Counsel: Medical board wrong on role of assistants

By Cy Ryan (contact)

Wednesday, Nov. 18, 2009 | 2 a.m.

The Legislature’s chief attorney says allowing medical assistants to administer dangerous drugs under a doctor’s supervision — a practice the medical board recently endorsed and which could be set forth in a proposed regulation — violates state law.

In a legal opinion addressed to Douglas Cooper, interim executive director of the medical board, legislative counsel Brenda Erdoes said state law permits 18 categories of persons to possess and administer dangerous drugs. Medical assistants are not among them.

In addition, Erdoes said the practice appears to be in conflict with other sections of the law on delegation of medical tasks. The regulation allows a doctor or a physician assistant to delegate “medical tasks” to medical assistants as long as they’re supervised. Erdoes said the term “medical task” could include any work a doctor or physician assistant would perform on a patient.

That conflicts with the law, which requires licensing of persons, such as nurses and practical nurses, who perform “medical tasks.”

The medical board met Nov. 6, before Erdoes issued her opinion, to consider the issue. Board officials said they anticipated there would be problems with their reading of the law.

The board took up the issue after officials discovered medical assistants were administering drugs, including Botox, without physician oversight.

Neither Cooper nor Dr. Charles Held, president of the board, could be reached for comment.

If the board of medical examiners continues to push its regulation, Erdoes said she would present her opinion to the Legislative Commission or its Subcommittee to Review Regulations, which must approve the final draft of any new regulation.

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Nevada doesn’t intend to slow its negotiations with Utah over dividing water in Snake Valley in eastern Nevada, despite the Utah governor’s suggestion this week that the states should proceed slowly in their talks.

“As far as Nevada is concerned, we are moving full-steam ahead,” said Allen Biaggi, director of the state Department of Conservation and Natural Resources and a member of the two-state negotiating committee. He said he hopes to have final recommendations from the committee by the end of November or early December.

The Southern Nevada Water Authority is seeking 40,000 acre-feet of water from Snake Valley, on the Nevada-Utah line. Utah Gov. Gary Herbert said Monday there is no reason for the states to rush into a deal dividing the water.

Gov. Jim Gibbons said Tuesday that he wants to make sure Nevada gets its fair share and that “may take time.”

Biaggi said the state has not made a decision on whether to appeal a district judge’s ruling that would stop the authority from pumping 18,775 acre-feet of water a year from other portions of rural Nevada. The water authority board meets Thursday to officially decide whether to appeal District Judge Norman Robinson’s decision to the Nevada Supreme Court.

Robinson ruled that the decision of State Engineer Tracy Taylor to grant the rights to the water authority in Cave, Dry Lake and Delamar valleys was arbitrary. He said Taylor failed to provide evidence of how the future water needs in the area would be met.

Scott Huntley, public information manager for the authority, said there are numerous grounds for appeal.

The tentative agreement on Snake Valley has the two states dividing 132,000 acre-feet of water per year. One acre-foot is about the same amount of water the average Las Vegas Valley home uses in two years.

After negotiating in secret for several years, the two-state committee opened it up for public comment.