Annual Meeting Highlights
Election
Results
Annual Reports for Year 2001 Activity
Committee and Liaison Reports:
- Nominating, Chair Mark D. Tripp, MD, FACEP
- Membership, Chair Sabina A. Braithwaite, MD, FACEP
- Government Affairs, Chair Pamerla A. Ross, 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 Andrew B. Cole, MD, FACEP
Nominating
Chair: Mark
D. Tripp, MD, FACEP
Committee Members:
Andrew B. Cole, MD, FACEP
Pamela A. Ross, 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.
MDT/gmh
Membership
Chair: Sabina
A. Braithwaite, MD, FACEP
Members:
Renate Austin, MD, FACEP
Stuart E. Brown, III, MD, FACEP
Goals and Accomplishments:
- Welcome new members to VaCEP. As of end-2001, there were 464 members,
no significant change from last year (460).
- At the Board’s direction, the committee developed a membership
brochure describing VaCEP and its benefits for use in mailings to prospective members.
Funds were budgeted to complete a mailing of these brochures to ED’s in Virginia,
this will be completed pending staff availability. In addition, a web-based survey
instrument was developed to gauge potential members’ areas of interest in specific
benefits and services that VaCEP offers to better allow us to serve our membership. This
will be instituted based on Board prioritization, and the results taken into consideration
when allocating VaCEP resources in the future.
- The committee suggested that increasing our web presence and
directing the flow of information from VaCEP to its members through our website more
aggressively was a direction we should move to for the future. Before staff resources are
allocated to this considerable effort, the Board will be provided the results of the
survey in (2) to determine whether this is a resource our membership values.
/SAB
Government Affairs
Chair: Pamela
A. Ross, MD, FACEP
Committee Members:
Sabina A. Braithwaite, MD, FACEP
Andrew B. Cole, MD, FACEP
James R. Dudley, MD, MBA
Mark D. Tripp, MD, FACEP
Advisor:
Melanie R. Gerheart, Lobbyist
Goals and Accomplishments:
Due to the lack of consensus on the state budget for
the 2000-2002 biennium, the General Assembly adjourned without a budget leaving the
Governor holding all the cards and able to craft his own budget with a myriad of agency
cuts expected. This stalemate may impact on the indigent care funding for one state
hospital which had been included in his earlier budget bill. More funding was requested
for indigent care in all state hospitals with regard to the deregulation of the
certificate of public need (COPN) program but that funding was not forthcoming thus the
COPN deregulation was defeated.
VaCEP has been working for two years with all parties involved in
the commitment process which is also a tangled web. VACEP representatives emphasized how
many aspects of current practice potentially place us in direct violation of federal law.
Hospitals, physicians, magistrates, community service board representatives and state
officials have tried to take an orderly approach to examining the flaws in the law and
have attempted to clarify each organization’s role in the commitment process. Thus
far, it appears the law is "bigger than the both of us." There are a myriad of
extenuating factors involved at every level of the commitment process and problems vary
throughout the state so, try as we might, it seems that the issue only becomes more
complicated the more it is examined.
VaCEP has worked with the parties involved on both the state and
local level to address the current shortage of psychiatric beds. This shortage is acute in
the Richmond area, and other parts of the state are experiencing this problem. We continue
to seek answers on reforming a system which is truly on the edge of being broken in
Virginia.
Proposed epinephrine legislation/meeting with Senator Puller. Drs.
Ross and Lapetina, Ms. Gerheart and Ms. Harry met with Senator Puller on October 2. The
meeting proved beneficial, with Sen. Puller requesting VaCEP draft a response to her
constituent on the inadvisability of proposing legislation for EMS to carry and administer
epinephrine, and supporting education of patients with known allergies to obtain and carry
epinephrine in the event of an allergic reaction.
Proposed Anti-drug diversion legislation/current status. The
proponents of such legislation have made modifications that better address patient
confidentiality and potential physician liaibility, however the cost to the Commonwealth
to implement this legislation makes it unlikely a bill on this issue would pass. Ms.
Gerheart will continue to monitor.
Proposed membership in Child Safety Locks Coalition. An overview of
the Coalition’s purpose and goal was presented. There is no direct cost of
membership. There was discussion.
VaCEP BOD voted to join the Child safety locks Coalition.
VaCEP was instrumental in killing the motorcycle helmet legislation.
Thanks to Michael J. Bono, MD, FACEP and Michael S. Gonzalez, MD, FACEP who sat for hours
waiting for the bill to be heard in committee and then did a wonderful job in spelling out
why the bill was a bad public policy move. Also, your phone calls and letters to
legislators concerning the primary seat belt legislation were well received and heeded.
There is no substitute for contacting your own legislators and letting them know your
perspective on these important safety issues.
Legislation to allow physician assistants the identical
prescriptive authority which nurse practitioners currently possess was passed with very
little discussion. Conversely, legislation to allow physicians, nurse practitioners and
pharmacists to distribute emergency contraception to patients without a prescription was
defeated in a conference committee after passing both the House and Senate. The House
tacked on an amendment calling for parental consent for minors with which the Senate
disagreed. A conference committee was called and by a vote of 3-3 killed the entire bill.
The main reason given by the opposition was that the bill (and the pill) promoted
promiscuity.
The Medicaid (DMAS) department’s recent decision to change
their reimbursement methods to finally come into compliance with the prudent layperson
provisions of the Balanced Budget Act (BBA) of 1997. DMAS has agreed to change the way
they reimburse for services by no longer automatically reducing reimbursement based on
diagnostic codes (See detailed explanation at vacep.org). DMAS officials subsequently
indicated that back billing would be possible and that is apparently not going to happen.
There are a number of issues which we know will be reintroduced in
the 2002 Session of the General Assembly. We will see the primary seat belt law bill being
considered. You may recall that VaCEP was a part of a coalition in the 2001 Session which
supports this legislation for its recognized effectiveness in other states. Another issue
which was defeated during the last Session was the motorcycle helmet law, which would
rescind the current mandate that all motorcyclists must wear helmets. This legislation
also will be reintroduced in 2002. There is also word that another child safety locks bill
will be reconsidered.
A bill to legalize lay midwifery will be considered for the fifth
year in a row. The OB/GYN Society and Medical Society of Virginia are working together to
oppose this legislation and need the help of Emergency Physicians who may have had
patients present in the Emergency Department with no prenatal care and no OB/GYN to
contact. We are trying to document some of the possible problems patients face when under
the care of a lay midwife. If you know of any such cases, please contact our lobbyist,
Melanie Gerheart, at mrgerheart@aol.com.
As we look ahead to future issues, we must be ever mindful that many
important decisions concerning the safety and welfare of Virginia’s citizens are not
made on the basis of scientific evidence. There is an ideology at play that bases
decisions on how to best get oneself re-elected down the road. We must keep this in mind
as we go forward into the next General Assembly.
/PAR
MDT/gmh
Health
Finance/ Reimbursement
Chairman: Michael W. Potter, MD, FACEP
Members:
Andrew Cole, MD, FACEP
Jason T. Garrison, MD, FACEP
Daniel J. Isaacman, MD, FAAP
Gaylord Ray, MD, FACEP
Mark Tripp, MD, FACEP.
Advisory Members: Gay Barnes; Kathleen
Cardella; Martin Gottlieb; Susan Harris; Rusty Hundley; David McKenzie; Garland
"Moe" Mosby; Sandy Oliver; Jean M. Pletl; Fran Rogers; Kaye Wear; Patricia A.
Criswell.
Goals and Accomplishments:
In June of 2001 the HF&R committee saw one of its
projects come finally to fruition. Due to our ongoing efforts and dialogue with the
Virginia Department of Medical Assistance Services (DMAS), they have modified their
process of reviewing and reimbursing claims for emergency services paid on behalf of
Medicaid recipients. DMAS is now finally compliant with the Prudent Layperson standard
enacted in the 1997 Balanced Budget Act. The prior practice of automatically down-coding a
claim based on the final diagnosis has been eliminated. Since June 1st, 2001
DMAS now either automatically pays a claim at the appropriate emergency rate in full, or
will manually review that claim to see if the Prudent Layperson standard was met; if so,
then the claim is paid in full, and if not, then the claim is paid as a non-emergency. We
continue to monitor DMAS’ payment practices for further developments.
We also had a very successful Practice Management day at the Summer
Symposium despite the unfortunate last minute cancellation by one of our two scheduled
speakers. No issues significant to Emergency Medicine have arisen at the Medicare CAC
meetings.
/MWP
Doctors Insurance Reciprocal (DIR)
Doctors Insurance Reciprocal, Council of Governors
Liaison: Andrew B. Cole, MD, FACEP
Goals and Accomplishments:
DIR continues to work diligently to meet the needs of its
members. The malpractice environment nationwide has progressively worsened with greater
numbers of lawsuits and markedly increased malpractice awards. While conditions remain
relatively stable in Virginia, there are states such as West Virginia and Pennsylvania
where physicians are having a difficult time acquiring reasonable malpractice coverage.
DIR has responsibly raised premiums, and a revised underwriting plan has been developed.
This plan will allow for improved assessment of current and future accounts aiding the
stability of the company.
2001 ended with news that will have a profound effect on the
malpractice industry. St. Paul, a large insurer, announced they will be quitting the
medical malpractice business entirely. DIR will be working to meet the needs of some of
those physicians affected by this loss.
In follow up to information presented in this report last year, DIR
was successful in obtaining CME credit for their educational courses. Live seminar and
self-study courses are eligible with Internet offerings currently under review.
/ABC
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:
The VaCEP Emergency Medical Services (EMS)
committee has been working with the Virginia Department of Health’s Office of EMS and
the Governor’s EMS Advisory Board’s Medical Direction Committee to establish
standards for EMS agency Operational Medical Directors (OMDs) for several years. In
support of that mission, VaCEP has sponsored an EMS OMD workshop in conjunction with the
annual Statewide EMS Symposiums to provide standardized education and networking
opportunities for these physicians.
As a result of these positive activities, the Virginia Rules and
Regulations governing EMS are being updated to include a requirement for OMDs to
participate in EMS Medical Direction training.
At VaCEP’s recommendation, a
workgroup was formed to modify the National EMS Medical Direction curriculum developed by
ACEP and NAEMSP, to be Virginia-specific. The workgroup participants included VaCEP
committee members and staff, and Office of EMS staff and Dr. Carol Gilbert, State EMS
Medical Director. The first pilot program was presented at the 22nd Annual
Statewide EMS Symposium as a presymposium program, November 8, 2001. Doctors Kim Mitchell,
Sabina Braithwaite, George Lindbeck, Jerry Mothershead, Carol Gilbert, and James Dudley
presented material covering many of the salient and timely topics regarding functioning as
an OMD in the Commonwealth. Our colleagues from the Office of EMS then finished the
seminar, clarifying many of the technical and regulatory issues. VaCEP jointly sponsored
the program with ACEP to provide participants with up to 7.25 Category I ACEP/AMA CME
credit.
The program was very well received by the attendees, and their
evaluations will be used to improve this for future offerings. Future plans include
refining and expanding some of the program content, making the program more accessible to
Operational Medical Directors in remote areas by delivering the program in several
regions, as well as investigate packaging it as a home study program.
JRD/gmh
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 purpose of this liaison is to
assist the Virginia EMS-C committee in its functions by participating in their quarterly
meetings and ongoing projects, to provide feedback to VaCep and to provide a mechanism for
the integration and interaction of the missions of the two groups.
In the last year the EMS-C committee has pursued continued funding.
It has become a full standing committee of the State EMS Advisory Board with the VaCEP
liaison as a voting member. Data collected on school health issues will be placed before
the 2002 legislature. Educational programs for EMS personnel in all facets of emergency
care for children are being addressed, improved and expanded. A state wide trauma care
needs assessment is being conducted with EMS-C funds. We will continue to participate
fully and monitor closely in 2002.
/KF
Governor’s
Advisory Board for Emergency Medical Services
Representative: Carl F.
Wentzel, III, MD, FACEP
The EMS community entered the year
by continuing debate on the revision of the Policies and Procedures Manual as directed by
the office of EMS. There were several regulatory issues that sparked intense discussion
especially concerning radio communications and provider re-certification. However, the
differences were eventually reconciled and I believe the current document is one that has
the support of the vast majority of the EMS community. Additionally, the new document now
recognizes and incorporates the significant changes that have occurred in Emergency
Medical Services since the last revision occurred almost a decade ago.
Funding shortfalls are now a perennial issue with EMS as well as
with many departments of state government. The Advisory Board has addressed the funding
shortage by evaluating and prioritizing the needs of the EMS community. The board has
determined that provider training and continuing education are the areas of greatest need.
As such, funding has been directed to those areas first. Unfortunately, areas that were in
critical need several years ago have only gotten worse. The Advisory Board has unanimously
approved a motion to endorse the $4 for Life initiative presently before the General
Assembly. Passage of this bill would help to address the undisputed critical needs in EMS
funding. We will see how this bill fares in the milieu of General Assembly finances and
politics.
The reality of terrorism at home this year has brought a new level
of recognition and respect for Emergency Medical Services. There has been broad-based
support for EMS as a pivotal component of any plan addressing homeland security. For
years, the EMS community has been anticipating and planning for the types of challenges it
was faced with this year. I believe that the public holds EMS in a much higher esteem
since the events of last fall. This new momentum can be used for positive change.
Hopefully, legislators and the public will recognize the asset we all share in EMS and
will give it the resources it needs to not only cover the shortfalls but to address the
new challenges that lie ahead.
/CFW
Basic Trauma Life
Support (BTLS)
Chairman: Joanne Lapetina, MD, FAAP
Committee Members:
J. David Barrick
Gwen E. Messler Harry
Accomplishments:
Implement the nationally recognized Basic Trauma Life
Support training program, and provide certification to successful participants. Provide
for the training of Instructors and Medical Directors, and support State Affiliate Faculty
and Course Coordinators responsible for oversight and administration of local training
programs. Participate in activities of the BTLS International organization to promote
program deployment, ensure compliance with International standards, and improve training
offered at the state level.
The total number of students trained for the fiscal year ending
September 30, 2001, are as follows:
| Course
Description |
Students
Trained |
| Advanced
Provider |
1042 |
| Basic
Provider |
227 |
| Pediatric
(Adv & Basic) |
85 |
| Failed
Students |
23 |
| Instructors |
48 |
| Medical
Directors |
5 |
| Total
Trained |
1430 |
| Total
Certified |
1407 |
BTLS International. The annual Congress
scheduled to be held in Toronto, Canada, in late September was cancelled as a result of
the terrorist events of September 11, 2001. This has now been rescheduled for the Fall
2002 at that same location. The following individuals provide leadership to the
organization as follows: Sabina Braithwaite, MD, Board of Director and Treasurer; James
Kelly, EMT-P, Congress Vice Speaker; Gwen Harry, Bylaws Committee; and J. David Barrick,
EMT-P, Editorial Board.
JEL/gmh
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
James R. Dudley, MD
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
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 is as follows:
2001 Scientific Assembly, Program Director Timothy Evans, February
12-15 at the Homestead, offered up to 23.0 hours. There were 88 attendees, including
faculty and staff. Revenues ($37,506) exceeded direct expenses ($28,401) by $9,105
compared to budget of $9,600.
2001 Summer Symposium , Program Director Cynthia Dorr, July 23-27
at the Kingsmill Resort, Williamsburg, offered up to 33.5 hours including Presymposium
programming. The EMTALA Presymposium drew 41 participants and Symposium had 120 attendees,
including faculty and staff. Revenues $54,791 exceeded direct expenses ($52,627) by $2,164
compared to budget of $13,000.
Spring Reimbursement seminar , Program Director Michael Potter,
April 18 at the Embassy Suites Hotel, Richmond, offered 7 hours CME. There were 52
attendees, including faculty and staff. Revenues ($4,339) exceeded direct expenses
($3,468) by $871 compared to budget of $3,000.
ACLS/PALS. VACEP jointly sponsored ACLS and PALS
certification and recertification courses with Network Medical Systems, Inc. throughout
the year.
- 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 regarding their CME
preferences was conducted in October 2001, and the results are being tabulated for
consideration by the committee at it’s next meeting.
Other objectives
Future Considerations
As indicated above, the educational offerings of the College during
the last year have failed to meet their budget targets. The reasons for this are
multifactorial and include stagnant registration numbers, failure to generate significant
educational grants, expenses related to recruiting highly attractive speakers and the
expenses of holding these events at attractive locations. The Education Committee will
focus in the upcoming year on analyzing all aspects of the College’s educational
activities in an effort to identify means of maximizing revenue and minimizing expenses
while continuing to offer high quality, affordable, and well received CME.
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 three
categories: Post-Graduate, Residency and non-Physician.
/gmh
Bylaws
Chair: Michael J. Bono, MD, FACEP
Members: VACEP Councillors & Alternates
No activity. Bylaws changes have not been suggested nor recommended.
/gmh
Technology
Chair: Pamela A. Ross, MD, FACEP
Goals and Accomplishments:
The final
"release" of the site for public and member access was made available late
December 2000. Please visit the web site at www.vacep.org.
Internal development needs regarding technological equipment, training, etc. have been
presented and reviewed. Various budgetary limitations currently exist.
Future goals include: implementation of online membership surveys in
conjunction with the Membership committee; CME online registration; acquisition of new,
updated technological equipment for the VaCEP office.
/PAR
Long Range Planning
Chair: Andrew B. Cole, 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.
ABC/gmh |
