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2012 ACEP Council Meeting Resolutions Summary

Here are the resolutions as adopted by the Council and ACEP Board of Directors at the 2012 Council Meetings in Denver, CO.

Resolutions Not Discussed by the Council
Resolution 28 Study of the Effects of Psychiatric Patient Boarding

Resolutions Not Adopted (NA) or Withdrawn (W)
Resolution 6 Council Officers “Standing” in the ACEP Bylaws – Bylaws Amendment (NA)
Resolution 14 ACEP Principles for the US Health Care System: Individual and Physicians’ Rights (NA)
Resolution 15 Choosing Wisely Campaign (NA)
Resolution 16 Development of Guidelines for the Treatment of Chronic Pain (NA)
Resolution 19 Pediatric Emergency Preparedness Recognition (NA)
Resolution 20 Single-Payer Universal Health Insurance (NA)
Resolution 26 Patient Satisfaction Scores and Pain Management (NA)

Referred Resolutions
Resolution 13 Expert Witness Database and Reporting
Resolution 25 Maintenance of Licensure

Non-Bylaws Resolutions
Resolution 1 Commendation for Anita H. Hodson, MD, FACEP
Resolution 2 Commendation for Sandra M. Schneider, MD, FACEP
Resolution 3 In Memory of Michael B. Pipkin, MD
Resolution 4 In Memory of Michael P. Wainscott, MD, FACEP
Resolution 10 Commercial, Political, or Promotional Use of the ACEP Member Directory (as amended)
Resolution 11 Councillor Housing Block at Scientific Assembly
Resolution 12 Criteria for Inclusion of Organizations in the ACEP Council
Resolution 17 Ensuring ED Patient Access to Adequate and Appropriate Pain Treatment (as amended)
Resolution 18 Opposition to Routine Abscess Culturing (as amended)
Resolution 21 Support of Non-Punitive Sobering Centers and Community Recovery Services (as amended)
Resolution 22 Behavioral Health Patients in the Emergency Department (by substitution in lieu of Resolution 28)
Resolution 23 Free Standing Emergency Departments (by substitution)
Resolution 24 Joining Forces Roundtable (by substitution)
Resolution 27 Radiation Exposure in the Emergency Department Patient (by substitution)
Resolution 29 In Memory of Richard A. Midthun, MD, FACEP
Resolution 30 In Memory of John A. Marx, MD, FACEP
Resolution 31 Firearm Injury Prevention (as amended)
Resolution 32 Commendation for Robert C. Solomon, MD, FACEP

Bylaws Resolutions
Resolution 5 Alternate Councillors – Bylaws Amendment (as amended)

Council Standing Rules Resolutions
Does not require action by the Board of Directors
Resolution 7 Alternate Councillors
Resolution 8 Conflict of Interest Disclosure (as amended)
Resolution 9 Council Standing Rules Housekeeping Changes (as amended)
2012 Resolutions Adopted by the Council & Board of Directors

Resolution 1 Commendation for Anita H. Hodson, MD, FACEP
RESOLVED, That ACEP recognizes Anita H. Hodson, MD, FACEP, with a Council commendation for her extensive clinical career, dedication to resident education, and care of and advocacy for patients in the State of Delaware.

Resolution 2 Commendation for Sandra M. Schneider, MD, FACEP
RESOLVED, That the American College of Emergency Physicians commends Sandra M. Schneider, MD, FACEP, for her outstanding service, leadership, and commitment to the specialty of emergency medicine and to the College.

Resolution 3 In Memory of Michael B. Pipkin, MD
RESOLVED, That the American College of Emergency Physicians remembers with gratitude and honor the contributions made by Michael B. Pipkin, MD, as one of the leaders in emergency medicine; and be it further
RESOLVED, That national ACEP and the Maryland Chapter of ACEP extends to his wife, Pam, and his family, friends, and colleagues our deepest sympathy, our sense of loss, and our gratitude for his service to the specialty of emergency medicine.

Resolution 4 In Memory of Michael P. Wainscott, MD, FACEP
RESOLVED, That the American College of Emergency Physicians recognizes the dedication, professionalism, and contributions to emergency medicine, ACEP, the Council, the Texas Chapter, and the educational programs at Texas Tech and the University of Texas Southwestern Medical Schools; and be it further
RESOLVED, That ACEP extends to Dr. Wainscott’s family, friends, and colleagues our sympathy, great sense of sadness and loss, and our gratitude for having been able to share a part of his life.
Resolution 5 Alternate Councillors – Bylaws Amendment (as amended)
RESOLVED, That the ACEP Bylaws, Article VIII – Council, Section 1 – Composition of the Council, be amended to read:
“Each chartered chapter shall have a minimum of one councillor as representative of all of the members of such chartered chapter. There shall be allowed one additional councillor for each 100 members of the College in that chapter as shown by the membership rolls of the College on December 31 of the preceding year. However, a member holding memberships simultaneously in multiple chapters may be counted for purposes of councillor allotment in only one chapter.
EMRA shall be entitled to four councillors as representative of all of the members of EMRA, each of whom shall be a candidate or active member of the College.
AACEM shall be entitled to one councillor as representative of all of the members of AACEM, who shall be an active member of the College.
CORD shall be entitled to one councillor, who shall be an active member of the College, as representative of all of the members of CORD.
SAEM shall be entitled to one councillor, who shall be an active member of the College, as representative of all of the members of SAEM.
Each chartered section shall be entitled to one councillor as representative of all of the members of such chartered section if the number of section dues-paying and complimentary candidate members meets the minimum number established by the Board of Directors for the charter of that section based on the membership rolls of the College on December 31 of the preceding year.
A councillor representing one component body may not simultaneously represent another component body as a councillor or alternate councillor.
Each component body shall also elect or appoint alternate councillors who will be empowered to assume the rights and obligations of the sponsoring body's councillor at Council meetings at which such councillor is not available to participate. An alternate councillor representing one component body may not simultaneously represent another component body as a councillor or alternate councillor.
Councillors shall be certified by their sponsoring body to the Council secretary on a date no less than 60 days before the annual meeting.”
Resolutions Adopted by the 2012 Council & Board of Directors

Resolution 10 Commercial, Political, or Promotional Use of the ACEP Member Directory (as amended)
RESOLVED, That the Board of Directors adopt, implement, and present to the 2013 Council a privacy policy regarding the use of the Member Directory.

Resolution 11 Councillor Housing Block at Scientific Assembly
RESOLVED, That ACEP provide a block of rooms to be secured at the Scientific Assembly hotels within ACEP’s entire room block, closest to the headquarters hotel, to be made available to councillors up to 60 days prior to the Council meeting.

Resolution 12 Criteria for Inclusion of Organizations in the ACEP Council
RESOLVED, That the ACEP Council, through the Council Steering Committee, develop explicit criteria for the inclusion of additional organizations as component bodies of the ACEP Council; and be it further
RESOLVED, That the Council Steering Committee report these criteria for review and discussion to the 2013 ACEP Council no later than six weeks prior to the deadline for submission of regular resolutions.

Resolution 17 Ensuring ED Patient Access to Adequate and Appropriate Pain Treatment (as amended)
RESOLVED, That ACEP support each state chapter having the autonomy to establish guidelines or protocols for pain management of emergency department patients; and be it further
RESOLVED, That ACEP support the development of evidence-based, coordinated pain treatment guidelines, promoting adequate pain control, health care access, and flexibility for physician clinical judgment; and be it further
RESOLVED, That ACEP oppose non-evidence based public or private limits on prescribing opiates, mandatory opioid related documentation, and mandatory opioid related CME; and be it further
RESOLVED, That ACEP work with government and regulatory bodies on the creation of evidence-supported guidelines for responsible emergency physician prescribing that takes into consideration lack of access while respecting the uniqueness of every individual doctor-patient encounter

Resolution 18 Opposition to Routine Abscess Culturing (as amended)
RESOLVED, That ACEP recognizes the treating emergency physician as the clinician most appropriate to determine the necessity of antibiotic therapy and/or cultures in the management of abscesses in emergency department patients; and be it further
RESOLVED, That ACEP oppose the recommendation and/or requirement that all abscesses with cellulitis treated with antibiotics be cultured; and be it further
RESOLVED, That ACEP oppose federal or state legislation and/or regulation that require an attending physician to be the person who contacts and notifies patients of positive cultures.

Resolution 21 Support of Non-Punitive Sobering Centers and Community Recovery Services (as amended)
RESOLVED, That ACEP explore the development of sobering centers, identify medical and professional needs for these community centers, and promulgate efforts to appropriately support the development of these entities in our communities.

Resolution 22 Behavioral Health Patients in the Emergency Department (by substitution)
RESOLVED, That ACEP convene a work group of appropriate stakeholders to explore and identify additional resources, technologies, and best practices that promote quality patient care for timely evaluation and disposition of behavioral health patients.
RESOLVED, That a report from the work group on behavioral health care be delivered to the 2013 ACEP Council.

Resolution 23 Free Standing Emergency Departments (by substitution)
RESOLVED, That ACEP study the emergence and proliferation of free-standing EDs and facilities advertising emergency care including: applicable federal and state regulatory and accreditation issues, the potential impact on the emergency medicine workforce, the potential fiscal impact on hospital-based EDs, and provide informational resources to the membership.
Resolutions Adopted by the 2012 Council Requiring Board Action

Resolution 24 Joining Forces Roundtable (by substitution)

RESOLVED, That ACEP collaborate with other professional societies, the Department of Veterans Affairs, and the Department of Defense to share educational resources and research opportunities related to the treatment and referral options in the management of patients suffering the acute sequelae of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) that present to the ED.

Resolution 27 Radiation Exposure in the Emergency Department Patient (by substitution)
RESOLVED, That ACEP work with appropriate stakeholders to promulgate techniques to minimize radiation exposure.

Resolution 29 In Memory of Richard A. Midthun, MD, FACEP
RESOLVED, That the American College of Emergency Physicians remembers with gratitude and honor the contributions and service of Richard A Midthun, MD, FACEP; and be it further
RESOLVED, That the American College of Emergency Physicians and CAL/ACEP extend to his wife, Sue Midthun and his daughter, Lauren, his family, friends and colleagues our deepest sympathy, our sense of loss, and our gratitude for his service to the specialty of emergency medicine.

Resolution 30 In Memory of John A. Marx, MD, FACEP
RESOLVED, That the American College of Emergency Physicians recognizes John Andrew Marx, MD, FACEP for his outstanding dedication, professionalism, and contributions to emergency medicine, ACEP, the North Carolina and Colorado Chapters, and the educational programs at Carolinas Medical Center and the Denver Affiliated Residency in Emergency Medicine; and be it further
RESOLVED, That ACEP extends to Dr. Marx's family, friends, and colleagues our sympathy, tremendous sense of sadness and loss, and our gratitude for having been able to share and embrace the life of a man who embodied humility, greatness and a love of humanity.

Resolution 31 Firearm Injury Prevention (as amended)
RESOLVED, That ACEP reaffirm its commitment against gun violence including advocating for public and private funding to study firearm violence prevention.

Resolution 32 Commendation for Robert C. Solomon, MD, FACEP
RESOLVED, That the American College of Emergency Physicians commends Robert C. Solomon, MD, FACEP, for his exemplary service, leadership, and commitment to the specialty of emergency medicine and to the College.

 
ACEP Slams "Blame the Patient" Trend

Data From Massachusetts and South Carolina
On Emergency Patients Do Not Add Up

Washington, DC — Aiming to stop a trend in which emergency patients are blamed for the nation’s high health care costs, Dr. Sandra Schneider, president of the American College of Emergency Physicians (ACEP), today issued the following statement:

“We are disturbed by reports coming from Massachusetts and South Carolina that suggest emergency patients are responsible for the high cost of health care.  Emergency care amounts to only 3 percent of all the health care spending each year in the United States.  Focusing on emergency care as a source of waste in the health care system is counterproductive, as are efforts to keep a small subset of emergency patients out of the ER.

“Most distressing is the rhetoric in South Carolina directed at Medicaid patients, who have been characterized as ‘abusers’ of the health care system.  Medicaid patients are usually the most vulnerable members of society because of poverty, illness or both.  These are patients who need the most help, not the least.  A legislative effort in South Carolina to keep these patients out of the emergency department is built on incorrect and discredited data, as well as quotes by ACEP member Dr. William Gerard that were taken out of context and used without his permission.  There is also no indication that it would actually save the state money, though it would accomplish the goal of discouraging sick people from seeking medical care they desperately need.  It’s very bad medicine.

“Studies show that most emergency patients classified as frequent users – who make up only 8 percent of all emergency patients – have complex physical and mental health problems and a usual source of medical care outside the ER.  The Robert Wood Johnson Foundation reported in 2009 that these patients use the emergency department as ‘a supplement rather than a substitute’ for other medical care.

“Another target, non-urgent emergency patients, actually comprise less than 8 percent of the nearly 124 million emergency patients who seek care every year, according to the Centers for Disease Control and Prevention.  But the CDC points out that non-urgent does not mean unnecessary, as these patients require medical treatment in 2 to 24 hours.  ACEP worked for 17 years for passage of a prudent layperson standard to require health insurance plans to base coverage of emergency care on a patient’s symptoms, not the final diagnosis.  Last year’s health care reform legislation applies this standard to virtually all health plans.  Patients should not be diagnosing themselves.

“Considering that two-thirds of all emergency visits occur after normal business hours, most of these patients have no place to turn for care other than the ER.  The Robert Wood Johnson Foundation cast doubt on the idea that diverting non-urgent patients from the emergency department ‘to other settings would produce significant cost savings.’”

In addition, Dr. Schneider said the “Report on Frequent Users of Hospital Emergency Departments in South Carolina” is inaccurate when it says the proportion of non-urgent visits has increased nationwide.   The percentage of nonurgent patients actually has declined for 3 years to less than 8 percent in 2007, according to the CDC.

ACEP is a national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

 
CMS Relaxes Anesthesia Guidelines

CMS Relaxes Anesthesia Guidelines – Message from ACEP President

One of the core competencies of an emergency physician is procedural sedation. Our clinical policies have outlined the evidence that we are skilled in the area of analgesia, sedation, and emergency airway management.

The Centers for Medicare & Medicaid Services (CMS) has revised its interpretive guidelines for anesthesia services. Hospitals are to use these guidelines in developing their individual credentialing policies. These guidelines and their FAQs note that "...emergency medicine-trained physicians have very specific skill sets to manage airways and ventilation that is necessary to provide patient rescue. Therefore, these practitioners are uniquely qualified to provide all levels of analgesia/sedation and anesthesia (moderate to deep to general)."

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Emergency Medicine Action Fund Announced

Emergency Medicine Action Fund Announced
New grassroots effort aims to influence health care reform’s regulatory implementation.

By Nancy Calaway, ACEP Communications Manager

With changes in the health care system already underway, a new initiative is looking to positively impact the regulations that will be written and implemented under this sweeping reform. The Emergency Medicine Action Fund, launched by ACEP in February, will pool contributions from individual emergency physicians and groups, chapters, and anyone else interested in advancing emergency care to provide financial support for advocacy activities in the regulatory arena.

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