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Council Comments - Spring 2019

The SDSMA's Council Comments is your connection to the actions of the SDSMA's Policy Council. This issue covers the May 31 meeting held in conjunction with the SDSMA Annual Leadership Conference in Sioux Falls. Read past issues at sdsma.org.

President's Report
Board of Directors Update
Christopher T. Dietrich, MD, SDSMA President, gave the President's Report to the Policy Council. The Board of Directors on June 1 will review the SDSMA’s financials, discuss administrative issues including the building and membership, and the association's leadership program that just graduated its inaugural class, along with the policy issues from the Membership Open Forum to prioritize and provide guidance for follow up.  

The Association $2.6 million in long-term investments; and realized a 3.5 percent gain in the last 12-month period and a 8.5 percent annualized gain in the last three years. We are up by 10 percent in 2019 as of March 31. Net operating income for the first quarter of 2019 is $50,000 compared to $230,000 one year ago, due to a decrease in our membership. Other income (primarily from investments) is $220,000 higher than a year ago.  

Regarding the building, Avera is interested in moving both of its health plans into the same building this year. Options are being discussed for the current building. The lease with Avera is through December 2021, unless it is mutually agreed upon to terminate the lease earlier if a new tenant is found. While the SDSMA had fewer members renew from last year, new members joined, resulting in a net loss of 47 members from 2018. Staff have met with the Sioux Falls and Aberdeen district leadership to discuss recruitment plans for the coming year, as these are the areas of the state with the most members lost.  Staff will also meet with Sanford Health and Avera Health about the potential for bringing back membership as a benefit to their employed physicians.  

In April, SDSMA’s leadership program graduated its inaugural class of physician leaders. The program has had excellent feedback and plans are being made for a second cohort. The Board will consider the issues discussed today by the Policy Council -- gun laws, disaster response, and MOC -- and decide on ad hoc committees that may be needed to follow up on issues.

Other Highlights

2019 Legislative Session

During the 2019 legislative session, there were a number of key policy issues including opioid prescribing, DUI, and telemedicine legislation.

AMA National Advocacy Conference
A delegation from the SDSMA including Drs. Mary Carpenter, Robert Summerer and Barb Smith attended the AMA’s National Advocacy Conference in February and met with members of South Dakota's congressional delegation. The focus was on prescription drug abuse prevention, addiction treatment, residency training funding, unanticipated medical bills, gun violence and the Conrad 30 waiver program.   

District Visits
Dr. Dietrich said he enjoyed the district visits and expressed appreciation for the involvement in the SDSMA by all of the Policy Council members and so many physicians in the communities.

Elections 
SDSMA officers and AMA representatives elected for the coming year are.

  • President-Elect: Benjamin Aaker, MD
  • Vice President: Kara Dahl, MD
  • Secretary-Treasurer: Jessica Claussen, MD
  • AMA Alternate Delegate: Robert Allison, MD
An election was then held for three at-large members of the Board of Directors. Candidates for the three positions included Drs. Susan Anderson, Denise Hanisch, Jeffrey Johnson, Yorell Manon-Matos, Robert Marciano, and Stephan Miller. The policy Council voted by ballot with Drs. Anderson receiving majority votes. The Council then voted by a second and third ballot for the third position and Dr. Marciano was elected. 

Next, nominations were taken from the floor for Policy Council chair. A motion was made an seconded to nominate Dr. Mark Harlow and with no additional nominations, Dr. Harlow was elected upon voice vote. 

Committee on Ethics & Judicial Affairs Report
Dan Heinemann, MD, chair of CEJA, presented proposed bylaws revisions for review and consideration. The proposals, which were accepted by the Council, will do the following:

1. Grant the Board the authority to review issues and take a position on those that are important to the SDSMA and/or medical profession in situations in which there is not sufficient time to develop policy and/or convene the Policy Council.
2. Provide a definition for SDSMA policies, position papers and resolutions.
3. Remove the SDSMA from the practice of investigating complaints, due to the fact that the association is not a peer review organization and has no authority regarding practice matters.

Legislative Advocacy
Dean Krogman, SDSMA lobbyist, presented the association's 2019 legislative accomplishments. For more about the legislative accomplishments of the SDSMA, visit our page, At the Legislature

COPIC
Gerry Lewis-Jenkins, COO of COPIC, presented an update on COPIC's presence in South Dkaota and its relationship with the SDSMA to promote affordable malpractice insurance to South Dakota physicians. COPIC is nationally recognized for patient safety and risk management programs that support insureds. It is endorsed by the SDSMA as the medical professional liability carrier of choice for SDSMA members. COPIC insure physicians, allied health providers, medical practices, facilities and hospitals. 

Ad Hoc Committee on Pain Management and Prescription Drug Abuse
Dr. Dietrich, committee chair, presented the report from the Ad Hoc Committee on Pain Management and Prescription Drug Abuse which the Council approved. In continuation of work previously completed, the committee developed a proposed set of guidelines for prescribers to be used for the treatment and management of acute pain. These guidelines have been developed in collaboration with a number of other stakeholder organizations to include representatives from the dental, PA and nurse practitioner professions. See the white paper, Effective Management of Acute Pain.  

Ad Hoc Committee on Prescription Drug Pricing
Dr. Mary Carpenter presented the report from the Ad Hoc Committee on Prescription Drug Pricing. It was approved by the Council. To date, since its formation last year, the committee has reviewed the following: South Dakota statutes and rules related to prescription drugs; AMA and other organizational policies on the management and pricing of prescription drugs; and responsibilities, potential liabilities and ethical aspects of prescription drug management and pricing.  In follow up of last November's Council approval of a policy on Prescription Drug Pricing, the committee has reviewed the AMA model legislation on Drug Price Transparency. Dr. Carpenter reported that it is the committee's intent to draft legislation to include prescription drug benefit protections similar to what is proposed in the AMA model legislation. The committee will report back to the Policy Council in November.

Medical Orders for Scope of Treatment (MOST)
Mark East reported on MOST. In November, the Council voted to support MOST legislation, which was introduced and passed during the 2019 legislative session. MOST is an approach to end-of-life planning that helps obtain, document and honor patient treatment wishes. He presented a draft policy statement regarding MOST that the Council approved. Included in the statement is that the SDSMA will work with other organizations to advance the adoption and recognition of MOST.

AMA Policy Issues
Dr. Rob Allison, alternate delegate to the AMA, reported that he and AMA delegate Dr. Carpenter worked with SDSMA staff on the development of the following proposed policies upon their return from the AMA Interim Meeting: Comprehensive Breast Cancer Treatment, Breast Cancer Screening, Prevention of Opioid Overdoses, and Use of CDC Guidelines for Opioid Prescribing. Policies recently developed by the AMA have been used to provide guidance to the SDSMA in the formation and development of proposed policies. These are pertinent issues and ones that we have seen or will most likely see in the state legislature.  

Membership Open Forum Topics
Next, the Council held a discussion on Membership Open Forum topics from the forum earlier in the day.

Gun Violence
Gun violence was presented by Shannon Hoime, MD. The Council asked the SDSMA to form an ad hoc committee to work with the governor’s office to propose the development of gun safety educational material, public service announcements, as well as to develop policy, and present back to the November Policy Council meeting for potential action at the 2020 legislature. The Council voted that the committee initially investigate gun violence and how it pertains to SDSMA, to educate ourselves before moving forward with policy and legislation. 

MOC
MOC was presented by Lu Huber, MD. The Council directed the SDSMA to develop policy, then to potentially develop legislation that MOC should not be a certification requirement to be used in the credentialing process. 

Emergency Response and Disaster Management
Emergency Response and Disaster Management was presented by Matthew Owens, MD. The Council directed the SDSMA to advocate for SERV-SD to be included as part of new or renewal of licensure, and added that PDMP registration should be part of the new and renewal process. 

 
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