Welcome to this week's edition of Health Alert. The Health Alert is transmitted on Monday of each week (unless there is a public holiday on Monday).
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The DLA Phillips Fox Health Team
New South Wales. Administrative Decisions Tribunal
Privacy – information protection principle – personal information –Health information – health privacy principle – collection – security – access – accuracy – disclosure
This case concerns whether NK, an employee of a hospital operated by North Sydney Central Area Health Service ('respondent'), should be entitled to damages concerning alleged breaches of his privacy pursuant to the Health Records and Information Privacy Act 2002 and the Privacy and Personal Information Protection Act 1998 ('Privacy Act').
On 28 August 2008 NK presented at the hospital's Emergency Department seeking help in relation to anxiety and stress concerning his workplace experiences. He had experienced thoughts of harm to others, but only towards one employee, Nurse M. Another nurse, Nurse W, conducted an assessment of NK. He complains that his medical records were disclosed and used by the respondent without authority, that his personnel record was inaccurate and was also used and disclosed inappropriately to third parties.
The respondent was found to be in breach of various Health Privacy Principles and Information Privacy Principles including due to the disclosure and use of information by Nurse W, and the failure for the Human Resources Manager to take reasonable steps to confirm the accuracy, relevancy or completeness of the information. Member Montgomery considered that damages should be awarded as NK suffered significant loss or damage due to the respondent's conduct. While there were several separate acts by officers of the respondent, each related to the actions of Nurse W and should be treated as related acts for the purpose of section 55 of the Privacy Act and thus only one amount of damages should be provided (maximum of $40,000).
Further submissions are to be heard in relation to further Orders.
Victoria. Coroners Court
This Coronial Inquest concerned the death of a 55 year old man on 21 September 2007 as a result of multiple injuries sustained in an accidental fall.
The man had a history of depression and alcohol dependence, erratic behaviour and suicide attempts. During a suicide attempt in January 2007 he was successfully negotiated to move to a place of safety, however due to his level of intoxication he lost his balance and fell, sustaining serious injuries to both legs. He spent three months in Intensive Care, three months in a ward and then underwent rehabilitation. He was later discharged on 4 September 2007 to a special accommodation home. This discharge was of issue in the inquest.
Coroner Peter White considered that the arrangements to discharge the man from psychiatric care were premature and made without full consideration of his history of depressive conduct. The psychiatric staff was not fully appraised of his psychiatric history including previous admissions and suicide attempts. The Coroner noted that whilst the conduct was viewed as being in connection with the man's alcoholism, its repetition suggested the need for a more comprehensive management than what was offered.
The Coroner recommended the hospital review its procedures for assessing the suitability of discharging patients with multifaceted presentations including ensuring all patients suffering from mental illness receive full medical appraisal based on a complete history and consideration of treating specialist's reports. If a review indicates release is appropriate, he also recommended that the receiving Community Mental Health Service be given a period of notice of at least two weeks.
This Coronial Inquest concerned the death of a 34 year old man on 17 June 2006 who died as a result of suicide.
At the time his death, the man had a fifteen year history of suffering from chronic paranoid schizophrenia, chronic poly-substance abuse and suicide attempts. At the beginning of 2006 he was on a Community Treatment Order ('CTO'). He had twice been placed involuntarily at a Psychiatric Unit in March and May 2006. After his discharge on 5 May 2006 he was placed on a six month CTO.
The State Coroner, Judge Coate, considered that the decision to discharge the man on a CTO on 5 May 2006 and Treatment Service multidisciplinary support was a reasonable decision in the circumstances and of the reality of what options were available to the treating team. She also considered that ongoing risk assessments were being made and there was no evidence that a failure to make such assessments could be causally linked to the man's death. In the proceeding, the treating Psychiatric Unit conceded that it had inadequate documentation of the patient's mental state examinations to enable an understanding and tracking of his condition and dangers. An internal review suggested that such documentation must be improved by providing an electronic medical record including risk assessments for self harming behaviour leading to suicide risk. The Coroner noted that she was satisfied that the Psychiatric Unit had taken appropriate action to address the inadequacy of documentation in this case.
National Health Act (Pharmaceutical Benefits - Early Supply) Amendment November 2010 - Specification Under Subsection 84AAA(2) (No. PB 106 of 2010) - F2010L02895 - Health - This instrument amends the National Health Act (Pharmaceutical Benefits - Early Supply) - specification under subsection 84AAA(2) Instrument 2009 (No. PB 30 of 2009) that lists the medicines for which Pharmaceutical Benefits Scheme Safety Net entitlements will not apply when the next supply of the same medicine is obtained within 20 days.
Private Health Insurance (Lifetime Health Cover) Amendment Rules 2010 - F2010L02896 - Health - These Rules amend the Private Health Insurance (Lifetime Health Cover) Rules 2007 to update the references to reflect the new name of the Department of Sustainability, Environment, Water, Population and Communities.
National Health Act 1953 - Amendment declaration under subsections 85(2) and 85(2AA) - Amendment determination under subsection 85(2A) - drugs and medicinal preparations (No. PB 95 of 2010) - F2010L02854 - Health - This instrument declares and determines additions and changes to the list of drugs and preparations available as pharmaceutical benefits and the circumstances in which they may be prescribed.
National Health Act 1953 - Amendment determination under paragraph 98C(1)(b) - conditions (No. PB 99 of 2010) - F2010L02858 - Health - This Determination provides for changes to the conditions subject to which payments will be made by the Commonwealth in respect of the supply of pharmaceutical benefits by approved pharmacists and approved medical practitioners.
National Health Act 1953 - Amendment determination under section 84AF - responsible persons (No. PB 97 of 2010) - F2010L02856 - Health - This instrument provides for additions and changes to the responsible persons for the brands of pharmaceutical items.
National Health Act 1953 - Amendment Determination under subsection 85AB(1) - Listed drugs on F1 or F2 (No. PB 107 of 2010) - F2010L02863 - Health - This Determination amends the National Health (Listed drugs on F1 or F2) Determination 2010 (No. PB 93 of 2010) and determines drugs on F1 for the purposes of the Pharmaceutical Benefits Scheme.
National Health Act 1953 - Amendment determination under subsections 85A(1) and (2) and 88(1C) - Prescription of pharmaceutical benefits by authorised optometrists (No. PB 98 of 2010) - F2010L02857 - Health - This Determination amends National Health Act 1953 - Determination under subsections 85A(1) and (2) and 88(1C) - Prescription of pharmaceutical benefits by authorised Optometrists (No. PB 11 of 2009) to provide for changes to listed drugs which may be prescribed by an approved optometrist.
National Health Act 1953 - Amendment determinations under sections 85, 85A and 88 - pharmaceutical benefits (No. PB 96 of 2010) - F2010L02855 - Health - This Determination amends the National Health Act 1953 - Determinations under sections 85, 85A and 88 - Pharmaceutical benefits (No. PB 68 of 2010) to provide for additions and changes to the names, forms and brands of listed drugs on the Pharmaceutical Benefits Scheme and the conditions for prescribing pharmaceutical benefits.
National Health Act 1953 - Amendment special arrangements under subsection 100(1) - Chemotherapy Pharmaceuticals Access Program (No. PB 105 of 2010) - F2010L02862 - Health - These Arrangements amend the National Health Act 1953 - Special Arrangements under subsection 100(1) - Chemotherapy Pharmaceuticals Access Program (No. PB 55 of 2009) to provide for changes to chemotherapy pharmaceuticals available at participating public hospitals to non-admitted patients, day-admitted patients or patients on discharge.
National Health Act 1953 - Determination under section 84AH - Exempt items (No. PB 100 of 2010) - F2010L02859 - Health - This Determination amends National Health Act 1953 - Determination under section 84AH - Exempt items (No. PB 58 of 2007) to add one drug which meets the exempt status of a pharmaceutical item which determines the exempt status of a pharmaceutical item which has a particular form and manner of administration listed on the Pharmaceutical Benefits Scheme and removes another.
National Health Act 1953 - Determinations under sections 93 and 93AA - Pharmaceutical benefits supplied by medical practitioners and authorised nurse practitioners (No. PB 103 of 2010) - F2010L02861 - Health - This Determination specifies the pharmaceutical benefits that can be obtained and supplied by medical practitioners and authorised nurse practitioners to patients for treatment.
National Health (Highly specialised drugs program for private hospitals) Special Arrangements Amendment Instrument 2010 (No. 3) (No. PB 102 of 2010) - F2010L02860 - Health - These Arrangements provide for changes to the highly specialised drugs made available to persons who are receiving treatment at private hospitals as non-admitted patients, day admitted patients or patients on discharge.
National Health (Highly specialised drugs program for public hospitals) Special Arrangements Amendment Instrument 2010 (No. 4) (No. PB 101 of 2010) - F2010L02866 - Health - These Arrangements provide for changes to highly specialised drugs available at public hospitals to non-admitted patients, day admitted patients or patients on discharge.
Private Health Insurance (Benefit Requirements) Amendment Rules 2010 (No. 7A) - F2010L02894 - Health - This instrument amends the Private Health Insurance (Benefit Requirements) Rules 2010 to reflect changes in Medical Benefits Schedule item numbers which commence on 1 November 2010.
Private Health Insurance (Complying Product) Amendment Rules 2010 (No. 5) - F2010L02893 - Health - These Rules amend the Private Health Insurance (Complying Product) Rules 2010 and makes minor changes to the Principal Rules by increasing the amount for the nursing-home type patients contribution at public hospitals in Western Australia.
Therapeutic Goods (Medical Devices) Amendment Regulations 2010 (No. 3) - F2010L02787 - Health - These Regulations amend the Therapeutic Goods (Medical Devices) Regulations 2002 to allow reduced assessment fees relating to IVDs where, under specified circumstances, an abridged assessment can be carried out.
Health Insurance Amendment Regulations 2010 (No. 4) - F2010L02797 - Health - These Regulations amend the Health Insurance Regulations 1975 to implement a 2010-11 Budget measure to recognise Addiction Medicine, Sexual Health Medicine and Sport and Exercise Medicine as medical specialties.
Health Insurance (Diagnostic Imaging Services Table) Regulations 2010 - F2010L02765 - Health - These Regulations repeal the Health Insurance (Diagnostic Imaging Services Table) Regulations 2009 and prescribes a new table for the 12 month period commencing 1 November 2010.
Health Insurance (Pathology Services Table) Regulations 2010 - F2010L02766 - Health These Regulations repeal the Health Insurance (Pathology Services Table) Regulations 2009 and prescribe a new table for the 12 month period commencing 1 November 2010.
Health Insurance (Positron Emission Tomography) Facilities Determination 2010 (No. 2) - F2010L02816 - Health - This Determination revokes and replaces the Health Insurance (Positron Emission Tomography) Facilities Determination 2010 to allow for continued eligibility of Medicare benefits for positron emission tomography services.
Consent to Medical Treatment and Palliative Care (Termination of Pregnancy) Amendment Bill 2010 - private member's Bill, sponsored by Dennis Hood MLC - second reading speech on 27 October 2010.
Perinatal Registry Amendment Act 2010 No. 32 - assented to on 4 November 2010 (Click on link to Sessional version at bottom of page)
Australia. Department of Health & Ageing
04 November 2010 - Young Aboriginal Men Set Pace For New York City Marathon - Four young men from remote parts of Northern Australia are to become the nation's first Aboriginal marathon team to compete in the world-famous New York City Marathon on 7 November.
01 November 2010 - MyHospitals to Launch with Public Hospitals from all States - The MyHospitals website will be online in December with information about public hospitals in all states and territories – including Western Australia.
01 November 2010 - Nurses and Midwives Access Medicare and the PBS - Nurse Practitioners and Midwives will from 1 November be able to access the Medicare Benefits Schedule and provide Pharmaceutical Benefits Scheme medicines in the community.
29 October 2010 - Next Steps Taken to Establish Medicare Locals - The Australian Government has taken an important step in establishing a network of primary health care organisations – Medicare Locals – by releasing a discussion paper on their planned roles, functions and governance.
Private Health Insurance Circulars
Have your say about the protection of aged care residents' savings - In April the Australian Government announced it would increase protections for the more than $9 billion of residents' savings held in aged care accommodation bonds. The Enhanced Prudential Regulation of Accommodation Bonds Issues Paper provides information about these measures and explains how you can have your say during the consultation - 1 November 2010.
Australia. Pharmaceutical Benefits Scheme
New PBS Prescribers - Midwives and Nurse Practitioners - November 2010
Australia. Private Health Insurance Ombudsman
02 November 2010 - Quarterly Bulletin 56 - The bulletin for 1 July - 30 September 2010 is now online.
Australia. Professional Services Review
PSR Annual Report 2009 – 2010. Copy available Here
Australia. Therapeutic Goods Administration
TGA looks to improve regulatory framework for medical devices (media release, The Hon Catherine King MP, Parliamentary Secretary for Health and Ageing)
Another milestone for prescription medicine reforms (media release, The Hon Catherine King MP, Parliamentary Secretary for Health and Ageing)
TGA approved terminology for medicines (updated 3 forms)
Application form for proposing a botanical name for a herb (AHN)
Application form for proposing a herbal substance name (AHS)
Application form for proposing a herbal component name (HCN)
Pre-submission planning form (updated)
Information for sponsors completing the pre-submission planning form (new)
Transitional prescription medicine streamlined submission process (new)
Transitional mandatory requirements for effective submissions (new)
Section 23 instruments
Australia. National e-Health Transition Authority
4 November 2010. NEHTA's Annual Report 2009-10 is now available and can be downloaded from NEHTA's website via http://www.nehta.gov.au/publications/nehta-publications.
Australia. National Health & Medical Research Council
Australian Researcher in International Virus Research 5 NOVEMBER 2010 - Minister for Mental Health and Ageing Mark Butler, and Member for Fraser Dr Andrew Leigh today announced that Professor Suresh Mahalingam, a University of Canberra Professor, has been awarded a National Health and Medical Research Council - European Union grant. » View Media Release
Assassin's tricks revealed in Nature today 1 NOVEMBER 2010 - An NHMRC supported project is featured in the latest issue of science journal Nature. A team of Melbourne and London researchers have shown how a protein called perforin punches holes in, and kills, rogue cells in our bodies. » View Media Release
Australian Competition & Consumer Commission
ACCC conditionally authorises generic medicines code - The ACCC has granted conditional authorisation to the Generic Medicines Industry Association's Co. Issued: 3 November 2010 Release # NR 242/10
Australian Capital Territory. Department of Health
Public hospital emergency waiting times improve Katy Gallagher, MLA 5 November 2010
$340,000 to support local GPs Katy Gallagher, MLA 3 November 2010
Donated artwork helps cancer patients Katy Gallagher, MLA 1 November 2010
Launch of home telemonitoring for patients with chronic disease Katy Gallagher, MLA 29 October 2010
Health Services Performance Report (5 November 2010) - See the latest quarterly report on the performance of the public health services provided by ACT Health.
Local Health Network consultation (3 November 2010) - ACT Health has commenced community consultation on a new Local Health Network for the ACT.
$340,000 to support local GPs (3 November 2010) - ACT Health has just announced the successful applicants for Round 2 of its GP Development Fund.
Chronic disease home telemonitoring (29 October 2010) - A new cutting-edge service helps patients with heart failure, chronic lung disease or diabetes.
Clinical Repository Implementation Planning Study - A clinical repository is the first step on the journey to a shared electronic health record and will move the ACT from point to point exchange of clinical information to a shared information model. ACT Health-Wide - Information Services BranchCED10-030 Clinical Repository Implementation Planning Study (PDF File 5951)
New South Wales. Department of Health
Tracheostomy Clinical Management (ADULT) PD2010_066 02/11/201
MBS Item Number Update for NSW Health's Fees Procedures Manual IB2010_056 01/11/2010
Queensland. Department of Health
04/11/2010 RADIATION ONCOLOGY SERVICES ONE STEP CLOSER
South Australia. Department of Health
Tasmania. Department of Health & Human Services
Victoria. Department of Health
Information about the register of convictions - As of 1 July 2010, details of offences under the Victorian Food Act 1984 or the regulations involving the conviction of a person by a court after that date are publicly available on the Department of Health website. This is in accordance with section 53D of the Food Act, which requires the Secretary of the Department of Health to keep a register of convictions for offences under the Food Act or the regulations, and section 53E, which requires that register to be published on a Department of Health website. The Act requires that each conviction is to be included in the register for 12 consecutive months. Ordinarily, a conviction under the Act is dealt with in open court - typically in the Magistrates' Court. The purpose of the register is to increase the opportunities for a court's decision to become more widely known. This will make information about non-compliance with the Act more readily available to the public.
Nursing & Midwifery Board of Australia consultation on registration standards for Nurse Practitioners - The NMBA is seeking input by the 26th November 2010 from key stakeholders on registration standards and guidelines for nurse practitioners http://www.nursingmidwiferyboard.gov.au/
Western Australia. Department of Health
2 November 2010 - Sentinel event report provides opportunities for learning
30 October 2010 Hames - Hospital information at the click of a mouse
Western Australia. Office of Health Review
Office of Health Review 2009/10 Annual Report - 29/09/2010 The Office of Health Review 2009/10 Annual Report was recently tabled in State Parliament. Please use the link below to view. Click here for attachment.
New Zealand. Ministry of Health
2 November : Proposed Amendments to Regulations under the Medicines Act 1981 - Report on Submissions and Final Decisions - This publication summarises feedback on each proposal, and the Government's final decisions on changes to regulations made under the Medicines Act.
1 November: Food and Nutrition Guidelines for Healthy Children and Young People (Aged 2-18 Years): A background paper - Draft for Consultation Submissions are invited on this Draft for Consultation. It aims to provide up to date, evidence-informed food and nutrition related technical information for health practitioners working with children and young people (aged 2-18 years). Submissions close: 13 December 2010 at 5pm.
New Zealand. Medsafe
Consultation - Outcome of the consultation on proposed updates to the New Zealand Good Clinical Research Practice Guideline
New Zealand. Medical Council of New Zealand
An external audit of the Medical Council - In April this year, the United Kingdom based Council for Healthcare Regulatory Excellence (CHRE) undertook an audit of the Medical Council's policies and processes. The CHRE promotes the health and well-being of patients and the public in the regulation of health professionals. It also scrutinises and oversees the work of the nine UK regulatory bodies that set standards for training and conduct of health professionals. The audit has suggested that openness and transparency, together with public engagement are the two main areas for review by the Medical Council. - CHRE final report pdf. - CHRE report - Philip Pigou - TNS Qualitative research with key audiences Doctors and Stakeholders
Regular practice reviews and medical migration - Following consultation with the profession last year, we have decided to work with the Colleges to implement regular practice reviews (RPR) for all doctors. The RPR is a formative process that is a supportive and collegial review of a doctor's practice by peers, in a doctor's usual practice setting. - Fitness to practise & Medical migration - Joan Crawford
New Zealand. Human Rights Commission
Making Complaints – A Guide for Mental Health Service Users + Read more
United Kingdom. Department of Health
United States of America. Department of Health & Human Services
October 29, 2010 - HHS Announces New Competitive "Early Innovator" Grants for States that Lead the Race to Develop IT Systems for State Exchanges - The U.S. Department of Health and Human Services (HHS) today announced competitive funding opportunities for States to design and implement the Information Technology (IT) infrastructure needed to operate Health Insurance Exchanges. The Exchanges represent new competitive insurance marketplaces that will help Americans and small businesses purchase affordable private health insurance starting in 2014 and a strong IT infrastructure will be critical to their success. For the first time, funding will be directed to States that are willing and able to lead the race to develop IT systems. These systems can then be used as models by all States in their efforts to establish Exchanges.
Australian Medical Association
AMA submission to Health Workforce Australia - Clinical Supervisor Support Program 3 November 2010 - 4:00pm - The 2008 national partnership agreement on hospital and health workforce reform includes a specific component to expand clinical training supervision capacity and competence. $28 million has been set aside to expand clinical supervision capacity across the health professions. Health Workforce Australia (HWA) prepared a discussion paper to consider supervision across professions and the educational continuum from professional entry through to postgraduate and vocational training. The AMA prepared a submission to HWA on the discussion paper.
Traffic-related air pollution can trigger Asthma in children under five 31 October 2010 - 12:00pm - MJA Media Release - Children aged four and under are most at risk for asthma attacks from traffic-related air pollution, according to a study published in the Medical Journal of Australia. Gavin Pereira, epidemiologist at the University of Western Australia and CRC for Asthma and Airways, and co-authors conducted a study to determine whether changes in background ozone, nitrogen dioxide, carbon monoxide, and particulates increase the risk of hospital emergency department presentations for asthma among children.
Study challenges evidence on age of onset of self-injury in Australia 31 October 2010 - 12:00pm - MJA Media Release - The prevalence of self-injury in Australia is substantial and self-injury may begin at older ages than previously reported, according to an article in the Medical Journal of Australia. Self-injury is deliberate damage to the body without suicidal intent.
Reperfusion therapy reduces mortality rate from ST-segment-elevation myocardial infarction 31 October 2010 - 12:00pm - MJA Media Release -Timely reperfusion therapy in patients with acute ST-segment-elevation myocardial infarction (STEMI) greatly reduces the mortality rate associated with STEMI, according to an article in the Medical Journal of Australia. Professor Derek Chew, Professor of Cardiology at Flinders University and Regional Director of Cardiology at Flinders Medical Centre, Adelaide, and co-authors conducted a study to describe the contemporary management and outcomes of patients presenting with STEMI in Australia, and to determine the factors associated with timely reperfusion and the effects of reperfusion on mortality.
Comprehensive and complementary surveillance strategies should be introduced to manage vaccine safety 31 October 2010 - 12:00pm - MJA Media Release - Passive and active surveillance strategies should be implemented to effectively identify adverse effects following immunisation (AEFI), according to an article in the Medical Journal of Australia. Dr Michael Gold, Senior Lecturer in Paediatrics at the University of Adelaide, and co-authors reviewed Australia's response to AEFI such as febrile convulsions in children aged five years and under after the seasonal trivalent influenza vaccine was administered.
GP Network News, Issue 10, Number 38 - 29 October 2010 29 October 2010 - 3:00pm - AMA urges passage of Preventative Agency Bill, AMA List of Medical Services and Fees - 1 November 2010, Government Roadmap for Primary Health Care reforms, New President for Rural Doctors Association of Australia, New RACGP President takes the reigns
AMA urges passage of Preventative Agency Bill 26 October 2010 - 1:30pm - AMA President, Dr Andrew Pesce, today urged all parties and Independents to support the Australian National Preventive Health Agency Bill, which is expected to be debated in Parliament this week. Dr Pesce said the establishment of the Agency would provide momentum for the Government's National Prevention Strategy and the implementation of the recommendations it accepted from the Preventative Health Taskforce.
British Medical Association
New doctors must not be expected to work beyond level of training, says BMA - Responding to Professor John Collins' evaluation of the first two years of junior doctor training (The Foundation Programme), Dr Tom Dolphin, Co-Chair of the BMA's Junior Doctors Committee said: "Instead of being an exciting launch pad for their careers many junior doctors are finding that the first two years of training are characterised by inadequate levels of supervision. Our medical education system produces highly skilled graduates, but they must be properly supported once they begin direct patient care." (Thursday 4 November 2010)
Tuition fee rise will leave medical students £70,000 in debt, warns BMA - Medical students will be left almost £70,000 in debt under Government plans to allow universities to charge up to £9,000 in tuition fees, the BMA warned today (Wednesday 3 November 2010).
BMA response to PAC report on health inequalities - Commenting today (Tuesday 2 November 2010) on the Public Accounts Committee (PAC) report on health inequalities in England, Dr Richard Vautrey, Deputy Chairman of the BMA's GPs Committee, said: "Like the Public Accounts Committee, the BMA is very concerned that the gap between the rich and poor in this country continues to widen." (Tuesday 2 November 2010)
BMA response to Derrick Bird report - Commenting today (Tuesday 2 November 2010), on the report from the Association of Chief Police Officers (ACPO) into the Derrick Bird killings, a BMA expert in this area, Dr John Canning, said: "The BMA supports closer working and cooperation between the medical profession and the police. Under current legislation doctors already have a duty to breach confidentiality if they think a patient presents a risk of serious harm to themselves or others. This does not just relate to the ownership of firearms but when a doctor believes the patient or others may be at risk of serious harm more widely." (Tuesday 2 November 2010)
Canadian Medical Association
11/04/2010 - Canada dodged bullet with H1N1, CMA tells Senate
American Medical Association
Michael Maves, MD, MBA, Executive Vice President and CEO, to Leave the AMA on June 30, 2011 - AMA Press Release, Nov. 4, 2010 - The Board of Trustees of the American Medical Association (AMA) and Michael Maves, MD, MBA, Executive Vice President, Chief Executive Officer, have mutually decided that Dr. Maves will complete his successful leadership of the AMA when his current contract ends on June 30, 2011. Dr. Maves has served in this role since 2001. Read more
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