LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH   Policy 303.07 Reporting Named or Alleged Licensees to Licensing Boards     PROCEDURES

Department's Third Party Administrator (TPA) and/or the defense counsel shall: Identify named/alleged licensee(s) prior to settlement and before reporting any apportioned amount to a respective licensing board. Inform the named/alleged licensee(s) of the reporting requirements and provide licensee(s) with a copy of this policy. Named/alleged licensee(s) shall be: Reviewed by County Counsel to determine involvement in the claim/lawsuit. Should it be determined that a named/alleged licensee(s) is not involved, County Counsel may request to have the named/alleged licensee(s) dismissed from the lawsuit. Provided with documentation demonstrating the allegation/naming within the claim/lawsuit. Afforded the opportunity to meet with Clinical Risk Management (CLRM) and defense counsel (when applicable) prior to roundtable meeting(s), and throughout the process to discuss the implications of the reporting requirements, and to be appraised on the status of the claim/lawsuit. If dismissal of a named/alleged licensee(s) is not a condition of settlement, the dismissed licensee(s) from a lawsuit prior to settlement, judgment, or arbitration award, shall not be reported to the National Practitioner Data Bank (NPDB). Dismissal is not reliant on how often the licensee(s) has involvement in the case. If factor for settlement is determined to be solely related to a system, legal, or economic issue, then all of the named/alleged licensee(s) shall be apportioned $0 of the settlement.  Licensee(s) shall not be reported to the respective licensing board or NPDB when apportioned $0 of the settlement. If factor for settlement is determined to be, in whole/in part, related to a medical malpractice issue, then the apportionment process shall commence. Apportionment Process: If factors for settlement were not system, legal or economic and The following are true: The settlement meets a reporting threshold; The settlement is within 10 business days of a decision; and Named/alleged licensees are subject to the reporting requirements. Then the TPA shall prepare the following copies: Clinical record(s); Complaint(s); County Counsel's determination on the factors for settlement; Relevant deposition summaries; Relevant deposition transcripts; and The Trial Counsel Report (TCR), including the Final Summary of Potentially Reportable Licensees. Exclude peer-review documents CLRM shall forward the documents received from TPA to the designated Program Manager. The designated Program Manager shall have 10 business days to review the documents and provide the following regarding each reportable licensee: Role Specific activities Relevant clarifying or explanatory statements/documents, as needed CLRM shall have 10 business days to return the documents and any additional information provided by the Program Manager to TPA. TPA shall forward the documents to the County’s apportionment consultant, an independent contractor with both medical and legal credentials. The consultant shall review the documents and renders a written opinion for the apportionment of liability within 10 business days and forward it to CLRM. CLRM shall forward the written opinion to the Program Manager.  If the Program Manager agrees with the apportionment recommendation, CLRM or the Program Manager shall notify each identified reportable licensee of the decision, including: The total amount of the settlement; and The amount attributed to each licensee.  Notification shall be: In person followed by written confirmation; By telephone followed by written confirmation; or Via fax, secure email, postal service, or certified mail to the last known address.  The Program Manager and licensee(s) shall have 30 business days to review and respond to the decision for apportionment recommendations greater than 0%. If the Program Manager and licensee(s) agree or do not dispute the recommendation: The recommendation shall be sent to CLRM who shall forward the decision(s) to TPA.     TPA shall prepare the appropriate documents to report licensee(s) to the respective board(s). A copy of the report shall be forwarded to CLRM, the Los Angeles County Department of Mental Health (DMH) Director/designee, the Program Manager, and any reported licensee(s). If the Program Manager or licensee(s) do not agree, they may provide additional clarifying information in writing to CLRM for dispute resolution within 30 business days. CLRM shall provide the documents to the apportionment consultant immediately upon receipt. The apportionment consultant shall have five (5) business days to review the documents and, if appropriate, modify the recommendation. The apportionment consultant's final recommendation shall be forwarded to the Program Manager and TPA. CLRM shall forward the final recommendation to each licensee. If the Program Manager and/or licensee(s) do not agree with the apportionment consultant's final recommendation, they shall be afforded the opportunity to an appeal meeting with the DMH Director/designee to provide additional documents relevant to the apportionment decision, including explanations of systems issues within 15 business days. In the event the DMH Director/designee is privy to peer review information related to the case, a designee shall be appointed to act for the DMH Director/designee in the dispute resolution. The DMH Director/designee shall make a determination and inform the licensee, Program Manager, and CLRM within 15 business days. If the DMH Director/designee's determination modifies the initial or final apportionment consultant's recommendation to increase the apportionment for any licensee, that licensee shall be notified and afforded an opportunity to meet with the DMH Director/designee to provide additional documents relevant to the apportionment decision, including explanations of systems issues within 15 business days. Decisions by the DMH Director/designee shall be final once the above dispute resolution processes are completed. Final decisions shall be provided to CLRM who shall forward the decisions to TPA.  The amount of settlement apportioned to a potential reportable licensee(s), shall be reported to the appropriate licensing board. The TPA shall prepare the appropriate documents to report said licensee(s) to the respective licensing board.  A copy of the report shall be forwarded to CLRM and any licensee(s) reported by the TPA. Reporting to the Licensing Boards: The licensing board of the named/alleged licensee(s) shall be notified by the Department’s TPA when the apportionment decision, settlement, arbitration award, and/or judgment exceeds the reportable limits noted below.  Named/alleged licensee(s) may provide a written statement to accompany the report to the licensing board within 7 days of the final apportionment decision.  The report shall be submitted to the licensing board no later than 30 days after the settlement is approved by the Board of Supervisors.  The current reportable limits for each licensing board are any amount above the following limits:            $30,000        Medical Board of California            $30,000        Board of Podiatric Medicine            $30,000        Physician Assistant Board            $30,000        Osteopathic Medical Board            $10,000        Board of Behavioral Sciences            $10,000        Board of Psychology            $10,000        Dental Board of California            $10,000        Board of Registered Nursing            $10,000        Veterinary Medical Board            $3,000          State Board of Chiropractic Examiners                       $3,000          Board of Vocational Nursing and Psychiatric Technicians            $3,000          State Board of Optometry            $3,000          Physical Therapy Board of California                       $3,000          Pharmacy Board            $3,000          Respiratory Care Board