Ala. Admin. Code r. 540-X-12-.03.01 - Application For A Qualified Alabama Controlled Substances Registration Certificate (QACSC)
An applicant for a Qualified Alabama Controlled Substances Certificate shall disclose whether:
(1) Applicant's privilege for 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.
(2)
Applicant has ever been arrested for, cited for, charged with, or convicted of
any crime, offense, or violation of any law, felony, or misdemeanor, including,
but not limited to, offenses related to the practice of medicine, state or
federal controlled substances laws, or driving under the influence
(DUI).
(3) Any Federal Drug
Enforcement Administration registration ever held by applicant has ever been
suspended, restricted, revoked, or voluntarily surrendered while under
investigation.
(4) Applicant's
staff privileges at any hospitals have ever been suspended, restricted,
revoked, or disciplined in any manner for any reason related to the prescribing
or administering of controlled substances.
(5) Applicant is currently suffering from any
condition that impairs their judgment or that would otherwise adversely affect
their ability to practice as a physician assistant in a competent, ethical, and
professional manner.
(6) Within the
last five years, applicant has raised the issue of any physical or psychiatric
health disorder as a defense, mitigation, or explanation for their actions
during any administrative or judicial proceeding or investigation; any inquiry
or other proceeding; or any proposed termination by an educational institution;
employer; government agency; professional organization; or licensing
authority.
(7) Applicant has read
and understood this statement and attested to their understanding: The Board
recognizes that licensees encounter potentially impairing health conditions
just as their patients and other health care providers do, including
psychiatric or physical illnesses which may impact cognition, as well as
substance use disorders. The Board expects its licensees to address their
health concerns, both mental and physical, in a timely manner to ensure patient
safety. Licensees should seek appropriate medical care and should limit their
practice when appropriate and as needed. The Board encourages licensees to
utilize the services of the Alabama Professionals Health Program, an advocacy
organization dedicated to improving the health and wellness of healthcare
professionals in a confidential manner. The failure to adequately address a
health condition, where the licensee is unable to practice as a physician
assistant with reasonable skill and safety to patients, can result in the Board
taking action against the license to practice as a physician
assistant.
Notes
Author: Alabama Board of Medical Examiners
Statutory Authority: Code of Ala. 1975, § 20-2-60, et. seq.; Act 2009-489.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
An applicant for a Qualified Alabama Controlled Substances Certificate shall disclose whether:
(1) Applicant's privilege for 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.
(2) Applicant has ever been arrested for, cited for, charged with, or convicted of any crime, offense, or violation of any law, felony, or misdemeanor, including, but not limited to, offenses related to the practice of medicine, state or federal controlled substances laws, or driving under the influence (DUI).
(3) Any Federal Drug Enforcement Administration registration ever held by applicant has ever been suspended, restricted, revoked, or voluntarily surrendered while under investigation.
(4) Applicant's staff privileges at any hospitals have ever been suspended, restricted, revoked, or disciplined in any manner for any reason related to the prescribing or administering of controlled substances.
(5) Applicant is currently suffering from any condition that impairs their judgment or that would otherwise adversely affect their ability to practice as a physician assistant in a competent, ethical, and professional manner.
(6) Within the last five years, applicant has raised the issue of any physical or psychiatric health disorder as a defense, mitigation, or explanation for their actions during any administrative or judicial proceeding or investigation; any inquiry or other proceeding; or any proposed termination by an educational institution; employer; government agency; professional organization; or licensing authority.
(7) Applicant has read and understood this statement and attested to their understanding: The Board recognizes that licensees encounter potentially impairing health conditions just as their patients and other health care providers do, including psychiatric or physical illnesses which may impact cognition, as well as substance use disorders. The Board expects its licensees to address their health concerns, both mental and physical, in a timely manner to ensure patient safety. Licensees should seek appropriate medical care and should limit their practice when appropriate and as needed. The Board encourages licensees to utilize the services of the Alabama Professionals Health Program, an advocacy organization dedicated to improving the health and wellness of healthcare professionals in a confidential manner. The failure to adequately address a health condition, where the licensee is unable to practice as a physician assistant with reasonable skill and safety to patients, can result in the Board taking action against the license to practice as a physician assistant.
Notes
Author: Alabama Board of Medical Examiners
Statutory Authority: Code of Ala. 1975, § 20-2-60, et. seq.; Act 2009-489.