted. The report
recommended an increase in EMS funding to address these needs. Most significantly is the
need to increase funding for education and training of EMS providers in the state. After
reviewing the report, the governor’s office declined to support any increase in EMS
funding above previously budgeted levels. The governor’s office is against any
actions that would be perceived as raising taxes in the Commonwealth. EMS funding has
historically come from automobile registration fees and increasing those fees would in
essence be raising car taxes. As we are all aware, one of the tenants of this
governor’s administration is the abolition of the car tax.
Faced with this reality the board was tasked
with addressing funding the new needs with the same resources as before, ‘doing more
with less’. At this time we have had to re-prioritize the line items of EMS funding
in the state. The board has agreed that education is the priority need at this time.
Therefore education initiatives receive preference with other needs falling in behind.
Other critical needs still exist, however they will most likely remain unmet until
additional funding can be obtained. The board is also exploring new ideas and options in
funding outside of its traditional revenue sources.
Additional areas of interest:
The medical direction committee has been
very busy addressing the upcoming changes in the ALS curriculum. They have been involved
in an extensive review of the new curriculum and its impact on our current ALS teaching
guidelines. They are currently involved with constructing a plan for transitioning the EMS
system from the ‘old’ curriculum and certification levels to the ‘new’
ones. It has been the topic spirited discussion and anxiety within the EMS community and
will continue to be so until all the wrinkles are ironed out. Additionally the committee
has been producing position papers to guide EMS agencies in best practice procedures and
techniques. These position papers are also being used as guidelines for prioritizing grant
applications for Rescue Squad Assistance Funds.
The Financial Assistance Review Committee has been successful in
funding their initiatives for AEDs and computers. These initiatives have resulted in a
significant increase in the number of AEDs placed throughout the state. They have also
provided funds so that every EMS agency in the state has access to a computer. Over
$700,000 was awarded as part of these initiatives.
Looking ahead, many of the issues from last year remain on the table
as the board enters 2001. Funding the educational needs of the system remains a priority.
The needs for equipment within the system are relatively well met. However, without new
sources of revenue for repair, maintenance and replacement, these needs will quickly slip
down to the critical level again. The board continues to explore innovative funding
options and needs prioritization. Until there is a change in the present political
climate, the traditional sources of EMS funding will remain unchanged.
CFW/gmh
Basic Trauma Life Support (BTLS)
Chairman: Joanne Lapetina, MD, FAAP
Committee Members:
J. David Barrick
Gwen E. Messler Harry
Accomplishments:
The total number of students trained in FY99-00
is 2087. Students categorized as follows:
Course description Students Trained
Advanced |
1655 |
Basic |
227 |
Pediatrics |
127 |
Instructor |
054 |
Failed
Students |
016 |
MD
Instructor |
008 |
Total Trained
|
2087
|
Total
Certified |
2071 |
Policy revision. A recommendation to abolish the Steering Committee from the policy manual was
approved at the May 2000 Board meeting. The Steering Committee has not convened in years.
The BTLS Executive Committee will assume the responsibilities and all issues that are
presented.
BTLS International: BTLS International Congress in Denver
in November was attended by several staff members and delegates. Rob Braithwaite, Chaired
and Gwen E. Messler Harry served on the Bylaws Committee this past year. Committee
Appointments for 2001 are pending. David Barrick continues on the Editorial Board, Jim
Kelly continues on as Congress Vice Speaker, and Sabina Braithwaite, MD continues on the
Board of Directors.
JEL/teb
Education Committee
Chairman: Timothy C. Evans, MD, FACEP
Members:
Tamera C. Barnes, MD, FACEP
Ioliene Boenau, MD, FACEP
T. Bret Bolton, MD, FACEP
William J. Brady, MD, FACEP
Arthur Chambers III, MD, FACEP
Andrew B. Cole, MD, FACEP
Cynthia E. Dorr, MD, FACEP
Kelly Anne Foley, MD, FACEP
Michael S. Gonzalez, MD, FACEP
Charles S. Graffeo, MD, FACEP
Sarah A. John, MD, FACEP
Joanne E. Lapetina, MD, FAAP
George H. Lindbeck, MD, FACEP
Michael W. Potter, MD, FACEP
Pamela A. Ross, MD, FACEP
Mark D. Tripp, MD, FACEP
Goals and Accomplishments:
- Offer 50 hours of CME annually. A summary of educational programs
offered this past year are as follows:
2000 Scientific Assembly, Program Director
Timothy Evans, February 7-9 at the Homestead, offered 22.5 hours. There were 88 attendees,
including faculty and staff. Revenues ($38,732) exceeded direct expenses ($26,324) by
$12,408 compared to budget of $10,000.
2000 Summer Symposium, Program Director Cynthia Dorr, July 24-28 at the Ramada Plaza Resort,
Virginia Beach, offered up to 33.5 hours including Presymposium programming. The EMTALA
Presymposium drew 76 participants and Symposium had 53 attendees, including faculty and
staff. Revenues ($37,809) exceeded direct expenses ($29,675) by $8,134 compared to budget
of $18,000. While attendee evaluations for the Symposium continue to be excellent, support
of this program has declined over the past several years and significant changes are
planned for 2001, when this conference will move to Kingsmill Resort, Williamsburg, July
23-27. The EMTALA Presymposium will be updated and presented.
Spring Reimbursement seminar, Program Director Michael Potter, March 8 at the Wyndam Hotel, Richmond,
offered 7 hours CME. There were 57 attendees, including faculty and staff. Revenues
($7,055) exceeded direct expenses ($3,134) by $3,921 compared to budget of $$3,500.
ACLS/PALS. VACEP jointly sponsored ACLS and
PALS courses throughout the year (certification and recertification) through Network Medical Systems, Inc.
- Ensure meetings receive positive evaluations from the attendees.
Evaluations are conducted at all College CME and results indicate
excellent satisfaction in the quality of programming.
- CME self-supporting for direct/indirect costs +10%; and,
Increase attendance at CME programs by 20%.
Accomplishment of these objectives is
an ongoing challenge. Reduced rates and CEU credits for non-physicians are now regularly
offered for CME programs. Our committee has identified several areas to improve marketing,
as well as providing more family-oriented activities and shorter CME days. A survey of
members, who’ve not attended VACEP CME opportunities in the past 5+ years, is planned
for this coming year.
Oral Board Review courses. Desire to hold
annual program specific to EM Resident career planning is under consideration, to include
potential offering of Oral Board courses. ABEM recently announced plans to change from a
10-year recertification cycle to a "continuous certification" system that could
impact the demand for Oral Board courses in the future. This will be considered by
committee in the coming year.
AudioTapes and interactive
web-based CME. The committee determined VACEP does
not have the resources at this time to succeed in these markets and is no longer an
objective.
Committee composition. We have considerable talent on this committee for generating CME ideas, yet
the actual work to organize and implement CME programs continues to fall on the shoulders
of a few members. To help spread the work load and responsibility for the many different
activities necessary to support continuing quality in our CME programs, specific job
descriptions and delegation of duties, to include some form of recognition/compensation,
will be investigated in the coming year.
TCE/gmh
Research Awards
Chair: David H. Lander, MD, FACEP
Members:
Stuart A. Smith, MD, FACEP
Eunice M. Singletary, MD, FACEP
Goals and Accomplishments:
From papers submitted, recipients of the John
McDade Award for Research in Emergency Medical Services were selected and announced at the
July Membership meeting. Awards were given in the Post-Graduate and Residency categories;
no papers were submitted for the non-Physician category, intended for prehospital
personnel and agencies.
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Bylaws
Chair: Michael J. Bono, MD, FACEP
Members: VACEP Councillors & Alternates
No activity. Bylaws changes have not been suggested nor
recommended.
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Technology
Chair: Pamela A. Ross,
MD, FACEP
Goals and Accomplishments:
Work on the VACEP website was successfully taken over internally by
staff. Unexpected computer problems in the College office hampered updates. Nevertheless,
the final "release" of the site for public and member access was made available
late December 2000. Thanks to our staff for their diligence and excellence on this
project. Please visit the web site at www.vacep.org.
PAR/gmh
Long Range Planning
Chair: Peter J.
Weimerskirch, MD, FACEP
Goals and Accomplishments:
The Board has adopted an agenda that designates
time for Strategic Planning discussions. While no specific LRP committee action has
occurred, the Board and Officers evaluate suggestions for any new activity against the
goals and objectives outlined in the Strategic Plan adopted in 1999. All other College
committees are working toward attainment of their assigned Objectives.
PJW/gmh |
