Michelle Parker vs. LSBME

jmacmidwife

WOW. Just when I am having a pity party thinking the that the Louisiana Board of Medical Examiners singled me out, another case crops up where lo and behold the LSBME has cartelled itself into action against another victim. You just can’t make this stuff up. The LSBME fired Michelle Parker because she knew they were not following the law. She knew it and called them out on it and I would not be surprised if the LSBME made this “testimony” up. I bolded the interesting parts of this decision. Ms. Parker complained a year earlier about the administration being crooked. Then she noted how one could pay off police officers! Also noting how racist and fraudulent they were. It sickens me that this board continues to be above the law. It is much like the current administration that if it is consistenly obnoxious, unethical, corrupt, and mafia-like then it seems weird when it isn’t. So by setting the standard to be illegal, it almost ensures that they have to hover around that illegal bar. The whole place needs to be shut down.

Decision Filed: October 6, 2015 State of Louisiana Civil Service Commission Docket No. S-17992 Michelle Parker Versus Louisiana State Board of Medical Examiners ______________________________________________________________________ Rule(s): 12.2; 13.19(s)2 Topic(s): Dismissal; improper and unprofessional conduct, violation of agency confidentiality policy; retaliation _____________________________________________________________________ Appearances: Michelle Parker, in proper person Leslie Lanusse and Brooke Duncan, counsel for LSBME Statement of the Appeal The Louisiana State Board of Medical Examiners (LSBME) employed Michelle Parker as an Accountant Supervisor 1 and she served with permanent status. By letter dated October 28, 2014, LSBME dismissed Ms. Parker from her position effective November 5, 2014, for engaging in improper, unprofessional conduct and violating the agency’s confidentiality policy. On November 24, 2014, Ms. Parker appealed her dismissal. In her appeal, she denies the allegations of the dismissal letter and alleges that she is the victim of retaliation. As relief, Ms. Parker requests reinstatement and back pay. I held a public hearing on August 7, 2015, in New Orleans, Louisiana. Based upon the evidence presented and pursuant to the provisions of Article X, § 12(A) of the Louisiana Constitution of 1974, as amended, I make the following findings and reach the following conclusions. Findings of Fact 1. LSBME employed Michelle Parker as an Accountant Supervisor 1 and she served with permanent status. 2 2. LSBME licenses and regulates eleven categories of health care providers, including physicians. Its compliance investigation unit investigates complaints made by the members of the public against health care providers, which are confidential in nature. Ms. Parker did not work in the compliance investigation unit and her job duties did not involve the investigation or processing of complaints. 3. In early 2014, Ms. Parker requested and received clarification from LSBME’s human resources office regarding employees’ use of funeral leave under the Civil Service Rules and agency policy. 4. In September of 2014, Ms. Parker sent a letter to LSBME regarding what she perceived as problems with its administration. 5. On October 6, 2014, E.C. filed a complaint in person with LSBME about a physician.1 He spoke with Lester St. Amant, Compliance Investigator 4-B, and Virginia Madere, Compliance Investigator 2, of LSBME’s compliance investigation unit.2 6. As E.C. was leaving the LSBME building, he was approached by Ms. Parker, who asked him why he was at LSBME. E.C. replied that he “had to take care of some business.” Ms. Parker asked him if he was complaining about a doctor; E.C. acknowledged that he was. Ms. Parker then informed him that he had “spoken to the wrong man,” i.e. Mr. St. Amant. 7. Ms. Parker told E.C. that Mr. St. Amant was a former New Orleans police officer and that he was one of the “crooked” ones, as Mr. St. Amant “took money from doctors.” E.C. asked Ms. Parker, “So, I’m really not going to get anything done?” Ms. Parker responded, “Yes.” Ms. Parker stated to E.C. that LSBME was “very racist” in its personnel practices and that she had reported LSBME employees for making fraudulent meal reimbursement claims. 8. E.C. immediately reported Ms. Parker’s statements to Mr. St. Amant. Cecilia Mouton, LSBME’s Executive Director, and Mr. St. Amant later met with E.C. and assured him that his complaint would be handled honestly, fairly and professionally. 9. Rule IV of LSBME’s Employee Handbook states in relevant part as follows: CONFIDENTIALITY … Workplace: As in any workplace, employees must have access to information that is sensitive. Improperly passing on sensitive information can be very disruptive to the office as well as to the agency. Employees 1 The complainant is identified by his initials in this decision to protect his confidentiality. 2 I have taken judicial notice of Ms. Madere’s job title from the LaGov Human Capital Management system (HCM). 3 should be discreet with this type of information in allowing it to flow through the organization using the proper supervisory chain. Discussion and Conclusions of Law An employee with permanent status in the classified civil service may be disciplined only for cause expressed in writing. Cause for disciplinary action is conduct of the employee that is prejudicial to the public service or detrimental to its efficient operation. Bannister v. Dept. of Streets, 666 So.2d 641 (La. 1996). The right of a classified state employee with permanent status to appeal disciplinary actions is provided for in Article X, § 8(A) of the Louisiana Constitution of 1974. That section states that “[t]he burden of proof on appeal, as to the facts, shall be on the appointing authority.” The appointing authority is required to prove its case by a preponderance of the evidence, which is evidence that is of greater weight or more convincing than that which is offered in opposition thereto. Proof is sufficient to constitute a preponderance when, taken as a whole, it shows the fact or causation sought to be proved as more probable than not. Wopara v. State Employees’ Group Benefits Program, 2002-2641 (La. App. 1 Cir. 7/2/03); 859 So.2d 67. LSBME charges Ms. Parker with engaging in improper, unprofessional conduct and violating the agency’s confidentiality policy. On October 6, 2014, Ms. Parker accosted E.C. as he was leaving the LSBME building and interrogated him about his complaint, even though she did not work in the compliance investigation unit and her job duties did not involve the investigation or processing of complaints. She then made very serious allegations of professional misconduct against Mr. St. Amant, other coworkers, and LSBME. E.C.’s complaint was confidential and absolutely none of Ms. Parker’s business. Her confronting him about his complaint was in itself a violation of confidentiality, as doing so was completely outside of her job duties. Ms. Parker’s statements to E.C. that Mr. St. Amant is corrupt, her coworkers are thieves, and LSBME is racist were inappropriate and unprofessional. E.C. was not a governmental official vested with authority to investigate her allegations; he was simply a citizen seeking LSBME assistance. Ms. Parker’s behavior and statements were clearly disturbing to E.C. and undermined his confidence that his complaint would be properly handled, as he immediately reported Ms. Parker’s misconduct to Mr. St. Amant. Her actions reflected poorly on the agency and were detrimental to the state service. LSBME has thus proved cause for discipline against Ms. Parker. In her appeal, Ms. Parker claims that her dismissal is in retaliation for having questioned the agency’s application of funeral leave in early 2014 and sending a letter to LSBME in September 2014 regarding alleged mismanagement. Retaliation is a form of non-merit factor discrimination; therefore, under Civil Service Rule 13.19(s)2, Ms. Parker had the burden of proof on this issue. 4 After a careful review of the record, and in light of Ms. Parker’s obvious misconduct, I am unpersuaded that LSBME dismissed her over funeral leave questions posed six months earlier and a complaint letter that she did not even introduce into evidence at the hearing. Ms. Parker has therefore failed to prove that she is the victim of retaliation. The Supreme Court of Louisiana has held that it is the duty of the Commission and its Referees to independently decide from the facts presented whether the appointing authority has legal cause for taking disciplinary action and, if so, whether the punishment imposed is commensurate with the dereliction. AFSCME, Council #17 v. State ex rel. Dept. of Health and Hospitals, 789 So.2d 1263 (La., 2001). Ms. Parker engaged in improper, unprofessional conduct and violated E.C.’s confidentiality, all to the detriment of the state service. Based upon the foregoing reasons, I conclude that LSBME proved legal cause for discipline and that the penalty imposed, dismissal, is commensurate with the offenses. Accordingly, this appeal is hereby denied. ____________________________ Brent C. Frederick Civil Service Commission Refer

https://www.civilservice.louisiana.gov/files/appeals_opinions/s-17992.pdf

Public records request finally answered 2 months later

jmacmidwife

There is probably a statute that the LSBME violated in not returning my public records request in a timely manner, but they do not care. Since I have been patiently waiting for Dr. Culotta or Dr. Cresswell to reply to an email on December 27, 2018 I send a follow-up email…

Dr Culotta 
It seems you have neglected to address my concerns. Do public records requests not need to be answered as promised?  JM

He replies, albeit quickly…

2/27/2019 This has been referred to our legal staff and they are preparing your response

Dr. Cresswell responds the next day 2/28/2019…

Dear. Ms. M, Please see our responses below:
1.      Ms. Spooner miscalculated my payment plan. I have asked her several times to revisit the numbers. She has not done this. 
Response:  I have reviewed Ms. Spooner’s email and have noted the miscalculation.  Total Administrative costs are $17,669.00
Proposed payment plan:  Repayment over 36 months:  35 payments of $500, with a final payment of $169.00
2.      I’ve asked for a new compliance officer be assigned to me as Ms. Spooner does not seem to be able to fulfill her job requirements competently.
Response: This will not be granted.
3.      I requested a breakdown of the costs associated with my hearing i.e. attorney fees, copies, expert witness, judge, transcriptionist/court reporter, etc. 
Response: A detailed breakdown of your administrative hearing costs was sent to you on December 28, 2018 via email from Rita Arceneaux, as well as by US Mail to your address of record. Please verify that you are not in receipt of the December 28, 2018 email?
4.      When the LSBME has spent tens of thousands of dollars on computer software and equipment, why is my test I need to take to fulfill one of my sanctions not online yet? Why can it not be emailed to me? What is taking so long? The LSBME is obstructing justice by withholding the test I need to take to fulfill sanctions. 
Response:  Your test was placed online and you have successfully completed the examination on January 26th, 2019 (2nd attempt).
5.      What tests do I need to have administered by a doctor in order to fulfill my psyche evaluation? I have been asking for my diagnosis for over a year and the LSBME has failed to answer my simple question. I cannot simply call a doctor and ask for a psyche evaluation. Surely the medical board understands this. I need to know what tests need to be administered in order to even consult with doctors to see if they are able to conduct a psyche evaluation.
Response:  The LSBME does not diagnose.  You were given the name of Board approved facilities that provide Psychiatric Evaluations.  To clarify, you will need a “Forensic Assessment”.  A forensic assessment is one where the referral comes from a licensing entity.  The assessment is considered “forensic” due to it occurring within an administrative law context in which the facility is asked to provide an expert opinion regarding an individual’s fitness to practice.  The list of Board Approved facilities includes:

            Approved Psychiatric Evaluation/Treatment Centers:

Professional Renewal Center (PRC)

1421 Research Park Dr. #3B

Lawrence, KS 66049

T: 785-842-9772

Pine Grove/Next Step

2253 Broadway Dr.                

             Hattiesburg, MS 39402

T: 888-574-4673

Acumen Assessments

730 New Hampshire, Suite 222

Lawrence, KS 66044

T: 785-856-8218

Elmhurst Memorial Healthcare

Professionals Program

360 West Butterfield Rd., Suite 340

Elmhurst, IL 60126

           T: 630-615-7800   

If there is any additional information needed, please do not hesitate to contact myself or Ms. Spooner. 

Respectfully, Dr. Cresswell

I have discussed in earlier posts about the nature of PHPs. They are notoriously corrupt and work hand-in-hand with licensing boards. There is no justice in not choosing who can evaluate you especially when it is subjective and the licensing board is basically paying the PHP to diagnose their problem ppl. How is any of that fair?

Also, after looking up one of these assessment centers in Kansas, I find it ironic that they publish in PLOS (a free journal) the findings that a normative standard must be applied to your target audience or else you will overdiagnose the patients. Huh, I wonder if they have a norm for midwives. I am going to guess not. And then who will be held to an obstetrical standard again? Sigh.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5650180/

https://www.linkedin.com/pulse/php-assessment-doctors-a-rigged-monopoly-needs-michael-langan-m-d-

I do not understand why I cannot get a competent compliance officer assigned to me. But then again, maybe that is the LSBME’s angle–to only hire incompetent people that will frustrate and drag out everyone’s sentence. Quite possibly.

I am glad the payment plan was finally recalculated correctly. SMH. Not that I have $500 to donate to the cartel for 3 years. But seriously, the fact that my license is suspended and I cannot work should make this criminal. How can I earn any measurable amount of money with a suspended license- but once again, a suspension is not indefinite- this is more like a revocation as a suspension has a time limit.

I finally get the test they want me to get. I am unsure if a fitness for duty is one size fits all or if I will have to again ask for more clarification. I contacted two psychiatrists today via email. I will see what they say. I am also going to call around tomorrow and see if any of these public mental health facilities will provide an evaluation. It appears that the state of Florida will provide services to people with adjudications regarding incompetency, but most are criminal or civil based. At this rate I think it would be easier for me to resolve all of my issues if I had a felony. The state seems to be ok with rehabilitating criminals on its dime while healthcare providers have to fend for themselves and cough up thousands of their own noninsurance dollars for their evaluations. I just cannot make this stuff up.

Food for the Brain: Cognitive function test

jmacmidwife

So, looking around today to see if I could take any part of my mental health evaluation online, I stumbled upon this well-documented test from England. Apparently the study has been going on for a while and fairly accurate as far as results go, so why not give it a whirl. It was only 15 mins of my time. Although it is mostly designed for people aged 50-70, some days I feel 50, but I am not quite there yet.

I scored a 67. Woooooooohooooooo. Wait. What does that mean? It means that your Cognitive Function Test result showed that you performed at or above the norm for your age. This suggests that you are not showing the early cognitive function problems that that can be a symptom of future cognitive impairment and Alzheimer’s disease.

A score of 54.2 is the average expected score, and we expect most respondents to score between 43.2 and 65.2. These scores are at 1 standard deviation above and below the mean for the age group 50 to 70.  A score above 54 means that your score is higher than the average person’s score in this age group. We expect 84.1% of those who took the test to score higher than 43 and we expect 15.9% to score below it.  A score of between 38 and 43 is lower than one standard deviation below the mean. We classify this as amber or an ‘at risk’ score. A score lower than 37.7 places the respondent below 1.5 standard deviations from the mean, in the bottom 6.7%, which is classified as a red or ‘significant risk’ score.

People with Mild Cognitive Impairment (MCI) would be expected to score in the red range, but a score in this range does not mean that you are definitely impaired. This score is consistent with risk of MCI rather than risk of Alzheimer’s Disease (AD). It is not a diagnosis. MCI is more likely to occur after the age of 65. However, about 50% of people who have MCI are at risk of progressing to AD or other dementia 5 years after they are in the MCI stage. Thus, to have a ‘red’ score now is an indication that further investigation is worth considering. First, you could visit your GP to see if a medical explanation can be found for the low score. Second, you might consider, in discussion with your GP, some preventive action to slow changes in the brain. If your score was ‘amber’ your result showed that you performed slightly below the norm for your age. This may just be a chance result or it may reflect early changes in your brain function or it may be due to other factors, including interruptions or technical problems during the test. To find out more about the impact of these please see Frequently Asked Questions.

Your test score has already been adjusted for age, education and computer skill level. These are factors that we know affect the test score in a predictable fashion and the adjustments are based on our pilot study and concur with already published research.  The test has been designed for those aged 50 to 70. If you are older than this when you take the test the results may be less accurate. It is likely that for older people the risk is slightly less for a lower score as one expects test performance to decline with age.

It is important to remember that poor cognitive test scores could also be due to depression, medication, some types of dyslexia or other factors. It is also important to follow the instructions about not being disturbed and checking that your mouse is working properly.

It is not a good idea to retake the test within a year as we wish to avoid any learning effects on the test from repeated performance as this might affect the reliability of your results.

Think Licensure is a good idea? Think again.

jmacmidwife

As I study the latest Louisiana midwifery rules and regulations, for the test which will satisfy the third sanction that the LSBME has bestowed upon me i.e. “Ms. Macaluso shall demonstrate her understanding of the Board’s rules and regulations regarding Midwife practice in this state, in a manner determined by the Board,” I wonder how in the world did these updated rules get promulgated?

Read rules here:
https://www.lsbme.la.gov/sites/default/files/documents/Rules/Individual%20Rules/Midwife%20Dec%202016.pdf

*side note, I wanted to demonstrate my understanding of the Board’s rules in either an interpretive dance or a book report, but apparently those suggestions were shot down in favor of a boring test. The Board obviously lacks humor. LOL But seeing that the LSBME has spent tens of thousands of dollars on computer software and equipment in the past few years, its not surprising that they want to use that technology. Oh, wait…I am still waiting for my test “to be put online” according to my compliance officer. That was in October. They must’ve been taken advantage of if they paid that much and can’t email a test to me or put it online, but that is a whole other post.

Back to the rules….Is anyone paying attention? Did anyone read these new rules? They are that insane. There are so many examples, but I’ll start with the one in Chapter 23 under statute 2315 (Effect of Application) B. By submission of an application for licensing to the board, an applicant shall be deemed to have given his or her consent to submit to physical or mental examinations if, when and in the manner so directed by the board and to waive all objections as to the admissibility or disclosure of findings, reports, or recommendations pertaining thereto on the grounds of privileges provided by law. The expense of any such examination shall be borne by the applicant.

Let me tell you what that says in plain English: THE LSBME CAN REQUIRE MIDWIFE APPLICANTS TO HAVE A MENTAL AND PHYSICAL EXAM AND THE APPLICANT HAS TO PAY FOR THE EXAM. HOLY BLEEP!

The LSBME is calling midwife applicants crazy! While I have to admit I felt this whole witch hunt has been nothing short of crazy since the beginning, I never imagined these unbelievable rules would grow out of the Board’s unbridled lack of oversight. It is like a runaway train with no stop in sight. So one has to ask oneself—self, why would the Board institute such a rule? A rule which will undoubtedly frighten potential midwifery applicants, especially ones with any preexisting conditions. I mean, the Board does not describe what it will do with that information, so how will applicants know if their heart murmur or Hashimotos or depression will affect their application process? How does this rule not discriminate against applicants with preexisting conditions? How is this not antitrust? This seems like a rule ripe with restrictive capabilities to practice ones trade. And as someone who has been denied a license in another state, let me tell you how hard that makes getting a job or other licenses (again, another post). So, potential applicants will think they are going to start this new profession as a midwife in Louisiana, take all the classes, do all the training, take all the tests, pay the application fees, pay for a mental evaluation and may still get denied? Yes, yes, I know its a privilege to have a license, but this is ridiculous. Not only will it scare away potential applicants, but why would I want the medical board to have my medical records? That is invasive and wrong. And do you think the Board won’t implement that rule? hahahahahahahahahahahahahahahahahahahahahahahahahahahahaahahYes, yes they will use it. How do I know this? Oh, because my first sanction is ordering me to get a mental/physical evaluation. No big deal right? Seems legit as they should make sure healthcare providers are relatively sane and healthy enough to do their jobs, but there is a catch. There is always a catch. Do you think they will allow you to go to just any doctor for this evaluation? I highly doubt it. Why am I so skeptical you say? Oh, it might stem from the fact that I have to go to a “physician or group of physicians who have been pre-approved in writing by the Board and be deemed competent to resume the practice of midwifery.” Ms. Mouton, the ex-executive director of the cartel, err I mean LSBME, so graciously offered me a list of five drug and alcohol rehabs to choose from to get my evaluation, but Ms. Mouton apparently does not know that a person cannot just go get an evaluation for no reason. The rehabs will not evaluate someone without a demonstrable problem. I know that seems obvious right? Not for the corrupt medical board as they don’t care about doing anything legal. Physician Health Programs (PHP) (like the drug and alcohol facilities list provided by Ms. Mouton) and medical boards make strange bedfellows until you realize they are both benefiting. The medical boards provide a steady stream of victims, err customers, err patients at the tune of $5-10,000 and four days of your life followed by “recommendations” for treatment which might mean several tens of thousands of dollars and months spent in a facility for absolutely no reason at all. There are many reports of the corruption surrounding PHPs and licensing boards. It was not until the admissions counselor at PineGrove in Mississippi reached out to my compliance officer that suddenly I was a perfect candidate for an extensive psych evaluation, even though after previously reading my court documents she had stated that I needed something their facility couldn’t provide. Sounds fishy because it is!

It is interesting to note that the LSBME has included this rule into most of the healthcare professions it oversees. So, doctors could be subject to this requirement of having an evaluation too. However, I could not find the rule associated with clinical laboratory personnel, acupuncturists, and X-ray techs. See list of professions below:

In a letter to the British Medical Journal, Dr. Manion states: “A compulsory forensic psychiatric evaluation of a physician is, by all understandings, a form of involuntary mental commitment whose unlawful use is banned by the Fourth Amendment to the US Constitution prohibiting unlawful search and seizure by a government agency. Without rigorous oversight, a PHP can get away with utilizing what one court euphemistically referenced as “relaxed diagnostic criteria.” The extreme danger of crafting one’s own illness criteria sets, not to mention – especially in the context of refusal of provision of their report – falsely adding non-existent symptoms to embellish a case history to support a diagnosis and achieve desired outcomes (e.g. to appear to justify costly referral to a PHP preferred program), ought to alarm every physician.” https://www.bmj.com/content/353/bmj.i3568/rapid-responses

When Ms. Mouton was taken off her thrown at the LSBME and Dr. Cresswell stepped into her small stilettos, he, not surprisingly said, well of course you do not have to go to a drug and alcohol center as there is no basis for it in your case. Yeah, no shit. Dr. Cresswell suggested I find a doctor in my neck of the woods to conduct the evaluation. So, just go find a physician, right? There are 17,000 of them in Louisiana according to the 2018 census from the National Federation of Medical Boards. http://www.fsmb.org/advocacy/news-releases/fsmb-releases-2018-u.s.-medical-regulatory-trends-and-actions-report/

Well, it seems that in order to call a doctor and ask if you can have an evaluation by said doctor, one must have a diagnosis or something that needs testing. Ok, so ask the Board what they want tested. Go ahead. Ask. Oh, they won’t tell you what you need to have tested? Shocking. It is so shocking that the Board would create a sanction that is illegal. There is no legal basis for me to get a mental/physical evaluation. In fact, they will have to make something up in order for me to ethically have a mental evaluation. Yes, they will have to lie or the could remove that sanction as it really is not legal. But no, instead of looking like the incompetent fools they are, the Board would rather tell me to go find a doctor, then I am supposed to tell the doctor to call the board and ask what needs to be tested. UHHHHH. That is so shady.

I have been waiting and asking repeatedly for over a year to have the LSBME tell me what needs to be mentally evaluated as I cannot go get this sanction accomplished without more information or lies, whatever is considered ethical to the LSBME. The LSBME has caused me great stress and prohibited me from working. Oh, and let’s not forget, because I cannot get a job because my suspension comes up in a background check, I cannot afford health insurance to get my cancer removed. I will continue to wait patiently and suffer knowing that my cancer may be spreading and affecting my health.

The Board is purposefully obstructing justice. I believe that is called maleficence, but I am not an attorney. Is it truly that shocking that the Board would obstruct justice like this? No. The LSBME continues to violate ethics, harm midwifery by placing burdensome and egregious requirements on its applicants, which will undoubtedly limit choices for consumers in the state of Louisiana and continue its disgusting deathcare spiral killing mothers along the way. Killing mothers, you say? Isn’t that a little harsh? No, no it isn’t. There is a maternity crisis in Louisiana and throughout the US. https://adams.house.gov/media-center/press-releases/congresswoman-adams-introduces-bill-address-maternal-mortality-racial

We do not have enough providers to give safe and effective maternity care. The South lags behind the rest of the country in maternal mortality especially for women of color. In fact, women of color in Louisiana are dying at a rate of 73/100,000 compared to 27/100,000 of white women. HOLY BLEEP. https://www.americashealthrankings.org/explore/health-of-women-and-children/measure/maternal_mortality/state/LA

Read that again– for every one white woman who dies in Louisiana almost three black women die. UHHHHHH. Something tells me doctors and hospitals are doing something wrong, very wrong. How do you know its doctors providing bad care? Because there are 17,000 of them in Louisiana compared to the 20 midwives practicing and licensed midwives do not work in hospitals. Doctors are killing women, not midwives. The LSBME needs to focus its investigations inward to truly achieve its mission statement of protecting the citizens of Louisiana. https://www.cnn.com/videos/health/2017/11/13/mother-birth-america-louisiana-orig.cnn

The limiting of safe out of hospital providers by the competition needs to end. We need to be making more midwives not less. According to one study, Louisiana ranks as the worst place to have a baby because hospitals are not following safety measures. “The report also breaks down a state-by-state ranking of maternal harms and deaths. In Louisiana, the state with the highest maternal death rate, there were 58.1 deaths per 100,000 births over the course of the study period from 2012 to 2016.” https://www.cbsnews.com/news/best-and-worst-states-to-give-birth-usa-today-investigation/

Tell me again how out of hospital midwives are incompetent and dangerous. I’ll wait. Oh, you have no statistics to back up that claim? It is because midwives are beyond safe. We provide one-on-one care and are able to assess women constantly because of our philosophy and model of care. Sure it takes time and is cost prohibitive for the provider, but cost effective for insurance companies and Medicaid, and you know what–our women and babies are alive, happy, and grateful at the end of the day. And you know what is better than money—safety, lives, and an investment in future generations. If healthcare providers got into the healthcare field to help make a positive change in lives then it would be seem intuitive to promote midwives on the basis of evidence-based care alone. https://mana.org/blog/home-birth-safety-outcomes

The LSBME needs to follow the spirit of the law in order to rehabilitate its licensees and promote the welfare and health of its citizens by encouraging more midwives, if that is truly its intentions, and not harass, extort, and financially drain them out of existence. No one should be above the law especially a board who creates the very laws they are violating. And it would behoove them to adopt some ethics while they are at it.


Public Records request never answered. Why does this not surprise me?

jmacmidwife

I press on, despite the Louisiana Board of Medical Examiners best interest. I am not sure how many times this year I have stated that I cannot make this stuff up, but I really cannot make this stuff up. It is not only frustrating, but pathetic how corrupt and incompetent this group of people who are supposedly protecting the citizens of Louisiana are. Sigh. Keep writing emails. Keep complaining. The irony is I don’t think they even read their own emails nor keep track of what they said. They constantly change the rules to fulfilling these sanctions. Wonder why its taken me so long? haha. I write this email to my compliance officer, and Drs. Culotta and Cresswell. I include the doctors, because no matter how many times I tell my compliance officer, she doesn’t believe me that her calculations for the payment plan are incorrect. Ummmmmmm, I am not sure how many ways I can say do the math again. I know I am a midwife for a reason–calculus was not my best class–but I can add. Hopefully, someone else will catch her mistake and correct it…..

Dear LSBME, I was not aware that my emails have been shared so freely and unknowingly throughout the LSBME. So, I am unsure who to address this to as I have no idea who will be responding. 
As usual, I appreciate the prompt email. I have not yet digested it all, and will be communicating my questions surrounding it soon. However, you did not answer all my questions in my emails, specifically:
1. Ms. Spooner miscalculated my payment plan. I have asked her several times to revisit the numbers. She has not done this. 
2. I’ve asked for a new compliance officer be assigned to me as Ms. Spooner does not seem to be able to fulfill her job requirements competently.
3. I requested a breakdown of the costs associated with my hearing i.e. attorney fees, copies, expert witness, judge, transcriptionist/court reporter, etc. 
4. When the LSBME has spent tens of thousands of dollars on computer software and equipment, why is my test I need to take to fulfill one of my sanctions not online yet? Why can it not be emailed to me? What is taking so long? The LSBME is obstructing justice by withholding the test I need to take to fulfill sanctions. 
5. What tests do I need to have administered by a doctor in order to fulfill my psyche evaluation? I have been asking for my diagnosis for over a year and the LSBME has failed to answer my simple question. I cannot simply call a doctor and ask for a psyche evaluation. Surely the medical board understands this. I need to know what tests need to be administered in order to even consult with doctors to see if they are able to conduct a psyche evaluation. Thank you, JM

Dr.Culotta, the Executive Director, acknowledges this public records request and responds that he will have another email following in the first of the new year…. but that never happens. See February 27, 2019 when I sent Dr. Culotta a follow-up email regarding his lack of response.

Dear Ms. M, This will acknowledge your public records request and this is the first I have heard your complaints. I will begin to address them today and the formal response to the public records request will be after the first of the year. Regards, Dr. Culotta

In Dr. Culotta’s defense, he did get the ball rolling on my quiz, which only took over a year.

Hi Mrs. J, Dr. Culotta asked me to get in touch with you to assist with account setup and access to our training courses.
I attempted to contact you via your cell phone in LSBME records, but that number seems to belong to someone else.
Please feel free to call me at my direct line (504) 568-1078 at your earliest convenience.
All of our training materials are at this site: (LSBME)
Once there, you can click on the button on the bottom right of the welcome screen to create an account.
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The Christmas Spirit

jmacmidwife

“If serving is below you, leadership is beyond you.”

Anonymous

It is decidedly easy to choose not to celebrate Christmas when there is not much to celebrate. I am thankful for the roof over my head and the food I have to eat. I am thankful for my friends and of course my roommate. I am thankful for my parents and extended family. I am thankful to be able to borrow my dad’s car. I am thankful for my stubbornness, resilience, and determination. But I do not have my kids with me this holiday. I am not in good health. I have no money to purchase anyone gifts. It is hard to see families together and hear about my friends plans, parties, and vacationing. Yes, Christmas is only one day, but the days surrounding it are usually filled with anticipation, joy, and preparation, of which this year I have none. I plan to spend the break in my pajamas, working and distracting myself from the holidays. Fortunately, I am in sunny Florida and the turquoise skies and warm breezes make this easy to achieve.

When out of the blue, I get a call. Not many people call me anymore, especially from Louisiana. So, when I see a number from northern Louisiana, I am exceedingly happy— I know it is Senator John Milkovich— on Christmas Eve nonetheless. After I say hello, he asks to speak with me. I reply with thank you for calling Senator. He responds with—well you do not sound like a criminal. LOL. Of course not, I suggest it is because I am not one, to which we both laugh. It felt more like a call from a friend whom I have not spoken with in a while than a Senator. His intentions, sincerity, and honesty transpired throughout our conversation making it feel like a visit to church, a coffee shop, and grandma’s house all at the same time.

Our conversation focused mostly on the spirit— the spirit of the law, the spirit of Christmas, but most importantly, the spirit of humanity. Senator John Milkovich was not calling today to discuss the Louisiana State Board of Medical Examiners, even though that is what initially brought me to his attention. He said he had me on his mind and he felt like he needed to reach out and spread a message of hope today and for the coming year. How he knew I needed to hear this today I will never know, but his phone call made all the difference in my outlook. (Tears still well up in my eyes, even as I type this.) As I thanked him for taking the time to call me, he insisted its not him to thank but a higher calling, one that represents Christianity, the triumph of good over evil, blessings above curses, and hopefulness despite injustice. He lifted me up in prayer, not as an elected official, but as a kind, caring stranger. This call replenished everything that had been lacking not only in preparation for the Christmas holiday, but in my life. Senator Milkovich didn’t call me to secure my vote–I don’t even live in Louisiana anymore– he called to gift me with the best present anyone could ask for– concern, care, compassion, empathy, hope, love, and most importantly, value in this world. In his humble goodbye, again, he asked me to not thank him for calling, but instead encouraged me to reach out to others in need of this message and pay forward the spirit of hopefulness.

Sometimes we have to sit back and appreciate the mysteries of this world: how we came to be where we are today and who crossed our paths. Despite the many hardships I have faced over the last few years, its people like Senator Milkovich who make me appreciate the journey I have unfortunately taken and those who have blessed my life. It is a humbling reminder that we are not in charge and this world is not for us to understand. Eventually, we will have all the answers, but for now our role, whether we are Senators from Louisiana or out-of-hospital midwives, is to be the good in the world. And towards that noble endeavor I will graciously pay it forward.

Why do you want my address?

jmacmidwife

Seemingly innocuous, yet not. My compliance officer continues to ask albeit politely for my mailing address, but why? I do not live in Louisiana nor do I ever plan on living there again. I have shared this information with them. They can send everything to me via email. I refuse to be harassed and traumatized by having certified letters delivered. I lived that nightmare. Then I woke up.

12/19/2018: JM, Please provide your current mailing address so the information you requested can be mailed to you. Thanks, ES

12/21/2018: JM, Please provide a mailing address so the information can be sent to you. If not, we will use the address on record which is in Baton Rouge, Louisiana. 
Thanks,ES

Is that a threat?

12/21/2018: ES, Why do you need an address? You sent the info electronically.  JM

12/26/2018: JM, The information is not coming from me.  The Board attorneys instructed me to obtain your current mailing address. Thanks, ES

This does not answer my question of WHY do you need my address? I do not care who told you to get it. SMH.

12/26/2018: ES, Do you know why the Boards attorneys need my address? And you didn’t answer any of my questions from my email from December 21. When will the test be ready? The LSBME is obstructing me from fulfilling my sanctions. I look forward to your reply. Thank you. JM


It’s time to tell this story. Please be patient.

jmacmidwife

It’s been over three and a half years since my license was indefinitely suspended. It has taken nearly two years to even look at this stuff again and another frustrating year of battling the LSBME. I’m done. I’m done trying to play by rules, regulations, and laws that only seem to apply to me. Just recently, thank goodness, the Louisiana legislators passed a law providing oversight to this obnoxious regulatory agency. The LSBME has been implicated in more suicides and destruction of citizens’ lives and careers than I can shake a stick at. Its disgusting, unethical, obscene, corrupt, and honestly– evil. It is no way near the spirit of any law. They have taken my livelihood simply because they could. It’s time to share my nightmare so that I can get out from under this illegal suspension and so that others may benefit, learn, and avoid what I’ve been through during this unprecedented adjudication. Although my story truly begins in 2014, I have only written about the last year. I do plan on filling in from the beginning as soon as I can, but as of right now, I just want to inform others about the incredible year interacting with the LSBME in attempts of trying to fulfill my sanctions, which, for all intents and purposes, are impossible to complete. It is truly unbelievable. So, this segment of my story begins in 10/2017 with my first email contact with Ms. Esparonzia Spooner (ES) who is my designated (by the LSBME) Compliance Officer. I honestly do not think ES knows what she is doing and is merely passing along orders from Cecelia Mouton, who was Executive Director of the LSBME, and still maintains a position at the LSBME for some unknown reason. Grab a tall drink and some popcorn. You’ll need it. 

Reaching out to more Representatives

jmacmidwife

Knowing it is the holiday season and that elected officials are busy humans too, I continue to research sympathetic representatives who can champion my cause, hoping to find one or two who have time to invest in me. I find Senator Gerald Boudreaux, who supported Senator Milkovich’s bill providing oversight to the corrupt LSBME.

https://create.piktochart.com/output/34853999-how-antitrust-affects-louisiana-midwives-2018
Dear Senator,
I want to thank you for your support of Sen Milkovich’s bill that provided oversight for the LSBME. My midwifery license was destroyed because of Ms mouton. It is indefinitely suspended even though no one was hurt nor injured. I cannot get my sanctions lifted. Please consider helping me deal with this horrible board. My story is below. Thank you for your time. 

Louisiana Representatives

jmacmidwife

I have to admit, I was never good at civics. My friend and I joke that everytime we discuss rules, laws, and bills we have to sing the SchoolHouse Rock! song “I’m just a bill” to remember how it happens. As comical as it is, I really wish I paid more attention in government class. I did spend some time in college writing postcards for a representative in Georgia for extra credit. And that is the extent of my government experience. However, this year, I have to thank the millions of constituents who became active and reached out to their representatives. I believe this movement of being active instead of passive in our government has helped the relationship and understanding as well as expectations of our elected officials. Hence, why I reached out to mine. I have to admit, Dr. Feldman also encouraged me to reach out to a few representatives in particular, to which I am grateful for his guidance.

I continue to reach out to Representative Steve Carter, Senator John Milkovich, and Representative Katrina Jackson….

Dear Representatives, 
I have yet to hear from any of you, so I will keep trying. My license remains suspended. I need help communicating with the LSBME. I am now being told I need to find my own physician to conduct a mental exam, but I need to know what the board wants tested in this exam. The board will not tell me, but rather wants the doctor I find to contact my compliance officer so that she can communicate what the board is looking for. It is almost impossible to cold call psychologists and ask if I can get a mental exam without knowing what I am needed to be screened for. Its like casting a net to catch a guppie. Can someone please help me? I have already been on suspension for over three years. I cannot work anywhere doing anything as my suspension appears in a background check. Please pressure the LSBME to curb their ridiculousness. They need oversight so that practitioners like me who are seeking to fulfill their sanctions can do so in a timely manner, but they are preventing me from doing so. 

Conveniently, the media group Gatehouse recently published a series of articles pertaining to out of hospital midwifery of which they complied a database of all midwives across the US. If we look at Louisiana’s active licensed midwives (and the five midwives who would still be practicing if their licenses were not acted upon) we will find shocking statistics—32% (8/25) have had their licenses acted upon in some capacity. This further underscores the restriction of trade and antitrust issues occurring there. Out of those 20 with active licenses, three have been acted upon by the LSBME for violations and are still practicing in some capacity, whether that is on probation or in a state of undocumented, involuntary suspension. These violations, which midwives carry on their record forever, stem from simple clerical errors to natural occurrences that no one can predict or prevent like stillbirth. Two midwives, including myself have their licenses suspended. One Naturopathic physician was also targeted by the LSBME and had her license to practice midwifery revoked. The data speak for itself: more midwives have inactive licenses in Louisiana than those actively working (26 with two of those licenses having been acted upon). This means that there are more midwives in Louisiana that have, for one reason or another, stopped practicing in Louisiana. Is this because Louisiana unfairly and unjustly monopolizes the practice of midwifery? We can imagine that these midwives who are not practicing anymore or have declined to renew their licenses were dissuaded to do so because of the unethical railroading that occurs there. We can assume they would still be working in the field of midwifery if this Board had oversight and any adherence to the spirit of the law. When 32% of the Louisiana midwives are targeted, no one can claim this field is not being restricted.