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2006-2007 Annual Report: July 1, 2006 – June 30, 2007 Charlie Crist Governor Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General Lucy C. Gee, M.S. Director The Division of Medical Quality Assurance Annual Report: July 1, 2006 – June 30, 2007 MQA Annual Report : July 1, 2006 - June 30, 2007 Contents Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Message from the State Surgeon General . . . . . . . . . . . . . . . 2 Message from the Division Director . . . . . . . . . . . . . . . . . . . . . 3 Employee Covenant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Structure of MQA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 Strategic Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Licensure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Enforcement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Information: Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 MQA Annual Report : July 1, 2006 - June 30, 2007 Executive Summary This report as required by Section 456.026, F.S., details the Department of Health's (DOH) Division of Medical Quality Assurance's (MQA) finances, administrative complaints, disciplinary actions and recommendations. The report also details MQA's long-range policy planning and monitoring process. The information is organized around the division's mission, with an emphasis on performance-driven results. During 2006-2007, MQA continued to fulfill its mission to protect the public through healthcare licensure, enforcement and information. Working in conjunction with 22 boards and six councils, MQA licenses and regulates seven types of facilities and 200plus license types in more than 40 healthcare professions. MQA evaluates the credentials of all applicants for licensure, issues licenses, analyzes and investigates complaints, inspects facilities, assists in prosecuting practice act violations, combats unlicensed activity and provides credential and discipline history about licensees to the public. The division understands its success depends not only on the knowledge, skills and abilities of its employees, but also on their character and cooperation. Because of our continued commitment to excellence, the division developed an MQA Employee Covenant, which all employees sign to express their commitment to the division’s Mission, Vision and Values. The strategic plan continues to serve as MQA’s road map to accomplishing its mission and remaining current with future trends in health care and healthcare regulation. The plan was developed, revised and modified through input from MQA employees, board/council members, and the division’s many stakeholders. A number of key principles, including alignment with DOH’s strategic priorities, guide the plan. The division continues to strive to be a national leader in healthcare regulation. The Florida Board of Chiropractic Medicine, Florida Board of Osteopathic Medicine, board members and MQA employees received national recognitions and appointments. An increase in licensure workload is demonstrated through an all-time high in licenses issued. A continued focus on technological enhancements is evidenced by a 50% increase in the number of licenses renewed online compared to 2004-2005, resulting in over $837,000 in savings. MQA continues to see improvements in its enforcement efforts. For cases against licensed healthcare professionals, the division’s increased enforcement case load included 37% more statutory reports and complaints, and 26% more legally sufficient complaints than just two years earlier. Although there was an increase in work load, there was a 10% increase in the number of cases meeting the 180-day requirement for analysis, investigation and recommendation of probable cause. For cases against unlicensed individuals, there was an all-time high in investigations completed, cease and desist orders issued, and arrests made. MQA’s website – www.FLHealthSource.com – is an important tool for people taking an active role in their healthcare decisions. On the site, healthcare consumers can verify their healthcare professional’s license, disciplinary history, and other pertinent information. Additional information, including educational background, financial responsibility, specialty certifications and malpractice claims history is also available for medical doctors, advanced registered nurse practitioners, and osteopathic, chiropractic, and podiatric physicians. 1 MQA Annual Report : July 1, 2006 - June 30, 2007 Message from the State Surgeon General It is my honor to serve as Florida’s first State Surgeon General. As the state’s leading advocate for wellness and disease prevention, I am committed to improving health care in Florida by making the healthcare system more user-friendly, promoting healthy habits among Florida's youth, preparing the state for any type of disaster, reducing health disparities, and leading Floridians to better health by example. I share Governor Charlie Crist’s commitment to a comprehensive approach to keeping Floridians healthy. Preventing diseases, being prepared, and taking personal responsibility are three important areas of health that every Floridian has the power to control and change. I refer to these important messages, which I will be promoting over the next year throughout all 67 counties of our great state, as the Three P’s: Prevention: Floridians can engage in preventive health behaviors such as eating well, getting daily doses of physical activity, not smoking, and staying current on immunizations. Preparedness: Preparedness for man-made or natural disasters is important to ensuring Floridians and their loved ones are ready for any type of emergency. By having a preparedness kit of canned food, medicines and other essentials, as well as having an emergency plan, we can reduce the impact these unforeseen events have on our health and speed our recovery time. Personal Responsibility: Each Floridian should also accept personal responsibility for their own bodies, seeing their physician regularly, knowing their family history of disease and taking the time to ask important health questions so they can make informed decisions about their health care. The Department of Health’s Division of Medical Quality Assurance (MQA), working closely with the healthcare boards and councils, serves a vital role in helping people in our state achieve the Three P’s. Together, MQA and the boards/councils maintain standards of care that ensure safe, reliable healthcare services for the citizens of Florida. They ensure licensees have received appropriate training and certification in their fields, and hold healthcare practitioners accountable for their actions. Additionally, the division’s online services website – www.FLHealthSource.com –provides the public with 24-hour-a-day free health information to make informed choices about their healthcare providers. The site allows users to verify their healthcare professional’s license, disciplinary history, and other pertinent information. Additional information, including educational background, financial responsibility, specialty certifications and malpractice claims history is also available for medical doctors, advanced registered nurse practitioners, and osteopathic, chiropractic, and podiatric physicians. I am excited about the opportunities and challenges that lie ahead as we advance the Department of Health's vision of ensuring all Floridians are healthy, safe and well. Ana M. Viamonte Ros, M.D., M.P.H. State Surgeon General 2 MQA Annual Report : July 1, 2006 - June 30, 2007 Message from the Division Director As the Director of the Division of Medical Quality Assurance (MQA), I am proud to present our 2006-2007 Annual Report. This year’s report is organized around our three core functions of licensure, enforcement and information, with an emphasis on performance-driven results. Since its creation in 1988, MQA has provided the core functions of licensure and enforcement. In August 2006, we updated our mission to include a third core function – information – as more and more people look to our division to provide easy access to licensure and disciplinary information. During the past year, we also updated our vision – “To be the nation’s leader in quality healthcare regulation.” There are many indications that we may already be there, as we often hear from national and other state organizations how we set the benchmark for so much of the work regulatory agencies do. We also continue to be frequently invited to speak at national conferences to share the success of our services, including our unlicensed activity program, online services, and practitioner profiling; however, we need evidence to verify that we are indeed the nation’s leader. The division continues to focus on the Sterling Criteria for Organizational Performance Excellence and believes it will be instrumental in helping achieve and chart our success. The category of Measurement, Analysis, and Knowledge Management serves as the foundation of the Sterling management system, and will be essential in providing us with the trend data to confirm our successes and identify our opportunities for improvement in an ever-changing healthcare industry. One area in which the division continues to shine is the commitment and achievement of our MQA employees and the many volunteers who give selflessly of their time to serve on our boards and councils. In addition to the awards, recognitions, and state and national regulatory board appointments highlighted in this year’s report, their commitment is reflected in the receipt of 7 Davis Productivity Awards (5 team, 1 individual, 1 partnership) for efficiencies totaling approximately $3 million. MQA believes strongly in its employees, and their dedication to our Mission, Vision and Values. To make our values of integrity, commitment, respect, excellence, accountability, teamwork and empowerment easier to remember, we developed the theme “I CREATE,” using the first letter of each value. This is what our employees do on a daily basis by using these values – create the professional, positive, and helpful image that our state’s healthcare consumers and licensees expect and deserve. Also, with input from employees throughout the division, we developed an MQA Covenant, which details these ideals and our employees’ dedication to them. A copy of the covenant is included in this year’s report, and we will continue to share it with our stakeholders, partners, and others with whom we do business. I am excited about the coming year and the many challenges and accomplishments it will hold as we continue our strides toward becoming the unquestioned national leader in quality healthcare regulation. Lucy C. Gee, M.S. Director, Division of Medical Quality Assurance 3 MQA Annual Report : July 1, 2006 - June 30, 2007 Employee Covenant Our employees are our single greatest asset. MQA’s success depends not only on the knowledge, skills and abilities of its employees, but also on their character and cooperation. The Employee Covenant is signed by all MQA employees to express their commitment to MQA’s Mission, Vision and Values. We, the employees of the Department of Health, Division of Medical Quality Assurance, mutually agree that we want to offer the highest quality service to achieve our mission and further our shared values. Our mission is to protect the public through healthcare licensure, enforcement and information. Our vision is to be the nation's leader in quality healthcare regulation. Our values are: Respect – We recognize and honor the contributions of one another in our daily activities and create an environment where diversity is appreciated and encouraged. • Use please and thank you • Speak in a pleasant manner • Listen without interrupting • Be cordial to others using greetings and a smile • Avoid personalizing problems by focusing on behavior Excellence – We achieve and maintain quality results and outcomes through continuous performance improvement and learning. • Display a positive, optimistic attitude towards challenges and problems • Produce high quality work • Encourage team members to achieve higher levels of quality • Help team members plan for professional development • Engage in activities designed to improve performance • Be clean and professional in your appearance and that of your work area Accountability – We take full responsibility for our behavior and performance. • Admit mistakes; move forward to correct mistakes • Offer solutions to problems and take action to correct those problems • Follow through timely including returning phone calls, responding to e-mails, answering letters, responding to requests from public as well as peers • Give credit where credit is due • Be accountable for the example you set for others, e.g., courtesy, timeliness, attendance at work and meetings, fairness, loyalty to office/division/state Empowerment – We create a culture that encourages people to exercise their judgment and initiative in pursuit of the organizational goals. • Demonstrate openness for new ideas or suggestions • Use words of encouragement • Give tools and training necessary to do the job well • Demonstrate willingness to allow employees to make dayto-day decisions and take risks • Be calm, open and accepting when dealing with mistakes Commitment – We dedicate ourselves to provide services unconditionally and without partiality. • Strive to go "above and beyond" in all job duties • Know and understand DOH and MQA mission and how it applies to your job • Ensure customers’ needs are met; eliminate "not my job" mentality • Share successes and failures with co-workers and learn from them • Assist Others – Ask co-workers if you can assist them with their duties; if you see someone needs help, help them • When speaking about DOH, MQA or your co-workers, be positive Integrity – Our guide for actions–which incorporates our commitment to honesty, fairness, loyalty and trustworthiness– is in the best interests of our customers and employees. • Be open, honest and compassionate • Communicate to all with one face • Demonstrate reliability through your actions • Keep your word • Treat others as you want to be treated Teamwork – We encourage active collaboration to solve problems, make decisions, and achieve common goals. • Encourage a collaborative environment and motivate each other to participate • Model shared values and vision • Congratulate each others’ successes • Admit weaknesses and mistakes to strengthen team • Exhibit a can-do attitude for each task • Be empathetic Therefore, by our signature, we are each committing ourselves to a mission driven, value centered, customer focused, and employee appreciated culture of superior service. Employees of MQA  MQA Annual Report : July 1, 2006 - June 30, 2007 Structure of MQA Healthcare professions are established within individual practice acts and are further regulated by Chapter 456, F.S., under the Department of Health within the Division of Medical Quality Assurance. It is the Legislature's intent that healthcare professions shall be regulated only for the preservation of the health, safety, and welfare of the public. We regulate, as directed by law, because the unregulated practice of a healthcare profession has the potential to cause harm or endanger the public; the public is not already effectively protected by other laws or local regulation; and, a less restrictive way to regulate the profession is not available. Boards are responsible for approving or denying applicants for licensure and routinely handle requests for declaratory statements (interpretations of statutes and rules) and waivers or variances from their rules. Boards conduct disciplinary hearings, promulgate rules, and develop proposed legislation. The range of disciplinary actions taken by boards includes citations, fines, suspensions, reprimands, probations and revocations, as well as continuing education requirements and mandatory participation in intervention programs. When provided for in their individual practice acts, board members approve continuing education providers and/or courses for their licensees. Board members partner with the division to develop and implement a long-range policy plan that is submitted to the Governor and Legislature each year. Boards and councils are composed of consumers and professionals with the number of members and other requirements established under each individual practice act. Board members are appointed by the Governor, typically for four-year terms. Upon term expiration, the Governor may choose to re-appoint members for a second four-year term. A member may serve no more than two consecutive four-year terms. Each board member is accountable to the Governor for the proper performance of duties as a member of the board. Council members are appointed by either the State Surgeon General or the supervising board. Persons interested in an appointment to any regulatory board may obtain a gubernatorial questionnaire from the Governor’s Executive Office through its 2007 Board and Commission Vacancies web page. To find the page: 1. Go to www.myflorida.com 2. Choose Governor’s Web Site 3. Click on “The Crist Team” 4. Click on “Gubernatorial Appointments” 5. Click on “Board and Commission Vacancies” 6. Click on “Gubernatorial Appointments Questionnaire” You may also obtain a form by calling the Governor’s Appointments Office at (850) 488-2183. MQA Division Director Bureau of Health Care Practitioner Regulation Strategic Planning Services Unit Deputy Director/Enforcement Bureau of Operations Bureau of Management Services Unlicensed Activity Program Consumer Services & Compliance Management Unit Investigative Services Unit Prosecution Services Unit* *Note: The Prosecution Services Unit reports directly to the Office of the General Counsel  MQA Annual Report : July 1, 2006 - June 30, 2007 Strategic Plan Section 456.005, F.S., requires the Division of Medical Quality Assurance (MQA) to develop and implement a strategic plan. This plan serves as a five year road map for accomplishing our mission. It is an active plan, and must be revised and modified to remain current with future trends in healthcare services and regulation. Gathering input and feedback from MQA employees, board/council members, and the division’s many stakeholders is essential, as is familiarizing them with the plan and involving them in accomplishing plan goals. Several key principles guide MQA in creating the strategic plan: • Goals are aligned with the Department of Health’s strategic priorities; each goal has objectives with performance measures to ensure MQA is meeting that goal. • Goals are in direct relation to the division’s three core processes of licensure, enforcement and information. • The plan solicits and incorporates input from employees, board/council members, and various stakeholders on a periodic basis. • The plan has specific objectives and key performance indicators to measure success. • The plan requires the participation of all MQA employees and board/council members to achieve success. The Florida Department of Health Strategic Priorities 1. Improve health status of Floridians through prevention and wellness 2. Preparedness 3. Assure access to quality care 4. A vital organization that is ethical, fiscally sound, and customer and human resource focused Board/CounCil Chairs and ViCe-Chairs ProVide inPut for MQa’s strategiC Plan As part of the strategic plan input and feedback process, in September 2007, the Board/Council Chairs and Vice-Chairs were asked to participate in a Long-Range Planning Survey. The survey asked for their input on the importance of each of MQA’s six goals, listed as 3.1, 3.2, 3.3, 4.1, 4.2, and 4.3 in the Strategic Plan. Ninety-four percent of those responding felt it was important for MQA to have 3.1 as a goal, and 100 percent felt it was important for the division to have 3.2, 3.3, 4.1, 4.2 and 4.3 as a goal. Important for MQA? If so, is it essential to adequately protecting customers? If so, is it essential to adequately enforcing unlicensed activity? Goal 3 .1 Expeditiously licensed healthcare professionals who meet statutorily mandated minimum standards of competency . 3 .2 Healthcare standards are enforced through timely discipline, education, and remediation of healthcare professionals found in violation of the law . 3 .3 Timely and accurate information for stakeholders and consumers that will enable informed healthcare decisions and promote equitable and accessible health care for all persons in Florida . 4 .1 Customers are informed of, have confidence in, and value MQA services . 4 .2 A motivated workforce committed to excellence . 4 .3 A fiscally sound organization . Yes 94% Yes 94% Yes 75% 100% 100% 94% 100% 94% 88% 100% 100% 100% 94% 82% 88% 76% 94% 94% 6 MQA Annual Report : July 1, 2006 - June 30, 2007 2007-2008 MQA Strategic Plan MQA Strategic Goal 3 .1 Expeditiously licensed healthcare professionals who meet statutorily mandated minimum standards of competency . MQA Strategic Objective 3.1.1 Provide an efficient licensure process that meets statutory requirements Measure 3.1.1.1 3.1.1.2 3.1.1.3 Average # of days to issue an initial license Average # of days to issue a nursing license % of incomplete initial licensure applications in which a notification of deficiency is sent within 30 days % of complete initial licensure applications approved or denied within 90 days % of applicants denied licensure # of licenses that turn null and void # of licenses and renewals issued Average # of days to issue an order following board action # of Cease and Desist Orders Issued % of ULA cases referred for criminal prosecution # of ULA cases investigated % of priority 1 investigations resulting in emergency action Average # of days to take emergency action on priority 1 investigations % of initial investigations and recommendations as to the existence of probable cause completed within 180 days of receipt # of practitioner complaints determined legally sufficient # of licensees found to be practicing on a delinquent license 3.1.1.4 3.1.1.5 3.1.1.6 3.1.1.7 3 .2 Healthcare standards are enforced 3.2.1 through timely discipline, education, and remediation of healthcare professionals found in violation of the law . Provide an efficient enforcement process that meets statutory requirements 3.2.1.1 3.2.1.2 3.2.1.3 3.2.1.4 3.2.1.5 3.2.1.6 3.2.1.7 3.2.1.8 3.2.1.9 3.2.1.10 # of legally sufficient complaints resolved by findings of no probable cause 3.2.1.11 # of legally sufficient complaints resolved by findings of no probable cause (letters of guidance) 7 MQA Annual Report : July 1, 2006 - June 30, 2007 2007-2008 MQA Strategic Plan MQA Strategic Goal MQA Strategic Objective Provide an efficient enforcement process that meets statutory requirements Measure 3.2.1.12 # of legally sufficient complaints resolved by findings of no probable cause (notice of non-compliance) 3.2.1.13 # of legally sufficient complaints resolved by the issuance of a citation for minor violations 3.2.1.14 # of legally sufficient complaints resolved by findings of stipulations or informal hearings 3.2.1.15 # of legally sufficient complaints resolved by findings of formal hearings 3.2.1.16 Average # of complaint investigations per FTE 3.2.1.17 % legally sufficient complaints offered for Alternative Dispute Resolution 3.2.1.18 % of cases offered for Alternative Dispute Resolution resulting in successful resolution 3.2.1.19 % of ULA cases referred to law enforcement that result in arrest 3.2.1.20 Average # of days to respond to a complaint 3.2.1.21 % of administrative complaints filed with DOAH or otherwise resolved within 1 year from finding of probable cause 3.2.1.22 % of enforcement actions for failing to report statutorily required information (profile) 3 .3 Timely and accurate information 3.3.1 for stakeholders and consumers that will enable informed healthcare decisions and promote equitable and accessible health care for all persons in Florida . 4 .1 Customers are informed of, have confidence in, and value MQA service . 4.1.1 Improve accuracy and compliance with reporting requirements and accuracy of information received from internal and external sources Increase knowledge of customer expectations regarding quality, cost, effectiveness, and timeliness of products and services 3.3.1.1 Average # of days to fulfill a public record request for license application Average # of days to post final disciplinary actions on the web % of new licensees satisfied with the services received from the division % of customers satisfied with fulfillment of public record requests 3 .2 Healthcare standards are enforced 3.2.1 through timely discipline, education, and remediation of healthcare professionals found in violation of the law . 3.3.1.2 4.1.1.1 4.1.1.2  MQA Annual Report : July 1, 2006 - June 30, 2007 2007-2008 MQA Strategic Plan MQA Strategic Goal 4 .1 Customers are informed of, have confidence in, and value MQA service . MQA Strategic Objective 4.1.1 Increase knowledge of customer expectations regarding quality, cost, effectiveness, and timeliness of products and services Measure 4.1.1.3 4.1.1.4 % of customers satisfied with web information % of parties involved in enforcement actions satisfied with services received % of external customers satisfied with services provided by MQA # of inquiries to the practitioner profile website % of employee satisfaction % of employee turnover 4.1.1.5 4.1.1.6 4 .2 A motivated workforce committed 4.2.1 to excellence . Recruit, hire and retain skilled and motivated employees that will exemplify MQA’s mission, vision and values All regulated professions have a positive cash balance 4.2.1.1 4.2.1.2 4 .3 A fiscally sound organization . 4.3.1 4.3.1.1 4.3.1.2 % fines and costs imposed that are collected % of enforcement expenditures recouped through assessed disciplinary costs Amount of revenue collected from delinquent fines % of professions with adequate licensure renewal fees % of professions operating with a positive or neutral cash balance % error of actual cash expenditures from projected expenditures by board 4.3.1.3 4.3.1.4 4.3.1.5 4.3.1.6  MQA Annual Report : July 1, 2006 - June 30, 2007 Licensure MQA, in conjunction with 22 boards and six councils, licenses seven types of facilities and more than 40 healthcare professions. Licensure activities include preparing and administering licensure examinations; issuing and renewing licenses; tracking licensure conditions; monitoring compliance with continuing education requirements; and evaluating and approving training programs and continuing education for providers. online renewals The division’s continued focus on online renewals resulted in a nearly 10% increase from FY 04-05 in online renewal percentage. Most importantly, the effort resulted in more than $837,000 in cost savings compared to manually processing those same renewals. 2004-2005 Online Renewals 2006-2007 Online Renewals 50.78% 49.22% Online Renewals Manual Renewals 41% 59% national Board and indiVidual awards “The vision of MQA is to be the nation’s leader in quality healthcare regulation, and these awards represent great strides in reaching that goal. There is no greater honor than being recognized by your national peers as the best of the best; every Floridian should be proud.” • The Florida Board of Osteopathic Medicine was recognized as the "Best of the Boards for 2007" by the Administrators in Medicine (AIM). The Board was acknowledged for its communication plan, which included an educational video aimed at increasing the number of osteopathic physicians choosing to practice in Florida. • The Florida Board of Chiropractic Medicine received the Federation of Chiropractic Licensing Boards’ (FCLB) 2007 Outstanding Board Award. The board was cited for its current initiatives in public outreach and information distribution. • Former Florida Board of Chiropractic Medicine Chair and FCLB Past President Wayne Wolfson, D.C., received FCLB’s George R. Arvidson Award for Meritorious Service for his exceptional leadership and service to public protection. This is FCLB’s highest individual honor. • MQA Investigative Services Unit Chief Tom Hannah, who currently serves on the AIM/FSMB Committee on National Medical Investigator Certification, received AIM’s outstanding investigator award. - State Surgeon General Ana M . Viamonte Ros, M .D ., M .P .H . 10 MQA Annual Report : July 1, 2006 - June 30, 2007 inCrease in new liCenses issued During 2006-2007, MQA once again set an all-time high in the number of healthcare licenses issued, with an astonishing 51.8% increase from just two years earlier (FY 04-05). The greatest increase was seen in the profession of certified nursing assistants, with 15,174 more licenses issued. Also impacting the workload were the additions of the Drugs, Devices and Cosmetics, Emergency Medical Services, and Radiologic Technology professions. New Licenses Issued 80,000 69,333 60,000 47,198 71,655 2004-2005 2005-2006 2006-2007 40,000 20,000 0 state and national serViCe A number of MQA employees and board and council members continue to represent Florida and the Department of Health in both the state and national healthcare arena. Board Members Serving on National Regulatory Boards Board Member Jim Andriole, D.O. Board of Osteopathic Medicine Probable Cause Panel Chair Robert Easton, O.D. Board of Optometry member Frank Ervolino Board of Acupuncture Vice-chair Robert Fedor, D.O. Board of Osteopathic Medicine Vice-chair Dave Quiring, LMT Board of Massage Therapy Chair Tully Patrowicz, M.D. Board of Medicine member National Regulatory Board Federation of State Medical Boards Board of Directors President of the Association of Regulatory Boards of Optometry (completed term June, 2007) Federation of Acupuncture and Oriental Medicine Regulatory Agencies Board of Directors Federation of State Medical Board’s Nominating Committee Vice-chair of the Federation of State Massage Therapy Boards Federation of State Medical Boards Board of Directors 11 MQA Annual Report : July 1, 2006 - June 30, 2007 MQA Employees Representing DOH on State and National Workgroups and Regulatory Boards Member Joe Baker, Jr. Executive Director for the Boards of Chiropractic Medicine, Clinical Laboratory Personnel, Medical Physicists, Nursing Home Administrators, Optometry, Orthotists & Prosthetists, and Podiatric Medicine Joe Baker, Jr. Executive Director for the Boards of Chiropractic Medicine, Clinical Laboratory Personnel, Medical Physicists, Nursing Home Administrators, Optometry, Orthotists & Prosthetists, and Podiatric Medicine Joe Baker, Jr. Executive Director for the Boards of Chiropractic Medicine, Clinical Laboratory Personnel, Medical Physicists, Nursing Home Administrators, Optometry, Orthotists & Prosthetists, and Podiatric Medicine Joe Baker, Jr. Executive Director for the Boards of Chiropractic Medicine, Clinical Laboratory Personnel, Medical Physicists, Nursing Home Administrators, Optometry, Orthotists & Prosthetists, and Podiatric Medicine Charles Coats District Investigation Manager Nina Saxon Investigator Tom French Investigator Lucy C. Gee, M.S. Director, Medical Quality Assurance Lucy C. Gee, M.S. Director, Medical Quality Assurance Tom Hannah District Investigation Manager Department of Financial Services: National Insurance Crime Bureau MiniMedical Task Force AHCA Patient Safety Workgroup AHCA State Electronic Prescribing Advisory Panel Administrators in Medicine & Federation of State Medical Boards, National Medical Investigator Certification Committee Administrators in Medicine (AIM) Medical Insurance Fraud Workgroup/Board Association of Chiropractic Board Administrators (ACBA) Purpose Networking/communication . Discuss issues that affect the regulation of the Chiropractic profession Association of Regulatory Board of Optometry (ARBO) Information exchange regarding professional education of optometrists, continuing education, reciprocal relations between licensing jurisdictions, solve mutual problems, improving standards of the profession Federation of Chiropractic Licensing Boards (FCLB) Promoting excellence in Chiropractic Regulation United Way, Leon County, and City of Tallahassee: Community Human Services Partnership To determine annual allocations for United Way (FSECC), Leon County and City of Tallahassee funds Department of Health: Operation Spot-check Inspection of pharmacies dispensing medicine to the public including nursing homes and animal shelters . Study s . 395 .0197, F .S . Established pursuant to HB 1155 (07) mandating electronic prescribing Certification and training of investigators on a national level Pamela King Executive Director for the Boards of Acupuncture, Anesthesiologist Assistants, Massage Establishments, Massage Therapy, Midwifery, Office Surgery Facilities, Osteopathic Medicine, and Speech-Language Pathology & Audiology Pamela King Executive Director for the Boards of Acupuncture, Anesthesiologist Assistants, Massage Establishments, Massage Therapy, Midwifery, Office Surgery Facilities, Osteopathic Medicine, and Speech-Language Pathology & Audiology Pamela King Executive Director for the Boards of Acupuncture, Anesthesiologist Assistants, Massage Establishments, Massage Therapy, Midwifery, Office Surgery Facilities, Osteopathic Medicine, and Speech-Language Pathology & Audiology Non-profit organization to assist and support administrators for medical licensing and regulatory authorities to achieve administrative excellence and advance public safety . Family Health: Governor’s Women’s Health Care Conference Advisory Committee Committee to develop educational agenda for the 2007 Women’s Health Conference . Federation of Acupuncture and Oriental Medical Regulatory Agencies Non-profit organization that provides an organization where member acupuncture agencies work together to assure the protection of the public through good communication about licensure, practice, regulatory activity and professional disciplinary action to promote the delivery of quality health care to the public . 12 MQA Annual Report : July 1, 2006 - June 30, 2007 MQA Employees Representing DOH on State and National Workgroups and Regulatory Boards Member Pamela King Executive Director for the Boards of Acupuncture, Anesthesiologist Assistants, Massage Establishments, Massage Therapy, Midwifery, Office Surgery Facilities, Osteopathic Medicine, and Speech-Language Pathology & Audiology Pamela King Executive Director for the Boards of Acupuncture, Anesthesiologist Assistants, Massage Establishments, Massage Therapy, Midwifery, Office Surgery Facilities, Osteopathic Medicine, and Speech-Language Pathology & Audiology Pamela King Executive Director for the Boards of Acupuncture, Anesthesiologist Assistants, Massage Establishments, Massage Therapy, Midwifery, Office Surgery Facilities, Osteopathic Medicine, and Speech-Language Pathology & Audiology Roxanne McCarthy Investigator Workgroup/Board Federation of State Massage Therapy Boards Purpose Non-profit organization that supports its member boards in their work to ensure that the practice of massage therapy is provided to the public in a safe and effective manner . Federation of State Medical Boards Non-profit organization that provides continual improvement in the quality, safety and integrity of health care through development and promotion of high standards for physician licensure and practice . National Council of State Boards of Speech-Language Pathology and Audiology Non-profit organization that facilitates the role of state speech-audiology licensure boards through communication and education . Seminole County State Attorney’s Office: Seminole County Multidisciplinary Task Force Prevent elderly abuse Larry McPherson, J.D. Administrators in Medicine (AIM) Executive Director for the Boards of Anesthesiologist Assistants, Medicine, Naturopathy, Office Surgery, and Physician Assistants Larry McPherson, J.D. AHCA Florida Health Information Executive Director for the Boards of Anesthesiologist Privacy and Security Project Legal Work Assistants, Medicine, Naturopathy, Office Surgery, Group and Physician Assistants Rodney Johnson DOH Privacy Officer Larry McPherson, J.D. Federation of State Medical Boards Executive Director for the Boards of Anesthesiologist Assistants, Medicine, Naturopathy, Office Surgery, and Physician Assistants Cassandra Pasley, B.S.N., J.D. Chief, Bureau of Health Care Practitioner Regulation Rebecca Poston, R.Ph., C.Ph. Executive Director for the Board of Pharmacy Governor’s Office/Drug Control: Substance Abuse Gender Specific Services Workgroup Florida Pharmacy Council Supports and assists administrators for medical licensing and regulatory authorities to achieve administrative excellence and advance public safety . Collaborative efforts lead by the Agency for Health Care Administration (AHCA) . Florida was one of 34 states and U .S . territories awarded a contract to conduct a study of the variations in business practices and laws related to electronic health information exchanges (E-Health Exchange) Non-profit assisting state medical boards in protecting the public’s health, safety and welfare through promotion of high stands for physician licensure and regulation Workgroup to examine comprehensive services for women based upon the National Center on Addiction and Substance Abuse book, Women, Under the Influence Represents a liaison between the professional, regulatory, academic, chain and distribution organizations within the State of Florida with common goals and objectives for the profession of Pharmacy . The Mission of the Florida Pharmacy Council is to facilitate discussion on professional, technological, regulatory, and related issues through the exchange of ideas of common interest relating to the profession of pharmacy . Serve on the Task Force on Continuous Quality Improvement, Peer Review, and Inspecting for Patient Safety Prevent and investigate prescription drug misuse For administrators to come together in a forum that is beneficial to all to discuss and share issues that affects the physical therapy profession . Rebecca Poston, R.Ph., C.Ph. Executive Director for the Board of Pharmacy Lija Scherer Investigator Cheryl Searcy Program Operations Administrator National Association of Boards of Pharmacy Florida State Office of Drug Control: Diversion Response Team (DRT) Federation of State Boards for Physical Therapy: Council of Board Administrators 13 MQA Annual Report : July 1, 2006 - June 30, 2007 Enforcement MQA protects the public by investigating, prosecuting and disciplining incompetent, unethical, or impaired practitioners. Enforcement activities include intake, analysis, and investigation of complaints and reports; tracking licensee compliance with disciplinary sanctions; healthcare facilities inspections; issuance of citations and emergency suspension and restriction orders; and conducting disciplinary proceedings against licensed healthcare practitioners. The division’s Unlicensed Activity (ULA) Program protects Florida’s residents and visitors from the potentially serious and dangerous consequences that may result from the actions of an unlicensed person, including further injury, disease or even death. The ULA Program works in conjunction with law enforcement and the state attorney’s offices to prosecute individuals practicing without a license. ula Cases MQA’s focus on Unlicensed Activity is evident from the notable increases in investigations completed (48.6%), cease and desist orders (81%), and arrests (34%) over the last three years. ULA Cases 1,000 850 800 2004-2005 2005-2006 610 2006-2007 600 572 400 243 157 115 200 195 134 211 0 Investigations Completed Cease and Desist Orders Arrests 1 MQA Annual Report : July 1, 2006 - June 30, 2007 inCrease in legally suffiCient Cases 2006-2007 saw an all-time high of 9,950 legally sufficient complaints – an increase of more than 26% over just two years earlier (FY 04-05). Legally Su cient Complaints 10,000 8,000 6,000 4,000 2,000 0 9,661 7,841 9,950 2004-2005 2005-2006 2006-2007 Cases Meeting 180-day reQuireMent Section 456.073, F.S., requires analysis, investigation and recommendation of probable cause within 180 days of the receipt of a complaint. During 2006-2007, nearly 93% of disciplinary cases met this requirement – 10% higher than in 2004-2005. 2004-2005 Percentage of Cases Meeting 180-day Requirement Meeting 180-day Requirement Not Meeting 180-day Requirement 2006-2007 Percentage of Cases Meeting 180-day Requirement 7.2% 17.5% 82.5% 92.8% Note: The department is not prevented from continuing with the disciplinary process on cases not meeting the 180-day requirement . 1 MQA Annual Report : July 1, 2006 - June 30, 2007 inCrease in CoMPlaints and rePorts reCeiVed 2006-2007 saw a dramatic increase in the total number of statutory reports and complaints received, with the 41,675 total representing a more than 37% increase over the total number received in 2004-2005. Complaints and Reports Received 45,000 2004-2005 2005-2006 41,675 30,000 26,064 30,242 33,681 2006-2007 17,415 19,126 0 Statutory Reports Complaints Received 12,827 14,555 15,611 15,000 Total inCrease in eMergenCy orders During 2006-2007, the division once again had a record-number of emergency orders issued. Through these actions, the State Surgeon General is able to restrict the practice of a health professional considered an immediate danger to the public. Emergency Orders 300 252 200 186 212 213 220 256 2004-2005 2005-2006 2006-2007 100 27 0 8 4 Emergency Suspension Orders Total Emergency Orders Emergency Restriction Orders 16 MQA Annual Report : July 1, 2006 - June 30, 2007 CoMPlaints resolVed By Citation Citations serve as a quick and efficient way to resolve minor violations, usually involving a fine and obligations imposed as approved by board rule. The number of complaints resolved by citation has more than doubled over the last three years, allowing the division to focus additional time and resources on more serious violations. Complaints Resolved by Citation 2,000 2004-2005 1,500 1,591 2005-2006 2006-2007 1,000 739 500 1,117 0 17 MQA Annual Report : July 1, 2006 - June 30, 2007 Information To help people make more informed choices about their healthcare practitioners, MQA provides easy access to licensure and disciplinary information and ensures that data is accurate, timely, consistent and reliable. Visit www.FLHealthSource.com today to find current licensure information for all licensed healthcare providers and more extensive profile information for physicians, podiatrists, chiropractors, osteopathic physicians, and advanced registered nurse practitioners. Visits to the PraCtitioner Profiling weBsite MQA’s practitioner profiling site serves a vital function for people taking an active role in their healthcare decisions, as indicated by a 19% increase in the number of visits to the site in the last three years. Visits to the Practitioner Pro ling Website 1,750,000 1,500,000 1,250,000 1,000,000 750,000 500,000 250,000 0 Visits to Board and CounCil weBsites 1,331,641 1,511,583 1,587,562 2004-2005 2005-2006 2006-2007 MQA’s Board and Council Websites serve an important function for consumers, applicants and licensees alike. The sites include profession updates, renewal information, laws and rules, contact information, and links to reports, profiles, and final orders and emergency actions. Over the past three years, visits to the site have increased more than 70%, to over 2.6 million in 2006-2007. Visits to Board and Council Websites 3,000,000 2,632,474 2,000,000 1,545,375 1,000,000 2,170,592 2004-2005 2005-2006 2006-2007 1 0 MQA Annual Report : July 1, 2006 - June 30, 2007 Information: Tables Table 1 • Summary of Licensed Practitioners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Table 2 • Summary of Licensed Establishments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Table 3 • Recognized Continuing Education (CE) Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 Table 4 • Applications Received and Initial Licenses Issued . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Table 5 • Examinations Developed and Administered by MQA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Table 6 • Emergency Orders Issued Against Healthcare Licensees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 7 • Stop Sale Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 8 • Reports Received, Complaints Received, and Investigations Completed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 9 • Probable Cause Actions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Table 10 • Summary of Disciplinary Cases Against Healthcare Licensees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Table 11 • Medical Malpractice Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Table 12 • Hospital Annual Report Claims . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Table 13 • Unlicensed Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34 Table 14a • Revenue, Expenditures & Cash Balances for the MQA Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Table 14b • Revenue, Expenditures & Cash Balances for the Drugs, Devices & Cosmetics Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . 35 Table 15a • Projected Cash Balances for the MQA Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Table 15b • Projected Cash Balances for the Drugs, Devices & Cosmetics Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 Table 16a • Review of the Adequacy of Renewal Fees for the MQA Trust Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Table 16b • Review of the Adequacy of Renewal Fees for the Drugs, Devices & Cosmetics Trust Fund . . . . . . . . . . . . . . . . . . . . . . . 39 Table 17a • Web Usage for Boards & Councils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Table 17b • Web Usage for Program Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Table 17c • Web Usage for MQA Online Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Table 18 • Online Renewals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Table 19 • Student Loan Defaults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 1 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 1 • Summary of Licensed Practitioners PROFESSION Acupuncturist Anesthesiologist Assistant Athletic Trainer Audiology - Audiologist Audiology - Audiology Assistant Audiology - Provisional Audiologist Certified Nursing Assistant (CNA) Chiropractic - Certified Chiropractic Physician's Assistant Chiropractic - Chiropractic Physician Chiropractic - Registered Chiropractic Assistant Clinical Laboratory Personnel Clinical Laboratory Trainee Clinical Laboratory Training Program Clinical Social Work - Certified Master Social Worker Clinical Social Work - Clinical Social Worker Clinical Social Work - Clinical Social Worker Intern Clinical Social Work - Provisional Clinical Social Worker Dental Hygienist Dental Radiographer Dental Residency Permit Dental Teaching Permit Dentist Dietetics & Nutrition - Dietitian/Nutritionist Dietetics & Nutrition - Nutrition Counselor Drugs, Devices & Cosmetics Certificate Designated Representative Electrologist EMS - Emergency Insect Sting Treatment EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Marriage & Family Therapy Marriage and Family Therapist Marriage & Family Therapy Provisional Marriage and Family Therapist Marriage & Family Therapy Registered Marriage and Family Therapy Intern Massage Therapist Medical Physics - Diagnostic Radiological Physicist Medical Physics - Medical Health Physicist Medical Physics - Medical Nuclear Radio Physicist Medical Physics - Medical Physicist in Training Medical Physics - Therapeutic Radiological Physicist Medicine - House Physician Medicine - Limited License Medical Doctor Medicine - Medical Doctor Medicine - Medical Doctor Area Critical Need Medicine - Medical Doctor Limited to Cleveland Clinic Medicine - Medical Doctor Limited to Mayo Clinic IN-STATE ACTIVE 1,579 6 1,243 811 24 103 132,657 242 4,219 2,442 12,762 918 39 3 5,708 1,899 69 9,891 21,746 331 276 9,551 2,838 168 320 763 276 28,990 19,240 852 1,228 11 472 26,165 48 30 36 53 169 380 233 40,065 83 0 5 IN-STATE INACTIVE 37 0 33 17 0 0 0 21 101 0 562 0 0 0 167 0 0 105 0 0 0 57 25 9 0 12 0 89 47 13 60 0 0 429 0 2 0 0 0 0 1 190 1 0 0 IN-STATE DELINQUENT ACTIVE 60 0 183 45 5 0 0 76 79 1 757 0 5 1 210 409 0 204 1 0 0 129 297 20 0 84 0 0 0 82 39 0 99 2,277 3 0 2 1 7 1 24 674 3 0 1 IN-STATE DELINQUENT INACTIVE 15 0 14 3 0 0 0 5 26 0 234 0 0 0 60 0 0 33 0 0 0 19 7 5 0 12 0 0 0 3 15 0 0 157 0 0 0 0 0 0 2 105 2 0 0 OUT-OFSTATE ACTIVE 172 3 82 56 0 11 2,917 4 674 13 1,061 32 9 0 428 24 9 1,638 155 1 0 1,902 134 16 340 22 11 395 514 24 88 1 14 2,046 33 12 26 10 44 3 10 11,968 14 0 0 OUT-OFSTATE INACTIVE 56 0 25 4 0 0 0 2 360 0 353 0 0 0 194 0 0 143 0 0 0 149 9 0 0 5 0 7 13 8 46 0 0 153 0 1 0 0 0 0 0 941 1 0 0 OUT-OFSTATE DELINQUENT 42 0 28 11 0 0 0 5 109 0 277 0 0 0 113 20 0 165 1 0 0 145 50 4 0 7 0 0 0 10 23 0 5 453 5 1 1 0 10 0 2 1,285 1 0 0 RETIRED 9 0 2 7 0 0 1 0 75 0 105 0 0 0 90 0 0 145 0 0 0 195 24 4 0 19 0 0 0 14 26 0 0 66 0 1 0 0 1 0 6 733 2 0 0 TOTAL 1,970 9 1,610 954 29 114 135,575 355 5,643 2,456 16,111 950 53 4 6,970 2,352 78 12,324 21,903 332 276 12,147 3,384 226 660 924 287 29,481 19,814 1,006 1,525 12 590 31,746 89 47 65 64 231 384 278 55,961 107 0 6 20 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 1 • Summary of Licensed Practitioners PROFESSION Medicine - Medical Doctor Medical Faculty Certificate Medicine - Medical Doctor Public Health Certificate Medicine - Medical Doctor Public Psychiatry Certificate Medicine - Medical Doctor Restricted Medicine - Medical Doctor Visiting Faculty Certificate Medicine - Resident Registration Mental Health Counseling - Mental Health Counselor Mental Health Counseling Provisional Mental Health Counselor Mental Health Counseling Registered Mental Health Counselor Intern Midwife Naturopathic Physician Nursing - Advanced Registered Nurse Practitioner (ARNP) Nursing - Licensed Practical Nurse (LPN) Nursing - Registered Nurse (RN) Nursing Home Administrator Nursing Home Administrator Provisional Occupational Therapist Occupational Therapy Assistant Opticianry - Apprentice Optician Opticianry - Optician Optometric Faculty Certificate Optometrist Orthotics & Prosthetics - Orthotic Fitter Orthotics & Prosthetics - Orthotic Fitter Assistant Orthotics & Prosthetics - Orthotist Orthotics & Prosthetics - Pedorthist Orthotics & Prosthetics - Prosthetist Orthotics & Prosthetics - Prosthetist-Orthotist Osteopathic - Osteopathic Faculty Certificate Osteopathic - Osteopathic Limited License Osteopathic - Osteopathic Physician Osteopathic - Osteopathic Training Registration Pharmacy - Consultant Pharmacist Pharmacy - Nuclear Pharmacist Pharmacy - Pharmacist Pharmacy - Pharmacist Intern Physical Therapist Assistant Physical Therapist Physician Assistant Podiatry - Certified Podiatric X-Ray Assistant Podiatry - Podiatric Physician Psychology - Limited License Psychologist Psychology - Provisional Psychologist Psychology - Psychologist Radiologic Technologist Radiologist Assistant IN-STATE ACTIVE 69 4 2 2 0 3,618 6,285 87 1,899 115 6 10,645 59,215 169,633 1,283 18 5,307 1,563 1,038 3,229 13 2,153 96 121 99 106 68 155 0 7 3,619 390 2,183 147 17,079 4,849 4,561 9,858 4,038 481 1,258 0 43 3,571 21,459 2 IN-STATE INACTIVE 0 0 0 0 0 0 241 0 0 6 0 61 790 2,147 65 0 79 25 0 111 0 5 2 0 1 0 0 0 0 0 21 0 105 5 121 0 115 187 20 4 15 1 0 22 108 0 IN-STATE DELINQUENT ACTIVE 23 0 0 0 0 60 165 0 394 14 1 282 4,796 8,148 88 0 283 109 0 114 0 26 10 24 6 6 3 4 0 1 55 0 149 10 245 0 131 244 157 130 21 1 0 52 8,276 0 IN-STATE DELINQUENT INACTIVE 0 0 0 0 0 0 65 0 0 2 0 16 345 997 10 0 20 6 0 30 0 3 0 0 0 0 0 0 0 0 11 0 29 0 27 0 32 41 15 0 1 0 0 5 0 0 OUT-OFSTATE ACTIVE 26 0 0 0 1 934 363 6 42 12 0 1,735 4,754 26,316 179 0 512 148 11 156 1 551 1 1 6 3 3 12 0 0 1,100 184 128 45 6,622 2,281 330 1,392 438 2 376 0 2 382 1,863 0 OUT-OFSTATE INACTIVE 0 0 0 0 0 0 167 0 0 0 0 109 337 2,247 16 0 104 14 0 65 0 66 0 0 0 0 0 0 0 0 263 0 28 9 384 0 100 579 40 0 71 0 0 40 38 0 OUT-OFSTATE DELINQUENT 1 0 0 0 0 37 80 0 21 11 0 360 1,167 7,184 39 0 180 56 0 22 0 46 1 0 1 0 2 2 0 0 130 0 32 9 505 0 81 302 95 2 45 1 0 51 2,919 0 RETIRED 0 0 0 0 0 0 89 0 0 1 0 106 329 2,064 42 0 18 8 0 22 0 27 1 1 4 0 3 4 0 0 52 0 11 1 67 0 7 37 25 0 33 2 0 99 0 0 TOTAL 119 4 2 2 1 4,649 7,455 93 2,356 161 7 13,314 71,733 218,736 1,722 18 6,503 1,929 1,049 3,749 14 2,877 111 147 117 115 79 177 0 8 5,251 574 2,665 226 25,050 7,130 5,357 12,640 4,828 619 1,820 5 45 4,222 34,663 2 21 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 1 • Summary of Licensed Practitioners PROFESSION Respiratory Therapy - Certified Respiratory Therapist Respiratory Therapy - Registered Respiratory Therapist Respiratory Therapy Respiratory Care Practitioner by Exam Respiratory Therapy Respiratory Care Practitioner Critical Care Respiratory Therapy Respiratory Care Practitioner Non-Critical Care Respiratory Therapy Respiratory Care Registered Student Exemption School Psychologist Speech-Language Pathology Provisional Speech-Language Pathologist Speech-Language Pathology Speech-Language Pathologist Speech-Language Pathology Speech-Language Pathology Assistant Total IN-STATE ACTIVE 3,707 4,915 0 68 27 70 595 1,061 5,726 376 685,863 IN-STATE INACTIVE 136 159 0 2 0 0 25 0 55 19 6,631 IN-STATE DELINQUENT ACTIVE 584 325 0 8 5 373 14 1 277 118 31,512 IN-STATE DELINQUENT INACTIVE 48 45 0 2 2 0 8 0 21 5 2,503 OUT-OFSTATE ACTIVE 196 327 0 0 1 0 14 43 366 8 76,789 OUT-OFSTATE INACTIVE 47 79 0 0 0 0 8 0 39 0 7,320 OUT-OFSTATE DELINQUENT 114 145 0 2 0 1 5 0 91 2 16,515 RETIRED 18 25 0 3 0 0 11 0 23 0 4,658 TOTAL 4,850 6,020 0 85 35 444 680 1,105 6,598 528 831,791 Note: In-State and Out-of-State is determined by the mailing address of the licensee, not practice location. Definitions: In-State Active – The licensed practitioner has a Florida address of record and is clear to practice his/her profession in the state of Florida. In-State Delinquent Active – The licensed practitioner has a Florida address of record and is not authorized to practice his/her profession in the state of Florida, because he/she failed to renew his/her active license by the expiration date. In-State Delinquent Inactive – The licensed practitioner has a Florida address of record and is not authorized to practice his/her profession in the state of Florida because the practitioner inactivated his/her license and has failed to renew his/her inactive license by the expiration date. In-State Inactive – The licensed practitioner has a Florida address of record and is not authorized to practice his/her profession in the state of Florida because the practitioner inactivated his/her license. Out-of-State Active – The licensed practitioner has an out-of-state address of record and is clear to practice his/her profession in the state of Florida. Out-of-State Delinquent – The licensed practitioner has an out-of-state address of record and is not authorized to practice his/her profession in the state of Florida, because they failed to renew his/her license by the expiration date. Out-of-State Inactive – The licensed practitioner has an out-of-state address of record and is not authorized to practice his/her profession in the state of Florida, because the practitioner inactivated his/her license. Retired – The licensed practitioner is not practicing in the state of Florida, but maintains a retired license status. The licensed practitioner is not authorized to practice in the state of Florida. The practitioner is not obligated to update his/her profile data. 22 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 2 • Summary of Licensed Establishments ESTABLISHMENT DDC - Complimentary Drug Distributor DDC - Compressed Medical Gases Manufacturer DDC - Compressed Medical Gases Wholesaler DDC - Cosmetic Manufacturer DDC - Device Manufacturer DDC - Diethyl Ether DDC - Exemption - Research, Teaching, and Testing DDC - Freight Forwarder DDC - Limited Veterinary Prescription Drug Wholesaler DDC - Medical Oxygen Retailer DDC - Non-resident Prescription Drug Manufacturer DDC - Out-of-State Prescription Drug Wholesale DDC - Over The Counter Drug Manufacturer DDC - Prescription Drug Manufacturer DDC - Prescription Drug Repackager DDC - Prescription Drug Wholesaler DDC - Prescription Drug Wholesaler Broker only DDC - Product Registration Permit DDC - Restricted Prescription Drug Distributor - Charitable Organization DDC - Restricted Prescription Drug Distributor - Destruction DDC - Restricted Prescription Drug Distributor - Government Program DDC - Restricted Prescription Drug Distributor - Health Care Entity DDC - Restricted Prescription Drug Distributor - Institutional Research DDC - Restricted Prescription Drug Distributor - Reverse Distributor DDC - Retail Pharmacy Wholesaler DDC - Veterinary Legend Drug Retailer DDC - Veterinary Prescription Drug Wholesaler Dental Laboratory Electrolysis Facility Massage Establishment Office Surgery Registration Optical Establishment Permit Optometry Branch Office Pharmacy Establishment TOTAL ACTIVE 205 135 372 121 138 13 448 24 6 1,472 648 197 99 89 15 166 5 325 26 7 21 109 0 8 128 17 35 1,129 316 8,792 309 1,119 789 7,493 24,776 DELINQUENT 2 3 1 0 0 0 0 0 0 21 3 0 0 0 0 0 0 2 0 1 1 0 0 1 8 0 0 22 11 1 0 0 0 135 212 TOTAL 207 138 373 121 138 13 448 24 6 1,493 651 197 99 89 15 166 5 327 26 8 22 109 0 9 136 17 35 1,151 327 8,793 309 1,119 789 7,628 24,988 Definitions: Active – The licensed facility is authorized to operate in the state of Florida. DDC – Drugs, Devices & Cosmetics Delinquent – The licensed facility is not authorized to operate in the state of Florida, because it failed to renew its active license by the expiration date. 23 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 3 • Recognized Continuing Education (CE) Providers BOARD OR COUNCIL Acupuncture Athletic Training Certified Nursing Assistants (CNA) Chiropractic Medicine Clinical Laboratory Personnel Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling Dentistry Dietetics and Nutrition Electrolysis Council Emergency Medical Services Hearing Aid Specialists Licensed Midwifery Massage Therapy Medical Physicists Medicine1 Nursing Nursing Home Administrators Occupational Therapy Practice Opticianry Optometry Orthotists & Prosthetists Osteopathic Medicine Pharmacy Physical Therapy Practice Physician Assistants2 Podiatric Medicine Psychology Radiologic Technologists Respiratory Therapy School Psychology Speech-Language Pathology & Audiology Total BOARD APPROVED PROVIDERS 88 10 148 12 176 529 143 0 10 17 4 1 396 0 NA 1,050 92 166 18 116 1 20 98 0 NA 2 65 0 115 10 69 3,356 STATUTE/RULE APPROVED PROVIDERS 14 19 0 15 6 57 96 65 10 299 12 4 45 4 NA 0 0 22 0 0 8 0 38 148 NA 10 69 515 21 9 485 1,971 TOTAL PROVIDERS 102 29 148 27 182 586 239 65 20 316 16 5 441 4 NA 1,050 92 188 18 116 9 20 136 148 NA 12 134 515 136 19 554 5,327 RECEIVED APPLICATIONS 39 11 60 8 18 59 39 20 7 176 6 1 63 0 NA 89 36 30 5 32 2 2 24 69 NA 1 18 19 17 1 54 906 APPROVED APPLICATIONS 36 5 58 4 18 29 31 13 5 176 4 1 63 0 NA 89 34 30 2 29 2 1 15 62 NA 1 8 19 10 1 49 795 SUBMITTED COURSES 426 123 2,458 314 3,390 6,258 900 2,789 203 503 69 2,048 799 55 NA 17,346 828 1,439 688 1,497 185 189 1,894 2,395 NA 193 4,100 3,859 3,369 2,813 1,446 62,576 Notes 1The Board of Medicine does not approve Continuing Medical Education (CME) providers . The Board recognizes and approves all American Medical Association category 1 or 2, CME courses provided by nationally affiliated associations, any state or federal agency, and any home study courses approved by those agencies . 2The Physician Assistants Council does not approve Continuing Medical Education (CME) providers . The Council recognizes CME courses provided by The American Academy of Physician Assistants, the American Medical Association, the American Osteopathic Association, the Accreditation Council on Continuing Medical Education, and any state or federal agency, or nationally affiliated professional association or any home study courses approved by the above agencies . Definitions: Board Approved Providers – Continuing Education Providers approved on an individual basis by a board or the department if there is no board . Statute/Rule Approved Providers – Continuing Education Providers automatically approved by statute or rule . Submitted Courses – Courses submitted by board approved providers, statute/rule approved providers, and in some professions, licensees . Total Providers – Board Approved Providers and Statute Rule Providers . 2 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 4 • Applications Received and Initial Licenses Issued PROFESSION Acupuncturist Anesthesiologist Assistant Athletic Trainer Audiology - Audiologist Audiology - Audiology Assistant Audiology - Provisional Audiologist Certified Nursing Assistant (CNA) Chiropractic - Certified Chiropractic Physician's Assistant Chiropractic - Chiropractic Physician Chiropractic - Registered Chiropractic Assistant Clinical Laboratory Personnel Clinical Laboratory Trainee Clinical Laboratory Training Program Clinical Social Work - Certified Master Social Worker Clinical Social Work - Clinical Social Worker Clinical Social Work - Clinical Social Worker Intern Clinical Social Work - Provisional Clinical Social Worker Dental Hygienist Dental Radiographer Dental Residency Permit Dental Teaching Permits Dentist Dietetics & Nutrition - Dietitian/Nutritionist Dietetics & Nutrition - Nutrition Counselor Drugs, Devices & Cosmetics - Certificate Designated Representative Electrologist EMS - Emergency Insect Sting Treatment EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialists Marriage & Family Therapy - Marriage and Family Therapist Marriage & Family Therapy - Provisional Marriage and Family Therapist Marriage & Family Therapy - Registered Marriage and Family Therapy Intern Massage Therapist Medical Physics - Diagnostic Radiological Physicist Medical Physics - Medical Health Physicist Medical Physics - Medical Nuclear Radio Physicist Medical Physics - Medical Physicist in Training Medical Physics - Therapeutic Radiological Physicist Medicine - House Physician Medicine - Limited License Medical Doctor Medicine - Medical Doctor Medicine - Medical Doctor Area Critical Need Medicine - Medical Doctor Limited to Cleveland Clinic Medicine - Medical Doctor Limited to Mayo Clinic INITIAL APPLICATIONS RECEIVED 177 2 200 72 9 27 25,588 43 481 929 1,115 248 10 0 613 540 34 1,472 776 73 28 877 237 0 714 418 95 11,471 5,306 260 129 7 135 3,629 8 1 2 22 19 59 28 3,098 55 0 0 LICENSES ISSUED 154 5 189 58 6 27 18,495 29 170 860 884 215 9 0 380 506 29 645 731 73 24 271 197 0 85 179 78 4,027 1,691 191 59 5 123 3,192 3 1 2 25 18 48 18 3,001 32 0 0 2 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 4 • Applications Received and Initial Licenses Issued PROFESSION Medicine - Medical Doctor Medical Faculty Certificate Medicine - Medical Doctor Public Health Certificate Medicine - Medical Doctor Public Psychiatry Certificate Medicine - Medical Doctor Restricted Medicine - Medical Doctor Visiting Faculty Certificate Medicine - Resident Registration Mental Health Counseling - Mental Health Counselor Mental Health Counseling - Provisional Mental Health Counselor Mental Health Counseling - Registered Mental Health Counselor Intern Midwifery Naturopathic Physician Nursing - Advanced Registered Nurse Practitioner (ARNP) Nursing - Licensed Practical Nurse (LPN) Nursing - Registered Nurse (RN) Nursing Home Administrator Nursing Home Administrator Provisional Occupational Therapist Occupational Therapy Assistant Opticianry - Apprentice Optician Opticianry - Optician Optometric Faculty Certificate Optometrist Orthotists & Prosthetists - Orthotic Fitter Orthotists & Prosthetists - Orthotic Fitter Assistant Orthotists & Prosthetists - Orthotist Orthotists & Prosthetists - Pedorthist Orthotists & Prosthetists - Prosthetist Orthotists & Prosthetists - Prosthetist-Orthotist Osteopathic - Osteopathic Faculty Certificate Osteopathic - Osteopathic Limited License Osteopathic - Osteopathic Physician Osteopathic - Osteopathic Training Registration Pharmacy - Consultant Pharmacist Pharmacy - Nuclear Pharmacist Pharmacy - Pharmacist Pharmacy - Pharmacist Intern Physical Therapist Assistant Physical Therapist Physician Assistant Podiatry - Certified Podiatric X-Ray Assistant Podiatry - Podiatric Physician Psychology - Limited License Psychologist Psychology - Provisional Psychologist Psychology - Psychologist Radiologic Technologist INITIAL APPLICATIONS RECEIVED 19 1 0 3 0 1,160 514 53 622 20 0 808 9,973 18,674 244 4 591 322 212 279 6 334 16 43 7 22 5 10 0 0 300 217 189 13 2,695 1,542 1,069 1,766 497 122 86 4 15 642 5,342 LICENSES ISSUED 24 0 0 2 0 1,158 361 51 552 11 0 841 6,324 15,700 68 1 393 210 191 126 4 91 10 35 5 17 3 7 0 0 275 205 168 10 1,123 1,331 351 685 427 114 46 0 13 167 2,105 26 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 4 • Applications Received and Initial Licenses Issued PROFESSION Radiologist Assistant Respiratory Therapy - Certified Respiratory Therapist Respiratory Therapy - Registered Respiratory Therapist Respiratory Therapy - Respiratory Care Practitioner by Exam Respiratory Therapy - Respiratory Care Practitioner Critical Care Respiratory Therapy - Respiratory Care Practitioner Non-Critical Care Respiratory Therapy - Respiratory Care Registered Student Exemption School Psychologist Speech-Language Pathology - Provisional Speech-Language Pathologist Speech-Language Pathology - Speech-Language Pathologist Speech-Language Pathology - Speech-Language Pathology Assistant Total INITIAL APPLICATIONS RECEIVED 2 457 519 0 0 0 0 43 265 520 120 109,374 LICENSES ISSUED 2 392 472 0 0 0 0 34 245 461 109 71,655 Definitions: Initial Applications Received – Complete review of applicants’ credentials by the respective board or council for that profession. Licenses Issued – Actual licenses issued to those applicants whose credentials meet the minimum standards outlined by the Legislature and the respective board or council for that profession. 27 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 5 • Examinations Developed and Administered by MQA PROFESSION Certified Designated Representative - Laws & Rules (CBT) Chiropractic Medicine Laws & Rules (CBT) Physical Diagnosis Clinical Technique Clinical X-Ray Interpretation (CBT) Dentistry Clinical Laws & Rules (CBT) Dental Hygiene Clinical Laws & Rules (CBT) Massage - Colonics (CBT) Nursing Home Administration - Laws & Rules (CBT) Opticianry Clinical Lens Neutralization Clinical Optometry Laws & Rules (CBT) Clinical Pharmacology & Ocular Disease Clinical (CBT) Paramedic - Certification Psychology - Laws & Rules (CBT) TOTALS Clinical Exams (non-CBT only) Laws & Rules Exams CBT Exams ALL EXAMS 1,922 2,268 5,448 7,370 1,875 1,898 4,754 6,629 193 308 1,139 1,332 10 .3% 16 .2% 24 .0% 20 .1% 1,682 1,590 3,615 5,297 89 .7% 83 .8% 76 .0% 79 .9% 102 112 111 2,826 284 101 111 111 2,513 153 1 23 12 791 26 1 .0% 20 .7% 10 .8% 31 .5% 17 .0% 100 88 99 1,722 127 99 .0% 79 .3% 89 .2% 68 .5% 83 .0% 147 146 147 145 21 23 14 .3% 15 .9% 126 122 85 .7% 84 .1% 643 763 30 109 631 739 26 88 15 112 1 25 2 .4% 15 .2% 3 .8% 28 .4% 616 627 25 63 97 .6% 84 .8% 96 .2% 71 .6% 431 497 417 467 38 60 9 .1% 12 .8% 379 407 90 .9% 87 .2% 189 238 205 213 184 228 196 206 12 61 12 27 6 .5% 26 .8% 6 .1% 13 .1% 172 167 184 179 93 .5% 73 .2% 93 .9% 86 .9% SCHEDULED 324 EXAMINED 166 FAILED 72 % FAILED 43 .4% PASSED 94 % PASSED 56 .6% Note: This table includes statistics for only those examinations developed by the Department . Definitions: CBT – Computer Based Testing 2 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 6 • Emergency Orders Issued Against Healthcare Licensees PROFESSION Certified Nursing Assistant (CNA) Chiropractic Medicine Clinical Laboratory Personnel Clinical Social Work Dentistry Massage Therapy Medicine Mental Health Counseling Nursing – Advanced Registered Nurse Practitioner (ARNP) Nursing – Registered Nurse (RN) Nursing - Licensed Practical Nurse (LPN) Occupational Therapy Optometry Osteopathic Medicine Pharmacist Physical Therapy Physician Assistant Podiatric Medicine Psychology Radiologic Technology Respiratory Therapy Total EMERGENCY RESTRICTION ORDERS 1 0 0 0 0 0 2 1 0 0 0 0 0 0 0 0 0 0 0 0 0 4 EMERGENCY SUSPENSION ORDERS 18 5 1 2 2 3 28 1 2 95 52 1 1 6 24 1 1 2 1 2 4 252 TOTAL EMERGENCY ORDERS 19 5 1 2 2 3 30 2 2 95 52 1 1 6 24 1 1 2 1 2 4 256 Definitions: Emergency Restriction Order – An order issued by the Florida Department of Health stating that a practitioner may only practice in the state of Florida under restrictions specified by the Department. Emergency Suspension Order – An order issued by the Florida Department of Health suspending the license of a practitioner. A practitioner may not practice in the state of Florida while under an emergency suspension order. Table 7 • Stop Sale Orders PROFESSION Drugs, Devices, & Cosmetics Definitions: Stop Sale Order – An order issued for the removal from commerce of any drug, device, or cosmetic that is adulterated, misbranded or considered contraband. STOP SALE ORDERS 18 Table 8 • Reports Received, Complaints Received, and Investigations Completed PROFESSION Acupuncture Anesthesiology Assistant Athletic Training Certified Nursing Assistant (CNA) Certified Social Worker Chiropractic Medicine STATUTORY REPORTS 0 0 0 763 0 52 COMPLAINTS RECEIVED 53 2 2 770 1 623 LEGALLY SUFFICIENT1 37 2 1 899 1 341 INVESTIGATIONS COMPLETED2 18 2 2 926 0 206 INSPECTIONS COMPLETED 0 0 0 0 0 0 1Excludes 311 cases found not legally sufficient following commencement of investigation. 2Includes 13 cases found not legally sufficient upon completion of investigation. 2 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 8 • Reports Received, Complaints Received, and Investigations Completed PROFESSION Clinical Laboratory Personnel Clinical Social Work Dental Hygienist Dental Laboratory Dentistry Dietetics and Nutrition Drugs, Devices & Cosmetics Electrolysis Electrolysis Facilities EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Marriage & Family Therapy Massage Establishment Massage Therapy Medical Physics Medicine Mental Health Counseling Midwifery Nursing - Advanced Registered Nurse Practitioner (ARNP) Nursing – Registered Nurse (RN) Nursing - Licensed Practical Nurse (LPN) Nursing Home Administration Occupational Therapy Optical Establishment Opticianry Optometry Orthotics & Prosthetics Osteopathic Medicine Pharmacy Establishment Pharmacist Physical Therapy Physician Assistant Podiatric Medicine Psychology Radiologic Technology Respiratory Therapy School Psychology Speech-Language Pathology & Audiology Total Referred Non-Jurisdictional Grand Totals STATUTORY REPORTS 1 0 0 0 148 2 1 0 0 2 3 0 0 1 0 0 6,014 0 5 80 363 232 171 5 0 0 8 0 469 6 9 12 36 200 2 13 1 0 0 8,599 17,465 26,064 COMPLAINTS RECEIVED 35 49 37 7 934 10 515 39 6 165 132 107 18 186 414 6 4,457 100 11 319 1,369 752 108 23 22 33 46 221 514 617 678 100 432 96 127 103 64 8 63 14,374 1,237 15,611 LEGALLY SUFFICIENT1 15 19 32 5 502 3 471 27 0 80 97 51 13 97 268 7 2,567 42 8 164 1,179 681 85 11 15 26 22 194 325 387 586 82 326 50 50 71 38 6 49 9,932 21 9,953 INVESTIGATIONS COMPLETED2 13 20 15 6 427 4 523 13 0 58 82 58 10 52 177 9 2,060 38 11 150 904 614 97 10 11 22 26 57 240 448 411 54 49 62 51 67 35 5 36 8,079 19 8,098 INSPECTIONS COMPLETED 0 0 0 974 204 0 2,408 0 207 0 0 0 0 8,034 0 0 4,001 0 0 948 0 0 0 0 602 0 33 0 631 7,784 0 0 1 111 0 0 0 0 0 25,938 0 25,938 1Excludes 311 cases found not legally sufficient following commencement of investigation. 2Includes 13 cases found not legally sufficient upon completion of investigation. 30 Definitions: Legally Sufficient – Complaints that, if found to be true, show a potential violation of Florida statutes or rules. Referred Non-Jurisdictional – Complaints received over which DOH has no statutory authority and are referred to the agency with the statutory authority. Statutory Reports – Reports required by statute to be submitted to the Florida Department of Health. MQA Annual Report : July 1, 2006 - June 30, 2007 Table 9 • Probable Cause Actions PROFESSION Acupuncture Certified Nursing Assistant (CNA) Chiropractic Medicine Clinical Laboratory Personnel Clinical Social Work Dental Hygienist Dental Laboratory Dentistry Dietetics & Nutrition Drugs, Devices & Cosmetics Electrolysis EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Marriage & Family Therapy Massage Establishment Massage Therapy Medical Physics Medicine Mental Health Counseling Midwifery Nursing – Advanced Registered Nurse Practitioner (ARNP) Nursing – Registered Nurse (RN) Nursing - Licensed Practical Nurse (LPN) Nursing Home Administration Occupational Therapy Opticianry Optometry Orthotics & Prosthetics Osteopathic Medicine Pharmacy Establishment Pharmacist Physical Therapy Physician Assistant Podiatric Medicine Psychology Radiologic Technology Respiratory Therapy School Psychology Speech-Language Pathology & Audiology Total Referred Non-Jurisdictional Grand Totals NO PROBABLE CAUSE FOUND 9 648 108 11 14 11 4 379 3 552 5 47 41 103 8 54 67 7 2,011 31 11 102 356 290 155 7 14 19 9 189 465 325 29 42 65 31 41 9 1 20 6,293 11 6,304 PROBABLE CAUSE FOUND 3 221 129 6 10 3 2 115 0 0 7 55 65 10 2 50 84 1 426 12 5 53 450 307 35 2 6 10 10 78 21 147 23 14 17 12 43 16 2 14 2,466 0 2,466 ADMINISTRATIVE COMPLAINTS FILED 3 223 130 1 13 2 1 113 0 0 6 46 48 6 1 40 51 1 440 12 5 50 438 293 41 3 6 1 8 79 19 142 25 11 18 15 21 2 0 0 2,314 0 2,314 Definitions: Administrative Complaint – Legal document that charges violation(s) of Florida statutes or rules against a licensee. Probable Cause Found – A panel of a Board or the Florida Department of Health found sufficient evidence to bring formal charges against a licensee. Referred Non-Jurisdictional – Complaints received over which DOH has no statutory authority and are referred to the agency with the statutory authority. 31 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 10 • Summary of Disciplinary Cases Against Healthcare Licensees PROFESSION Acupuncture Athletic Training Certified Nursing Assistant (CNA) Certified Social Worker Chiropractic Medicine Clinical Laboratory Personnel Clinical Social Work Dental Hygienist Dental Laboratory Dentistry Dietetics & Nutrition Drugs, Devices & Cosmetics Electrolysis EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Marriage & Family Therapy Massage Establishment Massage Therapy Medical Physics Medicine Mental Health Counseling Midwifery Nursing - Advance Registered Nurse Practitioner (ARNP) Nursing - Registered Nurse (RN) Nursing - Licensed Practical Nurse (LPN) Nursing Home Administration Occupational Therapy Opticianry Optometry Orthotics & Prosthetics Osteopathic Medicine Pharmacy Establishment Pharmacist Physical Therapy Physician Assistant Podiatric Medicine Psychology Radiologic Technology Respiratory Therapy School Psychology Speech-Language Pathology & Audiology Total REVOCATION 0 0 34 0 4 6 3 1 0 0 0 7 0 9 13 3 0 9 8 0 16 0 0 1 38 20 0 0 0 0 0 4 3 13 1 0 0 0 4 1 0 0 198 VOLUNTARY SURRENDER 0 0 25 0 6 0 1 3 1 11 0 0 0 6 1 1 0 4 31 0 38 9 1 3 50 52 12 0 0 1 0 1 1 15 1 0 0 0 8 3 0 0 285 SUSPENSION 2 1 56 0 6 3 2 0 0 11 0 0 0 3 4 4 1 0 7 0 33 0 2 9 160 137 2 0 1 2 0 8 1 39 3 3 0 1 9 0 0 0 510 PROBATION 2 0 59 0 23 0 1 0 0 7 0 0 0 7 16 0 1 1 1 0 29 1 1 9 43 49 0 0 0 2 0 6 4 31 1 3 0 3 1 1 0 0 302 LIMITATION/ OBLIGATION 2 1 121 0 76 3 6 1 1 53 0 1 3 4 5 4 1 0 9 0 196 1 5 36 314 229 4 0 7 3 0 45 12 119 8 10 2 13 13 1 0 0 1,309 FINE 1 1 130 0 76 4 6 0 1 55 0 166 4 17 29 8 1 29 38 0 207 1 5 35 273 200 4 0 8 4 0 45 25 104 6 10 4 11 37 2 0 0 1,547 REPRIMAND 1 0 141 0 10 2 5 0 1 19 0 0 0 11 21 2 1 7 10 0 46 1 4 40 329 245 1 0 0 3 0 13 2 21 2 3 0 8 5 1 0 0 955 CITATION 19 0 63 1 154 3 0 19 0 66 1 0 14 0 0 0 0 12 87 1 273 0 0 111 179 82 29 0 4 0 92 113 14 69 20 144 3 3 0 1 2 15 1,594 DISMISSAL 2 0 38 0 28 5 3 1 0 20 0 0 1 7 7 1 1 2 2 0 49 2 2 5 44 29 9 1 4 2 0 9 9 23 2 2 2 3 1 0 0 0 316 *RESOLVED THROUGH FINAL ORDERS 3 1 196 0 116 10 10 5 2 79 0 174 4 36 44 23 1 35 71 0 330 19 6 47 450 333 14 0 9 6 6 80 31 163 18 11 6 13 57 14 0 8 2,431 *This number represents the actual number of cases resolved by the issuance of a final order, not the number of final orders issued . A final order may contain more than one type of discipline, such as probation, fine, and reprimand . 32 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 11 • Medical Malpractice Claims PROFESSION Dentistry Medicine Osteopathic Medicine Podiatric Medicine Total Referred Non-Jurisdictional Grand Totals CIVIL COURT CLAIMS 5 291 22 7 325 38 363 CLOSED CLAIMS 134 4,811 395 186 5,526 3 5,529 NICA CLAIMS 0 45 2 0 47 3 50 “3 IN 5” INITIATED 20 168 7 2 197 0 197 “3 IN 5” DISCIPLINES 4 10 1 0 15 0 15 CLOSED CLAIMS DISCIPLINED 5 18 1 0 24 0 24 CLOSED CLAIMS NON-DISCIPLINE 16 224 17 4 261 0 261 Definitions: 3 in 5 Disciplines – Disciplines as a result of investigations initiated when the practitioner has had three or more closed medical malpractice claims within a five year period as required by Sections 458.331(6), 459.015(6), 461.013(1)(s), and 466.028(6), F.S. 3 in 5 Initiated – Investigation started when the practitioner has had three or more closed medical malpractice claims within a five year period as required by Sections 458.331(6), 459.015(6), 461.013(1)(s), and 466.028(6), F.S. Medical Malpractice – Civil suits alleging medical malpractice against healthcare practitioners that have been resolved. NICA Claims – Claims filed with the Florida Birth-related Neurological Injury Compensation Association (NICA) as required by Section 766.305(5), F.S. Referred Non-Jurisdictional – Closed civil claims received over which DOH has no statutory authority and are referred to the agency with the statutory authority. Table 12 • Hospital Annual Report Claims Hospitals/Facilities Reporting Practitioners Reported Non-Jurisdictional Medicine Nursing - Advanced Registered Nurse Practitioner (ARNP) Osteopathic Medicine Definitions: Hospital Annual Report Claims – Reports from hospitals of civil suits in which there are judgments against healthcare practitioners for which the hospital assumes liability (Section 395.0197(3), F.S.). 26 60 32 23 2 3 33 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 13 • Unlicensed Activity PROFESSION Acupuncture Athletic Training Certified Nursing Assistant (CNA) Chiropractic Medicine Clinical Laboratory Personnel Clinical Social Work Dental Hygienist Dental Laboratory Dentistry Dietetics and Nutrition Drugs, Devices & Cosmetics Electrolysis Electrolysis Facilities EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Marriage & Family Therapy Massage Establishment Massage Therapy Medical Physics Medicine Mental Health Counseling Midwifery Naturopathic Medicine Nursing - Licensed Practical Nurse (LPN) Nursing – Registered Nurse (RN) & Advanced Registered Nurse Practitioner (ARNP) Nursing Home Administration Occupational Therapy Optical Establishment Opticianry Optometry Orthotics & Prosthetics Osteopathic Medicine Pharmacy Establishment Pharmacist Physical Therapy Physician Assistant Podiatric Medicine Psychology Radiologic Technology Respiratory Therapy Speech-Language Pathology & Audiology Total Referred Non-Jurisdictional Grand Totals COMPLAINTS 8 0 29 8 3 3 1 10 63 10 123 4 5 3 0 4 2 98 159 1 67 7 4 5 13 16 1 1 26 17 6 7 4 42 9 7 3 2 13 23 2 2 811 30 841 REFERRED FOR INVESTIGATION 7 0 27 8 3 4 1 10 61 10 120 2 5 3 0 3 2 90 154 1 61 7 4 5 11 10 0 1 27 17 6 7 4 23 9 6 3 2 14 12 2 2 744 28 772 INVESTIGATIONS COMPLETED 4 2 23 5 1 4 1 9 75 10 84 5 6 5 1 5 0 114 140 0 114 11 4 7 8 16 0 0 28 17 4 17 3 47 10 6 4 5 16 21 3 1 836 14 850 CEASE & DESIST ISSUED 4 0 3 1 4 0 1 5 10 9 0 3 3 1 0 5 0 60 48 0 14 2 3 4 2 5 0 0 18 6 3 10 0 3 1 4 0 1 4 8 0 1 246 3 249 NOTIFICATION TO LAW ENFORCEMENT 3 1 16 4 2 2 1 7 38 8 7 4 4 4 0 3 0 64 67 0 54 15 0 3 7 10 0 0 22 5 1 12 1 16 5 4 1 3 1 12 1 2 410 9 419 ARRESTS 1 0 7 2 0 0 0 1 22 0 0 0 2 1 0 3 0 18 95 0 28 1 0 0 3 3 0 0 1 0 4 0 4 2 2 2 3 0 2 0 0 0 207 4 211 Definitions: Referred Non-Jurisdictional – Complaints received over which DOH has no statutory authority and are referred to the agency with the statutory authority. 3 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 14a • Revenue, Expenditures & Cash Balances for the MQA Trust Fund PROFESSION Acupuncture Anesthesiologist Assistant Athletic Training Chiropractic Medicine Clinical Laboratory Personnel Certified Nursing Assistant (CNA) Certified Social Worker Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling Dentistry Dental Hygienist Dental Laboratory Dietetics & Nutrition Drugs, Devices & Cosmetics Electrolysis EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Massage Therapy Medical Physics Medicine Midwifery Naturopathy Nursing Nursing Home Administration Occupational Therapy Opticianry Optometry Orthotics & Prosthetics Osteopathic Medicine Pharmacy Physical Therapy Physician Assistant Podiatry Psychology Radiologic Technology Respiratory Therapy School Psychology Speech-Language Pathology & Audiology Total BEGINNING CASH BALANCE $1,645,233 $(60,869) $375,951 $2,043,790 $494,324 $(1,684,927) $(127,840) $2,462,991 $226,353 $1,627,771 $639,680 $312,759 $(271,212) $(610,264) $(993,876) $(363,358) $(886,975) $6,059,306 $154,837 $7,963,186 $(689,729) $(293,221) $6,349,943 $(541,064) $564,780 $1,516,823 $294,732 $(375,222) $1,431,880 $3,130,156 $2,904,042 $862,694 $(153,844) $2,318,354 $(570,809) $543,221 $243,445 $3,050,946 $39,593,987 REVENUES $148,554 $(3,114) $196,724 $840,405 $1,361,936 $485,241 $680 $3,033,268 $958,273 $455,367 $21,303 $404,582 $(4,705) $124,424 $26,723 $25,478 $533,574 $2,402,975 $84,338 $17,271,232 $18,318 $1,831 $14,703,182 $551,275 $598,919 $699,873 $1,191,276 $291,047 $688,770 $4,125,920 $469,783 $263,882 $630,461 $373,338 $1,104,091 $1,297,303 $23,215 $245,636 $55,645,378 EXPENDITURES $271,343 $4,218 $85,574 $1,843,177 $664,535 $2,683,958 $1,118 $1,820,525 $2,770,717 $776,129 $73,492 $199,483 $656,623 $159,599 $972,571 $562,563 $264,010 $2,024,749 $38,290 $16,133,212 $150,710 $8,416 $14,543,141 $361,530 $466,221 $502,193 $750,589 $250,770 $1,657,221 $4,978,183 $771,201 $784,740 $462,544 $770,195 $1,319,733 $682,414 $47,194 $427,799 $60,940,680 ENDING CASH BALANCE $1,522,444 $(68,201) $487,101 $1,041,018 $1,191,725 $(3,883,644) $(128,278) $3,675,734 $(1,586,091) $1,307,009 $587,491 $517,858 $(932,540) $(645,439) $(1,939,724) $(900,443) $(617,411) $6,437,532 $200,885 $9,101,205 $(822,121) $(299,806) $6,509,984 $(351,319) $697,478 $1,714,503 $735,419 $(334,945) $463,429 $2,277,893 $2,602,624 $341,836 $14,073 $1,921,497 $(786,451) $1,158,110 $219,466 $2,868,783 $34,298,684 UNLICENSED ACTIVITY CASH BALANCE $32,410 $12 $17,203 $(16,505) $228,343 $213,731 $(6,529) $435,804 $(330,061) $123,183 $(5,340) $18,073 $(16) $(46,634) $(15,703) $(1,694) $(34,404) $(31,941) $5,582 $121,343 $(28,965) $(29,248) $3,960,260 $2,544 $159,528 $(30,205) $19,232 $(74,133) $10,893 $(27,476) $94,047 $54,337 $4,372 $(2,287) $(29,953) $195,515 $9,008 $69,149 $5,063,475 Table 14b • Revenue, Expenditures & Cash Balances for the Drugs, Devices & Cosmetics Trust Fund PROFESSION Drugs, Devices & Cosmetics BEGINNING CASH BALANCE $3,272,046 REVENUES $2,653,581 EXPENDITURES $2,127,537 ENDING CASH BALANCE $3,798,090 UNLICENSED ACTIVITY CASH BALANCE NA Note: Neurological Injury Compensation Association (NICA) is excluded . 3 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 15a • Projected Cash Balances for the MQA Trust Fund PROFESSION Acupuncture Anesthesiologist Assistant Athletic Training Chiropractic Medicine Clinical Laboratory Personnel Certified Nursing Assistant (CNA) Certified Social Worker Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling Dentistry Dental Hygienist Dental Laboratory Dietetics & Nutrition Drugs, Devices & Cosmetics Electrolysis EMS - Emergency Medical Technician EMS - Paramedic Hearing Aid Specialist Massage Therapy Medical Physics Medicine Midwifery Naturopathy Nursing Nursing Home Administration Occupational Therapy Opticianry Optometry Orthotics & Prosthetics Osteopathic Medicine Pharmacy Physical Therapy Physician Assistant Podiatry Psychology Radiologic Technology Respiratory Therapy School Psychology Speech-Language Pathology & Audiology Total PROJECTED CASH BALANCE 2007-2008 $1,818,017 $(72,518) $436,463 $2,131,729 $1,139,779 $994,321 $(129,056) $2,398,639 $2,231,000 $1,886,733 $719,972 $397,170 $(933,373) $253,588 $(2,668,460) $(1,075,874) $(806,685) $10,080,394 $167,740 $8,396,348 $(861,387) $(327,914) $8,589,771 $(643,990) $412,025 $1,357,304 $219,801 $(189,434) $963,899 $3,715,129 $3,694,917 $765,695 $357,023 $3,015,445 $(967,014) $655,017 $349,475 $3,468,317 $51,940,006 PROJECTED CASH BALANCE 2008-2009 $1,589,427 $(72,246) $553,059 $709,999 $1,792,729 $(2,477,877) $(129,367) $3,652,710 $(267,063) $1,332,028 $637,403 $576,638 $(1,127,115) $180,062 $(3,691,477) $(1,569,411) $(463,815) $9,923,729 $196,026 $8,050,944 $(961,008) $(353,947) $10,999,946 $(417,247) $595,105 $1,522,792 $626,814 $(371,120) $(432,334) $1,314,112 $3,155,063 $147,514 $(34,436) $2,537,474 $(1,122,005) $1,259,309 $322,034 $3,169,716 $41,354,162 PROJECTED CASH BALANCE 2009-2010 $1,881,581 $(76,604) $501,501 $1,780,230 $1,733,532 $(2,721,153) $(130,153) $2,357,523 $602,230 $1,901,827 $768,907 $453,755 $(1,331,278) $206,830 $(4,746,734) $(2,078,899) $(656,058) $13,542,080 $162,351 $7,177,243 $(1,001,399) $(382,326) $12,924,542 $(713,974) $305,319 $1,160,455 $103,670 $(228,451) $50,091 $2,696,218 $4,237,818 $562,702 $186,474 $3,623,340 $(1,314,579) $749,307 $451,549 $3,764,115 $48,503,582 PROJECTED CASH BALANCE 2010-2011 $1,645,570 $(76,423) $616,099 $314,032 $2,370,737 $(2,906,795) $(130,481) $3,572,314 $(1,967,585) $1,325,572 $684,217 $628,460 $(1,532,252) $129,345 $(5,792,122) $(2,583,505) $(319,632) $13,332,197 $189,484 $6,465,253 $(1,103,463) $(408,946) $14,997,774 $(496,037) $478,992 $1,314,789 $494,344 $(416,310) $(1,385,320) $175,504 $3,677,258 $(74,305) $(215,113) $3,127,821 $(1,495,649) $1,338,598 $423,037 $3,454,367 $39,851,828 PROJECTED CASH BALANCE 2011-2012 $1,931,670 $(80,855) $562,913 $1,347,997 $2,298,701 $(3,193,980) $(131,279) $2,245,092 $(1,156,809) $1,877,796 $813,990 $501,692 $(1,742,312) $152,885 $(6,865,624) $(3,102,020) $(517,130) $16,907,147 $154,868 $5,292,585 $(1,145,845) $(437,804) $16,647,579 $(799,945) $181,535 $943,356 $(42,126) $(278,676) $(934,846) $1,459,992 $4,743,126 $325,530 $(2,462) $4,199,376 $(1,709,491) $816,362 $551,679 $4,039,676 $45,854,343 PROJECTED CASH BALANCE 2012-2013 $1,689,625 $(80,747) $675,888 $(154,345) $2,923,110 $(3,445,301) $(131,620) $3,427,955 $(3,784,946) $1,284,025 $727,576 $672,524 $(1,949,163) $72,182 $(7,929,196) $(3,615,623) $(185,942) $16,654,006 $181,064 $4,282,624 $(1,249,894) $(464,902) $18,446,934 $(589,166) $347,563 $1,088,624 $335,267 $(471,551) $(2,402,102) $(1,158,013) $4,165,735 $(326,779) $(412,282) $3,689,594 $(1,911,758) $1,393,459 $522,296 $3,720,868 $36,037,589 Table 15b • Projected Cash Balances for the Drugs, Devices & Cosmetics Trust Fund PROFESSION Drugs, Devices & Cosmetics PROJECTED CASH BALANCE 2007-2008 $3,071,495 PROJECTED CASH BALANCE 2008-2009 $2,467,580 PROJECTED CASH BALANCE 2009-2010 $1,577,306 PROJECTED CASH BALANCE 2010-2011 $909,391 PROJECTED CASH BALANCE 2011-2012 $(44,883) PROJECTED CASH BALANCE 2012-2013 $(776,797) 36 Note: Revenue collected from Neurological Injury Compensation Association (NICA) and Unlicensed Activity fees is excluded from the amounts shown above . MQA Annual Report : July 1, 2006 - June 30, 2007 Table 16a • Review of the Adequacy of Renewal Fees for the MQA Trust Fund PROFESSION1 1 . Acupuncture 2 . Anesthesiologist Assistant 3 . Athletic Training 4 . Certified Nursing Assistant (CNA) 5 . Chiropractic Medicine A . Chiropractic Physician B . Certified Chiropractic Physician's Assistant C . Registered Chiropractic Assistant 6 . Clinical Laboratory Personnel A . Director B . Supervisor C . Technologist D . Technician E . Training Program F . Inactive 7 . Certified Social Worker 8 . Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling A . Clinical Social Work B . Marriage & Family Therapy C . Mental Health Counseling D . Intern 9 . Dentistry 10 . Dental Hygienist 11 . Dental Laboratory 12 . Dietetics & Nutrition 13 . Electrolysis 14 . Hearing Aid Specialist 15 . Massage Therapy A . Massage Therapist B . Massage Establishment 16 . Medical Physics A . Medical Physicist B . Medical Physicist in Training 17 . Medicine 18 . Midwifery 19 . Naturopathy 20 . Nursing A . Nurse B . Advanced Registered Nurse Practitioner (ARNP) 21 . Nursing Home Administration 22 . Occupational Therapy 23 . Opticianry $833,684 $890,545 $1,055,973 1,543 7,752 3,561 $540 $115 $297 $34,705,893 $231,199 $55,641 $31,899,481 53,997 133 6 277,989 $643 $1,738 $9,274 $115 No Cap No Cap No Cap No Cap $350/$50 $80/$55 $130/$75 $325/$250 $55 $150/$50 Yes Yes $109,141 464 $235 $500 No Cap $500 $500 $1,000 $150 $50 $360/$121 $500/$500 $250 Yes Yes $6,793,002 $2,040,187 $200,864 $450,995 $374,800 $610,099 $5,038,315 11,659 11,777 1,129 3,199 1,118 897 37,585 $583 $173 $178 $141 $335 $680 $134 $200/$250 $200 $150 $150 Yes $1,539 $3,718,784 3 19,325 $513 $192 $250/$50 $250/$50 $250/$50 $100 $300 $300 $300 $500 $100 $600 $150/$50 $150/$50 $150/$50 $75 $300 $100 $200 $100/$95 $100 $375 Yes Yes Yes Yes See Note 5 FY 07-08 & 08-09 ESTIMATED EXPENDITURES $702,711 $8,545 $189,055 $7,649,926 $4,209,907 LICENSEES 1,844 9 1383 135,574 8,078 COST TO REGULATE2 $381 $949 $137 $56 $521 RENEWAL FEE CAP3 $500 $1,000 $200/$100 $50 $500 $250 $25 CURRENT RENEWAL FEE3 $300/$150 $500 $125/$50 $50 $500/$250 $50/$28 $25 SUFFICIENT CURRENT RENEWAL FEE4 Yes Yes $1,490,492 14,738 $101 $150 $150 $150 $150 $300 $50 $250 $150 $130 $110 $75 $300 $50 $150/$150 Yes Yes 37 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 16a • Review of the Adequacy of Renewal Fees for the MQA Trust Fund PROFESSION1 24 . Optometry A . Optometrist B . Optometry Faculty C . Branch Office 25 . Orthotics & Prosthetics 26 . Osteopathic Medicine 27 . Pharmacy A . Pharmacist B . Consultant Pharmacist C . Nuclear Pharmacist D . Pharmacy Permit 28 . Physical Therapy A . Physical Therapist B . Physical Therapist Assistant 29 . Physician Assistant A . Physician Assistant B . Prescribing Physician Assistant 30 . Podiatry A . Podiatric Physician B . Certified Podiatric Technician C . Certified Podiatric X-Ray Assistant 31 . Psychology A . Psychologist B . Limited License Psychologist 32 . Respiratory Therapy 33 . School Psychology 34 . Speech Language Pathology and Audiology A . Pathologist & Audiologist B . Pathologist & Audiologist Assistant Total $129,372,950 683,636 $189 $1,420,218 $101,408 $1,055,314 9,664 642 7,501 $147 $158 $141 $500/$100 No Cap $125/$100 $50 $1,661,288 4,016 $414 $958,867 2,207 $434 $350 No Cap No Cap $500 $500 $500 $200/$50 $500 $350 $100/$50 $75 $400 $400 $25 $121/$50 250/$150 Yes Yes Yes Yes $1,782,284 4,536 $393 $500 $500 $150 $300 $1,960,367 17,122 $114 $200 $150 $100/$50 $100/$50 $584,365 $3,709,109 $11,332,039 674 5,584 34,349 $867 $664 $330 $250 $250 $250 $250 $245 $50 $100 $250 Yes FY 07-08 & 08-09 ESTIMATED EXPENDITURES $1,546,913 LICENSEES 3,578 COST TO REGULATE2 $432 $300 No Cap $100 $500 $500 $300 $100 $100 $500 $400/$200 RENEWAL FEE CAP3 CURRENT RENEWAL FEE3 SUFFICIENT CURRENT RENEWAL FEE4 Yes Notes: 1 . Emergency Medical Technicians, Paramedics, and Radiological Technicians are not included with the MQA trust funded professions because revenues collected for these professions are not deposited into the MQA trust fund and because these professions are not governed by Chapter 456 . 2 . Cost to regulate is computed by adding FY 07-08 and FY 08-09 projected expenditures and dividing by the total number of non-delinquent active and inactive licensees eligible to renew as of June 30, 2007 . 3 . Two amounts in the column for fee caps and/or current fees represent two different amounts for active and inactive licensees . 4 . If there is a projected positive cash balance at June 30, 2013, then the current renewal fee is deemed to be sufficient . 5 . Electrologists are projected to have a temporary positive cash balance at June 30, 2013 due to a one-time assessment . 6 . Renewal fees paid annually . 3 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 16b • Review of the Adequacy of Renewal Fees for the Drugs, Devices & Cosmetics Trust Fund PROFESSION 1 . Drugs, Devices & Cosmetics A . Drugs Prescription Drug Manufacturer Over the Counter Drug Manufacturer Prescription Drug Wholesaler6 Freight forwarder Prescription Drug Wholesaler-Broker Only6 Non-Resident Prescription Drug Manufacturer Retail Pharmacy Wholesaler Out of State Prescription Drug Wholesaler6 Prescription Drug Repackager Complimentary Drug Distributor Restricted Prescription Drug Distributor Healthcare Entity Restricted Prescription Drug Distributor Charitable Organization Restricted Prescription Drug Distributor Reverse Distributor Restricted Prescription Drug Distributor Destruction Facility Restricted Prescription Drug Distributor Government Program Restricted Prescription Drug Distributor Institutional Research Veterinary Legend Drug Retailer Veterinary Prescription Wholesaler Limited Prescription Drug Vet Wholesaler B . Medical Gases Compressed Medical Gases Manufacturer Compressed Medical Gases Wholesaler Medical Oxygen Retailer C . Cosmetic Manufacturer D . Device Manufacturer E . Product Registration F . Ether Diethyl Ether Manufacturer6 Diethyl Ether Distributor6 Diethyl Ether Dealer6 Diethyl Ether Purchaser6 Total $6,227,459 2 4 1 6 4,381 $1,421 $700 $700 $350 $150 $700 $700 $350 $150 135 372 1,472 121 138 325 $1,000 $600 $600 $800 $1,200 $30 $1,000 $600 $600 $800 $1,200 $20 89 99 166 24 5 648 128 197 15 205 109 26 8 7 21 0 17 35 6 $1,500 $800 $800 $600 $800 $1,000 $100 $800 $1,500 $500 $600 $600 $600 $600 $600 $600 $600 $1,000 $1,000 $1,500 $800 $800 $600 $800 $1,000 $100 $800 $1,500 $500 $600 $600 $600 $600 $600 $600 $600 $1,000 $1,000 FY 07-08 & 08-09 ESTIMATED EXPENDITURES $6,226,102 LICENSEES 4,381 COST TO REGULATE2 $1,421 RENEWAL FEE CAP3 CURRENT RENEWAL FEE3 SUFFICIENT CURRENT RENEWAL FEE4 Notes: 1 . Emergency Medical Technicians, Paramedics, and Radiological Technicians are not included with the MQA trust funded professions because revenues collected for these professions are not deposited into the MQA trust fund and because these professions are not governed by Chapter 456 . 2 . Cost to regulate is computed by adding FY 07-08 and FY 08-09 projected expenditures and dividing by the total number of non-delinquent active and inactive licensees eligible to renew as of June 30, 2007 . 3 . Two amounts in the column for fee caps and/or current fees represent two different amounts for active and inactive licensees . 4 . If there is a projected positive cash balance at June 30, 2013, then the current renewal fee is deemed to be sufficient . 5 . Electrologists are projected to have a positive cash balance at June 30, 2013 due to a one-time assessment . Renewal fee caps need to be raised to preclude future one time assessments . 6 . Renewal fees paid annually . 3 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 17a • Web Usage for Boards & Councils BOARD/COUNCIL Acupuncture Anesthesiology Assistants Athletic Training Certified Nursing Assistants Chiropractic Medicine Clinical Laboratory Personnel Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling Consumer Advocacy Program Dentist, Dental Hygiene, or Dental Laboratory Dietetics & Nutrition Drugs, Devices and Cosmetics Electrologist or Electrology Facilities Emergency Medical Services Health Care Clinic Registration Hearing Aid Specialists Massage Therapist or Establishments Medical Physicists Medicine Midwifery Naturopathy Nursing Nursing Home Administrators Occupational Therapy Opticinary or Optical Establishments Optometry or Optometry Branch Facilities Orthotists & Prosthetists Osteopathic Medicine Pharmacist or Pharmacy Establishment Physical Therapy Physician Assistants Podiatric Medicine Psychology Radiation Technology Respiratory Therapy School Psychology Speech Language Pathology & Audiology Total VISITS 26,904 13,502 17,053 125,139 52,026 47,113 138,920 3,989 127,384 25,265 161,439 31,656 94,082 5,227 16,439 116,300 14,829 260,981 16,765 2,667 558,493 32,794 46,060 24,232 32,414 14,927 41,497 181,879 77,672 52,612 20,410 56,155 94,082 46,128 15,687 39,752 2,632,474 DOWNLOADS 9,000 9,824 4,194 115,817 33,485 34,316 106,753 0 113,817 13,526 85,532 18,927 49,891 7,998 4,155 92,838 2,623 249,660 7,995 0 401,612 22,586 26,136 13,726 18,232 6,551 24,322 139,669 55,039 47,210 10,673 30,158 49,891 15,897 2,902 37,258 1,862,213 HITS 59,971 21,041 35,156 336,678 132,754 133,398 428,205 4,375 349,879 54,924 346,747 65,461 258,518 94,564 31,642 298,068 27,904 718,403 32,684 3,308 1,799,238 76,973 104,429 58,898 72,564 27,100 82,723 592,232 213,332 131,576 39,917 145,884 258,518 95,608 28,964 99,939 7,261,575 0 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 17b • Web Usage for Program Services PROGRAM SERVICES SITES Client Services (Public Record Requests) COMPAS (non- web-application pages) Compliance Enforcement (Complaints & Discipline) Exam Florida Commission on Excellence Health Care - Legislation Licensee Data Profiling (non-web-application pages) Publications Unlicensed Total VISITS 703,408 433,118 236 189,682 95,844 6,017 9,944 223,858 120,589 18,107 1,800,803 DOWNLOADS 0 0 4 337,004 76,468 9,277 0 183,091 63,553 0 669,397 HITS 985,723 520,947 299 555,153 263,996 14,315 21,483 499,547 206,117 24,939 3,092,519 Table 17c • Web Usage for MQA Online Services MQA ONLINE SERVICES MQA Services (Program System Application) Total VISITS 1,308,932 DOWNLOADS 0 HITS 4,520,736 Definitions: Downloads – Number of times the specified file was downloaded by a visitor. If an error occurred during a transfer, the transfer is not counted. Hits – Each file requested by a visitor registers as a hit. There can be several hits on each page. While the volume of hits reflects the amount of server traffic, it is not an accurate reflection of the number of pages viewed. Visits – A visit is a series of actions that begins when a visitor views their first page from the server, and ends when the visitor leaves the site or remains idle beyond the idle-time limit. 1 MQA Annual Report : July 1, 2006 - June 30, 2007 Table 18 • Online Renewals PROFESSION Athletic Training Clinical Laboratory Personnel Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling Dietetics & Nutrition Emergency Medical Services Hearing Aid Specialist Medical Doctor Medical Physicists Nursing Nursing Home Administration Occupational Therapy Opticianry Optometry Pharmacy Radiologic Technologist Respiratory Therapy Totals RENEWALS PROCESSED ONLINE (NUMBER OF TRANSACTIONS) 1,143 8,326 9,489 1,783 18,207 295 13,037 196 86,944 818 5,059 1,667 1,776 3,798 2,405 6,664 161,607 E-RENEWAL USAGE PERCENTAGE 98% 85% 52% 57% 43% 43% 54% 51% 66% 56% 69% 48% 54% 40% 24% 72% 59% Definitions: E-Renewal Usage Percentage – The number of online renewals processed divided by the number of renewals processed on time. Table 19 • Student Loan Defaults PROFESSION Chiropractic Medicine Dentistry Total REPORTS OF DEFAULT RECEIVED 0 0 0 INVESTIGATIONS COMPLETED 2 1 3 ESO ISSUED 1 0 1 PROBABLE CAUSE FOUND 1 1 2 NO PROBABLE CAUSE FOUND 4 1 5 DISCIPLINARY ACTION TAkEN 4 0 4 FINE AMOUNTS COLLECTED $29,307 .23 $0 $29,307 .23 Definitions: ESO – Emergency Suspension Order. An order issued by the Florida Department of Health suspending the license of a practitioner. A practitioner may not practice in the state of Florida while under an emergency suspension order. Probable Cause Found – A panel of a Board or the Florida Department of Health found sufficient evidence to bring formal charges against a licensee. Student Loan Default – As required by Section 456.0721, F.S., reports received from the United States Department of Health and Human Services on healthcare practitioners failing to repay a student loan or comply with scholarship service obligations. 2 www.FLHealthSource.com