Ala. Admin. Code r. 540-X-12-.05.01

Current through Register Vol. 43, No. 1, October 31, 2024

Section 540-X-12-.05.01 - Renewal of a Qualified Alabama Controlled Substances Registration Certificate (QACSC) - Required Disclosures

(1) The applicant shall disclose whether:

(a) Applicant's privilege for dispensing or prescribing controlled substances has ever been suspended, restricted, voluntarily surrendered while under investigation, revoked, or disciplined in any manner in any state or U.S. territory.

(b) Applicant has ever been convicted of any state or federal crime relating to any controlled substance.

(c) Any Federal Drug Enforcement Administration registration ever held by applicant has ever been suspended, restricted, revoked, or voluntarily surrendered while under investigation.

(d) Applicant's privileges at any hospitals have ever been suspended, restricted, revoked, or disciplined in any manner for any reason related to the prescribing or dispensing of controlled substances.

(e) Applicant is currently engaged in the excessive use of alcohol, controlled substances, or the use of illegal drugs, or receiving any therapy or treatment for alcohol or drug use, sexual boundary issues or mental health issues.

1. If applicant is an anonymous participant in the Alabama Professionals Health Program and is in compliance with their assistance agreement, they may answer "No" to this question. Such answer for this purpose will not be deemed upon certification as providing false information to the Alabama Board of Medical Examiners.

2. The term "currently" as it is used in paragraph (5) above does not mean on the day of, or even in the weeks or months preceding the completion of the application. Rather, it means recently enough so that the condition referred to may have an ongoing impact on one's functioning as an assistant to physicians within the last two years.

3. Applicant shall initial certifying an understanding of a statement of the duty as a licensee to address any such condition, which states as follows:

IMPORTANT: The Board recognizes that licensees encounter health conditions, including those involving mental health and substance use disorders, just as their patients and other health care providers do. The Board expects its licensees to address their health concerns and ensure patient safety. Options include anonymously self referring to the Alabama Professionals Health Program (334-954-2596), a physician advocacy organization dedicated to improving the health and wellness of medical professionals in a confidential manner. The failure to adequately address a health condition, where the licensee is unable to practice medicine with reasonable skill and safety to patients, can result in the Board taking action against the QACSC and/or license to practice as a Physician Assistant.

Ala. Admin. Code r. 540-X-12-.05.01

Adopted by Alabama Administrative Monthly Volume XLI, Issue No. 03, December 30, 2022, eff. 2/13/2023.

Authors: Alabama Board of Medical Examiners

Statutory Authority:Code of Ala. 1975, 20-2-60, et seq.