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Surgeon General speeds up ‘emergency’ suspensions

The Department of Health is streamlining the process of getting dangerous health professionals out of practice -- and it may already be paying off.

Several simple, common-sense steps have been introduced for high-priority cases, Surgeon Gen. Frank Farmer said Friday in an interview.

For example, he said, an employee is now in charge of flagging important complaints as they come into the Consumer Services Unit. And when those cases zip up to prosecution, they are on bright yellow paper, to set them apart.

After a doctor is arrested on a matter concerning medical practice, it should take only days, not months, to issue an emergency suspension order, Farmer said.

“It’s not acceptable to the public to see these guys still in practice after reading about them being arrested,” Farmer said. “It’s not acceptable to me, either.”

Health News Florida reported in May that two dozen Florida doctors who lost their Drug Enforcement Administration licenses as part of a federal crackdown on pain clinics still had clear Florida medical licenses on the DOH consumer web site.

The article noted that DEA licenses are entirely separate from state medical licenses.

Farmer said DOH now has an official whose job is to stay in touch with law-enforcement agencies, such as DEA and the Attorney General’s Office.

That might make a difference in situations like one HNF reported in April, in which the Attorney General’s Office settled a Medicaid fraud case against a registered nurse with a requirement that she pay $1.66 million. The nurse’s license was still “clear/active” at DOH, which apparently did not know about the case.

Other HNF articles, published in April as a "Special Report: DOH flying blind on crime", noted that dozens of Florida health professionals -- including dentists, psychologists and social workers -- still had “clear/active” licenses even after being charged with serious crimes, and sometimes even after they were convicted.

The law requires DOH to run a criminal background check on doctors, nurses and a few others, but most health professionals are not covered by it.

So the new steps at DOH to improve communication with law-enforcement agencies may help, but the agency can’t go back and find those it misses by doing criminal background checks if the profession isn’t one that is covered by the law.

“That would take legislative action,” Farmer said.

Even though licensees themselves pay for the background checks, the Legislature has taken the position that it would cost too much to hire state employees to look at the reports.

The new streamlining process at DOH involves three levels of "Priority 1" cases for emergency suspension orders in which the investigative process can be skipped because that has already been done by law enforcement. And in many cases, such as sexual assault or operating while drunk, there is no need for an expert witness opinion on whether the behavior constitutes malpractice because the law says so.

Farmer said Priority 1A cases should be signed in an average of 19 days, and the 1B and 1C cases in 25 days.

"That's the goal," he said.

That would represent a savings of 96 days for the Priority 1 cases and 90 days for the others, Hirst said.

Although the changes are new, they're showing up. DOH said it issued 20 emergency suspension orders last month, compared to only four in June 2010.

Here is the list of top-priority cases by category:

Priority 1A:

• Arrests that include accusations of wrong-doing related to licensed practice.

• Over prescribing, inappropriate prescribing, or inappropriate compounding (licensed practitioner and establishment).

• Sexual assault or sexual battery on a patient.

• Assault or battery on a patient.

• Allegation of gross substandard care leading to serious patient injury or death.

• Practicing while impaired from drug or alcohol abuse or mental illness.

Priority 1B Cases:

• Convictions with underlying allegation related to practice or ability to practice.

• Allegations of malpractice involving multiple patients.

• Notification that a professional enrolled in a program for impaired professionals is no longer participating.

• Sexual misconduct

• Discretionary situations as defined in section 456.074, Florida Statutes

Priority 1C Cases:

• Mandatory emergency actions as defined in that section of the law.

--Carol Gentry, Editor, can be reached at 727-410-3266 or by e-mail. We welcome Letters to the Editor.