Minutes

North Carolina State Board of Examiners in Optometry

June 11 - 14, 2009

Myrtle Beach, South Carolina

The North Carolina State Board of Examiners in Optometry met at the Embassy Suites Hotel at Kingston Plantation in Myrtle Beach, South Carolina, June 11 – 14, 2009 for the purposes of approving the applicants to take the Summer 2009 Clinical/Practicum examinations, to finalize the examination schedule based upon the number of approved applicants, to review and adopt the budget for the fiscal year beginning July 1, 2009 and ending June 30, 2010, to review complaints, to conduct the Annual Meeting to elect officers for the coming year, to monitor continuing education during the Annual Spring Congress of the North Carolina State Optometric Society, and for other purposes. Present were Drs. Joel Banks, President, William Hendrix, Secretary/Treasurer and Drs. David Anderson, Michael Clark, William Rafferty, and Mr. Roger Mitchell and Ms. Mary Richardson, Members of the Board. Also present was Dr. John Robinson, the Board’s Executive Director, Janice Peterson, RN, the Administrative Secretary and Sara Roberts, the Administrative Assistant. Present on Thursday at the 10 A.M. time certain as posted on the agenda was the Board’s attorney, Mr. Johnny Loper, who joined the meeting by way of conference telephone.

At 8:35 a.m. on Thursday, June 11, 2009 the meeting was called to order by the President who first read from Section 138A-35 of Chapter 138A of the State Government Ethics Act pertaining to ‘Conflict of Interest’ following which he opened the meeting with prayer.

Approval of Minutes.

On a motion by Dr. Anderson seconded by Dr. Clark the Minutes of the March 29, 2009 Meeting were unanimously approved.

Report of the President. Dr. Banks stated that he had no formal report to give at this time, but that he would be making comments concerning various items on the agenda as the meeting progressed. On a motion by Mr. Mitchell seconded by Ms. Richardson that carried unanimously the report of the President was accepted.

Report of the Secretary Treasurer. The Secretary-Treasurer presented the Budget Report that covered the period 07/01/08 through 06/05/09. With less than a month remaining in the fiscal year, Dr. Hendrix noted that those line items in the budget that exceeded the amounts budgeted were the subject of review at the last meeting and that there are no unexpected changes in this report. With less than 30 days remaining the totals of the various sources of income and of the total of all expenditures show the Board to be approaching the end if its fiscal year without a risk of deficits.^. It is important that those expenses incurred within a fiscal year be paid prior to the start of the ensuing fiscal year; therefore, it is important that Board Members who have not yet submitted all of their meeting expenses for this fiscal year to do so before June 30^th. On a motion by Dr. Hendrix seconded by Mr. Mitchell and carried unanimously the Report of the Secretary-Treasurer was accepted.

Report of the Executive Director.

The Executive Director reported:

• There are 53 applications in the Board office that were received in a timely manner. Assuming that all of the required documents and correct and verifiable information are in each applicant’s file by the time of the start of the examinations, there will be 53 persons appearing for examination, thus requiring 11 examination sessions over a four day period. Reservations for space at the McKimmon Center are made years in advance by the Board Staff. For this examination reservations are for one room (the procedures station where the equipment will be delivered) on Thursday, July 30, 2009. The remaining rooms are reserved for Friday July 31 through Monday, August 3, 2009 with the first session starting on Friday morning. The schedule is as follows: three sessions to be held each day beginning Friday, July 31^st through Sunday, August 2^nd and two sessions on Monday, August 3^rd. Before adjourning this meeting the Board must agree on the dates of the meeting to determine the results of the examination and a date for review of the results of the examination to be announced at time of the examinations in order that every applicant is informed of the ‘review date’ prior to their leaving the McKimmon Center.

• The proposed budget for fiscal year 2009 – 2010 is in the meeting notebook. The office rent that appears as a line item in the budget is in the amount approved by the North Carolina Department of Administration who took responsibility for drafting the terms of the office lease some years ago. For the first time the Department drew a three year lease, the terms of which were approved by the Board and the Department of Administration in June of last year. Beginning July 1, 2009 the Board will begin the 2^nd year of the 3 year lease.

• There continue to be complaints received in the Board office concerning the sale of ‘colored’ contact lenses by retail merchants, mainly beauty and nail salons, convenience stores, etc. most of whom are located in or near minority neighborhoods. As in the past the complaints come from the doctors rather than patients. A new development is colored contact lenses packaged in containers without the FDA statement printed on them. Best guess is that these are lenses being shipped in from off shore, likely China. Lenses in their unopened containers have been sent to the offices of the American Optometric Association for submission to the appropriate Federal Authorities as evidence in seeking an end to illegal distribution of this product. To date we have heard nothing back.

• There has been a complaint involving an individual who holds a Doctor of Optometry degree who has yet to become licensed in this state. We are currently awaiting statements from the patient and from the licensee in whose office the event took place.

• Board Certification will be the subject of debate at the upcoming meeting in Washington of the American Optometric Association. A proposal to approve ‘board certification’ and to form an American Board of Optometry (ABO), the stated purposes of which are to ‘certify’ optometrists at a level above licensure and to ‘re-certify (MOC)’ them at yet to be determined intervals for purposes of ensuring the ‘maintenance of competency (MOC)’ to practice optometry, will be voted on. A resolution consistent with current Board Policy that would seek support of organized optometry within the state in instructing the North Carolina Delegation at this meeting to vote NO on this proposal is a part of your notebook for your consideration at this meeting.

• The Board must remain aware of the Federal mandates currently placed on the pharmaceutical industry if they are to continue to provide financial support to the various organizations and institutions providing continuing education programs for the benefit of the various health professions. It appears that the Board will become more involved in the area of enforcement of the so-called ‘industry guidelines’ and could require the revision of the forms required for approval of continuing education programs. Dr. Rafferty will be leading a discussion of this issue later in the meeting.

• Clinical Examiners and Observers for the Summer 2009 Clinical/Practicum examinations. Because of the later than usual time of this meeting I have already begun contacting clinical examiners for the Summer 2009 examinations. As of this date I have commitments from 9 of the 10 who served at the Winter 2009 examinations and one new examiner. Because of family vacations it is more difficult to fill the 10 needed positions than it is in the Winter. As for observers I have only one name that has been submitted and he has been contacted. If there are individuals you see at this meeting that you would recommend as observers please let me know who they are and I will contact them when I return to the Board office next week.

Mr. President, that concludes my report. On a motion by Dr. Clark seconded by Mr. Mitchell and carried unanimously the report of the Executive Director was accepted.

Resolution Reaffirming the Board’s Opposition to ‘Board Certification’. On a motion by Dr. Clark seconded by Dr. Anderson and carried unanimously the Board approved a Resolution opposing a proposal by the American Optometric Association (AOA) to create a national program of ‘board certification’ and the establishment of an ‘American Board of Optometry (ABO)’ the stated purpose of which would be the ‘certifying’ and ‘re-certification’ of optometrists as meeting standards above those required for licensure as a means of ensuring ‘maintenance of competency (MOC)’ as an encroachment on the powers and duties of the North Carolina State Board of Optometry. Further, the resolution encourages the North Carolina Optometric Society (NCSOS) to send their delegates to the upcoming meeting of the AOA ‘instructed’ to vote NO when the issue is brought to the floor for a vote at the House of Delegates of the AOA in Washington on June 26, 2009.

Report of the Board’s Data Systems Manager and Software Writer.

Mr. Dixon in a report written to the Board on the morning of June 10, 2009 stated:

• Problems with the navigation of the Office and CE Modules have been corrected, requiring the updating of the Development System with a Service Pack from Microsoft to fix the problems with Dialogs closing after acknowledgement of an activity. There were also minor code changes that went along with the new Service Pack and library updates.

• The code has been tested on his computer and all problems related to Dialogs were corrected by application of this update. The system was loaded on both Jan’s and Sara’s computers at 5:30 a.m. this morning (June 10, 2009) for them to test when they came in at 8:00 a.m. (after being up for nearly 48 hours and near the point of exhaustion he forgot to load the new library on their computers at the same time he reloaded the system; therefore they saw problems when they tried to test).
• When informed of the problem at 11:30 a.m. the Executive Director was told that the loading of the updated library was a process that takes about 20 minutes to load and then 2 to 3 hours for the update to apply itself. This could not be accomplished prior to his leaving for the Board meeting in Myrtle Beach.
• That he is confident that when the new library is installed and allowed to update this component of the system will work (having tested these modules for 2 hours on his own computer before loading it on the Board’s machines).

Upon reading Mr. Dixon’s report and after discussion of the progress that has been made in completing the writing of the new software to operate the Board’s data management systems, Dr. Anderson moved and Dr. Rafferty seconded a motion that the Board hire an outside consulting firm to evaluate the status of the development and implementation of the Board’s new computer operating systems if not completed to the satisfaction of the Board’s Executive Director and Staff by Wednesday, July 1, 2009. For clarification the following minimum requirements must be met:

· Renewals of licenses, duplicate licenses, professional corporations

· Continuing education transcripts (individual per request & annual printing)

· Requests for licensees’ data

· CE courses (by year, vendor, educator, attendee, type)

· SHEPS Center annual data upload

· Lists of Professional Corporation/office locations & duplicate license locations/optometrists, including those not renewed/capability to run occasional database searches or queries as needed to respond to specific inquiries and/or requests

· Any report/query from individual data fields (including candidates)

· 5 year CE history capability plus transfer of all continuing education records from the old d-base system

The motion carried unanimously.

Meeting with the Board Attorney. At 10:15 a.m. Mr. Loper joined the

Meeting by conference telephone call. On a motion by Dr. Anderson seconded by Dr. Rafferty and carried unanimously the Board went in to closed session in accordance with NCGS 143-318.11(a)(3) to receive privileged advice and information from its attorney regarding an inquiry from Wake Forest Medical School concerning scope of practice and the CPT codes allowed to be billed by optometrists. Mr. Loper discussed with the Board the possible relationship of this issue with the settlement agreement with the Board of Medical Examiners and the Board’s position that the practice of optometry in North Carolina is not defined by CPT codes. While no vote was taken in closed session, the consensus of the Board was that the question posed by Wake Forest Medical School is likely to recur in other or related contexts and the Board should develop a ‘standard’ response to such questions. Mr. Loper then left the conference call and the Board returned to open session.

The Zeiss Visante OCT. The Board had received an inquiry from one its licensees concerning their use the Zeiss Visante OCT, an instrument identical in its capability in performing non-invasive imaging of the anterior segment of the eye as the Zeiss Stratus OCT which is in common use by optometrists for imaging the retina and optic nerve (posterior segment of the eye). The question that was raised is while the use of the OCT (or similar technologies like the HRT) has been a reimbursable procedure for the imaging of the posterior segment of the eye when performed by an optometrist, reimbursement for the use of the Zeiss Visante OCT for anterior segment imaging for diagnostic purposes is denied as not being within the scope of the practice of optometry. Following brief discussions it was the unanimous opinion of the Board that when used for imagining the anterior segment of the eye for diagnostic purposes the procedure utilizing the Zeiss Visante OCT or similar technologies is within the lawful scope of the practice of optometry and should be properly reimbursed as would the use of similar technologies to image the posterior segment of the eye (retina and optic nerve).

Applicants for the Summer 2009 Clinical/Practicum Examinations. On a motion by Dr. Rafferty seconded by Mr. Mitchell and carried unanimously the applications for the Summer 2009 Clinical/Practicum were approved subject to each applicant’s application file containing correct and verifiable information, and further that all documents required by the Board are received and in the applicants’ file prior to their appearing for examination; and that the schedule for the Summer Clinical/Practicum Examinations as stated in the Executive Director’s report above be approved. The motion carried unanimously.

Clinical Examiners and Observers. At the suggestion of the President and without objection the Board approved those Clinical Examiners who have made commitments to the Executive Director that they would serve at the Summer 2009 examinations. Observers to be invited are those whose names have been timely submitted by the Board Members to the Executive Director.

Review of the Proposed Budget. While in open session the Board reviewed the draft of the budget prepared by the Executive Director. Following the asking and answering of questions in open session adoption of the budget was postponed until after the Board’s meeting in closed session to evaluate the performance of the staff and to consider the cost of living and pay increases

Executive Session to Evaluate Performance of Staff and Consider Cost of Living and Pay Increases . On a motion by Dr. Hendrix seconded by Ms. Richardson and carried unanimously the Board went into Executive Session to discuss Staff performance, salaries and benefits. Following discussion of the proposed budget and evaluation of the Board’s staff on a motion by Dr. Clark seconded by Mr. Mitchell that carried unanimously the Board returned to open session.

Evaluation of Staff. Reconvening the meeting the President announced that the Board unanimously agreed that the performance of the Board Staff over the past year had been exemplary and that the Members of the Board were deeply appreciative of their dedication and professionalism in the performance of their duties; further, that the Members of the Board were of the opinion that a 3.5% increase in the salaries of the Executive Director, Administrative Secretary and the Administrative Assistant for fiscal year 2009-2010 are recommended.

Employee Retirement Accounts (Seps Accounts) Upon returning to open session and before voting on the adoption of the budget Dr. Clark moved and Dr. Rafferty seconded a motion that the Board approve a 10% contribution to the SEP’s accounts of the Executive Director, the Administrative Secretary and the Administrative Assistant based upon salaries recommended for fiscal year 2009-2010. The motion carried unanimously.

Board Office Lease July 1, 2008 – June 30, 2011 Since the Board and the Department of Administration have previously approved the terms of a three year lease beginning July 1, 2008 ending on June 30, 2011 no further action on the part of the Board at this meeting is required.

Adoption of the Budget. the Secretary-Treasurer presented the amended Budget for fiscal year 2009-2010, said budget reflecting an increase of 3.5 % in the salaries of the Executive Director, the Administrative Secretary and Administrative Assistant. Without further discussion on a motion by Mr. Mitchell seconded by Ms. Richardson and carried unanimously the Budget for fiscal year 2009-2010 as presented by the Secretary/Treasurer was adopted.

Debra M. Barnes, OD Request for License Re-instatement. After the reading of Dr. Barnes’ request for re-instatement of her license and a careful review of all previous correspondence and related material in her file, on a motion by Mr. Mitchell seconded by Ms. Richardson the Board unanimously approved the following: “That Debora Maxine Barnes, OD, having been deemed eligible to take the North Carolina Board’s licensing examination at the time of the Summer 1978 examinations remains eligible to sit for the Board’s Clinical/Practicum Examination, the current requirement that eligibility is based upon the applicants having passed the National Board examinations under one of three formats dating back to April of 1978, notwithstanding.” Further, that Dr. Barnes be notified of the Board’s action on her request.

Report of the Examination Review Committee. One applicant who failed the Winter 2009 C/P Examination requested a review of their examination results. That applicant appeared in the Board office on Tuesday, April 29, 2008 to review their results. Meeting with them as the Examination Review Committee were Dr. William Rafferty, a Member of the Board and the Executive Director. After spending approximately an hour with the applicant in a detailed review their examination results as reported to them earlier, the Committee could find no evidence to support the changing of a score as reported to the candidate. Therefore, it is the Committee’s recommendation that the results of the Clinical/Practicum examinations stand as reported to each of these applicants. On a motion by Dr. Anderson seconded by Mr. Mitchell and carried unanimously the examination results as reported to the applicant stand as reported to him.

Annual Audit as Required by State Law. The proposal for performing the Audit of the Board’s financial records for fiscal year beginning July 1, 2008 and ending June 30, 2009 by the Accounting Firm of Waters and Piver was presented. On a motion by Mr. Mitchell seconded by Ms. Richardson and carried unanimously the proposal by Mr. Waters on behalf of his firm was accepted.

ARBO/AOA Meeting. As reported and approved in the minutes of the February meeting Drs. Anderson, Clark and Rafferty and the Executive Director and Administrative Secretary will be attending the Annual Meeting of the Association of Regulatory Boards in Optometry on June 21 -23, 2009 in Washington, DC. Dr. Robinson’s travel will include attending the AOA House of Delegates meetings on June 24-27 to monitor and speak on issue of Board Certification when the matter is brought up for a vote at the House of Delegates. The President appointed Dr. Anderson as the Board’s voting delegate at the ARBO meeting.

Summer 2009 Clinical/Practicum Examination Dates. The Board Members and the Clinical Examiners are to arrive in Raleigh and meet in Room 9 at the Jane McKimmon Center in Raleigh at 4 o’clock p.m. on Thursday, July 30^th. The first examination session will start promptly at 7:40 a.m. on Friday, July 31^st. Breakfast will be served each of the four days beginning at 7:00 a.m. There are to be three sessions on Friday, Saturday and Sunday and two on Monday.

Meeting Dates to Determine the Summer 2009 Examination Results. The meeting to determine the results of the Summer 2009 Clinical/Practicum Examinations will be held in the Board’s office in Wallace beginning at 4:00 p.m. on Thursday, September 3, 2009 and end by no later than 5 p.m. on Friday September 4, 2009.

Examination Review. The review of the Summer 2009 examination results for those applicants wishing to review their results will be held in Wallace at the Board’s offices on Wednesday, October 14, 2009 beginning as early as 9:00 a.m. (depending on the numbers of applicants requesting a review of their results).

Council On Post-graduation Education (COPE). Dr. Rafferty led as discussion as to the necessity of establishing better and more effective parameters around the numbers of continuing education programs offered over the country without the possibility of even limited oversight by the Board. A number of states in an effort to compensate for their lack of presence have looked to ARBO and its COPE program to help off set these difficulties. It was his suggestion that the North Carolina Board start requiring COPE or ACCME approval of continuing education programs offered outside of the state. After sufficient time was given for asking questions and his responding to them, Dr. Rafferty moved and Mr. Mitchell seconded a motion that effective on and after January 1, 2010 that all courses that are to be considered for approval as meeting the requirements of this Board must first be approved by the Council on Postgraduate Education (COPE) or the Accreditation Council for Continuing Medical Education (ACCME). The motion carried unanimously.

Annual Meeting. The Annual Meeting to elect officers was held at 12:00 p.m. in the Eaton Room at the Embassy Suites Hotel in Myrtle Beach, SC as previously scheduled. Elected President for 2009-2010 was Dr. Joel Banks. Mr. Roger Mitchell was elected as Secretary/Treasurer. (see minutes of 2009 Annual Meeting).

The remainder of the time in Myrtle Beach was spent in monitoring the continuing education programs at the Spring Meeting of the North Carolina Optometric Society which began on Friday, June 12 and ended on Sunday June 14, 2009.

Adjournment. There being no further business the meeting of the Board was officially adjourned at noon on Sunday, June 14, 2009. The next meeting will be at the Jane McKimmon Center in Raleigh, NC beginning at 4:00 p.m. on Thursday, July 30, 2009.

Approved 07/30/09

Raleigh, NC