Findings Of Fact Based upon the evidence adduced at hearing, and the record as a whole, the following Findings of Fact are made: The Agency is a state government licensing and regulatory agency. Respondent is now, and has been since January 5, 1981, a medical doctor licensed to practice medicine in the State of Florida. His license number is ME 0037656. In or about February of 1988, a complaint was made against Respondent alleging that he engaged, or attempted to engage, in the practice of medicine in this state without an active Florida license. The complaint was reviewed by the Probable Cause Panel of the Board, which disposed of the matter by issuing, on April 23, 1988, the following Closing Order: THE COMPLAINT: Complainant alleges that the Subject of the investigation practiced or attempted to practice medicine without an active license in violation of Section 458.327 (1)(a), Florida Statutes. THE FACTS: Investigation substantiated the allegations in that Subject's license to practice medicine expired December 31, 1987, and was placed in an inactive status. Subject practiced medicine with an inactive license until approximately February 5, 1988, before he took steps to renew his license. THE LAW: Based on the foregoing, there is sufficient evidence to support a finding of probable cause that Subject violated Section 458.327(1)(a), Florida Statutes, and there- fore is in violation of Section 458.331(1)(x), Florida Statutes. However, as Subject's license was inactive for a period of less than six months, this case should be closed by issuing Subject a Letter of Guidance. It is, therefore, ORDERED that the complaint be, and the same is hereby CLOSED with a Letter of Guidance. In January of 1991, the Agency's predecessor, the Department of Professional Regulation, issued a 22-count Administrative Complaint against Respondent alleging that, in connection with his dealings with 11 patients in 1989 and 1990, Respondent violated subsections (1)(g)(Counts Twenty-One and Twenty-Two), (1)(m)(Counts Ten, Thirteen and Eighteen), (1)(q)(Counts Two, Five, Eight, Eleven, Fifteen and Nineteen), (1)(t)(Counts One, Four, Seven, Twelve, Fourteen, Sixteen and Twenty) and (1)(v)(Counts Three, Six, Nine and Seventeen) of Section 458.331, Florida Statutes. Proceedings on these allegations were conducted in accordance with Section 120.57(2), Florida Statutes. On August 24, 1992, the Board issued a Final Order finding Respondent guilty of the violations alleged in each of the 22 counts of the Administrative Complaint and disciplining him for having committed these violations. That portion of the Final Order addressing the Respondent's punishment provided, in pertinent part, as follows: IT IS HEREBY ORDERED AND ADJUDGED: Respondent's license to practice medicine is REPRIMANDED. Respondent shall pay an administrative fine in the amount of $5000 to the Board of Medicine, Department of Professional Regula- tion, within 3 years of the date this Final Order is filed. Respondent's license to practice medicine in the State of Florida is placed on PROBATION for a period of 3 years, subject to the follow- ing terms and conditions: . . . f. Respondent shall not practice except under the indirect supervision of a physician fully licensed under Chapter 458 who has been approved by the Board or its Probation Committee. Absent provision for and comp- liance with the terms regarding temporary approval of a monitoring physician, as provided below, Respondent shall cease pract- ice and not practice until the Probation Comm- ittee or the Board approves a monitoring physician. Respondent shall have the monitoring physician with Respondent at the first probation appearance before the Probation Committee. Prior to the approval of the monitoring physician by the Committee, the Respondent shall provide to the monitoring physician a copy of the Administrative Comp- laint and Final Order filed in this case. Failure of the Respondent or the monitoring physician to appear at the scheduled Probation Committee meeting shall constitute a violation of this Order. Prior to the approval of the monitoring physician by the Committee, Respondent shall submit to the Committee a current curriculum vitae and description of the current practice from the proposed monitoring physician. Said materials shall be received by the Board office no later than fourteen days before the first scheduled probation appearance. The attached definition of a monitoring physician is incorporated herein. The responsibilities of the monitoring physician shall include: Submit semi-annual reports, in affidavit form, which shall include: Brief statement of why physician is on probation. Description of probationer's practice. Brief statement of probationer's comp- liance with terms of probation. Brief description of probationer's relationship with monitoring physician. Detail any problems which may have arisen with probationer. Respondent shall be responsible for ensuring that the monitoring physician submits the required reports. Be available for consultation with Respondent whenever necessary, at a frequency of at least once per month. Review 50 percent of Respondent's patient records selected on a random basis at least once every other month. In order to comply with this responsibility of random review, the monitoring physician shall go to Respondent's office once every other month. At that time, the monitoring physician shall be responsible for making the random selection of the records to be reviewed by the monitoring physician. Review all patient records of patients treated with Schedule II-V controlled substances. Receive and review copies of all Schedule II-V controlled substance prescriptions in order to determine the appropriateness of Respondent's prescribing of controlled substances. Report to the Board any violations by probationer of Chapters 455 and 458, Florida Statutes, and the rules promulgated pursuant thereto. . . Respondent shall submit semi-annual reports in affidavit form, the contents of which shall be specified by the Board. The reports shall include: Brief statement of why physician is on probation. Practice location. Describe current practice (type and composition). Brief statement of compliance with probation terms. Describe relationship with monitoring/ supervisory physician. Advise Board of any problems. . . Respondent may prescribe Schedule II-V controlled substances with the restrictions set forth below: Respondent shall utilize sequentially numbered triplicate prescriptions in the prescribing of said controlled substances. Respondent shall provide one copy of each prescription for said controlled substances to the Department's investigator within 30 days. Respondent shall, within two weeks after issuance, provide one copy of each prescription for said controlled substances to his monitoring/supervising physician. Respondent shall maintain one copy of each prescription for said controlled sub- stances in the patient's medical record. This copy may be a xerox copy. During this period of probation, semi- annual investigative reports will be compiled by the Department of Professional Regulation concerning Respondent's compliance with the terms and conditions of probation and the rules and statutes regulating the practice of medicine. . . . At a meeting held November 18, 1992, Respondent received the approval of the Probation Committee to have Oliver Anderson, M.D., serve as his monitoring physician. Both Respondent and Dr. Anderson appeared before the Probation Committee at this November 18, 1992, meeting. Dr. Anderson is in his late seventies. Like Respondent, he has a general family practice. He and Respondent have known each other for over ten years. Dr. Anderson first visited Respondent's office, in his capacity as Respondent's monitoring physician, in February of 1993. At the outset of the visit, Dr. Anderson asked for, and was given, a list of all the patients that Respondent had seen in the last two months. From the list, he randomly selected the names of 71 patients (which was one half the number of patients on the list). He then obtained from Respondent, and thereafter reviewed, the records Respondent maintained on these 71 patients. Dahna Schaublin, a Department investigator, was assigned to serve as Respondent's probation monitor. On or about February 10, 1993, she prepared and transmitted to her supervisor, Crystal Griffin, an investigative report concerning Respondent's compliance with the terms and conditions of his probation. In her report, Schaublin stated the following: A Final Order was filed on 8/24/92 regarding John Jackson, M.D. for prescribing Dilaudid to patients in 1989, violating FS. 458.331 (1)(q)(v). The Probation term is 08/24/92 to 08/23/95. Dr. Jackson was contacted and presented to the Miami BIS on 01/27/93 for an interview. He brought copies of prescript- ions for controlled drugs prescribed in Dec/ 1992-Jan/1993. Dr. Jackson did not have copies of other prescriptions with him stating he mailed one copy to the Board of Medicine and one copy to his physician monitor. Dr. Anderson, a family practitioner, is supervis- ing physician. Dr. Anderson has only been to Dr. Jackson's office on one occasion (the Order states he should review 50 percent of patient records on a random basis, and shall go to Dr. Jackson's office once every other month). Dr. Jackson decided to xerox each daily chart for each patient seen in the office and then mail Dr. Anderson a copy of the treatment chart (for that one occasion). Dr. Jackson stated that the reason he is not following the Order to the letter is because it was difficult for Dr. Anderson to review 50 percent of his patient records in person every month. We told Dr. Jackson this practice was contrary to the Final Order and we suggested he inform the Probation Committee. Dr. Jackson has not paid his $5000 yet, stating that he has 5 years to do so. Dr. Jackson has gone before the Probation Committee two times. Griffin inadvertently failed to forward Schaublin's investigative report to the Probation Committee. Accordingly, the Probation Committee took no action in response to the allegations made in the report. Respondent did not provide Schaublin with copies of prescriptions he wrote in February and March of 1993, "within 30 days," as required by paragraph 3k(2) of the Board's August 24, 1992, Final Order. It was not until April 14, 1993, that Respondent furnished Schaublin with copies of these prescriptions (which were written on numbered prescription forms). Respondent wrote prescription numbers 1041 through 1047 in April and May of 1993 (more specifically, prescription number 1041 on April 12, 1993; prescription number 1042 on April 14, 1993; prescription number 1043 on April 24, 1993; prescription number 1044 on April 26, 1993; prescription number 1045 on April 30, 1993; prescription number 1046 on May 2, 1993; and prescription number 1047 on May 12, 1993). These prescriptions were not among those that Respondent furnished copies of to Schaublin on April 14, 1993, however, none of them were written 30 days or more prior to April 14, 1993. On or about March 17, 1993, Respondent submitted his first semi-annual probation report to the Department. In the fourth paragraph of his report, Respondent asserted the following: I have complied fully with the terms of my probation. I have taken the course "Protecting your Practice" at the University of South Florida. I meet as scheduled with my monitoring physician Dr. O.D. Anderson whose letter will be Coming soon to you. We cover for each other every week taking calls on Wednesdays for Dr. Anderson and Thursdays for myself. We also alternate taking calls for each other every other weekend. We discuss patient care, as per the order, for all scheduled prescriptions written. In his report, Respondent did not indicate that there were "any problems" concerning Dr. Anderson's compliance with the provisions of the Board's August 24, 1992, Final Order which prescribed the responsibilities of Respondent's monitoring physician. Dr. Anderson submitted to the Department his first semi-annual report concerning Respondent's probation on or about June 13, 1993. In the third, fourth and fifth paragraphs of his report, Dr. Anderson asserted the following: In my opinion, Dr. Jackson has been very sensitive to the Administrative Complaint and Order of the Department of Professional Regulation. This has been demonstrated by his good attitude in my visits with him, and in his compliance with providing for me duplicate copies of his Numbered Schedule II-V prescriptions. Dr. Jackson and his office personnel have been very responsive in allowing my random selection of charts for review on my visits to his office. With his wife's support, Dr. Jackson has complied well with the requirements of his probation. Although he indicated otherwise in his report, Dr. Anderson had made only one visit to Respondent's office in his capacity as Respondent's monitoring physician. It was not until September of 1993, that he next visited Respondent's office in his capacity as Respondent's monitoring physician. In conducting his review during this visit, he followed essentially the same procedure that he had followed during his February visit. In September of 1993, Respondent filed with the Board a Petition for Early Termination of Probation on the grounds of "1) hardship due to changed circumstances; and 2) fulfillment of purposes of penalty." In his petition, Respondent asserted that he had "fully complied with the requirements of probation with the exception of the fine." He did not mention that he had failed to provide Schaublin with copies of the prescriptions he wrote in February and March of 1993, "within 30 days," as required by paragraph 3k(2) of the Board's August 24, 1992, Final Order or that Dr. Anderson had failed to make the number of office visits required by paragraph 3f(3) of the Final Order. Dr. Anderson wrote a letter, dated October 21, 1993, in support of Respondent's petition. The letter read as follows: This is an interim report following the first semi-annual report dated May 19, 1993, which I submitted. I was appointed monitoring physician for Dr. Jackson at the Miami November 18, 1992, meeting of the Probation Committee of the Department of Professional Regulation. Again I have reviewed the Administrative Complaint dated January 24, 1991, and also the Notice of Right to Judicial Review, and Certificate of Service signed August 24, 1992, which were received by Dr. Jackson. He is on probation for the inappropriate prescribing of Dilaudid to eleven patients in 1989. Dr. Jackson continues his good care of his private patients, and the Insurance PPO and HMO patients here in Hialeah, Florida. In my opinion Dr. Jackson has been very sensitive to the Administrative Complaint and Order of the Department of Professional Regulation. This has been demonstrated by his continuing compliance with providing for me the duplicate copies of his Numbered Schedule II-V prescriptions. Dr. Jackson continues to be very responsive in allowing my random selection of charts for review on my visits to his office. Dr. Jackson continues to be very aware of which medications fall into Schedule II-V. We both have copies of the Drug Abuse Prevent- ion and Control Schedule II-V list. This letter is written to support Dr. Jackson's release from probation. In my opinion he is worthy of release as demonstrated by his continuing compliance. The Board considered Respondent's petition at its October 1-3, 1993, meeting. Both Respondent and Dr. Anderson addressed the Board during this meeting. Dr. Anderson told the Board that, in his opinion, Respondent had "corrected all his past difficulties very effectively." By letter dated October 6, 1993, from Crystal Griffin, Respondent was informed of the Board's action. The letter read as follows: This is to inform you that the Florida Board of Medicine, in a meeting held October 1-3, 1993, . . voted to: Terminate your probation; however, you will be required to pay your administrative fine by August, 1995 and complete 300 hours of community service per year for a period of 2 years. Furthermore, you are required to submit a plan for your community service. You should receive an Order shortly. If you have any questions regarding this matter, please feel free to contact the Board office at (904) 488-0595. Sometime after the Board's October 1-3, 1993, meeting, but before the Board had issued the written order promised in Griffin's October 6, 1993, letter to Respondent, Schaublin first learned about Respondent's petition and the Board's action thereon. Thereafter, on December 7, 1993, she filed an investigative report concerning Respondent's compliance with the terms and conditions of his probation from the time of her last investigative report. In her December 7, 1993, report, she stated the following: Monitoring of the Subject's Probation is impeded because Dr. Jackson's failed to comply with terms of the Probation Order. The Final Order states: "k. Respondent may prescribe Schedule II-V controlled substances with the restrictions set forth below: (2) Respondent shall provide one copy of each prescription for said controlled substances to the Department's investigator within 30 days." Dr. Jackson: Did not provide copies of controlled substances prescriptions for February/March until April 14, 1993. There are 6 missing prescription forms from numbers 1041 to 1047. Dr. Jackson has failed to provide prescriptions for October/November 1993. This investigator met with Dr. Jackson at the Miami BIS on January 27, 1993 and requested copies of prescriptions be sent to this office within the 30 day time frame as mandated in the Final Order. A U.C.F. was issued by this Investigator on 12/7/93. This Investigator spoke with Constance Campbell on December 06, 1993 regarding Dr. Jackson's lack of compliance with the terms of the Final Order. We reported on 2/10/93 that Dr. Jackson's monitoring physician was not visiting his office "every other month" and making "random selection of the record[s]" as outlined in the Final Order f.(3). We are attaching copies of prescriptions for Controlled drugs for the months February 1993 through September 1993. On May 24, 1994, the Board issued a written order terminating Respondent's probation. The order provided as follows: THIS CAUSE came on before the Board of Medicine (Board) on October 3, 1993, in Miami, Florida for the purpose of considering Respondent's request to terminate the probation imposed by the Board's Final Order filed August 2 [sic], 1992. Upon review of the request, the testimony and evidence offered in support thereof, the recommendation of the Board's Probation Committee, and being otherwise fully advised in the premises, IT IS HEREBY ORDERED AND ADJUDGED that Respondent's probation shall be terminated. However, Respondent is still required to pay the administrative fine of $5,000.00 imposed by the previous Final Order and said fine must be paid by August 2, 1995. Furthermore, Respondent is required to complete 300 hours per year of community service in an area where medical services are needed during each of the next two years. This Order shall take effect upon filing with the Clerk of the Department of Professional Regulation.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, it is hereby recommended that the Board of Medicine enter a final order finding Respondent guilty of the violations of subsection (1)(x) of Section 458.331, Florida Statutes, alleged in the Amended Administrative Complaint, with the exception of the alleged violation relating to the submission of copies of prescription numbers 1041-1047, and disciplining him for having committed these violations by fining him $2,500.00, suspending his license for a period of 30 days and placing him on probation for a period of two years (subject to those terms and conditions the Board deems appropriate) beginning immediately after the end of the suspension. DONE AND ENTERED in Tallahassee, Leon County, Florida, this 26th day of December, 1995. STUART M. LERNER Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 26th day of December, 1995.
Findings Of Fact The Respondent is now and was at all times material to the allegations in the Administrative Complaint, a licensed Registered Nurse in the State of Florida, license number 71601-2. On April 13, 1982, Respondent's Florida nursing license was placed on probation. On April 13, 1982, the Florida State Board of Nursing entered a Final Order placing the Respondent's license on probation for two years, with the following terms and conditions. The licensee shall not violate any applicable federal or state laws, or rules or orders of the Board of Nursing. For the duration of the probationary period, the licensee will report immediately (within seven calendar days) either by telephone or letter to his/her probation supervisor assigned by the Department, and by certified registered mail to the Department of Professional Regulation, Attention Administrator, Office of Investigative Services, 130 North Monroe Street, Tallahassee, Florida 32301, by license number and licensed name, any change in Respondent's residence address; any change in Respondent's employment (including address); and any arrests. If employed as a nurse, the licensee will be responsible for causing reports to be fur- nished by his/her employer to the Board or the probation supervisor, relative to the licensee's performance, and any problems. These reports shall be submitted every 3 months during probation as scheduled by the probation supervisor. The licensee shall not consume alcohol while on duty as a nurse, nor function as a nurse while under the influence of alcohol. The licensee shall obtain/continue counseling with a psychiatrist, psychologist or other recognized drug/alcohol rehabilita- tion program, and shall cause progress reports to be furnished to the Board or probation supervisor every 3 months during treatment as scheduled by the probation supervisor. Any deviation from the requirements of this probation without the prior written consent of the Board or the Department shall constitute a violation of this probation. Upon a finding of probable cause that a violation of this probation has occurred, the licensee's license to practice nursing in this state shall be immediately and automatically suspended pending the licensee's appearance before the next Board meeting, or such subsequent meeting as may be mutually agreed upon between the licensee and the Department. The licensees will be given notice of the hearing and an opportunity to defend. The Petitioner assigned Investigator Gerry Padgett to be Respondent's probation supervisor. During 1982, the Respondent satisfactorily complied with the terms of her probation. During the latter part of January, 1983, Respondent received a letter from the Board of Nursing indicating that she had not complied with the probationary terms. After receipt of the letter, Respondent went to see her probation supervisor, who in turn informed the Board of Nursing that the Respondent was, in fact, in compliance with the probationary terms. At that meeting in late January 1983, between Respondent and her probation supervisor, the latter told Respondent that she would be seeing her in three months. Prior to that meeting, Respondent had made appearances in her probation supervisor's office every three months. The next date which the probation supervisor had scheduled to see Respondent was April 1, 1983. There was no clear evidence adduced to show that the scheduled date of April 1, 1983, was communicated to Respondent, and she denied being told specifically to return on April 1, 1983. However, Respondent acknowledged that she knew that she was to see her probation supervisor sometime during April 1983. For several months prior to April 1983, Respondent had been employed by Indian River Memorial Hospital. The last day that Respondent worked at Indian River Memorial Hospital was April 19, 1983. On April 27, 1983, the Respondent admitted herself to the Heritage Health Corporation, an alcohol treatment program located in Sebastian, Florida, to he treated for alcohol abuse. At that time, according to the Respondent's own testimony, she could not have functioned as a nurse due to alcohol impairment. The program in Heritage Health Corporation was a 30 day in-patient alcoholic rehabilitation program. During the Respondent's stay at the Heritage Health Corporation, her employment with Indian River Memorial Hospital was terminated. The Respondent did not report her change in employment status nor her change in residence or entry into an alcohol rehabilitation program to her probation supervisor as required by the above quoted order of probation. On May 18, 1983, after not having beard from the Respondent, her probation supervisor attempted to locate her, and did in fact locate Respondent at the Heritage Health Corporation facility. At that time, Respondent informed the probation supervisor that her employment with the Indian River Memorial Hospital had been terminated. The meeting between the probation supervisor and Respondent on May 18, 1983, was the last time until the formal bearing in this matter that the Respondent reported any information to her probation supervisor. On or about June 20, 1983, the Respondent moved her residence address from Vero Beach to Sebastian, Florida. Three weeks prior to the formal bearing in this matter, the Respondent moved her residence address from Sebastian, Florida to Orlando, Florida. Neither changes of residence address were forwarded by Respondent to her probation supervisor or to the DPR administrator, as required by the order of probation. However, she reported the move from Vero Beach to Sebastian, Florida directly to the Board of Nursing office in Jacksonville. Respondent never received written consent to deviate from the terms of the order of probation.
Recommendation Based on the foregoing, it is RECOMMENDED that Respondent's license as a Registered Nurse be suspended until such time as she demonstrates to the Board of Nursing her fitness to practice nursing. This demonstration should include a psychological or psychiatric evaluation, along with a recommendation from a licensed mental health care professional, that Respondent be reinstated. Upon reinstatement, Respondent should be placed on probation with generally the same terms as her previous probation, along with any other reasonable terms, such as urine or blood screens as appropriate under the circumstances. DONE and ENTERED this 16th day of March, 1984, in Tallahassee, Florida. R. T. CARPENTER Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 16th day of March, 1984.
The Issue Whether Respondent failed to comply with a valid order of the Board of Dentistry and, if so, what disciplinary action should be taken against Respondent’s license to practice dentistry.
Findings Of Fact Petitioner, the Department of Health, is the state agency charged with regulating the practice of dentistry pursuant to Chapters 455 and 466, Florida Statutes. However, at the time the complaint in this cause was filed, this responsibility was assigned to the Agency for Health Care Administration. At the time the Final Order which is the subject of this proceeding was entered, this responsibility was assigned to the Department of Business and Professional Regulation. Respondent, Arnold G. Clement, is now and was at all times material hereto a licensed dentist in the State of Florida, having been issued license number DN 0002500. Respondent’s last known address is 1405 Lennox Road East, Palm Harbor, Florida 34683. On April 22, 1993, the Department of Business and Professional Regulation, Board of Dentistry, entered a Final Order in DPR Case Nos. 90-3628, 90-4117, 0092038, and 0092039 (Final Order), a prior disciplinary action against Respondent. The Final Order, which incorporated by reference an Order issued on February 16, 1993, and a Stipulation approved August 31, 1991, set forth the conditions of Respondent’s probation. Respondent’s signature is on the Stipulation and copies of the Order and Final Order were mailed to counsel representing Respondent in that proceeding. Respondent was aware of the Final Order and Order entered by the Department of Business and Professional Regulation. The Final Order suspended Respondent’s license for six months, and after the period of suspension, placed Respondent’s license on probation for three years. As a condition of probation, Respondent was required to: (1) pay an administrative fine of $2,000; (2) perform ninety-six (96) hours of community service during each year of probation; and (3) complete sixty (60) hours of continuing education in removable prosthetics. Prior to the end of his six-month suspension period, Respondent was required to submit for Board approval, a written practice plan that provided for supervision by a Board approved licensee and for submission to the Board of written reports by the supervising licensee. During the probationary period, Respondent’s practice was restricted to work involving removable prosthetics. On or about October 23, 1993, and December 7, 1993, respectively, Respondent submitted to the Board the required Medical Practice Plan and Dental Practice Plan. These plans were apparently approved by the Board. By letter dated February 15, 1997, the agency reiterated the terms and conditions of Respondent’s probation. That letter provided in pertinent part the following: Pursuant to the final order filed April 22, 1993, the “hearing” held October 23, 1993 concerning the “Dental Practice Plan”, and the subsequent receipt and review of this practice plan, please note the following: * * * Probationary Conditions - 60 hours continuing education in “Removable Prosthetics. Quarterly Written Reports from Woodrow D. Wheetley, DDS, effective March/94, and continuing on a three (3) month quarter thereafter, ending December/96. Submit proof of 96 hours community service, with the first report due December/94, and continuing through December each year ending in 1996. We are requesting “Proof” be in the form of a notarized affidavit from the community service organization. The required fee of $2,000.00 is due April 24, 1994. It is your responsibility to assure that all reports are submitted timely and as specified in the final order filed April 22, 1993. . . . In the Medical Practice Plan submitted by Respondent on October 23, 1993, he agreed to: egin doing his community service work which if approved by the [B]oard would consist of seeing indigent patients at Dr. Wheetley’s office for either no fee or for the cost of the dentures only. In the Dental Practice Plan that Respondent submitted to the Board, he agreed to: egin doing his community service work consisting of removable prosthetics, which if approved by the [B]oard would consist of seeing patients referred to Dr. Clement by the Department of Health and Rehabilitative Services, Pasco Community Health Agency or any other agency as directed by the Board of Dentistry. . . . Respondent failed to submit the requisite proof that he performed ninety-six hours of community service hours for the years ending December 1994 and December 1995. In fact, no such proof was submitted at any time during Respondent’s during entire probationary period. Respondent failed to comply with the requirements of the Final Order relative to submission of quarterly written reports. Pursuant to the terms of Respondent's probation, these reports were to be submitted quarterly beginning March 1994, and continuing thereafter on at three month intervals, with the last report due December 1996. While these quarterly reports were to be prepared by the dentist supervising Respondent, it was Respondent’s responsibility to assure that all reports were timely submitted. In 1994, only two quarterly reports, not the required four, were submitted on Respondent’s behalf. The first report, due the end of March 1994, was not received by the Board until May 6, 1994. The second report was due at or near the end of June 1994, but was not submitted to the Board until November 1994. Thus, the only two quarterly reports received by the Board in 1994, were untimely submitted. Moreover, no quarterly reports were submitted by or on behalf of Respondent during the 1995 and 1996 calendar years. If Respondent had complied with the terms of and conditions of his probation as set forth in the Final Order, his probationary status would have ended in December 1996. Respondent violated the provisions of the Final Order entered in DPR Case Nos. 90-04117, 90-03628, 0092038, and 0092039 by failing to comply with the terms and conditions of his probation.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that Petitioner, the Department of Health, Board of Dentistry, enter a Final Order finding that Respondent violated a lawful order of the Board and revoking his license to practice dentistry. DONE AND ENTERED this 3rd day of December, 1997, in Tallahassee, Leon County, Florida. CAROLYN S. HOLIFIELD Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (904) 488-9675 SUMCOM 278-9675 Fax Filing (904) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 3rd day of December, 1997. COPIES FURNISHED: Craig A. McCarthy, Esquire Greg W. Files, Esquire Thomas E. Wright, Esquire Agency for Health Care Administration Office of the General Counsel Allied Health Post Office Box 14229 Tallahassee, Florida 32317-4229 Arnold G. Clement, D.D.S. 1405 Lennox Road East Palm Harbor, Florida 34683 Angela T. Hall, Agency Clerk Department of Health 1317 Winewood Boulevard Building Six Tallahassee, Florida 32399-0700
Findings Of Fact In July, 1988, the Petitioner applied for renewal of dual annual licenses to operate both an alcoholism prevention and treatment program (APT) and a drug abuse treatment and prevention program (DATAP). On July 26, 1988, a representative of the Department, Aixa Reyes-Wajsman, made a site visit to Petitioner's facility to determine whether Petitioner was complying with the provisions of the Florida Administrative Code for the operation of an alcoholism prevention and treatment program (APT) and a drug abuse treatment and prevention program. The Department's representative found that the Petitioner was in violation of several administrative regulations, but the Petitioner took steps to comply with the regulations, and the Department renewed the Petitioner's regular annual DATAP license and regular annual APT license, authorizing the Petitioner to operate those programs through July 30, 1989. On June 27, 1989, a Department representative, Lorenzo Thomas, made a site visit to the Petitioner's facility to determine whether or not Petitioner was complying with regulations for the operation of an APT program. (The Petitioner requested renewal of the APT license only, not the DATAP license.) At the time, the Petitioner, primarily a small human development counseling service, had only two APT clients. By the time Mr. Thomas returned with his supervisor, Gail Potter, for a second site visit on July 27, 1989, the Petitioner had one additional APT client, who had just been accepted as a client. Although the Petitioner's client files included forms which would have allowed for the inclusion of initial and individualized treatment plans which identified target dates for completion of goals identified in the client's plan, the Petitioner did not utilize the forms so as to adequately describe the treatment plan or identify target dates. The Petitioner's client files did include progress notes. But the progress notes were incomplete and disorganized, some consisting of cryptic notes on pieces of scrap paper loose in the files, and did not adequately relate the progress of each client in accordance with the individual treatment plan. The Petitioner took the position that the notes were sketchy so as not to reveal client confidences in the event the records were required to be disclosed pursuant to a subpoena. One of the Petitioner's client files--the file on the new, third client--did not include a psychosocial assessment. The other two client files did include a partially completed psychosocial assessment, but neither was signed, credentialed and dated by the treating counselor. Since there had been no request for the release of client information on the Petitioner's three APT clients, there was no reason for the Petitioner's client files to include a client consent form for the release of confidential information. (The blank forms that the Petitioner had available for use in the event of a request for client information did not include a time limit for the release of such information.) The Petitioner's client files did not include evidence of the development and utilization of admission and discharge criteria or standards. The Petitioner distributed to its APT clients an information sheet upon admission, but the information sheet did not include admission criteria. The Petitioner also had available a questionnaire for new clients to complete. But the questionnaire was not used for the clients the Petitioner had at that time and, besides, did not indicate how the Petitioner would score, or evaluate, the client's answers. Based on the June 27 and July 27, 1989, site visits, HRS issued to the Petitioner an interim APT license from August 1, 1989, to October 29, 1989, instead of a regular annual APT license.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is recommended that the Respondent, the Department of Health and Rehabilitative Services, enter a final order affirming the Department's action in issuing to the Petitioner an interim alcoholism prevention and treatment program license instead of a regular license. DONE and ENTERED this 3rd day of April, 1990, in Tallahassee, Florida. J. LAWRENCE JOHNSTON Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 3rd day of April, 1990.
