| Greensheets
TELEHEALTH - AN EMERGING ISSUE FOR STATE
REGULATORS To read this article in its entirety, click here.
The new IAB year is off and running and the 1998 IAB Annual Meeting passes into history. All of the reports, follow-up surveys, correspondences and appointments relating to the 1998 Annual Meeting have been completed. You, the member boards, rated the Orlando meeting as a very successful event, one in which you had the opportunity to listen, share and learn from your colleagues. The interactive Continuing Competency Forum was well received by attendees, and received the highest of reviews in our post-annual meeting survey. The Contemporary Issues Committee, chaired by Dr. Ron Detwiler, deserves a round of congratulations for organizing an innovative and informative program and format, a format which the IAB Annual Meeting organizers plan on utilizing in the future. The new IAB year has brought with it a renewed focus on the refinement and continued growth of COPE. After several productive discussions with the leadership of the American Academy of Optometry (AAO), all 200+ hours of the 1998 Ellerbrock portion of the AAO Annual Meeting in San Francisco was, for the first time, COPE Approved! This is a significant milestone in COPE's development. The Academy has always stood at the top of the optometric profession in terms of continuing education, creating the bridge between academia and practicing clinicians. The IAB Board of Directors dedicated themselves to assuring that COPE worked well for the AAO 1998 meeting, and will continue to do so in future years. The COPE Committee, under new chair Dr. Barry Schneider, will continue to refine and improve the internal structure of COPE, building on a new theme of making the process more user-friendly for the individual OD. Over the last few years the IAB has discussed at length the topics of Endorsement, Continued Competency, and Board Certification, both at the Annual Meeting and at the quarterly Board of Directors meetings. A possible common bond, or base foundation, for all three of these topics is a 'state of the art' optometric Continuing Education system. The IAB Board of Directors continues to research and promote the development of methods to enhance optometry's continuing education programs, thereby creating solutions to some of the seemingly intractable issues we all currently face. The IAB believes that an active involvement in continuing education is critical if the issues of Endorsement, Continued Competency, and Board Certification, are to be effectively understood and addressed by our member boards. In a related area the IAB has developed a new service, OptometryCE.org, a web-site that lists CE meetings. The page can be found by clicking here, and is currently sponsored by Vistakon, Inc. This information-rich Internet site has received over 53,000 hits in just its first six months of operation, and this number is rising fast. Similar efforts are planned concerning the COPE Web Page, which is also maturing at a rapid pace. Finally, remember the newly established IAB office in Bethesda, Maryland (staffed by our full time Executive Director, Jim Vrac, and our new Programs Coordinator, Ryan Higgins) is open and available for your questions and comments. Also, feel free to contact me directly with suggestions or concerns at my e-mail address seylerod@ix.netcom.com. Thanks for your involvement in the IAB; together we are looking forward to a great year.
IAB PREPARES TO HOST NATIONAL OPTOMETRIC CONTINUING EDUCATION CONFERENCE The IAB recently announced plans to host a National Optometric Continuing Education Conference that will feature representation from the American Optometric Association (AOA); the American Academy of Optometry (AAO); the Association of Schools & Colleges of Optometry (ASCO); the National Board of Examiners in Optometry (NBEO); and invited speakers and special guests from within the profession. The mission of the meeting is to develop a profession-wide, consensus-driven approach to the future of CE. Several key objectives are under development to help address this broad mandate, among them:
The meeting will be held April 9-11 in Oakbrook, IL, and is being planned and hosted by the IAB's Contemporary Issues in Optometry Committee, chaired by Dr. Charles Harrill. The Contemporary Issues in Optometry Committee will present a detailed report on the findings of the conference at the Annual Meeting in San Antonio, TX, in June. Dr. Eyler, IAB President, said "We are excited about organizing a conference that bring together some of the major "players and thinkers" within our profession to discuss and "brain-storm" on the current and future status of optometric continuing education." Dr. Eyler concluded by saying, "We are also very pleased to announce that CIBA Vision Corp. and Essilor Lenses have supplied grants to support the conference, and we wish to acknowledge the commitment of both companies to the future of the profession through these important contributions."
  Richard Weisbarth, OD, Executive Director of Professional Services and Customer Satisfaction for CIBA Vision, stated, "On behalf of CIBA Vision's commitment to excellence, we are proud to support [IAB's] National Optometric Continuing Education Conference." More details on this historic meeting will be available at the June Annual Meeting.
ANNUAL MEETING 1999 - SAN ANTONIO, TEXAS For more information, visit www.iabopt.org/about/annualmeeting99.shtml.
REGIONAL MEETING DATES FOR 1999 ANNOUNCED For more information, visit www.iabopt.org/about/regionalmeetings99.shtml.
The following resolutions were passed at the IAB Annual Meeting in June 1998, in Orlando, FL, by the House of Delegates and subsequently approved by the Judicial Council:
OptometryCE.org - A NEW RESOURCE FOR PRACTITIONERS The International Association of Boards of Examiners in Optometry (IAB) recently debuted on the Internet a new service for both CE providers and practitioners: OptometryCE. This new service is designed to provide optometrists with access to information about meetings and events that offer continuing education courses, 24 hours per day, seven days per week. This free, interactive site offers practitioners the ability to search for a CE meeting quickly and efficiently, using either date or location parameters. Meeting information is available for both national and international events. There are no membership requirements. IAB has contacted CE providers directly to input data in the web-site database, and has also created a mechanism to submit meeting information manually for those organizations that don't have Internet access. The only criterion that IAB has so far established is that meetings must feature CE to be included in the database. "We recognized that a void existed for practitioners that were looking for meetings that featured COPE-Approved courses", said Robert Nyre, O.D., Chair of the IAB's Information & Data Services Committee. "There are very few centralized sources for CE meeting information available for practitioners, even less available via the Internet, and none that identify if a meeting will feature COPE courses. As 49 boards of optometry (46 states + District of Columbia, Guam & Puerto Rico) now accept COPE courses for credit towards re-licensure, the lack of availability of this key information for practitioners who specifically want to attend COPE-Approved courses was considered unacceptable by the IAB. The creation of the OptometryCE.org database will remedy this discrepancy, and enormously benefit practitioners who are looking for CE but have found themselves limited in choices by what is available in the print media. Providers don't need to pay to list their meetings in this database - and correspondingly, the range of choices is far greater." While the service only debuted recently, the development of CE industry contacts, data entry, and development of the web-site, has taken almost 6 months. However, this has resulted in a database that, to date, lists over 460 separate events, more than any other resource for optometry CE meetings available.
IAB NEEDS YOUR HELP IN GETTING THE WORD OUT TO YOUR LICENSEES IAB believes this service will be very useful in helping your licensed optometrists keep current in continuing education, and subsequently in meeting the CE requirements established by your board. The service has already proven extremely popular with meeting planners as we have over 460 meetings entered into the database. We feel this will be a very useful service for all practitioners, and this has been proven by the 53,000 hits the page has received during the period June-December 1998. We encourage you to take a moment and visit the site. We would like to request your assistance in distributing a copy of the promotional flyer to your licensees to inform them of the service. We suggest including a copy of the flyer with your license renewal requests, or with the next distribution of your board's newsletter, or when sending a mailing of any kind to your licensees. The flyers are small enough to easily fit into a regular envelope. If you are able to assist with the distribution of the flyers to your licensees, please contact IAB at (301) 913-0641 or email at IAB@iabopt.org. Thank you in advance for your help. We look forward to hearing from you shortly.
The Council on Optometric Practitioner Education (COPE), a service of the International Association of Boards of Examiners in Optometry (IAB), now in operation for over three years, is pleased to announce the recent decision of five states to begin accepting COPE Approved courses. COPE received announcements from the Arizona State Board of Optometry, the Kentucky Board of Optometric Examiners, the Minnesota Board of Optometry, the New Hampshire Board of Registration in Optometry, and the Ohio Board of Optometry stating their intent to begin accepting COPE Approved Courses. Acceptance of COPE-Approved courses is effective immediately for all five states. Forty-nine (49) boards of optometry (46 states + District of Columbia, Guam and Puerto Rico) now accept COPE approved courses. COPE is a national clearinghouse designed to relieve the duplication of optometric continuing education review from boards of optometry, while simultaneously creating uniform standards for: CE administration, submission for CE approval, and reporting of CE data to boards. COPE was created as a service for participating boards of optometry, and is designed to reduce or eliminate the costly resources expended by boards of optometry when reviewing and approving courses that have already undergone the same process in other states. Once designated 'COPE Approved' all forty-nine participating boards (certain minor exceptions apply, depending on state laws) automatically accept a course for credit towards re-licensure. Practitioners benefit from the process by being able to easily confirm beforehand whether courses presented at a meeting they wish to attend are approved for credit towards re-licensure. Boards of optometry reserve the right to review local courses and may elect to accept or require COPE Approval for courses. Seven boards currently require COPE Approved courses for out-of-state CE: Arkansas, Massachusetts, New Jersey, North Dakota, Puerto Rico, Rhode Island and Utah. Ernest B. Brazina, O.D., President of the Ohio Board of Optometry, said, "In making the decision to accept COPE-Approved courses, the Ohio Board recognized the broad-based appeal of the service amongst both schools and colleges of optometry and major providers such as the American Academy of Optometry. We wanted to make it easier for our licensees to obtain CE credit and COPE's service has achieved a level of recognition amongst practitioners who understand the benefits of attending a COPE-Approved course. We also feel that using COPE's service will help conserve limited resources in our state board office - resources that can be used for other important tasks." Dr. Barry Schneider, COPE Chair, noted, "We are extremely pleased to welcome Arizona, Kentucky, Minnesota, New Hampshire, and Ohio as COPE-participating states. The recognition by these five states that COPE's standards meet, or exceeds, their own lends additional credibility to our program and adds extra value for practitioners attending COPE-Approved courses. COPE's service has now become a generally accepted standard for CE, and this will undoubtedly benefit the entire profession." The recent decision by the American Academy of Optometry to submit the entire Ellerbrock lecture series for Academy '98 to COPE for approval has demonstrated the level of acceptance the program has recently achieved. The Academy's use of COPE is considered by many in the profession as a sign of COPE's arrival as the de facto CE clearinghouse for optometry. COPE has processed over 2,600 courses since it's inception on January 1, 1995; has granted the COPE Qualified Administrator designation to over 150 organizations/individuals; and approved over 500 programs.
COUNCIL ON OPTOMETRIC EDUCATION SITE VISITATION At the request of Dr. Alan L. Lewis, Dean of the Michigan College of Optometry, the Council on Optometric Education (COE) extended an invitation to a member of the Michigan Board of Optometry to attend the COE Site Visitation from October 11-14, 1998. I volunteered to represent the board. The preparation for the visit started with the reading of the College's self study report consisting of an analysis of the nine standards to be evaluated by the council. Additionally, the College prepared an analysis of its Strengths, Weaknesses, Opportunities, and Threats. I was warmly accepted by the COE team and allowed full participation in all their activities excluding the executive sessions. The team arrived fully prepared and hit the deck running with an organizational meeting Sunday. They then conducted two days of meetings with various individuals and/or groups with ties to each of the nine standards being evaluated. The team conducted these meetings with a high degree of professionalism and efficiency, asking questions about the self-study and most importantly, listening to the responses. Attending the entire visit afforded me the opportunity to view a complete evaluation of a site visit, participate in an in-depth analysis of a program as well as participate in the drafting of a preliminary report on the strengths and concerns of the program. This was then presented to the college in an exit interview. If you are given the opportunity to participate in a site visit, DO IT! I walked away with: (1) a new respect for the standards of the COE, which govern a school or college of optometry's accreditation, (2) appreciation of the hard work of the council and its consultants, and (3) pride in the high standards that optometric schools must maintain. Robert L. Klein, O.D.
The Interpersonal Workgroup on Health Professions Regulations (which comprises 17 health professions organizations representing more than 4 million health care practitioners, and of which the IAB is a member) met Wednesday, November 8, 1998, in Chicago. The following is a summary of that meeting:
Don L. Crouch, O.D.
HEALTH CARE INTEGRITY AND PROTECTION DATA BANK (HIP-DB) UPDATE - FINAL COMMENTS TO RULES The publication of the Notice for Proposed Rule-making (NPRM) for Section 221(a) the Health Insurance Portability and Accountability Act of 1996 was made on Friday, October 30th. These rules pertain to the operations of the Health Care Integrity and Protection Data Bank (HIP-Data Bank) and provide specific details on the reporting requirements for state boards. The comment period on the rules closed on January 11. During the comment period, IAB received several remarks from member boards on the rules expressing concern over certain areas of the operations of HIP-DB. IAB has taken those remarks and joined with the Interprofessional Workgroup on Health Professions Regulation (IWHPR) to submit a multi-disciplinary response. This response was compiled by the IAB's legal counsel, Dale Atkinson, who also provides counsel to several other member organizations of IWHPR; a copy of IWHPR's final comments on HIP-DB was recently mailed to each state board. We also hope to see these comments appear on the IAB web-site shortly. Given the uncertainty over the role of Designated Agents to HIP-DB, and IAB's concerns over securing full participation by member boards in a reporting system, IAB has elected at this time not to act as a Designated Agent for HIP-DB on behalf of our member boards. It is important that your Board thus pays particular attention to the issues outlined in the IWHPR Response, and if necessary, re-reads the original rules promulgated on October 30. You may still obtain a copy of the original rules by going to: www.fclb.org/fclb/hiptext.htm or www.hrsa.dhhs.gov/bhpr/dqa/hipmain.htm Finally, the Information & Data Services Committee will be conducting an update workshop on HIP-DB on Sunday, June 20 at the June IAB Annual Meeting in San Antonio, TX. This discussion will feature Dale Atkinson, who will answer your questions on the HIP-DB rules and how they will impact your board. We encourage you to attend this important workshop. Please feel free to contact the IAB office should you have any questions, or email Dr. Robert Sorrell, IAB Board Director, at rsorrell@ix.netcom.com.
COUNSEL'S CORNER (Interstate) Practice Does Not Make Perfect With increased mobility of practitioners and, more importantly, increased mobility of practice itself, regulatory boards are confronted with difficult issues relative to practice and licensure requirements. Specifically, practitioners need not maintain a physical presence within a particular jurisdiction to practice within that jurisdiction. Questions will arise whether or where such practitioners subject themselves to the jurisdiction of your board or, more elementary, whether or where practice actually occurs. A recent California Supreme Court case addressed some of these unanswered questions. A New York law firm contracted with a California company to provide legal services relative to a dispute between the California company and a Delaware company. The dispute centered around a contractual relationship between the California company and the Delaware company. That contract specifically called for its interpretation to occur under California law. Such contract will be referred to as "company contracts." The New York law firm entered into a fee arrangement to provide legal services relative to the investigation and prosecution of all claims relating to the company contract. This arrangement between the New York firm and the California company will be referred to as the "fee arrangement." The New York law firm did not maintain any attorneys licensed in California. In the course of its representation, the New York law firm sent at least two attorneys to California on several occasions. During such trips, various matters related to the California company were discussed and attempts to resolve the dispute were undertaken. Eventually, a New York law firm attorney, while in California recommended that the proposed settlement from the Delaware company not be undertaken. The California company adhered to this advice. Thereafter, the matter was eventually settled and was never litigated nor arbitrated. Eventually, the California company sued the New York law firm for legal malpractice and related claims. The New York law firm counter sued for its fees under the fee arrangement. The California company argued that by practicing law without a license in California, which violated applicable California law, rendered the fee arrangement unenforceable. The New York law firm argued that various exceptions existed under California law which allowed such activities to transpire without violating the California code relative to the practice of law. The district court granted summary judgement in favor of the California company and held the fee arrangement to be unenforceable. In general, the appellate court agreed and the California Supreme Court agreed to review the matter. In an interesting opinion, the California Supreme Court identified that there exists a tension between interjurisdictional practice and the need to have a state regulated system. It also noted that the demands of business and the mobility of our society posed distinct problems in the regulation of the practice of a profession by the states. In the end, the Supreme Court recognized the legislature's intent to protect the public from those giving unauthorized legal advice and counsel. The Supreme Court rejected the arguments of the New York law firm and held the California law protects against the dangers of legal representation and advice given by persons not trained, examined, and licensed for such work, "whether they be laymen or lawyers from other jurisdictions." In so stating, the California court identified the obvious fact that other state laws may differ substantially from California law and that licensure in one jurisdiction does not necessarily provide the safety protections to California citizens. Succinctly, the California Supreme Court stated: "Although we are aware of the interstate nature of modern law practice and mindful of the reality that large firms often conduct activities and serve claims in several states, we do not believe these facts excuse law firms from complying with [California law]." Accordingly, the California Supreme Court held that the New York law firm improperly practiced law in California without the prerequisite licensure. In addition, the court held that the fee arrangement was unenforceable to the extent it attempted to compensate the New York law firm for practice which occurred in California. However, the court provided that to the extent the New York law firm practiced in New York, it would be entitled to compensation for such services. This particular case illustrates the struggle the judicial system will have relative to a society in which technology is driving mobility of both practitioners and practice itself. The California Supreme Court specifically stated that sufficient "contracts" within the state of California must occur to satisfy that actual legal representation existed. However, such contracts need not necessarily depend upon or require the unlicensed lawyer's physical presence in the state of California. Such a judicial recognition, while firmly based within the law, further complicates regulation in general. Regulatory boards are encouraged to surf the Internet and investigate other activities undertaken by practitioners through electronic and telephonic means within your jurisdiction. Practice can occur without a physical presence. Regulatory boards are also encouraged to examine their practice acts to determine if the scope of practice or applicable definitions encompass such electronic transmissions of information. As the practice acts are reviewed by legislatures, it may be prudent to anticipate technological advances and electronic practice in determining what constitutes "practice" as defined. Importantly, boards must inquire what constitutes practice "in" your jurisdiction. Birbrower, Monalbano, Condon & Frank v. Superior Court, 949 P.2d 1 (Cal. 1998). |
