Tag: LSBME

Reaching Out to an Attorney Again…

jmacmidwife

1/28/2018 Hi again. 

So I’m not sure if it will matter for a potential case. I’m sure it depends on many things especially if it’s timely anymore to even sue. Just wanted to update you on what I’ve been doing for two years since my license was suspended. 

I moved to Georgia to take care of my elderly grandma and conveniently got divorced but am waiting on my settlement to be finalized. I have been “working” as an unlicensed Midwife and birth assistant but honestly I’d rather be plucking chickens than doing midwifery at this point. Simply because I can’t pay my bills doing this. However I have been still educating my self in everything midwifery. I have probably taken hundreds of hours of online CEUs and courses. I’ve printed all the certificates and transcripts out. Bottom line is that I haven’t sat idly. I even graduated from another midwifery program (that’s two degrees in midwifery now in addition to my BS). I had a job at one of the midwifery colleges but they rescinded my offer after I revealed my licensure was suspended. So this whole issue has been horrifically devastating to my life. It’s unbelievable that although no one died or was hurt or injured and the parents even testified on my behalf that they can suspend my license like this. I even applied for licensure in Florida and was denied only because my Louisiana license is suspended.

I also had a routine physical from a few years ago from my general practitioner which shows everything is Normal except white coat hypertension (I wonder why lol). But recently last summer in 2017 I was diagnosed with thyroid cancer but haven’t had it removed yet because of my tenuous situation with needing medication my entire life if I get surgery but without having stable health insurance due to unemployment/divorce and living in a state that didn’t expand Medicaid. I tried applying for probably 50 jobs only to find out I can’t get a job due to this license suspension.  Conveniently I have the drug test results from a job application a few months ago which shows I have no drugs in my system nor have I ever for that matter. I drink socially but that’s it. I barely take Tylenol and don’t take any pharmaceuticals. Or smoke or inject or do any street drugs. I’m hardly the person who would need an evaluation from a drug or alcohol rehab center. So I don’t mind going and having the psych Evaluation done at the closest facility because they won’t find a medical reason for keeping me there but from what I read online these facilities are money making entities that rely on the state agencies to feed them so to speak with clients. While I realize I have no reason to be detained nor fit criteria to be in one of these treatment facilities I am wary that Somehow some form of corruption will occur because lsbme will tell more lies behind my back and present more untruths to convince the center that I’m not healthy.  And I don’t have an extra 40,000$ laying around which is the cost of these places “follow up treatment.” 

Should I go and get evaluated by an unbiased psychotherapist?  I’m afraid the whole system is so corrupt that something else egregious and biased will occur if I go to one of the lsbme sanctioned treatment facilities. I’ve spoken with several forensic psychologists near me in Georgia as well as my aunt who is a child psychologist and everyone says don’t enter one of these facilities and no one understands why or how lsbme cannot tell me what I need the psyche evaluation for or at least what tests need to be administered. 

Anyway sorry for the lengthy emails. I know it’s a lot of info. Thank you so much for any help. JM

1/29/2018 I received a reply from an attorney who works on birth issues. I cannot afford to hire her, but she is providing me feedback, time, and her guidance from the kindness of her heart. To keep her some-what confidential, I’ll paraphrase her message:

Good to hear from you. Wow, what a run-around. 
Have you contacted all of those places they referred you to? I can’t believe they all require a 3 day in treatment evaluation. I agree, that seems extreme. Did you call and say that the Board asked for you to contact them for an evaluation? Handling that would be a good first step…

So that is what I do. I begin reaching out to the closest treatment centers….

1/30/2018 Thank you again for all your info.  If you have a recommendation on any counsel I should contact I’m all ears.  I understand that you are a busy person and appreciate you even looking into this for me. 
Yes all of the treatment centers primarily offer a three day in patient evaluation and again are primarily drug and alcohol rehabs. I have contacted three of them and looked on all of the websites. But it doesn’t even make sense to have me only able to choose from five places that are in five different states. Supposedly if I did need treatment that wouldn’t be feasible nor realistic to commute to Texas, for example, as I’m in Georgia. The whole thing is insane. 
Again. Nowhere in my board order does it specify what treatment I need or what my rehabilitation would be for or even why this is necessary. I have no history of drug or alcohol abuse or mental history. And lsbme will not tell me what I’m being evaluated for.  Lsbme told me to have the treatment center contact them after I sign up and they will tell them what I need! Also Somewhere in my corresponding with Ms spooner from LSBME she mentioned that I needed an inpatient Evaluation.
 I called Talbot marsh recovery in Atlanta this afternoon and I am seeing if they can communicate with the lsbme on my behalf to see what tests I need or even what issue they need to treat me for. It’s frustrating to not be able to communicate to the lsbme. Im sure to the treatment centers I sound crazy even though I’m not. Sigh. Guess that’s the goal of the lsbme. 
Thank you again for your time. JM

Second Email that Continues to go Unanswered

jmacmidwife

It has been two months. It is now becoming frustrating working with Ms. Spooner, my compliance officer. My questions continue to go unanswered. They are ignored. How is this professional? The licensing board who holds my livelihood in its hands and could care less.

12/25/2017 ES, Thank you for the reply. I’d prefer to have all contact with you and LSBME in writing/email. I apologize if my emails seem repetitious but my questions are not being answered. 
Again. does the ALSO course work for the evaluations and identification of high risk pregnancy education requirement? http://www.aafp.org/cme/programs/also.html

Also on my order it states I need to demonstrate how I understand the rules and regs. Do you want a paper written?  I need to know what this means. How am I supposed to go about doing this? 

Again what is the psyche/Medical evaluation for? As I’ve stated numerous times in previous emails, I’ve spoken to several forensic psychologists and they have stated that they need to know what the evaluation is for specifically so that they can Tailor any specific testing that may be needed to determine whatever it is the evaluation is determining. I’m not sure why you and the LSBME cannot give me the exact reason for the evaluation and why it must be secretively given without my knowledge. This practice seems highly illegal and constitutionally violating. 
Thank you for your time. JM

No, it Screams Corruption and Shadiness to have the Drug and Alcohol Center Contact the LSBME

jmacmidwife

I won’t comply. I won’t go silently into the night. I won’t let this bullying and illegal bullshit go down. Nothing is wrong with me. I won’t continue to waste my time, money, and resources on a mental or drug/alcohol problem that I don’t have. I’m calling the LSBME out on its lack of oversight. This is war. Again, I want to stress that I have called several psychologists and they cannot tell me if they can give me a mental evaluation when they do not know what to test. I am not going to admit myself into a drug/alcohol center when I don’t know why and then have everyone communicate behind my back. My Compliance Officer continues to ignore my questions. Instead she tries insulting my intelligence telling me to have my attorney contact her so that my attorney can explain this to me. No, no I won’t submit to your ridiculous demands. If the LSBME truly wanted to “rehabilitate” me they would not be making this so difficult. But they don’t want to rehabilitate me. They want me to go away. 

12/18/2017 JM, Once you contact the one of the centers of the list, they will contact the Board. Please let the center know that you were required to have an evaluation by the Board. If you have an attorney, forward my contact information to them so they may contact me. It would be better for you or your attorney to call me because the emails are repetitious and I want to make sure you understand your Order Stipulations. ES

1/23/2018 ES,
Thank you for the reply. I’d prefer to have all contact with you and LSBME in writing/email. I apologize if my emails seem repetitious but my questions are not being answered. I do not appreciate the lack of cooperation from the LSBME I’m receiving. 
Again. does the ALSO course work for the evaluations and identification of high risk               pregnancy education requirement? http://www.aafp.org/cme/programs/also.html Also on my order it states I need to demonstrate how I understand the rules and regs. Do you want a paper written?  I need to know what this means. How am I supposed to go about doing      this? 
Again what is the psyche/Medical evaluation for? As I’ve stated numerous times in previous emails, I’ve spoken to several forensic psychologists and they have stated that they need to know what the evaluation is for specifically so that they can Tailor any specific testing that may be needed to determine whatever it is the evaluation is determining. I’m not sure why you and the LSBME cannot give me the exact reason for the evaluation and why it must be  secretively given without my knowledge. This practice seems highly illegal and constitutionally violating. 
Thank you for your time. JM

Confirm CEUs and third requirement. Also, where do I file a complaint??

jmacmidwife

JM Thank you for contacting the Louisiana State Board of Medical Examiners.I am out of the office and I will reply to all emails upon my return. ES

12/16/2017 ES, Can you please let me know if the also (advanced life support in obstetrics) course is in compliance with my order. 
And I need to know what the 3rd requirement on the order means. How am I to demonstrate understanding of rules and regs. Is this a paper? PowerPoint? How do I accomplish this? It states the board will determine. Please advise. JM

 

12/16/2017 ES, I’d like to know legally who oversees the LSBme? Is it the governor or state attorney general? Who decides if the Lsbme is following the law? JM

12/18/2017 JM, We are under the Department of Health and Hospitals. You may contact the attorney general’s office. ES

Reaching out to Attorneys

jmacmidwife

12/8/2017 I hope You are well. I’m still battling the Louisiana board of medical examiners. Sigh. My midwifery license was suspended two years ago. But I’m just now trying to figure out how to fix this. Of course LSBME is creating obstacles. 
They have ordered me to pay court fees totally over $17,000 and go to an inpatient three day ($3,000) psych evaluation. Idk if you remember but there was NO indication for a psych evaluation on my order or in my case. No drugs alcohol or mental health was an issue at any time in my life. The board won’t let me have an out patient psych evaluation. All the psychologists who I’ve spoken with say I have to have a diagnosis or reason for the psych evaluation or they can’t administer the correct tests. However Louisiana will not give me a diagnosis or reason for the psych exam other than stating the board order (see below) and it doesn’t have a reason. They are requiring I go to one of five choice which are all drug and alcohol treatment centers. Idk how they can require me to go to one of these when I don’t have a drug or alcohol problem. Never have. Is this legal? Can I appeal this? I don’t know how they can change the order or make it burdensome when there is no reason. How can I get treated for something that doesn’t exist and there isn’t any evidence for it? 
I would greatly appreciate your advice or info. 
Thank you for your time. JM

One practicing attorney has been particularly helpful and above all, kind. She continuously, when not busy with actual paying clients, offers wisdom and guidance. I could not have gotten this far without her help. I truly am indebted to people like her, whom I have never met, but care wholeheartedly and believe in fighting these horrific Boards. 

List of Five Drug and Alcohol Treatment Centers

jmacmidwife

12/7/2017 JM, I am waiting to discuss your case with the Director of Investigations.  The Board’s Decision was issued two years ago.  You would need to start with an evaluation at one of the places listed on the attached list and pay your fees before we can discuss having you placed on the agenda to appear before the Board.ES

Ahhh, so much to unpack in such a short email. The Director of Investigations is none other than the evil-doer Dr. Mouton. Curiously, Ms. Spooner seems to have a difficult time getting a hold of Dr. Mouton. I wonder if it has anything to do with Dr. Mouton’s infamous affairs with attorneys working with the LSBME? That is one way to maximize revenue with a smile. 

Did I seem to not realize that the Board’s decision was two years ago? Again, the fact that Ms. Spooner consistently makes random obvious statements is bizarre and makes me truly question her competency for this compliance officer position. 

The list of places I can go to has finally been generated. Praise Jesus. Oh, but wait, all of these five facilities are drug and alcohol inpatient treatment centers. UHHHHHH. Again, did I miss something? I am neither an alcohol nor drug addict. In fact, nowhere in my court documents does it even suggest I am. How can I go to a place for an evaluation when I do not have the problem they are evaluating? Cue the unethical, corrupt, unbelievable. Sigh. 

12/7/2017 ES, Again, I don’t have an addiction nor mental health issues. It would not be prudent nor lawful to require me to seek treatment when I do not have a diagnosis for treatment. Nor is it in my board order to have treatment. The facility closest to me is for addiction. I do not have an addiction. 
Perhaps I’ll have to seek legal council if the board doesn’t want to provide a reasonable, ethical out patient option for a psyche evaluation for someone without psyche nor addiction disorders. 
I cannot comply with the order when I don’t have a reason for a psych evaluation. Please provide the reason for me to pursue compliance. I’ve spoken with several psychologists and it is impossible to have a psych evaluation when I don’t have a reason for one. They don’t know which tests to administer nor what they are looking for as far as what they need to treat, if anything at all.  
This is burdensome and egregious behavior on the part of the board and has nothing to do with my ability to practice midwifery nor the law. 
Thanks for your time and attn regarding this matter in my attempt to satisfy the boards requirements in a timely, reasonable manner. JM

12/7/2017 JM, I am sending another copy of your Order.  Please note on page 6 of the Order, item 1 states: Ms. Macaluso shall undergo a mental/physical evaluation by 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.  If you obtain an attorney, please have him contact me. Thanks, ES

Again, Ms. Spooner seems to be missing the point. While yes, I am willing to have the unnecessary mental evaluation, I do not understand why I am required to go to a place where I clearly do not have the disorders. She seems to avoid explaining why, because she doesn’t have a reason other than Dr. Mouton said so. 

12/8/2017 ES, Yes I am aware the order states a psych evaluation is ordered. However there is not an indication for one anywhere in the order or connected case. I cannot enter a drug and alcohol treatment facility without any proof of needing said treatment. If you could provide evidence from the order of what the psych evaluation is for then I can comply with the order. Otherwise I cannot comply and I’ll have no choice but to contact counsel as it would be impossible to seek treatment for something that doesn’t exist. 
Thank you for your assistance. JM

CEUs: RN.com is better than the MA Medical Society?

jmacmidwife

12/1/2017 JM, Please use the courses from Louisiana State Board of Nurses. The courses you sent are good for continuing education but are not comprehensive enough to satisfy the stipulations of your Order. ES

*Ms. Spooner is referring to the courses I sent her on 11/28/2017 from the Massachusetts Medical Society. (Courses for physicians.) She is saying that these ones are not comprehensive enough, yet the courses from Rn.com, written by virtually anyone, are more rigorous. *Head desk* I email her to clarify, because…. I’m dumbfounded. 

12/1/2017 ES, Just to be clear. These courses are sufficient? And not the ones from Massachusetts? 
https://www.lsbn.state.la.us/Portals/1/Documents/rnp/ResourcesCECourses.pdf
Thank you. Jm

Still don’t know what the mental evaluation is for…

jmacmidwife

I sent this email three times before Ms. Spooner replied. 

12/1/2017 ES, You haven’t answered any of my questions to my last email (below). I’d like to know what this psych evaluation is for. And why it needs to be so involved (inpatient) when I don’t have a reason for it. It seems malicious, egregious, and not what a true professional regulatory board is designed to do. How is it ethical if y’all are requesting I have inpatient treatment when I don’t have a diagnosis? And how is it ethical for the psychiatrists to perform a psych evaluation when there isn’t an indication? And nothing in my order nor in my case suggests I have a mental illness or addiction.
 I’d like to know legally who oversees the LSBme? Is it the governor or state attorney general? Who decides if the Lsbme is following the law? 
I sent an email asking if ridgeview institute in Smyrna ga is sufficient to provide the psych evaluation. You did not respond. Is this place sufficient? 
Likewise how am I supposed to pay total of court fees back when I can’t get a job with the suspension on my background check? Is there an appeal process or another way to pay this? Can I pay in community service hours? I’m not a doctor. I don’t make this much a year even when I did practice midwifery. And again I don’t have an income at the moment.  
I’m homeless. You can reach me at this email address. If I get a job or donate enough blood each month to get my own residence I’ll send you a permanent address. 
I’m trying to be compliant with whatever is realistically doable but it’s like the lsbme isn’t following the spirit of the law and is making decisions based on emotion rather than reality. 
I attached the Louisiana state board of nursing Cme’s in another email since my profession is most like a certified nurse Midwife not a doctor. Will these courses on the nursing Boards website suffice? You never replied to that other email which again makes it hard to be compliant with the order. 
Also does the ALSO course work for the evaluations and identification of high risk pregnancy education requirement? http://www.aafp.org/cme/programs/also.html
Also on my order it states I need to demonstrate how I understand the rules and regs. Do you want a paper written?  I need to know what this means. How am I supposed to go about doing this? 
Likewise it states i need to make a personal appearance once off suspension. How do I get on the schedule? 
Thank you for your help. JM

Reaching out to the Federal Trade Commission

jmacmidwife

I am now frustrated, annoyed, and getting nowhere fast with the LSBME. They are bullying me around and preventing me from getting a job and health insurance that I need to get rid of the thyroid cancer. I reached out to many lawyers and public interest groups. However, because there are not many licensed midwives in Louisiana, there are not a lot of people affected or so it seems. One of the reasons for that is the antitrust issues the LSBME presents. It intimidates midwives so that of course there will not be many in the state especially ones who they have deemed disruptive. I wrote to the FTC, but have not heard from them yet. 

12/1/2017 I am certified as a certified professional Midwife (CPM) through the North American registry of midwives (narm). I have an associates degree in direct entry midwifery (non nursing). I had a midwifery license that was unrestricted in WI. 

I would appreciate any help with the Louisiana state board of medical examiners (LSBME). It is beyond corrupt. Two years ago my (non-nurse direct entry) Midwife license was suspended based on their opinion that I was a danger to the community even though no one was hurt or injured. They claimed I delivered a baby incorrectly even though the parents testified on my behalf that nothing went wrong and they’d hire me again. The complaint was from a photographer who didn’t have any medical training. Conveniently that same year a competing birth center opened five miles away from my home in my city. The photographer worked closely with that birth center.  When Home birth non-nurse midwives (certified professional midwives or CPMs) were originally licensed the state rules required a board of Midwives to review licensing complaints. As years passed and the state couldn’t afford to fund the midwifery board because of budgetary constraints it was absolved and combined under the medical board (all physicians). Currently no midwives (nurse or non nurse ones) serve to review complaints. During the adjudication the lsbme held me to an obstetrical standard or a CNM ( certified nurse Midwife) one. I’m not a certified nurse Midwife. 

By suspending my license indefinitely the LSBME limited its citizens access to a home birth Midwife because i had a patient who delivered unassisted without any trained medical provider at Home three days after my suspension because I didn’t have time to petition the Board for a completion of her care as it was a weekend. I had no choice but to stop caring for clients in the middle of their pregnancies even though I was not sure how I was a danger to clients as no one in my care had been hurt or injured or died. I had only had a midwifery license in la for a year. And it was my second delivery. Additionally I had a doctor overseeing all of my clients per la law. The doctor stated in EMR five times that my client was suitable for a home birth. I have an associates degree in midwifery that I cannot use now as my license is permanently suspended. I also have another degree in midwifery from a private school in Florida but I cannot gain licensure there because of my suspended one in la.  I had a license in Wisconsin also which was not affected but I chose not to renew it. Since there are only 10 licensed midwives in Louisiana losing one Midwife can limit access to care for women seeking out of hospital births. Clearly midwives are competition for doctors.

The board is imposing egregious and burdensome requirements for my Suspension to be satisfied. For instance a psych evaluation with no basis for this. And although the order doesn’t state the level of psych evaluation the doctor in charge of the board is making me get an in-depth three-day in-patient  evaluation. Again there is no basis for this as no drugs, no alcohol, nor psych disorders were involved in my case. Likewise the Order doesn’t give a “diagnosis” for the psych evaluation as their isn’t one but nevertheless I need to complete one. 

Please help. I moved to Georgia to continue working as a Midwife because it isn’t regulated in ga. And because I cannot get a job because background checks prevent me from qualifying. 

I tried to link the adjudication from the lsbme website but it is unavailable at this time. Thank you. JM

No total yet and still waiting for reason for mental exam

jmacmidwife

11/28/2017 ES, I hope your Thanksgiving holiday was well. 
I need to seek preapproval for this Institute to do a psyche eval, despite the fact that there is no basis for the psyche eval. Please let me know if it is acceptable. https://ridgeviewinstitute.com/recovering-professionals/ 
“The Recovering Professionals Program is offered at our Ridgeview Institute Smyrna location.
Ridgeview Institute began treating health professionals in 1977. We learned that professionals in other fields experience similar stressors, develop similar coping styles, and often require the same kind of intervention and treatment to bring about recovery. In 1987, our program expanded to include treatment for all professionals with addiction and dual diagnosis disorders. Since 2004, we have earned a national reputation for also treating professionals with a primary psychiatric illness. Safe Drug Use for the Recovering Addict or Alcoholic.Professionals may self refer, be referred by an employer or mandated for evaluation by a licensing board or agency to determine both the nature and extent of current problems in functioning. Upon admission, our multi-disciplinary team will provide a comprehensive evaluation of the patient’s physical, psychological, and spiritual health. Additional testing or screening may be provided, as needed. At the conclusion of the evaluation, the professional and referring organization receives a diagnostic summary and recommendation for further treatment at the inpatient, day hospital, intensive outpatient level. Aftercare is available to assist the professional in the transition after treatment.”
Likewise, will my primary care doctor (Dr. Lee or another doctor at OLOL Primary Care physicians in BR) be adequate for a physical exam? What exactly are you looking for? Any certain tests?
Also, the Louisiana State Board of Nursing has already compiled a list of acceptable remedial courses, I am seeking preapproval for one of these courses in either ethics and medical documentation from this list. Please let me know asap which courses are acceptable. http://www.lsbn.state.la.us/Portals/1/Documents/rnp/ResourcesCECourses.pdf
“Preferred Continuing Education Providers for disciplinary remediation. If you wish to take a course not on this list to fulfill your CE requirements as stipulated in your Board Order or Agreement, please e-mail a course description with the provider name to monitoring@lsbn.state.la.us for pre-approval.”National Council State Boards of Nursing Learning Extension http://learningext.com• Righting a Wrong: Ethics and Professionalism in Nursing- Renew your commitment to ethical and professional conduct.• Ethics of Nursing- Balance your values and the right of your patient to self determination.• Medication Errors- Understand dangers and minimize risk of nursing medication errors.• Documentation-Help doctors prescribe care based on accurate nurse charting.
American Nurses Association (ANA) http://ananursece.healthstream.com• Applying ANA’s Code of Ethics to Everyday Practice (exp. 12/31/2016)• The Sacred Ethos of the Everyday World of Nursing (exp. 12/31/2014)
RN.org www.rn.org/• Documentation: Accurate and Legal• Legal: Ethics for the Professional Nurse
Nurse.com http://ce.nurse.com• Document it Right: A Nurse’s Guide to Charting (exp. 06/22/2015)• Document it Right: Would Your Charting Stand Up to Scrutiny (exp. 06/22/2015)
RN.COM http://www.rn.com• Professional Documentation: Safe, Effective and Legal (exp. 06/01/2015)

Thanks for the assistance. I look forward to hearing from you soon. And I am still waiting for the total of court fees. 

11/28/2017, ES, I forgot to add would any of these courses suffice for ethics or medical documentation? They are from the Massachusetts Medical Society. Thanks, JM

It has been two weeks in addition to two years of waiting for the LSBME to add up the total for my hearing. A four-year old could add this up faster. One has to wonder how ethical this is? Doesn’t the LSBME have to submit a budget to the state? Doesn’t the LSBME have to balance its books so-to-speak? How is the fact that they didn’t have a total yet legal? Additionally, I am now doing my own research to find what courses will suffice and still asking about mental health evaluation criteria. I ask if my personal general practitioner is good enough for the physical part and if a local treatment center in Georgia is good enough.