Tag: Midwives

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.
Once completed, you will receive an email with a confirmation link – please click on that link to confirm your email address.
Once confirmed, please contact me and I will manually enroll you in the quiz – this should take very little time, and you should then be able to begin immediately.

Gatehouse Media Group Failure To Deliver Series and Midwife Database Gives Birth to my Piktochart

jmacmidwife

http://gatehousenews.com/failuretodeliver/explore-the-database/#midwives

A nationwide news conglomerate (Gatehouse Media) wrote several articles surrounding midwives attending out-of-hospital births. This series of articles stemmed from several complicated deliveries and newborn deaths in Florida. Ironically, Florida is one of the most regulated states with regards to midwifery licenses. In their research, the group rounded up all the midwives in the United States into one convenient database. (Thanks!) The database allows one to search for midwives by state or look at birth centers. Sadly, much of its birth center “data” is incorrect or incomplete, so I am unsure if it really gives the picture the media group was going for. However, the individual data for midwives seems to be accurate. In fact, its so accurate for Louisiana that its astounding. If we tweeze out the Licensed Midwives from the Certified Nurse Midwives, then separate the inactive licenses, from the revoked, suspended, and active licenses, we find shocking statistics, which I conveniently made into a piktochart/infographic. 

https://create.piktochart.com/infographic/saved/34853999#

The take home message is that 32% of midwives have had their licenses acted upon in Louisiana. Sound incredible? Yes, yes it is. Let me break down my findings:

20 active licenses. Out of those three have been acted upon……….. 3/20

26 inactive licenses. Out of those two have been acted upon……… 2/26

2 suspended licenses and one revoked license……………………………. 3 

If we assume that the three midwives who cannot practice because of suspensions and a revocation would still be in business as well as the two who have inactive licenses, we can add the total of active licensees to 25. If we total all the actions taken against licenses compared to the active ones, we have 8/32 or 32% of licenses that have been acted upon in some capacity by the LSBME. Midwives have been licensed in Louisiana since 1984 when the Midwives Practitioners Act was passed.

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.78.9.1161  

The fact that Louisiana disciplines midwives more than doctors is insane and reeks of antitrust, restraint of trade, and a monopoly over the maternity care in Louisiana.  There is no denying that this Board, the Louisiana State Board of Medical Examiners, is not biased and inhibiting midwives from working in Louisiana. The biased, corrupt, unfair and unjust policing of the LSBME is driving midwives away from Louisiana and in doing so limiting choices of consumers and driving costs of maternity care in that state through the roof as out-of-hospital midwives cost around a third of doctors. No other licensed profession has more inactive licenses than active ones. One might imagine that maybe less licenses are because midwifery and out-of-hospital birth is going out of fashion? No, no it isn’t. In fact, out-of hospital birth is on the rise. Never mind its the standard in the rest of the world.  https://www.reuters.com/article/us-health-homebirths/out-of-hospital-births-on-the-rise-in-u-s-idUSKCN0WU1G1

According to the 2016 census from the Federation of State Medical Boards, there are 16, 894 active physician licenses in Louisiana.

Click to access 2016census.pdf

According to an article in NOLA.com, Dr. Cecelia Mouton, the most recent reigning Executive Director of the LSBME, between 30-50 doctors have their licenses acted upon each year. 

https://www.nola.com/politics/index.ssf/2015/06/louisiana_medical_examiners_le.html    

If we assume that the number of doctors has remained stable since 1984 (for comparison sakes with when midwifery licensure began in Louisiana,) between 30-50 doctors a year have had their licenses acted on. If we do the maths: 30-50 x 34 years=1,020-1,700 potential licenses acted upon, depending on how discipline-y the LSBME felt that year or maybe if they needed new fixtures or maybe raises? Since Cecelia Mouton still is on salary at the LSBME making $229,445 a year. 

https://wwwcfprd.doa.louisiana.gov/boardsandcommissions/viewEmployees.cfm?board=20

Back to my math problems. So, if between 6-10% of doctors have had their licenses acted upon while 32% of midwives….Houston I think we have a problem. For simplicity sake, I took the average (8%) for my piktochart. 

And we will look at why the Board might be biased in another post–one reason is that they dismantled the Midwifery Advisory Board, which is crucial in fairly assessing potential discipline actions. Most other trades have such advisory boards when the overseeing board is not the same trade and won’t be able to fairly or accurately assess what is standard of care for the trade it oversees.

My story…the short version

jmacmidwife

A pathologist, nephrologist, and urologist walk into a boardroom…

Though this sounds like the start of a joke, what happened next was hardly funny. These three doctors, who are on the Louisiana State Board of Medical Examiners (LSBME), decided to indefinitely suspend my midwifery license.

What Happened?

Nothing. Other than a normal homebirth, where an 11-pound baby was safely delivered, nothing happened. There were no injuries. The mom and baby were not transported to the hospital before,during or after the birth. In accordance with the law, this mother’s obstetrician stated five times in her medical record that she was low risk and healthy for a homebirth.

On Christmas Eve in 2014, as I was leaving to a holiday party, I received a certified letter.  It stated that the Louisiana State Board of Medical Examiners summarily suspended my midwifery license under the guise of protecting Louisiana citizens, from what I am not sure.  While the news of being unable to attend any further births put a damper on my holiday, it pales in comparison to the experience of one of my other clients. She gave birth three days later without a healthcare provider by her side because she could not find a midwife to replace me in that limited amount of time and the LSBME, with blatant regard for this woman and her baby’s safety, refused to allow me to continue care.

The next three months following my suspension consisted of being at the mercy of the LSBME.  The LSBME’s idea of following the law included lying, withholding evidence, and purposefully manipulating the rules and regulations. In the end, the LSBME accused me of deviating from midwifery standards of practice, exhibiting incompetence as determined by local midwifery standards, and fraud and deceit in connection with services rendered. None of these allegations are true.

The LSBME allowed a videographer, who attended the birth, to file a complaint against me.  Ironically, while the labor was caught on video the actual birth was not, yet I was still accused of not delivering a baby correctly. However, I did not know who filed the complaint or what the allegations were until the day before my adjudication.  Of course this allowed me no time to prepare for her coached and rehearsed untruthful testimony.  Not only did this single, childless videographer lack medical training, her complaint was based on untrue allegations.  Her dishonesty was propagated by a local midwife and obstetrician, who coincidentally opened a new birth center located five miles from my home. Can anyone say competition? I can.

The videographer, without the birth parents consent, showed the video to this competing midwife and obstetrician. Coincidentally this was the same obstetrician my client, the mother, was transferring care from when she decided to have a homebirth with me.  The videographer worked closely enough with the birth center that they exclusively listed her photography services on its website.

Healthcare providers should be petrified that a videographer/photographer was allowed to file a complaint against their license especially when no one was injured.  Though anyone should be allowed to make credible complaints against anyone’s license, the allegations should be truthful.  None of the videographer’s allegations were proven to be anything but her opinion. Had the LSBME consulted with a noncompeting midwife, the charges would have been dropped.  Instead, I was judged by three doctors (a pathologist, nephrologist, and urologist). They did not understand what was happening at this homebirth nor could they imagine what was normal because management of a homebirth is vastly different than a doctor-led hospital birth.

Likewise, the LSBME could have interviewed any of the other four adults present in the room during the birth. This included a nursing student and doula with more knowledge and experience with normal births than the videographer, which would have laid the videographer’s false allegations to rest. The parents testified on my behalf,explaining to the board that they were overjoyed with my careful, quality of care and would do the same birth all over again with me as a provider. The parents even asked me to attend the birth of their next child, but because my license is indefinitely suspended, I was unable to attend. This mom went on to have another 11-pound baby in a hospital setting, attended by another midwife without judgment on her license.

No one can control how a birth is perceived. It all depends on the persons’ perspective. The people with the most important perspective are the parents. They thought the birth was perfect, not at all traumatic as indicated by the LSBME. Homebirth is raw,natural, messy and organic.  It’s hardly the same as a hospital birth. So of course a nephrologist, urologist, and pathologist who have never seen an out-of-hospital birth might perceive the normal sights and sounds of a homebirth as traumatic. Nothing unlawful or malicious happened at this birth or post-partum.

The LSBME was the investigator, accuser, judge, and jury in my case. In fact, the Lead Investigator was also the Executive Director of the LSBME—further evidence of injustice and conflict of interest. The Executive Director’s behavior, widely-known to be abrasive, abusive, and hostile did not lend itself to any professional negotiating or understanding. Under her direction, the LSBME acted like a soap opera; she allegedly had an affair with an attorney who worked with the LSBME to prosecute its victims, then hired his niece as part of the investigative staff, as evidently nepotism doesn’t apply to Louisiana. You just can’t make this stuff up.

Additionally, I didn’t have adequate access to the testimony nor appropriate peers to sift through the false allegations. Even though no one was hurt, injured, died, and no transfer to a hospital occurred, my livelihood was stripped from me because of competition. There was no oversight to this board. It screams of antitrust. Louisiana law states that a board of midwives serving underneath the LSBME would oversee any midwifery complaints. However, that board of midwives was dismantled years previously, evidently due to budgetary constraints.

In Adam Crepelle’s article, Guest column: Louisiana licensing rules stifle free market, he noted that “by making it harder to enter a profession, licensing can also reduce employment opportunities and lower wages for excluded workers, and increase costs for consumers.” The report notes that licensing is particularly burdensome on those required to move for work,like military families. It also asserts licensing hits the poor the hardest because they are often unable to afford licensing’s training costs.Furthermore, the report concludes that “most research does not find that licensing improves quality or public health and safety.”

Also, according to Alden Abbott of the Heritage Foundation, “In recent years, however, there have been signs that the Fourteenth Amendment ‘rational basis’ test that applies to economic regulation may be applied more expansively by the courts when it comes to analyzing anti-competitive licensing restrictions and related affronts to one of the most basic civil rights of all: the right to earn a living.”

Off the record, I consulted several midwives who are expert witnesses in other states and they agreed that my case was biased and unfounded, but I could not utilize their testimony because the prosecution set the tone of the courtroom, whereby doctors were used to defend midwifery rules and regulations. This is something doctors cannot adequately do because, well, they are not midwives and do not understand what occurs at a homebirth. Midwifery rules and regulations, especially for autonomous, out-of-hospital midwives are, and uniquely designed for, complete,continuous independent care of low-risk, healthy mothers. The mother whose baby I delivered was low-risk and healthy, as indicated five times in her medical records by the obstetrician she was seeing during the pregnancy. The LSBME told me that this obstetrician was “wrong.”

Why didn’t I appeal the decision?

Unfortunately I didn’t have the available funds. This was my second client in Louisiana as a licensed midwife,so my income was minimal. My attorneys were flabbergasted at the railroading that occurred at my hearing. Initially, they thought these allegations would not amount to anything close to a suspension because license suspensions are usually only given when a practitioner does something horrific like operates on the wrong leg, practices under the influence of drugs or alcohol, or prescribes medications illegally, not during a birth where no one was hurt or injured.

The decision the LSBME made in my case was unprecedented. A regulatory board like the LSBME is responsible for “protecting the public from unsafe practitioners,” but clearly it overstepped its jurisdiction because it did not have any oversight. It took advantage of its intended purpose and instead applied irrational, unreasonable, arbitrary, and burdensome requirements to unduly limit my individual constitutional liberties. Due to institutional corruption, an appeal was looking unfavorable, and it would cost me an additional $30,000. Unable to get the upper hand and find additional funds, I had to cut my losses and regroup. Besides, my family needed me.

I spent the next two years helping to care for of my 86-year old grandmother, while my mother took care of her dying husband, all while going through a divorce. Additionally, I found out I have thyroid cancer. Last year, I attempted to find some gainful employment doing something, anything that would help me afford health insurance. I live in a ‘red state,’ so even Medicaid insurance would cost me hundreds every month. I applied to about 50 different jobs from department stores to libraries. I couldn’t get past the background check with a suspended license on my record,despite having had a midwifery license in Wisconsin that was never acted upon and had no lawsuits. I chose not to renew my Wisconsin license, as I did not live there. I was fortunate enough to maintain my skill set in midwifery by working as an assistant midwife and birth assistant, but the pay is not as steady nor much as it would be if I were an independent midwife.  I could not afford to keep paying my health insurance premium of nearly $700 a month.

I moved to Florida in the spring of 2018 to work at a birth center where I would have a more steady income as an office assistant and birth assistant. I took a second job house sitting so that I would have a place to stay. After realizing that my first application for midwifery licensure in Florida should not have been denied, I chose to reapply after completing the in-state requirements. But once again, the suspended license in Louisiana is somehow preventing the Department of Health in Florida from granting me a license, even a temporary one, in the underserved area where I live. Although Florida has a Council of Midwives who assist the Department of Health in making decisions regarding midwifery rules and regulations, the Council was not given the ability to have any input on my application. Likewise, if my allegations were true and I was adjudicated in Florida, my sanctions would be at most a fine of a few hundred dollars and a few months of probation compared to an indefinite suspension.

The stipulations required to lift my suspension and place me on probation include paying the LSBME nearly$18,000 in fees (which the LSBME didn’t calculate until 11/2017), going to the LSBME’s handpicked rehab in Mississippi, completing three courses, demonstrating my understanding of the Louisiana midwifery rules and regulations (which the LSBME will elaborate only after I go to rehab), and paying a $300 fine. According to an email from my compliance officer on November 13, 2017, the LSBME accepts cash or money orders only. They do not take credit cards, have payment plans, or will agree to community service in lieu of fines or fees.  However,in an email correspondence tonight with the new Director of Investigations, he stated that “the board has been willing to work with licensees in the past if money is the primary reason a person would not be able to comply with orders and sanctions of an administrative hearing.  Paying over an extended period of time has been granted in the past.” Clearly, the LSBME personnel lack consistency and understanding of LSBME policies, procedures, and options regarding payments.

Despite the fact that physical, mental, drugs, or alcohol were never an issue in my case, the LSBME is requiring me to go to one of five rehabs to prove it. Interestingly, two of the rehabs closest to me declined to admit me after viewing my court documents because I do not fit their criteria for admission. Coincidentally, after the Mississippi rehab Pine Grove consulted with my compliance officer at the LSBME,they decided I was a “perfect” candidate. There is abundant information on how Physician Health Programs (PHP) choose to utilize fraud, deceit, and fabrication to go above the law to commit crimes for these boards, whom conveniently give them immunity and a constant flow of “customers.” Furthermore, the LSBME continues to change its requirements. For example, it stated that I could take courses found on the Board of Nursing’s website, but months later were silent on whether those courses that I already completed were adequate.

In a contrary statement, the new Director of Investigations wrote in October of 2018 that he reviewed my file and found that “there is no mention or recommendation of a drug and alcohol treatment facility.  This is not a requirement of the Board and therefore you do not have to commit yourself to a drug and alcohol treatment center.  The Board does require a mental/physical evaluation by a physician or group of physicians who have been pre-approved in writing by the Board.  You must also have an evaluation showing that you have been deemed competent to resume the practice of midwifery.” This sounds confusing because it is. I have several emails from my compliance officer stating the opposite. These boards are notorious for (un)comically being Lucy constantly moving the football so that I, Charlie Brown, can’t kick it.

Likewise, in an even more frustrating turn of events, the new Director also stated in an email from October 2018 that my compliance officer could set up a payment plan for the almost $18,000 fee, but my compliance officer stated that I would have to get preapproval from the LSBME before she could set up a payment plan because she could not guarantee that the LSBME would accept a payment plan even though the Director of Investigations stated to do so. Also, now I am apparently supposed to find my own physician to conduct a mental evaluation but they will not tell me what I need to be evaluating. Once I find someone who I think can do the evaluation I am to have that person contact my compliance officer for specific instructions on what exactly needs to be evaluated. Sound shady? Yes, yes it is.

Why share this story now? Why didn’t I share it three years ago when it happened?

The Supreme Court has finally realized how out-of-control and cartel-like these state boards have become. In 2015, in North Carolina State Board of Dental Examiners v. FTC, the Supreme Court held that when a controlling number of state board members are market participants, the board must be “actively supervised” to be immune from antitrust law. States have three options for complying with this ruling. First, they can choose not to put a controlling number of active market participants on boards. Second, they can actively supervise boards where market participants make up a controlling number of members. Third, they can forgo state action immunity by not actively supervising boards and keeping a controlling number of market participants on boards. Without such changes, state boards may be subject to antitrust liability for actions that are deemed to be anticompetitive.

In May 2018, Louisiana Senator John Milkovich introduced a bill to the Louisiana legislature to provide oversight to actively supervise these corrupt boards, like the LSBME. The bill was approved and instituting its requirements have begun, albeit slowly.  Therefore, I finally feel like I have a chance to positively change my circumstances. Louisiana needs to nullify the absurd sanctions placed on me. Please join me in contacting the following agencies and complaining on my behalf at the injustice and the unreasonable restraint on competition violating federal antitrust law that occurred. *However, since this bill was just “dropped on them” as stated by the secretary of the House and Governmental Affairs Committee, at this time, she does not know what a formal complaint should include.  I will update this information as soon as their attorney returns my call.

In compliance with Act 2018-655, the board gives notice to its licensees and applicants of their opportunity to file a complaint about board actions and board procedures. You may submit such complaints to one or more of the following organizations:

  1. Louisiana State Board of Medical Examiners; 630 Camp Street, New Orleans, LA 70130; (504) 568-6820; lsbme@lsbme.la.gov
  2. Committee on House & Governmental Affairs; La House of Representatives; PO Box 444486, Baton Rouge, LA 70804; (225) 342-2403; h&ga@legis.la.gov
  3. Committee on Senate & Governmental Affairs; La Senate; PO Box 94183, Baton Rouge, LA 70804; (225) 342-9845; s&g@legis.la.gov

Conveniently, the media group Gatehouse recently published a series of articles pertaining to out-of-hospital midwifery. 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.

According to the NOLA.com article Under Fire from Opponents, Medical Examiners Bill Stripped of Key Provisions, the number of doctors having active licenses acted upon is around 30-50 per year according to Cecelia Mouton then Executive Director of the LSBME. A census in 2016 from the Federation of State Medical Boards states that there are 16,894 active licensed physicians in Louisiana. Louisiana has provided licensure for midwives since 1984. So if we compare the amount of midwives to doctors over the last 34 years and the irrespective disciplinary actions (taking an average of 40 per year for doctors),midwives licenses have been acted upon 32% vs doctors 8%. How is the LSBME not overstepping its administrative function? How is this not a restraint of trade?How is the LSBME able to adequately discipline midwives when it is obviously biased?

The LSBME has traumatized me.From investigators showing up at my house to hand deliver a subpoena to knocks on my door from the mail carrier delivering certified letters—I lived in a constant state of fear of how the LSBME would affect my life. I lost over 20 pounds in two months from the stress. The LSBME combed through social media to use posts against me, forcing me to delete or make private all social media support systems I had established. I was concerned that my husband could lose his job, since he worked for the state of Louisiana. I worried that my daughter would be bullied in school by the obstetrician’s children. I was concerned that a lien would be placed on my property so that I could not move until I paid the fees. No part of my life was untouched by the evilness of the LSBME.

I am an over-qualified, educated, competent midwife, who cannot practice because of a bogus adjudication. I have never lost a mother or baby. I have never had a lawsuit. In the last three years, I have taken over 300 hours of continuing educational units. That’s far beyond any required amount in any state. I would be a valuable asset to any state, city, and community. I have two degrees in the study of midwifery, in addition to a bachelor’s degree. I have completed a course as an EMT. I have several job opportunities awaiting me at birth centers in Florida, but I only need a license. My position as a college midwifery clinical coordinator was rescinded as soon as my license was suspended. I am a preceptor for midwifery students. While I have suffered emotionally, physically, financially, and mentally because of my suspension, ultimately it is consumers seeking midwifery services who have suffered by not having access to one. Likewise, students who need preceptors are suffering from not having one more choice. Therefore, the LSBME is not only hurting me, but also mothers, babies, and future midwives.

Although I have been very blessed in the opportunities I have been given and the kindness and gratitude of my friends and family, it is simply not enough to sustain any lifestyle, especially one where I also need medical care. Please help spread my story to attorneys, organizations, and writers so that I can get the word out on the unconstitutional and biased decision made by the Louisiana State Board of Medical Examiners. Please call and/or write to the LSBME, the LA House, and LA Senate and complain on my behalf towards the goal of nullifying these sanctions so that I do not need to pursue litigation in either state.  Please help me raise the funds I need to overcome all of this and once again provide safe, competent, quality midwifery care.

Thank you.  

Jacqueline Macaluso

10/22/2018

http://narm.org/

https://apps.lsbme.la.gov/disciplinary/DocViewer.aspx?decision=true&fID=115520

http://www.soundoffla.com/?p=1750

file:///C:/Users/Macaluso/Downloads/DH-MQA%205015%20(09.2015)%2064B24-8.002%20[REVISED%20post-adop’n].pdf

https://www.physicianrights.net/?r_done=1

https://ij.org/pillar/economic-liberty/

http://gatehousenews.com/failuretodeliver/explore-the-database/#midwives

https://harvardlawreview.org/2015/11/north-carolina-state-board-of-dental-examiners-v-ftc-2/

Senate Bill 286 attempts to rein in dictatorial actions of State Board of Medical Examiners, runaway investigators

https://aapsonline.org/louisiana-needs-to-rein-in-unaccountable-medical-board-states-aaps/

http://copylinemagazine.com/2016/05/18/louisiana-state-board-of-medical-examiners-accused-of-racism-in-firing-of-african-american-employees/

https://www.heritage.org/report/constitutional-constraints-federal-antitrust-law#_ftn46

https://www.theadvocate.com/baton_rouge/opinion/article_46e02ba4-5fee-11e6-9b9d-e754e5adc4b6.html

https://regproject.org/

http://static1.1.sqspcdn.com/static/f/624306/26552206/1442864215407/SLLC+NC+Dental+Board.pdf?token=WVQM%2FK4rEWquAxF4AXLEp53fwvM%3D

https://www.arkansasonline.com/news/2018/oct/06/lawsuit-seeks-to-lift-midwife-restricti-1/

Click to access 162-U-Pa-L-Rev-1093.pdf

https://www.ftc.gov/system/files/attachments/competition-policy-guidance/active_supervision_of_state_boards.pdf?utm_source=govdelivery

https://www.newsmax.com/janeorient/ct-lsbme-management-mri/2018/05/09/id/859361/

http://woundedhealersnc.net/

Physician Health Programs (PHPs) are not above the law; They just think they are

http://thepsychologytimes.com/2017/05/08/meaningful-oversight-task-team-recommends-supervision-for-boards/

http://jmronline.org/doi/abs/10.30770/2572-1852-102.4.7?code=fsmb-site

Click to access la.pdf

Click to access 2%20February%202016%20Minutes.pdf

https://www.nola.com/politics/index.ssf/2015/06/louisiana_medical_examiners_le.html

Click to access 2016census.pdf

The New Director of Investigations at the LSBME

jmacmidwife

Below is my email on 10/22/2018 to the new Director (Lawrence Cresswell) of the Louisiana State Board of Medical Examiners. He is replacing Cecilia Mouton. It is about time. 

Dr. Cresswell CCs my compliance officer, Esparonzia Spooner when he replies promptly also on 10/22/2018. The take home from this email exchange is that I do not have to go to a drug and alcohol facility for the unwarranted mental/physical exam. Likewise even thought my compliance officer said a year ago that I could not make payments on the egregious fees/fines, that Dr. C said I could. Finally, he said he would be happy to help facilitate any request I have for a Board decision. Yes, we shall see. It is surprising to me how helpful he is being. It is almost as if he realizes the unprecedented amount of injustice that has occurred. 

Dear Mr. Cresswell, 
Welcome to the LSBME. 
I am one of the unfortunate souls to have been railroaded by the corruptness of the board and Dr. Mouton in the past few years. I am wondering if you can be of help in nullifying my egregious sanctions that are keeping my license indefinitely suspended? I do not live in the state of Louisiana anymore and will never return. However, because of my unconstitutional adjudication dripping with antitrust issues, I am unable to make a living in the state of my choosing. As you will see in my file, I have never hurt nor injured anyone. I have followed all the rules and regulations. I am over-qualified. In the last three years, I have taken over 300 hours in continuing education in addition to completing yet another degree in midwifery studies. Without a job, I cannot pay the board its fees of almost $18,000 and the board will not allow me to make payments, use credit cards, nor substitute community service for payment. Likewise, I cannot commit myself to a drug and alcohol treatment facility of the board’s choosing in good conscience as I do not have a drug nor alcohol problem, not to mention the $5000 required to pay for the evaluation. Furthermore, the inability to complete one of my sanctions because the board will not tell me how to complete it, until after my unnecessary drug and alcohol evaluation, is beyond ridiculous. It is not legal for my livelihood to be tied to a board with no oversight. I do not see how the board can continue to deny a good citizen like myself the inability to earn a living in any field. I look forward to a review of my case and the rescinding of all sanctions. 
Thank you. JMac

Dr. C’s reply:

Thank you for my welcome to the LSBME.  I have reviewed your file and would like to offer the following suggestions.  The board has been willing to work with licensees in the past if money is the primary reason a person would not be able to comply with orders and sanctions of an administrative hearing.  Paying over an extended period of time has been granted in the past.  I would recommend that you make a formal request to the board in writing that can be submitted to the Board on your behalf for consideration.  During my review of your file, there is no mention or recommendation of a drug and alcohol treatment facility.  This is not a requirement of the Board and therefore you do not have to commit yourself to a drug and alcohol treatment center.  The Board does require a mental/physical evaluation by a physician or group of physicians who have been pre-approved in writing by the Board.  You must also have an evaluation showing that you have been deemed competent to resume the practice of midwifery.  In addition, education in the areas of Medical Record Keeping, Medical Ethics, and Evaluation and Identification of High Risk Pregnancies are required.  These courses must be approved in advance by the Board.  If you have taken these classes since your suspension, please submit proof of course completion.  After the completion of the above, it has been ordered that your license may be reinstated, however your license would be reinstated on probation. 
I do believe there is a path for you to move forward and a way to regain your license.  You stated that you have no intention to practice in the State of Louisiana.  If this is the case, I recommend including this in your formal written request for Board consideration.  As the Director of Investigations, I do not make administrative decisions pertaining to any individual licensee as this is a decision of the Board.  I would, however be happy to help facilitate any request you may have to the Board for a decision.   I hope this has been helpful.

Sincerely, 
Dr. Lawrence H. Cresswell III, DO, JD

Does your medical licensure board protect you? lol no

jmacmidwife

I was inspired after reading Dr. Jane Orient’s article “Does your medical licensure board protect you?” It was due to this exposure of this article and its embedded video of the Louisiana legislature discussing the proposed bill (SB 286) providing oversight for the LSBME that I first virtually met Senator John Milkovich (the author of the bill) and Dr. Feldman (a doctor abused and punished by this horrific board). Both of these men spoke so passionately, honestly, frustratingly, eye-openingly, and fervently of the scandalous abuses, corruption, and absolute terror the medical board has been infiltrating into the healthcare community for decades. The healthcare industry in Louisiana is the proverbial good ol’ boy system. This here establishment don’t want nobody comin’ on up in here and fixin’ anything. Cuz they don’t think anything is wrong with the way they been doing business for literally centuries. The LSBME looks at anyone who comes from outside the state as a foreigner who wants to change things. Well, yeah, of course we want to improve the system, provide more choices— I think its called progressivism and most states embrace and even encourage it. Nope not Louisiana. Most of the standards of care in the South are notoriously outdated, racist, and inhumane. So if you ain’t one of the good ol’ boys with a name that has a -eaux in it, they will hang you, literally. There are at least six physician suicides attributed to the harassment and investigation done by this board. And although I am still alive, the trauma and emotional abuse of dealing with the LSBME is something to which I can attest. So after stumbling upon this article, I finally felt like there were other humans out there who could understand my sheer and utter frustration and anger at this illegal process. Instantly I was filled with gratitude and hopefulness to have found these doctors and the Senator who are not afraid to call out the injustice happening in Louisiana. I finally felt like possibly with the passage of this bill that there would finally be a platform for others to listen to my story and believe it. The board was finally being called out on their blatant railroading and destroying of people’s lives without fair investigations nor hearings. I am thankful that these individuals have had the guts to stand up to these bullies and speak the truth. I am thankful to be able to sleep more soundly knowing that other people have the sanctity of the healthcare field in their sights since my children still live in Louisiana. Below is Dr. Jane Orient’s article.

https://aapsonline.org/does-license-board-protect/

A bill, SB 286 introduced by Sen. John Milkovich, that would give doctors the right to defend themselves if brought before the state licensure board, the Louisiana State Board of Medical Examiners (LSBME), was heard in the Louisiana state House of Representatives on May 2. If it passes, doctors could find out exactly what they’re accused of, see the evidence, and present a defense to an unbiased judge and jury. They are Americans, right? Even terrorists and rapists have these rights.

In fact, a doctor can be delicensed, bankrupted, disgraced, and made unemployable, based on an anonymous complaint that might have come from a disgruntled employee, a jealous competitor, an insurance company that doesn’t want to pay a bill, or a drug addict who wants a lighter sentence for stealing a prescription pad and forging prescriptions.

A board employee functions as investigator, prosecutor, judge, jury, and executioner. The politically appointed members of the board almost always rubber-stamp what the board staff wants. The staff generally controls the flow of information to board members and accused doctors. The doctor has no right to cross-examine accusers, to ask that conflicted or biased staff be recused, or to challenge the evidence against him—which he might not even have seen.

Don’t believe it? Listen to the testimony on SB286, the Physician’s Bill of Rights. (It starts at 1 hr, 34 minutes into the official video.) You’ll hear about doctors who were tops in their field unable practice their profession anywhere. At least six physicians were driven to suicide. A physician’s disabled employee lost her profession and livelihood when the board forced him to fire her. Families were devastated. Doctors were forced to spend tens of thousands of dollars and months in remote in-patient drug rehabilitation facilities, even though the facilities themselves found that the doctor never had a drug problem.

Most disturbing are the remarks by the opponents of due process rights for physicians, including the Federation of State Medical Boards and Public Citizen, a self-identified consumer advocate group. They did not contradict testimony about abuses. Instead, they asserted that “doctors need to be held to a higher standard” because “patients’ lives are at stake.” There’s an opioid epidemic, and sexual misconduct occurs, and complainants may fear retaliation of some sort if their identity is disclosed. Therefore, we dare not “tie the board’s hands” and impede their ability to “protect the public against bad doctors.” If the board ruins a few good doctors and even drives some to suicide, so what?

Doctors have “enough” rights, it was claimed. The current executive director of the LSBME read aloud from the board’s policy manual. But despite a legislator’s repeated attempt to get a “straight answer” out of him, he would not say whether one of the doctors who testified could finally get a copy of his own complete file, which he had been requesting for years.

The board’s supporters were dismayed at the prospect that a doctor might be able to question an investigator’s objectivity. Witnesses for the bill mentioned, several times, the chief investigator, She-Who-Is-Not-Supposed-to-Be-Named, who was formerly also the executive director. She had dismissed thousands of complaints and had been helpful to some doctors, but had ferociously attacked others, who appeared to be exemplary physicians.

So, who should care about a few doctors who might have been treated unfairly?

Doctors thinking of practicing in Louisiana should watch what happens with this legislation. Young people considering a medical career should be aware that their huge investment of money and years of their life could be wasted at the whim of a powerful official who is immune from any accountability for wrongfully destroyed lives. (The situation is not confined to Louisiana.)

Patients should worry. Thousands of Louisiana patients found themselves suddenly without treatment, and shunned by other doctors who feared being the next pain-management doctor to be cut down. Patients needing an affordable diagnostic test will have fewer choices because an excellent CT scanner and MRI machine were sold to someone in Dubai by a highly competent American doctor delicensed and bankrupted by the LSBME. Sick patients will have to rely more on practitioners with limited training because of the shortage of highly trained, experienced physicians.

All Americans should be alarmed at the burgeoning power of the administrative state, which is exempt from the limits placed on regular civil and criminal courts. If doctors can be stripped of their rights, so can you. Please watch the hearing and see for yourself.

I cannot get admitted into any LSBME-sanctioned treatment center because (not)surprisingly I do not fit the criteria for admission!

jmacmidwife

Since the LSBME refuses to explain to me what I need to have evaluated in the mental evaluation, I am relying on the treatment center’s admissions counselors to advise me on what they think I need. The fact that these facilities won’t just accept me to take my $5,000 does speak to their integrity, ethics, and honesty as they could easily say I can have an evaluation at their facility and take my $5,000, but they don’t.  The irony is that these are the treatment centers that the LSBME provided for me to contact. I cannot get admitted to the centers they said I had to go to! How can any of this be legal? Again, this is costing me time, effort, and energy. Not to mention– I still have cancer that I cannot get treated because I cannot afford health insurance. My attorney friend (who does not represent me) continues to provide valuable insight and encouragement. I could’t have made it through this whole ordeal without her kindness, knowledge, and willingness to help. I cannot express enough gratitude for her time and talents. 

2/8/2018 Attorney, I hope you are well. I spoke with the closest facility in my state about evaluation and this is the reply…. basically I don’t fit their criteria so I cannot get the $5k assessment at their center. 
Again this is what I was worried about. Since I don’t have a documented addiction how can I get an evaluation at any of the substance abuse facilities that the lsbme is requiring me to go to?  It makes no sense. 
Any thoughts? JM

2/8/2018 JM, This is a great and helpful reply! Now you have some terms “fitness for duty evaluation” – that’s what you need. And of course her advice that you need a provider who can do that to be approved by the board first. I would make sure you contact everyone on the list and say “Can you provide me with a Board ordered fitness for duty evaluation not related to substance use?” And then document every reply, and then we will send that to the Board. –Attorney

I continue to reach out via websites and emails to the other treatment centers on the list. To this day, Palmetto has not replied to my repeated emails. Bradford Health agrees with Talbott in that I do not fit their criteria for admittance. Pine Grove gets back to me and I’ll write another blog entry about how admission counselor Jessica Brook initially says, after reading my Board Order, that I do not fit Pine Grove’s criteria for admittance either. Surprise, surprise, but wait….. after Jessica Brook calls Esparonzia Spooner, who she knows “very well” (her words), to confirm that I do not fit the criteria, she changes her mind and decides that I need an in-depth, extensive several-inpatient stay mental health evaluation, which is bizarre considering the other two facilities who are not “good friends” with ES did not come to the same conclusions. It is almost as if after talking with ES that Jessica Brook comes away biased, influenced, and now recommending something not legally warranted. Huh, how bizarre! No, just crooked and corrupt, just the way LSBME likes to do its business. And ES wonders why I do not think its legal to withhold the reason for my mental health evaluation from me and insist on the facilities calling her for the reason. Shady, shady, shady, shady. 

2/21/2018 , 2/26/2018, 4/14/2018 Thank you for contacting The Palmetto Addiction Recovery Center.

We have received your information and a Palmetto team member will be reach out and contact you shortly. If it is important that you speak with someone immediately please call 866-848-3001.

We know how hard recovery can be, but getting the process started does not have to be.

Thank you again for reaching out to us. We look forward to the opportunity to speak with you.

Palmetto Addiction Recovery Center
86 Palmetto Road
Rayville, Louisiana 71269
Phone: 866-848-3001

2/21/2018, 4/14/2018 Thank you for writing to Pine Grove.
Our team will reply to your message soon, however, it may take up to 48 hours for a response.  If you need to speak to someone immediately, please call 888-574-HOPE (4673). 
 If you feel that you are in a dangerous situation as a result of your behavior, please seek help immediately at the nearest emergency department or contact local authorities for assistance.

2/21/2018 Bradford Health, 
Hi I am wondering if you can provide a Board ordered fitness for
duty eval not related to substance use? Thanks for the info. JM

2/21/2018 JM, Unfortunately we would not be able to provide that service. We are primarily
a substance and alcohol abuse treatment facility. If you need help related
to that, your next step is to come for a consultation – it’s completely
confidential and free. At the consultation we will answer any questions you
may have, determine the best level of care for your particular situation
(it’s different for everyone), and provide a clinical recommendation for
what comes next. Please call our 24 hour helpline 888-577-0012 and a
Recovery Advisor will arrange that consultation with you. Your life matters.
The best time to call is right now.

With You,
Loren, Recovery Advisor
Bradford Health Services
Recovery Advisory Center
www.bradfordhealth.com
888-577-0012

Again, the take home message is that the facilities that I have been forced to go to will NOT accept me into their programs because like I keep telling the LSBME— I do not have a problem with drugs, alcohol, nor mental health nor was any of it ever an issue in my case or adjudication. How is this legal again? oh, it isn’t. 

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. 

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