Minutes

North Carolina State Board of Examiners in Optometry

June 5 - 8, 2008

Myrtle Beach, South Carolina

The North Carolina State Board of Examiners in Optometry met at the Embassy Suites Hotel at Kingston Plantation in Myrtle Beach, South Carolina, June 5 – 8, 2008 for the purposes of approving the applicants to take the Summer 2008 Clinical/Practicum examinations, to finalize the examination schedule based upon the number of approved applicants, to review and adopt the budget for the fiscal year beginning July 1, 2008 and ending June 30, 2009, to review complaints, to conduct the Annual Meeting to elect officers for the coming year, to monitor continuing education during the Annual Spring Congress of the North Carolina State Optometric Society, and for other purposes. Present were Drs. David Anderson, President, William Hendrix, Secretary/Treasurer and Drs. Joel Banks, Michael Clark, William Rafferty, and Mr. Roger Mitchell and Ms. Mary Richardson, Members of the Board. Also present was Dr. John Robinson, the Board’s Executive Director. Present on Thursday at the 10 A.M. time certain as posted on the agenda was the Board’s attorney, Mr. Johnny Loper, who joined the meeting by way of conference telephone. Also present on Thursday afternoon was Dr. M. Scott Edwards who was placed on the agenda to appear at 3:00 p.m. following an earlier request by his attorney, Steve Smith, that he be given an opportunity to address the Board.

At 8:45 a.m. on Thursday, June 5, 2008 the meeting was called to order by the President who opened the meeting with prayer. Prior to taking up the any item of on the agenda he read aloud the North Carolina Board of Ethics’ “Conflict of Interest” statement.

Approval of Minutes.

On a motion by Dr. Banks seconded by Mr. Mitchell the Minutes of the March 28 - 29, 2008 Meeting were unanimously approved.

On a motion by Dr. Banks seconded by Dr. Hendrix the Minutes of the May 30, 2008 Special Meeting were unanimously approved.

Report of the President.

Dr. Anderson stated that his report would center on the Board’s Clinical/Practicum Examinations and the need to continue invest those resources necessary to provide uniformity in the preparation and scoring of its examinations. He opined that while each administration of the examination has seen improvement over the previous one, the move to have the Clinical Examiners prepare their cases using their own computer and software provided by the Board has proved challenging. The first trial, while considered to be a success, is in need of improvements on the part of the examiners preparing the cases and the Board and its Staff in order that changes can be made in the software based upon the experiences of those preparing the cases. An immediate need for improvement was found in the lack of the preparer’s ability to attach photographs to their cases as they are prepared rather than having to depend on those found in texts, on the internet or other sources. Complete and readable documentation of scores at the examination site continues to be a source of concern. It is the responsibility of each Member of the Board to oversee this portion of the examination. Before leaving at the examination station and proceeding to the next the Board Member must make certain that complete and readable documentation of the scoring is in place rather than having to have the Board’s Staff and/or the Board Members during the review process contact Clinical Examiners in order to gain further insight as to how a particular score was determined.

On a motion by Mr. Mitchell seconded by Ms. Richardson that carried unanimously the report of the President was accepted.

Report of the Secretary Treasurer.

The Secretary-Treasurer presented the Budget Report that covered the period 07/01/07 through 05/30/08. With a month remaining in the fiscal year, Dr. Hendrix noted that those line items in the budget that exceeded the amounts budgeted were the subject of review at the last meeting and that there are no unexpected changes in this report. Based upon the income and expenditures as reflected in this report it appears that Board will end the fiscal year without a deficit. While the interest income cannot be determined until the completion of the annual audit, this report shows that the Board’s revenues for the year exceed the budgeted amounts. This is subject to change, since there are outstanding expenses including meetings, travel, per-diems, legal, utilities, equipment, supplies and other budgeted items that have or will be incurred within the current fiscal year but have not yet been billed and/or paid. The Executive Director will supply each Member a report showing meeting and per-diem expenses that so far have been billed and paid. On review of their report Board Members who find that they have not yet submitted all of their meeting expenses, including this meeting, incurred during this fiscal year should do so before June 30^th. It is important that all expenses incurred within a fiscal year be paid prior to the start of the ensuing fiscal year. On a motion by Dr. Rafferty seconded by Ms. Richardson and carried unanimously the Report of the Secretary-Treasurer was accepted.

Report of the Executive Director.

The Executive Director reported:

• Based upon the action of the Board at the Specially Called Meeting on May 30, 2008 in the matter of M. Scott Edwards, O.D. , the matter being resolved without the need for a hearing, I am pleased to report that the Board’s files in the matter have been closed.

• There are 49 applications in the Board office that were received in a timely manner. Based upon all of the required documents and correct and verifiable information be in each applicants file by the time of the start of the examinations, there will be 49 persons appearing for examination. The first session will have to start on Friday morning, August 1, 2008. Reservations for space at the McKimmon Center for the Board’s examinations are made years in advance. This summer the reservations are for one room (the procedures station where the equipment will be delivered) on Thursday, July 31, 2008. The remaining rooms are reserved for Friday, Saturday and Sunday and a half day on Monday, August 4, 2008. With this 49 applicants to examine, ten examinations sessions will be required. Therefore, the schedule calls for three sessions to be held each day beginning Friday, August 1^st through Sunday, August 3^rd and one session on Monday, August 4^th. Prior to leaving this meeting the Board will need to agree on the dates of the meeting to determine the results of the Summer 2008 examination. Further, the date for the review of the results by those who may not be successful in achieving a passing score should announced at the time of the examination so that every applicant will be informed of the ‘review date’ prior to their leaving Raleigh in August.

• The proposed budget for fiscal year 2008 – 2000 includes recommended pay increases for the Executive Director, the Administrative Secretary and the Administrative Assistant is in the meeting notebook. The office rent that appears as a line item in the budget is in the amount approved by the North Carolina Department of Administration who took responsibility for drafting the terms of the office lease some years ago. It is the Department that sets the amount of rent increase they will approve for each year of a three year lease. The final year of the current lease ends on June 30^th, a little over three weeks from now. The Department has drawn a new lease, the terms for which are in the meeting notebook. I would like to note that after terms of the lease were agreed to I was informed that final approval was contingent upon there being a ‘handicap’ access ramp to the office and ‘grab’ bars installed in the bathroom within 90 days of the signing, otherwise the State could cancel the lease. The current lease has no such requirement. Rather than risk controversy later I had the ramp built and the grab bars installed in the bathroom. Upon approval of the Budget for the fiscal year beginning July 1, 2008 by the Board I am prepared to sign the lease and return copies to the North Carolina Department of Administration for final execution.

• There have been increasing numbers of complaints received in the Board office concerning the sale of ‘colored’ contact lenses by retail merchants, mainly beauty and nail salons, convenience stores, etc. that are located in or near minority neighborhoods. To date the complaints have been from practitioners reporting patient harm caused by these products and not from patients. None have been supported by written statements made by the patient or by copies of notes from the doctor’s records documenting ocular disease or injury resulting from use of these products. With proper documentation such as affidavits by patients accompanied by copies of notes in the doctor’s charts indicating the ocular problems/treatments/costs, etc. the Board would have proper grounds for action. Finally, since calls from practitioners in these matters are being received by Board Members it is recommended that such calls be referred to the Board office and that callers be informed that for the Board to pursue such matters there will have to be documentation in the way of signed complaints by the patient accompanied by documentation by the practitioner of any injury and/or harm to the patient.

• Practice by graduates awaiting licensure is an occasional problem; however, the Board’s policy in this regard has been of great help. Once referred to the policy, practitioners seem to understand their responsibility in having an unlicensed person assisting in patient care in their office. Similarly, the unlicensed person has clear guidelines as to what they, as an unlicensed doctor, can and cannot do in the way of patient care.
• Licensure by Endorsement. There is a paper on Licensure by Endorsement in the meeting note book. I prepared this draft on instructions from the Board at its last meeting. It has been circulated to the Board Members and to the Clinical Examiners who were at the Winter 2008 examinations for their information and/or comment. A number of changes were made in this draft based on comments and suggestions by Members of the Board. Agreement with the principals set forth in this document among the Clinical Examiners was unanimous in support of the Board’s licensing optometrists to practice optometry in North Carolina based upon current licensing requirements that include the passing of the Board’s Clinical/Practicum examination by all applicants for licensure. Approval of this statement on the issue of licensure by endorsement by the Board is on the agenda for this meeting.

• Board Certification will likely be a subject of debate at the upcoming meeting in Seattle of the American Optometric Association. Ten years ago this proposal was overwhelming rejected. The North Carolina Board’s position in opposition to the proposal at the time is well documented in an exchange of letters and in the Board’s minutes. Copies of correspondence and excerpts from the Board’s minutes during this period were put in the meeting notebooks at the time of the Winter 2008 examinations. It was the opinion of the Board at the time that the proposal to establish the American Board of Optometric Practice (ABOP) that ‘board certification’ and/or credentialing of optometrists in their scope of practice and/or in their competency to practice the profession of optometry is a matter to be determined by the State Boards of Optometry in their respective jurisdictions. There was a consensus among North Carolina optometrists as well that Board Certification by any national organization such as ABOP would be tantamount to a plan of national re-licensure and should be presented as such to the profession at large their consideration and debate.

• There are copies of the Board’s continuing education approval forms currently in use along with two additional forms whose use is being advocated by Dr. Rafferty. The information and or/use of these additional forms according to Dr. Rafferty are going to be required because of Federal mandates currently being placed on the pharmaceutical industry if they are to continue to provide financial support to the various organizations and institutions providing continuing education programs for the benefit of the various health professions. Dr. Rafferty will be leading a discussion of this issue later in the meeting.

• Clinical Examiners and Observers for the Summer 2008 Clinical/Practicum examinations. There have been prior discussions of the need to build a pool of clinical examiners so as to assure the Board that it will have the ten clinical examiners plus the emergency backup required at both the Winter and Summer examiners. I have been informed by at least two of those serving at the Winter examinations this year that they will not be available for the Summer . There are others that feel it necessary to take a sabbatical for several years for personal reasons. For the Summer 2008 examinations I request that the Board authorize Staff to contact those who were at the Winter examinations plus others who have been examiners in the past in order to secure the number of commitments needed to fill the ten slots that are required. As for observers, we have a number of names that have been submitted, but request that you give us more as you see individuals you would recommend as potential examiners while you are at this meeting. I will be contacting those who have been recommended when I return to the Board office next week.

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

Applicants for the Summer 2008 Clinical/Practicum Examinations. On a motion by Dr. Rafferty seconded by Dr. Clark and carried unanimously the applications for the Summer 2008 Clinical/Practicum were approved subject to each applicant’s application file containing correct and verifiable information, and further that all documents required by the Board are received and in the applicants’ file prior to their appearing for examination; and that the schedule for the Summer Clinical/Practicum Examinations as stated in the Executive Director’s report above be approved. The motion carried unanimously.

Clinical Examiners and Observers. Without objection the President assigned the task of securing commitments from ten of those clinical examiners who have served in the past, starting with the ten who were at the Winter 2008 examinations to the Executive Director and the Board Staff. Observers to be invited are those whose names have been submitted by the Board Members and the Clinical Examiners to the Executive Director.

Review of the Proposed Budget. Upon review of the draft of the budget proposed by the Executive Director and the asking and answering of questions, an increase was made in the income derived from examination fees based upon the numbers of applicants to the two examinations during the current fiscal year.

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

Evaluation of Staff. Reconvening the meeting the President announced that the Board unanimously agreed that the performance of the Board Staff over the past year had been exemplary and that the Members of the Board were deeply appreciative of their dedication and professionalism in the performance of their duties; further, that the Members of the Board were of the opinion that a 5 % increase in the salaries of the Executive Director and the Administrative Secretary and a 8 % increase in the salary of the Administrative Assistant for fiscal year 2007-2008 are recommended.

Employee Retirement Accounts (Seps Accounts) Upon returning to open session and before voting on the adoption of the budget Dr. Banks moved and Ms. Richardson seconded a motion that the Board approve a 10% contribution to the SEP’s accounts of the Executive Director, the Administrative Secretary and the Administrative Assistant based upon salaries recommended for fiscal year 2008-2009. The motion carried unanimously.

Board Office Lease July 1, 2008 – June 30, 2011 On a motion by Mr. Mitchell seconded by Dr. Rafferty and carried unanimously the three year Board Office Lease drafted by the North Carolina Department of Administration, the terms of which have been approved by said Department and stated in the proposed budget as amended was approved for fiscal years beginning, July 1, 2008 and ending June 30, 2011.

Adoption of the Budget. the Secretary-Treasurer presented the amended Budget for fiscal year 2008-2009, said budget reflecting an increase of 5 % in the salaries of the Executive Director and the Administrative Secretary and an increase of 8% in the salary of the Administrative Assistant. Without further discussion on a motion by Dr. Clark seconded by Dr. Banks and carried unanimously the Budget for fiscal year 2008-2009 as presented by the Secretary/Treasurer was adopted.

Licensure by Endorsement. On a motion by Dr. Banks seconded by Dr. Clark the Board unanimously approved the Policy Statement on Licensure by Endorsement as corrected. (Copy to be attached as a part of these minutes)

Report of the Examination Review Committee. Six applicants requesting a review of their examination results appeared in the Board office on Tuesday, April 29, 2008 to review their results. Meeting with each of them as the Examination Review Committee were Dr. Michael Clark, a Member of the Board and the Executive Director. After spending approximately 40 minutes with each of the applicants in a detailed review their examination results as reported to them earlier, the Committee could find no evidence to support the changing of a score as reported to the candidate. Therefore, it is the Committee’s recommendation that the results of the Clinical/Practicum examinations stand as reported to each of these applicants. On a motion by Dr. Banks seconded by Dr. Hendrix and carried unanimously the examination results as reported to these applicants stand as reported to them.

Litigation Update. At 10:40 a.m. Mr. Loper joined the meeting by way of conference telephone. In light of concluding all matters that were the subject of litigation prior to this meeting there was no need to go into closed session. The Board and Mr. Loper took the opportunity during their meeting to clarify issues that sometimes arise when the Board has cause to appoint probable cause committees, how the committees are to proceed in their investigations and in negotiations that can lead to settlement without the need to go to formal hearings. This session lasted for approximately fifteen minutes and ended when there were no further questions for Mr. Loper from Members of the Board.

Annual Audit as Required by State Law. The proposal for performing the Audit of the Board’s financial records for fiscal year beginning July 1, 2007 and ending June 30, 2008 by the Accounting Firm of Waters and Piver was presented. On a motion by Mr. Mitchell seconded by Dr. Clark and carried unanimously the proposal by Mr. Waters on behalf of his firm was accepted.

ARBO/AOA Meeting. As reported and approved in the minutes of the February meeting Drs. Hendrix, Rafferty and the Executive Director will be attending the Annual Meeting of the Association of Regulatory Boards in Optometry on June 22 -24, 2008 in Seattle, WA. Dr. Robinson’s travels also include attending the AOA House of Delegates meetings on June 26-28 to monitor and speak on issues of Board Certification and Licensure by Endorsement in the likelihood that these topics are brought to the floor for discussion. Before leaving the meeting the President appointed Dr. Robinson as the Board’s voting delegate at the ARBO meeting.

Dr. M. Scott Edwards’ Appearance before the Board. At 3:00 p.m. Dr. Edwards appeared following an earlier request made through his attorney, Steve Smith, that he be allowed to address the Board at some point during this meeting. As a courtesy to Dr. Edwards since he had asked that he be allowed to address the Board in the absence of the Board Staff, the Executive Director left the meeting room after arranging for Mr. Mitchell to make those notes necessary to construct the minutes for this portion of the meeting. While 15 minutes were allotted on the meeting Agenda, a copy of which had been furnished Dr. Edwards prior to Boards arrival in Myrtle Beach, his appearance took approximately an hour and a half. From Mr. Mitchell’s notes “In the absence of the Executive Director from 3 p.m. to 4:30 p.m. which was in open session, Dr. Edwards addressed the Board. During this time he summarized the events leading up to and following his felony charge and conviction. Dr. Edwards did not request or direct any questions to any of the Board Members. His stated purpose for addressing the Board was to provide his version of those events. He concluded by thanking the Board for providing him the time”. At 4:35 p.m. the Executive Director returned to the room and the Board meeting resumed.

Summer 2008 Clinical/Practicum Examination Dates. The Board Members and the Clinical Examiners are to arrive in Raleigh and meet in Room 9 at the Jane McKimmon Center in Raleigh at 4 o’clock p.m. on Thursday, July 31^st. The first examination session will start promptly at 7:40 a.m. on Friday, August 1^st. Breakfast will be served each of the four days beginning at 7:00 a.m. There are to be three sessions on Friday, Saturday and Sunday and one on Monday.

Meeting Dates to Determine the Examination Results. The meeting to determine the results of the Summer 2008 Clinical/Practicum Examinations will be held in the Board’s office in Wallace beginning at 4:00 p.m. on Friday, August 22, 2008. It is anticipated that the meeting will be adjourned no later than 5:-00 p.m. on Saturday, August 23^rd.

Examination Review. The review of the Summer 2008 examination results for those applicants wishing to review their results will be held in Wallace at the Board’s offices on Wednesday, October 8, 2008 beginning as early as 9:00 a.m. (depending on the numbers of applicants requesting a review of their results).

Annual Meeting. The Annual Meeting to elect officers was held at 12:00 p.m. in the Eaton Room at the Embassy Suites Hotel in Myrtle Beach, SC as previously scheduled. Elected President for 2008-2009 was Dr. Joel Banks. Dr. William Hendrix was re-elected as Secretary/Treasurer. (see minutes of 2008 Annual Meeting).

The remainder of the time in Myrtle Beach was spent in monitoring the continuing education programs at the Spring Meeting of the North Carolina Optometric Society which began on Friday, June 6 and ended on Sunday June 8, 2007.

There being no further business the meeting of the Board was officially adjourned at noon on Sunday, June 8, 2008. The next meeting will be at the Jane McKimmon Center in Raleigh, NC beginning at 4:00 p.m. on Thursday, July 31, 2008.

Approved 07/31/08

Raleigh, North Carolina