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Oregon Bulletin

November 1, 2013

Oregon Medical Board, Chapter 847

Rule Caption: Reorganizes and updates the rules on licensure

Adm. Order No.: OMB 23-2013

Filed with Sec. of State: 10-1-2013

Certified to be Effective: 10-1-13

Notice Publication Date: 2-1-2013

Rules Amended: 847-020-0140

Subject: The rule specifies the qualifications for a Limited License, Medical Faculty and the requirements for a physician practicing with this license. The rule is being amended here because the text originally filed in April 2013 omitted a part of the sentence in section (4). This rule filing corrects that error.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-020-0140

Limited License, Medical Faculty Qualifications

(1) Any physician who does not qualify for a medical license under any of the provisions of this chapter and who is offered by the Dean of an approved medical school in this state a full-time faculty position may, after application to and approval by the Board, be granted a Limited License, Medical Faculty to engage in the practice of medicine only to the extent that such practice is incident to and a necessary part of the applicant’s duties as approved by the Board in connection with such faculty position.

(2) To qualify for a Limited License, Medical Faculty an applicant must meet all the following requirements:

(a) Furnish documentary evidence satisfactory to the Board that the applicant is a United States citizen or is legally admitted to the United States.

(b) Furnish documentary evidence satisfactory to the Board that the applicant has been licensed to practice and has practiced medicine and surgery for not less than four years in another state or country whose requirements for licensure are satisfactory to the Board, or has been engaged in the practice of medicine in the United States for at least four years in approved hospitals, or has completed a combination of such licensed practice and training.

(c) The dean of the medical school must certify in writing to the Board that the applicant has been appointed to a full-time faculty position; that a position is available; and that because the applicant has unique expertise in a specific field of medicine, the medical school considers the applicant to be a valuable member of the faculty.

(d) The head of the department in which the applicant is to be appointed must certify in writing to the Board that the applicant will be under the direction of the head of the department and will not be permitted to practice medicine unless as a necessary part of the applicant’s duties as approved by the Board in subsection (1)(a) of this rule.

(e) The applicant may be required to take and pass an examination by the Board.

(3) A Limited License, Medical Faculty is valid for one year after issuance and may be renewed as frequently as needed for a total period not to exceed four years. The four years must be consecutive.

(4) Having completed four years of practice under a Limited License, Medical Faculty and successfully passed one of the examinations or combination of examinations per OAR 847-020-0170, the applicant is eligible for licensure.

Stat. Auth.: ORS 677.132 & 677.265

Stats. Implemented: ORS 677.100, 677.110, 677.132 & 677.265

Hist. BME 9-2001, f. & cert. ef. 7-24-01; BME 2-2002, f. & cert. ef. 1-28-02; BME 5-2002, f. & cert. ef. 4-23-02; BME 3-2006, f. & cert. ef. 2-8-06; BME 4-2007, f. & cert. ef. 1-24-07; BME 18-2008, f. & cert. ef. 7-21-08; BME 23-2008, f. & cert. ef. 10-31-08; OMB 9-2013, f. & cert. ef. 4-5-13; OMB 23-2013, f. & cert. ef. 10-1-13


Rule Caption: Memorializes the authority previously delegated to the Executive Director to issue Notices of Civil Penalty

Adm. Order No.: OMB 24-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Adopted: 847-001-0040

Subject: This rule adoption puts into administrative rule the authority that has been previously delegated by the Board to the Executive Director over approving and signing Notices of Civil Penalty for violation of Board administrative rules.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-001-0040

Approval of Notices of Civil Penalty

(1) The Executive Director has the authority to issue Notices of Civil Penalty, which include default final orders, for violations of the Board’s administrative rules.

(2) The Executive Director’s signature grants approval of the Notice of Civil Penalty, which becomes a public document. As a public document, the Notice of Civil Penalty may be released to the public. However, the civil penalty is not an adverse action.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.190, 677.205, 677.265

Hist.: OMB 12-2013(Temp), f. 7-12-13, cert. ef. 7-15-13 thru 1-11-14; OMB 24-2013, f.& cert. ef. 10-15-13


Rule Caption: Board member compensation

Adm. Order No.: OMB 25-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Adopted: 847-003-0200

Subject: The new rule establishes the compensation authorized for Board members.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-003-0200

Board Member Compensation

(1) Board members of the Oregon Medical Board shall receive up to $250 compensation for each day or portion thereof during which the member is actually engaged in the performance of official duties, which includes Board and committee meetings and activities that the Board has pre-approved or requested that the member attend as its representative.

(2) The compensation amount shall be in addition to the allowable reimbursement for travel expenses.

Stat. Auth.: ORS 677.235

Stats. Implemented: ORS 292.495, 677.235

Hist.: OMB 25-2013, f.& cert. ef. 10-15-13


Rule Caption: Fee changes as approved

Adm. Order No.: OMB 26-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-005-0005

Subject: The rule amendment reflects fees approved by the legislature for the 2013-15 biennial budget, including adjusted registration fees, a $100 application fee for a physician to supervise a physician assistant, a one-time surcharge for physician assistants, and a passthrough fee for the actual cost of criminal records checks on applicants or licenses.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-005-0005

Fees

(1) Licensing Fees:

(a) Doctor of Medicine/Doctor of Osteopathy (MD/DO) Initial License Application — $375.

(b) MD/DO Registration: Active, Administrative Medicine, Inactive, Locum Tenens, Military/Public Health, Telemedicine, Telemonitoring and Teleradiology — $253/year+*.

(c) MD/DO Registration: Emeritus — $50/year.

(d) MD/DO Limited License, SPEX/COMVEX, Visiting Professor, Fellow, Medical Faculty, Postgraduate, Special Application — $185.

(e) MD/DO Application to Supervise a Physician Assistant — $100.

(f) Acupuncture Initial License Application — $245.

(g) Acupuncture Registration: Active, Inactive, Locum Tenens and Military/Public Health — $161/year*.

(h) Acupuncture Registration: Emeritus — $50/year.

(i) Acupuncture Limited License, Special, Visiting Professor, Postgraduate Application — $75.

(j) Physician Assistant Initial License Application — $245.

(k) Physician Assistant Registration: Active, Inactive, Locum Tenens and Military/Public Health — $191/year*.

(L) Physician Assistant Registration: Emeritus — $50/year.

(m) Physician Assistant Surcharge for 2014-2015 registration period — $65.

(n) Physician Assistant Limited License, Special, Postgraduate Application — $75.

(o) Podiatrist Initial Application — $340.

(p) Podiatrist Registration: Active, Administrative Medicine, Inactive, Locum Tenens, Military/Public Health, Telemedicine and Telemonitoring — $243/year*.

(q) Podiatrist Registration: Emeritus — $50/year.

(r) Podiatrist Limited License, Special, Postgraduate Application — $185.

(s) Reactivation Application Fee — $50.

(t) Electronic Prescription Drug Monitoring Program — $25/year**.

(u) Workforce Data Fee — $5/license period***.

(v) Criminal Records Check Fee — $52****.

(w) Oral Specialty or Competency Examination ($1,000 deposit required) — Actual costs.

(2) Delinquent Registration Renewals:

(a) Delinquent MD/DO Registration Renewal — $195.

(b) Delinquent Acupuncture Registration Renewal — $80.

(c) Delinquent Physician Assistant Registration Renewal — $80.

(d) Delinquent Podiatrist Registration Renewal — $195.

(3) Licensee Information Request Charges:

(a) Verification of Licensure — Individual Requests (1-4 Licenses) — $10 per license.

(b) Verification of Licensure — Multiple (5 or more) — $7.50 per license.

(c) Malpractice Report — Individual Requests — $10 per license.

(d) Malpractice Report — Multiple (monthly report) — $15 per report.

(e) Disciplinary — Individual Requests — $10 per license.

(4) Base Service Charges for Copying — $5 + .20/page.

(5) Record Search Charges (+ copy charges in section (4) of this rule):

(a) Clerical — $20 per hour.

(b) Administrative — $40 per hour.

(c) Executive — $50 per hour.

(d) Medical — $75 per hour.

(6) Data Order Charges:

(a) Standard Licensee Data Order — $150 each.

(b) Custom Licensee Data Order — $150.00 + $40.00 per hour Administrative time.

(c) Address Label Disk — $100 each.

(7) All Board fees and fines are non-refundable and non-transferable.

(8) The Board may waive or reduce fees for public records upon written request if the Board determines that making the record available primarily benefits the general public.

+Per ORS 677.290(3), fee includes $10.00 for the Oregon Health and Science University Library.

*Collected biennially excepted where noted in the Administrative Rules.

**Per ORS 431.960-431.978, fee is assessed to licensees authorized to prescribe or dispense controlled substances in Oregon for the purpose of creating and maintaining the Prescription Drug Monitoring Program administered by the Oregon Health Authority.

***Per ORS 676.410, fee is assessed for the purpose of creating and maintaining a healthcare workforce data base administered by the Oregon Health Authority.

****Per ORS 181.534(9)(g), fee is the actual cost of acquiring and furnishing criminal offender information.

Stat. Auth.: ORS 181.534, 431.972, 676.410, 677.265 & 677.290

Stats. Implemented: ORS 181.534, 192.440, 431.972, 676.410, 677.265 & 677.290

Hist.: ME 7-1984, f. & ef. 1-26-84; ME 17-1984, f. & ef. 11-5-84; ME 6-1985, f. & ef. 7-30-85; ME 3-1986(Temp), f. & ef. 4-23-86; ME 4-1986, f. & ef. 4-23-86; ME 9-1986, f. & ef. 7-31-86; ME 2-1987, f. & ef. 1-10-87; ME 7-1987(Temp), f. & ef. 1-26-87; ME 9-1987, f. & ef. 4-28-87; ME 25-1987, f. & ef. 11-5-87; ME 9-1988, f. & cert. ef. 8-5-88; ME 14-1988, f. & cert. ef. 10-20-88; ME 1-1989, f. & cert. ef. 1-25-89; ME 5-1989 (Temp), f. & cert. ef. 2-16-89; ME 6-1989, f. & cert. ef. 4-27-89; ME 9-1989(Temp), f. & cert. ef. 8-1-89; ME 17-1989, f. & cert. ef. 10-20-89; ME 4-1990, f. & cert. ef. 4-25-90; ME 9-1990, f. & cert. ef. 8-2-90; ME 5-1991, f. & cert. ef. 7-24-91; ME 11-1991(Temp), f. & cert. ef. 10-21-91; ME 6-1992, f. & cert. ef. 5-26-92; ME 1-1993, f. & cert. ef. 1-29-93; ME 13-1993, f. & cert. ef. 11-1-93; ME 14-1993(Temp), f. & cert. ef. 11-1-93; ME 1-1994, f. & cert. ef. 1-24-94; ME 6-1995, f. & cert. ef. 7-28-95; ME 7-1996, f. & cert. ef. 10-29-96; ME 3-1997, f. & cert. ef. 11-3-97; BME 7-1998, f. & cert. ef. 7-22-98; BME 7-1999, f. & cert. ef. 4-22-99; BME 10-1999, f. 7-8-99, cert. ef. 8-3-99; BME 14-1999, f. & cert. ef. 10-28-99; BME 4-2000, f. & cert. ef. 2-22-00; BME 6-2001(Temp), f. & cert. ef. 7-18-01 thru 11-30-01; BME 10-2001, f. & cert. ef. 10-30-01; BME 8-2003, f. & cert. ef. 4-24-03; BME 16-2003, f. & cert. ef. 10-23-03; BME 17-2004, f. & cert. ef. 9-9-04; BME 6-2005, f. & cert. ef. 7-20-05; BME 15-2006, f. & cert. ef. 7-25-06; BME 1-2007, f. & cert. ef. 1-24-07; BME 1-2008, f. & cert. ef. 1-22-08; BME 15-2008, f. & cert. ef. 7-21-08; BME 1-2009, f. & cert. ef. 1-22-09; BME 15-2009(Temp), f. & cert. ef. 9-11-09 thru 3-8-10; BME 1-2010, f. & cert. ef. 1-26-10; OMB 10-2011(Temp), f. & cert. ef. 7-13-11 thru 1-4-12; OMB 18-2011(Temp), f. & cert. ef. 10-13-11 thru 4-10-12; OMB 22-2011, f. & cert. ef. 10-18-11; OMB 33-2011(Temp), f. 12-28-11, cert. ef. 1-1-12 thru 6-29-12; OMB 3-2012, f. & cert. ef. 2-10-12; OMB 9-2012(Temp), f. & cert. ef. 3-2-12 thru 8-29-12; OMB 20-2012, f. & cert. ef. 8-3-12; OMB 27-2012(Temp), f. 10-12-12 thru 4-10-13; OMB 5-2013, f. & cert. ef. 4-5-13; OMB 13-2013(Temp), f. 7-12-13, cert. ef. 7-15-13 thru 1-11-14; OMB 26-2013, f. & cert. ef. 10-15-13


Rule Caption: Memorializes the licensing authority previously delegated to the Executive Director and Medical Director

Adm. Order No.: OMB 27-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Adopted: 847-008-0003

Subject: The rule adoption puts into administrative rule the licensing authority that has been previously delegated by the Board to the Executive Director and Medical Director.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-008-0003

Delegation of Authority

(1) The Executive Director or, in the absence of the Executive Director, the Medical Director has the authority to grant, renew and reactivate licensure for all license types and statuses upon satisfactory completion of the application.

(2) The Executive Director or, in the absence of the Executive Director, the Medical Director has the authority to approve visiting physician applications and visiting acupuncturist applications.

(3) The Executive Director has the authority to waive the registration fee for good and sufficient reason.

(4) The Executive Director has the authority to require additional documentation or explanatory statements for the application file to be considered satisfactorily complete.

(5) The Executive Director has the authority to determine that an applicant qualifies for licensure by expedited endorsement.

(6) The Executive Director has the authority to perform initial reviews of applications to determine whether an applicant or licensee meets the qualifications, has satisfactorily completed the application and should be approved or whether the application file contains derogatory information that requires review by an advisory committee and a determination by the Board.

(7) The Executive Director has the authority to perform initial reviews of re-entry plans for applicants who have ceased clinical practice for a period of 24 or more consecutive months to determine whether the proposed re-entry plan meets the Board’s guidelines for re-entry or whether the proposal requires review by an advisory committee and a determination by the Board.

(8) The Medical Director has the authority to determine whether an applicant or licensee has significant malpractice claims or patient care issues that require additional review by an advisory committee and a determination by the Board.

(9) The Executive Director has the authority to grant waivers of the competency examinations if the applicable waiver requirements are met.

Stat. Auth.: ORS 677.235

Stats. Implemented: ORS 292.495, 677.235

Hist.: OMB 14-2013(Temp), f. 7-12-13, cert. ef. 7-15-13 thru 1-11-14; OMB 27-2013, f. & cert. ef. 10-15-13


Rule Caption: Merges the names of the two former national databanks into one

Adm. Order No.: OMB 28-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-008-0055

Subject: The rule amendment reflects the merger of the two national databanks (formerly the National Practitioner Data Bank and the Health Integrity & Protection Data Bank) into one (now known as the National Practitioner Data Bank).

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-008-0055

Reactivation from Locum Tenens/Inactive/Emeritus/Active-Military or Public Health to Active/Locum Tenens Status

(1) A licensee of the Board who wishes to reactivate from an inactive or emeritus status to an active or locum tenens status, or from locum tenens status to active status, must provide the Board with the following:

(a) Completed Affidavit of Reactivation form;

(b) Completed application(s) for registration;

(c) Appropriate fees for processing of affidavit and registration;

(d) A Board Action Databank Inquiry report sent directly to the Board from the Federation of State Medical Boards or Federation of Podiatric Medical Boards;

(e) The results of a Practitioner Self-Query from the National Practitioner Data Bank sent to the Board by the applicant;

(f) Verification of current licensure sent directly from each of the State Boards in the United States or Canada where the licensee has been practicing during the past 5 years, or from the date the license to practice in Oregon changed to inactive, locum tenens or emeritus status, whichever is the shorter period of time, showing license number, date issued, and status; and

(g) An official letter sent directly to the Board from the director, administrator, dean, or other official of each hospital, clinic, office, or training institute where the licensee was employed, practiced, had hospital privileges (MD/DO/DPM), or trained in the United States or foreign countries during the past 5 years, or from the date the license to practice in Oregon changed to locum tenens, inactive or emeritus status, whichever is the shorter period of time. The letter must include an evaluation of overall performance, and specific beginning and ending dates of practice/employment/training.

(2) A licensee who wishes to reactivate from an active-military or public health status to an active or locum tenens status must provide the Board with a completed Affidavit of Reactivation form and a copy of the Active Duty Orders, Change of Duty Orders or Reassignment Orders.

(3) A personal appearance before the Board may be required.

(4) If, in the judgment of the Board, the conduct of the licensee has been such, during the period of active-military or public health, locum tenens, inactive or emeritus registration, that the licensee would have been denied a license if applying for an initial license to practice medicine, the Board may deny active registration.

(5) If a licensee has ceased the practice of medicine for a period of 12 or more consecutive months, the licensee may be required to demonstrate clinical competency.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.265

Hist.: ME 5-1990, f. & cert. ef. 4-25-90; ME 2-1997, f. & cert. ef. 7-28-97; BME 6-2000, f. & cert. ef. 7-27-00; BME 7-2002, f. & cert. ef. 7-17-02; BME 2-2004, f. & cert. ef. 1-27-04; BME 14-2004, f. & cert. ef. 7-13-04; BME 25-2006, f. & cert. ef. 10-23-06; BME 2-2008, f. & cert. ef. 1-22-08; OMB 12-2011, f. & cert. ef. 7-13-11; OMB 28-2013, f. & cert. ef. 10-15-13


Rule Caption: Fee for criminal records checks as approved

Adm. Order No.: OMB 29-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-008-0068

Subject: The rule amendment specifies that the criminal records check cost will be passed through to the applicant or licensee as approved by the legislature in the 2013-15 budget.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-008-0068

State and Nationwide Criminal Records Checks, Fitness Determinations

(1) The purpose of these rules is to provide for the reasonable screening of applicants and licensees in order to determine if they have a history of criminal behavior such that they are not fit to be granted or renewed a license that is issued by the Board.

(2) These rules are to be applied when evaluating the criminal history of an applicant or licensee and conducting fitness determinations based upon such history. The fact that an applicant or licensee has cleared the criminal history check does not guarantee the granting or renewal of a license.

(3) The Board may require legible fingerprints of all applicants for a medical (MD/DO), podiatric (DPM), physician assistant (PA), and acupuncturist (LAc) license, licensees reactivating their license, licensees renewing their license and licensees under investigation to determine the fitness of an applicant or licensee. These fingerprints will be provided on prescribed forms made available by the Board. Fingerprints may be obtained at a law enforcement office or at a private service acceptable to the Board; the Board will submit fingerprints to the Oregon Department of State Police to conduct a Criminal History Check and a National Criminal History Check. Any original fingerprint cards will subsequently be destroyed.

(4) The Board will determine whether an applicant or licensee is fit to be granted a license based on the criminal records background check, any false statements made by the applicant or licensee regarding the criminal history of the individual, any refusal to submit or consent to a criminal records check including fingerprint identification, and any other pertinent information obtained as part of an investigation. If an applicant is determined to be unfit, the applicant may not be granted a license. If the licensee is determined to be unfit, the licensee’s license may not be reactivated or renewed. The Board may make a fitness determination conditional upon applicant’s or licensee’s acceptance of probation, conditions, limitations, or other restrictions upon licensure.

(5) In making the fitness determination, the Board will consider:

(a) The nature of the crime;

(b) The facts that support the conviction or pending indictment or that indicate the making of the false statement;

(c) The relevancy, if any, of the crime or the false statement to the specific requirements of the applicant’s or licensee’s present or proposed license; and

(d) Intervening circumstances relevant to the responsibilities and circumstances of the license. Intervening circumstances include but are not limited to:

(A) The passage of time since the commission of the crime;

(B) The age of the applicant or licensee at the time of the crime;

(C) The likelihood of a repetition of offenses or of the commission of another crime;

(D) The subsequent commission of another relevant crime;

(E) Whether the conviction was set aside and the legal effect of setting aside the conviction; and

(F) A recommendation of an employer.

(6) All background checks must include available state and national data, unless obtaining one or the other is an acceptable alternative.

(7) In order to conduct the Oregon and National Criminal History Check and fitness determination, the Board may require additional information from the licensee or applicant as necessary, such as but not limited to, proof of identity; residential history; names used while living at each residence; or additional criminal, judicial or other background information.

(8) Criminal offender information is confidential. Information received may be disseminated only to people with a demonstrated and legitimate need to know the information. The information is part of the investigation of an applicant or licensee and as such is confidential pursuant to ORS 676.175(1).

(9) The Board will permit the individual for whom a fingerprint-based criminal records check was conducted to inspect the individual’s own state and national criminal offender records and, if requested by the subject individual, provide the individual with a copy of the individual’s own state and national criminal offender records.

(10) The Board may consider any conviction of any violation of the law for which the court could impose a punishment and in compliance with ORS 670.280. The Board may also consider any arrests and court records that may be indicative of an individual’s inability to perform as a licensee with care and safety to the public.

(11) If an applicant or licensee is determined not to be fit for a license, the applicant or licensee is entitled to a contested case process pursuant to ORS 183.414-183.470. Challenges to the accuracy or completeness of information provided by the Oregon Department of State Police, Federal Bureau of Investigation and agencies reporting information must be made through the Oregon Department of State Police, Federal Bureau of Investigation, or reporting agency and not through the contested case process pursuant to ORS 183.

(12) If the applicant discontinues the application process or fails to cooperate with the criminal history check process, the application is considered incomplete.

(13) The applicant or licensee must pay a criminal records check fee.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 181.534, 677.100 & 677.265

Hist. BME 20-2006(Temp), f. & cert. ef. 9-14-06 thru 3-12-07; BME 4-2007, f. & cert. ef. 1-24-07; BME 4-2008, f. & cert. ef. 1-22-08; OMB 20-2011(Temp), f. & cert. ef. 10-13-11 thru 4-10-12; OMB 5-2012, f. & cert. ef. 2-10-12; OMB 10-2012(Temp), f. & cert. ef. 3-2-12 thru 8-29-12; OMB 24-2012, f. & cert. ef. 8-3-12; Renumbered from 847-020-0155 by OMB 6-2013, f. & cert. ef. 4-5-13; OMB 15-2013(Temp), f. 7-12-12, cert. ef. 7-15-13 thru 1-11-14; OMB 29-2013, f. & cert. ef. 10-15-13


Rule Caption: Corrects the licensing process for Limited License, Medical Faculty

Adm. Order No.: OMB 30-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-010-0063

Subject: The rule amendment accurately reflects that the Limited License, Medical Faculty is approved weekly rather than quarterly as a result of the delegation of these license application approvals to the Executive Director in July 2010.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-010-0063

Limited License, Medical Faculty

(1) A physician qualifying under OAR 847-020-0140 may be granted a Limited License, Medical Faculty. This license allows the physician to practice medicine only to the extent that such practice is incident to and a necessary part of the applicant’s duties as approved by the Board in connection with the faculty position.

(2) A Limited License, Medical Faculty is valid for one year after issuance and may be renewed as frequently as needed for a total period not to exceed four years. The four years must be consecutive.

(3) Every physician who is issued a Limited License, Medical Faculty to practice in this state and who intends to continue practice in such faculty position beyond the period granted for the license must submit a new limited license application and fee at least 30 days before the expiration date of the license.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.100 & 677.132

Hist.: ME 21-1987, f. & ef. 10-29-87; ME 11-1988, f. & cert. ef. 8-5-88; ME 4-1993, f. & cert. ef. 4-22-93; BME 5-2001, f. & cert. ef. 4-23-01; BME 2-2002, f. & cert. ef. 1-28-02; BME 5-2004, f. & cert. ef. 4-22-04; BME 3-2007, f. & cert. ef. 1-24-07; BME 23-2008, f. & cert. ef. 10-31-08; OMB 16-2013(Temp), f. 7-12-13, cert. ef. 7-15-13 thru 1-11-14; OMB 30-2013, f. & cert. ef. 10-15-13


Rule Caption: Expands Visiting Physician approval to physicians volunteering at community nonprofit organizations

Adm. Order No.: OMB 31-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-010-0066

Subject: The rule amendment expands the visiting physician approval to include out-of-state physicians who provide health care services without compensation at a community nonprofit organization such as a county health fair. The rule amendment also deletes the requirement for the visiting physician applicant to submit a curriculum vitae as the needed information is now gathered through the electronic application process.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-010-0066

Visiting Physician Requirements

(1) The Oregon Medical Board may grant approval for a visiting physician to practice under the supervision of an actively licensed Oregon physician who is in good standing without disciplinary action in order to:

(a) Obtain or provide training unrelated to enrollment in a postgraduate training program for a period up to thirty days per year in a hospital, ambulatory surgical center or accredited office-based surgery facility per OAR 847-017-0010; or

(b) Provide health care services without compensation at a community nonprofit organization for a period up to five consecutive days per year.

(2) Prior to being granted approval, the physician must submit an application and the following information to the Board:

(a) A letter from the requesting hospital administrator or administrator of the accredited facility and a letter from the hospital chief of staff, hospital department chairperson or member of the governing body of the accredited facility; or a letter from the community nonprofit organization; or a letter from the Oregon licensed physician supervising the visiting physician. The letter(s) must contain the following information:

(A) Dates of Oregon practice of the visiting physician;

(B) Description of the procedure(s);

(C) Name of the responsible Oregon-licensed staff physician who will supervise; and

(D) If the visiting physician application is requested under section (1)(a) of this rule, documentation that the requesting hospital, ambulatory surgical center or accredited facility has approved privileges for the visiting physician.

(b) Documentation that the visiting physician’s license in the state or country in which they are practicing is active and in good standing.

(3) The visiting physician application must be submitted at least two weeks prior to the beginning date of such practice.

(4) Patients shall be informed that they are being treated by an approved visiting physician, who is not an Oregon licensed physician.

(5) The visiting physician who requests additional time in Oregon must apply for and obtain a license to practice in the State of Oregon.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.132, 677.265

Hist.: BME 7-2000, f. & cert. ef. 7-27-00; BME 13-2002, f. & cert. ef. 10-25-02; BME 24-2006, f. & cert. ef. 10-23-06; BME 17-2009, f. & cert. ef. 10-23-09; OMB 31-2013, f. & cert. ef. 10-15-13

Rule Caption: Drug dispensing, distribution and administration requirements

Adm. Order No.: OMB 32-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-015-0025

Subject: The rule amendment establishes documentation standards for drugs dispensed, distributed or administered; requires provision of take-home instructions for drugs dispensed or distributed; clarifies that distribution, as defined by the Board of Pharmacy, is distinct from dispensing; and clarifies that a physician supervising a physician assistant with drug dispensing authority without first registering as a dispensing physician is a violation of the rule.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-015-0025

Dispensing, Distribution and Administration

(1) Any actively licensed physician or podiatric physician who dispenses drugs must register with the Board as a dispensing physician before beginning to dispense drugs.

(2) A physician must register with the Board as a dispensing physician before supervising a physician assistant or any other health care provider with dispensing privileges.

(3) At the time of license registration renewal, all dispensing physicians must indicate their status as a dispensing physician on the registration renewal form.

(4) Dispensing of drugs must be documented in the patient record. Documentation must include the name of the drug, the dose, the quantity dispensed, the directions for use and the name of the physician or physician assistant dispensing the drugs. The physician or physician assistant must verbally counsel the patient concerning any new medications and must provide written information on the directions for use.

(5) Distribution of samples, without charge, is not dispensing under this rule. Distribution of samples must be documented in the patient record. Documentation must include the name of the drug, the dose, the quantity distributed and the directions for use. The physician or physician assistant must verbally counsel the patient concerning any new medications and must provide written information on the directions for use.

(6) Administering drugs in the physician’s or podiatric physician’s office is not dispensing under this rule. Administration of drugs must be documented in the patient record. Documentation must include the name of the drug, the dose and the quantity administered.

(7) Any physician or podiatric physician who dispenses drugs or who supervises a physician assistant with drug dispensing authority without first registering with the Board will be fined $195 and may be subject to further disciplinary action by the Board.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.010, 677.089, 677.510, 677.515

Hist.: ME 22-1987, f. & ef. 10-29-87; ME 9-1993, f. & cert. ef. 7-27-93; BME 1-2005, f. & cert. ef. 1-27-05; BME 24-2007, f. & cert. ef. 10-24-07; OMB 30-2011, f. & cert. ef. 10-27-11; OMB 32-2013, f. & cert. ef. 10-15-13


Rule Caption: Defines office-based procedures and clarifies provider qualifications and requirements

Adm. Order No.: OMB 33-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Adopted: 847-017-0003, 847-017-0008, 847-017-0037

Rules Amended: 847-017-0000, 847-017-0005, 847-017-0010, 847-017-0015, 847-017-0020, 847-017-0025, 847-017-0030, 847-017-0035, 847-017-0040

Subject: The rule amendments classify levels of office-based surgeries and set forth the corresponding requirements; reorganize and add new definitions; establish a standard of practice for licensees performing office-based surgery; set forth requirements for office-based surgery facilities; clarify the assessment and informed consent procedures prior to the performance of an office-based surgery; clarify the requirements for patient medical records; expand the emergency care and transfer protocol requirements; require reporting of specified office-based surgical adverse events; and contain general grammar and language housekeeping changes.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-017-0000

Preamble

Licensees of the Oregon Medical Board providing office-based invasive procedures are accountable for the welfare and safety of their patients and responsible for ensuring that the performance of these procedures meets the standard of care.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0003

Classification of Office-Based Surgery

Office-based surgeries are classified by complexity.

(1) Level I are minor surgical procedures performed without anesthesia or under topical, local, or minor conduction block anesthesia not involving drug-induced alteration of consciousness, other than minimal sedation utilizing preoperative oral anxiolytic medications.

(a) The licensee must pursue continuing medical education in the field for which the services are being provided and in the proper drug dosages, management of toxicity, and hypersensitivity to local anesthetic and other drugs.

(b) The licensee must maintain active basic life support (BLS) certification.

(2) Level II are minor or major surgical procedures performed under moderate sedation/analgesia, such as oral, parenteral, or intravenous sedation or under analgesic or dissociative drugs.

(a) In addition to the requirements in section (1) of this rule, the licensee must:

(A) Maintain board certification or board eligibility in a specialty recognized by the American Board of Medical Specialties (ABMS), the American Osteopathic Association’s Bureau of Osteopathic Specialists (AOA-BOS), the American Board of Podiatric Medicine (ABPM), the American Board of Podiatric Surgery (ABPS) or the National Commission on Certification of Physician Assistants (NCCPA), or

(B) Obtain fifty hours each year of accredited continuing medical education (CME) relevant to the Level II surgical procedures to be performed in the office-based facility. This requirement may not be satisfied with cultural competency CME or other CME that is only generally relevant to the licensee’s practice.

(b) The licensee must be certified in advanced resuscitative techniques and must be on site at all times when patients are under the effects of anesthetic.

(c) The patient must be appropriately monitored as defined in 847-017-0005.

(3) Level III are major surgical procedures that require deep sedation/analgesia, general anesthesia, or regional blocks, and require support of vital bodily functions.

(a) In addition to the requirements in section (1) of this rule, the licensee must:

(A) Have staff privileges to perform the same procedure in a hospital or ambulatory surgical center, or

(B) Maintain board certification or board eligibility in an appropriate specialty recognized by the ABMS, the AOA-BOS, the ABPM, the ABPS or the NCCPA.

(b) The licensee must be certified in advanced resuscitative techniques and must be on site at all times when patients are under the effects of anesthetic.

(c) The patient must be appropriately monitored as defined in 847-017-0005.

(d) The licensee performing the procedure may not administer anesthesia other than additional local anesthesia and may not be primarily responsible for monitoring anesthesia during the procedure.

(4) Procedures or treatments involving the injection of a medication or substance for cosmetic purposes are the practice of medicine and must be performed as an office-based surgical procedure.

(5) Lipoplasty involving the removal of 500 cc or less volume of supernatant fat may be performed as a Level I surgical procedure. Office-based lipoplasty involving more than 500 cc volume of supernatant fat must be performed as a Level II or Level III surgical procedure.

(a) The performance of lipoplasty in an office-based setting may not result in the removal of more than 5% of total body weight or more than 4500 cc volume of supernatant fat removed, whichever is less.

(b) The licensee may not use more than 55 mg/kg of Lidocaine or 70 mcg/kg of epinephrine for tumescent anesthesia. The concentration of epinephrine in tumescent solutions may not exceed 1.5 mg/L.

(6) The following may not be performed in an office-based surgical facility:

(a) Procedures that may result in blood loss of more than 4% of the estimated blood volume in a patient with a normal hemoglobin;

(b) Procedures requiring intracranial, intrathoracic, or abdominal cavity entry; and

(c) Joint replacement procedures.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.265

Hist.: OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0005

Definitions

For the purpose of these rules, the following terms are defined:

(1) “Ambulatory surgical center” has the meaning given in ORS 442.015. Nothing in OAR chapter 847, division 17 is meant to exempt a physician’s office from the licensure requirements in ORS 441.015 if the office meets the definition of an ambulatory surgical center in ORS 442.015. A physician’s office that meets the definition of an ambulatory surgical center must comply with OAR chapter 333, division 76.

(2) “Board” means the Oregon Medical Board.

(3) “Certified in advanced resuscitative techniques” means that the individual is currently certified either with Advanced Cardiac Life Support (ACLS) for adults or Pediatric Advanced Life Support (PALS) or Advanced Pediatric Life Support (APLS) for children.

(4) “Deep sedation/analgesia” means the administration of a drug or drugs that produces depression of consciousness during which patients cannot be easily aroused and only respond purposefully following repeated or painful stimulation. The ability to independently maintain ventilatory function may be impaired. Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate.

(5) “Facility” has the same definition as “office.”

(6) “General anesthesia” means a drug-induced loss of consciousness during which patients are not able to be aroused, even by painful stimulation. The ability to independently maintain ventilatory function is often impaired. Patients often require assistance in maintaining a patent airway, and positive pressure ventilation may be required because of depressed spontaneous ventilation or drug-induced depression of neuromuscular function.

(7) “Health care personnel” means any person, licensed or unlicensed, who is directly related to the provision of health care services including, but not limited to, a physician assistant, nurse practitioner, certified registered nurse anesthetist, registered nurse, licensed practical nurse or medical assistant.

(8) “Hospital” has the meaning given in ORS 442.015.

(9) “Licensee” means an individual holding a valid license issued by the Board.

(10) “Lipoplasty” means any instrumentation under the skin through incisions for the reduction of subcutaneous volume. This includes, but is not limited to, liposuction, laser lipolysis, suction assisted lipectomy and liposculpture.

(11) “Local anesthesia” means the administration of a drug or drugs that produces a transient and reversible loss of sensation in a circumscribed portion of the body.

(12) “Minimal sedation” (anxiolysis) means the administration of a drug or drugs that produces a state of consciousness that allows the patient to tolerate unpleasant medical procedures while responding normally to verbal commands. Cardiovascular or respiratory function is unaffected and defensive airway reflexes remain intact.

(13) “Minor conduction block” means the injection of local anesthesia to stop or prevent a painful sensation in a circumscribed area of the body (that is, infiltration or local nerve block), or the block of a nerve by direct pressure and refrigeration. Minor conduction blocks include but are not limited to, intercostal, retrobulbar, paravertebral, peribulbar, pudendal, and sciatic nerve and ankle blocks.

(14) “Moderate sedation/analgesia” means the administration of a drug or drugs that produces depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by a light tactile stimulation. Reflex withdrawal from painful stimulation is NOT considered a purposeful response. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate.

(15) “Monitor” means regular visual observation and continuous physiologic measurement of the patient as deemed appropriate by the level of sedation or recovery using appropriate instruments to measure, display, and record physiologic values, such as heart rate, blood pressure, respiration, oxygen saturation, and end tidal capnography.

(16) “Office” means a location, other than a hospital or ambulatory surgical center, at which medical or surgical services are rendered.

(17) “Office-based surgery” means the performance of any surgical or other invasive procedure requiring anesthesia, analgesia, or sedation, including cryosurgery, laser surgery and the use of lasers that penetrate the skin, which results in patient stay of less than 24 consecutive hours and is performed by a licensee in a location other than a hospital or ambulatory surgical center.

(18) “PARQ conference” means a Procedures, Alternatives, Risks and Questions conference, in which the licensee performing the procedure explains in general terms the procedure or treatment to be undertaken, any alternative procedures or methods of treatment, and any risks to the procedure or treatment and allows questions from the patient.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0008

Standard of Practice

A licensee performing office-based surgery must have received appropriate training and education in the safe and effective performance of all surgical procedures performed in the office. Such training and education should include:

(1) Indications and contraindications for each procedure;

(2) Identification and selection of appropriate patients for each procedure;

(3) Identification of realistic and expected outcomes of each procedure;

(4) Selection, maintenance, and utilization of products and equipment;

(5) Appropriate technique for each procedure, including infection control and safety precautions;

(6) Pharmacological intervention specific to each procedure;

(7) Identification of complications and adverse reactions for each procedure;

(8) Standards in surgical medical care; and

(9) Emergency procedures to be used in the event of:

(a) Complications;

(b) Adverse reactions; or

(c) Equipment malfunction.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.265

Hist.: OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0010

Licensee Use of Office-Based Surgical Facilities

A licensee performing office-based surgery must ensure that the facility meets standards to ensure patient safety.

(1) Facilities where office-based surgeries are performed must comply with all federal and state laws and regulations that affect the practice.

(2) Facilities where Level II or Level III office-based surgeries are performed must be accredited by an appropriate, Board-recognized accreditation agency, including the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), the Accreditation Association of Ambulatory Health Care (AAAHC), the Joint Commission, or the Institute for Medical Quality (IMQ). Facilities accredited by the Oregon Medical Association (OMA) prior to January 1, 2013, will continue to be recognized as accredited facilities until the accreditation period expires. Licensees of the Board performing office-based procedures in a new or existing facility, must ensure that facility is accredited within one year of the start date of the office-based procedures being performed or the date these rules are adopted, whichever is later. During the period of time the facility is in the accreditation process, the facility will make changes to come into compliance with the Administrative Rules in this Division.

(3) Facilities where Level II or Level III office-based surgeries are performed must provide health care personnel who have appropriate education and training for administration and monitoring of moderate sedation/analgesia, deep sedation/analgesia, general anesthesia or regional block.

(4) A licensee who holds a MD or DO degree as well as a DDS (Doctor of Dental Surgery) or DMD (Doctor of Dental Medicine) degree and is an active member of the Oregon Society of Oral Maxillofacial Surgeons (OSOMS) may perform maxillofacial procedures in a facility approved by the OSOMS and function under the administrative rules of the Oregon Board of Dentistry, OAR chapter 818, division 026. For all procedures that are not oral maxillofacial in nature, licensees with medical and dental licenses must follow rules laid out in OAR chapter 847, division 017.

Stat. Auth.: ORS 677.265, 679.255

Stats. Implemented: ORS 677.060, 677.265, 679.255

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; BME 14-2007, f. & cert. ef. 7-23-07; BME 10-2008, f. & cert. ef. 4-24-08; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0015

Selection of Procedures and Patients

(1) The licensee who performs the office-based surgery or anesthetic is responsible for the safety of the patient.

(a) The licensee must evaluate and document the condition of the patient and the potential risks associated with the proposed treatment plan;

(b) The licensee must be satisfied that the procedure to be undertaken is within the scope of practice of the health care personnel, the capabilities of the facility and the condition of the patient; and

(c) The licensee must examine the patient immediately before the procedure to evaluate the risks of the procedure and the risks of anesthesia if applicable.

(2) Informed consent for the nature and objectives of the anesthesia planned and office-based surgery to be performed must be in writing and obtained from the patient[s] before the office-based surgery is performed. Informed consent is only to be obtained after a PARQ conference and must be documented in the medical record. The informed consent must include a disclosure of the licensee’s specialty board certification through the ABMS, the AOA-BOS, the ABPM, the ABPS or the NCCPA or lack thereof. The requirement for written informed consent is not necessary for minor Level I procedures limited to the skin and mucosa.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0020

Patient Medical Records

(1) A legible, complete, comprehensive and accurate medical record must be maintained for each patient evaluated or treated. The record must include:

(a) Identity of the patient;

(b) History and physical, diagnosis and plan;

(c) Appropriate lab, x-ray or other diagnostic reports;

(d) Documentation of the PARQ conference;

(e) Disclosure of the licensee’s specialty board certification through the ABMS, the AOA-BOS, the ABPM, the ABPS or the NCCPA or lack thereof;

(f) Appropriate preanesthesia evaluation;

(g) Narrative description of procedure;

(h) Intraoperative and postoperative monitoring;

(i) Pathology reports;

(j) Documentation of the outcome and the follow-up plan; and

(k) Provision for continuity of post-procedure care.

(2) If the office-based surgery is a Level II or Level III surgical procedure, the patient record must include a separate anesthetic record that contains documentation of anesthetic provider, procedure, and technique employed. This must include the type of anesthesia used, drugs (type and dose) and fluids administered during the procedure, patient weight, level of consciousness, estimated blood loss, duration of procedure, and any complication or unusual events related to the procedure or anesthesia.

(3) The patient record must document if tissues and other specimens have been submitted for histopathologic diagnosis.

(4) The licensee must ensure that the facility has specific and current protocols in place for patient confidentiality and security of all patient data and information.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0025

Discharge Evaluation

The licensee performing the procedure is responsible for the determination that the patient is safe to be discharged from the office after the procedure.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0030

Emergency Care and Transfer Protocols

In facilities where Level II or Level III office-based surgeries are performed, the licensee must ensure that a written plan is in place for the provision of emergency medical care as well as the safe and timely transfer of patients to a nearby hospital should hospitalization be necessary.

(1) Age-appropriate emergency supplies, equipment, and medication should be provided in accordance with the scope of surgical and anesthesia services provided at the licensee’s office.

(2) All office personnel must be familiar with the documented plan for arranging emergency medical services and the safe and timely transfer of patients to a nearby hospital and must be able to take necessary actions. If cardiopulmonary resuscitation (CPR) is instituted, the plan must include immediate contact with emergency medical services.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0035

Quality Assessment

(1) Office-based surgical practices must develop a system of quality assessment that effectively and efficiently strives for continuous quality improvement.

(2) Documentation of complications and adverse incident review must be available.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0037

Reporting Requirement

(1) Licensees performing office-based surgery must report the following complications and adverse incidents to the Board within ten business days of the event if the complication occurred within 30 days of the procedure:

(a) Surgical related death;

(b) Emergency transfer of the surgical patient to the hospital;

(c) Anesthetic or surgical event requiring cardiopulmonary resuscitation (CPR); and

(d) Unscheduled hospitalization related to the office-based surgery.

(2) Licensees performing or intending to perform office-based surgery must report any restriction, limitation, loss or denial of privileges in a hospital or accredited outpatient facility within ten business days of the restriction, limitation, loss or denial of privileges.

(3) The Board will review reports made under this rule to determine whether an investigation is necessary.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.415

Hist.: OMB 33-2013, f. & cert. ef. 10-15-13

847-017-0040

Facility Administration and Equipment

The licensee must ensure that specific and current arrangements are in place for obtaining laboratory, radiological, pathological and other ancillary services as may be required to support the surgical and/or anesthetic procedures undertaken.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.085, 677.097, 677.265

Hist.: BME 23-2006, f. & cert. ef. 10-23-06; OMB 33-2013, f. & cert. ef. 10-15-13


Rule Caption: Merges the names of the two former national databanks into one

Adm. Order No.: OMB 34-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-020-0150, 847-020-0185

Subject: The rule amendment merges the two national databanks (formerly the National Practitioner Data Bank and the Health Integrity and Protection Data Bank) into one (now known as the National Practitioner Data Bank).

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-020-0150

Documents and Forms to be Submitted for Licensure

The documents submitted must be legible and no larger than 8 1/2” x 11”. All documents and photographs will be retained by the Board as a permanent part of the application file. If original documents are larger than 8 1/2” x 11”, the copies must be reduced to the correct size with all wording and signatures clearly shown. Official translations are required for documents issued in a foreign language. The following documents are required:

(1) Application: Completed formal application provided by the Board. Required dates must include month, day and year.

(2) Birth Certificate: A copy of birth certificate.

(3) Medical School Diploma: A copy of a diploma showing graduation from an approved school of medicine or an international school of medicine.

(4) American Specialty Board Certificate or Recertification Certificate: A copy of the certificate issued by the American Specialty Board in the applicant’s specialty, if applicable.

(5) Photograph: A close-up, passport quality photograph, front view, head and shoulders (not profile), with features distinct, taken within 90 days preceding the filing of the application.

(6) The results of a Practitioner Self-Query from the National Practitioner Data Bank sent to the Board by the applicant.

(7) Legible fingerprints as described in 847-008-0068 for the purpose of a criminal records background check.

(8) An applicant must pass an open-book examination on the Medical Practice Act (ORS Chapter 677) and an open-book examination on the Drug Enforcement Administration’s regulations governing the use of controlled substances. If an applicant fails one or both examinations three times, the applicant’s application will be reviewed by the Board’s Administrative Affairs Committee and the applicant must attend an informal meeting with a Board member, a Board investigator and/or the Medical Director of the Board to discuss the applicant’s failure of the examination(s), before being given a fourth and final attempt to pass the examination(s). If the applicant does not pass the examination(s) on the fourth attempt, the applicant may be denied licensure.

(9) Any other documentation or explanatory statements as required by the Board.

Stat. Auth.: ORS 677.100 & 677.265

Stats. Implemented: ORS 677.010 & 677.265

Hist. BME 9-2001, f. & cert. ef. 7-24-01; BME 3-2006, f. & cert. ef. 2-8-06; BME 15-2007, f. & cert. ef. 7-23-07; BME 20-2007, f. & cert. ef. 10-24-07; BME 6-2010, f. & cert. ef. 4-26-10; OMB 9-2013, f. & cert. ef. 4-5-13; OMB 34-2013, f. & cert. ef. 10-15-13

847-020-0185

License Application Withdrawals

(1) The Board will consider a request by an applicant to withdraw his/her application for licensure in the State of Oregon under the following circumstances:

(a) The applicant is eligible for licensure; and

(b) The file contains no evidence of violation of any provision of ORS 677.010 — 677.855.

(2) An applicant may request to withdraw his/her application for licensure in the State of Oregon and the withdrawal will be reported to the Federation of State Medical Boards under the following circumstances:

(a) The applicant is eligible for licensure; and

(b) The file contains evidence that the applicant may have violated any provision of ORS 677.010 — 677.855, but the Board has decided that there is an insufficient basis to proceed to formal discipline, or a licensing body in another state has imposed formal discipline or entered into a consent agreement for the same conduct, and that action has been reported to the National Practitioner Data Bank.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.100, 677.190, 677.265

Hist.: BME 11-2006, f. & cert. ef. 5-8-06; OMB 34-2013, f. & cert. ef. 10-15-13


Rule Caption: Licensure for military spouses or domestic partners

Adm. Order No.: OMB 35-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 9-1-2013

Rules Adopted: 847-020-0165, 847-050-0022, 847-070-0024, 847-080-0016

Rules Repealed: 847-020-0165(T), 847-050-0022(T), 847-070-0024(T), 847-080-0016(T)

Subject: The new rules implement an augmented process for licensure of military spouses or domestic partners as required by 2013 House Bill 2037. Four rules are included (broken down by appropriate division of the administrative rules) for medical and osteopathic physicians, physician assistants, acupuncturists, and podiatric physicians. Specifically, each rule defines “military spouse or domestic partner,” provides the qualifications for this augmented process, provides the documents that will be accepted in lieu of other documents, lists any information that the Board will obtain on behalf of the applicant, and specifies the additional documents that will be required as part of this augmented application process.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-020-0165

Application for Licensure by Military Spouse or Domestic Partner

(1) “Military spouse or domestic partner” means a spouse or domestic partner of an active member of the Armed Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure under this rule, the military spouse or domestic partner must:

(a) Meet the qualifications for licensure as stated in OAR 847-020-0120, 847-020-0130, and 847-020-0170;

(b) Be married to, or in a domestic partnership with, a member of the Armed Forces of the United States who is assigned to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice medicine in another state or territory of the United States;

(d) Be in good standing, with no restrictions or limitations upon, actions taken against, or investigation or disciplinary action pending against his or her license in any jurisdiction where the applicant is or has been licensed; and

(e) Have at least one year of active practice or teaching of medicine during the three years immediately preceding the application.

(3) If a military spouse or domestic partner applies for a license to practice medicine, the Board may accept:

(a) A copy of the medical school diploma to fulfill the requirement for a Dean’s Letter of Recommendation and the Verification of Medical Education form; and

(b) Verification of licensure in good standing from the jurisdiction of current or most recent practice of medicine to fulfill the requirement of verifications of licensure from all jurisdictions of prior and current health related licensure.

(4) If a military spouse or domestic partner applies for a license to practice medicine, the Board will obtain the following on behalf of the applicant:

(a) The results of a query of the National Practitioner Data Bank; and

(b) The results of a query of the Federation of State Medical Boards’ Board Action Data Bank.

(5) In addition to the documents required in section (3) of this rule and by OAR 847-020-0150 and 847-020-0160, the military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or domestic partnership registration with the name of the applicant and the name of the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station located in Oregon by official active duty military order for the spouse or domestic partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265 & HB 2037 (2013)

Stats. Implemented: ORS 677.010, 677.100, 677.265 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 35-2013, f. & cert. ef. 10-15-13

847-050-0022

Application for Licensure by Military Spouse or Domestic Partner

(1) “Military spouse or domestic partner” means a spouse or domestic partner of an active member of the Armed Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure under this rule, the military spouse or domestic partner must:

(a) Meet the qualifications for licensure as stated in OAR 847-050-0020;

(b) Be married to, or in a domestic partnership with, a member of the Armed Forces of the United States who is assigned to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice as a physician assistant in another state or territory of the United States;

(d) Be in good standing, with no restrictions or limitations upon, actions taken against, or investigation or disciplinary action pending against his or her license in any jurisdiction where the applicant is or has been licensed; and

(e) Have at least one year of active practice as a physician assistant or teaching at a physician assistant education program during the three years immediately preceding the application.

(3) If a military spouse or domestic partner applies for a license to practice as a physician assistant, the Board may accept:

(a) A copy of the physician assistant education program diploma to fulfill the requirement for the Verification of Medical Education form; and

(b) Verification of licensure in good standing from the jurisdiction of current or most recent practice as a physician assistant to fulfill the requirement of verifications of licensure from all jurisdictions of prior and current health related licensure.

(4) If a military spouse or domestic partner applies for a license to practice as a physician assistant, the Board will obtain the following on behalf of the applicant:

(a) The results of a query of the National Practitioner Data Bank; and

(b) The results of a query of the Federation of State Medical Boards’ Board Action Data Bank.

(5) In addition to the documents required in section (3) of this rule and by OAR 847-050-0015 and 847-050-0020, the military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or domestic partnership registration with the name of the applicant and the name of the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station located in Oregon by official active duty military order for the spouse or domestic partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265 & HB 2037 (2013)

Stats. Implemented: ORS 677.265, 677.512 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 35-2013, f. & cert. ef. 10-15-13

847-070-0024

Application for Licensure by Military Spouse or Domestic Partner

(1) “Military spouse or domestic partner” means a spouse or domestic partner of an active member of the Armed Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure under this rule, the military spouse or domestic partner must:

(a) Meet the qualifications for licensure as stated in OAR 847-070-0016;

(b) Be married to, or in a domestic partnership with, a member of the Armed Forces of the United States who is assigned to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice acupuncture in another state or territory of the United States;

(d) Be in good standing, with no restrictions or limitations upon, actions taken against, or investigation or disciplinary action pending against his or her license in any jurisdiction where the applicant is or has been licensed; and

(e) Have at least one year of active practice or teaching of acupuncture during the three years immediately preceding the application.

(3) If a military spouse or domestic partner applies for a license to practice acupuncture, the Board may accept:

(a) A copy of the acupuncture school diploma to fulfill the requirement for a letter from the Dean of the applicant’s acupuncture school; and

(b) Verification of licensure in good standing from the jurisdiction of current or most recent practice of acupuncture to fulfill the requirement of verifications of licensure from all jurisdictions of prior and current health related licensure.

(4) In addition to the documents required in section (3) of this rule and in OAR 847-070-0022, the military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or domestic partnership registration with the name of the applicant and the name of the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station located in Oregon by official active duty military order for the spouse or domestic partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265 & HB 2037 (2013)

Stats. Implemented: ORS 677.275, 677.759 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 35-2013, f. & cert. ef. 10-15-13

847-080-0016

Application for Licensure by Military Spouse or Domestic Partner

(1) “Military spouse or domestic partner” means a spouse or domestic partner of an active member of the Armed Forces of the United States who is the subject of a military transfer to Oregon.

(2) To qualify for licensure under this rule, the military spouse or domestic partner must:

(a) Meet the requirements for licensure as stated in OAR 847-080-0010;

(b) Be married to, or in a domestic partnership with, a member of the Armed Forces of the United States who is assigned to a duty station located in Oregon by official active duty military order;

(c) Be licensed to practice podiatric medicine in another state or territory of the United States;

(d) Be in good standing, with no restrictions or limitations upon, actions taken against, or investigation or disciplinary action pending against his or her license in any jurisdiction where the applicant is or has been licensed; and

(e) Have at least one year of active practice or teaching of podiatric medicine during the three years immediately preceding the application.

(3) If a military spouse or domestic partner applies for a license to practice podiatric medicine, the Board may accept:

(a) A copy of the podiatric medical school diploma to fulfill the requirement for a Dean’s Letter of Recommendation and the Verification of Medical Education form; and

(b) Verification of licensure in good standing from the jurisdiction of current or most recent practice of podiatric medicine to fulfill the requirement of verifications of licensure from all jurisdictions of prior and current health related licensure.

(4) If a military spouse or domestic partner applies for a license to practice podiatric medicine, the Board will obtain the results of a query of the National Practitioner Data Bank on behalf of the applicant.

(5) In addition to the documents required in section (3) of this rule and in OAR 847-080-0013 and 847-080-0017, the military spouse or domestic partner must submit a copy of the:

(a) Marriage certificate or domestic partnership registration with the name of the applicant and the name of the active duty member of the Armed Forces of the United States; and

(b) Assignment to a duty station located in Oregon by official active duty military order for the spouse or domestic partner named in the marriage certificate or domestic partnership registration.

Stat. Auth.: ORS 677.265, 677.820 & HB 2037 (2013)

Stats. Implemented: ORS 677.820, 677.825, 677.830 & HB 2037 (2013)

Hist.: OMB 21-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 35-2013, f. & cert. ef. 10-15-13


Rule Caption: Merges the names of the two former national databanks into one

Adm. Order No.: OMB 36-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-026-0010

Subject: The rule amendment merges the two national databanks (formerly the National Practitioner Data Bank and the Health Integrity & Protection Data Bank) into one (now known as the National Practitioner Data Bank).

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-026-0010

Documents, Letters, Certifications Obtained by the Board

The Board will obtain the following documents, letters, certifications if any and results of queries of national databases required for licensure on behalf of the applicant:

(1) Verification of certification by the American Board of Medical Specialties or the American Osteopathic Association’s Bureau of Osteopathic Specialists;

(2) Verification of re-certification by the American Board of Medical Specialties or the American Osteopathic Association’s Bureau of Osteopathic Specialists;

(3) The results of a query of the National Practitioner Data Bank; and

(4) The results of the query of the Federation of State Medical Boards’ Board Action Data Bank.

Stat. Auth.: ORS 677.265, 677.115

Stats. Implemented: ORS 677.265, 677.115)

Hist.: BME 21-2009(Temp), f. & cert. ef. 10-23-09 thru 4-15-10; BME 4-2010, f. & cert. ef. 1-26-10; OMB 36-2013, f. & cert. ef. 10-15-13


Rule Caption: Supervising physician application fee and physician assistant surcharge fee as approved

Adm. Order No.: OMB 37-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 8-1-2013

Rules Amended: 847-050-0027, 847-050-0042

Subject: As approved by the legislature in the 2013-15 budget, the rule amendment specifies that there is a fee for the supervising physician application and implements a one-time surcharge for physician assistants renewing or applying for initial licensure in the 2014-15 licensure biennium.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-050-0027

Approval of Supervising Physician

(1) Prior to using the services of a physician assistant under a practice agreement, a supervising physician or primary supervising physician of a supervising physician organization must be approved as a supervising physician by the Board.

(2) The primary supervising physician of a supervising physician organization must apply as a supervising physician with the Board and must attest that each supervising physician in the supervising physician organization has reviewed statutes and rules relating to the practice of physician assistants and the role of a supervising physician.

(3) Physicians applying to be a supervising physician or the primary supervising physician of a supervising physician organization must:

(a) Submit a supervising physician application and application fee; and

(b) Take an online course and pass an open-book exam on the supervising physician requirements and responsibilities given by the Board. A passing score on the exam is 75%. If the supervising physician applicant fails the exam three times, the physician’s application will be reviewed by the Board. A supervising physician applicant who has failed the exam three times must also attend an informal meeting with a Board member, a Board investigator and/or the Medical Director of the Board to discuss the applicant’s failure of the exam, before being given a fourth and final attempt to pass the examination. If the applicant does not pass the exam on the fourth attempt, the physician’s application may be denied.

(4) The physician may be subject to Board investigation prior to approval or may be limited or denied approval as a supervising physician for the following:

(a) There are restrictions upon or actions against the physician’s license;

(b) Fraud or misrepresentation in applying to use the services of a physician assistant.

(5) The Board may defer taking action upon a request for approval as a supervising physician pending the outcome of the investigation of the physician for violations of ORS 677.010-990.

(6) Failure to apply and be approved as a supervising physician by the Board prior to using the services of a physician assistant under a practice agreement is a violation of ORS 677.510 and is grounds for a $195 fine. The licensee may be subject to further disciplinary action by the Board.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.205 & 677.510

Hist.: ME 4-1981(Temp), f. & ef. 10-20-81; ME 2-1982, f. & ef. 1-28-82; ME 5-1984, f. & ef. 1-20-84; ME 8-1985, f. & ef. 8-5-85; ME 5-1986, f. & ef. 4-23-86; ME 21-1989, f. & cert. ef. 10-20-89; ME 2-1990, f. & cert. ef. 1-29-90; ME 5-1994, f. & cert. ef. 1-24-94; ME 9-1995, f. & cert. ef. 7-28-95; BME 13-2003, f. & cert. ef. 7-15-03; OMB 2-2011, f. & cert. ef. 2-11-11; [OMB 21-2011(Temp), f. & cert. ef. 10-13-11 thru 4-10-12; Suspend temporary by OBDD 28-2011(Temp), f. & cert. ef. 10-26-11 thru 4-10-12]; OMB 32-2011(Temp), f. 12-15-11, cert. ef. 1-1-12 thru 6-29-12; OMB 7-2012, f. & cert. ef. 2-10-12; OMB 11-2012(Temp), f. & cert. ef. 3-2-12 thru 8-29-12; OMB 26-2012, f. & cert. ef. 8-3-12; OMB 2-2013, f. & cert. ef. 1-11-13; OMB 17-2013(Temp), f. 7-12-13, cert. ef. 7-15-13 thru 1-11-14; OMB 37-2013, f. & cert. ef. 10-15-13

847-050-0042

Registration

(1) The registration renewal form and fee must be received in the Board office during regular business hours and must be satisfactorily complete on or before December 31 of each odd-numbered year in order for the physician assistant’s registration to be renewed for the next 24 months. This application must also include submission of an updated practice agreement or validation of an existing practice agreement or Board-approved practice description.

(2) Upon failure to comply with section (1) of this rule, the license will automatically lapse as per ORS 677.228.

(3) A one-time surcharge is required for each physician assistant renewing his or her license for the 2014-2015 biennial registration period or applying for an initial license during calendar years 2014 and 2015.

Stat. Auth.: ORS 677.265

Stats. Implemented: ORS 677.510 & 677.512

Hist.: ME 1-1979, f. & ef. 1-2-79; ME 5-1979, f. & ef. 11-30-79; ME 4-1980(Temp), f. 8-5-80, ef. 8-6-80; ME 7-1980, f. & ef. 11-3-80; ME 4-1981(Temp), f. & ef. 10-20-81; ME 2-1982, f. & ef. 1-28-82; ME 7-1984, f. & ef. 1-26-84; ME 2-1990, f. & cert. ef. 1-29-90; ME 7-1990, f. & cert. ef. 4-25-90; ME 7-1991, f. & cert. ef. 7-24-91; ME 5-1994, f. & cert. ef. 1-24-94; BME 6-2003, f. & cert. ef. 1-27-03; BME 25-2008, f. & cert. ef. 10-31-08; [OMB 21-2011(Temp), f. & cert. ef. 10-13-11 thru 4-10-12; Suspend temporary by OBDD 28-2011(Temp), f. & cert. ef. 10-26-11 thru 4-10-12]; OMB 32-2011(Temp), f. 12-15-11, cert. ef. 1-1-12 thru 6-29-12; OMB 7-2012, f. & cert. ef. 2-10-12; OMB 17-2013(Temp), f. 7-12-13, cert. ef. 7-15-13 thru 1-11-14; OMB 37-2013, f. & cert. ef. 10-15-13


Rule Caption: Legislative updates to the Health Professionals’ Services Program

Adm. Order No.: OMB 38-2013

Filed with Sec. of State: 10-15-2013

Certified to be Effective: 10-15-13

Notice Publication Date: 9-1-2013

Rules Amended: 847-065-0015, 847-065-0025, 847-065-0035, 847-065-0055, 847-065-0060, 847-065-0065

Rules Repealed: 847-065-0015(T), 847-065-0025(T), 847-065-0035(T), 847-065-0055(T), 847-065-0060(T), 847-065-0065(T)

Subject: The rule amendments reflect changes made by 2013 House Bill 2124 regarding the Health Professionals’ Services Program. Specifically, the rule amendments refer to the new statutory location for the definition of “substantial noncompliance,” remove the term “successful completion” from the definitions and add the substantive information to the rule on Completion Requirements, clarify the purpose of the investigation into the licensee’s practice that occurs prior to full enrollment in the program, clearly establish the ability for licensees to self-refer to the program, exempt enrolled licensees with solely a mental health disorder from random drug or alcohol testing unless otherwise required by the Board, require the Board to assess the licensee’s compliance with the monitoring agreement to complete the program or the contractor to assess compliance if the licensee is self-referred, specify that civil commitments for mental illness are considered substantial noncompliance rather than all admissions for mental health treatment, and allow the Board to review reports from the program for substantial noncompliance rather than mandating investigation of all reports.

Rules Coordinator: Nicole Krishnaswami—(971) 673-2667

847-065-0015

Definitions

The following definitions apply to OAR chapter 847, division 065, except as otherwise stated in the definition:

(1) “Assessment or evaluation” means the process an independent third-party evaluator uses to diagnose the licensee and to recommend treatment options for the licensee.

(2) “Board” means the Oregon Medical Board.

(3) “Business day” means Monday through Friday, except legal holidays as defined in ORS 187.010 (or ORS 187.020).

(4) “Contractor” means the entity that has contracted with the Division to conduct the HPSP.

(5) “Diagnosis” means the principal mental health or substance use diagnosis listed in the current Diagnostic Statistical Manual (DSM). The diagnosis is determined through the assessment and any examinations, tests or consultations suggested by the assessment.

(6) “Division” means the Department of Human Services, Addictions and Mental Health Division.

(7) “DSM” means the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association.

(8) “Federal regulations” means:

(a) As used in ORS 676.185(5)(d), a “positive toxicology test result as determined by federal regulations pertaining to drug testing” means a test result that meets or exceeds the cutoff concentrations shown in 49 CFR § 40.87 (2009); and

(b) As used in ORS 676.190(5)(g), requiring a “licensee to submit to random drug or alcohol testing in accordance with federal regulations” means licensees are selected for random testing by a scientifically valid method, such as a random number table or a computer-based random number generator that is matched with licensees’ unique identification numbers or other comparable identifying numbers. Under the selection process used, each covered licensee must have an equal chance of being tested each time selections are made, as described in 40 CFR § 199.105(c)(5) (2009). Random drug tests must be unannounced and the dates for administering random tests must be spread reasonably throughout the calendar year, as described in 40 CFR § 199.105(c)(7) (2009).

(9) “Fitness to practice evaluation” means the process a qualified, independent third-party evaluator uses to determine if the licensee can safely perform the essential functions of the licensee’s health practice.

(10) “Final enrollment” means a licensee has provided all documentation required by OAR 847-065-0035 and has met all eligibility requirements to participate in the HPSP.

(11) “Independent third-party evaluator” means an individual or center who is approved by the Board to evaluate, diagnose, and offer treatment options for substance use disorders and/or mental disorders.

(12) “Licensee” means a licensed physician, podiatric physician, physician assistant or acupuncturist who is licensed or certified by the Board.

(13) “Mental disorder” means a clinically significant syndrome identified in the current DSM that is associated with disability or with significantly increased risk of disability.

(14) “Monitoring agreement” means an individualized agreement between a licensee and the contractor that meets the requirements for a diversion agreement set by ORS 676.190.

(15) “Positive toxicology test result” means a test result that meets or exceeds the cutoff concentrations shown in 49 CFR 40.87 (2009), a test result that shows other drugs or alcohol, or a test result that fails to show the appropriate presence of a currently prescribed drug that is part of a treatment program related to a condition being monitored by HPSP.

(16) “Provisional enrollment” means temporary enrollment, pending verification that a licensee meets all program eligibility criteria.

(17) “Self-referred licensee” means a licensee who seeks to participate in the program without a referral from the Board.

(18) “Substance abuse” means a disorder related to the taking of a drug of abuse (including alcohol); to the side effects of a medication; and to a toxin exposure, including: substance use disorders (substance dependence and substance abuse) and substance-induced disorders (including but not limited to substance intoxication, withdrawal, delirium, and dementia, as well as substance induced psychotic disorders and mood disorders), as defined in DSM criteria.

(19) “Substantial non-compliance” means that a licensee is in violation of the terms of his or her monitoring agreement in a way that gives rise to concerns about the licensee’s ability or willingness to participate in the HPSP. Substantial non-compliance and non-compliance include, but are not limited to, the factors listed in ORS 676.185(5). Conduct that occurred before a licensee entered into a monitoring agreement does not violate the terms of that monitoring agreement.

(20) “Toxicology testing” means urine testing or alternative chemical monitoring including blood, saliva, breath or hair as conducted by a laboratory certified, accredited or licensed and approved for toxicology testing.

(21) “Treatment” means the planned, specific, individualized health and behavioral-health procedures, activities, services and supports that a treatment provider uses to remediate symptoms of a substance use disorder and/or mental disorder.

Stat. Auth.: ORS 676.185 - 676.200 & 677.265

Stats. Implemented: ORS 676.185 - 676.200 & 677.265

Hist.: BME 15-2010(Temp), f. & cert. ef. 8-3-10 thru 1-18-11; BME 20-2010, f. & cert. ef. 10-25-10; OMB 9-2011, f. & cert. ef. 4-25-11; OMB 17-2012(Temp), f. & cert. ef. 7-31-12 thru 1-15-13; OMB 33-2012, f. & cert. ef. 10-22-12; OMB 22-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 38-2013, f. & cert. ef. 10-15-13

847-065-0025

Eligibility for Participation in Health Professionals Services Program

Eligibility for Participation in Health Professionals’ Services Program

(1) Licensee must be evaluated by an independent third-party evaluator.

(2) The evaluation must include a diagnosis of a substance use disorder and/or mental disorder with the appropriate diagnostic code from the DSM, and treatment options.

(3) Licensee must provide a written statement agreeing to enter the HPSP and agreeing to abide by all rules established by the Board.

(4) Licensee must enter into the “HPSP Monitoring Agreement.”

(5) The Board will determine whether a Board-referred licensee’s practice has presented or presents a danger to the public. The contractor will determine whether a self-referred licensee’s practice has presented or presents a danger to the public.

Stat. Auth.: ORS 676.185 - 676.200 & 677.265

Stats. Implemented: ORS 676.185 - 676.200 & 677.265

Hist.: BME 15-2010(Temp), f. & cert. ef. 8-3-10 thru 1-18-11; BME 20-2010, f. & cert. ef. 10-25-10; OMB 9-2011, f. & cert. ef. 4-25-11; OMB 17-2012(Temp), f. & cert. ef. 7-31-12 thru 1-15-13; OMB 33-2012, f. & cert. ef. 10-22-12; OMB 22-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 38-2013, f. & cert. ef. 10-15-13

847-065-0035

Procedure for Self-Referred Licensees

Board licensees may self-refer to the HPSP.

(1) Provisional Enrollment: To be provisionally enrolled in the program, a self-referred licensee must:

(a) Sign a written consent allowing disclosure and exchange of information among the contractor, the licensee’s employer, independent third-party evaluators and treatment providers;

(b) Sign a written consent allowing disclosure and exchange of information among the contractor, the Board, the licensee’s employer, independent third-party evaluators and treatment providers in the event the contractor determines the licensee to be in substantial non-compliance with his or her monitoring agreement as defined in OAR 847-065-0065;

(c) Attest that the licensee is not, to the best of the licensee’s knowledge, under investigation by the Board; and

(d) Agree to and sign a monitoring agreement.

(2) Final Enrollment: To move from provisional enrollment to final enrollment in the program, a self-referred licensee must:

(a) Obtain at the licensee’s own expense and provide to the contractor, an independent third-party evaluator’s written evaluation containing a DSM diagnosis and diagnostic code and treatment recommendations;

(b) Agree to cooperate with the contractor’s investigation to determine whether the licensee’s practice while impaired presents or has presented a danger to the public; and

(c) Enter into an amended monitoring agreement, if required by the contractor.

(3) Once a self-referred licensee seeks enrollment in the HPSP, failure to complete final enrollment may constitute substantial non-compliance and may be reported to the Board.

Stat. Auth.: ORS 676.185 - 676.200 & 677.265

Stats. Implemented: ORS 676.185 - 676.200 & 677.265

Hist.: BME 15-2010(Temp), f. & cert. ef. 8-3-10 thru 1-18-11; BME 20-2010, f. & cert. ef. 10-25-10; OMB 9-2011, f. & cert. ef. 4-25-11; OMB 17-2012(Temp), f. & cert. ef. 7-31-12 thru 1-15-13; OMB 33-2012, f. & cert. ef. 10-22-12; OMB 22-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 38-2013, f. & cert. ef. 10-15-13

847-065-0055

Licensee Responsibilities

All licensees must:

(1) Agree to report any arrest for or conviction of a misdemeanor or felony crime to the contractor within three business days after the licensee is arrested or convicted of the crime;

(2) Comply continuously with his or her monitoring agreement, including any restrictions on his or her practice, for at least two years or longer, as specified in the monitoring agreement;

(3) Abstain from mind-altering or intoxicating substances or potentially addictive drugs, unless the drug is approved by the contractor and prescribed for a documented medical condition by a person authorized by law to prescribe the drug to the licensee;

(4) Report use of mind-altering or intoxicating substances or potentially addictive drugs within 24 hours to contractor;

(5) Participate in a treatment plan approved by a third-party evaluator or treatment provider;

(6) Limit practice as required by the contractor or the Board;

(7) Cooperate with supervised monitoring of practice;

(8) Participate in a follow-up evaluation, when necessary, of licensee’s fitness to practice;

(9) Submit to random drug or alcohol testing, unless the licensee is diagnosed with solely a mental health disorder and the Board does not otherwise require the licensee to submit to random drug and alcohol testing;

(10) Report at least weekly to the contractor regarding the licensee’s compliance with the monitoring agreement;

(11) Report applications for licensure in other states, changes in employment and changes in practice setting to the contractor;

(12) Agree to be responsible for the cost of evaluations, toxicology testing, treatment and monitoring;

(13) Report to the contractor any investigations or disciplinary action by any state, or state or federal agency, including Oregon;

(14) Participate in required meetings according to the treatment plan; and

(15) Maintain current license status and/or report any changes in license status.

Stat. Auth.: ORS 676.185 - 676.200 & 677.265

Stats. Implemented: ORS 676.185 - 676.200 & 677.265

Hist.: BME 15-2010(Temp), f. & cert. ef. 8-3-10 thru 1-18-11; BME 20-2010, f. & cert. ef. 10-25-10; OMB 9-2011, f. & cert. ef. 4-25-11; OMB 17-2012(Temp), f. & cert. ef. 7-31-12 thru 1-15-13; OMB 33-2012, f. & cert. ef. 10-22-12; OMB 22-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 38-2013, f. & cert. ef. 10-15-13

847-065-0060

Completion Requirements

(1) The time spent participating in a monitored program before transferring from the Health Professionals Program to the Health Professionals’ Services Program effective July 1, 2010, will be counted toward the required term of monitored practice.

(2) The licensee will remain enrolled in the program for a minimum of two consecutive years.

(3) The Board-referred licensee must have complied with the licensee’s monitoring agreement to the satisfaction of the Board. The self-referred licensee must have complied with the licensee’s monitoring agreement to the satisfaction of the contractor.

Stat. Auth.: ORS 676.185 - 676.200 & 677.265

Stats. Implemented: ORS 676.185 - 676.200 & 677.265

Hist.: BME 15-2010(Temp), f. & cert. ef. 8-3-10 thru 1-18-11; BME 20-2010, f. & cert. ef. 10-25-10; OMB 9-2011, f. & cert. ef. 4-25-11; OMB 17-2012(Temp), f. & cert. ef. 7-31-12 thru 1-15-13; OMB 33-2012, f. & cert. ef. 10-22-12; OMB 22-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 38-2013, f. & cert. ef. 10-15-13

847-065-0065

Substantial Non-Compliance Criteria

(1) The contractor will report substantial non-compliance with a diversion agreement to the Board within one business day after the contractor learns of the substantial non-compliance, including but not limited to information that a licensee:

(a) Engaged in criminal behavior;

(b) Engaged in conduct that caused injury, death or harm to the public, including engaging in sexual impropriety with a patient;

(c) Was impaired in a health care setting in the course of the licensee’s employment;

(d) Received a positive toxicology test result;

(e) Violated a restriction on the license’s practice imposed by the contractor or the Board;

(f) Was civilly committed for mental illness;

(g) Entered into a diversion agreement, but failed to participate in the HPSP;

(h) Was referred to the HPSP, but failed to enroll in the HPSP;

(i) Forged, tampered with, or modified a prescription;

(j) Violated any rules of prescriptive authority;

(k) Violated any provisions of OAR 847-065-0055;

(L) Violated any terms of the diversion agreement; or

(m) Failed to complete the monitored practice requirements as stated in OAR 847-065-0060.

(2) The Board will review reports from the program. The Board may request the contractor to provide the licensee’s complete record, and the contractor must send these records to the Board as long as a valid release of information is in place.

(3) If the Board finds that a licensee is substantially noncompliant with a diversion agreement, the Board may investigate and determine the appropriate sanction.

Stat. Auth.: ORS 676.185 - 676.200 & 677.265

Stats. Implemented: ORS 676.185 - 676.200 & 677.265

Hist.: BME 15-2010(Temp), f. & cert. ef. 8-3-10 thru 1-18-11; BME 20-2010, f. & cert. ef. 10-25-10; OMB 9-2011, f. & cert. ef. 4-25-11; OMB 17-2012(Temp), f. & cert. ef. 7-31-12 thru 1-15-13; OMB 33-2012, f. & cert. ef. 10-22-12; OMB 22-2013(Temp), f. 8-2-13, cert. ef. 8-3-13 thru 1-30-14; OMB 38-2013, f. & cert. ef. 10-15-13

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2012.

2.) Copyright 2013 Oregon Secretary of State: Terms and Conditions of Use

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