Memorandum #11-09: PDF 34MB Approval of Southern Nevada Health District Regulations Governing the Sanitation and Safety of Body Piercing Establishments; Consideration of Business Impact Statement held from March 23, 2009 Board of Health meeting
Chair Giunchigliani declared the public hearing open.
The following is a verbatim transcription of the public hearing concerning Memorandum #11-09.
Dr. Sands: Next item is Memorandum #11-09, approval of Southern Nevada Health District Regulations Governing the Sanitation and Safety of Body Piercing Establishments and Consideration of Business Impact Statement. This item was held from the March Board meeting to be heard again at today’s meeting, pending research by staff. Mark Bergtholdt, our environmental health supervisor and John Cataline, one of our environmental health specialists will be presenting on this item and will be glad to answer any questions you may have on any additional information brought forward.
Chair Giunchigliani: We will open the public hearing on Memorandum #11-09 regarding body piercing establishments. Good morning.
Mark Bergtholdt: Good Morning Madam Chair and members of the board. At your March 26th meeting I presented revisions of the current body piercing regulations. At that time, Mr. Jim Reding and Mr. Bernie Ellis testified in opposition of the inclusion of single point piercing in the definition of Extreme Body Modification. The Board decided to postpone adoption of the regulations until staff gathers medical information about the practice. Also at that meeting Member Crowley requested a document that highlighted the changes between the existing regulations and the proposed regulations. Included in your board packets, excuse me, are two documents that highlight the changes. As stated in Memorandum 11-09, the proposed regulations are a complete re-write of the existing regulations. Attachment J is a listing in table format by section of the existing regulations and cross references the existing regulation sections to the proposed regulations. Items identified as new are highlighted in green; items that have been removed from the existing regulations are highlighted in red; and sections that have been changed in the proposed regulations are highlighted in yellow. Attachment K identifies what sections in the proposed regulations have been added or changed from the current regulations – those changes and additions are highlighted in green. The comments in the margins of the document identify where in the current regulations a section in the revised regulations can be found. Excuse me. During the previous sixty days, numerous discussions have occurred regarding the issue of single point piercing as a medical practice. Staff have met with Mr. Reding and other industry representatives and have received two letters from local physicians that support their position that it is not a medical practice. Physicians that the chief health officer has spoken with find that it is a medical procedure that needs close supervision of a medical doctor (attachment #1). After careful consideration, staff recommends that the prohibition of single point piercing stand.
Chair Giunchigliani: Thank you. Yes, Ms. Crowley.
Member Crowley: I just wanted to thank you for the table, especially. I apologize for asking you to kill a tree.
Chair Giunchigliani: We recycle here, I’m sure.
Member Christensen: It was green inside.
Member Crowley: Yeah, but the table was very, very helpful. Thank you very much.
Chair Giunchigliani: Thank you. The age issue, has that been resolved? Is it still 16 and older that can come for body piercing?
Mr. Bergtholdt: Correct. Fifteen, I’m sorry.
Chair Giunchigliani: Fifteen, then.
Mr. Bergtholdt: Thirteen.
Chair Giunchigliani: Thirteen?
Member Steinman: Thirteen?
Mr. Bergtholdt: But it’s with parental consent.
Chair Giunchigliani: Per consent. Correct, that’s what I thought.
Mr. Bergtholdt: Yeah.
Member Steinman: Up to what age?
Mr. Bergtholdt: Eighteen.
Member Steinman: Eighteen.
Mr. Bergtholdt: Age of consent.
Chair Giunchigliani: And then was there any legislation that was passed regarding body piercing at all this session?
Dr. Sands: No.
Chair Giunchigliani: No. OK, maybe that was a session before they tried. Um, gentleman, did you wish to make some comments about the proposed regulations?
Jim Reding: Sure. Basically we want to restate our argument…
Chair Giunchigliani: Would you state your name for the record so that Shelli has that, please. Thank you.
Mr. Reding: I’m Jim Reding with Club Tattoo. Behind me is Shawn Dowdell, the owner of Club Tattoo, and Club Tattoo’s attorney, Kevin Goff.
Chair Giunchigliani: Good morning.
Mr. Reding: And we’re here to restate our argument – single point piercing has been practiced for at least several years, and what we provided is a video that shows the procedure and also statements about how long it’s been being done, including how long it’s been performed, the practice has been performed by tattoo and body piercing establishments that you regulate. And your regulations also clearly state that any infections or complications that arise need to be reported within 48 hours. We haven’t heard any argument of specific cases being brought to the attention of the Board of Health, so obviously we’re talking about a procedure that’s been in practice, it’s common practice, and hasn’t had any issues. On top of the two letters by named, reputable medical experts in this area, we’ve also provided a contact list of people from nine different states that have also been performing this procedure for at least a few years and haven’t had any complications. The contacts were also issued with that, you have phone numbers and emails and whether or not they were contacted, I don’t know. So, that’s our argument. Did you have anything to add?
Kevin Goff: In fact we did contact them and none of those other, the people that were listed, had reported any incidents in the past of any infectious disease resulting from this single point piercing. I think Jim’s already covered with staff and with the district in the last meeting how the procedure works – very minimally invasive, a small figure-eight that’s two millimeters long that gets implanted in the, I’m sorry, gets placed under the upper layers of the skin and then a small, correct me…
Scott Dowdell: It’s basically the dermal anchors are two millimeters high in the shaft that are placed in between the dermis and epidermis. They don’t go beneath the subcutaneous layers. I’m reading some of these concerns about the infections in the subcutaneous layer – they don’t sit in the subcutaneous layer, they’re two to three millimeters at the minimum away from that layer of tissue. As far as the procedure’s concerned it’s no different than a dual point piercing, especially by your implantation definition. A dual point piercing simply means that you enter one side of the tissue with a needle and you exit the other side. The dermal anchor enters one side and then the needle gets withdrawn in the same fashion that it was pushed in, and then the jewelry’s put in. It’s no different except for the fact that you don’t exit the other side. The dermal anchors come out very easily. I’ve been doing them for over three years; I’ve done over 1,500 of them myself; I’ve invented the piece of jewelry that we’re talking about here. I have not had any issues in three years. I own six stores, a $2 million dollar facility here in Planet Hollywood. That’s how I feel about it.
Mr. Goff: And so given the absence of any history of problems with this procedure, we just think it’s…there’s no need to regulate it and if you did want to regulate it, it should be more under a special permit type of situation where you go in the facility and look at what’s actually being performed, who it’s actually being performed by and attach conditions to what they’re doing, if you think any regulation’s necessary at all. But I think the total prohibition in the absence of any evidence that this has ever caused any of the infections that the district’s concerned about is, it isn’t warranted here.
Mr. Reding: Also, I’d like to include that we searched the regulations of fifty states and did not find one single state that lists single point as a prohibited act. Not one.
Mr. Dowdell: I guess this is just my opinion, but the reason that is, is because there’s no difference from that and other piercings – it’s the same thing. Trying to differentiate doesn’t make sense. The two surgeons that I did meet with are very well-renowned in the community here. I showed them a video of our procedure. They both said it was very safe and would stand behind us a hundred percent. So I’m a little confused when I’m reading the findings of the two other doctors who aren’t named in their report as to how those doctors saw the procedure if the procedure’s not being done. And I’m the only one with the video – I don’t know where they would have seen that. So I’m confused and if possible, if this is postponed I’d like the opportunity to speak with the doctors.
Member Christensen: It’s called a wav file.
Mr. Dowdell: Is it?
Member Christensen: Yeah.
Mr. Dowdell: OK, I’m not sure, that’s why I’m asking.
Member Christensen: It was emailed.
Chair Giunchigliani: OK, so who were the other two doctors with the health district? I didn’t see that…
Dr. Sands: You have one letter…one of the doctors who is Ben Rodriguez, who’s a plastic surgeon who’s also a member of the Board of Medical Examiners; the other is a faculty member of the School of Medicine that was uncomfortable and at this point had asked to remain anonymous on this, but again they received all the same information provided us by Club Tattoo, including the video and so forth, so they could review those and were asked the same questions about their opinion about that procedure and how they view it and the response was based on that.
Member Christensen: Madam Chair, in my discussions with the other two physicians, they both…one sits on the Board of Medical Examiners and they’ve actually have agendized this and consider this at their next Board meeting for physician oversight. Something along these lines is happening in California with the supervision of medical spas that are popping up, and those are having to be supervised by physicians and extend the physician/patient relationship.
Chair Giunchigliani: I do think if someone’s going to go on the record they really shouldn’t be considered that they’re confidential, because otherwise you don’t really have a true public, transparent process.
Stephen Smith: Madam Chair, last time, I believe we were told that this was new technology. Now they are presenting it as a practice that has been engaged in beforehand. I distinctly recall being shown…that we were shown a video saying this was new technology…
Chair Giunchigliani: I think the issue was that the gentleman invented this new piece and that was the newness of it versus single point…
Mr. Reding: Sure, if you check the minutes you will see that I did state that it’s been performed for at least a few years.
Chair Giunchigliani: Further discussion from the Board? Yes, Tim.
Member Jones: What epidemiology or studies do we have on infection rates with this procedure?
Dr. Sands: We have not been able to find any studies…
Member Christensen: They’re not going to be reported. No, if someone gets a complication they’re not going to…they’re going to go see a physician and a physician’s not going to report that complication to either the Board of Health or the medical examiners – they’re just going to take care of it.
Chair Giunchigliani: Well, maybe that should be part of the process, if that’s the case, so you be getting some tracking, because as new fields and new businesses come in, you’re going to have an opportunity to track that and see if there really is a problem. If there is, then we have to deal with it as a public health agency. Seems to me in absence of that…I guess maybe, sometimes it’s the fine line. I don’t know where I’m at on this. I don’t personally believe in piercing, I’d rather wash off...But be that as it may, the dual point goes in twice, the single point is only one invasive or no?
Mr. Dowdell: It’s the same movement. You have a needle, you have the tissue. On a dual point piercing, you come in one side of the tissue and out the other side…
Chair Giunchigliani: Opposite…
Mr. Dowdell: …and the jewelry transfers in. With a single point piercing, the needle goes in – two to three millimeters – then it’s removed, then the jewelry’s placed.
Chair Giunchigliani: Is left there. OK.
Mr. Dowdell: And in the three years that I’ve been doing these procedures, I’ve not had a higher infection rate than any other piercing infection rate. If it helps, I’m not a doctor, but …
Chair Giunchigliani: In the industry is there a format for a client to complain or document? These regs don’t appear to anticipate that. I mean, it would seem to me that this Board of Medicine wants to get involved, that should be a place to start with is having some sort of notification so people know what the problems might be.
Mr. Goff: You actually did have that foresight. The proposed regulations do require reporting within 48 hours.
Mr. Reding: Yeah, the current regulation is section 5.14.
Chair Giunchigliani: OK.
Mr. Reding: And then the proposed regulation is section…
Mr. Goff: I’m sorry, the current regulations have it as well.
Mr. Bergtholdt: The current regulations require immediate reporting of any adverse effect.
Chair Giunchigliani: So you’ve never had any reports…
Mr. Bergtholdt: To environmental health.
Member Onyema: Who does the reporting?
Mr. Bergtholdt: It would be the business that would be required to do the reporting.
Member Onyema: So if you have an infection within 48 hours, the customer goes to the business, then the business then reports.
Mr. Bergtholdt: Is required to report by our current regulations.
Member Jones: Are the advisory documents that go to the client outlining the fact that if they suffer some type of infection they ought to be telling you?
Mr. Dowdell: Ours do, yes.
Member Jones: And is that part of this regulation that we require that?
Mr. Bergtholdt: Our regulations require that there be after-care instruction provided and it should be included in that after-care instruction.
Member Jones: And is it or it should be?
Mr. Dowdell: I’m pretty sure…
Mr. Goff: It is in our business, yes.
Mr. Reding: I’m pretty sure it’s…
Member Christensen: The after-care should probably give the name of the physician that they should go to because in my practice people come in and say, hey I’ve got this, take a look at this. And it’s like it’s infected – you’ve got to do x,y and z. It never gets reported. They don’t know about it. I sure as heck don’t report it to the health district – you just take care of the problem, it’s a local infection.
Member Jones: My thought would be, if we’re going here, that the document that the client signs should have an instruction to report back to the business that they experienced some kind of complication and that the business reports to the health district that they received that report of complication. Along with it, I don’t see it in here, maybe it’s in here, I see that the records need to be kept for two years?
Mr. Bergtholdt: Correct.
Member Jones: If a business goes out of business during the course of that two years, where do the records go?
Mr. Bergtholdt: It would go with the business and probably we would not have access to it after those two years.
Member Jones: So I’d recommend maybe there’s some process that if a business goes out of business today, somehow we collect those records…
Chair Giunchigliani: Mm-hmm.
Member Jones: …and then go with it.
Chair Giunchigliani: What other businesses, in this kind of a format, do we allow for self-reporting? Maybe that’s the key place where the customer, as well as the business…I mean, because there’s no check and balance.
Mr. Bergtholdt: In our child care regulations we also require self-reporting of any illness that occurs in the facility.
Chair Giunchigliani: That scares me.
Member Kirk: Madam Chair?
Member Christensen: And how often do we get those?
Mr. Bergtholdt: We get them, actually quite commonly.
Member Christensen: You get complaints.
Mr. Bergtholdt: We do get some illnesses where the facility will call because they require our assistance because the facility’s basically going through a firestorm, for lack of a better word, of an infection…
Member Christensen: Yeah.
Mr. Bergtholdt: …such as hand, foot and mouth disease.
Member Kirk: Madam Chair? The problem I have is, I look at this kind of like when you go to a restaurant and you get sick, what do you do? Do you go back to the restaurant? No, most of us swear off, you’re never going back, you just get better and you know. And so I think there’s a problem with reporting, because if I go and get a piercing and I get an infection, I’m going to swear off you and I never want to see you again. I’ll go to my doctor and get fixed. So I think we have, there’s some disconnect between the procedure and the reporting of infection, if there is one. I appreciate the fact that he’s never had a problem of anybody being infected. I’m not so sure that indicates that there’s never been infection. I think there’s, like I said, a disconnect. And so there ought to be some way of closing that loop.
Chair Giunchigliani: Mm-hmm.
Member Kirk: Secondly, it seems that we can’t, at least from my money, what I kind of get the sense from the Board, it’s difficult for us to come to consensus as to whether or not this is a medical procedure and it is even difficult for the medical community to come to consensus to whether this is a procedure or not, a medical procedure. So I think it ought to, it’s my opinion, it ought to go to the Board of Medical Examiners – let them weigh in on the issue. If they can come to consensus, then I think we follow, for my money, we follow their recommendation. I’m not comfortable with giving an opinion. This is not like a solid waste facility – this is a real public health issue and I think we ought to get real professional input. And if we adopt a regulation without that, I’m just not comfortable doing that. So my recommendation would be, if you’re looking for a recommendation right now, is to continue this until we get information back from the Board of Medical Examiners.
Chair Giunchigliani: And I think maybe, I would tend to agree that it’s a little bit premature. I served in the legislature when the optometrists versus ophthalmologists regarding putting drops and certain factors and it was a huge fight – it took three legislative sessions to resolve that matter. So, pending on that, because I think there would be disagreement within that body, why don’t we at least look at in the interim, what kind of reporting do we really want and who should it be reported to? And if we have childcare self-reporting, that is kind of bothersome to me, I don’t think I realized that, that maybe depending on what the Board says, maybe review that reporting procedure so it’s very clear to parents in that instance, and this instance the customer. Fine, if they have disclosure, and they should probably go back to the business so if you hired someone that wasn’t following their protocols you’d want to know that, but there should also be an automatic to the health district or some other body as well. So maybe it’s a parallel reporting procedure. And I would maybe ask that staff take a look at that, as well. We can then debate. Are there other components of the regulation though, other than the single point versus dual point and us trying to define it, that are needed now or is waiting not a problem for the other component?
Mr. Bergtholdt: We currently have regulations in place…
Chair Giunchigliani: Exactly. So those could still continue.
Member Steinman: Can I ask you, who sought the opinion of Dr. Rodriguez? Did the health district?
Dr. Sands: I did, the health district.
Member Steinman: And he very clearly says it needs close supervision by a licensed physician. How do you put that into the regulations that a physician must do close supervision when they’re operating a business? That’s my issue here, and I’m with Councilman Kirk on this, because I think we, trying to ride herd on this is going to be very difficult and if that’s his opinion I think the medical examining board must take a look, there’s no doubt about it. I concur with him.
Member Christensen: This is the same problem that California’s facing.
Chair Giunchigliani: Which is, I’m sorry, Jim, what was it?
Member Christensen: Well, it’s the supervision of the medical spas. There’s a lot of “medi-spas” out there now and they’re performing procedures that need supervision by physicians and licensed techs are performing it and it’s heating up in California and the lead article on the Board of Medical Quality Assurance quarterly newsletter was “outlining your responsibility should you do it” and how California is actually going in auditing these.
Chair Giunchigliani: OK. So the main change in this, I mean there’s other updates that are coming in, but you’re adding the definition of point of contact.
Mr. Bergtholdt: Can you rephrase the question?
Chair Giunchigliani: Yeah, I tried…other than the updates and other regulatory authority and making it clear a parent or authority and that part of it, the main issue right now, publicly, is between dual versus single point invasives…
Mr. Bergtholdt: Piercings. Correct.
Member Christensen: Piercings.
Mr. Goff: And specifically 8.6.4.
Member Mattocks: And right now the regulations prohibit single point, or say that it is a procedure that…
Mr. Bergtholdt: The current regulations do not identify single point piercing. Staff has considered it to be an implantation, which is prohibited under our current regulations.
Mr. Dowdell: It doesn’t follow that definition. The definition of implant in there on guidelines…
Chair Giunchigliani: Doesn’t speak to that, that’s why I was asking.
Mr. Dowdell: …completely are different than what it is.
Mr. Goff: 8.6.4 is the only piece of those regulations that we object to. And on the drops issue, I would just say I’ve been in that battle, too, with dentists versus hygienists, ophthalmologists, optometrists. Of course, this is going to channel business to docs if you say it’s a medical procedure and so they have a vested interest in saying that. And on the other side, we have no history of this causing any greater rates of infection, despite your mandatory reporting requirements, than a dual point piercing.
Chair Giunchigliani: Alright, thank you. Any further questions? So, anyone else from the public who wishes to testify on this item? Please.
Mr. Reding: Can we consider not prohibiting single point piercing until it actually becomes regulation? I understand that staff is calling it implantation, however that contradicts with their definition. Meanwhile we’re here trying to run a business and do something that looking at the regulations, current regulations, is perfectly legal and not in the definitions. So could we consider being allowed to do these single point piercings and build more history, because the fact of the matter is almost all of your piercing shops are currently doing single point piercings, even after receiving the cease and desist. We almost daily run into customers that had a single point piercing at another establishment or we talk to other establishments and they claim they had no idea that it was disallowed because it’s considered such a normal piercing procedure. And what I would ask is that we be allowed to do it until the regulation is decided that it’s not allowed.
Chair Giunchigliani: Can I clarify on a cease and desist order? Did we…
Mr. Smith: Excuse me. I think that might fall under, it’s not on the agenda, it’s like a variance what they’re asking for an opinion. That hasn’t been properly agendized on this item. What we’re looking at is to adopt or not to adopt regulations which have certain impact on, and they’ve come here and given their input; but this is taking us far afield from our agenda item. I think we would need to specifically agendize such an item, if that’s what the Board wishes to consider.
Chair Giunchigliani: OK and so let me ask this then. If in absence of acting on the new regulations, the current ones stand, which then draws the debate on what an implant is and it appears that they, any of these businesses would still be able to move forward pending us, or the Board, taking any action. Correct? So did we send out a cease and desist to all businesses then?
Mr. Bergtholdt: Yes we did.
Chair Giunchigliani: Based on what?
Mr. Bergtholdt: Based on our definition, which says implantation to be under the skin. This is it, implantation is considered jewelry under the skin.
Mr. Reding: Well, that’s not…every
Chair Giunchigliani: That’s not in our…
Dr. Sands: I mean that’s our current reg.
Mr. Smith: And the cease and desist has not been appealed. It is not an agendized item before the Board. Procedurally it’s firm. I just want to comment about whether it’s a medical procedure versus this procedure done by Club Tattoo – as a matter of state law, the Board of Medical Examiners or whatever agency is going to consider this, is a higher authority than the district and so you have a preemption argument, a preemption problem should they choose to say regulate this field, and say it is a medical procedure and therefore only licensed medical personnel can perform that procedure, then we have a problem.
Chair Giunchigliani: Mm-hmm. I think that’s why Councilman Kirk and Christensen recommend we postpone that part of it…
Mr. Smith: Right.
Chair Giunchigliani: …that part of it, depending upon the motion that might be made here…
Mr. Smith: Yes, I think that procedurally that’s fair.
Chair Giunchigliani: OK. Tim?
Member Jones: How long will it take to get that opinion and do we need the district to ask for that opinion to be rendered, or is it happening absent any health district action?
Member Christensen: We’ve asked for it. I asked for it informally. We can write a letter. Their next Board meeting is in August.
Member Jones: It seems like it would be worth moving along so at least their business prospect, they’re not waiting for something that may or may not happen.
Member Kirk: Madam Chair, I’m very conflicted because I feel like we need more medical guidance and direction as a Board, while at the same time no one, most of us feel, especially now during the downturn, that we want to really regulate anyone out of business. And so I’m a little conflicted and these guys haven’t had any big issues. I guess my question is this, is there any way we can get some information from the Board of Medical Examiners quicker than August? Or is that just absolutely not going to happen?
Member Christensen: The wheels turn real slow.
Chair Giunchigliani: Yeah, very slow unfortunately.
Mr. Smith: And it may be nothing responsive at August meeting as it may be gone for further study, further examination. I really don’t know exactly how their procedure is going to work….
Chair Giunchigliani: Why don’t we make a couple…
Mr. Smith: …and piggy-back on…
Chair Giunchigliani: …of suggestions. One being a motion from the Board requesting that the Board of Medical Examiners weigh in on this, to guide us on any regulation because technically we could go pass a regulation that we’re in conflict with, and that’s not where we want to go – that could be one motion. A second motion would be then to set this proposed new regulation aside pending that outcome, and then we can discuss whether we can under the public portion of this, or agendized portion on this, is do we then allow businesses to continue to function under our regulation, despite what, with no disrespect, staff has made a new determination that this Board hasn’t, and maybe let them continue to do business, and not just them but the other businesses pending the outcome of that.
Member Kirk: But they haven’t been allowed. I mean anyone that’s doing this is doing it…
Member Christensen: Sub rosa.
Member Kirk: …yeah, in violation of our regulations. So there isn’t allowance for what these guys are saying other businesses are doing.
Mr. Bergtholdt: Actually…
Chair Giunchigliani: But the letter from staff is new on our definition.
Mr. Reding: Yeah, that’s right.
Mr. Dowdell: And…
Member Mattocks: The definition is defined in the previous…
Member Christensen: Implantation of jewelry or objects under the skin.
Mr. Goff: You keep forgetting, though, the critical part of all this to produce the outline and texture of the desired image on the surface of the skin. What they’re talking about is something, they’re talking about real implants…
Mr. Bergtholdt: Excuse, for a moment here…
Chair Giunchigliani: Yes.
Mr. Bergtholdt: Section 2.13 of our current regulations state: “Scarification, branding, the implantation of jewelry under the skin, or any other form of unregulated invasive body modification is prohibited in body piercing establishments.” That’s our current regulation right now.
Chair Giunchigliani: Say the number again, would you?
Mr. Bergtholdt: 2.13.
Member Eliason: There’s also a thought process…
Mr. Reding: Isn’t a dual point piercing also under the skin?
Member Smith: It’s under the skin.
Mr. Reding: And something through an ear lobe in under the skins.
Member Eliason: It’s through the skin.
Member Christensen: That’s through.
Member Mattocks: It’s through the skin.
Member Eliason: It’s all the way through.
Member Christensen: The bottom line is the practice of medicine is the practice of opinion that we try to use the best evidence and I think that we need…I’ve polled a number of physicians, they weigh in to say that they think this is a medical procedure. They found physicians that think it should not be a medical procedure. Such controversies in the practice of medicine are commonplace and so you go with the general wisdom and collective wisdom of a larger body. Let the Board of Medical Examiners weigh in on this.
Member Onyema: Jim, I think the suggestion you made about referring to the Board of Medical Examiners for their opinion and then allowing these current regulations to stand is the right thing to do. I mean, I understand that they are talking about business and we understanding the economic times, but also I think our main obligation is to protect the public in regard to their health. So if there is any single item of doubt that any procedure can put the public in harm’s way, we’ll wait for the other guys to go in the other direction.
Member Christensen: Yeah.
Chair Giunchigliani: OK, so…
Member Eliason: On the same token, it’s prohibited now. What we adopt today, it hasn’t changed nothing. We can always come back after they weigh in and come in…
Member Christensen: Give them…
Member Eliason: I think we need to move forward and do something with this and then amend, because we’re not changing anything that’s prohibited in the current regulation, it’s prohibited under the new regulation, let’s go forward and amend if we have to after…because they might now even do nothing until their next meeting. Who knows?
Member Jones: I’ll tell you one thing. One difference is these new regulations are a direct prohibition versus what exists today is an interpretation.
Mr. Reding: Exactly.
Member Jones: And I think it might be a little more complicated than sitting on it and getting a good medical opinion on it.
Chair Giunchigliani: I think if I might weigh in. I think legislatively they attempted to do this last session and did not, and that was part of why I asked that question, because it is mixed. It’s a review and if we take an action that specifically prohibits based on no evidence, then it seems to me that we made a judgment call before the Board of Medical Examiners can make a judgment call.
Member Eliason: On the same token sit and do nothing creates the same problem, too. Dr. Christensen just spoke an opinion, if this Board approves this is our opinion…
Member Christensen: That’s right.
Member Eliason: What’s the difference between their opinion and our opinion? I mean, yeah they’re doctors and I don’t know if they’ll even make a decision. I think we just need to load it up, load it down, let’s go.
Member Jones: Well I think Mark has told us that he can regulate based on existing regulation while waiting for an opinion.
Chair Giunchigliani: Exactly. Well let’s try a few motions and see what we pass or don’t pass. Why don’t we at least get with the first the Board of Health requests that the Board of Medical Examiners weigh in on this and give us some direction, guidance and opinion and/or regulation.
Member Steinman: I’ll move that.
Member Crowley: Second.
Chair Giunchigliani: OK. Moved by David, seconded by Susan. All those in favor say aye.
Board members: Aye.
Chair Giunchigliani: Opposed? Motion carried. Oh, did I close, yeah I closed the public hearing. Thank you. Second motion would be to set this aside pending that outcome and allow our current regulation to remain in place.
Member Steinman: So moved.
Member Onyema: Second.
Chair Giunchigliani: OK, moved. John? Seconded. Any further discussion? All those in favor say aye.
Board members: Aye.
Board Members: Nay.
Chair Giunchigliani: Motion. Let me back…I think I heard three no’s. One, two, three.
Shelli Clark: Excuse me, Madam Chair. Who were the three no’s?
Chair Giunchigliani: It is Susan, Mr. Eliason and Mary Jo, was it? No, OK.
Member Barlow: It was me.
Chair Giunchigliani: Mr. Barlow. OK.
Member Weekly: And me.
Chair Giunchigliani: OK, four. Sorry. And Mr. Weekly. Motion carries. OK, so we’re at that point. So we’ll remain under that portion of the provision for now. Thank you very much.
Mr. Reding: Thank you for your time.
Chair Giunchigliani: Nothing’s ever easy here, especially in this part. Thank you.
A motion was made by Member Steinman to request that the Board of Medical Examiners weigh in on this and give us some direction, guidance and opinion and/or regulation; seconded by Member Crowley and carried unanimously.
A motion was made by Member Steinman to set this item aside pending the outcome of the previous motion and allow the current regulation to remain in place; seconded by Member Onyema and was approved with Members Barlow, Crowley, Eliason and Weekly voting in opposition.
